The health care debate has revolved around the sacrosanct principle that nobody who has health insurance should have to worry about any change in the slightest. President Obama paid lip service to that idea again tonight. But, when he wasn't doing that, he was trying to make people understand that the health care system actually isn't that great. Indeed, it's awful, as almost any empirical examination of costs and outcomes will show.
The second main message of the speech was to reposition Obama in the center. Obama did this during the campaign, running ads literally showing alternatives on the left and the right with his in the center. He did it again tonight. Of course, what constitutes the "center" is a slippery concept. When you consider how far to the right Obama is compared with national health care plans, like in Great Britain, or single-payer plans, like in many European countries, then he is in the center. When you compare him to where the health care system stands right now, he's clearly proposing a dramatically more liberal change. Of course, the current health care system is a disaster, and it's simply impossible to fix the perverse market-related features of this system (adverse selection, severe information asymmetries, etc.) without government intervention.
Obama tried to seperate serious conservative objections from the paranoia and demagoguery that has prevailed so far by promising to address legitimate concerns. Will it succeed in getting Republicans to negotiate? Of course not. It's a good message, though.
Now that I've gotten you to read this post on Obama's speech, I should say that i don't think it matters all that much. I've written criticially of this notion that health care is a drama revolving around Obama. It's not. The Senate is the key entity here. No speech is going to have much effect -- it could make health care more popular, but centrist Senators were dragging their feet long before Obama's slide in public opinion. Fortunately, I also think that at the end of the day, even moderate Democrats will recognize their self-interest in passing something substantial.