Don't look now, but Obama is finally living up to his promise.

President Obama began his remarks in the East Room on Wednesday with a reminiscence. Almost exactly one year before, he noted, he had stood in the very same spot, formally launching his initiative to reform America’s health care system.

I happened to be there that day and I remember it well. Representatives of every interest group were there, as were congressional leaders of both parties. In breakout groups and then a question-and-answer session that followed Obama’s speech, there was much talk of consensus--of a determination to work together in good faith.

“The status quo is the one option that’s not on the table,” Obama had told his audience. They seemed to agree.

Now that all seems very naive. And Obama seems to know it, as my colleague John Judis observes. The insurers have gone to war. The Republicans are united in opposition. An effort that was supposed to take a few months has stretched into a year, with weeks more still to go. It threatens to destroy the Democrats’ congressional majority and, just maybe, the Obama presidency too.

“Everything there is to say about health care has been said--and just about everybody has said it,” Obama said to laughter.

Still, if Obama on Wednesday was implicitly giving up on his hopes for constructive, bipartisan governing, he wasn't giving up on his hopes for what governing would achieve. He ran for president on a promise to tackle the nation's most challenging problems--and, since winning election, he’s gleefully defied those who warned him he was trying to do too much. On Wednesday, he made clear that he hasn't changed his mind about that:

At stake right now is not just our ability to solve this problem, but our ability to solve any problem. The American people want to know if it’s still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I do not know how this plays politically, but I know it’s right.

That's not just bluster. At any point in the last few months but particularly in the wake of the Massachusetts election, it would have been easy to back away from comprehensive reform--to cut a deal, be done with it, and move on.

Instead, Obama on Wednesday committed himself more fully to comprehensive reform than he has at any time since this effort started--rejecting incremental reforms explicitly, refusing Republican calls to start over, and demanding an up-or-down vote on his proposal.

This has been a long and wrenching debate. It has stoked great passions among the American people and their representatives. And that's because health care is a difficult issue. It is a complicated issue. If it was easy, it would have been solved long ago. As all of you know from experience, health care can literally be an issue of life or death. And as a result, it easily lends itself to demagoguery and political gamesmanship, and misrepresentation and misunderstanding.
 
But that’s not an excuse for those of us who were sent here to lead.  That's not an excuse for us to walk away.  We can’t just give up because the politics are hard.

Will it work? Who knows. The next few weeks will be excruciating, as Obama works with House Speaker Nancy Pelosi to build the 216-vote majority necessary to pass the Senate bill through the House. It'd be foolish to bet against the two of them. (Pelosi has been, if anything, even more determined than Obama.) Wavering members have every reason to hold out for maximum leverage, which means most won't commit until absolutely necessary.

Public support would obviously help--a lot. And Obama made a specific plea for it on Wednesday:

I will do everything in my power to make the case for reform. And I urge every American who wants this reform to make their voice heard as well--every family, every business, every patient, every doctor, every nurse, every physician’s assistant. Make your voice heard.

Of course, the public seems pretty ambivalent about reform these days. But perhaps that will change, even just a little. Americans always say they want politicians who lead rather than follow--who do what they think is right rather than what they think is popular. And liberals, in particular, say they want politicians who will think big and pursue far-reaching reforms, rather than triangulate their way with incremental measures.

Say what you will about Obama and his plan. Both, surely, are flawed. But, particularly with this latest statement, he's living up to those ideals.

Jonathan Cohn is a senior editor of The New Republic.