Declaring that "in the United States of America, no one should go broke because they get sick", Barack Obama exhorted Congress last night to overcome its jitters and divisions about health care reform insisting that the status quo, with soaring costs and 50 million Americans without insurance, cannot be an option.
"Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point," he said before a rare joint session of Congress, according to excerpts released by the White House shortly before he took to the podium. "Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy."
It was Mr Obama's make-or-break opportunity to push back against claims that his plan is a socialist plot, modelled in some way on a caricatured version of Britain's NHS, intended to insert big government in wards and surgeries, ration care and even create 'death panels' to decide when elderly patients should die.
"Instead of honest debate, we have seen scare tactics," he went on, accusing his critics of having "used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge. And out of this blizzard of charges and counter-charges, confusion has reigned. The time for bickering is over. The time for games has passed. Now is the season for action."
Striking for a few moments at least the kind of combative tone many of his supporters have been waiting for with decreasing patience, he said: "I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it."
Broadcast nationally during primetime, the address was aimed not only at lawmakers – the balancing act for Mr Obama was to hold onto mainstream liberal Democrats while corralling in conservative members of his party and possibly a few moderate Republicans – but also ordinary Americans, who have proved themselves equally wary of the fundamental reforms he is seeking.
The President insisted that those with health insurance now will not need to change their existing coverage. He also underscored insurance reforms that would instantly bar insurance companies from watering down coverage for people when they become ill or refusing coverage because of pre-existing conditions.
Joint sessions of Congress such as last night's are usually reserved for a president's state of the union address each January and moments of great national crisis, notably explanations by the Commander-in-Chief of why the country is going to war. But the White House can hardly forget that Bill Clinton chose the same setting to make his pitch for universal health care in 1993, only to see his effort die one year later.
Steering clear of the gobbledygook that such a complex reform plan inevitably entails, the President simply spelled out three main goals. "It will provide more security and stability to those who have health insurance. It will provide insurance to those who don't. And it will slow the growth of health care costs for our families, our businesses, and our government."
Even before last night's applause had faded, the analysis of the speech's effectiveness had begun. First to resume this morning will be the efforts by Senator Max Baucus to bring together Democrats and Republicans on the Senate Finance Committee to approve a draft bill to join those already adopted before the summer recess by other relevant committees in the Senate and the House of Representatives.
Mr Obama steered clear of making the so-called "public option" for health coverage that would compete for business with private insurers a condition of his support. He spoke instead of offering an "insurance exchange" where those without coverage now could shop for policies that suit them and their pockets best. "I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open," he said.
The quandary for Mr Obama has been that while the Democrat leaders consider a public entity offering coverage key to effective reform, most conservative Democrats and Republicans abhor it. Nothing in last night's speech suggested that Mr Obama is ready to veto a bill where it has been dropped, however. It was incumbent on Mr Obama to "appeal to both sides of the aisle, and to everyone involved in this situation, to embrace a sense of compromise and moderation," noted Zack Space, a so-called Blue Dog Democrat from Ohio who would rather that the public option were dropped.
Those Americans still with Mr Obama on this and other policy issues hope that this will be their time to be heard. A group calling itself YesWeStillCan.org, representing 400 former Obama campaign staffers and 20,000 former volunteers from the 2008 campaign, will run full page newspaper advertisements in the New York Times and other newspapers this week declaring their support for the public option.
Obama's popularity: Transatlantic trends
As the embattled President watches his previously sky-high popularity plummet at home, he can at least console himself with a look overseas. A new survey shows that 77 per cent of Europeans continue to approve of Mr Obama; in America, on the other hand, his popularity has levelled out to a lukewarm 57 per cent, roughly comparable to that of George Bush at the same stage.
While the news is encouraging for Mr Obama's hopes of fostering closer transatlantic ties, central and eastern Europeans are far more sceptical of his performance than those in the richer west. Britons were firmly behind the President, with four in five giving him their support. But even that endorsement was behind the most Obama-friendly European nation, Germany, where 92 per cent backed his administration.
But to some Republicans the adjective "European" has pejorative connotations. "He is a European socialist," said Fox News commentator Dick Morris. "He is cut from the same cloth."
My fellow Americans... When presidents go to Congress
Woodrow Wilson: The Great War, 1917
President Woodrow Wilson reluctantly went to war after the interception of a message from Germany to Mexico suggesting an alliance against the US. He told a joint session of Congress that staying on on the sidelines would no longer do. "The world must be made safe for democracy," he said, adding that Americans must fight "for the rights and liberties of small nations".
FDR: Pearl Harbour, 1941
The day after America was stunned by Japan's bombing of Pearl Harbour, President Franklin Roosevelt travelled to Capitol Hill to make his famous speech to a joint session. The bombing marked a "date that will live in infamy", he said, accusing Japan of negotiating peace under false pretences. He closed by asking that Congress approve a declaration of war against Japan, thus irrevocably engaging the US in World War II.
JFK: Man on the Moon, 1961
Not war this time, but rivalry with the Soviet Union was the backdrop to JFK's bold challenge in Congress for America to put a man on the moon by the end of the decade. The President, recently bruised by the Bay of Pigs fiasco, was keenly aware Russia had beaten the US into space four years earlier.
George W Bush: War on terror, 2001
Ten days after the trauma of the attacks against the Twin Towers, George Bush went to Capitol Hill. He had already used the bullhorn on the 'pile' in Manhattan and begun preparing to invade Afghanistan. In the speech he served notice to the Taliban, asked other nations to join the fight against al-Qa'ida and announced the creation of the Department of Homeland Security.