Obama Healthcare Speech to Address Tort Reform, Public Option, Costs

President Barack Obama takes on the bitter healthcare reform debate Wednesday with a high-stakes speech to Congress on his top domestic policy priority.

Faced with falling public approval ratings, Obama said his televised address at 8 p.m. EDT would provide Americans with "a much more detailed plan" about his vision for overhauling the $2.5 trillion U.S. healthcare system.

"They will have a lot of clarity about what I think is the best way to move forward," Obama told ABC network's "Good Morning America" show.

His fellow Democrats, who have solid majorities in both houses of Congress, have struggled to craft a reform bill they can agree on, while most Republicans have fought it, arguing that it amounts to a government takeover of healthcare.

Obama's speech marks a new approach in the White House's effort to rebuild support for the overhaul after Republicans took control of the healthcare debate during the summer with a volley of attacks on the Democrat proposals.

The Republican criticism resonated with many Americans worried that the $1 trillion cost of the overhaul would add to the country's mountain of debt, despite White House assertions that it would be fully paid for.

White House spokesman Robert Gibbs said Obama will discuss reforming medical malpractice lawsuits, which Republicans blame for raising medical costs.

"The president will talk about meaningful malpractice reform tonight. What I hope that does is cause Republicans to understand that we're close to getting something truly significant done for the American people, truly significant for those struggling with the high cost of health insurance," Gibbs said on "Fox Morning News."

But Gibbs would not say whether Obama would propose capping malpractice claims, as many Republicans want.

DEFINE HIS PRESIDENCY

Obama's success or failure in getting Congress to pass comprehensive healthcare reform this year could help define the rest of his presidency. If he fails he would be politically weakened and would likely struggle to get the rest of his ambitious legislative agenda through Congress.

Obama told ABC he would use his speech to "make sure that Democrats and Republicans understand that I'm open to new ideas, that we're not being rigid and ideological about this thing, but we do intend to get something done this year."

He dodged repeated questions on whether he would veto any healthcare bill that did not provide for a government-run healthcare plan to compete with private insurers.

"There are principles that if they are not embodied in the bill, I will not sign it," he said.

The bill should not increase the deficit, should expand healthcare coverage to the uninsured and include insurance reforms, he said.

Legislators have offered a variety of proposals, but appear divided over most of them.

Senate Finance Committee Chairman Max Baucus, a Democrat who leads a group of six senators trying to craft compromise proposals, will put forward a plan including sweeping insurance market changes and a fee on companies that will help pay to cover the uninsured, said a source familiar with the proposal.

It calls for non-profit cooperatives to compete with insurance companies but does not contain the government-run health insurance option sought by many liberal Democrats and backed by Obama, the source said.

One administration official said the president would use his speech on Wednesday to articulate his vision of bringing affordable coverage to those 46 million Americans without insurance and more security to those who do.

"His plan will bring reforms that will reduce the unsustainable growth in the cost of healthcare, which has doubled in the last decade and will again, unless we act," said the official, who requested anonymity.

Insurance companies, pharmaceutical manufacturers, hospital managers -- and average American patients -- all have huge stakes in how the battle plays out.

"We're at the point in the legislative debate where he needs to put some things on the table and take some other things off," said Darrell West, director of governance studies at the Brookings Institution think-tank in Washington.

GETTING THE VOTES

Obama discussed healthcare with Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi on Tuesday afternoon. The two Democrats expressed optimism after the meeting that a reform measure would pass.

Pelosi said she believed the House would not pass a reform bill without a public option.

Olympia Snowe, a Republican member of the Senate negotiating group, supports a compromise that would not initially include a public option but would "trigger" the creation of a government program if insurance companies failed to meet cost and quality benchmarks.

Obama's speech will be aimed at least as much at Democrats in Congress as the public. If he can energize and unite them, he can pass healthcare reform, analysts said.