Media analyses of President Obama's health care speech were divided on whether he had indicated serious support for a public option or had, instead, cleverly tossed a bone of "recognition" to the progressives while simultaneously demanding that they drop their insistence that the health care reform undercut insurance company profits.
The confusion, for once, is not with the media but with the incoherence of a centrist politics. Obama wishes to relieve the suffering of Americans, but he does not wish to challenge the profit-uber-alles old "Bottom Line" of the competitive marketplace. Unfortunately for him and for most Americans, he can't have it both ways. FDR recognized that--and so was willing to stand up to the vested interests of the class from which he emerged, not only rhetorically, as Obama is willing to do at some rare moments like his Health Care speech, but in the actual policies he promoted.
Goodness knows, Obama has tried. He understands the suffering caused by the military-industrial complex's insistence that American security can only come through economic, military and diplomatic domination of the world, and would like to alleviate it. He would prefer a world of peace. But he can't get that without challenging the fundamental equation of security with domination and presenting an alternative, e.g. that security might best be achieved through generosity and genuine caring about the well-being of others around the world, manifested in the kind of G-8 funded Global Marshall Plan that has been introduced into Congress by Keith Ellison (D,Minn). So, instead, he has escalated the war in Afghanistan.
Obama is aware that unless we can get down to not more than 350 particles per million of carbon emissions that life on the planet is finished. Standing up to the corporate interests that have resisted this and managed to eviscerate his environmental program into a corporate-giveaway called "cap and trade" would require championing a carbon tax that he fears would make him unpopular with the corporate polluters and with the public whose consciousness these polluter are able to shape through the media.
Obama knows that a single-payer program--extending Medicare to everyone--is far more rational than what he has proposed to Congress, but he also believes that eliminating the insurance companies, hospital chains, and other medical profiteers would require a battle beyond his current capacities.
To address any of these problems fully would require a fundamental challenge to the old Bottom Line. Obama would have to call for a New Bottom Line--to advocate for defining governmental and private corporate policies as "rational," "productive" or "efficient" not only to the extent that they maximize money and power, but also to the extent that they maximize love and caring, kindness and generosity, ethical and ecological sensitivity, enhance our capacities to respond to other human beings as embodiments of the sacred and our capacities to respond to the universe with awe, wonder and radical amazement at the grandeur mystery of the universe.
He actually reached in that direction momentarily at the end of his Health Care speech to Congress by seeming to endorse Senator Ted Kennedy's "large-heartedness: a concern and regard for the plight of others" which he defined as "our ability to stand in other people's shoes; a recognition that we are all in this together, and when fortune turns against one of us, others are there to lend a helping hand."
Yet over and over again in the details of his plan it was not this large-heartedness that he championed, but a belief in the positive outcomes of the competitive marketplace. What Obama omitted from mention is that the ethos of that marketplace, which rewards selfishness and materialism and "looking out for number one," as the "common sense" that guides individual as well as governmental behavior, is a product of the fear that we cannot count on others, that there will be no one there to take care of us, and that we must therefore maximize our own advantage lest someone else do so for themselves in ways that will permanently hurt or undermine us.

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