Last week President Obama gave his annual speech to Congress, using it as a platform to restart the healthcare reform effort in the Senate.

He spent much of the speech trying to counter statements made by Republicans and trying to explain the provisions included in the bills that have passed three committees in the House of Representatives and one committee in the Senate. But in the end his speech was massively disappointing, because it was built around a retreat from the principles that sparked the drive for healthcare reform in the first place.

At the beginning of his speech, Obama made it clear that healthcare reform is precisely that: reform-i.e., minor tweaks to the system we already have. Single-payer is completely off the table because we must, for unexplained reasons, protect the insurance industry and, by extension, insurance industry profits. He is not out to change the system, that is clear, even though he has made the point repeatedly that our system is broken, and that no other developed nation in the world has chosen the dysfunctional model we have.

Having said that, he gets to the heart of the matter at the mid-point of his speech: he wants a plan with a "not-for-profit public option," a term that can mean many different things. Instead of defining precisely what he means, Obama leaves the concept deliberately vague, indicating that he is willing to accept whatever Congress comes up with as a compromise solution-whether that means a government-administered plan, a plan run by a co-op or nonprofit entity, or a reform plan with a "trigger" option wherein the government would set up a public plan only if the health insurance exchange doesn't lower costs below a certain pre-set level.

This waffling will not help the Democrats pass a plan; instead, it will give the Republicans and other right-wing anti-government paranoics a chance to draw whatever conclusions they want, thereby further alienating the American people from the whole concept of healthcare reform and a "public option." We need specifics in order to counter the lies from folks like Sarah Palin and Rush Limbaugh. Barak Obama had the opportunity to lay out a specific plan and advocate for it, and he failed to do that.

The day after his speech, in a move that was timed for maximum political impact, the federal Census Bureau released its annual report showing that 46.3 million Americans (about 15.4% of the population) are uninsured. There were two noteworthy things about this report.

First, that statistics were tallied only through December 2008. Millions of people have lost their jobs in 2009. With those numbers included, the ranks of the uninsured are probably closer to 50 million, or about one-sixth of the population.

Secondly, the number of folks covered by employer-provided insurance plans decreased from 177.4 million down to 176.3 million (about 58% of the population-a very slight majority). Not all of the folks who lost their employer coverage became uninsured, however: many of them joined government-run programs like Medicare and state-run children's insurance programs. In fact, government-run programs are covering an ever-increasing number of people: the estimate as of December 2008 is 77.5 million, or more than one-quarter of the US population.

Obama failed to say that fewer and fewer Americans are being covered by employer plans, while more and more are joining government plans-a phenomenon created by our current private insurance system. <I>We already have public plans competing with private insurance, and the public plans are winning, even though they're hobbled by limitations on who can join.</I> This is why free-market extremists are so vocal in their protests against a public option; because, ironically, the private market can't compete against even the limited public plans we have now, and this exposes as a fallacy the notion that utilizing the private market is always the best and most efficient way to do everything.

No one, whether it's Obama, Democratic leaders in Congress, or members of the media, has stated the obvious: we are already moving in the direction of a single-payer plan without enacting any "reforms." It's time to make the ultimate reform: expand Medicare to cover everyone. Make our current public plan all-inclusive and let the languishing private insurance market expire from its own inefficiencies.

No, instead we will continue to have a patchwork of programs that cover the elderly, the disabled, and the children of extremely poor people. And we will continue to complain that those programs are costly because we've excluded healthy, working-age adults (who must participate in any plan to make it self-supporting, regardless of who's running it).

Obama deserves one pat on the back for saying that the wars in Iraq and Afghanistan have been far more expensive than his healthcare reform proposal. But he should have gone a step further and said that it's high time Congress got its priorities straight. Republicans and conservative Democrats must stop blaming a "public option" healthcare plan for breaking the federal budget; only an idiot would believe such nonsense. The federal budget deficit was created by the Bush administration spending the budget surplus on two wars and tax cuts for the rich, and the bailouts given to big banks to avoid a financial system collapse. The Democrats must address the reality of that, bring the wars to an end, and repeal the Bush tax cuts.

But we will have to wait until Hell freezes over to hear such strong words from President Obama, whose nickname should be "The Great Compromiser." Sometimes you have to get things done with a bare majority. Healthcare reform is one of those things.

As for the rest of what's needed, well, the millionaires who represent us in Congress will never add them to the agenda unless we, The People, make our voices heard. We need a powerful, revitalized progressive movement that demands that Congress and the Obama administration do the following: 1) end both wars right now, today, 2) repeal the Bush tax cuts, 3) pass a single-payer healthcare plan or a public option plan for those of us who want to move in that direction, 4) make banks repay the bailout money they received from the federal government, with interest, and 5) pass meaningful financial reform legislation and enforce it.

Americans know that trying to pass healthcare reform without balancing the budget is crazy. The only way to balance the budget is to reverse the policies that created the deficit in the first place. Barak Obama used his speech to Congress to address only one of the many things that must happen in the next year, thereby missing an important opportunity to get the nation back on track and to answer the fears that sparked fierce protests at town hall meetings this summer.

We're in for a rough winter.

--Maria Tomchick--