Still, another speech could be helpful -- if President Obama says something different.

Speaking to the American Medical Association back in June, the president said, "My view is that health care reform should be guided by a simple principle: fix what's broken and build on what works." But always absent from his list of things that are broken is the litigation free-for-all of medical malpractice. Howard Dean was frank about why the Democrats have left malpractice reform out of their plans. "The reason tort reform is not in the bill is because the people who wrote it did not want to take on the trial lawyers ..." The trial lawyers, Dean neglected to add, are the single largest contributors to Democratic office holders.
But if the president is sincere that bringing health care spending down is one of his chief motivations in reforming health care ("the cost of our health care is a threat to our economy ... it is unsustainable for the United States of America"), he cannot ignore the costs of medical malpractice and the defensive medicine it spawns. When he speaks to the Congress next week, the president could rock the political world if he acknowledged certain facts.