President Obama’s press conference last night is getting mixed reviews from the media. The AP says Obama’s "stepped-up public role comes as he faces rising criticism from Republicans, sliding public approval ratings and divisions within his party." The New York Times says the debate is "slipping away" from Obama. Politico says reform efforts are "flagging."

Is this what you saw last night?

Because I saw more of what Jon Cohn was seeing:

Tomorrow’s headline will probably focus on the length of Obama’s professorial answers, the small bits of news in his press conference, and the fact that he seemed genuinely pissed off about what happened to his friend, Henry Louis Gates, in Cambridge the other day. But the most striking thing to me was Obama’s willingness–in that question about doctors and a few others–to speak candidly about his health plan, even if that meant giving openings to some of his critics.

Consider that Obama’s mission tonight was actually very straightforward: to build support for health reform at a time when it is moving through Congress but, for the first time, running into serious obstacles. To accomplish this, Obama basically had two options at his disposal. He could reassure the public by minimizing the scope of change he was promoting or he could persuade the public by convincing them change, even extensive change, was actually necessary.

In the past, Obama has frequently emphasized the former approach. And at times tonight, he did it again–most clearly when he repeated his promise that people could keep their insurance if they liked it.

But Obama spent most of his time this evening explaining why things had to be different. He did this, first, by talking about the problems of the status quo. He talked about rising premiums, dwindling benefits, and growing costs that are strangling employers and government alike.

…

But it was later, when the discussion got into policy specifics, that Obama seemed determined to convince people that transformation was a good thing. Consider this question, which–again–focused on the importance of reducing unnecessary medical treatment:

When you describe health-care reform, you don’t–understandably, you don’t talk about the sacrifices that Americans might have to make. Do you think–do you accept the premise that other than some tax increases, on the wealthiest Americans, the American people are going to have to give anything up in order for this to happen?

Once again, Obama could have changed the subject or offered a bland denial. Once again, he did nothing of the sort.

They’re going to have to give up paying for things that don’t make them healthier. And I–speaking as an American, I think that’s the kind of change you want.

Look, if right now hospitals and–and doctors aren’t coordinating enough to have you just take one test when you come in because of an illness but instead have you take one test; then you go to another specialist, you take a second test, then you go to another specialist, you take a third test; and nobody’s bothering to send the first test that you took–same test–to the next doctors, you’re wasting money. You may not see it, because if you have health insurance right now, it’s just being sent to the insurance company, but that’s raising your premiums, it’s raising everybody’s premiums. And that money, one way or another, is coming out of your pocket, although we are also subsidizing some of that, because there are tax breaks for health care. So not only is it costing you money in terms of higher premiums, it’s also costing you as a taxpayer.

Now, I want to change that. Every American should want to change that. Why would we want to pay for things that don’t work, that aren’t making us healthier? …

It will require, I think, patients to–as well as doctors, as well as hospitals–to be more discriminating consumers. But I think that’s a good thing, because ultimately we can’t afford this.

Telling doctors and patients they need to be more "discriminating" takes a little bravery, at least in this media environment. Critics are already warning about a government takeover of medicine.

Obama seems to be banking on the fact that Americans will see past such ridiculous charges–and, more important, that they will come around to the idea that, yeah, maybe we really do need to start cutting down on all that unnecessary medical care.

Is he right? I’m way too close to this subject to have the necessary perspective. (And since I was actually in the East Room tonight, I can’t even speak to how it all played on television.)

All I know is that Obama wanted to speak to America like adults tonight–and make the case for the reforms he (quite rightly) believes are necessary. Time will tell whether that faith in the public’s patience and judgment is well-placed.

The commenters on Firedoglake watching live with me seem to agree.

It’s not surprising that the media only sees the horserace. The surprising thing is that the President seems to be making a bet that the American people can see through the smokescreen and realize our health care system is incredibly screwed up and needs fundamental change.

Time will tell if he’s right, but I personally respect him for taking the risk.

(also posted at the NOW! blog)

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