his friend, chuck grassley, knows that. they worked together to provide health care to children with disabilities. on issues like these, ted kennedy's passion was born of not some rigid ideology but of his own experience. it was the experience of having two children stricken with cancer. never forgot the sheer terror and helplessness that any parent feels when a child is badly sick. he was able to imagine what it must be like for those without insurance. what it would be like to have to say to a wife or a child or an ageing parent, there is something that could make you better, but i just can't afford it. that large heartedness, that concern and regard for the plight of others is not a partisan feeling. it's not a republican or a democratic feeling. it, too, is part of the american

character. our ability to stand in other people's shoes. a recognition that we're all in this together. that when fortune turns against one of us, others are there to lend a helping hand. a belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play. and an acknowledgement that sometimes government has to step in to help deliver on that promise. this has always been the history of our progress. in 1935 when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those that argued that social security would lead to socialism but the men and women of congress stood fast and we're all the better for it. in 1965, when some argued that medicare represented a government takeover of health care, members of congress,

democrats and republicans, did not back down. they joined together so that all of us could enter our golden years with some basic piece of mind. you see, our predecessors understood that government could not and should not solve every problem. they understood that there were instances when the gains and security from government action are not worth the add eed constraints on our freedom but the danger of too much government is matched by the perils of too little and that without the hand of wise policies, markets can crash, monopolies can stifle competition and the vulnerable can be exploited. and they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn. when any efforts to help people in need are attacked as unamerican, when facts and reason are thrown overboard, and

we can no longer even engage in a civil conversation with each other over the things that truly matter, that at that point we don't merely lose our capacity to solve big challenges, we lose something essential about ourselves. that was true then. it remains true today. i understand how difficult this health care debate has been. i know that many in this country are deeply skeptical that government is looking out for them. i understand that the politically safe move would be to kick the can further down the road and to defer reform one more year or one more election or one more term, but that is not what this moment calls for. that's not what we came here to do. we did not come to fear the future. we came here to shape it. i still believe we can act even when it's hard. [ applause ]

i still believe -- i still believe that we can act when it's hard. i still believe we can replace ak r with progress and we can do great things and that here and now we'll meet history's test because that's who we are. that is our calling. that is our character. thank you. god bless you and may god bless the united states of america. [ applause ] thank you.

>> presenting health care reform as a societal imperative and a test of the nation's character. the president completes his address to the joint session of congress inside the chamber of the house of representatives. it was to say the least, a broad and forward thinking speech on the rhetoric and the phrasing and the pacing and the design of the speech itself there seems to have been a touch of greatness. the impact whether the sales job works and what impact the president is selling in his proposal remains to be judged. i'm in new york joined by rachel maddow and howard fineman. rachel a lot of questions from the left going on. your thoughts and your thoughts about the left's response to what we heard tonight? >> i think the end of the speech

is going to be focussed on by the left not just in terms of what it means for health care but what it means for this presidency. keith, in the first half of the speech we heard the president explain a lot of the progressive policy ideas that democrats, the president's own supporters, progressives liberals in particular have supported, we heard the president not make promises or wave a veto pen and not draw a line in the sand about those specific policies. we got him to wrap up the speech with his dramatic announcement about the letter he received from ted kennedy asked to be delivered in the event of kennedy's death in which the president gave what i think is the only full formal at length defense of liberalism and defense of the idea of government for the people's good. in ideological terms.

it's the most ideological i ever heard him be and will make liberals happy. >> as with we await the government response by senator boustany, give me a take on the politics and to what degree he changed them tonight. >> i thought he did a good job of making the case clearly for a pretty specific plan. pretty specific objectives that was designed to meet the fears and meet the questions of a lot of people who hadn't been focusing so closely. a lot of people will tune in to this tonight and get a reaction to it that's number one. number two, while i think he praised some republicans here and there, he made it clear to the republicans in the room that he was going to go forward with or without them. >> howard, i have to interrupt you. here is the republican answer from charles boustany. >> good evening. i'm dr. charles boustany. i'm proud to serve the people of louisiana's seventh congressional district. i'm also a heart surgeon with

more than 20 years of experience during which i saw firsthand the need for lowering health cost. republicans are pleased that president obama came to the capitol tonight. we agree much needs to be done to lower the cost of health care for all americans. on that goal, republicans are ready and we've been ready to work with the president for common sense reforms that our nation can afford. afford is an important word. our country is facing many challenges. the cost of health care is rising. federal spending is soaring, we're piling huge debt on our children and families and small businesses are struggling to a jobless recovery with more than 2.4 million private sector jobs lost since february. it's clear the american people want health care reform but they want their elected leaders to get it right. most americans wanted to hear the president tell speaker

pelosi, majority leader reid and the rest of the congress that it is time to start over on a common sense bipartisan plan focused on lowering the cost of health care while improving quality. that's what i heard over the past several months in talking to thousands of my constituents. replacing your family's current health care with government run health care is not the answer. in fact, it will make health care much more expensive. that's not just my personal diagnosis as a doctor or a republican. it's the conclusion of the nonpartisan congressional budget office, the neutral score keeper that determines the cost of major bills. i read the bill democrats passed through committee in july. it creates 53 new government and raises taxes on job creators by $600 billion and it cuts medicare by $500 billion wile

doing virtually nothing to make the program better for our seniors. the president had a chance tonight to take the government run health care off the table. unfortunately, he didn't do it. we can do better with a targeted approach that tackles the biggest problems. here are four important areas where we can agree right now. one, all individuals should have access to coverage regardless of pre-existing conditions. two, individuals, small businesses, and other groups should be able to join together to get health insurance at lower prices. the same way large businesses and labor unions do. three, we can provide assistance to those who still cannot access a doctor. four, insurers issued be able to offer incentives for wellness care and prevention. that's something particularly important to me. i operated on too many people who could have avoided surgery if they simply made healthier

choices earlier in life. we do have ideas the president hasn't agreed with. we're glad the president mentionmention ed liability we foreform and we he's serious. we need to deter junk lawsuits that drive up the cost of care. real reform must do this. let's also talk about letting families and businesses buy insurance across state lines. i, and many other republicans, believe that will provide real choice and competition to lower the cost of health insurance. unfortunately, the president disagrees. you can read more about all of these reforms at healthcare.g healthcare.gop.gov. we can do these reforms now.

this congress can pass meaningful reform soon to reduce some of the fear and anxiety families are feeling in these very difficult times. working together in a bipartisan way, we can truly lower the cost of health care while improving quality for the american people. i'm dr. charles boustany. thank you for listening. >> congressman boustany. sued for malpractice three times. he believes there are questions about the president's citizenship and as rachel put it last night, a man reported in court papers to have fallen for a scam in which he tried to buy the british royalty title of lord and gave the republican answer tonight. govern y we're going to begin countdown in three minutes. let me bring back rachel maddow and howard fineman. rachel, as i understand it from some summaries and also from the

president's speech, essentially the keys to what he is proposing, no changes in current insurance basically for medicare, medicaid, va, not changing. illegal to deny insurance coverage for pre-existing conditions or to water down existing insurance. preventive care would become mandatory in terms of paying for it by insurance companies and insurance exchange in four years with the public option. but immediately offering low cost -- i guess it is bankruptcy protection for pre-existing conditions and for people who can't get insurance any other way. he didn't say who is paying for that or providing it and mandatory insurance as there are basically mandatory insurance for drivers. and malpractice reform. is this enough to sell it to the left and is it not too much to sell it to the middle? >> it is a process orientated grab bag one might say. it might also be comprehensive

health reform if all of those things passed together. the proposal about catastrophic insurance made available in the short-term, that is as he said a john mccain proposal. the idea of an individual mandate, that is a hillary clinton/john edwards proposal that barack obama rejected during the primaries as far as i understand it. he's definitely going beyond what he has previously proposed to bring together a lot of different ideas from across the ideological spectrum. that could be -- that's a process orientated form of being comprehensive. whether that's enough to bring down health care reform and change the experience for americans is probably something we wouldn't know until it went into effect. >> what happens from the republican side here. did we get telegraphed they won't accept anything no matter what? some idiot shouted about the fact that there's no health care provided for illegal aliens or people here illegally. someone shouted "you lie" which

i don't know how -- i'm hoping that was somebody's guest. >> the republicans were mostly stage props in this speech tonight. they acted like it. the president as rachel pointed out will take a couple republican ideas and knit them together in this birds nest if you will. if he gets this, what he's going to get is comprehensive regulation of the health insurance industry which believe it or not does not exist at this point. that's part of the point he's making. just like the great railroads of the 19th century needed regulations because they were so indispensable to the growth of america. in the 21st century when health and wellness and whether your brain works is wealth in how we operate, we need to have regulation of this industry. this speech at its root was an attack on the health care industry. i think he brought it off pretty well tonight. >> we're told by the associated press that that was congressman joe with wilson of south carolina ironically named indeed

given vocal considerations of the last ten years. my thanks to rachel maddow and howard fineman. our coverage continues and then rachel will join you at 10:00 p.m. eastern followed by a special late edition of "the ed show." that's at 11:00 p.m. eastern as our night of coverage of the president's speech to the joint session of congress continues. >> a president offering an interim plan to prevent bankruptcy from health care costs that would morph in four years to an insurance exchange containing a public option olding as he announced this a door open for bipartisanship crediting his election opponent for part of the health care reform plan he tonight endorsed insisting no one will be forced to change insurance, no abortions will be federally funded, no death panels calling that a lie insisting there will be no coverage for those here illegally and then greeted by congressman wilson of south carolina shouting from the safety of the crowd "you lie."

the state of health care reform and state of american health care and state of american politics on the ninth of september in the year 2009. our analysis begins now. with senator brown from ohio staunch opponents of public option in the senate health committee and what the president sought to accomplish on the and elizabeth edwards on the center for american progress tireless public advocate for health care reform. jonathan, the author of "sick, untold story of the crisis" on what the president outlined would really help and the obama deputy campaign manager in charge of field organization, the most senior campaign staffer to publicly express doubt about the white house's leadership and prioritization in the current crisis and there are always worse persons.

congresswoman gejean schmidt is back. this is "countdown" special coverage in the wake of president obama's address to the joint session of congress on health care reform. >> i'm not the first president to take up this cause but i am determined to be the last. good evening from new york. i am not the first president to take up this cause but i am determined to be the last. our fixture in the countdown that line from obama's second address to a joint session of congress certainly to be remembered whether in victory or in defeat long after the current health care debate has been decided. the president tonight urging lawmakers to enact sweeping health care reform including a public option or it would be he reminded both ends of the spectrum it would only be one part of his plan.

>> to my progressive friends i would remind that the driving idea behind reform has been to end insurance company abuses and make coverage available to those without it. the public option is only a means to that end. we should remain open to other ideas that accomplish our ultimate goal and to my republican friends, i say that rather than making wild claims about a government takeover of health care, we should work together to address any legitimate concerns you may have. >> and yet one of the president's republican friends identified by the associate press as congressman wilson of south carolina shouting "it's a lie" when senator obama said the reforms he's proposing would not apply to those in this country illegally. later the president still soliciting new proposals from anyone while laying down the law. >> the plan will not add to our deficit. the middle class will realize greater security and not higher

taxes. this is the plan i'm proposing. it's a plan that incorporates ideas for many of the people in this room tonight. democrats and republicans. and i will continue to seek common ground in the weeks ahead. if you come to me with a serious set of proposals, i will be there to listen. my door is always open. but, know this, i will not waste time with those who have made the calculation that it is better politics to kill this plan than to improve it. >> in a republican response, the goal would seem to be delaying reform. congressman would be lord boustany of louisiana proposing that lawmakers chuck everything out and start over. >> it's clear, the american people want health care reform but they want their elected leaders to get it right. most americans wanted to hear the president tell speaker pelo

pelosi, majority leader reid and rest of the congress that it is time to start over on a common sense bipartisan plan focused on lowering the cost of health care while improving quality. that's what i've heard over the past several months in talking to thousands of my constituents. replacing your family's current health care with government run health care is not the answer. in fact, it will make health care much more expensive. >> even though that's exactly the opposite of what the president had said. time to call on senator brown, a democrat from ohio. thanks for stopping by. did you hear what you needed to hear or wanted to hear from the president tonight? >> yes. i've been here for a decade and a half and it's the best speech i ever heard to a joint session. a sense of history but a focus about moving forward. it was specific as it needed to be. it had a strong public option to keep prices down and to give choice and keep insurance companies honest and he reached out. he did reach out to republicans. in our bill, keith, as you know

in the senate health committee, we incorporate 160 republican amendments in. this bill has bipartisan flavor to it. on the big questions, democrats and republicans have very different views. for instance, on the public option and a couple other issues. >> the idea of the insurance exchange kicking in in four years with where the public option would be contained, do you have a clear idea of what that means and also what that immediately offer of low cost bankruptcy protection and what that means? the president makes those key but not clear as they might be. >> that's new information. he's open to that idea. i think we can do it faster than four years. i would like to. i like the assistance in the meantime. part of that will be providing medicaid. the president has some other ideas, too. i think that's an example that even though republicans have rebuffed him and sent out this misinformation about illegal

immigrants and death panels, he wants to reach out to them. in the end when i look back to medicare, republicans voted against medicare and they found out two years, five years, 20 years later they were on the wrong side of history. a number of republicans in the end will vote for this bill because they don't want to their children and grandchildren a decade from now saying we're on the wrong side of history of this one. >> that's the intent of citing congressman dingell in pointing out that his father before him in the house had proposed legislation reminiscent of currently proposed reforms but two generations have gone through that house without getting anything seriously done. that was great symbolism i thought. absolutely pertinent. >> that's exactly right. when i hear what congressman boustany from louisiana said after the president's comments that we need to go slow and do

this again, 12,000 people every day are losing their insurance in this country. 390 in my state of ohio and cleveland and dayton and mansfield and all over and understand that we've been working on this for years starting with teddy roosevelt and then through john dingell and johnson and clinton up until now and we've had very long extensive debates and hearings on this. we're ready to do this and we need to do it before the end of the year. we'll get a bill with a strong public option to the president before the end of the year. >> there were two things in here i wonder how republicans can go out and say they oppose if these are final aspects of the bill. number one being malpractice reform which is something that dr. boustany mentioned for which the republicans stood and cheered and cheered and cheered. the other one, i imagine that out in the great american middle or out in the great american left or out in the great american right it doesn't matter. if you hear a president say that it will be illegal to deny

insurance for pre-existing conditions, i wonder if you couldn't get everybody in the country to vote yes. >> yeah. pre-existing conditions, when you get sick, your insurance company cancels your insurance because it cost too much. discrimination on gender and race and discrimination on people with disabilities and geography and all that. we can get good, strong support in the country but republican members of congress are on a short leash with the insurance industry and the insurance industry pulls that leash and republican members of congress sit back and so it's harder than it looks even though the whole country and even the most conservatives support that kind of consumer protection on these insurance policies. you betcha. >> to that last point, i don't want to waste your time with too many questions about the republican party but did they do themselves favors by showing the minority whip, mr. cantor, sitting there texting during the

message or the remarkable comment from congressman wilson that the president was -- he said it's a lie when the president said none of this would pertain to people here illegally. >> he might be a hero in certain parts of the country and other neighborhoods. they're playing themselves out of this week after week. whether it is opposition to the president of the united states and this one like the other in speaking to students and whether it is making up stuff about death panels and illegal immigrants and saying there's a lot of republicans here feed into that the president wasn't born into the united states. those things and their behavior tonight really isolates the republican party and it really has made them into a conservative southern white party that the rest of the country is leaving behind. it's too bad for the country they're doing that but it's really bad politics for them. they'll continue to pay for it. unfortunately as i said for the country and i hope they get off of that and come to the table and work with us.

>> i think that combat get against that is a phrase it will be illegal to deny insurance for pre-existing conditions. that may change the entire playing field. senator brown, always a pleasure. thank you for your time. >> for more on the president's speech and its intent, let's turn to valley jared. thank you again for joining us. >> my pleasure. good evening. how are you? >> i have some specific questions and i have a general question. the president left the overall intent of this for last. there were a lot of intriguing specifics and things that will sell well and extraordinary moments in the speech, but the emphasis of this and the goal of this if he had to blow it down to a sentence was this was a moral imperative. >> i think that's exactly what he said. he said it was something about the character of our country that makes it so important for us to deliver on behalf of the american people right now. for those who have insurance, they need additional safety and security and stability in the

system. for those who don't, they need affordable health care and we have to reduce the cost for everybody. it's a simple message and any american out there who was listening tonight knows where the president stands and i also think that by the nearly 30 standing ovations he received from congress, we have a good sense of momentum there as well. >> on a subject of the public option, which the president wants to pin as about 10% or 15% of the reform here, it is contained as i understood it from what he said and i will not say that i'm automatically right because i'm reading the president's speech and his words may mean something else. the insurance exchange would not take place for four years. is there a trigger system involved in this? is there a phase in or is there flexibility on that point? what are specifics you can tell us about that? >> sure. of course it is open. what he said tonight is he's interested in other ideas. his plan is let's take four years and make sure we put it in place and get it right but that

we have a safety net suggested originally by senator mccain in the meantime. >> anything more specific about that safety net or is that being built as we speak because it seems that's a new concept or at least a new -- as you said, senator mccain's campaign to some degree but a new essential component to this final version of what the president wants, is it not? >> it is new. what it shows is the president has been listening over the months just as he said he would from the outside. he's received a lot of terrific ideas from democrats, republicans, everyone across the aisle and what he tried to do this evening was incorporate the best of what he's heard and he considers that to be a good alternative until we can get the exchange up and running. >> and the idea of that interim solution that emergency care would be to specifically focus on people who were threatened with bankruptcy because of the

sudden onslaught of insurance expenses or is it wider than that? >> it's for people that don't currently have coverage. there are millions who can't afford coverage right now. if you lose your job or for whatever reason you don't have the coverage, and you are in dire straits, should be able to have a safety net. what he was talking about going back to the character is the importance in our country to make sure that we're taking care of our citizens. when you're sick, you should not have to worry about going bankrupt and pay for your health care. until we have an exchange up and running he would love to have the safety net in place. there are lot of great ideas he received in the course of this process that we've begen going through and 80% -- there's an agreement on 80% across the aisle. let's focus on closing this out once and for all and deliver on behalf of the american people. >> i think no one would ever look at the president's attempts for bipartisanship on this as

anything less than severe and admirable. even if the context of what he was able to achieve and address tonight, is there something over prioritized about that if when he says this is a lie. there are no death panels and there's not going to be coverage provided for illegal aliens are people in this country illegally and someone to turns out to be congressman wilson of south carolina shouts from the safety of the crowd that's a lie is bipartisanship feasible when there's this kind of almost blind reaction from the other side? >> i believe there is. i believe there is. i believe whith a president suc as barack obama we can achieve that bipartisan support. the fact he took an idea that came from his opponent, senator mccain, and incorporate it is a simple gesture and a way of showing what his character is all about. i think the measure of a person is whether or not they continue to reach out and continue to

listen and most importantly, he's focusing on what's best for the american people. he's going to defunk anything that he hears that's nonsense. the times are too important. there are too many people who each and every day are losing their insurance and having to choose between paying rent, sending kids to college and paying medical expenses and in this country a country as great as our country, we deserve better than that. i think his call tonight was a call to appeal to the better in all of us. stop this nonsense. stop this terrible rhetoric. remember who elected you and who sent you to congress. the people of this country did. >> to that point last question something very important, when the president said he will call people out who continue to spread lies about health reform no matter where they come from, did he mean that literally? will he be standing there reading a list of the people who are spreading this stuff the way so many others have had to do in the last six weeks? >> i think the president is a man of his word.

what he's saying very clearly is let's stop scaring the american people particularly our seniors. let's not do that. they don't deserve that. let's have an honest debate about the issues. there may be differences of opinion on substance and he said he welcomes new and exciting ideas but let's just not try to scare people to keep the status quo because while everyone is hurt around th hearing around the country is status quo is no longer acceptable and he's going to move the country forward. >> hopefully all of us calling out will get the job done. >> we know we can always count on you to call people out. thank you. >> i appreciate the way that was phrased. thank you kindly. >> take care. >> not all those who campaigned so hard for then senator barack obama have been excited about his version of health care reform. his deputy campaign manage forefield operatifor for field operations questioned that vision in a full page ad in "the

new york times" today. let's see if his opinion has changed. he'll join us for reaction and next elizabeth edwards here on "countdown." we let big oil make record profits... while we struggle. and we lose new energy jobs, that go overseas. but we can take charge of our economy... by passing strong clean energy legislation. 1.7 million new american jobs. less carbon pollution. and a cleaner america for our children. it's time for clean american energy.

jonathan cohn on what the president spelled out tonight including a four-year delay for an insurance exchange will constitute meaningful reform of the health care system now and a senior member of the obama staff to raise doubts about that join me but first elizabeth edwards first on this post-presidential address edition of "countdown." $

why do so many americans go without health care?

why do so many go bankrupt paying for it? tonight as we were told in the place, blame the insurance companies. what is the problem going to do about them based on what he just told us? americans who cannot afford health care will not get health care but they will be able to buy insurance and there will be an exchange in four years. americans who do have insurance get to keep their insurance or go for some other alternative form of insurance. health insurance in other words for everyone which amounts to pretty good news for the people the democrats told us were the bad guys, the insurance companies. is that a fair tradeoff? we're fortunate to have with us, elizabeth edwards, participant in the u.s. health care system. hello, my friend. how are you tonight? >> i'm doing all right. pretty pleased with the speech. >> let's expand on that. what pleased you on it?

>> i was watching msnbc earlier today. ed shultz did a survey. most were hopeful but 22% were worried. there's also a worry when the press plays something up as a crucial speech and i think the president met and exceeded people's expectations and the people listened to the speech and felt better about the chances for health care reform and the direction in which the president seems to be leading the country. >> do you think that encouragement stems from the imperative that he presented that this is less about as much as it may benefit the economy, he talked about how the deficit is similarly put and question of health insurance but larger than that is this call to the memory of ted kennedy that this is a moral imperative. >> i certainly think that was an enormously powerful part of the speech and may actually vault

that speech into one of the greatest speeches into joint sessions of congress that we ever heard. the big thing that happened and we've been -- we spent the summer where we were hearing all sorts of nonsense and it was constantly this road show that was going on orchestrated to derail the health care reform and the president basically came back in as the adult in the room and said, you know, there's no more talk of dare i say it death panels or nazis and we're through with all of that nonsense. now we have to go about the serious business of addressing a real crisis both in the american economy and in american families and even in the american character if we're going to continue to allow the kind of injustice, social injustice that occurs in our health care system to continue. >> not to waste more time on that reality of the circus as

you phrase it, this was followed by the congressman from south carolina, mr. wilson, i heard "you lie" or the ap heard "it's a lie" on the subject of health care for people in this country illegally. i wonder if the answer as much as the president promised to call people out who do things like that, i think that's great. i wonder if the answer of all of this is contained in one small sentence that he did not spend a lot of time on but that he said it and made it a centerpiece of this bill might be the sales tool to cut through all of the other noise and to get the circus to leave town finally and that would be simply this, it will now be illegal to deny insurance for pre-existing conditions. that would seem to be a universal message. >> as i have crisscrossed the country not just campaigning politically but in conversation i had with people in health care and i spend a lot of time doing that, that is perhaps the number one issue.

people are afraid -- most americans do have insurance coverage. they're afraid that when the time comes that some condition that is enormously important in their lives will not be attended to because it will either be deemed as pre-existing condition or deemed some reason for recision so the kind of imperative that all pre-existing conditions will be covered is i think enormously important to every american family. as you pointed out earlier with senator brown, that is an absolute winner across this country. >> in addition to that, recision would also be illegal or as the president phrased it in a better way, no watering down, no denying of care when it is time to pay up. this is the contract nature i would think that would appeal to people crossing party lines as well. >> the stories that he told about the illinois man who was

denied coverage in the middle of chemotherapy or the texas woman that the sister of the illinois man testified and the woman testified about the insurance abuses. it's one of the reasons why it's so important that we have something that people think exist but does not. and that is national guidelines for what insurance companies can and cannot do. right now there's been this threat of government control of your health care. i think americans today think they have insurance company control of their health care. >> as you know, i lost my mom this spring. my dad is sick. my dad is sick. fortunately i think he's going to be okay. i was in the hospital with him. in a rehab facility with him. i was thinking about this today when i was in there with him. if i didn't have the money to spread around where it was necessary, what in god's name would i do? >> i thought -- you could see nancy pelosi having trouble containing herself when she said for a family to say the answer

is out there, i just can't pay for it for you and a child that they love or a spouse that they love not getting the care that any need, when you talk about a northerly imperative, that's something that americans understand. that's what made this speech so incredibly powerful. >> agreed. elizabeth edwards of center for american progress, always a pleasure to speak with you and always a great point of pride to be able to say thank you, my friend. >> back to you, keith. >> take care. >> so long. is what we heard tonight real reform or does it funnel money to insurance companies? is the delay too much? is that negotiable or the big point that it would be illegal to deny insurance for pre-existing conditions or cut off insurance when you need it? answers from an expert on this. jonathan cohn, the author of "sick." late news on senator mccain's reaction to mr. wilson's actions shouting "lie" at the president and a full page ad in "the new york times" signed by volunteers and contributors to the obama

presidential campaign critical of his leadership on the subject of health care. the senior campaign staffer whose name is on that ad. has his mind been changed tonight? he'll join us. you're watching "countdown." for your family. it's the fabric of a sound economy. it built the middle class. and it's what the employee free choice act is all about... letting workers choose to join a union to earn better pay and benefits. the employee free choice act. it's time the economy worked for everyone again.

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that four-year delay in an insurance exchange. jonathan cohn tries to explain the details we heard tonight from the president and then deputy campaign manager for then

candidate obama, is he back on board with the president's leadership on the subject of health care reform? congresswoman jean schmidt, the editors that wrote a column about jaycee dugard ending with a reference to her having left the yard get published in her hometown paper and the "gentleman" from south carolina. congressman joe "it's a lie" wilson. apologize, resign, leave the country. it's your choice, goober. tonight's worst person and the analysis of the obama speech ahead. a smidge? y'know, there's really no need to weigh packages under 70 pounds. with priority mail flat rate boxes from the postal service, if it fits, it ships anywhere in the country for a low flat rate. cool. you know this scale is off by a good 7, 8 pounds. maybe five. priority mail flat rate boxes only from the postal service. a simpler way to ship.

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the president spoke loftily and appropriately about the moral imperative of health care reform this evening, movingly of the letter he received from the late senator kennedy, terrifyingly of the man who died because he did not report to his insurer gallstone that's he did not know he had. but our third story on the "countdown," what about the specifics, and where does the public option stand as of

tonight, as of the president's speech practically and as a priority? the president did in fact pitch it tonight, but contained it within an insurance exchange that itself will not begin for four years. and he also said he's open to better ideas, if any. >> the public option is only a means to that end, and we should remain open to other ideas that accomplish our ultimate goal. and i will continue to seek common ground in the weeks ahead. if you come to me with a serious set of proposals, i will be there to listen. my door is always open. >> let's turn now to the senior editor of the new republic, author of "sick: the untold story of america's health care crisis," jonathan cohn. thank you for your time tonight. >> happy to be here. >> what seems to be the practical piece of the president's speech tonight? what is the insurance exchange? why will it not kick in for four years? is there a co-op? why is the public option

seemingly buried within it? >> the insurance exchange, this is the heart of all of the health care proposals, including the bill that's have already gone through congress. this is basically setting up a marketplace where people who don't already have access to insurance through their employers can shop around from among a group of plans and they can get any plan they want. they can't be denied because they have a pre-existing condition, that sort of thing. it's really very similar to the way members of congress get health insurance and the way most people who now work for large corporations. now y. is it going to take four years? you know, there's a lot of pressure to keep the cost of this bill down. if you want to get an exchange up and running right away and get everybody into it, it's going to cost more. on the other hand, if you wait three or four years and you slow down the implementation, well, that brings down the cost. and this is basically a compromise that obama and all of the bill that's is already gone through committee, they all do the same thing, this basically is a compromised made so they can keep the costs down because, frankly, to be quite honest, i think congress doesn't have the guts to raise enough money to do

it right away so they're slowing it down a bit. >> and the idea that he attributed to senator mccain, the short-term emergency funding program that would prevent you or protect you against, as he put it, financial ruin if you become seriously ill, it didn't seem to have much more detail to it than that. is there anything to infer from what the president said as to what this is? is it a long-term process or a short-term process? do you know anything more about it than what we heard from the president? >> yeah, i checked into that little bit on the way over here. it sounds like what they're talking about. as you may recall during the campaign, senator mccain proposed these high-risk pools which basically say if you are somebody who has pre-existing medical conditions and you can't buy insurance yourself, they'll create this special pool, this special class of insurance just for you and people like you to give you coverage. now, the downside is not much of a long-term solution. typically these policies are very expensive. they have pretty high deductibles. you may have to wait a while

until you get your pre-existing conditions covered. it's not a long-term solution it is more of a band-aid so that's why people like me criticized it. is it better than nothing? yeah, it's pretty expensive. but i think there is a sense from the white house and from congress if they are going to roll this out pretty slowly, it is important that people see some benefits right away, and i think that is important. this is one way of giving them that. this is one way of giving in effect what they're calling a deliverable -- a benefit people will see up front so that they know this plan is working, and that they feel like they've gotten some benefit from it. >> understanding where this could have begun if the president had started with single payer and negotiated down to public option, rather than starting at public option and negotiating down from there, understanding it in that context, are you satisfied with what you heard from the president if that's the final bill, is that good enough for the time being? >> you know, i do think it is. look, my ideal bill would look a lot more like a single payer

system. it would look a lot more like some of the systems they have in other countries that work really terrifically. but i am also a political realist. i understand we have the united states senate with a lot of senators from conservative, small states. we have some very powerful special interests. and the fact of the matter is these plans are not perfect, but, boy, they make a big difference in the lives of a lot of people. and we're talking about getting insurance to tens of millions of people, you know, protecting these people from financial catastrop catastrophe, from medical catastrophe. people who are currently insured, making sure their insurance actually works for them. and you know, there's nothing to prevent us from coming back in a couple of years and building on this system and adding the part that's people like me, people like you, think are important. do i wish the plan were better or do i wish it looked more like a single payer plan? absolutely. do i think that what we're talking about now will make a dramatic difference in people's lives? absolutely. >> couldn't say it fairer than

this, as they say. jonathan cohn, the author of "sick." many thanks, as always. >> thanks. mr. cohn's perspective is one thing, yours is another. what about mr. obama wthe full-e in "the new york times" today? the senior staffer joins me next. is he converted back tonight? and rachel maddow joins us on this critical night as health care debate continues. among her guests, white house senior david axelrod, senator boxer, representative frank. and ahead of that, a month ago she announced the president is a natural born citizen. now jean smith of ohio changed her mind if she has ones. "worst persons," including congressman wilson, if she has one.

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