What should have been a “love game,” with Obama easily cruising to victory in the U.S. Health Open, has now turned  into a grueling last set, last game battle, with the President having to save match point.  The President will address a joint session of Congress next Wednesday night to add specifics to his vision of health reform, according to media reports.   If conversations with White House health advisors are any indication, it is difficult to discern anything new in the messaging.  If the President tells the nation we need more primary care, health IT, and research to find out what treatments work and don’t work, America will not be enthused.

 America wants to know what systemic changes the President wants in a health reform bill. Will he stand for a strong public option?  Will he provide the roadmap and transition time for changing the current health insurance industry? Will he ensure that the health workforce is a priority and address workforce issues now—not later?  Will he go beyond primary care—and provide a new vision for how to deliver primary and specialty care to all segments of society or will he be satisfied with a 19th century view of the primary care doc going off alone to the rural regions of the country to solve the workforce crisis? 

Will the President explain to the nation that whatever happens in the delivery of services will ultimately affect  the nation’s research enterprise because of the unique  role that academic health centers play in the nation’s health system?  Will he explain how health reform must take account of how the clinical monies help to support the nation’s biomedical research through these institutions?  If the answers to these questions are what is meant  when the White House says  “specifics,” then America will listen.  If not,  the  President will be forced to make a quick exit from Center Court.