While he probably didn't intend it this way, Obama's de facto target in Wednesday night's speech were the uninsured in America. People who have insurance can keep their plans, right? The majority reports satisfaction with their plans. Medicare recipients will still have Medicare, right? The VA will still give care to veterans.
The people that mattered were the uninsured, and the issue at hand was how the federal government under Obama proposed to help them. Imagine how it is to be uninsured, and then hear Obama's proposal for your problem. The answer? We will force you to buy private insurance under penalty of fine. Oh, and we will also credit you some of the money to pay for that (but we won't promise to make up all of the gap, and we won't guarantee a public plan, so you don't have to pay the extra overhead of corporate profit in your (mandated) premiums. Oh, and if you already have insurance, you won't be allowed to join a public plan, even if we pass one.
If I were uninsured in this climate, I'd be more than nervous; I'd be outraged.
Sure, we bourgeois commentators on DailyKos (and I admit that I am one of them) can talk about political pragmatism, and passing any kind of reform to bolster the Dems' credibility, but we are not the ones most affected by "reform." I'd wager that most of us have some kind of insurance policy that we think is OK. The fact is that the plan presented by Obama on Wednesday will leave millions without health care, will drive up costs (albeit at a lower rate), and will force tens of millions to buy into a for-profit insurance scheme that has already failed us time and again.
The most fiscally conservative and socially compassionate way forward is either Medicare for All (single payer, nationally pooled risk) or non-profit insurance for all (multipayer, regionally pooled risk, with surpluses put back into the payment system, real subsidies for lower incomes). Either way, universal coverage can be achieved, while taking the burden off our businesses, thus making them more globally competitive.
The president's plan is, at best, a move in this direction. Anything less will spell disaster for the Democratic party in the next election.