Will Barack Obama use the bully pulpit tonight to offer something new for the national debate on health-care reform?  Or will the President boot the opportunity as he did in his last prime-time presser, offering the same platitudes at a higher volume?  The White House has released excerpts from the speech, and it looks like the same old arguments … only less so.

Why less?  Obama has spent the last four months insisting that people who have insurance now will not have to change their plans, ignoring the fact that most people get their insurance through their employers, who may opt to dump it for the fine and send employees to the public option.  Obama now avoids committing that people can keep their existing plans (emphases mine):

First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will require you or your employer to change the coverage or the doctor you have.  Let me repeat this: nothing in our plan requires you to change what you have.

Obama’s being a little more honest, but his earlier statements make this nuance painfully obvious.  Instead of reassuring people that they can keep their insurance, now Obama insists that it won’t be Obama who makes you change your doctor and your coverage.  This is a serious walkback, especially since the overwhelming majority of people with health insurance want to keep exactly what they have.

Otherwise, based on the excerpts, we’re going to be hearing the same old tired lines of the last four months:

• Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
• Now is the season for action.
• If you misrepresent what’s in the plan, we will call you out.
• Instead of honest debate, we have seen scare tactics.

I like that last one especially, because after that, we get this:

Everyone in this room knows what will happen if we do nothing.  Our deficit will grow.  More families will go bankrupt.  More businesses will close.  More Americans will lose their coverage when they are sick and need it most.  And more will die as a result.

Bear in mind, of course, that our life expectancy has increased every year in the status quo.

Jake Tapper says that Obama will finally mention two dirty words, at least to Democrats:

But today, the White House indicated that as a gesture of bipartisanship, President Obama would discuss malpractice reform.

“The president is going to talk about the downside of what many doctors have told him is the practicing of defensive medicine, where doctors because they are worried about this order more and more tests in order to make sure that they don’t get sued,” Gibbs said on CNN. “That costs our system billions and billions of dollars every year.”

Gibbs called this “a big test, because the president is going to outline things that Republicans want to hear. I think the test for Republicans is to hear the message of millions and millions of Americans that are struggling with the high cost of health insurance. Are they ready, willing, and able to come to the table and work with the president to get something done, or are we just going to stand on the sidelines without a plan? That’s the challenge tonight for Republicans.”

Gibbs’ tone towards a suggestion of tort reform was remarkably different than it was just a few days ago.

Why did Gibbs change his tone? Because someone at the White House looked at the AP poll today and realized they had to offer something new.  Will Obama demand tort reform as part of the package, or will it just be one of the “good ideas” he’s willing to discuss with anyone who drops by 1600 Pennsylvania?  Something tells me it will be the latter; don’t expect it to be a demand.

People who listen carefully should understand that the only thing new in tonight’s speech, if these excerpts are any indication, is the sense of desperation in the Oval Office.