President Obama's return to public meetings on health care reform elevates a debate that had spiraled dramatically downward. He has been on the defensive. The challenge for Obama is to move from defending reform to selling it.

Vitriolic discourse is as American as apple pie, but the president shouldn't allow himself to get sidetracked from the promise of extending health care coverage to more than 45 million Americans without it and streamlining this country's unwieldy and unaffordable medical care system.

The proposed House health care bill has put Obama and supportive congressional lawmakers on the defensive. They should be selling the plan's many desirable points, such as the fact that reform would leave intact a system in which employers and private insurers are the primary conduits of health insurance.

Instead, political leaders have been reduced to defending reform from conspiracy theories.

One example is the bogus charge by opponents — backed by less-than-informed comments from former vice presidential candidate Sarah Palin — that Obama's health care reform would include a "death panel" that would make life-or-death decisions about which patients get care and which would not.

Amid the angry outbursts and protests have been the signs comparing health care reform to Adolf Hitler's efforts. One woman told reporters outside a Portsmouth, N.H., hall where Obama spoke: "Hitler killed 6 million people; he killed everyone who wasn't perfect . . . I have an elderly mom and a severely handicapped sister, and I fear for their lives if this plan goes though."

This is a gross distortion of a section of the House health bill that calls for Medicare reimbursements for optional consultations on end-of-life care. People who are very ill could be reimbursed for more-frequent consultations.

Developing a plan for medical orders and treatment options near the end of one's life or in case of an emergency is proper and allows the patient to be in charge of decisions, not doctors or the government. Congress passed a law in 1990 requiring patients be asked if they have a living will; paying for voluntary consultations would seem to support this.

To the New Hampshire protesters, Obama said: "Where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that has actually been proposed."

That was the president at his best, using calm, non-defensive language to pull citizens back from the brink and to the reality of health care legislation on the table.

— The Seattle Times