In 90 minutes, it seems anything is possible.

Just hours after the U.S. soccer team shocked the world Wednesday, upsetting Spain, 2-0, in the semifinals of FIFA's Confederations Cup, President Obama took the health reform debate to prime time, in an hour and half town hall discussion hosted by ABC News. (Video here.)

Answering sometimes skeptical questions from an ABC-selected audience of providers and patients, CEOs and at least one auto mechanic, the president showed both a grasp of the issues and a plan for addressing them. Following a somewhat tough week for the health reform process, Obama restated the case for reform, reiterated his commitment to paying for reform—and explained that we as country can finally make reform happen.

Describing how we could fix the system in a fiscally responsible way, Obama said we can reallocate existing health care dollars and find new revenues. He restated his own preference for capping the itemized deduction for high-income individuals, but also signaled a willingness to hear out proposals in Congress to cap the employer tax exclusion for so-called "Cadillac Plans." He was very clear to distinguish such proposals from what John McCain proposed during the campaign. (RWJF just put out a new paper on the tax exclusion.) 

Obama, who disappointed some backers of the public plan by seeming to waver on the option earlier this week at his news conference, argued strongly in favor of a public plan. He framed the issue in terms of broader insurance market reforms, "stressing that lot of the objection to the public option idea is not practical. It's ideological."

Many of the questions focused on the issues of choice and cost. As TNR's Jonathan Cohn notes, Obama took the opportunity to reiterate why the status quo was untenable:

On at least three separate occasions, Obama pointed out rising costs—left unchecked—are going to destroy the health care system. You might like your current insurance arrangements, Obama suggested, but there's no reason to think they'll be in place a few years from now.

At best, your plan will simply become less comprehensive and/or more expensive. At worst, it will no longer be available to you.

Or to put it more simply, change may be scary, but no change is even scarier.

Cohn seemed surprised that the plight of uninsured did not figure more prominently in the night's questions. We'd like to believe that part of the explanation is that covering all Americans has become a point of consensus, rather than contention. How you accomplish (and pay for) such an expansion remains open for debate, but most stakeholders and policymakers agree you have to start with covering everyone. It is a moral imperative and economic prerequisite for delivering high value health care to all Americans.