When ABC’s Jake Tapper asked about what Americans must give up to make reform happen, the president replied: “They’re going to have to give up paying for things that don’t make them healthier. And I—speaking as an American, I think that’s the kind of change you want.” Then Obama’s answer dissolved into a long discourse on doctors and hospitals not doing enough to coordinate care, and how that adds to premium costs. He talked about the deficit, and how his administration would continue its efforts to reduce it by eliminating waste in the system, like the F-22 weapons program.

Other than a question about obtaining a list of health care execs who’ve visited the White House, there were no questions and no words about the special interests swarming over Congress. In the past, the president used his national bully pulpit to rail against them. More astonishing was the lack of questions or remarks about the Massachusetts health plan, the model for the legislation coming out of Congress. The plan has run into serious financial trouble, which has caused state officials to drop some people from subsidized coverage. Even though the president mentioned that preventative care like check-ups and mammograms save lives and money, no reporter challenged the assertion about saving money. As Campaign Desk has shown, that would have been an easy one to push back on.

And there wasn’t much talk about the controversial public plan—no details on whether everyone could use it, or whether it would pay doctors rates similar to Medicare, which would help deliver its presumed cost advantage. Only near the end of the conference, in response to a question from Cleveland Plain Dealer reporter Steve Koff, did the public plan come up. The president repeated what he has said before: a public option would “help keep the insurance companies honest.”

For the most part, the press didn’t push hard enough. Perhaps that’s because of the constraints set by a presidential press conference. There isn’t much opportunity for follow-up questions; and, after all, if your intitial question is too tough, you won’t be invited to ask one the next time. But the press still has another chance. Reporters can bone up on what they didn’t ask this time, and try for the nuances and particulars at the next one. Or they can use the conference as a starting point, and tell their own stories about what the president did not say.

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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.