The president of the United States was determined: Universal health care was something Americans should expect, and he would deliver it. He argued forcefully for an employer mandate and for government-run insurance pools as an option for those who couldn’t obtain private insurance. Commentators in all the media were abuzz.

The time? Nearly 40 years ago. The president? Republican Richard Milhous Nixon.The irony doesn’t end there. Nixon’s plan failed because of one powerful opponent: Sen. Edward M. Kennedy. He stood firm in favor of a single-payer system, and the moment was lost.

In the years leading up to his death last week, Kennedy must have regretted this, as he heard the ideas that Nixon once espoused as conservative doctrine now slandered as socialism when proposed by President Barack Obama.

The Kennedy skill at collaboration had yet to evolve in the early 1970s. And given the family history with Nixon, who had run against John F. Kennedy, a Nixon-Kennedy plan for national health care was probably asking too much at the time.

It’s apparently asking too much for today’s Republicans to collaborate on the Nixon, or Obama, goals. But it should not be. Today, far more than in the ’70s, the good of the nation demands health care reform.

Obama’s mistake has been allowing opponents to frame the debate and put him on the defensive. The Obama who was a master communicator during the campaign can recapture the lost momentum. He has to hammer home the folly of doing nothing, which is what his opponents want, and convince the American people that only through reform will they be assured of affordable, high quality health care in the future. The current system is not sustainable.

While providing health care to the 20 percent of Americans who now have none is critical, the president needs to aim his arguments toward the 80 percent who have coverage at the moment _ at least until they get laid off _ and are scared to death that they will have inferior care in the future.

He also needs to more strongly challenge the pharmaceutical and private insurance industries to reduce costs. Agreements to do so have been touted, but the industries are not out there fighting for Obama’s reforms. If they’re not on board, then he should not let up on the challenge.

They have a right to reasonable profits, but the nation cannot sustain the rate of increase in costs. Fewer and fewer businesses will be able to offer insurance to their employees at the current pace.

The president should be talking more about the move to electronic medical records, which will reduce costs and cut back on medical errors, one of the top 10 causes of death. And he should accelerate his plan to emphasize outcome-based medicine, rewarding doctors and hospitals for quality, rather than quantity, of care. There is ample evidence that the two do not equate.

The president has the oratory skills to turn this around. He also happens to be right about what’s needed. Richard Nixon, that well known socialist, would agree.

• Mercury News