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Obama Recognizes He Must Lead on Health Care

Barack Obama's most ardent critics would have us believe that his bumbling of the health-care reform push -- and, yes, he has bumbled it -- will doom his presidency.

The critics would, of course, be wrong.

That does not mean, however, that their claims and charges are being dismissed by the White House.

Republican references to the current health-care fight as Obama's "Waterloo" are ridiculously overblown. But they appear to be having a positive influence on the administration's approach to broader struggles over this particular issue and this particular president's political future.

Indeed, the nasty turn that the debate has taken seems, finally, to have convinced Obama to speak up in a more forceful and -- supporters of real reform hope -- more focused manner.

"Right now, we're losing the messaging war," Senator Chris Dodd, D-Connecticut, noted this week, in what would certainly qualify as an understatement.

This is what Obama's hastily-scheduled Wednesday night press conference on the health care debate was all about.

Framing the fight as a struggle to get needed care to working families, the president declared, "This debate is not a game for these Americans, and they cannot afford to wait for reform any longer. They are looking to us for leadership. And we must not let them down."

Obama used the press conference to argue, at length, that his promised reforms would be fiscally responsible. In particular, he pledged to reject any plan "primarily funded through taxing middle-class families."

Again and again, the president returned to the theme that his reforms would be designed to serve working families and the middle class. He even credited them with setting his mid-summer deadline for House and Senate action on reform measures. "I'm rushed because I get letters every day from families that are being clobbered by health care costs, and they ask me can you help," said Obama.

The president's new mantra is: "I want to keep the pressure on."

Actually, Obama is only beginning to turn the pressure on.

The president is beginning to understand something that he should have recognized long ago: There is a consensus on the need for health-care reform. But there is no consensus on the scope and character of that reform.

As the Washington Post notes, "public opinion (is) still waiting to be shaped on health care" and "the legislative (are) details in flux."

Obama, alone, must forge the latter consensus.

He cannot wait for competing House and Senate committees to reconcile their various proposals and then present the White House with a turn-key program for providing health-care to all while controlling costs.

This is not a change that will come from Congress.

It must come from America. And Obama must use his bully pulpit to educate and organize on behalf of that change.

He seemed to recognize that reality Wednesday, when he and his aides arranged the primetime press conference after what could only be described as a series of unfortunate developments.

Central to the process -- and to the progression in the president's way of thinking -- was the emergence of the Republican fantasy that wrecking reform would wreck Obama.

"I can almost guarantee you this thing won't pass before August, and if we can hold it back until we go home for a month's break in August," South Carolina Senator Jim DeMint told backers of the anti-reform group Conservatives for Patients Rights -- a group headed by the former CEO of the scandal-plagued Columbia/HCA Healthcare corporation.


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"Senators and Congressmen will come back in September afraid to vote against the American people," imagined DeMint, who described the health-care fight as "D-Day for freedom in America."

Then came the senator's punchline: "If we're able to stop Obama on this it will be his Waterloo. It will break him."

DeMint was just confirming why his more enlightened constituents refer to him as Senator DeMented.

Obama's personal political fortunes will be no more damaged by the failure of health care reform -- in fact, probably less damaged -- than were those of the Democratic president whose reforms were blocked in the mid-1990s. And, though the more ranting-and-raving Republicans may have forgotten, Bill Clinton was easily reelected in 1996.

Defeating health care reform will only leave tens of millions of Americans in the quagmire to which they were consigned the last time that corporate-sponsored conservatives blocked moves to expand care and control costs.

The point here is not to suggest that Obama and his aides are unconcerned about his suddenly-shaky approval ratings. They are, when all is said and done, politicians.

But if approval was all that mattered to Obama, he and his staff could cobble together a soft reform -- protections for those with preexisting conditions, increased funding for programs that care for uninsured kids, expanded veterans hospitals and clinics, permission for states to experiment within the existing Medicare/Medicaid model -- find some "Blue Dog" Democrats and Republican "moderates" to sponsor it and claim "victory."

It is fair to say that Obama really does want to address the health-care crisis. It is in his DNA -- as the son of an activist mother who dies too young, a former community organizer and a relatively (dare we say it) liberal Democrat who came up politically in a city and state where health-care reform has long been a front-burner political issue.

No one need doubt the president's sincerity when he says: "(We) can't afford the politics of delay and defeat when it comes to health care. Not this time. Not now. There are too many lives and livelihoods at stake. There are too many families who will be crushed if insurance premiums continue to rise three times as fast as wages. There are too many businesses that will be forced to shed workers, scale back benefits, or drop coverage unless we get spiraling health care costs under control."

It is along this line of thinking, and within this context, that Obama is attempting to grab ahold of the health-care debate.

He is using DeMint as an easy foil.

"Just the other day," the president says, "one Republican senator said -- and I'm quoting him now -- 'If we're able to stop Obama on this, it will be his Waterloo. It will break him.' Think about that. This isn't about me. This isn't about politics. This is about a health care system that is breaking America's families, breaking America's businesses, and breaking America's economy."

Obama is right, and he is wrong.

This is about him.

The president's political future is not at risk.

But the prospect for meaningful health care reform is.

Only a presidential intervention that sees Obama take change of the debate will make real reform possible.

It will take more than a prime-time press conference, and a lot more than the faked-up town hall meetings Obama has been holding. (Tomorrow in Cleveland.)

This president must campaign, not for himself but for health-care reform.

If Obama wants to change our health-care system, he will have to work every bit as hard for that reform in 2009 as he did in 2008 to win the opportunity to present it.

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