Obama Is Losing the Health Debate - But He Can Still Mobilize and Win

1,000 demonstrators gathered at North Carolina's capitol on Saturday to support Barack Obama's proposals for universal healthcare.
In one of four rallies across the state, some carried placards stating:
"If it's broke, fix it", and "Insurance profits bad for my health",
while ironic "Billionaires against healthcare" strode the grounds in
top hats, carrying fat cigars and glasses of champagne as they mocked
their enemy. Across the street stood 50 counter-protesters with signs
saying "Socialism is an Obamanation", and "Revolution is brewing:
2010", and "Not ready for Obama's communist America".

In between stood a statue of Confederate general Zebulon B Vance
with the inscription: "If there be a people on Earth given to sober
second thought [and] amenable to reason ... it is the people of North
Carolina." Given the fistfight that broke out at a local town hall
meeting on healthcare recently that is, at best, debatable.

With
Congress about to return to work, the struggle for healthcare reform
reaching its most crucial and intense phase. Opportunities for a
Democratic president to overhaul the system while his party has
commanding controls both houses of Congress come around once in a
generation - if that. Yet over the last few months the momentum has
been slipping away. According to an ABC/Washington Post poll shortly before summer 53% of Americans approved of how Barack Obama was handling healthcare reform, against 39% who did not. Today 50% disapprove and only 46% back him.
To get through Congress any bill will inevitably contain compromises.
The issue is who will need to be placated and what will have to be
surrendered.

Faulkner Fox, an organiser for Durham4Obama,
knew there would be times like this. From the moment she started
campaigning for Obama during the primaries she has provided unstinting
but never uncritical support. After Obama took North Carolina by a
hair's breadth in November - the first Democrat to do so since Jimmy
Carter - she demanded that the campaign leave its data so the local
group could continue organising.

In January, before the
inauguration, she called a meeting to talk about what they should do
next. She expected around 40; more than three times that number showed
up. "We had brought together this very diverse brilliant group of
people and it was clear to me that this should not stop on 4 November.
We could not let those people go back into the woodwork. We had to keep
going. We never thought Obama would do all the things we wanted to do
and we always knew that we would have to pressure him to get some
things done. That's how politics works."

When trade unionist and
civil rights leader A Philip Randolph demanded that Franklin Roosevelt
integrate the military, Roosevelt responded: "I agree with you. I want
to do it. Now make me do it." Here they are, making him do it.

They
formed working groups and started organising. Michael Pearlmutter, who
co-chairs the healthcare committee, provides a daily digest of the
day's healthcare stories. One of their principal targets is their
senator, Kay Hagan,
who swept in on Obama's coat-tails but has since dragged her feet on
all the major votes. A moderate Democrat in a conservative state, she
is anxious to find ways to cover her right flank. Ask the
pro-healthcare demonstrators at the capitol how they think she will
vote and they shrug. But Faulkner, Pearlmutter and their fellow
activists have given her little wriggle room.

"We flood her
voicemail," says Fox "We visit her, email and get people to write her
letters. She always knows we're here. She does the right thing in the
end. But we have to make her." Currently in the middle of a 30 events
in 30 days spurt of activity, last week 75 people showed up to learn
about campaigning, including how to peacefully deal with rightwing
hecklers.

That is no minor feat. Central to derailing Obama's
reforms has been the high-profile disruption of town hall meetings by
conservatives alleging, among other things, that universal healthcare
would create death panels that could kill your grandmother. Small in
number but well organised, they captured the attention of the media. It
is the silly season, and a lot of these people are quite silly. Like
the "birthers", who insist
that Obama was not born in America, most of their claims are not only
demonstrably false but downright daft. They have argued that if Steven
Hawking were British he would be dead, even though Hawking is British
and alive. They insist that under the NHS the state decides whether to
"pull the plug on grandma".

But life expectancy in the UK is
higher than the US, meaning that even with our supposed state-sponsored
euthanasia our grannies still live longer than theirs. In a blend of
the comic and the tragic one protester, who was hospitalised after he
got into a fight at a town hall meeting in St Louis, had to have a
whip-round to pay for his medical bill - it turns out he had no health
insurance.

There are legitimate arguments, both philosophical and
economic, against the proposed reforms. Antipathy towards government
runs deep here, and the national debt was last week forecast to reach
$9tn. But that would be a case for different kinds of overhaul - not
none.

Sooner or later something will have to be done about
American healthcare. As a percentage of GDP the US spends twice as much
on it as the UK, and yet one in six aren't even covered. According to
government figures, life expectancy for women is lower than in Albania
and infant mortality is higher than Cuba. This national disgrace
conceals a regional outrage. Black infant mortality in Louisiana is on
a par with Sri Lanka; in the very city where the reforms will be
decided, Washington DC, life expectancy is lower than the Gaza Strip.

The
rightwing protesters are ridiculous, but that does not prevent them
from being effective. "It's much easier to turn up at a meeting and
yell," says Pearlmutter, "than to propose something that works.
Healthcare is complicated. Even within our own working group there are
many different positions."

The fact that the right has diminished
Obama's chances does not mean they have boosted their own. An NBC poll
shows that while only 41% support Obama's proposals, 62% disapprove of
the way the Republicans are handling it.

But those who complain
that the right's intervention has been the work of co-ordinated
activists rather than spontaneous individuals miss the point. The
problem is not that the right were organised but that - with a few
exceptions like Durham - the left has not been. At the very moment when
he needed the "movement" that got him elected most, it appears to have
largely stopped moving.

The bad news is there are all too few
places like Durham. The good news is there is still time. A significant
part of the country is desperate to be convinced and the battle for
public opinion - which will ultimately determine how wavering
congressmen vote - is finely balanced. "We're not going to out-yell
them," says Fox. "So we have to out-organise them."