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September 8th, 2009
03:08 PM ET

Can Obama overcome three big challenges on Wednesday night?

David Gergen | Bio
AC360° Contributor
CNN Senior Political Analyst

In his fiery speech over Labor Day to the AFL-CIO, President Obama signaled that he intends to seize the offensive on health care this Wednesday night as he addresses a joint session of Congress. His supporters believe that it is none too soon and hope that his appearance will be a game-changer.

Obama has shown repeatedly in the past that when a speech really matters, he can sink a three-pointer from 30 feet and he knows it – “I’m LeBron, baby,” he told journalist David Mendell just before he delivered a boffo speech to the 2004 Democratic convention that catapulted him to fame.

Even so, Wednesday night’s health care speech may be one of the toughest he has faced, as he has to overcome at least three major challenges all at once.

First, he has to reverse the tide of public opinion that has turned against the Democrats’ general effort to overhaul health care. While most Americans agree that the system needs to be fixed, poll after poll shows that the country is at best divided on Obamacare as the answer – and some polls show greater numbers oppose than favor. Moreover, many of those who oppose do so passionately – a factor that heavily influences Members of Congress.

The question becomes whether opinion has become so settled that it may be too late for even an Obama to change people’s minds. After President Clinton went before a joint session in 1993 to promote his health care plan, public approval shot upward. But that was because the public was just being introduced to the President’s ideas. Later on, opinion soured and Clinton could never find a way to turn it around. Once public opinion has started to crystallize against a President, it is devilishly hard to change it – just ask George W. Bush about Iraq. We will have to wait and see how hardened opinion is today about health care.

Equally important, the President has appeared on prime time so often that he may not find as attentive an audience as he did in his early, golden months. Nor are television outlets likely to give the speech as much attention. This is Obama’s sixth prime time appearance in 8 months (two speeches, four press conferences), surpassing the records of all other presidents. Even Franklin Roosevelt gave only four fireside chats in his first eight months.

Second, the President must overcome tensions within his own Democratic party. Possibly, he will pick up a few Republican votes for reform in the next few days – everyone is now watching for the outcome of the Senate Finance Committee. But Democrats already know that to win, they cannot count on Republicans, but instead must achieve unity among themselves.

No one knows whether Obama can heal the obvious divisions within his party. Indeed, one of the surprises of this speech is that he is giving it so quickly after Congress returns from recess: most presidents would have spent time quietly working behind the scenes for a week or two, hammering out a deal within their own party, and then with a deal in hand, taken it to the public and sold it hard. That’s a more traditional way to success.

In choosing to speak before a joint session before he has a deal, Obama is running an obvious risk: that Democratic liberals from the House will emerge from the speech insisting they will pass a bill only if it has a public option and Democratic moderates in the Senate will insist they will pass a bill only if the public option is dropped. That will hardly seem like unity.

Third, the President must overcome a tension within the speech itself about his leadership. His AFL-CIO speech shows that his inclination now is to pick up a banner and rally his troops behind a battle cry, “Yes, we can! Yes, we will change health care!” To many of his liberal supporters, that kind of passionate leadership has been sorely missing from the White House in recent months.

But it is hard to give a stem-winder in favor of change, if at the same time, the President is quietly signaling, “But hey guys, we have to be realistic. If we can’t get what we want, let’s be prepared to give things away - starting with a public option.” That is not the stuff of brave, bold leadership of the kind that liberals are demanding.

How will he overcome these three challenges? None of us can be sure, and perhaps the White House is not yet fully sure, either. That’s why so much drama is now building around Wednesday night. Much is resting on the line and he is shooting from over 30 feet.


Filed under: 360° Radar • David Gergen • Health Care
soundoff (231 Responses)
  1. Sara in ND

    The crux of this issue is that we cannot restore our economy until the dead weight of the health care system is taken off of the backs of the middle class, or what is left of it. Give me some good old love-thy-neighbor, be-thy-brother's-keeper socialism as outlined by Jesus Christ himself, any day. Unfortunately, we seem to be a "Christian Nation" only in times of convenience, like when we want to gin up support for a splendid little war against "infidels" somewhere. In the meantime, I'm waiting gingerly for my 1 year's waiting period to be up so that if some medical calamity should befall me I may possibly be out my 6000 deductible as opposed to selling my home to pay medical bills, or hearing those magical words "we can cure your cancer, but you can't afford the medicine." Wish me luck, folks.

    September 9, 2009 at 11:29 am |
  2. fred

    I admit that I do not know all of the details concerning health care. However, I do not think that any of its supporters do either. It appears to me that under the guise of "emergency", the proponents of this plan would like to have seen it passed in the middle of the night and deal with the details later – similar to the cap and trade bill. It is really arrogant of the president and the Democrat-controlled congress to resort to such tactics to attempt to pass a bill of this magnitude. If this plan is so good, why won't the administration and the supporters of the plan allow the public and the legislators sufficient time to thoroughly study – not review – the more than thousand pages of documentation for this plan, digest it, scrutinize it and have an honest debate?

    Make no bones about it, the insurance premiums that I pay for my family are astronomical, and my coverage is still not very good. As much as I dislike it, I am more scared of government adding any new social programs, much less health care. Look at Social Security and Medicare that are on the brink of insolvency. If Congress underfunded, in four days, a cash for clunkers program that was supposed to last for four months, we know that number crunching is above their pay grade.

    Let's not make health care another "teachable moment"!

    September 9, 2009 at 11:14 am |
  3. Jenn

    I find these comments interesting as I have experienced not having health insurance, having employer provided health insurance, having people close to me who are on medicaid, veterans, and medicare, and then living in Switzerland with their privately administered publicly mandated system, and I can tell you with confidence that the US health care system needs drastic reform. And I don't blame the government for wanting to 'take over' health care, as they currently provide health for 100 million Americans through various programs, it would make sense from their perspectives and ours to combine the various programs into one streamlined program that can pick up those for fall through the cracks (too poor to have employer provided insurance...or not able to pay the premiums out of their service sector paycheck... but not poor enough or old enough to qualify for current programs).

    For all of you saying that taxpayers are paying for those who don't have insurance right now, no you are not, taxpayers are paying for health care for senior citizens and for those who have qualified to be destitute enough to temporarily qualify for medicaid that is all. When a member of an uninsured family breaks their leg, for example, the family takes that person to the doctor, where said doctor provides treatment, but guess what you don't walk out that door until you pay for the $1,000 in treatment you just received. Now most people in the lower income brackets do not have $1,000 laying around so you end up putting it on a credit card (not on the taxpayers). As for medicaid and the other 'entitlement' programs, you have to be destitute (and i mean destitute) before you qualify (the one exception being pregnancy, but the 'coverage' ends shortly after birth). As for employer provided health insurance, it is already rationed-I was appalled to develop pneumonia and be told I had to wait a week for a chest X-ray to confirm the diagnosis. Or be told by a different and well respected insurance group that I had to wait four months to have physical when I was new to the program (after all isn't preventative care important, apparently not). As for veterans provided health coverage, it is great in some respects but it is so underfunded that the participants wait months for standard tests (like the type to find out if your cancer has come back or the type to find out why you are experiencing a continual stream of infections). In regards to 'european socialist' care. It was wonderful. We were living in Switzerland where the private insurance companies administer the mandated program and everyone (illegal or legal) is legally required to pick up a basic insurance policy (which is not deducted from your paycheck, but is instead a monthly bill you pay), which the federal government reimburses the insurance companies for. If you want more than basic health care, then you can add on amenities such as private hospitals, private rooms, your own personal nurses etc. This system was great and my family received excellent timely care no questions asked and we didn't have to think twice about visiting the emergency room (very important as my son has a rare medical condition that requires a lot of these visits) or being hospitalized (and believe me it was nice not to worry about hospital bills after spending 10 days in intensive care) or about paying for prescriptions (they were part of an annual deductible which you chose based on the premiums you were willing to pay). And oh yes, we got to choose our doctors and it didn't matter if they were part of the public or private system.

    In other words, for those of you who think US health care is so great, it is time you opened your eyes and realized the confusing mess of private and random government programs is probably actually costing you personally and taxpayers more than a streamlined, standardized system that smoothly combines the private system with the government programs.

    September 9, 2009 at 10:58 am |
  4. E

    To Rafaelo (& all the uninsured who don't think they should be required to have it)- If you were to get sick or in an accident who would you like to pay your hospital bills? Should the taxpayer pay now or wait until the hospital exhausts your savings so that you end up on Medicaid and the taxpayer can pay then? Or would you rather hire a lawyer to get out the bill completely so the taxpayer pays it + your lawyer fees? Or would you have a fundraiser and ask everyone to pitch in a little, which is the same thing as the dreaded socialized medicine that everyone seems to fear? Whatever you choose, it costs me (taxpayer) more than $3800 over my lifetime. And you're sick. Nobody wins. Is it worth it? Does it seem fair? Not to me.

    September 9, 2009 at 10:56 am |
  5. CalumetRegionBoy

    Some suggestions -
    First, we need tort reform to limit doctors' legal liability and costs. Take a look at all those cheesy ads by the medical malpractice and personal-injury lawyers who get rich by encouraging us to sue each other! They don't have to win; real harm doesn't even have to have happened: just by threatening to sue, they can get some money (the client doesn't see much of it, after the lawyer's cut PLUS his expenses.).
    When the state of Texas imposed these limits, it was flooded with doctors applying for licences to practice; and voila! - no shortage of doctors, and thus a lessening of wait times to see a doctor.

    Second, eliminate the ability of private insurance companies to deny coverage for previous conditions. With the increasing sophistication of genetic mapping, insurance companies will use that information to increase your rates and limit their risks.

    Third, please, please do not, do not let the government bureaucracy get its hands on running any aspect of health care! I worked in several Veterans Administration hospitals over the years, and I saw entrenched bureaucrats who had a job-for-life mentality. Because it's true; virtually no one ever gets fired from a government job. They also knew that cost-containment was of no importance; that's what the "private sector" had to worry about - not them! Do you want your health care to be run like the Post Office?

    September 9, 2009 at 10:54 am |
  6. Marlon La Rose

    Obama's fourth challenge is overcoming racism. With the tone of the right-wingers and the Beck-Hannity-Limbaugh clones who are utterly disrespectful to the office of the president, it doesn't matter if Obama was proposing to pay everyone's health care using his own money – they would still disagree. They obviously are bitter that he is the president and this is obviously all politics because when the former president was damaging this country’s reputation and economy, none of them spoke up with such passion. Just like the religious-right campaign strategy used to get Bush elected, the strategy of branding the president as a Nazi is being used to fuel the fire. The bad thing is that the hatred and bias for the president is so obvious but the mainstream media is not calling them on it – and in some cases (hint hint FOX NOISE) are encouraging it!

    September 9, 2009 at 10:49 am |
  7. Curt

    Tort reform must be included, otherwise the underlying costs and over the top preventive testing will continue escalate.

    Tort reform could be handled very simply.

    Litigates receive only "compensatory" damages (and their lawyers cut only comes from that). "Punitive" damages should go to funding the healthcare for all.

    September 9, 2009 at 10:47 am |
  8. Keith

    We need health reform for the good of our country, plain and simple. Change can be frightening and lots of special interests are afraid their piece of the pie will be smaller but this does not alter the fact that our citizens and our buisnesses need and deserve real health care reform.

    September 9, 2009 at 10:47 am |
  9. Robert W.

    What a quandary for the liberals. "It must be done now!" They have control of congress and the white house but the kitty is empty. If only I could spend money based on my wants instead of my budget.

    September 9, 2009 at 10:46 am |
  10. Sheila

    All the sudden, everyone is fiscally conservative. Where have all these nay-sayers been for the past 8 yrs? No teaparties when Bush added 1.3 trillion dollars and the cost of 2 wars ( 3 trillion ) on our credit card? Now that healthcare is finally being addressed (after 30 yrs), americans are saying " it can wait ". Let's try the other stuff first and see in 5 yrs, why is Obama shoving this down our throats? This is one of the issues Obama was elected on, and for him to not address it now, it will never be addressed again by a Dem President. Medicare isn't a socialist program, those hospitals and Dr's who participate DO NOT work for the government, they get REIMBURSED for care they provide, by the government. How many nay-sayers out there who say medicare is broke, know that it is partially privatized? Can you day Medicare Advantage? Medicare HMO's? All insurance providers for Medicare Advantage get subsidies which cost tax payers billions and the care isn't managed as well as traditional medicare. WHY? Either give Americans the chioce of a public option, or let these insurance companies, big pharma and any other industry the US Gov subsidizes survive on their own. I'm tired of my tax dollars only representing a segment of our population. Actually, I'm tired of politics period.

    September 9, 2009 at 10:45 am |
  11. Don

    Here's the real problem. The right has distorted so much about what is or is not in the current proposed bills and the left really hasn't done too much to discount any of that. I believe that if the President details exactly what it is he wants and why and explains how much it's going to cost/save he'll be successful... We'll know more after he speaks tonight... that much we know for sure!

    September 9, 2009 at 10:43 am |
  12. Lynn

    Rafaelo said:
    "I have no health insurance because I am unemployed. I am fifty-five and judging from the results of a year old job search, unemployable. I am fast drawing down my retirement savings, and will soon be out of money. And the President is considering Max Baucus’s health care plan that would FINE people for not getting insurance? Fines up to $3,800 according to reports."
    Response:
    You do not even know what President Obama have considered... this idea just came out recently by Max Baucus who is hoping that both Republican and Democrat can agree on. I'm sure the President is smart enough to come up with a better solution which I'm sure he will. And why is everyone blaming the president for the current healthcare bill that is being proposed? Isn't it that Congress wrote the bill and not President Obama? Because people in Congress couldn't do the job, he now have to re-write the whole bill again! Stop blaming everything to the president and put it to where it really belongs.
    FYI... I am neither a republican or a democrat but I am smart enough to listen and review the facts before making judgment.

    Also, out of curiosity... isn't the HealthCare reform a very important subject to American people? Why is it that all major networks are covering the speech tonight and FOX is showing the season premiere of So You Think You Can Dance?

    September 9, 2009 at 10:43 am |
  13. sue

    Unless he explains line by line what proposal he is supporting.....ppl who already have insurance will not support anything. Unless he explains exactly where he is getting the money to pay for such a huge restructuring of healthcare he will not gain any support. People no longer trust this President and especially after this Van Jones scandal....

    September 9, 2009 at 10:39 am |
  14. Joe

    I can't believe organized labor, of all "interest groups" is behind Obama's version of "reform." One of their signature reasons for being, supposedly, is to protect their members' interests. Right now, organized labor negotiates really good healthcare benefits for its members. A government option takes that all away from them!

    Lots of state governments have budget deficits. if a government option does become law, one of the first things that will happen is that state governments will dump their health insurance onto the federal government. All this will do is rearrange existing debt, but it also will be a royal screwing of union members as their wonderful health benefits become quite ordinary.

    I think union leadership is really selling out union members. I'm really surprised at the absence of any outcry over this betrayal. It's just like AARP supporting the plan while the most vocal opponents are seniors!

    September 9, 2009 at 10:33 am |
  15. Euguene

    The whole focus on heatlh care is like trying to decide how you are going to spend your inheritance before you have it. We need focus on energy independence and economic viability. If you want to spend some money on health care, that's something you can decide when you have money to spend. In the meantime, do tort reform and eliminate pre-existing conditions and move on to the real issues.

    September 9, 2009 at 10:33 am |
  16. Rodney in LA

    A public option goes against common sense. We are being lied to. It's a farce to claim that we can "keep our insurance" when in reality our employers will decide what we keep. With a "free" option available that is funded by the FED, we'll all be dumped into a public system that will quickly implode and explode with quotas and cost-cutting ... over-burdened "clinics" and health care "in MASS" where quality becomes less important than mandated quantity. The American people simply want costs reduced ... we don't want QUALITY eradicated!

    September 9, 2009 at 10:33 am |
  17. Billy J

    I am sure that we will fail as a nation if we don't get our manufacturing back from Wall Street, take the burden of health care off of small business by having universal, and stop spending more on bombs (not soldiers) than any other country (and most combined) in this world. THAT is where we have strayed.

    September 9, 2009 at 10:32 am |
  18. Rick McDaniel / Lewisville, TX

    On the contrary, with the content reported in the Baucus Bill, I foresee that Obama is going to encounter even more resistance, as that content is downright un-American, and unacceptable to the Citizens, and it is indeed the Citizens, and not the GOP, that are against this bill.

    September 9, 2009 at 10:30 am |
  19. Ken H.

    Wow, a lot of Obama supporters and their left-wing drivel. The health-care bill Obama and the democrat controlled Congress want to shove down our throats is just plain WRONG. The same people pushing this bill on us will NOT have to sign up for it. His failed policies are already costing us and future generations TRILLION$.
    Obama's speech will be the same rhetoric he has been spewing for months. His speeches are the same as when he was campaigning. He is president and serves US, the people.
    He is narcissistic and most people are getting tired of this. Those that continue to support Obama and his damaging agenda's need to pack up their belongings and get the heck out of my country and take Obama and the democrat controlled congress with you.

    September 9, 2009 at 10:30 am |
  20. Amy

    He has to go by himself.....forget about congress! They won't pass the bill with the public option because they received the big dollars from the insurance industry. They don't work for the people, they work for the big insurance mafia!

    September 9, 2009 at 10:28 am |
  21. Stanley

    For some strange reason, when Obama goes live, people listen. I believe he's going to do well tonight, even when the polls suggest otherwise.

    September 9, 2009 at 10:26 am |
  22. lf

    Hope this gentleman does not wind up as a duplicate of Mr. Carter's style of running the Oval Office. Micro-Manager can't do it all. It is too much for one person with this gigantic responsibility. He appears to be a 'NASCAR driver' attempting to win the race in everything and every time.

    You can't win all the races all the times, but you might get a few things done of higher priority. Healthcare may not wind up being one of them, at least for now in the present form.

    September 9, 2009 at 10:25 am |
  23. rk

    David, thank you for your commentary. You are one of the few commentators I truly respect. I am, however, feeling very sad at the extreme right's agenda – which is simply to poison. They have successfully brainwashed the masses – who are ignorant and unable to review facts and think for themselves. People like Sarah Palin, Glenn Beck, Shawn Hannity, Laura Ingram, Jim Greer etc. should be ashamed of themselves because they know exactly what they are doing. And frankly, I am also concerned that the media such as Fox News and CNN is providing them a forum for spreading their ugly and poisonous agenda which is dividing and destroying our great country. CNN is fully responsible for giving Jim Greer the center stage the other night and letting him present a healthy and wholesome event of the President speaking to schoolchildren as an evil and devious plot. And there are thousands of ignorant people who readily buy into that type of ugly propaganda. It is very sad.

    September 9, 2009 at 10:16 am |
  24. Carlos Diaz

    It's going to be the same Obama speach as always. He's going to say what everyone wants to here. He's going to say abortion wont be covered, assisted suicide wont be covered, and he theoretically wont be lying, too bad there wont be any mention of the loop holes that would allow them to be publically funded anyways. Not to mention the Public option is a joke everything he says it will accomplish, can be done by allowing insurance companies to compete in all states. I really wouldent doubt if everyone eats up this so called change again. In his defense he is an incredible speaker. If you ask me he is the second comming of John F. Kennedy but this time we have no Bobby to save us!

    September 9, 2009 at 10:12 am |
  25. RO

    THE AMA is supporting Obama's health care reform! WE NEED THE CHANGE!! Since Truman, presidents have been trying to change health care reform..What is wrong with going for something that will provide better care, no penalities for "existing conditions", and so forth? IF you are happy with your existing insurance, you still can keep it. We need competitions. Those of you who scream "socialism"... what do you think insurance companies are doing? They have control of YOU already. They, not the doctors, dictate what they will cover or not.. Please BE informed before speaking out.

    September 9, 2009 at 10:09 am |
  26. Manny Mota

    I'm so glad that this president was inept. Sending out congressmen to face voters in "town hall" meetings was a blunder that thankfully made congressmen think about their political futures if they voted for such a bill.

    I doubt if Obama can sway the very public who's already vocally against congressional control over the health care system. He's not as slick a salesman as he thinks he is...

    September 9, 2009 at 10:02 am |
  27. tidho

    If he does what the media is predicting this is going to blow up in his face.
    Trying to sell the false choice of 'public option is the way and those opposed want the status quo' will fail. The opposition wants change too, just not the change he's selling.
    He campaigned on common sense solutions and now he's selling a progressive agenda. Its not hard to see why his aproval numbers fell.

    September 9, 2009 at 10:02 am |
  28. John

    Well i think health care is messed up. I also have family members who have basically smoked and drank their way into poor medical conditions and have never really worked to pay for their own way thru life. I think everyone deserves good health care but i also do not want the care i receive to be degraded to pay for better care for illegals or people who do not care for their-selves. Doctors and hospitals think giving you a pill saves you when what you need is to push away from the biggie size. I have a hard time believing the same goverment who can not control medicare can control the costs of medical care for everyone else. I believe that once you prove you can do something you get more responsibility not that you have so far failed but now we will give you more. Seems irresponsible for us tax-payers to look at it any other way.

    September 9, 2009 at 9:57 am |
  29. MDLiberal

    Is this entertainment or what!

    Reminds me of the weekly crises on General Hospital in the old days. Remember the crisis/ point of resolution background music just before the ads?

    The crisis has shifted from the economy to GITMO to Iraq/ Afghanistan to a healthcare crisis to a Democratic party survival crisis. Whoa. Next crisis will be cap & trade and saving the planet after it rains in TOGO.

    Poor Sarah, she missed the first step to the "panels" was already tucked in the stimulus. Puleeze... That said, she makes a few good points. So does the Prez when he dumps the ultra -left. I am more of a liberal than BO is, and have been at it longer. But this radical leftist crap from Jarrett, Jones, Pelosi, and the caucuses (CBC, Progressives, etc), seem to have strayed so far from pragmatic, nothing important will get done. BO has lost the trust of those of us that listened in 2008.

    VERY SAD. I WANT MY VOTE BACK.... Hillary would have done better, Michell has more character (although she is also too far left for even me). I know many New England liberals in both parties. They are not spending any more on bad execution....

    September 9, 2009 at 9:41 am |
  30. Trylon

    Well – – – I hope this time they get the correct speech into the teleprompter. In September 1993, when President Clinton faced the same situation in his speech to Congress about desired health care reform, the wrong diskette was inserted into the computer. Bill Clinton winged it for seven minutes while George Stephanopoulos got the problem fixed.

    Having lived 33 years in Canada, this present concept of a "public option" appalls me. Discounted insurance premiums in response to a means test? Nationalize the entire insurance industry.

    September 9, 2009 at 9:35 am |
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