Obama is Still Looking for a Healthcare Strategy

Obama’s Wednesday healthcare address seems likely to sound like his end of July press conference – healthcare horror stories, statistics, etc. Unsure of how to move the debate forward, the White House appears to have decided to do more of the same. Like President Clinton's address to Congress almost exactly 16 years ago, Obama will get a bump in the polls – and little more.

In a news article boldly titled “What Obama will say in his address,” Politico’s Mike Allen and Carrie Budoff Brown attempt to provide a preview of Wednesday’s big address. The article is a few days old – it was posted on Saturday – and the White House strategy has no doubt evolved since.  That said, as of early September, the Administration seems no more focused than they were in August.  That month, you will recall, was spent floating one trial balloon after another in an attempt to find a winning message – or at least a coherent message.

The Allen-Brown article shows a total lack of clarity of thought by the White House: the President will use the speech to reach out to Republicans but seek to comfort liberal Democrats; the President will be in favor of the public option but not unduly so; he’ll propose details but will not have a formal plan, let alone draft legislation.

Let’s be clear: the White House is in trouble.  It’s not just the President’s popularity that is sinking, but support for his very healthcare ideas.

What can he do on Wednesday?

There are only a few strategies the President can employ.

1. Think big but bipartisan.  Reaching out to Republicans would look good and ensure passage of something.  Several Republican-supported plans (like Wyden-Bennett) would, in fact, achieve major goals that the President has set (universal coverage).  The only problem here is that the White House has completely alienated the opposition; with sagging polling numbers, GOP leaders are busy contemplating big wins in 2010, not health reform.
2. Play for the home team.  He has vast majorities in the House and the Senate, but the coalition is fracturing, in part because liberal House Democrats are pushing an agenda that offends the fiscal sensibilities of Senate Democrats.  The President could help bridge the gap with sensible compromises: a public option, yes, but only if private insurance fails to cut costs, etc.  The President, though, would need to temper the ambitions of his liberal base – something he’s been loath to do so far in 2009.
3. Think small.  It seems unlikely that a major bill will pass this year.  Why not settle for incrementalism?  Charles Krauthammer proposes a focus on regulating health insurance – a popular idea that would help push American health care toward the ultimate Democratic goal of greater government involvement.  My colleague Paul Howard suggests a few other goals that could achieve passage without breaking the bank.  Would the White House, however, be willing to settle for so little this year?
4. Waffle.  Liberal Democrats are in no mood to compromise; the opposition appears emboldened after a month of town halls and protests.  Why weigh in now?  The President could simply restate his motherhood-and-apple-pie goals, throw in a handful of new if technical proposals for the morning newspapers, and wait.  With sagging polls, eventually Speaker Pelosi will think twice about her passionate support of a public option; Republicans and their allies have almost surely overreached.  Cooler heads will eventually prevail, but not now.  Again, though, one wonders if the White House has the discipline.

If I were advising the President, I’d go with option 4.  Yes, that’s right: the speech would be a dud, and designed to be so.  This issue is too hot, with views too polarized just now.

But, alas, he’s advised by others.  And it seems that they’re looking seriously at option 2.  Aides emphasized that Monday’s speech in Cincinnati would be a warm-up to Wednesday.  What did he say in Ohio?  “I continue to believe that a public option... will help improve quality and bring down costs,” he said, in remarks colored by slogans and one-liners.  Wednesday seems likely to sound like the end of July press conference – the healthcare horror stories, the statistics, etc. Unsure of how to move the debate forward, the White House appears to have decided to do more of the same.

Like President Clinton's address to the joint session of Congress almost exactly 16 years ago, President Obama will get a bump in the polls – and little more.

At which point, they’ll go back to the drawing board.  And the strategy for the remainder of the year?  I predict option 3.  And if they take that tact, it means I can happily stand by my long-standing prediction: 2009 will be the year of health reform – not big, sweeping stuff, but the President will still have his Rose Garden ceremony.