What Obama needs to do in his address to Congress on health care

President Obama addresses a joint session of Congress in February 2009 (Pete Souza/White House)

It appears we’re about to start the endgame in regards to health care reform. I think President Obama’s address to both houses of Congress this coming Wednesday on health care will go a long way towards defining his effectiveness as a chief executive over the remainder of his term . There’s no question that after a string of early victories (the stimulus, S-CHIP, the Lilly Ledbetter Fair Pay Act), the president’s luck (and approval ratings) have started to turn, and not for the better. The August congressional recess was brutal for the White House, as conservatives aggressively attacked (and, in many cases, distorted) the Democrats proposed plans for health care reform and town hall meetings across the country turned into angry shouting matches.

So now it falls to the president to try to corral the wildly out of control debate with this speech and frankly, there’s probably nothing else left for the White House to do, so they’re going all in with the hopes that Obama, who has neatly threaded rhetorical needles before, can do it one more time. For this speech to work, the president is going to need to do, I think, three things:

1) He will need to let Americans know what he’s for. Obama’s team, trying to learn from Bill Clinton’s failure to pass health care back in the mid-1990s, decided to cede a lot of ground to Congress in constructing the bill. The Obama White House laid out broad guidelines and didn’t dictate specifics. At present, that might seem like the wrong move, but there were not a lot of other ways to do it. There are multiple, competing plans floating around in both houses, and, because of that, people are confused. Frankly, the White House hasn’t helped. For example, it continues to send mixed signals on the public option. But we’ve reached a point when it’s time for the poker player to show his hand. At this point, Obama’s choices seem to involve passionately defending the public option (which probably kills any remaining hope of a bipartisan bill), ditching the public option altogether (which might lead to a liberal revolt) or coming out with an as of yet unidentified alternative (which will probably please no one). Whatever he decides (my guess is that he’s going to support the public option and lay out its appeal as a cost-saving measure), he needs to make it crystal clear what he is supporting and why.

2) He will have to bring the discussion back to reality. The debate around health care has, as times, sounded like something out of dystopian science fiction (“death panels”) and people are scared by some of the things they’re hearing. Most of these things are grotesque distortions, but fear is a powerful motivator and it’s shifting people against the president’s reform plans. I suspect we’ll see the president’s professorial side make an appearance as he attempts to separate fact from fiction, but it will have to be carefully modulated; he can’t be too dry or emotionless, or he’s going to lose people, but, on the other hand, he can’t openly mock the absurdity of the claims, either. The setting is too august and the stakes are too high for humor, one of Obama’s favored rhetorical crutches, to be deployed. He will have to make an earnest effort to address people’s concerns on their face and use logic to show them that there’s nothing to fear.

3) He’s going to have to appeal to our better angels. After flailing around for awhile, the White House came up with a good applause line on health care: “No one in America should go broke because they get sick.” Most of us probably think that’s true to some extent or another. I think most of us also believe that you shouldn’t have to get a divorce to protect your assets in case a loved on gets sick nor should you be stuck in a crappy job just because you need health coverage. There are countless stories of how our current system has failed, and will continue to fail, to take care of people when they’re most in need. In short, Obama needs to make the (supposedly discredited) moral case for why we need to reform our health care system.

Now, that’s a simple list, isn’t it? Next Wednesday night is going to indeed be, must see TV.