Obama May Need Sense of Crisis to Revive Health-Care Overhaul

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By Julianna Goldman and Nicholas Johnston

Sept. 4 (Bloomberg) -- President Barack Obama returns to Washington next week in search of one thing that can revive his health-care overhaul: a sense of crisis.

Facing polls showing a drop in his approval, diminished support from independents, factions within his Democratic Party and a united Republican opposition, Obama must recapture the sense of urgency that led to passage of the economic rescue package in February, analysts said.

“At the moment, except for the people without insurance, we’re not in a health-care crisis,” said Stephen Wayne, a professor of government at Georgetown University in Washington. “You do need a crisis to generate movement in Congress and to help build a consensus.”

Obama speaks to labor leaders on Sept. 7 and to a joint session of Congress on Sept. 9 as he attempts to rebuild support for his top domestic priority, one that affects 17 percent of the economy. Lawmakers, trying to extend coverage to millions of uninsured Americans and rein in costs, are considering mandates on employers to provide coverage, new rules for insurers, and creating a government program to compete with private insurers such as Indianapolis-based WellPoint Inc.

Obama Chief of Staff Rahm Emanuel said the administration made unprecedented health-care progress in eight months.

‘Not There Yet’

“We gave Congress a charge, we gave them broad outlines, which is the reason we are farther along than any of the five presidents that have tried,” Emanuel said in an interview yesterday. “We’re not there yet, and this speech is intended to finish the job.”

Presidential speeches historically do little to move public opinion significantly, said George Edwards, author of “The Strategic President: Persuasion and Opportunity in Presidential Leadership.”

“This is almost like a Hail Mary, because they know that they’re substantially behind and the trajectory is negative for them,” Edwards said.

Unlike the financial crisis he inherited, the health-care debate is of Obama’s making and places a different burden on him, Edwards said.

“The best thing in presidential leadership is to recognize and exploit opportunities,” said Edwards. “The White House overestimated the nature of the opportunity.”

Stimulus Debate

Obama’s economic stimulus was debated as the Dow Jones Industrial Average dropped 18 percent from Nov. 4, 2008, to Feb. 13, when Congress approved the legislation. Unemployment had risen to more than 7 percent.

On the stimulus, Obama was able to say “that unless we do X right now, and X is pretty painful and pretty expensive, there is a serious danger in the next few weeks that the entire financial system will come crashing down,” said Bill Galston, a former official in President Bill Clinton’s administration, now a Brookings Institution scholar in Washington.

Emanuel remarked at the time that a crisis was a terrible thing to waste, and Obama pushed for health-care overhaul and energy legislation along with financial and auto bailouts.

He has framed health-care legislation as part of his long- term strategy to improve the economy. Republicans focused on the potential impact on patients. Throughout the summer and in town halls, Republican opponents said Obama wanted a government takeover of the system and creation of panels to decide end-of- life issues.

Democratic Critics

Within the Democratic Party, critics say Obama hasn’t pushed universal health care and others say the overhaul would balloon the federal deficit.

Obama “has said about this issue continually, if it was easy it would have been done by now,” said White House Communications Director Anita Dunn.

Obama’s difficulty on health care is compounded by broader economic worries. While 36 percent of Americans say the economy is getting better, only 10 percent see improvements in their households, according to a CBS poll at the end of August.

“People are not convinced the president’s strategy has helped their family during the economic downturn,” said Robert Blendon, a health-policy pollster at Harvard University in Cambridge, Massachusetts. “That has forced them to be more skeptical towards the president’s health-care proposals.”

Less than a fifth of Americans say a health-care overhaul will help them personally, compared to 31 percent who think the government’s efforts will hurt, and 46 percent who say it will have no effect, the CBS poll showed.

‘Not a Crisis’

“There is a problem in our health-care system today, and we need reform; it’s not a crisis,” said Ed Gillespie, White House counselor to President George W. Bush. “It’s just people saying this is way too much, way too fast, we don’t know where this money is going and we don’t know where it’s coming from.”

The CBS survey of 1,097 Americans Aug. 27-31 found Obama’s approval fell 12 percentage points from a high of 68 percent in April to 56 percent; the error margin is 3 percentage points.

A survey of 4,518 likely voters by Zogby International Aug. 28-31 put Obama’s approval rating at a record-low 42 percent; it also showed he’s well liked.

“He’s got to get control of his presidency,” said John Zogby, president of Zogby International. “There’s a way out of this. Some of it is going to have to be his personality and his ability to frame messages, which is still good.”

To contact the reporters on this story: Julianna Goldman in Washington at jgoldman6@bloomberg.net; Nicholas Johnston in Washington at njohnston3@bloomberg.net

Last Updated: September 4, 2009 00:00 EDT