How Obama can get out of healthcare ditch

The White House has spent the past two days insisting that nothing has changed in its position on healthcare reform: President Obama still prefers to have a “public option” – that is, a government-run health-insurance plan that would compete with private insurers – in the package, despite indications that he’s willing to give that up.

But maybe it is, in fact, time for the White House to change tack on reform, political analysts say. One idea is for Mr. Obama to come out with his own healthcare legislation.

“The initial strategy of letting Congress put this together and work out details was good and smart – kind of the anti-Clinton strategy – but at some point, he needs to spell out that items A, B, and C must be in this, or else it’s not worth passing,” says Julian Zelizer, a political scientist at Princeton University in New Jersey.

“The silence that we’ve heard on that very important issue – what he’s for – is becoming more damaging as time goes on,” Professor Zelizer adds.

Sixteen years ago, when President Clinton tried to enact comprehensive health reform, he presented a large, detailed bill to Congress and wound up with nothing. This time around, congressional committees have been central in negotiating and crafting different versions of reform. To be sure, the White House has been active behind the scenes, and it has gleaned important intelligence about what will and will not fly with each house of Congress and the public.

But at a certain point, only the president has the clout – and the megaphone – to drive the process home. One issue is whether the preternaturally cool Obama can channel a bit of President Johnson, who famously charmed and threatened Congress on his way to the creation of Medicare in 1965.

Even if Obama can’t become LBJ, “I do think he could take a couple of pages out of his book,” says Democratic media strategist Peter Fenn. “He’s got to be less Mr. Nice Guy and a little bit more Mr. Tough Guy.”

And that includes drawing a line in the sand over what he wants in the legislation. The result may be that he winds up with nothing, but that’s a risk he has to take, Mr. Fenn says.

With different versions of healthcare reform legislation in the works, opponents of reform have been handed a big, vague target to shoot at. And because the public isn’t clear on what exactly the president stands for, opponents have been allowed to frame the debate. Suddenly, the Democrats were for the creation of “death panels” that would force senior citizens to justify their continued existence, at least according to some reform opponents.

For months, the working assumption has been that Obama had to pass something, anything, even if it ended up looking like tinkering on the edges. The new president had expended so much political capital on reform, failure appeared not to be an option. Now, some Democrats, such as Howard Dean, former chairman of the Democratic National Committee, are suggesting that failure could be an option, in favor of waiting until next year.

Until recently, the conventional wisdom was that reform had to happen in 2009, because 2010 would be dominated by the politics of the midterm elections. Now, there’s some thought that waiting until next year might be preferable, assuming the economy continues to recover and the public is feeling less vulnerable.

There could also be political advantage for Democrats in allowing Republicans to kill this year’s effort at reform, says Democratic strategist James Carville.

“Put a bill out there, make them filibuster it, make them be what they are, the party of no,” Mr. Carville said Sunday on CNN’s “State of the Union.” “Let them kill it. Let them kill it with interest-group money, then run against them. That’s what we ought to do.”