Obama healthcare speech: What he needs to accomplish

After all the speeches and town hall meetings and press conferences and interviews, President Obama may appear to have exhausted his use of the bully pulpit on healthcare reform.

But by delivering a rare speech to a joint session of Congress on Wednesday night, Mr. Obama is demonstrating that he believes he can still shape debate – and public views.

Analysts expect Professor Obama to show up, the explainer-in-chief, not the fiery Candidate Obama who wowed the AFL-CIO picnic on Monday with his appeal to organized labor to help him enact health reform. The well of the House, after all, demands dignity, not rolled-up shirtsleeves.

But Obama knows he has lost momentum, and is fighting to get it back. In an interview with ABC-TV that aired Wednesday morning, he acknowledged that he has “probably left too much ambiguity out there, which allowed opponents to come in and fill up the airwaves with too much nonsense.”

Obama promised clarity in the speech, which begins at 8 p.m. Eastern time and will be shown on most major networks. “There are some principles that, if they are not embodied in the bill, I will not sign it,” he told ABC’s Robin Roberts.

Addressing the public option

Asked for an example, he replied that the legislation must be paid for. Notably, he did not cite the controversial “public option” – the proposal for a new government-run insurance program meant to compete with private insurers – as an essential element.

White House aides have said that he will back the public option in his speech, but not threaten a veto if it’s not in the final bill. That’s a signal that the final version is likely not to contain the public option, and that Obama is trying to let down liberals gently. Conservatives and some moderates object to the public option, saying it could drive private insurers out of business and create a government monopoly.

Progressive groups have made inclusion of a public option a cause célèbre, but key senators believe that element cannot pass their chamber. Sen. Max Baucus (D) of Montana, chairman of the Senate Finance Committee, said Wednesday that he would proceed with legislation that does not contain the public option, with or without Republican support. His full committee, the final of five in both chambers that are addressing health reform, will take up the bill the week of Sept. 21.

Rallying the troops

So what does Obama need to accomplish Wednesday night?

“He has got to explain, what is the problem with the current healthcare system that makes it unsustainable,” says Cal Jillson, a political scientist at Southern Methodist University in Dallas. “Then he’s got to provide a three-, four-, five-point program for addressing those difficulties. And it’s got to be memorable.”

Most Americans who have health insurance are satisfied with their coverage, polls have shown, and many are nervous that they’ll lose something if the system changes.

Obama also needs to rally his troops, says George Edwards III, a presidential scholar at Texas A&M University in College Station.

“He has to preach to the choir,” he says, referring to the Democrats on Capitol Hill. “The White House would be shocked if they got three Republican votes in the Senate…. They’ve got to buck up those inclined to support the president, which are the Democrats.”

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