Obama's Big Health Care Speech Won't Solve His Big Political Problem

As we await President Barack Obama's Big Speech on health care -- which he will deliver to a joint session of Congress on Wednesday -- let's flash back to this spring. Congress's approval ratings ranged from the high 20s to the high 30s. Obama was in the low 60s. On some days, his approval number was doubled that of Congress. (And that's true even now, though he has slid to the mid- to low-50s range.)

With all that in mind, here's the big question: Why did the White House allow its health care reform initiative to become the property of an entity much less popular than the president himself?

As Donna Trussell notes, figuring out health care reform -- what needs to be done, what should be in the legislation -- can be hard even for smart folks. Imagine how tough it is for people who aren't accustomed to reading policy papers. (What's a health insurance cooperative, anyway, and what exactly would it do? I still haven't seen a decent explanation.) Consequently, what is as important as the details of a health reform bill -- if not more crucial from a political vantage -- is who's selling it; that is, who's vouching for it. Obama basically handed this critical job to the leadership of Congress -- a body disapproved (rightly or wrongly) by a majority of Americans. Talk about bad branding.

Obama did indeed push for an overhaul of the health care system. He passionately and intelligently described the troubles of the system. He repeatedly outlined a set of principles that he wanted to see enacted. But ultimately he was like a trusted family doctor who tells you what's wrong but then sends you to a disreputable hospital for treatment. As others have noted, Obama lost control of the process and, thus, the issue. This led to health care reform becoming equated with (and defined by) the messy proceedings of Capitol Hill sausage-making.

It sure didn't have to be this way. Obama wasn't compelled to follow President Bill Clinton's failed footsteps by drafting specific legislation and then plopping it on Congress's doorstep. But Obama could have moved beyond stating principles to providing Congress a plan to start with, doing what he could to maintain the appearance that what was under construction was his plan, not that of the House Energy and Commerce Committee or the Senate Finance Committee. But this would have required him to lean on the House and Senate. Admittedly it's difficult for a fellow whose last job was a first-term junior senator to play Lyndon Johnson with his former colleagues.

With Obama toiling this holiday weekend on that special address, is it too late for him to take the helm? A bang-up speech could help. But it's unlikely to change the political dynamics on the Hill -- unless Obama near-miraculously generates an outpouring of grass-roots support that will cause conservative Democrats and the few moderate Republicans in the Senate to fear voting against reform.

Once the speech is over, Obama will still encounter the dilemma he presently faces: whom to tick off? If he tries to keep one or two Republican senators on board (Olympia Snowe of Maine, this means you!) through various compromises, such as jettisoning the public option (a government-run insurance plan of last resort for the uninsured), he will enrage dozens of liberal House Democrats who have vowed to vote against legislation that does not include a public plan. With House Republicans likely to say nyet to any legislation, Obama may need some of these House liberals to pass the measure.

Yet if he satisfies the progressives, he will have little chance of retaining Snowe or one or two other GOPers and lose the right to dub the package a bipartisan endeavor. But given the reluctance of some of the more conservative Dems in the Senate and Joe Lieberman the turncoat to back a bill with a public option, Obama could fall short of the votes needed to thwart a GOP filibuster. Can he thread the needle and keep House liberals and Senate moderates on the same bill? Or does he have to dump one group for the other?

A decent -- or even wonderful -- address to Congress will not get Obama out of this political bind. If it does return him to the driver's seat, he still will probably have to make a tough decision about which road to take and whom to leave behind.

You can follow my postings and media appearances via Twitter