Obama faces crucial TV test of health plan

Published on Sunday 6 September 2009 22:12

US PRESIDENT Barack Obama faces the biggest speech of his term so far this week when he goes on prime-time TV before Congress to urge it to save his ailing health care reform plan.

Having invested huge sums of political capital in pushing the plan, he faces seeing his grand election promise of "Change" rendered meaningless if it fails.

Despite having Democratic control of both houses of Congress, his ambitious plan to replace private-payer health insurance with government-run plans has so far foundered.

An August deadline for passing a bill came and went with disagreement among Democrats and massive opposition from Republicans, insurance companies, hospitals and drug companies. Many think the plan is now doomed.

For Democrats, the quagmire is eerily familiar. Sixteen years ago this month Hillary Clinton tried and failed with a similar health care reform proposal, leaving her husband's presidency permanently weakened.

Commentators say Mr Obama needs to tighten the focus on a multi-faceted plan that has become bogged down in rancourous debate. "What the president needs to do is clarify what he means," said NBC's Tom Brokaw. "The White House overstepped at the beginning by not having a clear simple plan."

Hoping to learn from the Clinton experience, Mr Obama tried to do it differently. Rather than craft a plan and ram it down the throat of Congress, he left Congress to craft the details. But so far the result has been the same: no agreement and a welter of argument.

He has failed also to co-opt Republicans. Aside from their reservations about a government-run health system, party leaders know that if Democrats fail, despite a once-in-a-generation control of White House and Congress, they will lose credibility among voters.

Republicans insist they too support reform, but worry that the existing plans will push costs up, not down. "The biggest mistake the president has made is he has not put a reasonable cost-saving proposal on the table," said former Republican presidential candidate and former New York mayor Rudy Guiliani.

The big unknown for Wednesday night is whether Obama will stick to his guns, or whether he will buckle, offering a watered-down plan. So far, the White House is giving nothing away.

But plenty of Americans are hurting. "We pay double what the British pay for health care and get the same or worse service," said New York gallery director Izabela Grocholski.

The key problem in Congress is a split among Democrats over where the emphasis of reform should be: the left of the party wants it to be on getting those already paying insurance to subsidise the 47 million who are uninsured. A more conservative wing wants the emphasis to be on cutting costs for those who already pay insurance.