President Obama didn't wear a bike helmet on vacation, but maybe he should when he returns to work next week. He'll need it to protect himself from the hail of incoming advice about how he should handle the health-care-reform fight. He's being told to be less liberal, change his message, stay on course, get more emotional, and (by everyone) to get more hands-on.
The president will get more involved, aides promise. He will get more specific about what he wants and build a coalition in Congress around those ideas. Then, he'll have to convince the public and hope that specificity will improve his connection with the American people. Until now, despite his constant effort to sell health care reform, the public-opinion numbers have been moving against him. In a just-released CBS poll, 40 percent approve of his handling of the health care issue, down seven points from a month ago. A plurality of Americans (47 percent) disapprove.
How did things get so low? If the president is going to make a new and successful pitch, knowing where he went wrong might help him keep from making the same mistake in the future.
A lot of smart analysts are saying that one of Obama's big mistakes—perhaps his biggest mistake—is that he talked too much about lowering health care costs as a way to shrink the budget deficit. (Slate's own Mickey Kaus has been arguing this for months.) Because the president was fixated on accounting, goes this argument, he didn't address the issue of security—people's worries that they'd lose coverage or their job or face financial ruin because of the broken system.
Is this right? Obama's budget director talked about the deficit, naturally (it's his job), and Obama has said regularly that the key to reducing the deficit is controlling health care costs, but looking back over the president's speeches, meetings, town halls and forums on health care, you discover there was something else he always talked about first and more extensively when it came to health care costs: personal security. Here is a typical comment from a town hall in Green Bay, Wis., in early June:
Every day in this country, more and more Americans are forced to worry about not just getting well, but whether they can afford to get well. Millions more wonder if they can afford the routine care necessary to stay well. Even for those who have health insurance, rising premiums are straining family budgets to the breaking point—premiums that have doubled over the last nine years, and have grown at a rate three times faster than wages. Let me repeat that: Health care premiums have gone up three times faster than wages have gone up. So desperately needed procedures and treatments are put off because the price is too high. And all it takes is a single illness to wipe out a lifetime of savings.