President Barack Obama hugs Debby Smith, 53, from Appalachia, Va., after she asks him about her health care during a town hall meeting at the Northern Virginia Community College in Annandale, Va., Wednesday, July 1, 2009.

Obama feels your pain on healthcare

With a major legislative battle looming, the president continues to sell his plan, this time on Facebook


Mike Madden
July 2, 2009 2:15PM (UTC)

The White House made a big deal out of the fact that anyone who wanted to could log on to Facebook Wednesday afternoon and watch President Obama's "virtual town hall" on healthcare reform, live from Annandale, Va. But when Virginia Gov. Tim Kaine -- whose gig on the side involves being one of Obama's top political surrogates as chairman of the Democratic Party -- showed up to speak, and the video stream went live, things went a little haywire.

The stream kept cutting in and out, and when it was working, it was way too fast. Kaine's remarks sounded as though they were being played at double speed; when White House domestic policy chief Valerie Jarrett stepped out to start moderating the event, she appeared to be race-walking to the podium. "Does it sound like it's on fast-forward for everyone else too?" one Facebook user asked, plaintively, in the chat box next to the video. "This feed makes Obama sounds like an autistic kangaroo," another one said.

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Eventually, though, the White House new-media gurus fixed the problem, and Obama dropped out of hyperspace and back into a normal speaking rhythm. What he had to say, though, wouldn't have come as news to anyone who watched his ABC News special last week, or his speech to the American Medical Association two weeks ago, or his town hall meeting in Green Bay a few days before that. Or, for that matter, anyone who has listened to anything the administration has been saying on healthcare reform this year. But such is the nature of pushing Congress to act on sweeping changes to massive sectors of the economy: You have to get a little repetitive. White House aides said the point of Wednesday's talk was to continue to make the case for what Obama says is his top domestic policy priority of the year. So he hammered away at his talking points, hoping to keep the pressure on lawmakers when they return to Washington from a Fourth of July break and pick up healthcare legislation again.

"The hardest part is yet to come, because everybody here knows that the easiest thing to do when you're looking at big policy questions like healthcare is just to be cynical," the president said. "'It can't be done.' And the naysayers are already starting to line up and finding every excuse and scare tactic in the book for why reform is not going to happen ... And what I say to these critics is, well, what's your alternative? Is your alternative just to stand pat and keep on watching more and more families lose their healthcare, more and more families with higher out-of-pocket costs for less insurance, businesses who are not able to compete internationally, a Medicare and a Medicaid system that has run amok?"

That may have been a bit of a straw man -- hardly anyone is defending the current system, with its hodgepodge of insurance companies, rapidly increasing premiums and more than 40 million Americans who lack coverage altogether. But the polls show fairly complicated attitudes about healthcare -- many people like the coverage they have but want the government to get more involved in improving it for the rest of the country. They're worried about costs, but think they get decent value for what they're paying. So Obama has been focusing his rhetoric on the problems that higher healthcare costs will pose for the nation as a whole; in his telling, it's an economic issue, not just a healthcare one.

"If we do not act to bring down costs, everybody's healthcare will be in jeopardy," Obama said. The White House wants Congress to force healthcare providers to pay for what works, not simply what's available, introducing evidence-based standards into a system that has, for decades, mostly paid doctors according to what tests and procedures they order.

As always, Obama handled questions from the audience with no trouble. The administration's message handlers know the president is his policies' own best salesman, which is why they keep putting him out to talk about healthcare, rather than leaving it up to lieutenants like Health and Human Services Secretary Kathleen Sebelius or budget wonk Peter Orszag. What was a little unclear during the event was how the questions were being selected. Obama hadn't gotten advance warning of any of them, aides insisted, but with comments and requests pouring in via Twitter, Facebook, e-mail and pre-submitted YouTube videos, the administration clearly had to use a heavy hand to cull them down. The hour-plus town hall had time for only seven questions -- two of which, in person, came from people who work for Health Care for America Now, an advocacy group that's pushing for reform, and the Service Employees International Union, another key Obama ally on the issue.

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It was the other audience question, though, that showed why the White House keeps coming back to the town hall format. Midway through the event, a woman named Debbie took the mic and said she'd "try not to cry" while talking. Eleven years ago, she'd had kidney cancer and didn't pursue the most aggressive treatment possible because she needed to care for her dying father. Now, her cancer is back, and because she's sick, she can't work. Without a job, she has no health insurance. She can't go on disability because kidney failure apparently doesn't qualify her for it. And now she just wonders "how I'm going to make it nine years" until she's old enough for regular Social Security retirement payments. Cue Obama. "Come on over here," he said, giving Debbie a hug. "First of all, we're going to find out what -- we'll get your information and we'll see what we can do to help you. I'm -- I don't want you to feel all like you're alone out there." And after the requisite sympathy, he pivoted back on message. "Debbie is a perfect example of somebody who we should, in a country this wealthy, be able to provide coverage for her healthcare problems," Obama said. "And, you know, what we don't want is a situation where Debbie gets worse and worse because she's not getting treatment and then ends up having to go to the emergency room. As I said before, all of you will pay for it anyway. It's just you'll pay for it in terms of a hidden subsidy, and she's not getting the best care, and we're actually paying more than we would have if Debbie right now was getting treated on a regular basis by a physician who knew her history. So, Debbie, you are Exhibit A."

Did the moment seem a little staged? Maybe. But it was also a sign that the White House knows what it'll take to get reform into law this year -- and they're ready to fight for the cause. Expect more of the same until Congress gets moving.


Mike Madden

Mike Madden is Salon's Washington correspondent. A complete listing of his articles is here. Follow him on Twitter here.

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