Health Insurance Reform?

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My cover story on health care reform in this week’s TIME focuses in part on this famously eloquent President’s frustration at his inability to come up with a message at a time when, as he acknowledges, public opinion is slipping away from him. (Also, be sure you don’t miss Kate Pickert’s excellent click-through guide of what health reform could mean to you.)

Charles Krauthammer today picks up on a recent change in the President’s choice of words, and says it marks the beginning of the end for comprehensive health care reform:

But that bill will look nothing like the massive reform Obama originally intended. The beginning of the retreat was signaled by Obama’s curious reference — made five times — to “health-insurance reform” during his July 22 news conference.

In my interview on Tuesday, I did get a chance to ask Obama about this new phrase, and (no surprise) he has a different explanation:

Well, I think partly because we’re just trying to provide some additional definition. Now, I do think that some of the insurance reform proposals are easier for people to understand. So if you just say insurance companies can’t block you from getting insurance because of a preexisting condition, people I think are familiar enough with those issues that it immediately resonates with them personally.

Some of these other issues, when it comes to the discussion we just had about delivery systems, get more complicated.

The phrase “health insurance reform” is indeed an effort to tailor his message to the concerns of people who have coverage–who are, after all, the vast majority in this country. But one challenge there is that these people–86% of them in our latest poll–are satisfied with what they have. And while you might think that in the middle of a recession, a lot of people would be concerned about losing that coverage, because it is something they get along with their jobs. Our poll found that only a surprisingly low (at least to me) 33% are.

Obama has been studying the same kind of numbers. He told me:

I will confess: I don’t spend a lot of time looking at my polls. I do look at the polling on health care, partly because I think that there is a terrific case to be made to the American public. But it is — this is complicated, it’s difficult. … And so when I see polls saying that it’s 50-50 and people are still worried about whether this is going to somehow increase their costs when every bill that’s out there would lower them, or that this is going to mean that they lose their doctors, or their health care is rationed, or, you know, all the other things that they’re worried about, it leads me to spend a lot of time thinking about how can I describe this in clearer terms so that we can get the health care that the American people deserve.

Can the President find his message? It’s something that bears watching, because in the end–as he himself knows better than anyone–that may tell us whether what we see at the end of this process is something truly transformative, or just another incremental step. As the President put it: “This has been the most difficult test for me so far in public life.”

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