Obama's big speech: Advice and history

As President Obama prepares for his big health care speech tonight, major players from the last health care debate offer him advice. Obama also has earlier health care experiences of his own to draw from.

Former House speaker Newt Gingrich, a formidable opponent for former President Bill Clinton 16 years ago, offered Obama some "free advice" on NPR. Gingrich now "offers paid advice to the [health care] industry" as a consultant. He argues against a comprehensive bill: "I don't believe it's intellectually possible to take 18 percent of the economy, of the largest economy in the world — life and death for every individual — and, in one sweeping bill, change all of it." Instead, he recommends Obama "take five to seven smaller bills, take one on litigation reform to lower the cost of defensive medicine and to save billions of dollars; take one on fixing Medicare and Medicaid so we are not paying billions to crooks who are not delivering services; have one on prevention and wellness; have one on better practices." He also reminds Obama that "a really good speech gives him about three days. It literally took about four days for the Clinton joint session address to disappear, because people said no. ... [T]hey said nice speech; really well delivered; articulate guy. And then he said, 'What do you think about the policy?' They said, 'No. We're against it'" (9/9).

In a separate NPR story, Dee Dee Myers, White House press secretary under President Clinton, offers her own advice. Obama needs to give more direction to Congress, she says, and "define what's victory, which may be defining down from his original goals." Myers adds that the Obama administration "overlearned some lessons" from the Clinton experience, such as letting Congress write the health care bill without "forceful leadership" from the president. At some point, she says, "you have to stop the debate, make a decision and act, and I think we're getting very close to that point. Not that the president is going to lay out all the details of a bill in his speech, but that he has to start to narrow down the set of options, he has to start to give Congress some clearer direction. It's easier to defend a bill when you know what's in it" (9/9). 

The Associated Press tracks the progress of the debate so far, identifying "several crucial moments and decisions that brought the health care saga to this point." Obama's "first big blow" was Congressional Budget Office director Douglas Elmendorf's July report that "the legislation significantly expands the federal responsibility for health care costs." AP also lists the decision "to give six senators from small states, the so-called Gang of Six, the time and prominence to fashion a bipartisan bill on overhauling the health care system" (Babington, 9/9).

The Washington Post charts Obama's health care history in the Illinois Senate. "The 2004 fight for the Health Care Justice Act in Illinois tested not only his skills as a legislator and community organizer, but his powers of persuasion as well. It was, in a sense, a practice run for this year's health-care campaign" (Shear and Connolly, 9/9). The Post also provides a summary of Obama's health care experiences in the Illinois statehouse, on the campaign trail and in the White House (9/9).