Obama aims to take control of health care debate

[September 03, 2009]  WASHINGTON (AP) -- Hoping to salvage his politically endangered health care overhaul, President Barack Obama will give a State of the Union-style address featuring fresh and more detailed arguments for revamping the system.

Scheduling of the speech for Wednesday, just a day after lawmakers return from their August recess, underscores the determination of the White House to confront critics of Obama's overhaul proposals and to buck up supporters who have been thrown on the defensive. Allies have been urging the president to be more specific about his plans and to take a greater role in the debate, and aides have signaled he will do that in the address to a joint session of Congress in the House chamber.

The speech's timing also suggests that top Democrats have all but given up hope for a bipartisan breakthrough by Senate Finance Committee negotiators. The White House had given those six lawmakers until Sept. 15 to draft a plan, but next week's speech comes well ahead of that deadline.

It follows an August recess in which critics of Obama's health proposals dominated many public forums. Approval ratings for Obama, and for his health care proposals, dropped during the month.

White House senior adviser David Axelrod told reporters Wednesday, "We believe this is the best way to kick off the final discussions, the final debate, and bring this thing to a close in a way that is meaningful."

Listeners to Obama's address will have "a clear sense of what he proposes and what health care reform is not," Axelrod said. He declined to offer details of what the president might discuss.

Axelrod said earlier that all the key ideas for revising health care are "on the table," suggesting Obama will not offer major new proposals.

But he may talk more specifically about his top priorities, and perhaps add details to pending plans, to save a high-profile initiative whose defeat would deliver a huge blow to his young presidency.

Many advocates of sweeping health care changes -- which would include health coverage for virtually every American, greater competition among insurers and incentives to increase the quality of care instead of the number of medical procedures performed -- welcomed the president's more direct role. Obama and congressional Democrats clearly lost momentum during the August recess, they say, and the president's high profile and still-considerable personal popularity are needed to change the dynamic.

"He's got to get into the nitty-gritty and embrace very concrete proposals," said Ralph Neas, head of the National Coalition on Health Care.

It's far from clear that Obama's speech will satisfy grumbling liberals. For instance, he consistently has refused to insist on a government-run program to compete with private health insurers, a top goal of liberals, even though he says he prefers such an option.

Axelrod called the public option important, but stopped short of saying it was essential to a final bill.

Several lawmakers say Obama must convincingly show that he can reduce the cost of pending health care plans. Nonpartisan budget officials have said Obama's proposals could increase the federal deficit by about $1 trillion over the next decade.

In one measure of the intense opposition Obama and his allies faced this summer, opponents of the Democratic effort outspent supporters on television commercials in August for the first time this year, according to a company that monitors political advertising.

Foes of the Democratic drive spent $12.1 million last month, compared with $9.1 million for backers of the effort, according to Evan Tracey, president of the Campaign Media Analysis Group in Arlington, Va. The U.S. Chamber of Commerce and several conservative groups were the biggest advertisers against the health care overhaul, while the drug industry, labor and AARP spent the most on the effort's behalf.

[Associated Press; By CHARLES BABINGTON]

Associated Press writers Alan Fram and Ben Feller in Washington, Mike Glover in Iowa, and Mead Gruver in Wyoming contributed to this report.

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