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Julian E. Zelizer: Obama has to speak up for health care reform

[Julian E. Zelizer is a professor of history and public affairs at Princeton University and author of the forthcoming, “Arsenal of Democracy: The Politics of National Security From World War II to the War on Terrorism.”]

Presidents need to accomplish two goals when pushing for major legislation: explain their vision and resolve the details. President Obama has been surprisingly reticent about explaining his vision for health care reform. To avoid President Clinton’s fate in 1994, when Congress killed health care as opponents framed the legislation as big government liberalism, President Obama has allowed Congress to work out the details of the legislation.

The problem is that he has neglected to keep working on the message. As Congress deliberates, reports inevitably emerged about the potential costs of the program and the limitations of the expected impact. Opponents of reform have steadily gained ground by warning of a government takeover. Support for reform has diminished. A coalition of centrist Democrats and Republicans are pushing legislation that falls far short of President Obama’s promise.

Obama must now sell a vision for health care where the government plays a larger role.

During the most successful struggle for health care reform — the passage of Medicare and Medicaid — Presidents Kennedy and Johnson were never shy in talking to the public about what they hoped to accomplish. Between 1961 and 1965, Kennedy and then Johnson took a two-pronged approach. On the one hand, like Obama, they allowed Congress to work out the details of the legislation.

At the same time, however, both of these presidents delivered speeches about what health care reform could accomplish. This was an era when liberals were comfortable talking to Americans about why government worked. At a rally at Madison Square Garden in May 1962, Kennedy rebutted every argument of his opponents and said, “This bill serves the public interest. It involves the Government because it involves the public welfare. The Constitution of the United States did not make the President or the Congress powerless. It gave them definite responsibilities to advance the general welfare, and that is what we are attempting to do.”

In January 1965, Johnson told Congress that “Thirty years ago, the American people made a basic decision that the later years of life should not be years of despondency and drift. The result was enactment of our Social Security program, a program now fixed as a valued part of our national life. Since World War II, there has been increasing awareness of the fact that the full value of Social Security would not be realized unless provision were made to deal with the problem of costs of illnesses among our older citizens. I believe this year is the year when, with the sure knowledge of public support, the Congress should enact a hospital insurance program for the aged.”

By the spring of 1965, following the 1964 Democratic landslide, public opinion was firmly on their side. Congress passed a bill.

Unfortunately for Mr. Obama, his news conference last week got bogged down by his “stupidly” comment about the Cambridge police. Congress will vote on a health care bill in September. That means that the battle to define this legislation will take place in August.

If President Obama wants to regain momentum for the type of reform he promised, he must now sell a vision for health care where the government plays a larger role. The tenor of his remarks in North Carolina on Wednesday suggests that he’s gotten the message about what he needs to do.


Read entire article at NYT blog: Room for Debate