Obama fights back as bid to reform US healthcare stalls

• President's approval ratings plummet as Republican campaign threatens to inflict devastating political defeat
• Debate fuelled by Sarah Palin's remarks that new legislation would force her child to go before a 'death panel'

Paul Harris in New York
The Observer, Sunday 9 August 2009


Barack Obama speaks at a rally. Photograph: Jim Young/Reuters

President Barack Obama has become mired in a frenzied fight over US healthcare reform as Republicans scent a devastating political victory that could hobble his presidency.

Obama yesterday lashed out at critics of his ailing push to provide coverage for America's 46 million uninsured people by saying that his critics were resorting to "outlandish rumours" and "misleading information" to scupper his plans.

But Sarah Palin, the Republican's former vice-presidential candidate, raised the temperature in the debate by declaring Obama's plans "downright evil" and accusing him of introducing a care rationing system that could threaten her own mentally handicapped child.

"The America I know and love is not one in which my parents or my baby with Down's syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide… whether they are worthy of healthcare," she wrote on her Facebook page.

Palin's astonishing comments were an incendiary contribution to a national debate that is threatening to spill over into civil disorder. Scores of "town hall" public meetings held by Democratic politicians in recent days have been disrupted by Republican supporters or protesters linked to groups funded by the healthcare industry. Some meetings have been cancelled out of a fear of violence. In Missouri six people were arrested at one event. A group of supporters even hung an effigy of a Democratic congressman outside his office; another Democrat has received death threats.

The efforts have prompted Obama's own campaigning body, Organising for America, which grew out of his presidential campaign, to promise to turn up to public meetings to provide a voice in favour of reform. Several union groups have also vowed to follow suit. In a memo sent to union activists by John Sweeney, president of the AFL-CIO union group, he called on members to go to the meetings to oppose the Republicans.

The tactics of Republicans, conservative protest groups and healthcare lobbyist-linked organisations have been decried by many commentators. Though Republican leaders and other conservatives have claimed the protests are a genuine outburst of anti-healthcare reform feeling, there have been instances of activists being caught red-handed.

One woman who protested at a public meeting held by Wisconsin congressman Steve Kagen, a Democrat, had said she was "just a mom" but turned out to be a former senior Republican party official. "They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems," said Washington Post columnist Steven Pearlstein.

But the tactics have been a political success. Obama's hitherto matchless sense of political timing appears to have run into a wall when it comes to healthcare. He vowed to get new legislation passed by August. That failed, despite Congress being controlled by Democrats.

Obama also vowed to make a "public option" (a government-run public health insurance programme) part of any reform package. But that also looks increasingly unlikely. It has raised the prospect that Obama may eventually be defeated on healthcare in the same way Bill Clinton was in the early 1990s.

"If they defeat him, it's going to be bad. He is being outfoxed by a Republican party that should be outnumbered," said Shaun Bowler, professor of political science at the University of California.

Obama is suffering from the political impact. His popularity ratings have been on a steady downwards track ever since he began his massive push on healthcare. A recent Quinnipiac University poll showed his approval rating had fallen to just 50%, shaving seven points from his figures in June. A CNN poll also showed a steady decline, pegging his approval at 56%, which was seven points off his standing in April.

It is a far cry from his first 100 days in office when he soaked up press plaudits for broad-ranging reform of government and foreign policy. His second 100 days have seen harsh political realities intrude as he has become tied to the economic crisis and the fierce Republican-led backlash over healthcare.

"It is the first time he has seemed to be weak," said Bowler. "He has started to seem like any other president. The shine has come off."

Ironically, Obama's main problems lie with his own party and with his desire to reach consensus on the healthcare issue rather than to dictate a reform programme. He has insisted on Republican involvement in the drafting of new legislation. He has also paid heed to the "Blue Dog" group of Democratic politicians who represent conservative-leaning electorates and who have pushed aggressively for him to water down his healthcare proposals by, among other things, taking out the public option.

At the same time, as anti-lobbying watchdog groups have pointed out, money has been flowing to the group's members from the healthcare industry in the form of campaign contributions. Blue Dog Democrats have collected more money than any other congressional grouping this year, with more than half the cash coming from healthcare businesses or the insurance and financial services sector.

But perhaps the most surprising thing about the whole debate is that the appetite for health reform remains extremely popular with most Americans, even as Obama's poll numbers sink and the fight with Republicans and the healthcare industry grows uglier and uglier. One recent poll showed that 62% of Americans favoured a public option and 61% supported higher taxes on the wealthy in order to pay for it.



The path to reform


â–* Democrats have vowed to keep holding town hall meetings despite the many and vocal public disruptions. They have decided to mobilise Obama's own supporters and union activists to attend the meetings, which will go on through August.


â–* Republicans and groups linked to lobbyists for the healthcare industry will keep up the pressure on the airwaves and by turning up to Democrat meetings.

â–* Congress reconvenes on 8 September; healthcare legislation will be the top priority. Both Houses of Congress will try to draw up legislation, though it is almost certain to be watered downheavily watered down by Republicans and conservative Democrats.

â–* Obama will finally have to make a brutal decision: accept a diluted version of his plans, or abandon compromise and force through what he wants.

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