Will Obama's Health Care Address Work?

Posted in The Gnovis Blog

Make no mistake: after a contentious summer, President Obama’s upcoming address on health care reform to a joint session of congress is a critical moment for his presidency. The question on everyone’s mind is whether or not the speech will be enough to reenergize, reframe, and restart the health care debate in a way more favorable to the White House. Will it work? To put it in a rather Clintonian way, it may depend on what the definition of “work” is.

The “Bully Pulpit”

Outside of the inaugural speech or the state of union address, in contemporary politics, presidential speeches before joint-sessions of congress are rare. Because of their exceptional nature, joint-session addresses are viewed by the polity, the public, and the news media as consequential. Some argue that these speeches are the loudest and most effective use of the President’s “Bully Pulpit.”

Presidential addresses of the kind planned for Wednesday typically garner larger mass media audiences than everyday political events. Traditionally, major networks (except for those watching on FOX, apparently) have shuffled their programming to make room for the President in prime-time. With so many tuning in on television and, now, inevitably, the web, it is reasonable to assume that, barring a major gaffe or misstep, President Obama will succeed in reframing the health care debate by delivering his address. There is a precedent for this agenda setting success and its location may be surprising: the Clinton Administration’s reform efforts of the early nineties.

Healthcare Reform, 1993

President Obama’s speech occurs almost sixteen years to the day after Bill Clinton, another Democratic president who promised to reform the health care system in his presidential campaign, spoke to a joint-session of congress about the urgency of enacting sweeping health care reform:





In terms of refocusing the debate, Clinton’s speech was a tactical success. In the days following the speech, it really did seem as if there was a chance for substantive reform. Yet, as we know, health care reform died in the months, and subsequent years, that followed the address (for those who are interested, PBS has a helpful truncated timeline of nineties health care reform efforts here).

While the speech itself was widely praised, in the critical period of time that followed the speech, the administration lost control of the debate and opponents of reform were able to, according to George Mason University Public Policy Professor James Pfiffner, “label the health care plan as too large, too complex, too costly, and too much government.” While the legacy Clinton’s effort to achieve health care reform is one of failure, the legacy of Clinton’s address before the joint-session of Congress is one of a missed opportunity.

Learning From Clinton’s Legacy

Clinton’s experience teaches the obvious lesson that one speech alone, no matter how well-written or well-received, isn’t enough to achieve success for an endeavor as large and complex as health care reform. Yet, it also teaches that the “Bully Pulpit” can be a powerful agenda setting tactic in a broader communication and legislative strategy.

Whether or not the architects of the Obama administration will forcefully articulate this broader strategy on Wednesday night is an open question–although, today, administration aides are signaling that they may be headed in that direction.

Whatever becomes of the latest generation of Democratic efforts to achieve substantive health care reform, President Obama’s speech will achieve its purpose: it will work, momentarily at least, and redraw the battlelines of the debate to grounds more favorable for the administration and reformers. The question that can’t be answered with any certainty, however, is whether or not that will matter in sixteen years.