There is no more classic use of the Bully Pulpit than a President trying to promote a controversial policy agenda. Thus we have the President’s health care speech in Shaker Heights Ohio, the day after his prime-time network news conference on the same topic.
Once again the President proves himself a master of the rhetorical arts. But rhetoric and policy are not the same thing.
He begins his speech by recognizing the Governor, the State Treasurer, Secretary of State, all members of his party, as well as the Mayor, and even the school superintendent. This is a time-honored tradition. A friendly mention by the President, especially less than a year after first taking up residence in the White House, can do wonders for the public approval rating of a local politician.
But in terms of speech craft, it serves a far larger purpose. Mentioning the home town political figures helps the President establish a shared identity with the audience. “I know the local folks just as well as you do,” it seems to say.
Establishing a shared identity, creating a common ground with the listener, is one of the most essential elements in effective speech writing. It is effectively done here.
Then it’s on to policy. But it begins with economic policy. “And when my administration came into office, we were facing the worst economy since the Great Depression.”
This is a bit of overreach, in terms of economic history. But no one will stand up and dispute this assertion.
It is also another classic technique. Because this is a relatively new administration, this is, by inference, an indictment of the previous one.
He takes credit for a two-year Recovery Act - then goes on to recite a litany of the administration’s other priorities - this includes transforming education from “cradle to college” - an interesting turn of phrase.
At that point, the speech transitions to health insurance and the larger question of health care.
A number of promises for the health care program are made - including coverage for pre-existing conditions, a marketplace where insurance companies will compete to cover you, nearly everyone is covered, and a promise is made that the federal deficit will not be increased to fund the program.
“I won't sign it if that reform adds even one dime to our deficit over the next decade -- and I mean what I say.”
Considering some of the cost estimates for the proposed program, this statement has something of a “Read my lips- no new taxes,” feel about it.
Along those lines - he also attacks the other party for opposing the program he has proposed. “You know, the Republican -- the Republican Party chair, seeking to stall our efforts, recently went so far as to say that health insurance reform was happening “too soon.”” This is another tried and true political technique - first, blame your predecessor, which happened earlier in the speech, then blame the other party.
Part of the problem here is that as much of the opposition has come from members of his own party, as from the other party. The President originally demanded that Congress vote on his Health Care program by early August. By the time of this speech, the day after a nationally televised press conference on the topic, he had already adjusted his sights to “I want it done by the end of this year.”
Reading this speech, it’s hard not to ask the question: Might this speech, with its ringing generalities, promises that sound to good to be true, and broad overreach, be a metaphor for the fate of the program?
In the end it is the persuasive power of the words which issue from the Bully Pulpit that determine its success. Words alone may not be sufficient to overcome the force of opposition to the policy those words are designed to enact.
THE PRESIDENT: Hello, everybody. Thank you. Thank you. Thank, please, everybody have a seat. Thank you. Hello! Hello, Shaker Heights! Hello, Ohio! It is great to be here. There are a couple of quick acknowledgments I want to make. First of all, please give Rick a big round of applause for his introduction.
Some special guests that we've got. First of all, the governor of the great state of Ohio, Ted Strickland, is in the house. There he is right there. Your State Treasurer Kevin Boyce is here. Your Secretary of State Jennifer Brunner is here. The mayor of the great city of Cleveland, Frank Jackson, is here. Shaker Heights Mayor Earl Leiken is here. The Shaker Heights school superintendent Mark Freeman is here.
Not here, but a couple of my favorite people: Congresswoman Marcia Fudge and Sherrod Brown couldn't be here today. They've got work to do in Washington.
It is good to be back in the great state of Ohio. Now, I know there are those who like to report on the back-and-forth in Washington. But my only concern is the people who sent us to Washington -- the families feeling the pain of this recession; the folks I've met across this country who have lost jobs and savings and health insurance but haven't lost hope; the citizens who defied the cynics and the skeptics -- who went to the polls to demand real and lasting change. Change was the cause of my campaign; it is the cause of my presidency.
And when my administration came into office, we were facing the worst economy since the Great Depression. We were losing an average of 700,000 jobs per month. Hundreds of thousands of Ohioans have felt that pain firsthand. Our financial system was on the verge of collapse, meaning families and small businesses couldn't get the credit they need. And experts were warning that there was a serious chance that our economy could slip into a depression. But because of the action we took in those first weeks, we've been able to pull our economy back from the brink.
Now that the most immediate danger has passed, there are some who question those steps. So let me report to you exactly what we've done.
We passed a two-year Recovery Act that meant an immediate tax cut for 95 percent of Americans and small businesses -- 95 percent. It extended unemployment insurance and health coverage for those who lost their jobs in this recession. It provided emergency assistance to states like Ohio to prevent even deeper layoffs of police officers and firefighters and teachers and other essential personnel. At the same time, we took needed steps to keep the banking system from collapsing, to get credit flowing again, and to help responsible homeowners -- hurt by falling home prices -- to stay in their homes.
In the second phase, we're now investing in projects to repair and upgrade roads and bridges, ports and water systems -- and in schools and clean energy initiatives throughout Ohio and all across the country. These are projects that are creating good jobs and bring lasting improvements to our communities and our country.
There's no doubt that the steps we've taken have helped stave off a much deeper disaster and even greater job loss. They've saved and helped create jobs and have begun to put the brakes on this devastating recession. But I know that for the millions of Americans who are looking for work, and for those who are struggling in this economy, full recovery can't come soon enough.
I hear from you at town hall meetings like this. I read your letters. The stories I hear are the first thing that I think about in the morning; they're the last thing I think about at night. They're the focus of my attention every waking minute of every day. The simple truth is that it took years to get into this mess, and it will take more than a few months to dig our way out of it. But I want to promise you this, Ohio, we will get there -- and we are doing everything in our power to get our people back to work.
We also have to do more than just rescue this economy from recession; we need to address the fundamental problems that allowed this crisis to happen in the first place. Otherwise, we'd be guilty of the same short-term thinking that got us into this mess. That's what Washington has done for decades. We put things off. And that's what we have to change.
Now is the time to rebuild this economy stronger than before. Strong enough to compete in the 21st century. Strong enough to avoid the waves of boom and bust that have time and time again unleashed a torrent of misfortune on middle-class families across the country. That's why we're building a new energy economy that will unleash the innovative potential of America's entrepreneurs -- and create millions of new jobs -- helping to end our dependence on foreign oil. We are -- we're transforming our education system, from cradle to college, so that this nation once again has the best-educated workforce on the planet. We are pursuing health insurance reform so that every American has access to quality, affordable health coverage.
I want to talk about health care just for a second. I want to be clear: Reform isn't just about the nearly 46 million Americans without health insurance. I realize that with all the charges and the criticism being thrown out there in Washington, many Americans may be wondering, "Well, how does my family, or my business, stand to benefit from health insurance reform? What's in this for me?" Folks are asking that, so I want to answer those questions briefly.
If you have health insurance, the reform we're proposing will give you more security. You just heard Rick's story. Reform will keep the government out of your health care decisions, giving you the option to keep your coverage if you're happy with it. So don't let folks say that somehow we're going to be forcing government-run health care. It's just not true. And it will keep the insurance companies out of your health care decisions, too – by stopping insurers from cherry-picking who they cover, and holding insurers to a higher standard for what they cover.
You won't have to worry about receiving a surprise bill in the mail, because we'll limit the amount your insurance company can force you to pay out of your own pocket.
You won't have to worry about preexisting conditions, because -- never again will anyone in America be denied coverage because of a previous illness or injury.
You won't have to worry about losing coverage if you lose or leave your job, because every American who needs insurance will have access to affordable plans through a health insurance exchange – a marketplace where insurance companies will compete to cover you, not to deny you coverage.
And if you run a small business and you're looking to provide insurance for your employees, you'll be able to choose a plan through this exchange, as well. I've heard from small business owners across America trying to do the right thing, but year after year premiums rise higher and choices grow more limited. And that's certainly true right here in Ohio.
Now, if you're a taxpayer concerned about deficits, I want you to understand I'm concerned about deficits, too. Because in the eight years before we came into office, Washington enacted two large tax cuts, primarily for the wealthiest Americans, added a prescription drug benefit to Medicare, funded two wars -- all without paying for it -- didn't pay for it. The national debt doubled. We were handed a $1.3 trillion deficit when we walked in the door -- one we necessarily had to add to in the short term to deal with this financial crisis.
Now, I have to tell you, I have to say, that folks have a lot of nerve who helped get us into this fiscal hole and then start going around trying to talk about fiscal responsibility. I'm always a little surprised that people don't have a little more shame -- about having created a mess and then try to point fingers, but that's another topic.
Because the truth is, is that I am now President and I am -- and I am responsible, and together we have to restore a sense of responsibility in Washington. We have to do what businesses and families do -- we've got to cut out the things we don't need to pay for the things we do.
And that's why I pledged that I will not sign health insurance reform -- as badly as I think it's necessary, I won't sign it if that reform adds even one dime to our deficit over the next decade -- and I mean what I say.
Now, we have estimated that two-thirds of the cost of reform to bring health care security to every American can actually be paid for by reallocating money that's already in the system but is being wasted in federal health care programs. So let me repeat what I just said: About two-thirds of health care reform can be paid for not with new revenues, not with tax hikes, just with taking money that's not being spent wisely and moving it into things that will actually make people healthy.
And that includes, by the way -- right now we spend more than $100 billion in unwarranted subsidies that go to insurance companies as part of Medicare -- subsidies that do nothing to improve care for our seniors. We ought to take that money and use it to actually treat people and cover people, not to line pockets of insurers. And I'm pleased that Congress has already embraced these proposals. And while they're currently working through proposals to finance the remaining costs, I continue to insist that health care reform not be paid for on the backs of middle-class families.
Now, in addition to making sure that this plan doesn't add to the deficit in the short term, the bill I sign must also slow the growth of health care costs, while improving care, in the long run.
I just came from the Cleveland Clinic where I toured the cardiac surgery unit, met some of the doctors who are achieving incredible results for their patients. There's important work being done there as well as at the University Hospitals and MetroHealth. And Cleveland Clinic has one of the best health information technology systems in the country. And that means they can track patients and their progress. It means that they can see what treatments work and what treatments are unnecessary. It means they can provide better care for patients. They don't have to duplicate test after test because it's all online. They can help patients manage chronic diseases like diabetes and high blood pressure and asthma and emphysema by coordinating with doctors and nurses both in the hospital and in the community.
And here's the remarkable thing: They actually have some of the lowest costs for the best care. That's the interesting thing about our health care system. Often, better care produces lower, not higher, expenses, because better care leads to fewer errors that cost money and lives. You, or your doctor, don't have to fill out the same form a dozen times. Medical professionals are free to treat people -- not just illnesses. And patients are provided preventive care earlier -- like mammograms and physicals -- to avert more expensive and invasive treatment later.
That's why our proposals include a variety of reforms that would save both money and improve care -- and why the nation's largest organizations representing doctors and nurses have embraced our plan. Our proposals would change incentives so that doctors and nurses finally are free to give patients the best care, not just the most expensive care. And we also want to create an independent group of doctors and medical experts who are empowered to eliminate waste and inefficiency in Medicare -- a proposal that could save even more money.
So overall, our proposals will improve the quality of care for our seniors, save them thousands of dollars on prescription drugs, and that, by the way, is why AARP has endorsed our reform efforts, as well.
So the fact is, lowering costs is essential for families and businesses here in Ohio and all across the country. Let's take the Ohio example -- over the past few years premiums have risen nearly nine times faster than wages. That's something that Rick and his wife understand very well. As we meet today, we're seeing double-digit rate increases on insurance premiums all over America. There are reports of insurers raising rates by 28 percent in California; seeking a 23 percent increase in Connecticut; proposing as much as a 56 percent increase in Michigan. If we don't act, these premium hikes will just be a preview of coming attractions. And that's a future you can't afford. That is a future that America can't afford.
We spend one of every six of our dollars on health care in America, and that's on track to double in the next three decades. The biggest driving force behind our federal deficit is the skyrocketing cost of Medicare and Medicaid. Small businesses struggle to cover workers while competing with large businesses. Large businesses struggle to cover workers while competing in the global economy. And we'll never know the full cost of the dreams put on hold, the entrepreneurial ideas that are allowed to languish, the small businesses never founded -- because of the fear of being without insurance, or having to pay for a policy on your own.
So, Ohio, that's why we seek reform. And in pursuit of this reform we've forged a consensus that has never before been reached in the history of this country. Senators and representatives in five committees are working on legislation; three have already produced a bill. Health care providers have agreed to do their part to reduce the rate of growth in health care spending. Hospitals have agreed to bring down costs. The drug companies have agreed to make prescription drugs more affordable for seniors. The American Nurses Association, the American Medical Association, representing millions of nurses and doctors who know our health care system best, they've announced their support for reform.
So we have never been closer -- we have never been closer to achieving quality, affordable health care for all Americans. But at the same time, there are those who would seek to delay and defeat reform -- is that the air-conditioning? That's good. It's a little warm. You can still hear me, though.
You know, we had one Republican strategist who told his party that even though they may want to compromise, it's better politics to "go for the kill." Another Republican senator said that defeating health reform is about "breaking" me -- when it's really the American people who are being broken by rising health care costs and declining coverage. You know, the Republican -- the Republican Party chair, seeking to stall our efforts, recently went so far as to say that health insurance reform was happening "too soon."
Well, first of all, let me just be clear. If there's not a deadline in Washington, nothing happens. Nothing ever happens. And, you know, we just heard today that, well, we may not be able to get the bill out of the Senate by the end of August -- or the beginning of August. That's okay. I just want people to keep on working. Just keep working. I want the bill to get out of the committees; and then I want that bill to go to the floor; and then I want that bill to be reconciled between the House and the Senate; and then I want to sign a bill. And I want it done by the end of this year. I want it done by the fall.
Whenever I hear people say that it's happening too soon, I think that's a little odd. We've been talking about health care reform since the days of Harry Truman. How could it be too soon? I don't think it's too soon for the families who've seen their premiums rise faster than wages year after year. It's not too soon for the businesses forced to drop coverage or shed workers because of mounting health care expenses. It's not too soon for taxpayers asked to close widening deficits that stem from rising health care costs -- costs that threaten to leave our children with a mountain of debt.
Reform may be coming too soon for some in Washington, but it's not soon enough for the American people. We can get this done. We don't shirk from a challenge.
We can get this done. People keep on saying, wow, this is really hard, why are you taking it on? You know, America doesn't shirk from a challenge. We were reminded of that earlier this week, when Americans and people all over the world marked the 40th anniversary of the moment that the astronauts of the Apollo 11 walked on the surface of the moon. It was the realization of a goal President Kennedy had set nearly a decade earlier. Ten years earlier he'd said we're going to the moon. And there were times where people said, oh, this is foolish, this is impossible. But President Kennedy understood and the American people set about proving what this nation is capable of doing when we set our minds to doing it.
There are those now who are seeing our failure to address stubborn problems as a sign that our best days are behind us; that somehow we've lost our sense of purpose, and toughness, and capacity to lead; that we can't do big things anymore. Well, I believe that this generation, like generations past, stand ready to defy the skeptics and the naysayers, that we can once again summon this American spirit. We can rescue our economy. We can rebuild it stronger than before. We can achieve quality, affordable health care for every single American. That's what we're called upon to do. That's what we will do with your help, Ohio. With your help.
A veteran writer, researcher and lecturer, with more than 25 years experience in politics, political communications, and public relations. I’ve studied speech writing at NYU, and authored a number of published articles on the practice of lobbying as well as topics in American history.
My lecture on the War of 1812: 1812 – Uncle Sam’s First War, is now a lecture in the New York Speakers in the Humanities bicentennial commemoration series.