Health-care reform stands on the edge of a dramatic precipice. Many times over the years, presidents have pushed for comprehensive health-care reform. And never has it come closer than it is today, with reform bills having past four of the five relevant committees and a version of reform poised to pass the fifth. At the same time, the president's approval rating has sunk from the post-election high to something around fifty-fifty and his specific approval and health care has sunk lower than that. Under the circumstances, it was a dramatic moment for a speech, and the president rose to the occasion with a dramatic address beginning with a broad historical narrative and ending with a touching invocation of the later Ted Kennedy.
Do key swing blocs like the House Blue Dog Caucus and senators such as Ben Nelson (D-NE) and Olympia Snowe (R-ME) want reform? If so, we'll get it. If not, we won't.
It's tempting, therefore, to view the delivery of the speech itself as a watershed moment; an opportunity to reshape history through rhetoric. The reality is that this is unlikely. In his book “On Deaf Ears,” political scientist George Edwards surveyed public reaction to every televised address between 1981 and 2001 and concluded that they don't really make a difference: "statistically significant changes in approval rarely follow a televised presidential address. Typically, the president’s ratings hardly move at all."
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Nevertheless, failure to move the dial of public opinion needn't doom reform. As the most recent Gallup Poll data shows, currently existing public opinion is easily flexible enough for reform to pass, with 37 percent saying they want their member of Congress to back reform and 24 percent saying they have no opinion. The only problem is that a majority for blocking reform also exists: 39 percent say they want a "no" vote and 24 percent have no opinion. The country, despite the polarized images on television, actually contains a large and decisive number of indifferent people.
Members of Congress can get away with casting a vote in favor of comprehensive health reform, and they can also get away with casting a vote against comprehensive health reform. And the fate of the country rests ultimately in their hands. Members tend to be uncomfortable with this reality and cast about for objective political constraints in which to take refuge, but the data doesn't support any such quest. And the press likes to focus on the president as the key agent of change, seeing the passage or failure of bills as his "success" or "failure." But the president's only real power would be to shift public opinion, and history's says that's unlikely. And the only thing that could force Congress's hand would be public opinion, but public opinion is indecisive. So does Congress want reform? Specifically, do key swing blocs like the House Blue Dog Caucus and senators such as Ben Nelson (D-NE) and Olympia Snowe (R-ME) want reform? If so, we'll get it. If not, we won't. And one way or another, the speech won't have been the difference-maker.
Matthew Yglesias is a Fellow at the Center for American Progress Action Fund. He is the author of Heads in the Sand: How the Republicans Screw Up Foreign Policy and Foreign Policy Screws Up the Democrats.
