US President Barack Obama is using political tactics and rhetorical devices honed in his White House campaign to regain the advantage in the health care debate over increasingly vocal and organised critics.
In person and over the internet, Mr Obama is trying to counter intense public scepticism that has flared across the US in recent weeks over Democrats’ plans to overhaul the nation’s health care system.
It is his top domestic priority and arguably his most challenging political fight yet as president, in no small part because of the vast number of diverse stake-holders involved. The issue affects every American.
Familiar tools from the Obama candidacy are being used in the struggle, adapted to his office: among them the town hall meetings with his sleeves rolled up, a quick-response website to douse critics’ claims, chain emails and a populist pitch against the entrenched powers in Washington.
He also now has the White House bully pulpit and used it again today in his weekly radio and internet address.
“I know there’s plenty of real concern and scepticism out there,” he said. “I know that in a time of economic upheaval, the idea of change can be unsettling, and I know that there are folks who believe that government should have no role at all in solving our problems.”
Careful not to alienate opponents even while taking them on, he cited “legitimate differences worthy of the real discussion that America deserves”. But, as Democratic allies face taunts and insults at town hall style gatherings nationwide, Mr Obama implored people to “lower our voices, listen to one another and talk about differences that really exist”.
In the weekly Republican Party address, Utah Senator Orrin Hatch pressed for a bipartisan solution.
“Ensuring access to affordable and quality health care for every American is not a Republican or Democrat issue – it is an American issue,” he said. “Our nation expects us to solve this challenge in an open, honest and responsible manner. More spending, more taxes and more government is not the answer.”
Mr Hatch said he strongly encourages respectful debate over the issue but cautioned against “stifling these discussions” and added: “There is nothing un-American about disagreements. In fact, our great nation was founded on speaking our minds.”
Mr Obama seeks legislation that would provide coverage for millions of uninsured people while controlling costs. Critics say proposals in Congress would spend too much and give government too big a role.
The United States is the only developed nation that does not have a comprehensive national health care plan for all its citizens. About 50m of America’s 300m people are without health insurance.
The government provides coverage for the poor, elderly and military veterans, but most Americans rely on private insurance, usually received through their employers.
However, not all employers provide insurance and not everyone can afford to buy it.
Conservative activists and Obama opponents have stepped up their attacks in recent weeks – and may be outmanoeuvring a White House known for its organisational abilities.
In campaign mode, Mr Obama is hosting question-and-answer sessions that proved valuable during the presidential race. The Democratic National Committee (DNC) and Mr Obama’s allies are spending millions on advertising campaigns to influence public opinion, much like they did last year.
Associates are going out to make the case, and the White House is using internet tools honed during his groundbreaking bid to rally supporters, but it is unclear whether the tactics are working.
Mr Obama is trying to energise his estimated 13m grass-roots supporters through his campaign apparatus, called Organising for America.
But there are indications that those who turned out to help elect Mr Obama are not doing the same to get a policy passed – evidence of the difficulty in the transition from campaigning to governing.
Over the past week, White House senior advisor David Axelrod asked supporters to forward a chain email to counter criticism circulating online. The White House also began a ’Reality Check’ website “to help Americans clear up health care lies and misinformation”.
DNC chairman Tim Kaine said that “reform opponents” have stepped up their game because they can tell the White House has “made more progress on health insurance reform than we made in the previous 60 years”.
Those efforts were reminiscent of the Obama team’s attempts during the 2008 campaign to debunk internet rumours about his faith and upbringing.
The DNC has created a web video – ’What You Won’t See on National Cable News’ - to highlight civil town hall meetings, and Mr Obama also plans to speak to backers by telephone during a health care event on Wednesday.
Over the past week, he has fielded questions from audiences in Portsmouth, New Hampshire, and Belgrade, Montana, and scheduled one for today in Grand Junction, Colorado, during his family’s tour of national parks.
So far, he has faced polite crowds – a stark contrast to the taunts and jeers that some Democratic lawmakers have endured at similar sessions during their August break.
Much like in the campaign, he is using people’s stories to illustrate his points.
Mr Obama talks about Lori Hitchcock of New Hampshire and Katie Gibson of Montana, who could not get sustained insurance coverage because of their medical conditions. “These are the stories that aren’t being told,” he said in his weekly address.
He is railing again against interest groups and lobbyists. “Every time we come close to passing health insurance reform, the special interests with a stake in the status quo use their influence and political allies to scare and mislead the American people,” Mr Obama said.