With President Obama's town-hall meeting in Portsmouth, N.H. underway, some last-minute thoughts:

If the decline in his approval ratings tells us anything, it's that the president may be in the process of losing control of the conversation about how to overhaul the nation's health-care system.

Polls indicate that the number of people who want to see major changes in the system has been declining. Blame it on whomever you want — talk radio, the insurance industry and Republican activists are popular targets for the Democrats — but there seems to be a clear division in the country on what health care "reform" is going to look like. The uncertainty and confusion have led to ugly confrontations at other town-hall meetings — witness the outbursts against Sen. Arlen Specter (D) earlier today in Lebanon, Pa., or the burning in effigy last month of a cardboard cutout of Rep. Frank Kratovil (D-MD).

Obama, declining numbers or not, is still the most effective communicator in the nation. If anyone can make the case that the status quo is unacceptable, it is the president. There is still a shocking number of people — 47 million — uncovered by health insurance, and many of those who are covered are finding the costs prohibitive and skyrocketing.

And, to be fair here, there are reasons to be unhappy, if not furious, with some of the practices of the insurance companies, especially in instances of their refusal to pay for coverage or limiting what they decide to cover.

But to dismiss the protesters as creations of conservative operatives misses the point. To dismiss the fear and unease about radical change in this country — no matter what the issue, even if it is overdue — is a mistake. This is still a pretty (small "c") conservative country. Change does not come easily. But that doesn't mean it shouldn't happen. It just takes awhile.

It doesn't excuse the vitriol, misinformation and hate that's out there. And there may be more nefarious agents out there trying to stop this than I'm acknowledging. But both sides still seem to be talking past each other, seem to be yelling at each other. One presidential town-hall meeting will not reduce the temperature. It is still only one side of the argument.

But it's a start.