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President Obama is following events overseas, even as he tries to sell his big priority at home. He addresses the nation tonight on changes to the health system. In an interview here on MORNING EDITION, his press secretary Robert Gibbs said the president wants to clarify what he wants.

Mr. ROBERT GIBBS (Press Secretary, White House): Well, look, I think there's been a lot of confusion out in the public about this. I'm not sure that the public has gotten as much of a discussion about the substance of what is in these proposals as much as we have about the process and more of the heat and the light of all this.

STEVE INSKEEP, host:

That's Robert Gibbs, the White House press secretary speaking this morning. Mr. Gibbs' challenge is familiar to our next guest. Dee Dee Myers was press secretary for President Clinton, whose own health care effort fell apart in 1994. And she's been watching President Obama's plan lose momentum.

Ms. DEE DEE MYERS (White House Press Secretary, President Bill Clinton): The thing that happened was, expectations met the complexity that is health care. It has happened to every president who's tried to take on health care for 50 years. Keeping control of this massive issue is a really difficult task. And so the biggest thing that's happened is just bumping up against the reality.

INSKEEP: Although, those are things that were known to this administration. And, of course, earlier in the year there were many stories about how they learned from the frustrations of the Clinton administration.

Ms. MYERS: Right. Right, and they overlearned some lessons, which is, you know, sort of predictable. The Clintons obviously started out by trying to write a health care bill. It was a 1300-page monstrosity. It took months to do, was done somewhat in secret, so without a lot of feedback from members of Congress or other interest groups, and obviously failed - for a lot of reasons, including the process.

President Obama and his team came in saying we're not going to do that. We're going to do the opposite. We're going to let Congress write this bill. It has to be done kind of in the give and take of the legislative process. And so they did that.

The downside to that is that you have all these details out there swirling around. You have all these different members of Congress with all kinds of different interests, and different districts, and different constituencies that they have to appeal to, and, you know, it's the sausage making.

INSKEEP: Have congressional leaders, on this issue, not done a very good job for the president? He's given them the ball and they haven't gotten very far with it.

Ms. MYERS: Well, I think, look, three House committees have passed bills and the Senate Finance Committee is close to passing something. That's behind the schedule that the president had hoped for, but it's actually a lot more progress than you would discern by sometimes listening to media accounts. I think the one thing that Congress has missed is a more forceful leadership from the president, a clearer sense of what he will accept and what he will not accept, and I think that's what people are looking forward to hearing from him tonight.

INSKEEP: Well, the president has been out for months talking about this. What has he not been saying?

Ms. MYERS: He's not been saying what he'll accept or not accept, and of course the best example of that is this debate about the public option.

INSKEEP: Um-hum.

Ms. MYERS: Should there be a publicly run, a government-run insurance plan to compete with private plans? And will the president accept a final bill that doesn't include that? Some members of the House say it has to be in there or they won't vote for it.

Members of the Senate say if it's in there, we won't vote for it, particularly a lot of Republicans. For them, it's a deal breaker. Most of them will never vote for this bill anyway. But that's one example of a case where a lot of members are saying, hey, if the president is going to accept a bill without a public option, I want to know that now.

INSKEEP: Well, does the president's rhetoric there reflects part of his dilemma, in that his party is divided and he can't necessarily put a marker down that all of his own party can get behind?

Ms. MYERS: Right. And that is exactly the dilemma for him. And so he's allowed Congress to work through this process, but at some point, as the president himself said over the weekend, you have to stop the debate, make a decision, and act, and I think we're getting very close to that point.

Not that the president is going to lay out all the details of a bill in his speech, but that he has to start to narrow down the set of options. He has to start to give Congress some clearer direction. It's easier to defend a bill when you know what's in it.

INSKEEP: I want to talk about that principle. Does that suggest that the whole process of going for a massive health care change, and you said the bill was 1300 pages back in the 1990s. They've gotten it down to 1,000-something now?

Ms. MYERS: Yeah, so it's streamlined.

INSKEEP: I mean, but it's like - there a point at which it just doesn't make sense to try a gigantic comprehensive reform like this.

Ms. MYERS: There's certainly a lot of people who believe that, that a more incremental approach to reform is more effective and less likely to be tripped up by these details that get buried in a thousand page bill. The president believes that the issue is so complex that you do need to do it all at once. That, you know, you can't pull a thread here without having some kind of reaction over there. And by the way, even with a 1,000-page bill, even as comprehensive as the president and Democrats in Congress have set out to make this, it will be less than the president started trying to achieve. It will be less than their initial goal - because of that process, because there are so many things to object to. And so, the president... Another thing he'll need to do, to a certain degree, is define what's victory, you know, which may be defining down from his original goals.

INSKEEP: Dee Dee Myers is a contributing editor of Vanity Fair magazine and a former Press Secretary to President Bill Clinton. Thanks for coming by.

Ms. MYERS: Thanks for having me.

INSKEEP: And we'll have complete coverage today and tomorrow as the president addresses Congress tonight. It's MORNING EDITION from NPR News.

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