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MICHEL MARTIN, host:

I'm Michel Martin. And this is TELL ME MORE from NPR News. My thanks to Jennifer Ludden, Korva Coleman, Linda Wertheimer, and Allison Keyes for sitting in while I was away.

Coming up, outbreaks of swine flu are beginning to show up around the country. And the information from one city shows that minorities could be disproportionately affected. We'll ask two doctors if there are additional issues minorities should be aware of and how the public and medical professionals should prepare. That's in just a few minutes.

But first, more on health. We want to talk about President Obama's much anticipated speech on health care tonight to a joint session of Congress, where he's expected to make the case again for his vision for reform. As he struggled to sell the plan, the president's approval ratings have been dropping. And according to one recent poll, which has gotten a lot of attention, his approval rating has declined among most groups but the biggest declines are among whites.

Joining me now in our studio to talk about where the president stands is Michael Dimock, associate director of research at the Pew Research Center for the People and the Press. That's the group which conducted the survey we're going to talk about. Also with us, Democratic strategist Celinda Lake, president of Lake Research Partners. And with us by the phone is pollster Frank Luntz. He is president of the public relations firm The Word Doctors. We're calling him a Republican Independent. And he has a new book coming out next week, "What Americans Really Want…Really." Welcome to you all. Thank you so much for joining us.

Ms. CELINDA LAKE (President, Lake Research Partners): Thanks for having us.

Mr. MICHAEL DIMOCK (Researcher, Pew Research Center): Thank you.

MARTIN: Michael, let me start with you. The Pew poll, which as I said, has gotten a lot of attention shows big declines in the president's approval ratings since the spring. Now the headlines focused on the drop among white voters, but that's a pretty big group.

Mr. DIMOCK: Right, you're talking…

MARTIN: So, that's a lot.

Mr. DIMOCK: Yeah, about three-quarters of the public there. And that's where the decline is coming. It's probably no real surprise that African-Americans are still backing Obama about as strongly as they already have. So, if there's a decline, it's coming mainly among white voters.

MARTIN: What about Latinos?

Mr. DIMOCK: A little bit of a drop there, but still you're getting majority approval among Latinos and other minorities.

MARTIN: Can you drill down at all on these - on these numbers. Is it particular white voters, as I said, it's kind of a big group of people.

Mr. DIMOCK: It is a big group. And it's interesting in that - in our polling, it's really across the board. You're seeing a decline in approval across most groups. And I think the perspective to keep on it is his approval was very high early on. And it's come down to modest numbers. We're seeing about 42 percent among - approval among whites now.

In some ways, that's about where he was during the election. Remember he didn't win majority of the vote among white voters. And now, his approval rating is back down to this kind of middle level.

MARTIN: So, it's back down to the earth from the stratosphere.

Mr. DIMOCK: That's one way of putting it.

MARTIN: And finally, Michael, before I turn to the other - other guests, you know, I attributed it to the health care…

Mr. DIMOCK: Mm-hmm.

MARTIN: …this debate. Do you?

Mr. DIMOCK: Health care…

MARTIN: Is that a correlation or is it a cause?

Mr. DIMOCK: Health care is the biggest issue right now. It's the focal point. It's setting the tone for his presidency. When pollsters ask approval on a variety of issues: health care, Afghanistan, the economy, his approval is coming down in all of those areas. But health care is really what's setting the tone right now.

And I think it's this turn towards - from a period of real action and achievement early on, setting a lot of goals, putting out a lot of proposals, getting through this stimulus package to a period now where things have really slowed down and bogged down a little bit and the excitement and vibrancy of that early presidency is starting to fade into politics as usual.

MARTIN: Celinda, what's your take on that? I have a couple of questions for you. One is, do you agree that it's health care driving the president's approval because remember earlier in the year there was, you know, economic stimulus, was sort of the big issue. So, do you agree, first of all, that health care is the number one issue driving our evaluation of the president? I'm also curious about what's your take about the - racial aspect of it?

Ms. LAKE: I think that, first of all, whether it's health care, I think it's -and I think Michael's analysis is very sophisticated and very thoughtful. I think, however, what's going on is a little bit of summer doldrums and kind of the show-me mentality that voters have. And he's right that there was a lot of excitement and now voters are like, well, show me the results.

And one of the things that's hard to remember particularly if you're staying in Washington, D.C. and in the beltway is how bad the economy is still is out there. And there's new stories of additional lay-offs, additional round of foreclosures, additional rounds of small businesses closing, someone that would really helped by the health care plan, by the way.

So, I think that voters are yet to see the full results of the plan. And it's - they're kind of in the show-me mood. I also think that there is a price being paid for the way that health care has bogged down and the lack of definition. And I think that the president realizes it. And it's something that he's going to start trying to fix tonight by really giving some definition.

I think it was a mistake, frankly, not to lay out some more specifics earlier on. In terms of the patterns, there's certainly the racial aspect. There's also a big partisan aspect though. And what you're seeing, particularly among white voters, is real polarization around partisanship. So while Democrats, independents, and Republicans are down, it's really the decline among Republicans that's driving the negative numbers.

And then, independents resembling Republicans more for the first time. And I think, as Democrats, that's the thing we have to worry about most. If the Republicans get mad at the Democratic president, oh well. But if the independents are mad too, that's a bigger issue. And so, I think as the president addresses the economy, as he addresses Afghanistan, as he addresses health care, he's got to think about addressing voters over 50 who make up a bigger proportion of the 2010 electorate and the independents.

MARTIN: You've given us a lot to work with. Frank - Frank Luntz, what's your take on this?

Mr. FRANK LUNTZ (Republican Pollster): That it had to happen. That when you talk about such serious significant fundamental issues, when you spend $800 billion in the stimulus, when you have deficits and a debt that's now somewhere between seven and nine trillion, and you tackle cap and trade, you tackle health care, you're going to divide the electorate.

My surprise - and if you went back and read some of my quotes four or five months ago - is that Obama actually hasn't gotten it right. That for the greatest order of our time, his speeches have had less and less impact. And I'm quite frankly surprised that he has been unable to keep the public focused on his agenda in a way that would allow him to move it forward. Remember…

MARTIN: Can I just ask you, Frank, if I could drill down on this - is this is a tactical problem or a rhetoric problem? I mean, Celinda seems to be saying that by letting Congress take the lead that the president has - it's a tactical error or a strategic error in that allowing Congress to take the lead means the president isn't showing leadership.

So, do you think this is a tactical and strategic or this is rhetorical? Is it his words don't have force?

Mr. LUNTZ: Well, let's be specific. If you ask who do you like more, Nancy Pelosi or Barack Obama? Probably you'd be 6:1 or 7:1 decision in favor of Obama. The Congress remains very unpopular, and the public believes the Congress has not delivered on its promise. And, in fact, you now have some polls that show Republicans pulling even with Democrats in terms of who they'd they want to win the next election.

And so, from that sense it is tactical. But it's also a policy oriented. Change doesn't mean everything to everyone. Your definition of change and mine will be quite different even though we both believe that the status quo is unacceptable. What I believe is that Barack Obama did not fully understand the direction of change that the American people wanted when they voted for him last year.

MARTIN: What do you mean by that?

Mr. LUNTZ: That they do want health care reform. And I think Republicans are foolish if they think that they don't. But they don't want the health care reform that seems to be at least coming out of the House of Representatives. That they do want a clean environment, but they don't want to pay more money in taxes and they don't support the current cap and trade. That they do believe that those who are unemployed deserve help and that we should focus on more jobs, but that's different than spending $800 billion on it.

MARTIN: If you're just joining us, you're listening to TELL ME MORE with Michel Martin from NPR News. And we're talking about President Obama's declining approval ratings. I'm speaking with public opinion experts Frank Luntz, Celinda Lake, and Michael Dimock of Pew Center for People and the Press.

Frank, if I could just, before we take a break and we're going to come back to all of you in our next segment. But before I take a break, could I ask you to reflect the question I asked Celinda about the racial aspect of this, if there indeed is one.

I mean, I know it's interesting that many people assume that African-Americans would support Obama, but it's also true that African-Americans are more likely to be uninsured. They're more likely to support a public option, for example, or some form of sort of federal involvement in health care. They're certainly strong advocates of universal coverage. So, I don't know that it's a given that they would necessarily continue to support him just because of their policy preference. I just want to ask you to reflect in the couple of minutes we have left before our break on your analysis of the sort of the racial breakdown of the numbers.

Mr. LUNTZ: I think it makes perfect sense that African-Americans are more likely to support government intervention. They're more likely to support an activist government policy. They're less likely to trust corporations. They're more willing to accept, in fact, even endorse tax increases on the rich. On policy after policy, the African-American community is behind Barack Obama regardless of his race.

And so, it makes perfect sense that the African-American community would continue to back him. And it also makes sense, as your two guests have said, that the white community has become much more polarized. What doesn't make sense is that it would happen so quickly and so deeply.

MARTIN: Michael, could I just ask you to reflect on that? We have a couple of minutes left here in that it's on - but Barack Obama hasn't delivered on some of the policy preferences that African-Americans prefer.

Mr. DIMOCK: Right.

MARTIN: I mean, he has indicated that he can support a tax increase. He's walked away from the public option, at least he seems to have.

Mr. DIMOCK: Right.

MARTIN: So, again, I mean, so let's just flip the script here and talk about why the African-Americans continue to support him?

Mr. DIMOCK: Right. And I think liberals in general, people who are more liberally minded. There is grumbling about him not going far enough on some of the issues, not taking as strong a stance as he could have. But I think most liberally minded folks have just come out of eight years of having a different president in office. And they're willing to give their president a little bit of leeway for a while, even if he doesn't take the hard line that they might want him to take.

MARTIN: Celinda, briefly.

Ms. LAKE: I think that's right. I think also, I think African-Americans also, rightly so, frankly, have an analysis of that there are organized political interests that are going after the president. And I think they're protective of the president, as the first African-American president, but also frankly as a Democratic president because African-Americans are Democratic and also is a change-oriented president.

So, I think we shouldn't miss how much of the results here have been produced, I think, by a very organized right wing that's trying to revive itself by going after the president and starting with the Birthers on to the socialized medicine and every accusation in between including death panels. And I think African-Americans have a more sophisticated understanding of the structure of politics and the structure that there are real villains out there. There are real enemies of this president who have very effectively organized, and I hope that this speech starts a more direct counter-offensive by the president.

MARTIN: I want to hear more from you after our break about what you hope and believe the president will talk about tonight. Please stay with us. We're going to continue this conversation in advance of the president's big speech tonight after a short break. We're speaking with public opinion experts Celinda Lake, Frank Luntz and Michael Dimock.

I'm Michel Martin. And you're listening to TELL ME MORE from NPR News. Please stay with us.

(Soundbite of music)

MARTIN: I'm Michel Martin, and this is TELL ME MORE from NPR News.

Coming up, how swine flu is challenging public health officials to put more thought into the cultural aspects of prevention. We'll have that conversation in just a few minutes.

But first, we continue our conversation about President Obama's declining approval ratings. The headlines say he's losing ground among white voters. We've been talking about that with pollsters Frank Luntz, a Republican independent; Celinda Lake, a Democrat; and Michael Dimock of the Pew Center for the People and the Press. They're still here with me. Thank you so much for standing by.

Frank, Celinda identified specific groups that she feels that the president particularly, actually both of you did, particularly needs to address. Now could you talk a little bit more about that. Are there particular groups that he needs to focus on in his speech tonight? And are there - is there anything he can say to attract more Republican support?

Mr. LUNTZ: I'm not sure that he should be focused on Republicans. I think that they have made a decision that his philosophy is not theirs. And the one thing that I would challenge from this conversation is that it's this right wing that's ginned up all the anger in August. If that were the case, it would not be just Republicans - or it would be just Republicans who have changed their opinion of this health care legislation and of the president. I think that Barack Obama needs to focus specifically on political independents - those who have rejected both political parties, moderates who have rejected both ideologies, people who are dead center both in the country and philosophically. And he has to explain to them why his plan will make their health care better, not just extending it to those who don't have it.

And the second group, and this is what I find most fascinating, is the decline in support for the president's plan among seniors. They will make up a large percentage of the 2010 electorate. They vote. They're vocal. They participate and they seem to have turned against this president to a greater degree than his base, than his core, which are people in their 20s and 30s.

MARTIN: I'm interested to know, Michael Dimock, because - and Celinda I certainly want to hear from you on this - but I'm interested in this because it's - looking at the breakdown of the chart, it seems to me that the 30 to 49 year olds show the steepest drop in support from April to August. That was a 14 percent drop in his approval rating compared to 8 percent for the 18 to 29 year olds, 9 percent for the 50 to 64 year olds and 9 percent for the 64 plus.

What do you think about that? And also, if you could address the question of are there - is there a center of gravity around the dissatisfaction that you think President Obama particularly needs to address?

Mr. DIMOCK: Right. Well, there's this notion that younger people back Obama, but you have to define younger the right way. It's under 30. And the folks who are 30 to 49 are one of the most Republican generations in this country. These are the folks who were raised under Reagan and now they're growing up and they've tend to have a more conservative take on things ever since they were younger. And they gave Obama some benefit of the doubt early on, but you're seeing that erode fairly quickly.

I agree with Frank that older - the reactions of older Americans to health care reform are fairly negative. And there's a lot of concern that this is going to hurt them in some ways. And it really is incumbent on him to persuade people and explain to people that this isn't going to affect the coverage that they receive currently from the government since most of them are on a government plan in one form or another.

I also agree that independents are clearly the swing group here and moderates and I would only add to what Frank said that independents are growing. I mean, our poll and other polls show that fewer and fewer Americans are identifying as either Democrats or Republicans. And we're seeing record levels of independent identification, the highest we've seen since Ross Perot was running as an independent candidate in 1992. So, there's clearly something going on and a rejection of the ideology that's happening out there.

MARTIN: Celinda, what's your take on this?

Ms. LAKE: I think that's right. I mean, we should also put some perspective on this and that is we need to remember that Barack Obama had a tough time with seniors even during the campaign. He lost them in the primaries to Hillary Clinton. He lost them in the general election to McCain. It was the one age cohort he lost. So, he's always had a tougher sell there. And I think endless affinity for that group.

And I think one of the most important things he needs to do tonight is to say if you're on Medicare that's it, you're fine. You're not touched. And you're not going into the public plan.

MARTIN: What is your take on Frank's point that there is a center of gravity around dissatisfaction with the president's performance that's based on policy and ideas and not just - it's not just - it's not solely partisan. And if that is the case, what does he do?

Ms. LAKE: Well, I think there's a center of gravity that is feeling cross pressured right now. On the one hand, they want a change. And let's remember the center of gravity voted for Barack Obama. That's why he's president and they voted for Democrats in Congress. By the same token, it's show me the money now. They want to see the economy improve. They want to understand what health care is going to mean for them, the insured.

And I think the most important thing that Frank said and that the president understands, frankly, is his speech tonight is to ensure to America 96 percent of the 2010 voters will be insured. He has to tell them what they're going to gain, not lose, by having national health care reform.

MARTIN: How do you know whether the speech is a success tonight or not?

Ms. LAKE: Well, first of all, I think it will not be a success if people think that it's just a speech and then we're done. The speech has to be the beginning of a new period of dialoguing with the public, laying out this plan, being very specific. And if it's just one speech, it won't be successful by definition. It has to be repeated. It has to be taken out there by members of Congress, by the president himself and this plan has to get defined in the public's mind now.

MARTIN: And Frank Luntz, final word from you. How will you decide whether the speech is a success or a failure?

Mr. LUNTZ: Because in reality it's not public opinion, it's the United States Senate that matters. And I will judge it as a success if I hear from the dozen or so conservative or moderate Democrats that, say, half of them changed their minds and that one Republican, Olimpia Snowe, -says, you know what, I'm going to go along with this. Success is not public focus. It needs to be on the United States Senate.

MARTIN: Michael, do you have a final thought?

Mr. DIMOCK: I sort of agree with Frank in the public is going to matter here, but the public is going to follow the direction of politics. If things look like they're happening and moving in a positive direction, I think you're going to see public support grow. But if this continues to be divisive and seen to be falling apart, the public skepticism is going to continue to grow.

MARTIN: Michael Dimock of the Pew Research Center for the People and the Press. He was here with me in our Washington, D.C. studio along with Celinda Lake, president of Lake Research Partners. On the phone, Frank Luntz, a Republican independent, president of the public relations firm The Word Doctors. His new book is "What Americans Really Want…Really," and it's available next week. I thank you all so much for joining us.

Ms. LAKE: Thank you.

Mr. DIMOCK: Thank you.

MARTIN: Remember at TELL ME MORE the conversation never ends. Now we'd like to hear from you. What's your take on President Obama's leadership on the health care issue? Has he lost your support? Did he ever have it in the first place? What do you want to hear from his health care speech tonight? To tell us more, please call our comment line at 202-842-3522. Again, that's 202-842-3522. Please remember to leave us your name or you can share your thoughts with us online. Just go to the new npr.org, select TELL ME MORE from the program tab and blog it out.

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