WASHINGTON - U.S. President Barack Obama is thinking of throwing more details and personal weight into the debate about a major overhaul of the American health care system, which polls indicate Republicans have been winning in recent weeks.
Faced with falling approval ratings and increasingly impatient with Senate negotiations, Obama is considering a speech in the next week or so in which he would be "more prescriptive" about what he feels Congress must include in a health bill, top adviser David Axelrod said Tuesday in an interview. Unlike all other wealthy nations, the United States does not have universal health care.
The speech might occur before the Sept. 15 deadline the White House gave Senate negotiators to seek a bipartisan bill, Axelrod said. He suggested that two key Republicans have not bargained in good faith.
Congress reconvenes next Tuesday after an August recess in which critics of Obama's health proposals dominated many public forums.
Some Obama allies feel he gave too much leeway to Congress, where one bill has passed three House of Representatives committees, another has passed a Senate committee and a third has been bogged down in protracted negotiations in the Senate Finance Committee.
Axelrod indicated that Obama would not offer new proposals but would be more specific about his top priorities.
"The ideas are all there on the table," Axelrod said. "Now we are in a new phase, and it's time to pull the strands of these together."
He said there is serious discussion in the White House of Obama "giving a speech that lays out in specific ways what he thinks" about the essential elements of a health care bill.
Axelrod said it was possible that the speech could occur before a planned Sept. 15 Obama address on health care in Pittsburgh.
Obama has called for innovations such as a public health insurance plan to compete with private insurers, but he has not insisted on it. It was not clear Tuesday the degree to which he might press for various proposals in a new speech.
Obama also plans to meet with Democratic congressional leaders when lawmakers reconvene next week.
Axelrod condemned recent comments by two chief Senate Republican negotiators - Charles Grassley and Mike Enzi - who have sharply criticized key elements of Democrats' health care plans even as they insisted that a workable bipartisan plan was possible.
Their remarks, Axelrod said, "were not exactly consistent with good-faith negotiations."
In an August fundraising letter, Grassley asked people for "support in helping me defeat Obama-care." He said Democratic-drafted bills would be "a pathway to a government takeover of the health care system."
Enzi, in a radio address Saturday, said Democratic proposals would restrict medical choices and make the country's "finances sicker without saving you money."
The two men are part of a six-senator, bipartisan negotiating team that also includes Republican Sen. Olympia Snowe. Hopes for a workable bipartisan plan have dimmed in recent weeks, and Axelrod's comments were the most dismissive yet from a White House official.
Congress' August recess was brutal for Obama and his allies, as lawmakers faced raucous crowds denouncing Democrats' health proposals. When Congress comes back Tuesday, Democratic leaders hope to change the dynamic by holding quiet, closed-door sessions with nervous colleagues and arguing that far-reaching health care changes can be good politics as well as good policy.
They also hope Republican-led opposition has peaked. But that's far from clear, and Republicans are eager to hand Obama his first major defeat.
A new CNN/Opinion Research poll found that 53 per cent of Americans disapproved of Obama's handling of health care, while 44 per cent approved. In March, far more people had approved than disapproved.
Liberal groups have held hundreds of events in a bid to show that a robust overhaul is more popular than August's news reports would suggest.
The message lawmakers will hear when they return to Washington "will be very different than what they heard when August started," said Jacki Schechner of Health Care for America Now. One idea her group will stress, she said, is that the politically smart vote, even in toss-up districts, will support widespread changes meant to expand health insurance coverage and options.
Some Democrats say congressional leaders will have to trim more costs from the health bills even though it would antagonize liberals and make it harder to cover uninsured people, one of Obama's top goals.
"That's the kind of thing we're going to look at," said Rep. Chris Van Hollen, a member of the leadership who is tasked with getting his colleagues re-elected.
Republicans approach the coming legislative session feeling upbeat about the ground they gained during the August recess. Some are confident that no amount of closed-door hand-holding of nervous Democratic lawmakers will reverse the momentum.
"After a disastrous month at home, the fact that Democrats' new health care strategy is to hide in Washington from the people who elected them to get health care passed shows what bad shape they're in," said Antonia Ferrier, spokeswoman for House Republican leader John Boehner.
