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Healthcare: Obama's final stretch

Barack Obama must win this – and to do so he has to persuade enough wavering Democrats to suck it up and vote yes

The president just finished his "final push" address on healthcare reform in the East Room of the White House. Did it change anything?

Maybe. He was more forceful than previously. He was clearer than before in insisting on an up-or-down vote in Congress "in the next few weeks" to settle the matter. And he said that in those weeks, "I will do everything in my power to make the case for reform."

Success may depend on what he means by "everything". Is he going to hit the road? That's a risk of political capital. George W Bush did a series of events in 2005 touting private accounts for Social Security, but he bombed in Peoria, never made Broadway, and his plan went nowhere at all. It hurt Bush badly. Then Katrina happened, and he was finished as president for all but 30% of the country.

But I don't see how Obama avoids making public appearances here. He can move the public opinion dial, still – maybe not massively, but possibly enough.

Remember, healthcare's overall unimpressive numbers include the fact that Republicans oppose it by overwhelming proportions. Democrats support it strongly. Independents are against, but not implacably so: they're 39-45, according to one poll last month. If Obama can shore up Democrats by five points and flip independents by five, that's probably enough.

As he travels, assuming he does, he should choose where he goes with great attention. He might, for example, try the 24th congressional district of New York, whose Democratic representative, Michael Arcuri, voted yes last November but just announced today that he plans on voting no (he did leave some wiggle room). There are a lot of states and districts like that he should touch down in.

He also is going to have to orchestrate some deals for some votes. It's good that he ditched the Cornhusker Kickback. But he will need to play ball with some House members. Their asking prices are typically far lower than senators', so within limits this should just amount to normal political horse-trading, although Obama will have to be careful because the Republicans and their media are pretty deft at blowing one deal way out of proportion.

And he will have to lean on people. That one most of all. It's his show now. There wasn't supposed to be this much at stake, but things happened the way they happened and now there is. He has to win this. He has to persuade enough wavering House Democrats (the Senate shouldn't be a problem under reconciliation rules) to suck it up and vote yes.

Is it bad for the Democrats if reform passes under controversial circumstances? Sure. But it would be far, far worse for reform to fail under controversial circumstances. It's really not even close. Winning is winning and losing is losing.

One senses that Democrats are starting to make their various peaces with this reality. But it's still going to be razor-thin until the date of the vote. Whenever that is, by the way. I found it a little frustrating that Obama stuck with "a few weeks" instead of just saying April 10 or whatever.

"I do not know how this plays politically, but I know it's right," Obama said. That's probably the best tack at this point. Position himself as above the politics and willing to take political hits for the sake of doing what he thinks is the right thing.

It may not persuade a huge number of people. But he only needs to persuade about 8% of the public (or so), and two or three Democratic House members.

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