Iran's Clenched Fist, Obama's Sliding Polls, Health Care Sticker Shock & More

The declaration that Mahmoud Ahmadinejad was reelected as Iran's president has led to an unexpected uprising that has brought to light the fragile ground on which Ahmadinejad's repressive regime stands. The protesters believe, and the evidence indicates, that the election was rigged in favor of the incumbent regime which has responded with the iron fist of violence and attempts to extinguish what it sees as dangerous demonstrations of freedom.

President Obama has been exceedingly reluctant to speak out strongly against the violence of the government against peaceful demonstrators and offer support for the people hungry for true freedom and democracy. Some caution is understandable as he is in a "no-win situation." As Reuters explains, "strong criticism could backfire but a muted response leaves an impression of weakness." His response indeed looked weak to many, leading Obama to shift his stance and strengthen his language in recent days "condemning" unjust actions and saying he is "appalled and outraged" by the violence. It has also been pointed out that this presents the President with a dilemma within his own liberalism. No one knows how the crisis in Iran will resolve, but here are four potential outcomes.

This is all happening against the backdrop of Iran and North Korea continuing to pursue nuclear weapons that would be a grave threat to the US, its allies and the world at large. This has weighed heavily on the President's response. Both rogue nations, along with other Mideast setbacks, seem to have intruded on Obama's diplomatic hopes although Secretary of State Clinton insists that, even in light of the "appalling" human rights violations we have seen in the last week, the administration will continue pursuing talks with the regime. Some on the right believe the election has exposed the flaw in Obama's approach to Iran, which has been to do the opposite of what his predecessor did.

As for North Korea, our President now stands accused of plotting nuclear war. This in response to the USS John McCain trailing a N Korean ship suspected of carrying nukes and other weapons. Meanwhile, residents of Hawaii are on edge as North Korea is reportedly planning to fire a long-range missile towards the islands on or around July 4th. To protect our 50th state, the Defense Department has moved ground-to-air missile defenses into position off the coast of Hawaii. These developments have increased criticism of President Obama's plan to cut missile defenses and the defense budget in general.

An interesting subplot of the Iran uprising story has been the essential role played by new media, particularly Twitter. Whereas in the past, Ahmadinejad's repressive actions of expelling journalists and cutting off communication from Iran would have succeeded in preventing the voices of demonstrators from reaching sympathetic ears around the world, today, we have Twitter, Flickr and Facebook, all serving as a "virtual mosque." Twitter has proved so critical to breaking through the information blackout, the US State Department actually asked the site to delay a schedule maintenance outage so as not to interrupt one of our only means of monitoring the situation. New media taking a prominent position in these events of global importance has led many in power to look at the fun tools of teenagers in a new light as even Defense Secretary Gates calls on the Pentagon to look for ways it can use social networking. Indeed, Twitter may change the way we live.

President Obama held a press conference yesterday, attempting to hit the "reset button" on several of his major issues on which he is losing public support. In the words of the RNC, Obama hoped for a hail mary as his agenda collapses on Capitol Hill. The President has been putting his high approval numbers to work on a myriad of major policies, but as the public looks more at his policies and less at him, the honeymoon appears to be coming to an end and his poll numbers are "starting to wilt." Gallop's daily tracking has Obama's job approval hitting new lows this week as his disapprove numbers steadily climb. As you see in the graph, the President's approval index hit 0 for the first time this week and actually fell as low as -2.

The big story is the gulf developing between Obama's still high favorability ratings and the much lower ratings for his specific policies. On his biggest policy priority, health care, Obama finds far less public support for rebuilding the system now than existed in 1993 when HillaryCare failed. The public is also wary of the growing deficit and actually opposes some of Obama's economic interventions. On the stimulus, confidence continues to fall as barely half now think it will boost the economy and Joe Biden concedes that "everyone guessed wrong." In a separate poll, a substantial majority do not believe Obama has a plan to deal with the budget deficit and many people disapprove of his health care plan, auto industry rescue and plan to close Guantanamo Bay. The public still does not blame Obama for the current state of the economy, but as time passes, unemployment continues to rise and people look at what the President does rather than what he says, it is becoming his to own.

Health Care is now, by far, the most dominant policy issue on both ends of Pennsylvania Avenue. The President and his allies on Capitol Hill have run into two different headwinds that threaten to derail their desired policies. The first is the public polling discussed above indicating less than an enthusiastic desire on the part of Americans for key parts of their plan. The second speed bump is sticker shock courtesy of the Congressional Budget Office which scored one Democratic proposal at $1 trillion over 10 years and another at $1.6 trillion amounting to a prognosis of debt. Some called the dose of reality a "death blow" to a government run health plan. This has led to concern within Obama's own party, finding themselves responsible for making unpleasant choices, that his health care plan lacks the votes needed to pass. The issue is sure to test Obama's resolve in the coming months as he continues pushing ahead and tries to keep his options open even as a bipartisan consensus looks increasingly unlikely. Try seeing the whole process from his perspective.

The issues and proposals at play in this debate are many, but I will highlight a few. Some believe doctors, the ones writing the bills, are the linchpin of real reform. These are, of course, some of the same doctors who booed Obama when he addressed them last week. A new Gallup poll shows that Americans trust doctors significantly more than Obama on health care.

The greatest point of contention to this point in the debate has been the public plan favored by Obama and the more liberal Congressional Democrats. Some believe the final reform bill is likely to have the public plan although the Senate Finance Committee's version leaves it out and Obama has signaled that he would be open to reform without it. Conservatives argue that the public plan would be the only plan and is a one-way-ticket to single payer health care but that it can be stopped. On the other side, Liberals say we need a public plan to force the private sector to improve. There is a fear that we could be creating a Welfare State that takes our country down the same path as GM as some even claim government health care would be unconstitutional.

When pressed at yesterday's press conference, Obama was forced to walk back his promise that even with a public plan, Americans would be able to keep the insurance they have, acknowledging that, as conservatives have repeatedly argued, the government plan could trump private plans leading some employers to dump their employees' coverage, this is what Americans worry about. Some believe you can't trust Obama on the issue, especially in light of past statements calling for a single payer system. They believe Obama is naive, hypocritical and dishonest in his claims that he will control health spending when his proposals have a good chance of doing the opposite.

Another point of debate is the rationing that conservatives fear would accompany a government takeover of the industry. Liberals push back that rationing will happen with or without the public plan. Also in the conversation, capping or eliminating the employer tax exclusion, which would be a goldmine of new revenue but is vigorously opposed by Obama supporters, and new taxes to pay for the overhaul. A proposal that has long been discussed is reining in medical malpractice lawsuits which have been credited for a large chunk of exploding costs. Obama's idea of extending Medicaid has met stiff resistance from governors of both parties who are facing record state deficits. Finally, Obama makes an argument about the global competitiveness of American busisnesses, one the WSJ finds hypocritical for a Democrat. On health care and other issues, Barone has picked up on an Obama pattern of dodging facts, skipping details and governing Chicago style.

Most Americans want health reform but express broad anxiety about its potential impact on their own care. Before trying to comprehend, much less form an intelligent opinion on this incredibly complex issue, it is important to gain some background and contextual knowledge. To this end, I have found Ezra Klein of the Washington Post helpful. While his views on the issue are decidedly liberal, he does a nice job of framing the debate. He offers a telling graphic showing that while the US pays more than other countries for health care, our results are rarely better and sometimes worse. He also explains the Dartmouth Atlas Studies showing the same phenomenon among US states. In his series Health Reform for Beginners, Klein explains the employer tax exclusion, a key player in McCain's proposals, as well as health insurance exchanges, both key players in the current debate. He also explains why it's the Senate Finance Committee that takes the lead on Health Care. He lays out why a reform aimed at bringing costs down long-term may come at a staggering initial cost and what a public plan is. Finally, he defines the difference between socialized medicine, single-payer health care and the unique system we are more likely to have. For a case study close to home, take a look at Massachusetts' experience with health reform under Mitt Romney.

OTHER STORIES OF NOTE:

There was a tragic crash on the Washington, DC metrorail this week as one train rearended another killing 9 people and injuring 70.

Obama has instituted new wage controls and proposed an overhaul of the nation's financial system which has provoked wide criticism, particularly from Wall Street. All the while, Obama claims he is aspiring to a "light touch" not a heavy hand as unemployment rises and the debt keeps him up at night.

It has been a bad week for two previously rising stars in the GOP. Nevada Senator John Ensign and South Carolina Governor Mark Sanford have both admitted affairs, significantly affecting the landscape of the 2012 Republican field of Obama challengers.

Barack Obama, in one of his most impressive acts as president, terminated a fly that was interupting his interview. PETA was very upset with the President... please.

Finally, see Danny's comment on last week's post in which he offers a thoughtful assessment of the Israeli-Palestinian conflict. A new poll shows that only 6% of Israelis now see the US government as pro-Israel.