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President Obama often tells audiences that he has waged his last campaign. But that's not exactly true.

The White House is gearing up for a massive campaign this summer that will cover all 50 states, plus Washington, D.C. And the president's legacy may hinge on whether it succeeds or fails.

The Affordable Care Act, or "Obamacare," has been through more life-and-death cliffhangers than a season finale of Homeland. After squeaker votes in Congress and a 5-4 ruling upholding the law at the Supreme Court, now there's another big hurdle: getting uninsured people to buy health care when it becomes available Oct. 1.

When Obama delivered the commencement address at Morehouse College this month, his advice to the graduates — along with working hard and helping others — was to sign up for health insurance this fall.

"We've got to make sure everybody has good health in this country," he said. "It's not just good for you, it's good for this country. So you're going to have to spread the word to your fellow young people."

Reaching Out

David Simas, deputy senior adviser to the president, works in a quintessential West Wing office — a windowless basement room — where he oversees one of the top projects on the Obama agenda: implementing universal health coverage.

In the first year, the administration hopes to sign up 7 million people across the country. Simas says that will require TV ads, door knocking and lots of word of mouth.

"It is an on-the-ground effort," he says. "It is a social media effort. It is a paid media effort. It is an earned media effort. But [it's] all leading to the same thing, which is that man or woman sitting in their living room online, comparing different prices for different products and deciding what works best for them."

The administration is developing an Expedia-style website, hoping to make the experience as customer-friendly as possible.

But just getting people to that website is a huge task. Last month, a Kaiser Family Foundation poll showed that 4 in 10 Americans don't even know the health care law is still on the books.

Nancy-Ann DeParle, who has worked on this issue for years — until recently as Obama's deputy chief of staff — says that's not a cause for concern.

"The truth is that people weren't paying attention until now," she says. "There's so much else going on that even if we had wanted to start a campaign two years ago, it wouldn't have been very effective because people weren't listening."

Financial Stumbles

But with the sign-up date approaching fast, the administration's efforts have already stumbled. Health and Human Services Secretary Kathleen Sebelius has repeatedly asked Congress for money to implement Obamacare.

Republicans have repeatedly said no, while they vote to repeal the law.

Without the money she wanted from Congress, Sebelius tried to fundraise for an independent group called Enroll America that is focused on implementing Obamacare. When Republicans heard that she was asking insurance companies and health care providers to donate millions of dollars, they cried foul.

Tennessee Sen. Lamar Alexander told Fox News: "Congress has said we refuse to give you more money to implement Obamacare, and she's saying, 'Well then, if you won't do it, I'll go outside and I will raise private money, use a private organization, and do it anyway.' "

Now two Republican-controlled House committees are investigating the solicitations. Dan Mendelson of the health care consulting group Avalere says that makes donors skittish.

"Much as a health care company might really want to improve enrollment, they also need to make sure that they do not run afoul of politicians on either side of the aisle," Mendelson says.

If health care companies hold back, he says, it's going to be much harder to reach all of those people in all of those communities.

"The fact of the matter is that if you starve a media campaign for funding, you're not going to have the reach that you otherwise would, and that's the situation that we find ourselves in," he says.

There's another key part of this campaign: Sicker and older people without insurance may be eager to sign up Oct. 1. But to make the system work financially, young and healthy people who don't need much medical care have to get into the pool, too.

So you can expect administration officials around the country to give lots more commencement speeches this season, telling captive audiences of 20-somethings: Congratulations on your diploma. Now make sure to sign up for health coverage in the fall.

It's difficult for an American president to govern through nuance, especially when it's necessary to persuade a majority of the people that certain actions are essential for national security. And effective persuasion usually requires clarity.

That's how you arrive at President George W. Bush's stark formulation "You're either with us, or you're with the terrorists" after Sept. 11, and much of what sprang from it.

But if President Obama's newly recalibrated counterterrorism strategy as outlined in his speech Thursday demonstrates anything, it is his penchant for nuance.

It's a tendency required by the times. After more than a decade of two large-scale wars, Americans long ago hit the kind of war weariness that made them open to the notion of downsizing what Obama's predecessor had described as a "global war on terror" that could last decades.

But there are still enemies who seek to wage an asymmetric fight against the U.S. Thus the need for the kind of complex U.S. approach — in short nuance — that can be hard to explain or easy to misstate in the Twitter era.

For an example of this nuance, just take Obama's new guidance for when the U.S. will target individuals for destruction by drone. In the past, a terrorist suspect could apparently be targeted for that fact alone.

But the administration's new guidance, according to a White House fact sheet, requires that a suspected terrorist only be targeted if he's a "continuing, imminent threat to U.S. persons. It is simply not the case that all terrorists pose a continuing, imminent threat to U.S. persons; if a terrorist does not pose such a threat, the United States will not use lethal force."

That's a distinction that's difficult to imagine the Obama administration's immediate predecessor making, with its more cut-and-dried approach.

But part of Obama's appeal to many Americans when he was first elected in 2008 was his promise of a smarter approach to counterterrorism than Bush's, one that would improve the U.S.' image abroad. That was a vow that appeared challenged, at least when it came to the Obama administration's controversial use of drones.

Obama greatly expanded the use of the remotely controlled unmanned vehicles, with their Hellfire missile payloads, far beyond anything that occurred under Bush. The result? Growing anger toward the U.S. in unstable places like Pakistan and Yemen, and in other nations with Islamic majorities across the region.

While the use of the high-tech weapons has engendered outrage elsewhere in the world, Americans have mostly embraced the tactic.

Recent polls indicate that a majority of Americans support drone attacks on terrorist suspects. Civil libertarians and human-rights activists like Code Pink protester Medea Benjamin, who interrupted the president's speech Thursday, may question the killing by drone of U.S. citizens abroad or of the innocent — but that doesn't appear to be a majority concern.

It's this widespread support of U.S. drone warfare among the public that has given Obama the latitude he has enjoyed until now to increasingly conduct these attacks. The president didn't mention in his speech the popularity of the drones with Americans among the reasons for continuing their use. Americans' support of the use of drones certainly has made this part of his counterterrorism policy easier than it would be otherwise.

Ironically, the one part of his counterterrorism policy in which Obama showed the least nuance has arguably been the most vexing: his campaign promise to close Guantanamo, freeing those detainees deemed as not dangerous while transferring the rest to the U.S. mainland for trial.

It's not by choice, of course. He ran into fierce congressional resistance when he first tried to make good on his promise in 2009 shortly after entering the White House, and all indications are that Republican lawmakers will do their best to thwart him again. And with most Americans agreeing with them that Guantanamo should remain open, their chances of winning are probably better than Obama's.

More than 30 million Americans experience significant hearing loss, but only a third of them gets hearing aids.

There are a lot of reasons why someone who needs a hearing aid won't get one: Some think their hearing loss is not that bad, others are too embarrassed to use them, and many people say they are just not worth the price.

A hearing aid costs an average of $1,500 per year for a basic model, and unlike most technology, their price has not dropped over time.

What is worse, most insurance companies do not pay for the devices. Even Medicare does not cover hearing aids — and the Affordable Care Act will not change that.

Some businesses see the hearing aid market as an opportunity. Costco has opened hearing aid centers in discount warehouses all over the country. Other companies have started selling their own brands of the devices directly online.

Ross Porter, the founder of online retailer Embrace Hearing, says that hearing aids are only expensive because audiologists and distributors charge steep markups on them.

But Virginia Ramachandran, an audiologist with the Henry Ford Hospital in Detroit, says it is unwise to buy a hearing aid for the first time online. She says the device might be fine, but you will not know how to use it correctly.

"If someone gave you a laptop computer, and you have never used one before, you would not know how to turn it on, you would not know what programs or how to use them," she says.

Shots - Health News

Listen Up To Smarter, Smaller Hearing Aids

In his national security speech Thursday, President Obama discussed drone warfare and the Guantanamo detention camp. But a third controversial issue went largely unmentioned: the use of interrogation methods that are tantamount to torture.

Obama banned those interrogation techniques on his second day in office. But he has largely avoided the debate over whether torture in some cases has produced valuable information. He may soon find himself caught between Senate Democrats and the CIA, however.

A Senate committee report approved last December essentially concluded that the CIA's enhanced interrogation program was a disaster. The CIA is preparing a response, which is expected to challenge some of the report's assertions.

Did It Work?

It's been years since a suspected terrorist faced waterboarding. But the debate over past practices continues, thanks in part to the Senate Intelligence Committee. Investigators from that committee spent six years poring over millions of CIA documents relating to agency interrogations of suspected al-Qaida members.

The committees' findings resulted in a report that's 6,000 pages long — and scathing.

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