In a few hours from now, President Barack Obama will give a live press conference to the nation. This is part of a new and concerted media effort by the White House to make Obama much more visible in the debate on healthcare reform. But being visible is one thing, and showing leadership is another. Because President Obama has so far been unwilling to tackle the tough decisions on healthcare reform, at least not in public. And, as Obama is accusing his detractors of doing, this is nothing more than playing politics with the issue by avoiding personal political risk to himself. Disturbingly, Obama hasn't even been very good at this political cheerleading, although he has gotten better in the past few days.

Obama's legislative style (as evidenced so far, on major bills) has been to vaguely define what he's for, introduce a plan that is quite obviously open to lots and lots of negotiation, and then sit back and let Congress work it out. The White House deploys Obama's chief of staff Rahm Emanuel up to Capitol Hill, who twists a few arms and makes more than a few compromises. At the eleventh hour, Obama appears tough, and says things like "the time for talk is over." So far (see: the stimulus package) this has worked well for him. He has gotten 80 to 90 percent of what he asked for, without too much pushback from his own party. Perhaps he is (or, at least at the beginning, "was") serious about wanting bipartisanship, but in reality it matters little as long as bills get passed that he can sign.

But this may not be enough on healthcare legislation. Obama is facing much stiffer resistance from within his own party, and Congress appears in danger of bogging down over the issue and not moving forward, or sacrificing so much of the core reform that whatever passes will be next to useless.

Now, Obama can help on two fronts tonight, if he has the political willpower. In other words, if he shows the willingness to deploy leadership skills and take a few risks, to draw a bit of heat off his allies in Congress. The first of these fronts is to make some sort of "the time for talk is over" statement. He could actually reject some of the possibilities being discussed on the Hill by some Democrats. Conversely, Obama could draw a few lines in the sand by threatening a veto if he doesn't get this or that program he supports. This would make big news. The other way he could drive the media narration is to loudly reclaim the high moral ground in the debate -- and remind the news media the starkness of the problem he is trying to solve for America. In chilling detail.

In the first instance, Obama needs to realize that when you're "for everything," you are to a large degree, "for nothing." Think about it -- Obama has offered varying degrees of support for just about every idea out there on healthcare reform at one point or another. And he has only denied a "seat at the table" to one very large idea -- single-payer. This is somewhat understandable both politically (Obama shows from the very start he isn't "captive to the far left") and practically (because single-payer is somewhat of an all-or-nothing choice, it leaves very little room for compromise). This also has absolutely enraged the single-payer supporters, as well it should. Because they were publicly and pointedly denied their "seat at the table," they weren't even provided an opportunity to make their case to the public. When Senator Max Baucus had some doctors arrested at a Senate committee hearing, the message could not have been clearer: "We do not even want to hear what you have to say." This was a public-relations mistake. If single-payer advocates had been allowed to make their case, and then had it wistfully rejected by the president, it would have made that bitter pill a lot easier to swallow.

But Obama has so far been reluctant to shoot down any other idea, no matter how unworkable or obstructionist it may be. This is also a mistake, and it is what I meant when I said Obama is playing politics with the issue. Obama appears to be more concerned with his own political capital than he is with solving the problem. This may be a mistaken appearance, but it is nonetheless one that is taking hold, even from the left -- which is dangerous for Obama not just on healthcare reform, but for the entire rest of his term and the rest of his agenda. If Obama is seen as figuring that he can just sit on the sidelines and cheer for every idea out there; because -- no matter what eventually passes -- he comes out of it on the winning side, it will damage his standing with the public in the long run. Alternatively, if he throws his weight behind one idea over another, and if his side loses in the congressional wrangling, then he risks "Obama's Plan Defeated!" headlines -- something he has just not been willing to risk as of yet. If Obama pushes for one idea over others, and doesn't get it, he risks being seen as forced to compromise on the issue. Since there are a number of key issues with healthcare reform (how to tackle it in general, how to pay for it, and how to reduce costs), Obama could wind up winning a few and losing a few. But he would (it seems) rather float above the fray, so that whatever emerges he can then call his own.

This is not leadership, it should be noted. This is political opportunism.

Obama's fans will likely point out at this point that he has indeed been getting a lot more forceful on defending his vague goals and aspirations for healthcare reform. And he has actually drawn one sharp line in the sand in the last few days, with a veto threat for "anything which adds to the national debt," or demanding that any bill be "revenue-neutral." The White House is already doing a bit of fudging with Medicare reimbursements on this issue, but at least Obama's standing up for something in the debate, so he has to be given credit for that.

But on the details, Obama appears much more willing to horse-trade away just about anything so that he can get a bill on his desk that he can sign, and then chalk it up as a significant legislative victory -- even if it is so watered down that it does little to "fix" the healthcare problem. He needs to (and most likely will) show some serious frustration at the way the process seems to be heading right now, and show some backbone towards getting it back on track. In plain language, Obama needs to show a lot better than he has yet that he cares about the actual result more than he cares about an empty political victory on healthcare reform. Sooner or later, he's going to have to say "no" to somebody, because not every Democrat is going to get what they want out of the bill. That's just the way the sausage grinds in Washington. Obama could score enormous political points by saying something along the lines of: "Some Democrats in Congress have taken an awful lot of money from the healthcare industry, and they need to make a decision -- vote with the special interests which funded your past campaigns, or vote for your constituents' needs." He could even back this up (which would also do wonders for him politically) by saying loudly: "Any Democrat who loses campaign donations as a result of voting for their constituents' interests over big donors' interests, I will personally raise money for and campaign for in your next election." This shows both the carrot and the stick at the same time.

Which brings us to the second front he needs to be fighting on. Obama also needs to project a greater sense of urgency about the process itself, to counteract all the "whoa... let's not rush into anything" soft obstructionism we've been hearing of late. In Obama's recent media blitz, he has been doing a fairly good job of this, but he needs to hit it harder. This, in his defense, is an area where Democrats routinely fail to communicate well on -- and fail so prominently that there's a number of excellent books explaining exactly how Democrats fail in this regard, and how they should frame issues better.

To reduce it to its core: you need to tell a story.

People relate to stories. They relate to urgency if it is explained. They relate to politicians who "understand people like them." And if healthcare reform is not achieved this year, it is my firm belief that this will be the reason why -- because Democrats just aren't that good at indignantly taking the moral high road. Obama used to be, back when he was on the campaign trail, but that "fierce urgency of now" has been all but absent in the entire healthcare debate so far.

Where are all the stories, for instance, of the millions of Americans who have gone bankrupt due to medical problems? Where are the stories of the millions who have seen their houses foreclosed upon due to medical problems? Where are the stories of people losing their life's savings to pay for something they thought they were covered for? Where are the stories of people being denied insurance because of pre-existing conditions? Where are the stories of people who have been dropped by insurance companies because they had the effrontery to actually get sick and want care paid for? Where are all these stories in this debate? Why do we not hear at least one of these stories -- a brutal description of what some average American citizen had to go through due to sickness -- each and every time a Democrat appears on the mainstream media? All it would take would be one Republican to scoff at such a sob story, and the framing would be complete: Democrats care, Republicans don't.

Statistics are just not good enough. Sure, it's fine to say: "over sixty percent of personal bankruptcies in America are due to medical problems," but it just doesn't have the same punch as saying: "I was talking to one of my constituents the other day, and she had worked hard all her life and paid medical insurance premiums for decades, but then had to have a hip replacement and was denied by her insurance company. She lost her home to foreclosure, she lost all her retirement money, and she still had to declare bankruptcy -- through no fault of her own other than needing treatment for a medical condition she thought she was insured for, and now she can't even afford the drugs she needs to keep her alive. This has to end! This is what we are trying to fix. This is why we're trying to fix it. And any bill I see which does not directly address her specific problem I can not and will not support."

See how easy that is? This ain't rocket science. All you have to do is tell a story that is similar to the stories we hear from our parents, our friends, or even what we're personally going through ourselves. You can say "sixty-two percent of bankruptcies blah blah blah," or you can tell someone's story -- the content of the argument is exactly the same, but the emotional effect on listeners is vastly different.

And as an added benefit, nobody can argue the other side of this equation, at least without leaving themselves wide open to charges of "defending the status quo." This isn't a debate on something like global warming, where scientists can dither about whether there's even a problem until the public stops listening. This is something that just about every American family either has faced, or is terrified of facing. It's not that hard to connect with the public on the issue, in other words. And it's also easy as pie to take the moral high ground in this case -- all you need to say is: "This must end."

President Obama has been moving in this direction in the past week or so. But he's still not really there yet. He has not adequately shown enough moral indignation at the status quo. He has not projected the image that he is fighting for you in this fight. He has not shown nearly enough dudgeon in denouncing the abuses we currently accept in our system on a daily basis. Tonight's press conference may be his best (or even his last) chance to make this connection with the American public.

Because even if Obama stayed away from the details, and politically rode above the fray in a risk-free manner, he could still "buck up" (as he said last week) the Democrats on the front lines of this fight who are actively fighting for Obama's goals in the congressional committees -- and who also are, at this point, fighting with other Democrats. Obama has shown some real frustration with the deterioration of the schedule he set for Congress, because he knows that the longer this fight drags on, the less chance there is of him signing anything this year. And if it gets pushed into next year, then Congress will start all over again, meaning he will have lost any ground (and any momentum) he now has.

But Obama also has to start to crack the whip a bit. He could do this in a number of ways, both direct and indirect. He has already started running ads which tell a few healthcare horror stories in home districts of wavering Democrats. But he could also let it be known that if Congress takes five weeks off in August without passing anything, that he will personally appear in town hall meetings in each and every home district of Democrats who are blocking legislation -- and explain to that congressman's constituents exactly how many dollars their elected representative has taken from the healthcare industry, and exactly what they are now opposing. If you think this wouldn't motivate a few Democrats, then you don't know Congress very well.

What Obama may be using as his giant lever tonight, though, is an issue that Nancy Pelosi may have just teed up for him, in the absolute guarantee that it would provoke a question for Obama: cancelling (or scaling back) Congress' five-week summer vacation, until they pass a bill. I have been suggesting using this lever for a while now, and will be interested to see if Obama firmly grasps this giant prybar tonight. Pelosi herself has shown (last year, mostly) that she is adept in this maneuver, having pushed through many tough votes and bills on the last days before congressional vacation weeks, and she has now given President Obama the gift of calling for such an action herself right before Obama's nationwide press conference, so I assume Obama's going to follow through on this tonight.

I would love to see tomorrow's headlines scream: "No Vacation For Congress Until They Pass Healthcare Reform!" Or perhaps: "Obama Issues Veto Threats In Support Of..." (just about anything that finished that one up would probably be OK with me at this point). Or even: "Obama Threatens Blue Dogs," again, no matter what the subtitle read. Obama is unlike every other politician in Washington, because he owns the bully pulpit. He can grab an hour of television time, which nobody else can do. But if he refuses to say anything new, if he refuses to strongly support or strongly come out against this idea or that, then he will show he hasn't mastered the power of that bully pulpit. I'd even settle for the headline: "Obama Says 'This Must End!' To Healthcare Woes."

Because each and every one of those headlines says, in essence, the same thing: "Obama Shows Leadership On Healthcare Reform." That is what has been painfully missing in this debate so far, and what is absolutely necessary for success at this point in time. Please, Mr. President, don't disappoint tonight. Show some frustration. Show some empathy for average Americans. Show some impatience. Show some backbone. But most importantly, show some leadership.

[Note: Possibly due to articles of this nature, I was not included in the White House's recent outreach to the liberal blogosphere on the healthcare issue. Just in case anyone was wondering, the opinions expressed in my columns on healthcare reform are my own, and have not been "encouraged" in any way from the current administration, or anyone else for that matter.]

Cross-posted at The Huffington Post