President Obama has framed the health-care debate in Washington as a campaign against insurance companies whose irresponsible actions, he repeatedly says, must be reined in to control costs and improve patient care. In North Carolina this week, he told an audience that the existing system "works well for the insurance industry, but it doesn't always work well for you."
The message is no accident, as the president's chief pollster made clear in a rare public speech last month. Joel Benenson told the Economic Club of Canada that extensive polling revealed to the White House what many there had guessed: People hate insurance companies.
"Take the public plan, for example," Benenson said. "Initial reaction to it wasn't as positive as it is now. . . . But we figured out that people like the idea of competition versus the insurance company, and that's why you get a number like 72 percent supporting it."
Earlier in the speech in Toronto, Benenson said bluntly that people "think the insurance companies have been the villains here, not the government."
Even if that is the case, recent polling also shows growing public anxiety about what health-care change would mean to them, and about the role of government in any new system.
Obama is known for his soaring speeches and his ready command of facts, but the health-care debate illustrates ways in which he and his team carefully calibrate his language with intensive polling, surveys and focus-group data.
Benenson, who also served as Obama's pollster during the campaign, declined to discuss the administration's efforts, as did many other senior White House officials. But since the early days in office, Benenson and other top advisers to the president have gathered every Wednesday night to discuss their latest polling and how to use the results to advance their ambitious agenda.
One top adviser said, "I mean, I'm looking at polling, like, all the time."
Obama's decision to focus his public rhetoric on insurance companies has become more noticeable as the White House has sought buy-in from most of the other health-care groups, including doctors, nurses, hospitals, drug companies and AARP.
In remarks at a town hall in Shaker Heights, Ohio, on July 23, Obama vowed that his changes would "keep the insurance companies out of your health-care decisions." At a meeting of the American Medical Association, Obama told doctors that his ire against insurance companies comes from personal experience.
"I will never forget watching my own mother, as she fought cancer in her final days, worrying about whether her insurer would claim her illness was a preexisting condition so it could get out of providing coverage," Obama said.
Benenson is part of a team of survey experts who have been with Obama since the campaign. Paul Harstad, Benenson's partner, and David Binder, a San Francisco-based expert on focus groups, also continue to provide guidance to the president about public opinion.
In his speech, Benenson ridiculed Republicans in Washington for misunderstanding the public mood on health care. He said the GOP is "still locked into the language they used 15 years ago to call it government-run health insurance, whereas . . . people like the idea of having a public plan that can compete with insurance companies."
Geoff Garin, a longtime Democratic pollster who worked for Hillary Rodham Clinton during last year's campaign, said Obama's use of polling to tap into the public's anger toward insurance companies has been particularly effective in putting the Republican Party back on its heels.
"When the Republicans speak against the public option, it comes across as 'Pity the poor private insurance companies who won't be able to compete with the private plan,' " Garin said. "They often end up sounding more concerned about what will happen to the insurance companies than what's happening to insurance."
The president's team believes in the use of sophisticated data to make sure his rhetoric does not strike a dissonant tone with the majority of the listening public.
That has been true in the White House before, no matter which party held the presidency. Bill Clinton attended polling and strategy meetings in the Oval Office, also on Wednesday nights, during the second half of his first term. Mark Penn, who was Hillary Clinton's chief strategist last year, ran the meetings.
But Benenson suggested in his speech that Obama's campaign operation -- now extended into the White House -- has gone further into trying to understand public sentiment than previous campaigns or administrations -- a claim that some of his rivals question.
Benenson said Obama's polling operation goes beyond the "top-line questions" that most pollsters ask, delving into areas that sometimes seem like tangents. He said that many pollsters think voters are "rational and logical" but that his team also focuses on their fears and emotions.