SPIEGEL: Barack Obama has finally managed to push his health care bill through Congress. But can it still be considered a success after the endless debates? Some Democrats are afraid of a disaster at the midterm elections in November because many Americans are skeptical about the reform proposal.
John Podesta: It will cover more than 30 million people with health insurance. We're spending more than 17 percent of our GDP on providing health care, and yet we don't have health outcomes that are anywhere near commensurate with that, particularly compared to European systems. So it is definitely a success.
SPIEGEL: The final bill, however, is very different from Obama's initial proposals. Cost-cutting in the health care sector is no longer a priority, and more competition for the insurance companies won't be introduced.
Podesta: It is certainly better for the Democrats to get something done even if this involved compromises. They have been fighting for better health care coverage for decades, and this bill is a very significant step. Let's also remember that some of the effects of this bill will be immediate. Right now, young people just entering the job market have the highest rate of unemployment. That means they don't have health insurance. Because of this bill, their families will be able to include them on their policies. The president and members of Congress will be heading out and explaining the benefits and I think the more people hear and understand about the bill, the more they will see how remarkable it is.
SPIEGEL: Not a single Republican sees it that way, though. It's a stark contrast to big social reforms in the 1960s, such as Medicare or Medicaid.
Podesta: I don't think you can say that the president did not try as hard as he could to engage Republicans -- and let's remember that the final legislation had over 200 Republican amendments included. But, at the end of the day, the Republicans were unwilling to help, and he was not going to let them prevent him from fulfilling his commitment. There is no doubt that the Republicans will campaign against the bill but, in doing so, they risk becoming simply the party of no.
SPIEGEL: Wasn't that predictable, though? As Bill Clinton's former chief of staff, you know how contentious health care debates can get -- and how fierce Republican resistance can be.
Podesta: Obama was trying to at least reach out to Republicans. But they pulled back again. That surprised him.
SPIEGEL: Many people have a different theory. This president is still popular personally, they argue, but members of Congress don't seem to be willing to follow him.
Podesta: I think that's natural. I saw similar things when I worked for President Clinton. President Bush had success with his party when he was asking them to do easy things. If you walk up to Capitol Hill and say "Please cut everyone's taxes," they'll be very happy to oblige you.
SPIEGEL: Do you think that Obama was too detached in the health care reform process?
Podesta: Quite the contrary: He got too entwined in these negotiations. So the story was all about the sausage-making and not about what he was trying to deliver and how it fit in with the other things he was trying to get done. The public lost a sense of what the big story was. He stopped making the case to the country about how his different reform elements fit together.
SPIEGEL: So he was more of a prime minister than a president?
Podesta: He has got to stop being the prime minister. Obama needs to project the strong power he has as the US president and use his cabinet more effectively.
SPIEGEL: Was it a mistake for Obama to go for the "Big Bang," to try several big reforms simultaneously in his first year?
Podesta: No. The analysis he proceeded from was that unless you could get these strong foundations by attending to the things that needed reform in the US economy, you couldn't have strong sustainable growth. What perhaps surprised the people in the White House was how long the health care debate took and how little real support there was from the Republican Party.