>> should even the insane be allowed to vote? last night, republican john campbell of california admitted finally after waterboarding from me, his belief that mr. obama was born in the u.s. but that wingnut base of the republican party that traffics in this kind of nonsense is threatening to become a big problem for the gop. at least if the party wishes to grab hold of reality on its way back to power. think this talk isn't important? do you remember that the guy who shot and killed the guard at the holocaust museum was one of these people? much more on that later in "hardball." plus, you think the fight for health care is rough, check what happened in south korea parliament. we eat get you that in the "side show." and in one hour, msnbc brings you live coverage of president obama's news conference. at 9:00 eastern it's the "rachel maddow show." and we'll have a brand-new show

tonight at 10:00. then at 11:00, time for an all new "ed show" with ed shultz. we're joined by david axelrod. thank you for join us. it's a big night for the president. before we get to health care which is right on the front burner right now, what do you make of these members of the u.s. congress, including senator shelby out there saying they don't know whether barack obama is legitimate as president. they don't know whether he's a native born american or not. >> i got to tell you, chris, given the problems that we have to deal with in this country and the struggles that people are going through in their daily lives i would think they'd be awfully frustrated that time was being wasted on something as silly and trite as that. i thought we left this behind when in the campaign when people were challenging both mccain and obama over whether they were constitutionally qualified. those issues were resolved. this is a heck of a time to resurface them.

>> let me ask you about what's on the front burner, as i say, health care. is there any feature of this bill that's being debated in the senate finance committee especially right now where the president will tell us what he wants? will he say he wants individual mandates, employer mandates, something on portability, something on pre-existing conditions? is there anywhere he will say i'm taking the lead, i want this in the bill? >> chris, a number of these things have been broadly agreed to, not just in the senate finance committee but in all the five committees that are considering this legislation. certainly banning the exclusion of people who have pre-existing conditions from getting health coverage is one of those. there are a series of health insurance reforms that are going to be very important for people who have insurance that everybody agrees to, in fact, 80% of what would go into a health insurance reform plan, a health reform plan are agreed to. there are a few issues left it need to be resolved and that's what's being discussed.

>> where is the president on an individual mandate, in other words, the requirement that young and healthy people have to share the costs of national health care? is he for that? >> the president has said that he embraces the concept that everybody should be in the system, and the reason is simple. every single american is paying for those who are not covered now. to the tune of $1,000 or $1200 per family in their health care premiums to pay for unreimbursed care. so it's important that we deal with that issue. >> let me ask you about, i guess i have to ask the question, what's in it for people who are insured? >> yeah, i think it's a very good question, and it's one the president will address tonight. and you know, other than the stability which is primary that if you lose your job, change your job, move, if you become ill, you'll still have coverage and it will for bid insurance companies to do some of the things that they've done before

such as banning people who have pre-existing conditions such as removing from coverage people who get sick. we have this perversion in the system called rescissions that allows insurance companies to say you know what? we didn't realize you were going to have this serious illness and so we're rescinding your coverage. all of those kinds of reforms will be part of this package, and so there's an enormous amount to be gained. and understand that in terms of bending the cost curve of health care, people in this country are paying 10% more every year. in the last decade, their health care costs have doubled. their out of pocket costs have increased by a third. and there is more and more and more people are under insured, losing their insurance. we have to chain the dynamic here and that's important for everyone whether they have insurance or not. >> up on capitol hill where i

worked all those years they had the federal employees credit union where you could borrow money say for a big purchase like a car and get it at pretty low interest because nobody was making any money on it. it was a shared cooperative. is that the role model perhaps for kind of a co-op which would meet the needs that democratic liberals want to have for a public option and may not fend the conservatives to the point they wouldn't be on board the bill? do you think it's something the president would go for. >> i think the public choice, the public option he has proposed would function in much the same way. it's not going to be subsidized more than private plans would be subsidized. the administrative costs would be lower because it would be a not for profit and that would force the insurance companies to compete. it's a way of keeping the insurance companies honest and creating more competition and so he believes that the public choice is the way to achieve that. others may have other ideas.

i've said many times that the president is interested in moving this process forward. and so he's not drawing bright lines in the sand except for a few issues. this certainly has to pay for itself. we can't add to our deficits through this reform. and it has to achieve the goal of bending the cost curve on the growth of costs in health care. >> you know what the conservatives are most concerned about a national health system like have you in britain. they don't want a big bureaucracy controlling all decisions about rationing any kinds of operations you might need or a heart transplant or liver transplant. they don't want the federal government deciding that. is a cooperative something that our president could accept rather than that kind of big bulky english style bureaucracy? >> look, chris, nothing that has been proposed either a public plan or the co-op would deliver a single pair system of the sort the republicans who oppose this have held up.

that's a strawman. the fact of the matter is if you want to talk about rationing, there's a lot going on in will your health system today controlled by the insurance companies who are denying people care that they need. so what we need are insurance reforms that will protect consumers in this process, and that will be delivered through this health care reform. >> the big question has been raised by some democrats 19 the democrats in the house have raised the question of abortion. the hyde amendment is strict. dick durbin said the hyde amendment still stands, you can not use federal money for abortions, period. is that going to be the case with regard to a national health bill? >> i know this issue is being discussed and there are people of great concern about this. our position is we ought not to be dragging that issue into this debate. we want to get people health care that they can afford.

we want to hold down this inexorable prodigious rise in rates that are crushing people, businesses, and the government and we ought to focus on the main issue and not make this another forum for that debate. >> but if the federal government spends money on abortions, that means people who believe abortion is evil would be forced to have their tax money go to pay for abortions. how do you justify that? >> i think that if people have the option to -- we want to provide people with choice within the health care system and they also will make a choice about their own personal decisions. we are not prescribing you know, that they choose abortion. in fact, the president has talked about discouraging abortion, but to me, this is a way of diverting the debate from the main issue which is what we're going to do about our runway health care costs. >> those 19 democrats who wrote

the letter to the president weren't trying to divert. they're probably for national health insurance. i'm asking you, can you promise monies paid by the government for the health plan will not go to pay for abortions along the lines of the hyde amendment that makes it very clear you can not do that. >> i'm sure this issue is being discussed and i'm sure we will arrive at a solution people can live with. >> let me ask you the last question, timing of this. the recess coming up in august. is there a sense on your part that it's now or never, that if you let this slip into the fall, that the organized opposition to any kind of national health effort will win the fight over the recess and you'll have an even tougher time when you get back? >> that is the game plan that senator demint laid out in his conference call with conservatives over the week when he said you know, if we stop him now, we can break obama. well, it's the american people being broken by the costs of this health care system. i believe that we need to move forward. understand that even if this

bill passes out of the house and passes out of the senate, individual bills, we're still go to have a big debate in the fall as they try and reconcile the two. the opponents want to stop the process now. they want to stop thoughtful consideration and want to stop the process from going forward and i think that would be a disaster for the american people. >> thanks so much for joining us on "hardball." david axelrod, senior adviser to the president. a big night for everybody tonight, including everybody watching tonight. everybody cares about health care. thank you very much, david. >> good to be with you. coming up, how big a problem does the republican party have with its lunatic fringe?

coming up, president obama will talk health care at the top of the hour. can he convince congress and the american people to seal the deal?

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president obama is holding a press conference tonight. but some don't believe he's president. some conspiracy theorists are saying he's not an american because he doesn't have a birth certificate. that's baloney, but that doesn't stop misomeone at mike castle's town hall meeting. watch. >> i want to go back to january 20th and i want to know why were you people ignoring his birth certificate? he is not an american citizen. he is a citizen of kenya. >> loony tunes. and this craziness has spread to capitol hill for real where a group of congressional republicans is pushing for a bill requiring presidential candidates to provide their

birth certificates. we know where that's coming from. dee dee myers was press secretary to bill clinton and a contributing editor to "vanity fair". this isn't a joke actually. senator shelby, richard shelby has been around a long time from alabama, he says i haven't seen any birth certificate. putting out that word. we've got somebody out here, congresswoman blackburn. we know her pretty well from tennessee said her persons putting the word out, people are losing faith in our system because they haven't seen his birth certificate. posey, bill posey from florida

who's a u.s. congressman saying i can't swear on a stack of bibles whether he is or he isn't a legitimate citizen. randy neugebauer doesn't know if obama is a citizen or not opening questioning whether he's an undocumented alien. what's this about? it smacks to me of what the republicans did to mike dukakis, deamericanize the guy. >> there was a certain element that tried to do that from the beginning of the campaign to the end. i guess it's coming back around now because of congressman castle's town hall which we saw. you didn't show it just now but the crowd turned on him when he said i think he's an american citizen. they went with the woman. every shred of evidence suggests that his birth certificate is legitimate. you have a copy of it right here. state officials in hawaii -- >> i feel like i'm in court here. got to defend the guy. >> state officials in hawaii -- >> a farm in california somewhere. we have to disclose the document here? what's going on here. >> can you confirm the chain of custody of this document, sir? >> take this -- excuse me, let me move on to the other witness here. excuse me for a second. back to you in a minute. tony blankly, what is it about the republican party that contains this wing?

>> it's not about the republican party. it's about american politics. both parties inevitably have some faction or fraction of their base that refuses to accept a certain fact or believe something wrong about the other candidate. we had the bush derangement syndrome. we had people who thought that kennedy couldn't keep a secret from the pope because evers a catholic. i remember hearing friends of parents of mine say that. you had people who thought eisenhower was a communist. it didn't matter his whole history. what happens is the politicians. >> and his brother milton were both communists, yeah. >> what happens in politics is we all understand is that no politics wants to offend any part of his base. >> even those who are

certifiable. >> so for instance, i can remember many liberal democratic, not even liberal democratic congressmen over the last eight years who wouldn't fundamentally disagree with the crazy stuff some of their people said about george bush or the vice president. it didn't mean they shared the view. as a practical matter, we've all been in politics. >> before we go completely illegitimate here, because i want to talk about this congressman on the show last night. had to water board him last night. john campbell came on with the pretense he was just doing this to clear the air as if it needed to be cleared. here he is talking about a requirement in this bill that presidential candidates show their birth certificates like they're going tore a job somewhere. i don't care if they have to show their birth certificates but we know why they're doing this. here we go. >> do you have any doubts, congressman, about the authentic native birth in this country of our president? do you have any doubts? >> chris, my -- it doesn't matter whether i have doubts or not. >> do you have any doubts. >> it doesn't matter if i have doubts or not. >> a simple question. no, no. you are feeding the whacko wing of your party. do you believe that barack obama is a legitimate native-born american or not? >> that is not what this bill is about, chris. >> what do you believe?

>> as far as i know, yes, okay? >> as far as you know? i'm showing you his birth certificate. >> i'm looking in a camera right now. i can't see that. >> do you want me to mail it to you? >> no. >> he was a good sport about it. clearly he changed direction. he went from saying i don't know to i know. >> that reminded me of what hillary did during the campaign when she said to the best of my knowledge she didn't know. same exact thing. >> not the same exact thing. she didn't want to offend that part of her. >> no, she wanted to win the prize. if you can get doubt about your opponent's bake right to run, you've got a leg up on them. >> that's the thing. you were having fun. he was willing a little bit. >> he was a good sport. crazy to cosponsor a bill he didn't really believe in though. >> i think he thinks it helps in his base. the problem for the republican party now is they're trying to rebuild a base that's been

shrunken over events in the last decade and it doesn't help when you build from the fringes in, you need to build from the middle out. >> more pressure from the democratic side to be even steven here. there are some that believe the ohio election results were fixed. diebold company was in league with the republicans and they fixed the machines out there. >> that's a good one. >> would you say that's equivalent? do you want to defend that. >> therefore not a legitimate president in either election. >> i believe that bush was -- i mean he didn't win the popular vote. >> do you believe that those machines were fixed? >> no, of course, not. i want to remind the people that bush did not get a majority of the popular vote in 2000. i still believe that he was legitimately elected. >> you guys are both communication experts. we both all did it, we all three

ex-communications experts. what's he have to do tonight, the president. >> has to reassure the person public he has a plan for health care that's going to be good for their individual families. >> and for people who have health insurance. >> right, because 90% of americans have health insurance and the majority of people feel pretty good about that, although the healthier they are the better they feel about their insurance which is an interesting pickle. >> the president seems to be off the tracks a bit. right now, i feel with orrin hatch dropping off the committee of thing, it's down to two republicans, olympia snow of maine and charlotte grassley of ohio on the finance committee. it's pretty precarious now for them. >> got to get republicans to help them. >> i don't know the head count. counts don't matter till you're up to the vote. >> i'm talking about getting to the floor. >> here's the fundamental problem the president has. his vision as he's described it about health care and the deficits are not consistent with what the cbo says the legislation coming up is about.

that fundamental contradiction he's got to fix somehow. fix the legislation so it's consistent with his vision what he's been calling for since the campaign or modify his vision in some way. if he keeps trying to push those two things that aren't the same together, i think he's going to eventually lose more and more ground. he needs to make a cold decision -- i think this is going to happen in september or october. not next week. he needs to decide which one of those pieces do i want to fix, change my vision. >> you're saying it's a compromise. >> he's got to be consistent. >> did you hear that? >> i agree that he's right now he's losing the argument on whether it will save money. you can may a strong argument that more people will be covered. under the bills we see coming out of the house and the one being negotiated in the senate, but cbo keeps saying the costs are going to rise, not shrink. >> the cost of the iraq war before the war. and the way republican -- >> the circumstances were different. they were trying to go along with it by leaving wiggle room

and later saying i told you so. >> here's the democrats' problem. republicans or any opponents of the president can take his own words when political ju-jitsu of what he wants to accomplish and oppose them on the legislation that's coming out. >> you're good at this. thank you very much. you both believe the president's an actual native born american. right? >> with all my heart. >> thank you, dee dee myers, tony blankley. up next, will governor marc sanford stop talking about his mistake? that's "hardball" side show. only on msnbc.

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back to "hardball." time for the sideshow. first up, it's hard to change the subject. just last month, south carolina governor mark sanford disappeared to buenos aires and admitted to a connection with a argentinean woman. yesterday, he was hoping to get

back to business with a press conference in a local dmv in order to talk about federal i.d. cards. well, the questioning didn't go as planned. >> do you think your affair will always be a distraction? be. >> life and the choices that we make begin each day anew, so it's as much a distraction as you want to make it. i'm going to move on with my life. i'll put it to you this way. have you made a mistake large or small in your life? >> i'm asking you. >> no, i'm asking you. >> where's your ring? >> what's that? >> where's the wedding ring? >> governor, why aren't you wearing it? you're still married to your wife, correct? or are you still taking trips down to argentina to see your soulmate? >> keep going. >> why do politicians have to go through this ritual of calling

things like this mistakes? did he think it was his wife down there waiting for him in argentina? did he make a mistake? did he think it was his wife he was writing those e-mails to? did he make a mistake? why doesn't he just say it is what it is. if he fell for the woman, shouldn't he keep his feelings about it to himself and his family? why do these guys have to debase themselves for us. next up, behind closed doors, catch this scene in south korea's parliament earlier today. members from the ruling party were hoping for a speedy vote for a reform bill that would ease restrictions on ownership of media networks. to stop them from doing it, some opposition members of congress blocked the door with a pile of furniture, at which point the ruling party forced their way through the door and began to conduct a vote. at this point, the opposition forces stormed the podium and tried to stop the vote. they failed. the bill ended up being passed. talk about a sharp elbow to democracy. now for tonight's big number. back in may, not so long ago, born-again democrat senator

arlen specter led republican pat toomey by 20 points. what a difference a few months have made. old toomey has closed the gap. accord to a new poll, specter now leads toomey, 45-44, which means it's a one-point race. given the limitations of polling it basically means it's a tie. folks, anything can happen here. people in pennsylvania had this crazy idea democracy means having a choice. we've got a one-point race for the senate in the 2010. tonight's big number. up next, president obama's prime time news conference tonight. will he convince the american people that his plan for health care reform is the way to go? you're watching "hardball" only on msnbc. ) illness doesn't care where you live... ...or if you're already sick... ...or if you lose your job. your health insurance shouldn't either. so let's fix health care. if everyone's covered, we can make health care as affordable as possible. and the words "pre-existing condition"

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i'm me -- milissa rehberger, goldman sachs paid back its original $9 billion in only nine months plus dividends. that's a return of 23%. vaccines and drug makers are asking for volunteers to test the swine flu vaccine. federal authorities spent more than two hours today searching the houston offices of michael jackson's doctor. dr. con regard murray's lawyers said they seized documents and a computer hard drive. on wall street, the end of a winning streak for the dow and s&p 500, but the 11th straight day of gains for the nasdaq. the dow jones industrials lost 34 points, the s&p 500 is down half a point and the nasdaq added ten. now back to "hardball."

welcome back to "hardball." less than 30 minutes from now, president obama's press conference begins. andrea mitchell's, nbc news's chief foreign affairs correspondent and host of mitchell reports and "newsweek's" howard fineman is an msnbc political analyst. here's an excerpt right now we're going to read to you of the president's prepared remarks. the white house put this out so we could get a little bait here, i suppose. this is from the president tonight. he'll use this in his opening statement. i realize with all the charges and criticisms being thrown around in washington, many americans may be wondering, what's in this for me? how does my family stand to benefit from health insurance reform. tonight, i want to answer those questions. i think he has to first answer the question, are you doing no harm? since i'm one of the 85% of the people, i'm speaking for the public out there who have health insurance. >> it's the political version of the hypocratic oath. i think what he's going to say is something he hasn't been

saying that much, even though he's been out there every day, which is this will improve the health care you already have. this will put a cap on the total amount that you will pay, this will bar the idea that you can't have a pre-existing condition. that's something in most vefrgss of the bill. he's going to say this will strengthen and improve what you have. >> it affects more people. than people who aren't insured. this says to a person, spouse or worker or to a family, if you hate your job, you can leave it now. if you lose your job, you can leave it now and still have health insurance. that's a hell of a commitment in times of double-digit unemployment. >> i think it's more a case of if you lose your job, don't worry. you can still afford to buy health insurance. that's the broader message to the american people. the other message is an internal

message. and his direction right now is to the conservatives to the moderate democrats, to those few stray republicans that there will be cost containment. and also to the broader american public concerned about cost. >> and this is a quote from the president's text tonight released by the white house. i have also pledged that health insurance reform will not add to our deficit over the next decade. and i mean it. is that what he's saying. this is to the fiscal hawks, which is almost everybody now. >> what he said originally and what his budget director said, guess what? we're going to improve health care and save money at the same time. this was going to bend the curve. it's going to save us money in the long run. other wise we'll go bankrupt. that doesn't quite say that. that just says in the first few years it's not going to cost us money. he hasn't shown how to do that either. >> he hasn't shown how he's going to do that. he's sending two messages. he's saying it will not increase

costs but he also said to "the washington post" in an interview they just released tonight, the editorial board director, he said we're going to bend that curve. i'm not going to sign anything unless it both contains cost and also brings down inflation. so if it contains costs in the short term. >> the only problem is -- as usual, andrea is ahead of the curve, so to speak. but the bending is over the horizon. you can't see the bending. it's out there somewhere. >> translate that, that means the cost curve will go down? >> at some point the percentage of the american kbeconomy devot to health care will go down. >> most people out there have some sort of health insurance, plus they know there are people sitting in emergency rooms for two or three hours to get basic health care. they've been told by democrats for decades, you're paying indirectly for those emergency rooms people because they're going to -- hospitals are charging that back to you as

part of your health care, right? so if that's true, there shouldn't be any added cost to health insurance. as they say, you're already paying for it indirectly. if we're already paying for the health insurance for the people in the emergency rooms, then why is the bill going up in the defic deficit? >> the president's problem is the congressional budget office is the scorekeeper. and what doug ellmendorf said in a hearing last thursday, what is still reverberating is the costs are going to go up. you can not expand coverage -- you haven't proved how you can bring those costs down. >> let's talk a minute about the politics in this. the president is saying in his speech tonight, here's a preview. i've heard that one republican strategist told his party that even though they may want to compromise, it's better politics to, quote, go for the kill." another republican senator said that defeating health care

reform is about breaking me. so let me be clear. this isn't about me. howard in a sense it is. he wants that "w" next to his scorecard the same way the republicans want there to be an "l" next to his. so there's politics in this. >> the people in the white house who have a sense of history believe that this is not '93-'94. >> but crystal has the same guy. >> he hasn't changed as all. what the obama people are saying is there's a consensus on the need to expand and reform health care. this is not a threat to the democratic president that's going to result in a revolution in '94. they on the white house believe they're on the right side of this this time. that's what they believe and what obama wants to do is be able to say i made history by guaranteeing health care for all. i did something that harry truman couldn't do, lyndon johnson couldn't do. >> that's a reasonable career

goal. >> for a democrat, it really is. >> if they're so confident this is not 1939, why is he so risk adverse. why does he not want to put out his principles? >> you know the answer and i will remind you. hillary rodham clinton thought she could take a bill up to the hill, hand it to them and say yes or no. the answer to that, let the hill work it out. let the republicans join in like grassley of iowa, like mike enzi of wyoming, like olympian snowe of maine. let them have a hand in preparing this dish, if you will. if goi up there and say eat this, they won't. >> they're saying we're getting close to eating the stew and we don't want to eat it until you give us -- >> i was talking to david axelrod. is the president willing to tiptoe out there on the clip tonight and say i want the following. i want an individual mandate.

young people, healthy people, sorry kids. you have to join a team here like with your driver's insurance. i want an employer mandate, i want at least a cooperative in this. something like a credit union. i want portability. i want something on pre-existing conditions. that's what i want. >> he's been out thereto every day saying the same stuff in the excerpts that we've got. this isn't all that stuff. he's got to be more specific. >> i like the way you wave it. agree with andrea, he has to get out there and negotiate in public to some extent. >> is there a risk of doing what he has to do, saying here's what i need, boys and girls. i can't no longer wait for you to do what you want to do. owe. >> it's a target on him, a absolutely. maybe he says mike enzi or chuck grassley say well, that's the one thing i can't do. >> what he's going to do is for one thing satisfy the blue dog democrats by saying he's in

favor of this outside commission, sort of like a base closing commission, but not really which will bring down costs. >> why is a republican in better shape by saying i'm a republican, i'm a fiscal conservative, but unless we have health care for everybody this society is not going to hold together. >> the thing is republican leaders in the congress have been getting out there on the floor of their respective chambers saying that in theory. they say we all are -- but they're not putting out -- >> that's like saying ronald reagan was for something like medicare, but he wasn't. he was for the ama version, which is not medicare. >> i know. >> thank you. up next, president obama will speak tonight at 8:00 in less than 20 minutes, in fact, trying to sell what has to be sold if he's going to have his big first year. and if a lot of people are going to have health care. this is "hardball" on msnbc.

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we're back. time now for the "politics fix." join meg tonight, kelly o'donnell, msnbc's rachel maddow, host of the rachel maddow show. and dr. nancy snyderman, chief medical editor and host of "dr. nancy" on msnbc. kelly, what do we know about his speech, the opening remarks. >> good evening, chris. the president really has two audiences. to the general public he wants to make a case that health care reform really affects every

individual, not just those who have a very personal need already. those without insurance, those who have a pre-existing condition or people who fear or experienced medical bankruptcy. he wants to get more americans thinking in terms of what this would mean for them. the other audience is in congress. will the president repeat his deadline of trying to get this done by august? i suspect he won't, because we heard from a top democrat today, dick durbin of illinois that he believes it just can't be done that quickly. that's been critical. the president wants speed with this in order to have the political momentum to get it done. so i suspect we will not hear the president repeating that deadline. but he'll try to encourage congress to get over the political pros churing that always plays well in peoria, as they say. while there's a tight team here working. one more quick note, senator max bachas, the head of the finance committee he's been speaking to the president every day and we learned that they

timelines, they talked about the progress they say they're making but we don't know exactly if the president will reflect that in his remarks. they claim they're making a little bit of progress but not many details yet. >> is it still down to three republicans, max bachus, chuck grassley, and mike enzy? >> three republicans, three democrats. what we saw today that was really important is that another republican, orrin hatch, conservative of utah, peeled away from this group. he is part of that committee too and has a record of trying to work in a bipartisan way on other kinds of health care bills over the years. today he said that what he's seen is that it looks too expensive, too big, and he doesn't believe that max bachus, who is the democrat from montana who's been in the senate forever, doesn't believe he's getting the flexibility from the white house to do what's needed to keep republicans even possibly considering this. that was pretty telling, chris. >> okay. thank you very much, kelly

o'donnell. let me go right now to rachel maddow. it seems odd that after all this campaigning for president, this big election last november, it's come down to this whole chance of getting something really historic here lies in the hands of basically, you know, chuck grassley, mike enzi, olympia snowe. three republicans. >> i think that what we've heard from the white house, chris, about what to expect tonight, in addition to some of the announced text they've already released, what we know about the big strategy is to say yes this is about health care and why we want to get it done but also about how much we've done over the last six months. i expect that they may walk it back from trying to sort of stake the success of the obama presidency thus far, the success of what it means to have elected him on health care. i think we'll see health care context yulized among all of the other things the president will try to make us feel good about tonight. >> you and i know first terms or

first years of presidencies you either win your signature goal or you don't. reagan did. lbj did. isn't it hard for this president to really have a good start to his four-year presidency or eight years, perhaps, if he doesn't get health care? if he doesn't get that "w" next to his name? >> i think there's two ways to look at it. it would absolutely be great for him to get a signature thing done. that was this big a deal in his first year. on the other hand if you look at it from the past, i don't know, 60, 70 years of trying to get health care reform in this country? if this president was able to get it this year it wouldn't be just a first-term success, it wouldn't be just the kind of thing every president wants to get done. it would be the signature domestic achievement in american politics of the century. it would be a huge deal if he pulls it off. so sort of seems to me that it's bigger than just obama. if he can do this, it's more than just his first term. it's about him being an historic president. >> nancy, what about this rationing? i know a lot of people in the

burbs, republicans are scared to death they won't get their liver transplant, heart transplant, whatever, if we go to a national plan here. >> it's beyond a national plan, chris. it's the word nobody wants to talk about, that rationing is going to have to find a softer, gentler synonym because the president won't talk about it. congress, people won't talk about it. but the president has asked now insurance companies, pharmaceuticals, hospitals, and doctors to step up to the plate. the one thing i haven't heard this great orator do is talk plain to the american public and say you know what? we all have to give something here. almost a post world war ii speech. we all have to give something. and it doesn't have to be on the backs of the middle class but there does have to be a rationalitiy for all of us that we can't all have everything. excess doesn't mean everybody gets everything. so oregon has frankly taken one of those steps and said here's a list. we'll do some things, not others. that's what the country has to do too.

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we're back with msnbc's rachel maddow and dr. nancy stineman for more of "the politics fix." rachel, do you think we'll get a right to health care in this country? >> no. i don't think americans are more interested in reforming health care because we call it a right than if we don't call it a right. i think the language of rights has been so politicized and made

so partisan right now it doesn't advance anybody's political agenda to call it that. more important is whether or not we get an expectation of health care in this country, whether it becomes part of what we expect from the american dream, from the american experience that 50 million people aren't left out of the health care system. the president tonight has to make it more scary to not act than to act to try to fix this thing once and for all. >> nancy, if you go to a hospital it seems to me you do get the right to health care because if you show up at the emergency room you are treated. we'll give it to you in extremists but will we as a normal practice? >> i think you'll hear the other "r" word, responsibility, more than right and what the president has to do tonight is frankly deflower some of the words and destigmatize them. access, mandate, taxes, insurance. they're frightening words when aimed at individuals. i think what he has to say is we all have some skin in the game and with some skin in the game we take on a different line of

responsibility. that's the other "r" word i think he has to concentrate on. >> you and i, rachel, have been talking about this for a long time with our viewers that the focus has been on the uninsured. does he have to shift the focus to the insured and what they get out of this bill? >> i think he does need to talk about the american people as a whole having an interest in this but frankly right now with the kind of economic insecurity so many americans are experiencing even people who have health insurance right now in an employer-based health insurance system when premiums are so outrageously expensive, particularly if you're not getting it through your job, everybody worries that they're going to end up going bankrupt because of some health problem. every american faces that. even americans right now who think that they've got a good job and good future who aren't currently uninsured. i think that fear is real and very tapable for political purposes. >> thank you. stay right there. the president's news conference is coming up right now.

good evening. this is msnbc's live coverage of president obama's primetime news conference set to begin in the east room of the white house in about one minute from now. i'm chris matthews in washington. i'm joined by rachel maddow and dr. nancy schneiderman both of msnbc. first you, rachel, the stakes tonight? >> the stakes tonight are whether or not the president can turn his personal popularity into the thing that bolsters this thorny, political issue that has stymied so many presidents for so many generations now, whether he can make this something that seems like the kind of thing that the president obama who americans still like and can therefore get done, rather than this issue to which has been attached so much fear in politics over the years. >> doctor, the health impact of the speech tonight on our public health? >> the health impact is huge because we can't sustain what we have. we know that.

i've never met a doctor who thinks we're in good shape now. i think the challenge is to tell the american public this isn't big government coming in to strongarm you. this is basically looking at health care and access and affordability in a very american way, that is that we all have a shared concern here. >> let me ask you, rachel, tonight as this debate goes on do you have a sense it's becoming more partisan as the dates dwindle down toward the final decision on whether we get this this year? >> i think so. i think the president at this point needs to say, the devil is not in the details here. i'm not going to draw a line in the sand and say this isn't going to happen unless i get x, y, and z and spell out all the details. tonight it's about claiming moral authority. here comes the president now. >> thank you very much. here comes the president of the united states. >> good evening. please be seated. before i take your questions, i want to talk for a few minutes about the progress we're making h