If anyone is still questioning President Barack Obama's commitment to health insurance reform, ask Valerie Jarrett. A longtime confidant and political aide to Obama, Jarrett now has his ear as the senior advisor and assistant to the president for Intergovernmental Affairs and Public Engagement.

"I've never seen him more determined, more focused, more passionate than he is about this issue," she told Black Voices the day after Obama pressed his case in a prime-time television address to Congress and the American people. "And it's personal for him. He watched his mom grapple with a preexisting condition that potential affected her insurance as she was terminally ill. ... He's been in the emergency room with his daughters, one with asthma and the other with meningitis. So he knows the terror of what it's like to have someone you love ill, and that at those moments, you shouldn't have to worry about how you are going to pay for the treatment."

For those who wonder how Republican Congressman Joe Wilson could even contemplate an outburst during the president's speech, or why the president's speech was explicitly addressed to the middle class when his base includes lower-income people, Jarrett shared her insights. And for those who think they should have the choice to remain uninsured, the president's right hand issued a blunt reality check. Read on. ...



Black Voices: Rep. Joe Wilson last night said during the president's address, "You lie" – a spectacular breach of protocol. Do you think he would have been so emboldened to yell out in that way if the president was not African American?

Valerie Jarrett: Oh, I wouldn't venture to guess what motivated him to do what he did, but I think he apologized swiftly. The president accepted his apology, and the president, when asked about it in his cabinet meeting by the press, they asked, "Would you speak with him?" and he said, "Of course. I speak with everybody." And I think that speaks volumes about the president's character and integrity. ... I think that what he was trying to say in his speech is that we can disagree without being disagreeable. We can have a substantive conversation about the merits of a particular program for health care, and it doesn't have to turn into a shouting match....And I think another important part of [the president's] message is we're better than that. That's not who we are. So he appealed to the better in all of us, and I think the fact that the congressman responded so swiftly in apologizing heartens me into thinking maybe he heard the president's message.

BV: In his address last night, the president said about the uninsured, "These are not primarily people on welfare. These are middle-class Americans who live every day just one accident or illness away from bankruptcy." Why is it so important to make those distinctions – not on welfare, middle class? I ask because blacks are part of the president's base, but are less likely to be middle class.

VJ: His message was this: It isn't simply the very poor, it's also working families, because he didn't want to just say it was one category alone. ... We really have to make it clear that it's a broad constituency that is affected by this. If you are working, and you are trying to pay for your rent, and trying to afford to send your kids to school, and paying for their school supplies, and you're trying to buy prescription drugs, and you have one event -- a health concern that isn't covered by insurance – oftentimes you think it was covered by health insurance, and then you discover, "Oh, my goodness, they've dropped me from coverage." Then you're a step away from bankruptcy. The point is to not let anybody be comfortable in thinking that they can't be affected by this. ... The broader the constituency [that believes it is affected ], the easier it will be to get consensus in Congress to support [health care reform].

BV: The president in his speech outlines a mandate for individuals to get health care coverage. What do you say to those who think they have a right to choose whether or not they want to pay for health insurance?

VJ: Well, the problem is that if they don't pay for it, we all pay for it. You shouldn't have the option of choosing, because ultimately if you end up in an emergency room and you receive charity care, then the taxpayers pay for it. There is no "free" health insurance. I think his point was that this is a community responsibility, and everybody should be prepared to accept their share of that responsibility. ... It's not fair to the system to, in a sense, game the system, and oftentimes people who think they're healthy to go, "Oh, I shouldn't have to pay for [health insurance] because I'm healthy." That's a short-sighted approach. One minute you're healthy, and the next minute you're not.