While the President has repeatedly stated his "support" for a government-run plan, to the dismay of his core liberal base he has steadfastly refused to demand that such a measure.
Remember that for these supporters and their allies in Congress, even this reform is viewed as a compromise of their ultimate goal of a full-scale, single-payer health care system.
The failure to win congressional action to this point has left the White House thinking it has a communications problem: if the President can explain the problem just one more time, Americans will follow. But Americans don't follow those who outline policy problems; they follow leaders who forcefully advocate policy solutions that make sense to them.
So Obama doesn't have a communications problem. He has a policy problem and he has a leadership problem.
The policy problem is that most Americans simply do not want government acting as a private firm. For most Americans the government role isn't a mere detail to be left for congressional negotiations; it is itself a matter of principle. And no matter how many times the President says they can keep their own insurance, Americans can recognize the camel's nose when it peeks under the tent. The so-called "public option" does not make sense to them.
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But the policy problem only highlights the President's more critical leadership problem. There are two leadership paths the President can take, and so far he's tried neither.
One path is to fight for what he believes in. If Obama's statements of support mean he truly believes the government should be in the health insurance business-and not just rhetorical appeasement of his base-then he should be willing to fight for it, even at the risk of defeat. The White House has instead indicated it will equivocate rather than accept defeat.
Alternatively, the President could lead by truly taking a bipartisan path. Obama's Nixon-to-China moment would be to include strong tort reform legislation as part of a comprehensive reform measure-an issue Obama, Democrats, and their trial lawyer allies have thus far considered anathema.
Another speech won't move the ball on health care if it fails the policy test or the leadership test.
Tony Fratto is a CNBC on-air contributor and most recently served as Deputy Assistant to the President and Deputy Press Secretary for the Bush Administration.