You have the choice between a public bathroom and a private bathroom, which one are you going to choose, yells the angry talk show host. Well come on…obviously private is better he exclaims, setting himself up to lay into Britain’s NHS and Europe’s drastically unsatisfactory socialised medicine.

Situated at the extreme end of the spectrum this hysteria and provocation is indicative of the mud slinging culture war that has engulfed Barack Obama’s recently proposed healthcare reform plans. Again we have the classic culture war rhetoric; the hardworking, taxpaying, ‘average Joe’ pitted against a liberal elite determined to pull apart the very fabric that holds this unique country together. They are set upon ‘ridiculing average Americans,’ shouts the Fox News anchor, they call us ‘crazy’ and ‘un-American.’

As Thomas Frank notes in his book, ‘What’s the matter with Kansas?’, the culture wars have become ‘a devastating political trap.’ Claiming to be on the side of average Americans, the backlash, as Frank terms it, mobilises voters with explosive social issues, yet time and time again the outcomes are devastating to middle America. Originating in the 1960s when prominent figures within the conservative and religious right began making noise about the corruptive effect the liberal ethos was having on American society, the culture wars have long been a thorn in the side for democrats. Indeed they have consistently struggled to find a language to reach out to the middle America that has become so fervently pitted against them.

Using Kansas as a lens through which to view America, Frank takes the title of his book from a Republican essay of the same name which appeared in 1896 deriding local activists for ruining the states economy with their heretical economic policies. This was after all the era in which great progressive leaders appealed to the sense of justice and equality so inherent in the American value system; a time when Woodrow Wilson’s estate tax and Theodore Roosevelt’s anti trust measures enjoyed popular appeal. How times have changed, decries Frank, arguing that the effects of the culture wars have rallied people who would once have been reliable partisans of the New Deal to the standard of conservatism.

Frank’s analysis was penned before the election of Barack Obama, yet regardless of the symbolism of his election, August has seen the culture wars roar on, fanned by carefully crafted messages which demonise the president and his healthcare proposals. Faced with public opinion turning against him, rumours are abounding that he, like Bill Clinton in 1993, will backtrack. Yet the president has responded with a message of cost effective healthcare tailored to an America worried about the economy.

Obama is well aware of the dynamics at play and the potentially corrosive effects a wrong step in this culture war might have. If he responds aggressively to the maelstrom of provocation and misinformation, he will be accused of ridiculing blue collar America. Nor can he attempt to intellectualise the debate for that is what fuels the culture war machine – they want the smooth talking, ivy league liberal to lecture ordinary Americans on how they should lead their lives. This is the bread and butter of talk show hosts across the country.

It must be remembered that central to the understanding of the culture war phenomenon is recognition of the strength of the American creed, or the civic nationalism which underpins America’s value system – a creed which is rich in respect for the rule of law, constitutionality, democracy, and social equality. As the great progressive era of the 1890s-1920s, the civil rights movements of the 1960s, and Obama’s very election demonstrate, this creed is as much hopeful and forward looking as it is reactionary and hostile to change. Obama, as he has already proved in his famous campaign, can engage middle America on an emotional level that appeals to these core American values. He should continue to do so in the healthcare debate.

In speaking about the immorality of 46 million Americans without healthcare and relating his own personal experiences – he previously talked about his cancer stricken mother worrying about health bills – he can reengage and rebuild America’s deep seeded civic identity. On the other hand, if he is to significantly backtrack in the face of the culture warriors and shadowy ‘tea-party alliances’ it could do serious damage to his hard won momentum and capacity for change. Retreat will only reinvigorate the ailing Republican movement and instil scepticism in those who pinned their hopes on his transformational powers.