Rahm Emanuel, Obama's Chief of Staff

The messy, year-long battle over health care reform is finally coming down to a make or break vote. A tremendous amount of capital has been expended to get the bill passed, and so much is riding on the outcome.

Behind the scenes of the negotiations has been President Obama's chief of staff, Rahm Emanuel. The hard-charging, high-octane Emanuel is a former influential congressman from Chicago, who is known as an arm twister on Capitol Hill, an enforcer with a reputation for getting things done. He was brought into the Obama administration for moments just like this.

Ironically, when health care reform began encountering opposition last summer, Emanuel reportedly urged the president to scale back his ambitious plans.

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"If you had your druthers, would you have said, 'Let's take smaller bites that, that are more palatable to the American people?" Couric asked Emanuel.

"My druthers is whatever the president wants," the chief of staff replied.

Once President Obama made the decision to go forward with a massive overhaul of health care, his chief of staff started selling the plan; according to senior White House advisors, health care reform would have died long ago had Rahm Emanuel not worked the phones and prowled the halls of the Capitol, pushing for support.

"Many people have suggested spending all this time on health care reform while the economy was in such bad shape was a big mistake," Couric remarked.

"The president is working on the economy every day. It's not an either or choice," Emanuel replied,

"But that wasn't the impression a lot of people had, you know that," Couric pointed out.

"I understand. What is basically the most fiscally dangerous part of the American economic system? Both its budget, what it affects families, small businesses, is health care costs," Emanuel replied.

"Are you concerned that pushing health care legislation through Congress without any bipartisan support is gonna leave a bad taste in voters' mouths?" Couric asked.

"The process does not trump the product. And if we get pre-existing conditions banned as discriminatory process, if we get people who are uninsured, health care that they never had, get senior citizens complete coverage of their prescription drugs…," Emanuel said.

Asked if opposition will fade if they do all that, Emanuel told Couric, "Yes. I absolutely believe that. Because people will see the immediate benefit. Right now, it's kind of out there. It's not touching their lives."

The bruising fight over health care contributed to President Obama's sinking approval ratings and polls show a vast majority of Americans think Washington is dysfunctional.

Asked if he thinks Washington is working, the chief of staff replied, "Yeah.""

"So you, you don't…believe this whole premise that Washington is broken?" Couric asked.

"I mean, look. Washington can deal with these issues. If you didn't think it could, you wouldn't get out of bed at 5 in the morning to go attack the day. I fundamentally believe America's set up to deal with this," he replied.

"Why do you think the impression, though, around the country in every news magazine you pick up it says, 'Washington is broken. Why can't Washington get anything done?' So are you saying, this isn't real?" Couric asked.

"Let me say this. You can get bipartisanship to get certain things done. Sometimes you will have differences, and that's not a negative. Just because there's politics or principle difference doesn't mean it's a negative. It means we have fundamental, philosophical policy differences. That's what elections are about. That's what governing's about," Emanuel argued.

"But what if they get in the way of progress or actually getting something done?" Couric asked.

"No, Katie, then there's a legitimate criticism. But that's not the total picture," he replied.

The total picture, he believes, includes several bills that had bipartisan support. Just this past week the president signed a $17 billion jobs package that had the backing of 11 Republican senators.

"What I do is, every day, I start the day with a to-do list," Emanuel told Couric, standing in his West Wing office.

Emanuel believes his job as the White House chief of staff is to put ideas into action.

His office, which is bigger than the vice president's, sits only 40 feet away from the president himself.

Asked how often he goes into the Oval Office on a daily basis, Emanuel said, "You know, I've never counted, but you know, more than eight, less than 15."

"But every day, you meet with him first thing in the morning when he gets in?" Couric asked.

"He walks in, I'll head down. We do about three minutes or four minutes…. There's the schedule. And I'll see him, at the end of the day, we do this thing called 'wrap up,'" Emanuel explained.

Traditionally, the chief of staff has been a gatekeeper, someone who controls access to the president. Emanuel admits he isn't interested in that. He relishes giving the president his unvarnished opinion.

Asked if he's ever told the president that he thinks he's wrong, Emanuel said, "I wouldn't, not in those words, but I've been, what you do as chief of staff, and I would only do it in privacy is, you gotta look, you know, there's another perspective here. Or have you, you know, when you're looking at this, you need to weigh these equities."

"But you certainly have strong feelings about certain things. Have you ever gotten into an argument with him and said, 'Listen, I really think you should do X, Y or Z?'" Couric asked.

"Well, obviously, I do have strong opinions, so it's not a hidden fact. Okay? But the way, I don't, you don't say, 'Mr. President, you're wrong,'" Emanuel said.

But he acknowledged he does try to convince the president on certain points. "I mean, one of his great strengths is, I mean, this is not a president, if you were a yes person, oh, I think he'd turn you off," Emanuel said.

Emanuel has disagreed with the president on important issues. He told the president he was against the deadline for closing Guantanamo and opposed trying Khalid Sheikh Mohammed in a civilian court. He's all about the politically possible.

But some Democrats complain the chief of staff is too willing to cut any deal just to declare victory.

"You've been in the crosshairs a lot lately," Couric remarked.

"You noticed?" he replied, laughing. "What I do is I focus on getting what the president needs done on any given day. If all I did was pay attention to the critics, I wouldn't have taken this job, since a lot of people thought it was crazy to give up your own career."

He wasn't part of the Obama campaign inner circle before he was offered the job, a job he initially didn't want. Emanuel had already worked at the White House under Bill Clinton, and while in Congress, he had been the mastermind of the Democrats'' 2006 takeover of the House, and seemed to be on the fast track to becoming speaker of the House one day. Undecided whether to accept Obama's offer, he phoned his older brother Zeke for advice.

Asked what advice he gave him, Zeke Emanuel said, "I listened to him scream and yell at me, and I told him that I thought as he knew in his soul, that he had to take the job."

Zeke Emanuel is considered the brains of the Emanuel family. A leading oncologist and bioethicist, he was brought on board to be one of President Obama's top health care advisors. His office is a two-minute walk from the White House.

And if two accomplished brothers weren't enough, their younger brother Ari is considered one of the top agents in Hollywood.

He's also the inspiration for super-agent Ari Gold on the HBO series "Entourage."

The Emanuel brothers were raised in suburban Chicago. Their father, an Israeli doctor; their mother, a social worker who required the boys to take ballet -- which they say helped build character. The family mantra: failure is not an option.

"If you walked into our house, you walked through the side door that went right through the kitchen. And right there was the kitchen refrigerator. My mother and father used to put our report cards up there. So anybody that walked in the house saw your report card," Emanuel recalled.

Asked if his report card was always good, Emanuel said, laughing, "My motto has been, 'As long as we're grading on a curve, I'm okay.'"

"Why do you think the three of you went in such different directions career-wise?" Couric asked Zeke Emanuel.

"Because I think growing up, we couldn't be anywhere…there wasn't enough space or oxygen in the same areas," he replied.

"And so, for awhile, you all had to live in different parts of the country?" Couric asked.

"We lived in different cities, we pursued completely different paths. Yes," Zeke Emanuel replied.

"So, now you can spend time together without killing each other?" Couric asked.

"No, I wouldn't say that. Did I say that? Yelling and screaming at each other, that's part of spending time together, yes," he replied.

The Emanuels don't hold back. When Rahm became chief of staff, his brothers gave him another title, inscribed on a plaque: "Undersecretary Of Go Blank Yourself."

"It was for my birthday last year. Every Thanksgiving, we get together. And when I took the job, they gave it to me," Emanuel remembered.

Rahm Emanuel is a cocky, in-your-face operator. He believes in creative revenge, once sending a dead fish to a pollster who had given him bad numbers.

"Here are some of the things Republicans have called you: a Chicago thug, Rahmbo. A partisan street fighter, a left-wing radical," Couric remarked.

"Why don't you do some of the quotes of what some of the Democrats have said? Could be far worse," he joked.

"Even his middle finger, or what's left of it, is part of his persona, a point that then Senator Obama noted in a 2005 roast: "He was working in a deli, ahh, accident with a meat slicing machine, he lost part of his middle finger. As a result of this, this rendered him practically mute….has he ever flashed that little stubby thing at you?" then-Senator Obama joked.

Emanuel is notoriously profane. His language was lampooned in a recent skit on Saturday Night Live.

"Why do you have such a foul mouth? Didn't your mom ever wash your mouth out with soap?" Couric asked.

"I read a piece in Time magazine about how swearing is good for your mental health. And maybe it's just, you know, keeping a semblance of life. And maybe it's just sometimes for a little drama. And maybe it's not as bad as people think. Maybe I've even matured," Emanuel said.

Asked if he has matured, Emanuel, laughing, told Couric, "No."

"Do you curse in front of the president, because I know he has tweaked you about your profanity in public?" Couric asked.

"I've cursed before, but I do not curse in the Oval Office," Emanuel said.

Ever?

"I've probably done it once in the time we've been here," Emanuel admitted.

Asked if the president curses, Emanuel shrugged, saying, "I will go to the grave with my secrets."

One of the secrets he didn't mind revealing to us was a GPS-like device in his office that tracks the major White House players. On a little screen, he can see where the president, vice president and family members are at all time.

He may keep an eye on the president's family but he has little time to keep track of his own.

"It's a tremendous amount of pressure. And, it's a tremendous amount to ask of your family," Emanuel told Couric.

"Emanuel has three kids. Quality time has taken on a new meaning.

"The kids swim with me in the morning. And I swim at 5:15 in the morning," he told Couric. "They do it about twice a week. But so, like, that's considered family time."

Emanuel told Couric he works seven days a week. "The joke I always used to say on Friday is, 'Two more work days till Monday.' It's seven days a week, constant. And even at night, you're never really calm sleeping. No matter how exhausted, you're not calm. You're never kinda off."

How long will he survive? No White House chief of staff has ever lasted an entire presidency. During the transition, Rahm Emanuel met with 13 former chiefs of staff, who offered their advice, including then-Vice President Dick Cheney. He kept the notes.

"Yeah, the Vice President at that point said, 'Keep your eye on the vice president. Not to be trusted.' So that was his advice," Emanuel recalled. "Don Rumsfeld was, 'You're not indispensable. Pick your successor early on.'"

Produced by Draggan Mihailovich and Jennifer Yuille