tonight on "nightline," do or die. with the health care debate finally coming to a head, an exclusive interview with president obama as he hits the road and tells one woman's sad story to plead his case. but does he have the votes? and forever young, from beavis and butt head, we go inside mtv, the television network that in nearly 30 years has reinvented itself more than madonna. four legged diplomacy, a touching dispatch from the front lines, work for vet earnarians is bringing help to a war torn country. good evening, i'm cynthia mcfadden. we begin tonight with politics and the battle over health care. at week's end, we may finally see a vote on president obama's sweeping reform proposal, or maybe not. it is an issue that has polarized americans and been a drag on the administration's popularity, and at this critical moment, the president left washington behind to make his case to the public in ohio, and senior white house correspondent jake tapper was there for an exclusive interview. >> reporter: the president is launching his final push. we can see the finish line now. >> one final push to get this done. >> reporter: there have been a lot of last stands for health care reform, a lot of deadlines, a lot of make or break moments. >> yeah, he's going to [ bleep ] in the skull. >> reporter: this week it is actually make or break, and the president knows it. 12 months, countless tea parties and one seven hour summit after he first announced health care as his number one domestic priority, president obama found himself on this dark dreary monday, here in a cleveland suburb for what we're told is his very last public rally to push the health care reform bill that we're told congress will hold its final votes on beginning this week. >> it's nice to be out of washington once in awhile. >> reporter: president obama always seems excited to escape the confines of the beltway, perhaps even more so today, in this gymnasium at a senior center. the health care debate has not gone exactly the way he hoped, so back to ohio, his third campaign style event in the last week or so. complete with upbeat music and cheering crowds, an attempt to move public opinion his way while simultaneously convincing shaky democrats in congress to vote yes, so here's the pitch. >> the american people want to know if it's still possible for washington to look out for their interests. for their future. so what they're looking for is some courage. they're waiting for us to act. they're waiting for us to lead. >> reporter: the president said today he was inmainly in the buckeye state to tell ohioens about one of their own, a cleaning woman and breast cancer survivor named natoma canfield. >> i'm here to introduce the president on behalf of my sister, natoma, who is sick. >> reporter: canfield wrote the president about being forced to drop her insurance because she could no longer afford the skyrocketing premiums. >> the insurance company is getting 10,000, paying out $900. now, what comes in the mail at the end of last year? it's a letter telling natoma that her premiums will go up again by more than 40%. natoma canfield -- >> reporter: president obama has been telling canfield's story all over the country, using it to describe what he sees as a moral imperative to pass his plan to make insurance affordable. canfield's story got more dire last week after she was rushed to the hospital and diagnosed with leukemia. i called her in the hospital. >> the thing i was most afraid of happened sooner han i thought. >> which is what? >> what if there would be a catastrophe and i was in the hospital and had pretty big medical bills. >> reporter: canfield had been asked to introduce the president today. >> the reason natoma is not here today is that she's lying in a hospital bed suddenly faced with an emergency, suddenly faced with the fight of her life. you want to know why i'm here, ohio. i'm here because of natoma. >> reporter: we were here to talk to the president. what would the bill do for natoma? >> what would have happened is natoma would have been able to be part of this exchange, this marketplace that gave her a choice of plans just like members of congress had, but because she would be a part of a million people who were in a pool, her rates would be lower. >> there are a lot of americans who are very afraid of this bill and they're represented by members of congress who are worried about voting for it. what's your message to the members of congress and the american people who are worried? >> well, i think if you looked at the health care summit that we held, seven hours, discussions with republican colleagues. i think what it came to was a lot of the misinformation about death panels or this was a government takeover of health care turned out not to be true. what is true is there is a philosophical disagreement. so what we've said is number one, let's tighten up some of the restrictions on insurance company practices. number two, let's allow folks like natoma, self employed individuals, small businesses to be able to pool so they have better purchasing power, and number three, let's start implementing some of these cost containment strategies eliminating waste, fraud and abuse. >> all of a sudden, there are going to be 31 million more people covered by health insurance. there's a lot of questions whether or not the infrastructure can take all those new people. >> the infrastructure couldn't take it right away, which is why this is all being phased in. the question is, if we don't start now, then it won't be in place three, four or five years from now and then we'll be waiting another decade or another 15 years or 20 years to actually take on this problem. look, this is not a problem i chose. this is a problem that is there. we've got to start now. if we don't start now, it's going to be too late. >> thank you, sir. >> thank you, jake. >> do you have the votes? >> i believe we are going to get the votes. >> of course implicit in his comment that he believes he's going to get the votes is the acknowledgment that they don't have them yet. for "nightline," i'm jake tapper in ohio. he especially needs the votes of the 37 house democrats who voted no the first time around. we shall see. when we come back, a video killed the radio star, what's going to save mtv, a hint is not just the jersey shore. host: could switching to geico really save you 15% or more on car insurance? host: does elmer fudd have trouble with the letter r? elmer: shhhh, be very quiet; i'm hunting wabbits. director (o/c): ok cut!!!! uh...it's i'm hunting "rabbits," elmer. let's try that again. elmer: shhhh, i'm hunting wabbits. director (o/c): cuuuuut! rabbits. elmer: wabbits director (o/c): rabbits. elmer: wabbits. director (o/c): rabbits with an ""r." elmer: aw...this diwector's starting to wub me the wong way. vo: geico. 15 minutes could save you 15% or more. fancy feast appetizers. 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[ male announcer ] talk to your doctor about the risks and benefits of adding abilify. we all do it. but you don't have to. thanks to time released odor protection from secret. secret flawless renewal. it's still working, so you can stop checking. secret flawless renewal. vegetables are naturally low in calories. v8 juice gives you 3 of your 5 daily servings. it's a tast, nutritious way to mke this number go up... and help this one go down. v8. what's yournumber? to entertainment now. don't call mtv music television anymore. no, the network that gave rise to the music video landing in our homes way back in 1981 has all but kissed its original go to programming goodbye. so how will the pop culture staple remain relevant to teens nearly 30 years later? bill weir counts the ways. ♪ there was. >> reporter: there was a time when mtv made global headlines because of the likes of cher. but when an erroneous report surfaced this weekend that they banned lady gaga's video, it was met with disbelieve. wait a minute, the bloggers wrote, mtv still plays music videos? ♪ >> reporter: from the moment it launched, mtv has existed in an almost perpetual state of reinvention. ♪ >> reporter: they gave us cartoon morons on a couch. >> i hate him so bad. >> reporter: and real strangers on camera. true stories. seven strangers. >> reporter: entire new genres respond in the 90s and old ones reimagined. jack ass brought howls of protest. >> this is how mtv does miami. check this out. >> reporter: and squeals of joy. >> i've never seen anything like it. >> i can hear the screams of trl. >> reporter: those screams and the music rotation faded even more. ♪ . >> reporter: as the channel leaned on tom greene and ashton kutcher. jessica simpson. >> it says chicken by the sea. >> reporter: and the osbournes. now the words music television have been stripped from the logo altogether. tanned abs. mtv is poised to turn 30, in the middle of yet another madonnaesque makeover. >> reporter: so where were you when that moment happened? frlgts i was in the production truck. we knew there would be, let's say an intimate interchange. we didn't know they would necessarily swap spit. >> how did you react in the production truck when that moment happened? is. >> i guess i would say elation. >> reporter: mr. toefler is the president of mtv. he joined the network when michael jackson was still in heavy rotation. ♪ would dance on the floor ♪ >> what happened to the music? >> the music is still there. it's different. if you think about what technology has done, a 19-year-old in their home can get any video they want legally and illegally on demand whenever they want. >> is sex on fire expensive. >> reporter: he spends his days trying to balance what's next with what's familiar and bankable. one moment hearing a pitch from "american idol" judge randy jackson on the possibilities of america's best dance crew. >> how can we refine and make the challenges more unpredictable. >> that's a cool idea. >> reporter: the next moment, he considers the lingering appeal of in sync. >> we believe the masses are yes or noing for sim plastplesistic. >> where does the audience look? >> the specialty blogs. >> reporter: slee has been here from the beginning, working from copy writer to ceo, more than 150 channels in more than 160 countries. ♪ >> reporter: she counts the taping of nervona unplugged as one of her greatest responsibilities. when kanye west pulls something like this at the vmas. >> beyonce had one of the best videos of all time. >> he did have that bottle and i saw a thousand people pick up their mobile devices and start texting immediately. i ran to the truck. >> with excitement because everybody is going to be talking about this tomorrow or crisis management? >> it was a little bit of the taylor swift's mother would like to see you right now. >> reporter: the next thing is a lot more scripted programming, including a show about a debotched puppet. >> cocaine? >> snorting habitually. >> any abuse, sexual abuse? >> you mean perpetrated by. >> upon. >> reporter: and the hard times of r.j. burger, about a high school bully magnet with a certain at tribute. >> he's well endo youed as a human. >> why do you need a character with a freakishly large sex organ as a center piece of a scripted series? >> it is sort of an unexpected twist. we don't want to do television like other networks. we want to do it differently and we want to specifically speak to our audience. >> he says they've always tried to balance the raunch from the redemtive. >> it's your last chance to ask obama. >> reporter: to live aid. to hope for haiti. today they show the unglossed reality of being 16 and pregnant. >> you were completely unprotected. >> yeah, completely. >> reporter: or young and hopeful in a repressive saudi arabia. >> where the very act of speaking out and appearing in a tv show can get you investigated. >> reporter: but the most buzz comes when self proclaim eed guidos make love on the stage. >> as you probably read, i thought it was going to resonate but i didn't think the show was going to be as controversial as it was. >> the music, the back street boys, kid rock, they were the stars. a few of us got sucked into the vapor trail of popularity. it was never about me. it's having to see the jersey shore kids and s and laguna be kids. >> snookie, maybe she is a talented young lady, she seems to be famous for being famous. >> these kids say things that are a bit outrageous, everybody talks about them and they move on. our audience is really fickle. so again, it does burn bright, but sadly, it burns pretty fast. >> your ratings slid a bit last year. >> there are moments when you're hot and there are moments when you're a little bit off your game. the failure rate is pretty extraordinary out there, but there's a lot of permission in this brand. i think people forgive it quickly and are ready for the next thing. you're going to serve up. >> reporter: as always, the evolution will be televised, much to the dismay of the nos tal jik jen xers. >> reporter: i'm bill weir for "nightline." the new mtv generation. we will turn to an intriguing lookality american soldiers and veterinarians who are making a huge difference on the front lines of war. with 4g from sprint, i can download files up to 10x faster than 3g... outside. i can stream the movie "airplane" to my cell phone... at the airport. i can have a crystal-clear videoconference with my clients... ...muffin basket or something... ...while working offsite, or share five high-speed connections for online gaming... while enjoying the great outdoors. 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[ male announcer ] experience 4g from sprint. it's more than a wireless network. deaf, hard-of-hearing and people with speech disabilities, it's a wireless revolution. access www.sprintrelay.com. want more acid-stopping power? prilosec otc has 24% more acid-stopping power than prevacid 24 hour. more power to you. prilosec otc. we turn now to the front lines of afghanistan. for american soldiers, the horrors of war are an everyday reality. 71 americans have lost their lives so far this year in that country, but a different kind of battle is being waged by a team from the california national guard. it's an operation designed to capture hearts and minds and take care of the animals. karen russo has our report. >> i'm feeling how much cover there is over the back, the amount of muscle development that the animals have. >> reporter: it's early morning in this remote mountainous part of afghanistan where farmers are flocking to a team of american soldiers and civilians. >> whoa, one at a time. >> reporter: with villagers lining up to watch, the atmosphere feels more like a county fair, but this veterinarian clinic is part of the u.s. military strategy to beat back the taliban. could the key to success lie in the health of a goat? or a sheep? or a cow? villagers here in the kunar province, that nearly 40% of the population is malnourished. the poor are recruited by the insurge ency. and that's where the agory business development team from the california national guard figures in. so far, the program seems to be working. more farmers and animals attend the clinics and perhaps more telling, the local elders allow the military to host the clinic next to a mosque. >> the animals will be able to survive the winter in numbers far greater than they would have otherwise. it's a big thing for them. >> reporter: the soldiers can never forget this is one of the most dangerous regions of afghanistan and security is priority. >> what are you searching for? >> just about anything, knifes. nail clippers. >> reporter: while returning from a clinician, the team's convoy came under attack. >> rockets just flying over our head. >> reporter: one soldier was injured during the nearly three hour fire fight. >> look, when you tie the cow, you make a knot. >> reporter: the commander is an electrician who grew up around farms as did many.of the members of his team. mohammed walked for an hour and a half with his sick animals to receive the care. shah has 25 family members depending on him to survive. he depends on the goats to support them. if the goats die, his family will not have enough money to live. the team works with afghan vets, so eventually, they can turn over the entire program to the afghans. >> what's wrong with the cow? >> he's got abscess in the mouth around the teeth. >> oftentimes, they're looking for a quick fix. give my animal medicine to make it milk more. unfortunately, those, you know -- that kind of thing isn't available. >> do you feel like a soldier? >> i'm definitely a soldier, but i'm helping other people. that's what we're here for. >> reporter: on this recent day, there were no attacks and the team cared for its highest numbers to date. 910, including 293 goats, 234 sheep, 12 dogs and for the first time. >> we have someone to care for monkeys. >> reporter: for "nightline," i'm karen russo, kunar proves, afghanistan. bonding with the human population over the animal one. when we come back, is the u.s. relationship with israel growing sour? but first, here's jimmy kimmel with what's coming up next on abc. >> jimmy: tonight on the show, bachelor jake and his fiance vienna, music from galactic and boss: hey, those gecko ringtones you put on our website are wonderful. people love 'em! gecko: yeah, thank you sir. turned out nice. boss: got another one for you. anncr: at geico.com, it's easy to get a free rate quote, manage your policy, make payments or even file a claim! boss: now that's a ringtone. gecko: uh yeah...it's interesting.... certainly not the worst ringtone i've ever heard... ♪ ringtone lyrics: a-ringedy- ding-ding-dingy-dong, ringedy-dong-ding-ding... ♪ gecko (to himself): yeah, that might be the worst. anncr: geico. 15 minutes could save you 15% or more on car insurance.