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Obama here today to pitch health care reform proposals to AMA

June 15, 2009

WASHINGTON -- President Obama comes home to Chicago today -- for less than three hours -- to sell his health care reform proposals to a wary American Medical Association as Congress wrestles over sending Obama a plan with the public insurance option he wants.

The Obama White House is ramping up a push for Congress to complete work on legislation that could cover the nation's uninsured and at the same time control health care costs. The Chicago-based AMA, meeting at the Hyatt Regency Chicago, while not rejecting a government run plan outright, is more focused on driving down the cost of private insurance and other alternatives Congress is mulling, such as some type of government-backed co-op care coverage.

Health care reform is a much tougher sell for Obama than one of his other major legislative initiatives, his $787 billion stimulus package. That's because few organized groups opposed the president's plan to spend, spend and spend money for national infrastructure, education and other projects to quickly jolt the economy back to life.

But a health care overhaul demands much harder choices. Even within Obama's Democratic ranks, there are divisions: The left is pushing Obama for universal coverage, preferably through a government-run program along the lines of Medicare, while an important band of conservative Democrats is concerned over how a new guarantee of health insurance for all will be paid for.

While in concept the AMA supports all Americans having health care coverage, the organization wants to avoid an outcome where payments to physicians treating patients in a government-run plan are capped at rates lower than private insurance companies pay.

Vice President Joe Biden, on NBC's "Meet the Press" on Sunday, when asked if Obama would sign a bill without a public or government-run plan, said "we think there should be a public plan. But a public plan is on a continuum. ... So the question is, what is the public plan?"

The Obama White House deliberately has not spelled out its vision of a public plan, not out of passivity but rather a reluctance to be boxed in at this stage, and a desire to avoid being perceived as dictating a plan to Congress.

Obama devoted his Saturday Web address to health care reform as the Senate Finance Committee and the House Energy and Commerce Committee work on detailed proposals.

Though Obama opposed a tax on existing employer-based health care benefits during the campaign -- attacking rival Sen. John McCain (R-Ariz.) on that matter -- Senate Finance Committee Chairman Max Baucus (D-Mont.) is mulling it as a revenue source.

Sen. Dick Durbin, on CBS' "Face the Nation," was asked if he would vote for a plan that taxed existing health benefits.

"Well, I'm not sure," Durbin said.

In his Saturday address, Obama said, "If more Americans are insured, we can cut payments that help hospitals treat patients without health insurance. If drug makers pay their fair share, we can cut government spending on prescription drugs. And if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid the unnecessary hospital stays, treatments and tests that drive up costs."

While the White House is looking for Republican support, health reform could move ahead without GOP votes. White House senior adviser David Axelrod, in Chicago to deliver a commencement speech at DePaul, told my colleague Abdon Pallasch on Sunday, "Obviously, our preference is always to build as broad a majority as we can, but the imperative is to move forward."

Obama has said people with employer-based private health insurance would see no change. Senate GOP leader Mitch McConnell (Ky.) on CBS' "Face the Nation" disagreed: "If the government is in the insurance business, there won't be any other insurers."

As for GOP votes, McConnell said, "I think that for virtually every Republican, a government plan is a non-starter."