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Health-Care Overhaul 2010

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'Single-Payer' Supporters Challenge Democrats

Sen. Tom Harkin (D-Iowa), left, and Sen. Max Baucus (D-Mont.) listen to President Obama at a White House meeting this week on health-care reform.
Sen. Tom Harkin (D-Iowa), left, and Sen. Max Baucus (D-Mont.) listen to President Obama at a White House meeting this week on health-care reform. (By Brendan Smialowski -- Getty Images)

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By Dan Eggen
Washington Post Staff Writer
Saturday, June 6, 2009

When President Obama convened a town-hall meeting in Rio Rancho, N.M., last month, he wanted to talk about credit card reform. But many in the crowd had a different agenda.

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"So many people go bankrupt using their credit cards to pay for health care," the first questioner said to applause. "Why have they taken single-payer off the plate?"

The "single-payer" activists had struck again. As Obama and congressional Democrats work to hammer out landmark health-care legislation, they face increasingly noisy protests from those on the left who complain that a national program like those in Europe has been excluded from the debate.

The White House and Democratic leaders have made clear there is no chance that Congress will adopt a single-payer approach -- named for the idea that a single government-backed insurance plan would pay for all Americans' medical costs -- because it is too radical a change.

That has not dissuaded single-payer activists, who have spent months hounding Democratic lawmakers and organizing demonstrations, including one that resulted in 13 arrests at a Senate hearing last month. The offensive continues this weekend with plans to swamp a series of "house parties" on health care hosted by Organizing for America, an Obama-backed project at the Democratic National Committee.

Opportunity and Challenge

The movement poses both an opportunity and a challenge for Obama, who is able to position himself as a centrist by opposing a single-payer plan but who risks angering a vocal part of the Democratic base.

"Obama is really the one who is puzzling to us," said Rose Ann DeMoro, executive director of the California Nurses Association, a union that has been leading many of the single-payer protests. "We were all supporters of him. . . . It's hard to understand how he can expect to rally support around a plan that will leave the big insurance companies in charge and keep hurting patients."

Many Republicans see the movement as evidence that Democrats are setting the country on the path to "government-run health care," as they describe it. Conservatives for Patients' Rights, an advocacy group bankrolled by ousted Columbia/HCA chief Rick Scott, unveiled a $1.2 million ad campaign Thursday that portrays Democratic plans as a "bulldozer" aimed at eliminating private insurance companies.

"It's just one step removed from a single-payer system," Scott said in an interview, referring to current Democratic proposals. "The goal is to get rid of the insurance companies, and then the government makes all the decisions."

Obama and other Democrats dispute such characterizations, saying they favor a plan that would marry private and public resources to control costs and expand coverage for 46 million uninsured Americans. Obama wrote in a letter to Democrats this week that he "strongly" backs creating a public insurance option to compete with private carriers, and also signaled that he is open to the idea of requiring coverage for all Americans.

Obama has rejected the idea of establishing a single government insurance program, however, saying the U.S. tradition of providing health care through employers would make such a shift politically and practically impossible.

"If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense," Obama said in response to the questioner in New Mexico, echoing comments he made during his presidential campaign. "The only problem is that we're not starting from scratch. . . . We don't want a huge disruption as we go into health-care reform where suddenly we're trying to completely reinvent one-sixth of the economy."


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