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White House aides reaffirm public option is not mandatory

Rahm Emanuel said the public option is
Rahm Emanuel said the public option is "not the defining piece of health care," but Sen. Christopher J. Dodd said he will continue to push to include it in the Senate bill. (Karin Cooper - AP)
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"Most of the stakeholders in this health-care debate are at the table; they're trying to produce real reform," Axelrod said. "The insurance industry has decided now at the eleventh hour that they don't want to go along with this. One of the problems we have is we have a health-care system now that functions very well for the insurance industry but not well for the customers."

Asked whether Obama has been "tough enough" in his first year in office, Axelrod replied: "The president in his radio address took on the insurance industry, at least rhetorically, and he suggested that he might be willing to take away their antitrust exemption."

The health-care battle will be tested this week in the Senate, as Democrats push a bill that would set aside nearly $250 billion over the next decade for higher Medicare payments to physicians. The reimbursement rates are scheduled for automatic reductions. But each year, Congress overrides the formula, which would trim fees by 21 percent in 2010.

Fixing the payment gap is of enormous concern to the American Medical Association, but lawmakers have yet to find the money to pay for it.

Obama and Senate Finance Committee Chairman Max Baucus (D-Mont.) kept the provision out of health-care reform legislation, saying it is something Congress would do regardless of broader reform. But Republicans and some Democratic deficit hawks object.

"This is so transparent," said Senate Minority Leader Mitch McConnell (R-Ky.). "They're taking this issue out of health care, suggesting that we spend a quarter of a trillion dollars, not pay for it, so that they can then argue, the very next week potentially, that this trillion-dollar health-care bill is paid for."

In between the talk show chatter, the AMA weighed in with an ad.

"For seniors, a doctor can mean everything -- independence, hope, security -- and Medicare makes it possible," the narrator says. "We need a permanent solution to protect Medicare and ensure seniors get the security and stability they've earned."

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