Health Care Debate Dominates US Politics

President Barack Obama has been busy in recent weeks waging the most important battle so far in his young presidency - reforming the U.S. health-care system. Republicans generally oppose the Obama plan as too costly and argue that it would lead to too much government involvement in health care. The battle is likely to drag on for months and will be waged at the grass-roots level as well as in the halls of Congress.

Each week they come by the busload from all across the country. Their demand is that Congress act now to expand health-care insurance to the estimated 47 million Americans who do not have it.

That was the reason Gordon Duvall came to Washington from his home in Denver, Colorado.

Duvall recently waged a successful battle against prostate cancer, but faced the prospect of losing his health insurance when he lost his job.

Duvall says he takes the issue of health care reform personally.

"Yes sir, it is, " said Gordon Duvall. "It is very personal. These organizing groups have given people, normal grass roots people, a voice. This is our government. It is a government of the people, by the people and for the people, and the by the people piece needs to get back into it."

But opponents of Mr. Obama's health-care reform effort are just as determined to kill the president's plan.

They object to the cost of the proposal, which could go as high as $one-trillion over 10 years, and they want to stop what they see as an expanding role for government in administering health care.

Opponents have already spent millions of dollars on television ads aimed at whipping up grass-roots opposition to the Obama plan.

"What will happen to your family's health care? This government run-plan could crush all your other choices. It could put a bureaucrat in charge of your medical decisions," warned one of the TV ads.

New public opinion polls suggest Republicans are making some headway in raising doubts and questions about the president's reform effort.

Polls by the New York Times and CBS News and the Wall Street Journal and NBC News show growing public concern that efforts to cover uninsured Americans could reduce the quality of health care for those who already are covered by health insurance.

Matt Dallek is a political expert at the Bipartisan Policy Center in Washington.

"I think a lot of Americans probably are quite torn," said Matt Dallek. "A lot of people have health insurance, and yet they believe that the system has all kinds of problems and they would like to see major reform happen. And yet, they are concerned that the debate as it is playing out is not going to get costs under control and maybe it will limit their choices someway, so I think there is just a kind of unease."

Mindful that political momentum appears to be slipping, President Obama has stepped up his efforts to win support for health care reform in recent weeks with a series of campaign style events around the country.

"Nobody is talking about some government takeover of health care," said President Obama. "I am tired of hearing that. If you like your doctor, you keep your doctor. If you like your health care plan, you keep your health care plan. These folks need to stop scaring everybody."

Democrats concede the political stakes on the health-care issue are very high, both for the president and for the Democratic majorities in Congress.

Mr. Obama promised reform in last year's presidential campaign, and congressional Democrats want a success they can boast about during next year's midterm congressional elections campaign.

Democratic Congressman Howard Berman of California is a guest on VOA's Press Conference USA program.

"It is very important," said Howard Berman. "I think the failure to pass health-care legislation this year will be a tremendous setback for the administration and for the leadership in Congress."

House Democrats have made some progress in recent days in bridging differences between liberal lawmakers focused on covering the uninsured and more conservative party members concerned about the cost of the reform effort.

A competing plan is being drafted in the Senate.

Congress will take its annual long recess in August, and Democrats hope to use the time to build support for health-care reform around the country.

But opposition Republicans will be busy too, trying to point out what they see as the flaws in the Obama approach when they meet with voters.

Congressman Paul Ryan is a Republican from Wisconsin.

"What is wrong with going home for August and having town hall meetings, listening to our constituents and then coming back in September and doing this right," said Paul Ryan.

Former Democratic Senator Tom Daschle has long supported health-care reform. But he told Bloomberg television that he is worried that Republicans will try to derail the president's plan during the congressional recess.

"Well, this is critical," said Tom Daschle. "The risk of defeat goes up during this time because you have got, in essence, a political campaign. You are going to take this entire issue and boil it down to 30 second ads."

In 2007, expenditures on health care totaled about one-sixth of the entire U.S. economy, and even top congressional leaders acknowledge that attempting to rein in health-care costs while at the same time expanding health-insurance coverage is a daunting task.

Nevada Senator Harry Reid is the Democratic majority leader:

"Would I like to move more quickly? Of course, but this is very, very difficult legislation," said Harry Reid. "In fact, I am not the first to have said it is the most difficult legislation probably in the last century because it affects literally everybody in America."

Democratic congressional leaders hope to agree on a final version of health-care reform by September or October, once they reconcile competing plans that emerge from the Senate and the House of Representatives.