Obama Says He Is Open to Altering Health Plan

Original Source

By ROBERT PEAR and SHERYL GAY STOLBERG

WASHINGTON — President Obama vowed Thursday to end a decades-long stalemate on overhauling the health care system, and he indicated for the first time that he was open to compromise on details of the proposal he put forth in the 2008 campaign.

Mr. Obama spoke at a White House forum on health care, where he bluntly warned lobbyists and “special interests” not to stand in the way of efforts to rein in costs and guarantee coverage for all Americans. He said he intended to achieve those goals this year.

“During the campaign,” Mr. Obama said, “I put forward a plan for health care reform. I thought it was an excellent plan. But I don’t presume that it was a perfect plan or that it was the best possible plan.”

As a candidate, Mr. Obama said he would establish a public insurance program to compete with private insurers and would require employers to contribute to the cost of coverage for their employees or to the cost of the public plan. Insurers oppose the idea of a new public plan.

Since the election, Mr. Obama has not restated the details of his campaign proposal, and he indicated Thursday that he would be pragmatic.

“If there is a way of getting this done,” he said, “where we’re driving down costs and people are getting health insurance at an affordable rate and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I’d be happy to do it that way. If there was a way of doing it that involved more government regulation and involvement, I’m happy to do it that way as well.”

Liberals say the public option would be an essential element of legislation to rein in costs and achieve universal coverage.

Five senior Republican senators, including Charles E. Grassley of Iowa, the senior Republican on the Finance Committee, and the minority leader, Mitch McConnell of Kentucky, warned the president on Thursday that the public option would face opposition from many Republicans.

In a letter to Mr. Obama, they said that “forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition.”

“Ultimately,” the letter said, “we would be left with a single government-run program controlling all of the market.”

At the White House forum, Mr. Obama defended the idea of a new public insurance program but said he understood the objections to it.

“The thinking on the public option has been that it gives consumers more choices and it helps keep the private sector honest, because there’s some competition out there,” Mr. Obama said.

But, he added, “I recognize the fear that if a public option is run through Washington and there are incentives to try to tamp down costs,” then “private insurance plans might end up feeling overwhelmed.”

The conference drew more than 150 participants, including members of Congress, doctors and leaders of labor unions, business groups, hospitals, insurance companies and consumer organizations. The day ended with tributes to Senator Edward M. Kennedy, Democrat of Massachusetts, who has made health care one of his top legislative priorities in more than 46 years in the Senate.

Mr. Kennedy, who is battling brain cancer and was greeted with sustained applause, said he had witnessed many efforts to overhaul the health care system. But, he said, “they haven’t been the kind of serious effort that I think we’re seeing right now.”

“This time we will not fail,” Mr. Kennedy said.

Mr. Obama provided no new details of how he would extend coverage to the 46 million people who have no health insurance. Instead, he expressed hope that a “transparent and inclusive” process would produce a bipartisan consensus and overcome the objections of those who had a financial stake in the status quo.

“Those who seek to block any reform at all, any reform at any cost, will not prevail this time around,” he said.

In the presidential campaign, Mr. Obama said he would require that all children have coverage, while his chief rival for the Democratic nomination, Hillary Rodham Clinton, said everyone should be required to be covered.

A wide variety of speakers at the White House conference expressed support for an individual obligation.

Speakers who endorsed such a requirement included Representative John D. Dingell, Democrat of Michigan; Representative Jo Ann Emerson, Republican of Missouri; Kendall J. Powell, the chief executive of General Mills and a member of the Business Roundtable, which represents large companies; Representative Allyson Y. Schwartz, Democrat of Pennsylvania; and Scott P. Serota, the president of the Blue Cross and Blue Shield Association.

Ms. Emerson said it was essential to “get the entire population in an insurance pool and spread the risk.”

Likewise, Mr. Serota said, “an enforceable mandate is the cornerstone to getting everybody covered.” Health insurance will not work if people can buy it when they are sick and drop it when they are healthy, he said.

Richard J. Umbdenstock, the president of the American Hospital Association, said the word “mandate” seemed to alarm some people, so he suggested using a term like “responsibility.”

Insurance should be viewed as “a responsibility on every individual, every institution and every enterprise in our society,” Mr. Umbdenstock said.

One of Mr. Obama’s ideas to finance the expansion of health insurance coverage has run into opposition from powerful Democrats. The president has proposed limiting the value of deductions that affluent taxpayers can take for expenses like mortgage interest, charitable gifts and state and local taxes.

The objections came from Senator Max Baucus of Montana, the chairman of the Finance Committee, and Representative Charles B. Rangel of New York, the chairman of the Ways and Means Committee.

Mr. Baucus said the administration should “dig down deeper to try to find viable savings.” Mr. Rangel said he was concerned that the proposal could discourage charitable giving.

Jackie Calmes contributed reporting from Washington.

Copyright 2009 The New York Times Company