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The Nation

Unlikely Allies Push Expanded Healthcare

Businesses that once fought the idea join unions and others: `The time for action is now.'

January 16, 2007|Tom Hamburger and Ricardo Alonso-Zaldivar | Times Staff Writers

WASHINGTON — In a sign of how the political climate is shifting, powerful business interests that once teamed up to defeat Democratic healthcare plans are joining with labor unions and other unlikely allies to advocate extending medical insurance to millions of Americans.

Among the champions of change is the trade group representing the nation's leading health insurance firms. That industry developed the "Harry and Louise" television ad campaign, which helped turn public opinion against the universal healthcare plan proposed by President Clinton and then-First Lady Hillary Rodham Clinton in 1994.

So devastating was the defeat that Washington politicians have hesitated to offer comprehensive proposals for change since then. Although Democrats talked of healthcare costs in the 2006 campaign, they have offered only modest proposals despite winning control of both chambers of Congress. Republican governors have offered some of the most ambitious plans recently, but GOP leadership in Washington has been muted.

Now, nongovernmental coalitions of seemingly strange bedfellows are stepping into the vacuum.

Today, the president of the Service Employees International Union will stand with the director of the Business Roundtable, which represents the nation's leading corporations, to announce one campaign to overhaul healthcare.

On Thursday, private health insurance companies will join with doctors' organizations and health-activist groups on the left to announce a plan for universal coverage.

"This week marks a kind of tipping point," said Karen Ignagni, who represents the health insurance industry in Washington. Members of the trade group she now leads -- America's Health Insurance Plans -- produced the Harry and Louise commercials, in which a middle-aged couple expressed alarm about the prospect of government meddling in their personal decisions about healthcare.

"The health insurance problem has been with us for decades," Ignagni said. "With all these different efforts, you are seeing a consensus emerge that the time for action is now."

Major questions remain about how a healthcare overhaul program would work -- including how it would be financed and who would participate. But broad agreement on the need for action is important, because the groups involved might have the political clout and lobbying muscle to push a plan through Congress.

The two plans being announced this week -- the details of which were not available -- come in the wake of ambitious blueprints for universal health coverage put forward by two prominent Republicans: in California by Gov. Arnold Schwarzenegger and in Massachusetts under Gov. Mitt Romney, who has since left office and is a 2008 presidential candidate

The Massachusetts plan -- the only comprehensive state proposal that has been enacted -- relies primarily on a requirement that individuals get health insurance. The state redirected funding that had been used to cover hospital care for the uninsured to subsidize health insurance premiums. The plan also levies a token fee on employers that do not provide coverage.

California's plan would rely on a combination of requirements for individuals and new fees -- essentially taxes -- on businesses and healthcare providers.

Governors from a dozen other states are considering similar proposals.

Now, Democratic constituent groups, including labor and seniors' organizations, are joining with big business to demand a substantive response to the nation's healthcare problem, which has left 46 million people uninsured and has undermined American corporations' ability to compete internationally.

"You take these two events, and you take what's happening in the states, and what you are seeing is a real surge of interest in the issue of health reform, and the feeling that enough is enough about saying that the sky is falling: Let's start to do something to put some answers out there," said John Rother, director of policy and strategy for AARP, the seniors' lobby. AARP is part of both nongovernmental coalitions.

The proposals may embolden Democrats, but party leaders note caution within their ranks. "I think the Democrats are concerned lest they seem too radical," said Rep. Pete Stark of Fremont, chairman of the House health subcommittee. "We've got to win again in 2008, and I don't think we want to come out and talk about universal coverage or anything that sounds like socialized medicine." Stark is author of a plan that would use Medicare as a model to cover the uninsured.

Andrew Stern, the service employees union leader, has met in recent months with corporate chiefs around the country, urging a joint effort on a comprehensive overhaul.

His goal is to force action in Washington.

Stern said the traditional job-based medical insurance system "simply isn't working."

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