Still unresolved are important details about the cost of a new system, provisions for increasing quality and a mechanism for compelling businesses and people to participate.
"People are unhappy with today's healthcare system," said Karen Davenport, director of health policy at the Center for American Progress, a liberal think tank with close ties to Obama. "But they are also nervous about letting go of what they have now."
For The Record
Los Angeles Times Wednesday, November 19, 2008 Home Edition Main News Part A Page 2 National Desk 2 inches; 61 words Type of Material: Correction
Healthcare: An article in Tuesday's Section A about the prospects for healthcare reform in Washington said the Pharmaceutical Research and Manufacturers of America had launched an ad campaign opposing Barack Obama's proposal to allow the federal government to negotiate lower Medicare drug prices. The ad campaign urges affordable health insurance but does not oppose government negotiation of lower Medicare drug prices.
Most observers expect conflicts between interest groups and policymakers as the debate heats up on Capitol Hill. Last week, the powerful Pharmaceutical Research and Manufacturers of America fired an early warning shot: an ad campaign opposing Obama's proposal to allow the federal government to negotiate lower Medicare drug prices.
Republican lawmakers are already expressing concerns about proposals that would drive the federal budget deeper into the red. By some estimates, extending coverage to the nation's uninsured could cost more than $100 billion a year.
"We have a huge financial problem in this country," said Joe Antos, a healthcare scholar at the conservative American Enterprise Institute, who called the idea that bold action would save money on healthcare "completely ludicrous."
"You have everybody gearing up and trying to make noise and saying, 'Don't forget us.' And health is right there with everybody else," he said. "They are trying to create political space next year for their issue, when there is going to be precious little political space to be had."
Obama has not indicated whether he will champion major healthcare legislation right away or if he will pursue a more incremental approach, as some lawmakers and analysts have counseled.
The president-elect and his Democratic allies on Capitol Hill have said immediate federal action to prop up the sagging economy will be their top priority.
But even before Obama takes office, business leaders are linking their fortunes to the fate of the healthcare debate.
"It's the single biggest cost pressure our members face," said John Castellani, president of the Business Roundtable. "This is coming to a tipping point." Castellani warned that failure to resolve the healthcare crisis would increasingly threaten major employers.
Healthcare providers are struggling to cover increasing costs with government and private insurance reimbursement schemes that are not keeping pace.
