WASHINGTON — In an age when Americans compare hotel rooms, cars and even prospective mates with the click of a mouse, helping people identify the most cost-effective medical care seems like common sense.
But when President Obama included money in his economic stimulus plan to do just that, he set off one of the sharpest, and most unexpected, political fights of his young administration.
Though Obama prevailed -- securing $1.1 billion for "comparative effectiveness" -- the ferocity of the tussle over a relatively obscure proposal provided a warning for those seeking to reshape the nation's healthcare system.
Obama is to outline more of his healthcare overhaul plans when he addresses Congress today and unveils his first budget two days later. He said Monday that he also planned to hold a conference next week on healthcare reform.
The comparative-effectiveness issue was supposed to help lay the groundwork for the broader reform effort. But it became a lightning rod for conservative commentators who labeled it a step toward socialized medicine, a line of attack that has doomed every health overhaul effort since World War II.
Rush Limbaugh joined the fray. So did an Iowa advocacy group that targeted Capitol Hill with a fierce e-mail campaign. The conservative Washington Times suggested that what Obama wanted to do might lead to Nazi-style euthanasia, and the paper posted a photo of Adolf Hitler next to an editorial denouncing the bill.
Within hours, newly empowered liberals struck back. Using muscles honed fighting the Bush administration for eight years, bloggers and television commentators attacked critics of the legislation as uninformed and unprincipled.
"I am a little surprised," said Kaiser Family Foundation President Drew E. Altman, a leading reform advocate. "But there are institutional forces in Washington set up to fight these fights. It's what they do. . . . The tone may have changed with the new administration, but not the way the game is played."
Altman and others had hoped the healthcare overhaul campaign promised by Obama would begin more harmoniously.
Many healthcare authorities and policymakers have agreed for years that a better system for tracking how well drugs, medical devices and surgical procedures work could improve the care Americans receive and ultimately save billions of dollars.
Almost from the start, the initiative proved explosive, although the battle was at first fought largely out of public view.
