WASHINGTON — Behind the open brawling over how to rebuild the nation's healthcare system, another struggle is beginning that may be the toughest test for the drive to cover millions of people without insurance and improve medical care for all: who should pay the eye-popping bill.
President Obama and his congressional allies -- who are also struggling to hold down the national debt after years of deficit spending and new outlays to combat the recession -- have pledged to raise more than $1 trillion over the next decade to offset the costs of what would be the biggest health overhaul in generations.
For The Record
Los Angeles Times Saturday, June 13, 2009 Home Edition Main News Part A Page 4 National Desk 1 inches; 50 words Type of Material: Correction
Healthcare lobbying: An article in Thursday's Section A about interest group lobbying on healthcare legislation said the liquor lobby sent a San Francisco brewer to meet with House Speaker Nancy Pelosi (D-San Francisco) to oppose a proposed increase in beverage taxes. The brewer met with her staff, not the speaker.
But the prospect of new taxes, new fees for businesses and cutbacks in other government spending has set off a furious behind-the-scenes struggle that is reviving the old maxim attributed to the late Sen. Russell Long of Louisiana: "Don't tax you, don't tax me, tax that fellow behind the tree."
Faced with a proposal to increase the tax on liquor and soft drinks, for instance, the liquor lobby sent Anchor Brewing Co. of San Francisco to see House Speaker Nancy Pelosi (D-San Francisco). The milk industry objected too, saying it would have to raise the price of chocolate milk.
And when congressional Democrats started warming up to the idea of curbing the tax break for employer-provided health benefits, the labor movement attacked one of the idea's leading champions, liberal Sen. Ron Wyden (D-Ore.).
"I suspect what will emerge as the toughest issue for lawmakers is not the ideological debate about the role of government, because there is some consensus there about the need for a centrist approach. Rather, it will be how to pay for the plan," said Drew Altman, president of the nonprofit Henry J. Kaiser Family Foundation. "The bottom line is there is no slam-dunk, easy way to do this."
To date, interest groups remain reluctant to appear intransigent and risk getting shut out of negotiations.
But the jockeying is expected to become public soon.
And it's already worrying Democrats on Capitol Hill, where there is little consensus about how to come up with hundreds of billions of dollars.
It also provides an indication of how hard it may be to maintain broad support once it gets down to specifics.
Obama, who at a White House meeting Wednesday urged a bipartisan group of senior lawmakers to press ahead with healthcare legislation, is stepping up his efforts. He travels to Wisconsin today for a town hall meeting focusing on healthcare.
