WASHINGTON — Under the banner of consensus and cooperation, President Obama on Thursday brought industry leaders, lawmakers, doctors and consumer groups to the White House for a healthcare forum to build momentum for his effort to reduce costs and expand insurance coverage.
But the largely symbolic event also showcased the political maneuvering -- and potential conflicts -- that is intensifying as the president moves forward on his reform initiative.
Liberal activists stepped up their campaign against the insurance industry, which many of them blame for scuttling the Clinton administration's efforts to reshape the healthcare system in the early '90s.
Several Republican lawmakers, meanwhile, pointedly cautioned the president about reaching too far to expand government's role in healthcare.
And Obama used the forum as a warning to those who might seek to derail his healthcare overhaul.
"Each of us must accept that none of us will get everything that we want and that no proposal for reform will be perfect," the president said as he welcomed more than 150 forum participants to the East Room of the White House.
"Everybody has a right to take part in this discussion. Nobody has the right to take it over. The status quo is the only option that is not on the table. And those who seek to block any reform at any cost will not prevail this time around."
Obama, who last week unveiled a budget that would set aside $634 billion for healthcare reform, has said he wants to tackle the issue this year, building on campaign promises to move toward universal coverage as well as improve healthcare quality and bring down skyrocketing costs.
And Thursday, the president stressed the progress being made, citing "a clear consensus that the need for healthcare reform is here and now." Many lawmakers and industry leaders at the White House echoed the president's words.
"We understand we have to earn a seat at the table," said Karen Ignagni, head of America's Health Insurance Plans, one of the industry's leading lobbying groups.
"You have our commitment to play, to contribute and to pass healthcare reform this year."
U.S. Chamber of Commerce President Tom Donohue talked of "a new day" for reform. "We're going to get some kind of an agreement here," he said.
But amid the optimistic words, evidence emerged of the ideological differences and competing interests that threaten the apparently gathering momentum behind changing America's healthcare system.
Iowa Sen. Charles E. Grassley, the senior Republican on the Senate Finance Committee, pleaded with the president to think hard about creating a new government insurance program to cover some of the more than 47 million people in America without coverage.
"There's a lot of us that feel that the public option is an unfair competitor," Grassley told Obama.
Many insurance companies are worried that a new government insurance program like Medicare or Medicaid would drive them out of business, and some providers worry about lower payments from the government.
A day earlier, Grassley and four other senior Senate Republicans, including Minority Leader Mitch McConnell of Kentucky, sent a letter to Obama calling for more bipartisan cooperation on healthcare.
"Unfortunately, the beginning of the 111th Congress has been marked by an increasingly partisan and closed process in which healthcare reform is being addressed piecemeal, including in the stimulus legislation," the lawmakers wrote.
"This was a missed opportunity."
Others at the White House meeting on Thursday took aim at doctors, accusing them of standing in the way of efforts to save money by empowering nurses and physicians' assistants to handle more care.
"The doctor lobby is very, very restrictive over what nurses can do," said Teamsters leader James P. Hoffa.
Sen. John D. Rockefeller IV (D-W.Va.), a longtime champion of overhauling the healthcare system, raised the controversial prospect of new limits on the care that Americans can get -- a deeply unpopular notion that already has stoked battles on Capitol Hill.
"We can't all have everything we want when we want it," Rockefeller said. "And it's going to hurt everyone's feelings. But I don't see any other way."
Even before Obama's White House forum began, a coalition of groups on Thursday brought to the White House more than 300,000 signatures gathered by MoveOn.org, the liberal grass-roots organization that helped elect Obama and scores of congressional Democrats.
"Don't let the insurance lobbyists delay health care any longer. In this economic crisis, we can't afford NOT to pass quality, affordable health care for all this year," the petition read.
"We're ready," said Richard Kirsch, who heads Health Care for America Now, a leading consumer advocate that is helping to organize the political campaign targeting insurers.
"We are not advocating for the status quo," said America's Health Insurance Plans spokesman Robert Zirkelbach, noting the group's work on reform proposals.
Insurance industry leaders have voiced concerns, however, about Obama's proposal to help finance his overall plans by cutting current federal payments to insurers that provide coverage to some Medicare recipients.
Drug and device makers, meanwhile, are watching warily as the federal government begins to look more closely at the comparative effectiveness of treatment options -- a process some fear will lead to new restrictions on more costly care.
"There's all this talk of 'It's all going to work. We've finally reached it, with the president behind it. People want it,' " cautioned Rockefeller, a veteran of the failed fight to pass President Clinton's healthcare overhaul 15 years ago.
"There are a lot of people who have an interest . . . in keeping costs high, in making sure that medical companies make money."