WASHINGTON — President Obama has pledged to find a middle ground in his drive to reshape the nation's troubled healthcare system.
But even before Congress debates a healthcare bill, the president is getting sucked into a fiercely polarized fight over a centerpiece of his agenda: a new government insurance program that patients could choose instead of private coverage.
The battle over the "public option" has mobilized interest groups on both sides of the political spectrum with millions of dollars in their campaign war chests. Television ads promoting and attacking the insurance provision are already hitting airwaves.
The Obama administration and its allies are now scrambling to contain a full-throated ideological debate that some fear could threaten the most ambitious healthcare campaign in nearly a generation.
"Everybody needs to keep their powder dry," Senate Finance Committee Chairman Max Baucus (D-Mont.) said in an interview. "We have a huge opportunity to accomplish very significant health reform. . . . Let's not have any sparks that could light a fire."
The sparks, however, are already flying.
Conservatives have zeroed in on the insurance proposal as a potential Achilles' heel in Obama's healthcare plan, casting it as a move toward Canadian-style government healthcare and contending that federal bureaucrats will dictate personal medical decisions.
Meanwhile on the left, longtime advocates of a single-payer system are also fomenting a showdown with the right to force Obama and Democratic leaders to stand firm behind a new government program.
"This has become a lightning rod," said Maine Sen. Olympia J. Snowe, a Republican who Democrats hope will work with them on healthcare. "There is a lot of suspicion. . . . I'm afraid this could easily be used as an excuse for not moving any further."
Policymakers and politicians have battled for decades over the government's role in a system that relies on both public programs such as Medicare, which serves the elderly, and private insurance, which covers most workers and their families.
Fifteen years ago, the Clinton administration's healthcare campaign was derailed in part by an insurance industry campaign featuring a fictitious couple named Harry and Louise who worried aloud about government making their medical choices.
