WASHINGTON -- Fifteen years after the last Democratic president failed to overhaul the nation's troubled health care system, President Obama kicks off his effort to try again today by bringing all the major players together at the White House.
It's a largely symbolic move, to be followed in the months ahead by tough negotiations over health care costs, access and quality. Even so, the White House has high hopes for the summit because of who will be in the room: consumers and providers, business and labor, insurers and drugmakers.
"They are coming to the White House and coming to the table because they want to get this done," says Melody Barnes, Obama's top domestic policy adviser.
Rather than being prescriptive, Barnes says, the president will be pragmatic.
The half-day session will include presentations by average Americans caught in the health care maelstrom. About 46 million people are uninsured, according to the most recent Census figures. Others are paying more than they can afford.
The assemblage of disparate interest groups is an important part of the summit. In 1994, the opposition of some groups, led by the health insurance lobby, doomed President Clinton's dream of remaking the health care system.
This time, insurers, drugmakers, doctors, hospitals and employers, as well as consumers, are more optimistic that a prescription can be found. Many have joined together because of common interests -- most notably a desire to drive down costs.
"The stakeholder community is no longer organizing to say 'no,' " says Karen Ignagni, president of America's Health Insurance Plans.
"There's a surprising level of agreement on the goals," says John Rother, director of public policy for the AARP, the nation's largest senior citizens group.
Senate Republican leaders voiced concern Wednesday that Democrats will demand a government health plan that would compete with private insurers. In a letter to Obama, Minority Leader Mitch McConnell, R-Ky., and four colleagues said, "Washington-run programs undermine market-based competition through their ability to impose price controls and shift costs to other purchasers."
Another issue that will prove divisive is whether to mandate that everyone get insurance -- something that Obama didn't advocate during the presidential campaign, while Democrats such as Hillary Rodham Clinton did.
Leaders of some interest groups predict the summit will be more amicable than what follows.
"We're not Pollyanna-ish," says Dan Danner, president of the National Federation of Independent Business. "There's no question that finding a solution is not going to be easy."
For now, most interest groups give Obama credit for starting the conversation. "The administration is seizing this historic opportunity to improve the system," says Nancy Nielsen, president of the American Medical Association.
And if the recession has a silver lining, it may be in bringing opposing groups together.
"Circumstances have certainly shaped the environment," Barnes says. "Everyone is hurting."
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