Experts Predict an Intense Battle Over Obama's Healthcare Reform

President Obama's healthcare forum at the White House was designed to get Congress started toward enacting comprehensive healthcare reform this year. Obama convened a daylong series of meetings Thursday, which included leaders of the healthcare industry and senior administration officials. But the forum made clear that the process has a long way to go. Despite assessments that quality care is too expensive and beyond the reach of millions of Americans, there was little consensus on specific legislation to fix the problem.

Obama said it's vital to address "one of the greatest threats not just to the well-being of our families and the prosperity of our businesses but to the very foundation of our economy—and that's the exploding cost of healthcare in America today." But he conceded: "Each of us must accept that none of us will get everything we want, and no proposal for reform will be perfect."

Obama administration officials say all the key players are now in place within the government to get the ball rolling. The president this week named Kansas Gov. Kathleen Sebelius to be secretary of health and human services. Obama also named Nancy-Ann DeParle to direct the White House Office for Health Reform. DeParle had headed the Health Care Financing Administration (now called the Centers for Medicare and Medicaid Services) under President Bill Clinton.

Obama's emphasis marks the start of a long-range effort to overhaul the entire healthcare system by the end of this year, according to senior administration officials. For starters, the president has proposed setting aside a $634 billion,10-year reserve fund as a "down payment" to help pay for universal coverage and strengthen the system. An estimated 46 million Americans currently are without health insurance.

The end result remains unclear. Administration officials will probably defer to Congress and let the House and Senate come up with their own versions of healthcare legislation, as they did with the recent economic stimulus.

Pollsters say the rising concern among Americans is affordability, with universality taking a back seat. And today the public seems more willing to give the federal government the dominant role. A CBS/New York Times poll in January found that 59 percent of Americans said the federal government should provide national health insurance, while 32 percent said it should be left only to private enterprise.

Obama and his senior aides are convinced that the nation is eager for the White House and Congress to take on the issue, even more so than at the start of Bill Clinton's administration in 1993, when the last effort at comprehen-sive reform failed. "Stakeholders" who fought against change 15 years ago "are now part of the conversation," says a senior Obama adviser who is at the center of formulating White House strategy. The official also says both Democrats and Republicans seem to want reform this year.

Yet there are so many special interests involved, and so many Americans aren't sure what system makes the most sense, that the battle over healthcare reform will be intense, and it's only just beginning.