When It Comes To Health Care, Define Change

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There have been signs of dissent on both sides of the health care debate this week, among supporters of President Obama's efforts to remake the system and among those opposed. It's been clear from the start that not everyone who wants change, wants the same kind of change.

RENEE MONTAGNE, host:

This August the debate over how to fix America's health care system just keeps heating up. Republicans and Democrats disagree over what's to be done. No secret there. Now there seems to be growing dissent among supporters and opponents about how to move forward. Joining us to talk about this is NPR News analyst Juan Williams.

Good morning.

JUAN WILLIAMS: Good morning, Renee.

MONTAGNE: Let's start with the Democrats. This week we saw the White House at least raise the idea of losing the public option - that is the government-run insurance plan or a government-run insurance plan. How does this change affect the president's support?

WILLIAMS: Well, you know, even just this week Senator Chris Dodd, who managed the mark-up of the health proposal reform in the Senate Health, Education, Labor and Pension Committee put out a letter saying you can't really have any kind of change in the health care system without really having a public option. And that follows on the footsteps of the House Progressive Caucus, Howard Dean, the former chairman of the DNC, John Sweeney of the AFL-CIO, Robert Reich - I could go on - all saying you must have this public option.

But what we've heard from President Obama himself is, well, the public option is just a sliver. Kathleen Sebelius, the secretary of health, said, you know what, we are flexible on this idea. Well, that has set off people who think that really this flexibility is a capitulation and they're not for it. They're trying to stop it, even as the White House is saying it's necessary to bring along people like Senator Kent Conrad, who's on the Senate Finance Committee, working with people like Max Baucus, the chairman of that committee, who said they don't believe that there are the votes for the public option in the Senate.

So you have this tremendous tension, Renee, among the Democrats as they try to move this bill forward.

MONTAGNE: Again, as they would say it, get something. Although what has come up possibly as a substitute are these nonprofit co-ops that are being talked about. But I wonder, given that he has made his own supporters angry, is the president any better off for moving away from a public option?

WILLIAMS: Yes. In the sense that if you move towards the co-ops that you mentioned, Renee, the president and most of his top aides believe they can get some kind of deal in place and that they can then work with the co-ops to have the co-ops be the kind of possibility, if you will, the kind of plan that would put pressure on America's insurance companies to be more competitive, to do more, to help individuals who might have preexisting conditions, individuals who have lost jobs and are seeking portability of their insurance plans.

They believe the co-ops can do this just as well as the public option, though it might not be the case at first. So yeah, they believe that they can get a deal if they are moving away from something that would be titled as the public option.

MONTAGNE: And then, Juan, among the opponents in Congress and in the private sector there seems to be a division over how much to resist the health care bill and how much to go all out and try and figure out how to influence what's in it.

WILLIAMS: Well, you know, it's interesting. On the Republican side, Renee, you get lots of interesting kinds of divisions. For example, if you think back to when the Clinton health care bill was out there back in the early '90s, you get people like, well, none other than Dick Armey, who was then a leader in the House opposing it. Now he's working for a lobbying firm. And the lobbying firm, DLA Piper, you know, they've been trying to work to somehow get a deal with the Obama administration. So Dick Armey has had to somehow move away from his own lobbying firm. He had to quit.

Or you think about former Representative Billy Tauzin…

MONTAGNE: Right.

WILLIAMS: …he represents the pharmaceutical industry in Washington. And minority leader John Boehner sent him a nasty letter basically saying that he was going overboard.

MONTAGNE: Yeah, well, that's all the time we have to talk about that now. More to come.

Juan Williams, thanks very much.

WILLIAMS: You're welcome, Renee.

MONTAGNE: This is NPR News.

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