To: Kenneth E. Phillipps who wrote (77964 ) 1/23/2010 11:14:26 AM From: Hope Praytochange Respond to of 224864 By LAURA MECKLER WASHINGTON—After decades spent seeking universal health care, Democrats are considering moving legislation that would set that goal aside, yet again. The debate is highlighting a contradiction present from the start of President Barack Obama's effort to overhaul the health-care system: Advocates have long been uncomfortable selling the bill's central feature, a significant expansion of health-care coverage, and instead chose to highlight cost cutting and insurance reforms. The late Sen. Edward Kennedy called universal coverage "the cause of my life," and bills passed by both chambers of Congress would expand insurance coverage to 30 million or more Americans. But the Obama administration rarely sold its plan as a way to cover the uninsured, believing that message wouldn't resonate with most Americans, who already have health insurance. If Democrats can't muster support for a comprehensive bill, Mr. Obama and other leaders signaled willingness to consider a smaller measure.That might include tax breaks for small business to buy insurance, cost controls or new rules for insurance companies. It would be a big retreat from an effort to ensure nearly all Americans have access to "decent, quality health care as a fundamental right and not a privilege," as Mr. Kennedy put it. President Bill Clinton tried to sell his health-overhaul plan in 1993-94 as a way to help the uninsured. He failed to get the plan through. Among the many reasons for the plan's failure: Americans were never persuaded that the legislation would benefit them. Democrats concluded from the Clinton experience that they had to explain why their plan would help people with insurance. Had President Obama focused on the uninsured, one aide said, his plan "would have been dead 100 years ago." Instead, Mr. Obama, beginning with his presidential campaign, talked about health legislation primarily as a way to control costs. Aides say that Mr. Obama did this not just for politics, but because he believes that costs are the central issue and must be controlled, for the sake of the federal budget as well as individuals and businesses. But arguments about cost control didn't explain why the country needed a health bill costing nearly one-trillion dollars over 10 years. Most of that money was needed to expand Medicaid and provide premium subsidies. The bills also included a mandate that most Americans get coverage, another aspect of the legislation that Mr. Obama rarely mentions. Republicans say the administration's plan didn't recognize public concern about large new federal programs at a time of rising budget deficits. "That's one of the mistakes Democrats have made—trying to do everything at once," said Rep. Dave Camp (R., Mich.). With support dropping, White House officials acknowledged last summer that it was confusing to say the government would save money by spending money on health care. So the president began emphasizing the proposed new rules for health-insurance companies.