The health-care debate comes to North Carolina

RALEIGH

As President Obama was in North Carolina yesterday defending his health-care plan, Democrats on Capitol Hill worked to solidify a deal that could help the plan advance through Congress, and Obama welcomed the agreement.

"I'm especially grateful that so many members, including some Blue Dogs on the Energy and Commerce Committee, are working so hard to find common ground," he said. "Those efforts are extraordinarily constructive in strengthening this legislation and bringing down its cost."

Obama's Raleigh visit was widely seen as an attempt to build support for his plan in a state that has several centrist-leaning congressional Democrats who will provide crucial votes. Later in the day, he held another town-hall meeting in Bristol, Va., where the political environment is similar.

He spent much of his 30-minute speech pushing back against what he described as cynical scare tactics by critics who say that some of his proposals could hurt Americans who already have health insurance .

"These folks need to stop scaring everybody," he said.

"Nobody is talking about some government takeover of health care," he said. "I have been as clear as I can be. Under the reform I've proposed, if you like your doctor, you can keep your doctor. If you like your health-care plan, you can keep your health-care plan.

In Raleigh, in a state that he won by less than one percentage point last year, and later in Bristol, members of each audience worried about the high cost of prescription drugs.

Small-business owners and employees asked how his ideas would cut costs to allow more revenue for employee benefits and raises.

Obama appealed aggressively to those who already have health insurance, saying that his plan would offer them protection from what he called unfair practices by insurance companies.

"It will provide you with more stability and more security, because the truth is, we have a system today that works well for the insurance industry, but it doesn't always work well for you," he said. He said that his plan would stop insurance companies from denying people coverage based on their medical history, or reducing people's coverage after they get sick.

He also called for changes to the way that doctors are paid, so that the health-care system encourages better preventive care by family doctors. Under the current system, he said, specialists are paid handsomely for performing expensive procedures, but there is not enough financial incentive for early detection and other simple measures that can prevent those procedures from becoming necessary in the first place.

And he repeated his pledge that health reform won't add to the federal deficit and will rein in the nation's rising medical costs. He said that most of the cost of health reform -- estimated at roughly $1 trillion over 10 years -- can be handled by eliminating waste in the system.

Criticism of the government's potentially larger role complicated Obama's message.

He asked the audience to reconsider any belief that the government is incompetent.

"This is not something that is impossible to do, but we've got to overcome the understandable skepticism that somehow Washington can never get anything right," he said.

That statement came in response to a question from Patty Briguglio, who owns a public-relations company and provides health-care benefits to her 20 employees. She asked Obama for evidence of why a new government-run health-care system would be better than the current one. Obama cited Medicare and the Veterans Affairs systems, which function differently but, he said, have high satisfaction rates.

He said that some opponents of his plan believe that any large government program is bound to be ineffective.

Some of those skeptics were on sidewalks outside Broughton High School, where Obama spoke. They held signs with such slogans as "Government is the problem!" and "Stop Spending, Stop Socialism.''

Republicans responded harshly to Obama's remarks, saying that a health-care overhaul is needed but that Obama's plan is the wrong approach. They said that his plan would lead to a bloated government program that would invade the private sector.

The importance of the moderate wing of the Democratic Party was evident yesterday as House leaders appeared to break through a legislative impasse by garnering the support of some key members of the so-called Blue Dog Democrats, a group of fiscally conservative Democrats, many from Southern states. North Carolina has two Blue Dogs: Rep. Mike McIntyre of Lumberton and Rep. Heath Shuler of Waynesville.

Another important vote on health-care reform could come from Sen. Kay Hagan, who has so far taken a cautious approach toward Obama's plan.

Hagan was not at Obama's Raleigh appearance. Most of the state's other top Democrats were, including Gov. Bev Perdue, former Gov. Jim Hunt and many state legislators.

■ Journal reporter James Romoser contributed to this report.

Five questions on a health-care overhaul

1. Will there be a public option?
President Obama and many Democrats want a choice for people who aren't satisfied with their private plan. Opponents say that would be government interference with private providers.

2. Will there be an employer mandate?
House and Senate proposals want this, but business groups oppose it. Republicans suggest tax credits for employers who provide insurance.

3. What will reform cost?
Cost estimates for the leading bills in Congress are in the range of $1 trillion over the next 10 years. Obama says that any bill must pay for itself.

4. How will it be paid for?
Obama says that most of the cost can be covered by eliminating waste in the current system.

5. What is the timeline for passage?
Obama said in Raleigh yesterday that he now expects Congress to vote on a health plan in late September or October.