WYPR: Debate Over Role of Federal Government in National Health Care Continues (2009-04-24)

Maryland Democrats want the federal government to have a bigger role in reforming the nation's health care system. Republicans are pushing back. Sara Sciammacco has more.

There are seven hundred sixty thousand people living in Maryland without health insurance. Democratic Congressman Elijah Cummings is fighting for a public plan those without coverage can afford.

"Some kind to have at least a minimum of coverage. There are people today who are literally dying and suffering in the United States of America because they don't have adequate health care."

Some Democrats want to model the plan after Medicare, the federal insurance program for seniors. Republican Congressman Roscoe Bartlett hates the idea of more government involvement.

"There is no reason that we should give a health care policy to poor people that can't buy one because with every health care policy comes an enormous cost of just bookkeeping. Why would we want to do that? That simply increases the cost of health care which everyone needs to pay."

Democrats argue private insurers game the health system to maximize their profits - making care unaffordable. They want to level the playing field. At a briefing with industry professionals Obama's health reform director, Nancy Ann DeParle, gave her definition of a public plan.

"Something that is sponsored by the government and therefore has very low or almost none existent administrative costs compared to others. It doesn't have the need to have brokers out selling. It wouldn't have the need to have a lot of costs and profits the way private plans would. It could operate by all the same rules as all the other plans do."

Several national groups who represent the private industry have come down hard against the proposal. They worry a government run option would wipe out insurers. North Carolina Republican Congressman Patrick McHenry says it's a move by Democrats that would lead to a nationalized health care system.

"It would destroy the marketplace. They would not be able to compete because the government would not price like the market must price because it would be supported by taxpayer dollars."

Maryland's largest health insurer, CareFirst Blue Cross Blue Shield, is more optimistic. Michael Sullivan is a spokesperson for the nonprofit.

"We are quite comfortable with the value and service that we provide our members and are confident in our ability to do so no matter what takes shape going forward."

Congressman Cummings wants those who are happy with their private plans to keep them. He says the federal insurance would be structured in a way to create fair competition.

"There would have to be some type of means test if you are under a certain income or whatever, in other words if you can afford insurance, that's one thing, if you can't that's another, all of that has to be worked out. The devils going to be in the detail."

Congressman Bartlett rather Congress pass bills that make it harder to sue doctors to bring down health care costs. He also wants tax deductible premiums, and favors health savings accounts to pay for patient's medical expenses.

"We have a really good sick care system. We need a health care system. People need to focus on health. The health savings accounts do that because now you are focused on staying healthy because if you get sick you are have to start spending money and it is your money so now you are going to want to stay well."

Congressional leaders hope to draft health care reform legislation by summer. Some Democrats have threatened to vote against unless a public plan is included.