Conyers said he was not invited to President Obama’s March 5 Health Care Summit until he threatened to go to the president. Earlier, he had been told single-payer was “off the table,” he said. Ultimately, he and other single-payer advocates were included.

Speaking at another event at Thomas Jefferson University here, Conyers said President Obama will not back single-payer health coverage now because he’s got too much on his plate — two wars and an economic crisis — and he has to settle for health care reform he can get, the Philadelphia Inquirer reported.

Conyers told that gathering Obama would push through a public-private reform package — keeping private employer-based insurance and expanding a Medicare-like system — “if he’s lucky.”

Given a choice, people will choose the public plan, Conyers told the town hall meeting. (In a recent New York Times poll, 67 percent favored national, single-payer health care.) But insurance companies don’t want to share — they want to keep their huge profits, he said, so they are pressuring every member of Congress and spending millions to scare the public and keep single-payer “off the table.”

Barack Obama said he would consider embracing a single-payer health-care system, beloved by liberals, as his plan for broader coverage evolves over time.

“If I were designing a system from scratch, I would probably go ahead with a single-payer system,” Obama told some 1,800 people at a town-hall style meeting on the economy.

A single-payer system would eliminate private insurance companies and put a Medicare-like system into place where the government pays all health-care bills with tax dollars.

Many liberals have long embraced the coverage plan, saying it would cover everyone, take the profit out of health insurance and allow for greater efficiencies. But Republicans cringe at such deep government involvement in the private sector, calling it socialized medicine. And many Democrats, including Obama and former rival Hillary Clinton, have taken a much more moderate approach.

Obama’s health-care plan aims for universal coverage by offering a new government-run marketplace where Americans could buy insurance, mostly from private plans. He would offer subsidies to individuals and to small business owners that offer their workers coverage. His plan also would require that parents get insurance for their kids. And he aims to lower health-care costs to make coverage more affordable. His plan includes one small step toward single payer. His new marketplace would create a new government-run plan, like Medicare, to compete against the private plans.

But Obama repeated that he rejects an immediate shift to a single-payer system. “Given that a lot of people work for insurance companies, a lot of people work for HMOs. You’ve got a whole system of institutions that have been set up,” he said at a roundtable discussion with women Monday morning after a voter asked, “Why not single payer?”

“People don’t have time to wait,” Obama said. “They need relief now. So my attitude is let’s build up the system we got, let’s make it more efficient, we may be over time—as we make the system more efficient and everybody’s covered—decide that there are other ways for us to provide care more effectively.”

The big difference here is that Obama wanted above all to leave the health insurance oligarchs in power.

Fall 2009 Democrats take the lead; war with the insurance industry; more deals are cut

Two days before the Senate is to vote on the Finance Committee's bill, America's Health Insurance Plans releases a report (PDF) alleging that health care premiums would increase sharply under the bill. "But the importance of that report and its issuance was not really the substance of the report so much as the decision by the industry to put it out there," explains Washington Post reporter Ceci Connolly. "It was the clearest signal in this long drama that the insurance industry was not going to be on board with any sort of health care reform."

On Oct. 13, the health care bill passes the Senate Finance Committee with the support of only one Republican, Sen. Olympia Snowe of Maine. Following the bill's passage, Senate Majority Leader Harry Reid (D-Nev.) takes back control of the bill -- talk of a public option is back on the table and the individual mandates that the insurance industry had fought for are watered down.

And the following Saturday, the president takes on the insurance industry in his weekly Internet address: "They're flooding Capitol Hill with lobbyists and campaign contributions, and they're funding studies designed to mislead the American people," he says. "It's all smoke and mirrors. It's bogus."

But Karen Ignani and her allies fight back by funneling millions of dollars into a tough ad campaign against the legislation sponsored by the Chamber of Commerce.
And the insurance industry's arguments hold sway with a number of key senators. The White House and the Democratic leadership begin cutting deals; they kill the public option, pleasing Sen. Joe Lieberman and others; they lower proposed taxes for medical device makers to win Sen. Evan Bayh's (D-Ind.) support.

The last holdout is Sen. Ben Nelson (D-Neb.), a former insurance industry executive. He agrees to support the bill if he can get a $100 million deal in which the costs of expanding Medicaid in Nebraska would be covered by U.S. taxpayers. Sen. Nelson denies there was a quid pro quo for his vote, saying instead he was opening the door for all states to receive similar Medicaid compensations. But Washington and the media see it differently; the deal becomes known as the "Cornhusker Kickback."

This theme had been reiterated all day: Obama is all about the art of the possible within the system. "This is a classic conflict within the left: Are you a revolutionary or are you a reformist?" Obama said. "I am less concerned with the labels that are placed on me in terms of what kind of leader I am, and I am more interested in results.... I think within the institutional structures we have, we can significantly improve the life chances of ordinary Americans." I asked him to give me some specific examples of what he meant. Is a proposal to convert America's healthcare system to one in which the government is the single payer for all services revolutionary or reformist? "Anything that Canada does can't be entirely revolutionary--it's Canada," Obama joked. "When I drive through Toronto, it doesn't look like a bunch of Maoists." Even so, Obama said that although he "would not shy away from a debate about single-payer," right now he is "not convinced that it is the best way to achieve universal healthcare."

Obama has a remarkable ability to convince you that his positions are motivated purely by principles, not tactical considerations. This skill is so subtle and impressive, it resembles Luke Skywalker's mastery of the Force. It's a powerful tool for a Democratic Party that often emanates calculation rather than conviction. "I don't think in ideological terms. I never have," Obama said, continuing on the healthcare theme. "Everybody who supports single-payer healthcare says, 'Look at all this money we would be saving from insurance and paperwork.' That represents 1 million, 2 million, 3 million jobs of people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?"

Shifting back to how he sees himself in the Senate, Obama seemed to amend his previous statement about what kind of leadership progressives can expect from him. "I am agnostic in terms of the models that solve these problems," he said. "If the only way to solve a problem is structural, institutional change, then I will be for structural, institutional change. If I think we can achieve those same goals within the existing institutions, then I am going to try to do that, because I think it's going to be easier to do and less disruptive and less costly and less painful.... I think everybody in this country should have basic healthcare. And what I'm trying to figure out is how to get from here to there." He went on to tell me about his support for other structural changes such as public financing of elections, forcing broadcasters to offer free airtime for candidates, adding strong labor protections to trade pacts and major efforts to create a more just tax system.

The only possible throttle on that was the public option - that Pelosi GOT THROUGH THE HOUSE and had to take out at the Administration's behest.

WASHINGTON — Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals, rather than using prices set by the government, aides said Wednesday.

Ms. Pelosi said the public plan, which she prefers to call a “consumer option,” would compete with private insurers. But the speaker was apparently unable to muster the votes needed for the “robust” liberal version of a public plan, which she has repeatedly said would save more money for consumers and the government.

Members of the House Democratic leadership team offered these details of their bill, to be unveiled on Thursday. It would provide coverage to 35 million or 36 million people. The 10-year cost of expanding coverage would be less than the $900 billion ceiling suggested by President Obama. The cost would be offset by new taxes and by cutbacks in Medicare, so the bill would not increase the federal budget deficit in the next 10 years or in the decade after that.

The new bill, like an earlier version, retains a surtax on high-income people, but increases the thresholds. The tax would hit married couples with adjusted gross incomes exceeding $1 million a year and individuals over $500,000 — just three-tenths of 1 percent of all households, Democrats said.

Ms. Pelosi can describe the proposal as a “millionaires’ tax.” The original thresholds were $280,000 for individuals and $350,000 for couples.

The government insurance plan would negotiate rates with doctors and hospitals, as private insurers do. Payments would not be based on Medicare rates, as Ms. Pelosi had wanted. Democrats from rural areas balked at the use of Medicare rates, saying they were so low that hospitals could not survive on them.

House Democratic leaders will hold a rally at the Capitol on Thursday to promote the legislation. They hope to take it to the House floor next week, with a final vote before Veterans Day, Nov. 11.

Scores of lobbyists were “cordially invited” to attend the rally in e-mail messages sent Wednesday by Ms. Pelosi. The Senate majority leader, Harry Reid, Democrat of Nevada, announced Monday that he too had decided to include a government plan, with negotiated rates, in the bill he intends to take to the Senate floor for weeks of debate.

House Democrats do not have firm commitments from enough lawmakers to guarantee passage of their bill at the moment. But their aggressive schedule suggests they are confident they can round up the votes they need.

Speaker Pelosi evidently fell well short of the votes needed for the “robust” public option.

A whip count, prepared Tuesday, shows that 47 House Democrats opposed that approach while 8 more were “leaning no.” That suggests that Ms. Pelosi had lined up, at most, 201 votes of the 218 she would probably need. Ms. Pelosi’s difficulties in securing votes for the most liberal version of a government insurance plan were illustrated by four members of her caucus.

The healthcare debate on Capitol Hill is expected to intensify today with the unveiling of House Speaker Nancy Pelosi’s healthcare bill. The measure reportedly includes a government insurance option and an expansion of Medicaid but drops a proposal to include a public option that would establish reimbursement rates to providers based on Medicare rates. Meanwhile, in the Senate questions remain over whether Senate Majority Leader Harry Reid has enough votes to pass the Senate version of the healthcare reform bill. [includes rush transcript]

TRANSCRIPT

This is a rush transcript. Copy may not be in its final form.

JUAN GONZALEZ: The healthcare debate on Capitol Hill is expected to intensify this morning with the unveiling of House Speaker Nancy Pelosi’s healthcare bill. The Washington Post reports the bill will include a government insurance option and an expansion of Medicaid.

But Pelosi has reportedly abandoned efforts to include a public option that would establish reimbursement rates to providers based on Medicare rates. Under Pelosi’s bill, rates would be negotiated between providers and federal health officials, similar to the way in which private insurance operates.

Pelosi’s bill will also reportedly include a surtax on high-income people. The new bill, like an earlier version, retains a surtax on wealthy Americans, but Pelosi has significantly reduced the number of taxpayers who will have to pay it. The tax would only hit married couples with an adjusted gross income exceeding $1 million a year and individuals over $500,000. Earlier Democratic bills called for new taxes on individuals making $280,000 a year and for couples making over $350,000.

AMY GOODMAN: In the Senate, questions remain over whether Senate Majority Leader Harry Reid has enough votes to pass the Senate version of the healthcare reform bill. On Wednesday, independent Senator Joseph Lieberman appeared on Fox and vowed to vote against the current legislation.

Remember, people in 1900 didn't know what an atom was. They didn't know its structure.

They also didn't know what a radio was, or an airport, or a movie, or a television, or a computer, or a cell phone, or a jet, an antibiotic, a rocket, a satellite, an MRI, ICU, IUD, IBM, IRA, ERA, EEG, EPA, IRS, DOD, PCP, HTML, internet. interferon, instant replay, remote sensing, remote control, speed dialing, gene therapy, gene splicing, genes, spot welding, heat-seeking, bipolar, prozac, leotards, lap dancing, email, tape recorder, CDs, airbags, plastic explosive, plastic, robots, cars, liposuction, transduction, superconduction, dish antennas, step aerobics, smoothies, twelve-step, ultrasound, nylon, rayon, teflon, fiber optics, carpal tunnel, laser surgery, laparoscopy, corneal transplant, kidney transplant, AIDS... None of this would have meant anything to a person in the year 1900. They wouldn't know what you are talking about.

But a funny thing happened on the way to the polls. Yes, Democrats were swept from power, and Reid from his post as leader. Yet few observers would place the blame on a lack of money. Instead, most would point to a tough political environment, a hostile Senate map, and—more than anything else—an unpopular president, as the factors that dragged down Democrats nationwide. Although Koch-linked organizations targeted key Senate races with negative ads in the spring, that effort was far in the rearview mirror by Nov. 4. Come summer and fall, Democrats had found the funds to answer. As Justin Barasky, a spokesman for the Democratic Senatorial Campaign Committee, told me a few days before the election, "It's clear that the early spending blitz by the Koch brothers was a giant waste of money."

In fact, although the midterm elections are believed to have set a new record, with nearly $4 billion spent on hundreds of thousands of mailers and about 1 million TV ads, political strategists on both sides of the aisle identify few, if any, major races where money was the biggest determining factor. The Democratic hype that the Kochs were buying the Senate proved overblown; so did the GOP's own fear campaign about liberal billionaire environmentalist Tom Steyer purchasing the upper chamber.

In the end, the two parties appear to have begged, borrowed, and fundraised their way to, if not parity, at least a financial draw. Each side had more than enough money to get its message out in the most important races; it just wasn't enough for Democrats, in the face of their other obstacles, to win. "I don't know, looking at the map, if you can point to any one race and say someone won or lost because of money," says Brian Walsh, a Republican strategist who was communications director for the National Republican Senatorial Committee in 2012.