Obama seeks to keep intact a shaky coalition on health care 

With liberal groups intensifying pressure to include a government-run insurance program in Democratic health care proposals, the White House continued to hedge on the issue -- saying President Obama is most concerned about fairness.

"What's important for all this process and for the end of this process is ensuring that at the end of this, we have in insurance markets the ability for people to have choice and competition," said White House press secretary Robert Gibbs. "We'll evaluate proposals as they happen."

Obama, meanwhile. continued his outreach to moderate Democrats, meeting privately with Sen. Kent Conrad of North Dakota who favors creating privately run health care cooperatives, an option the administration has never fully embraced.

Lawmakers this week resume the process of distilling two Senate bills and three House bills into a single version for each chamber. Meanwhile, deeper fault lines are emerging within political parties, affected industries and public opinion over the best way to reform health care.

A new Washington Post/ABC News poll found 57 percent of Americans favor including a government-run public option in health care reform, while 40 oppose it.

The poll numbers underscore the difficulty lawmakers have had in making their efforts track public opinion. The same poll in August found just 52 percent in support of a public option, down from 62 percent in June.

Their efforts were complicated over the weekend, when White House senior adviser Valerie Jarrett told NBC's "Meet the Press" that Obama believes the public option is "the best possible choice" but will not insist on it.

Her remarks were echoed by fellow senior adviser David Axelrod, who told ABC's "This Week" that the lack of a public option won't "halt the process" for the administration.

Those sentiments were a setback to labor and others who were the earliest enthusiasts of health care reform, and now find themselves at odds with Obama over its basic components.

The president, meanwhile, is holding together a fragile industry coalition that includes the pharmacy industry and doctors. The latter, however, are on board conditionally while the Senate this week debates their Medicare reimbursements -- a key legislative priority of the American Medical Association.

Michael Cannon, director of health policy studies at the Cato Institute, surmised that the pharmaceutical industry remains supportive because they believe they will make more money if reform is passed.

"It's hard to draw any firm conclusion because 'Mr. Open Government' has a secret deal with [the industry] and we don't know what it is," Cannon said. "We also don't know how much individual member companies have calculated they would gain under the deal."

The White House in June touted an agreement by the industry to cut drug costs for seniors -- a move that at the time was expected to be significantly offset by the number of new customers added by the Democratic plan.

jmason@washingtonexaminer.com

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