Top House Democrat says case grows for US government to compete with private health insurance

WASHINGTON — The case is growing stronger for allowing the government to sell health insurance in competition with private companies, the Democratic speaker of the House of Representatives said Thursday.

Rep. Nancy Pelosi's position is sure to prompt outrage from the Republican minority, who have been trying to plant the idea in the minds of Americans that such a government presence in the U.S. health care system would amount to socialized medicine, an anathema to many Americans.

Only the United States among major developed countries lacks universal health care yet spends more on health care than any other country. President Barack Obama has made health care his top domestic priority. He campaigned on the idea of a government option for health care, but after Republicans campaigned strongly against his program during Congress' vacation, he has been more circumspect about the subject.

"The need for a public option is very clear," Pelosi, the senior member of the House, told reporters at her weekly news conference Thursday, making the argument as lawmakers on both sides of the Capitol worked to complete sweeping legislation extending coverage to millions of the uninsured.

"Anyone who had any doubts about the need for such an option need only look at the behaviour of the health insurance industry this week," Pelosi said.

She was referring to an industry-funded study that said insurance premiums would rise under health overhaul legislation advanced by the Senate Finance Committee early in the week. Pelosi also referenced an insurance industry ad campaign targeted at older Americans, who are the main beneficiaries of the major government plan, Medicare.

It has been clear for some time that the House health overhaul bill probably would include a public plan, but its design remains unsettled.

In the Senate, Majority Leader Harry Reid, who controls the agenda due to his position as the senior Democrat, is weighing whether to include some version of a public plan as he works to merge the Finance Committee's bill with a more liberal version approved by the Health, Education, Labor and Pensions Committee.

Democratic Sen. Sherrod Brown spoke up during a Democratic caucus meeting Thursday for Senate liberals who support a strong public option, Brown's spokeswoman said. But because of opposition from moderate Senate Democrats, any public plan Reid includes probably would be some type of compromise, such as leaving the decision on a public plan to states, or offering public coverage only as a backstop in areas where one insurer has a lock on the market. That is the approach favoured by moderate Republican Sen. Olympia Snowe, who has considerable leverage as the only senator from her party to vote in favour of the health care bill that came out of the Finance Committee.