Pawlenty gets into position on health care

CHICAGO - In selling himself to Republican activists here last week, Minnesota Gov. Tim Pawlenty drove home his attacks on Democratic proposals to overhaul health insurance as prescribing a costly Washington grab for power.

Staking a claim as a vocal conservative counterpart to President Obama concerning the hottest issue in the nation could help raise Pawlenty's profile among potential Republican presidential candidates.

In Chicago on Friday night before party activists from around the nation, he slammed large government-run programs in an implicit criticism of Democratic proposals to overhaul health care.

"The entitlement programs that the federal government currently runs are all broke and headed to bankruptcy," he told more than 100 people, many of them local officeholders. "Medicare is bankrupt or essentially bankrupt. Medicaid is essentially bankrupt. Social Security is essentially bankrupt."

"Why in the heck would we give the federal government another entitlement program to match on that track record?" he said, drawing hearty applause.

Pawlenty noted in an interview after the speech that Democrats aren't embracing a Medicare-type single-payer model for health insurance. Asked why he talks about such a model, Pawlenty said that Obama has expressed a desire to "get there in installments." The governor called Democratic proposals for a public option for insurance "the camel's nose under the tent."

During the presidential campaign, Obama said, "If I were designing a system from scratch, I would probably set up a single-payer system. ... But we're not designing a system from scratch ... so what I believe is we should set up a series of choices. ... Over time it may be that we end up transitioning to such a system."

Talking up Minnesota's plan

Also, Pawlenty recently touted his state's insurance system for government employees as preferable to Democratic ideas in Congress for a public option to the current system of private health insurance.

Yet some argue that some of those ideas resemble Minnesota's state government employees plan.

"It's a public entity that put together a set of choices," said Susan Foote, a professor of health policy and management at the University of Minnesota who worked with U.S. Senate Republicans in the early 1990s as senior adviser to then-Sen. Dave Durenberger of Minnesota.

"Guess what that could be called?" she said. "Public option."

Pawlenty said the state employee plan is distinct from public options contemplated by Democrats because the state isn't a third-party broker for consumers and insurers, but negotiated terms with workers and insurance providers much as private employers and employees might do.

"This is not a government-run program," he said last week.

"I don't think you want the federal government saying we're going to negotiate one platform for all people with all health care providers and that's what you get," he said.

Pawlenty also has criticized the Massachusetts health care plan developed by former Gov. Mitt Romney -- another GOP presidential hopeful -- and Massachusetts Democrats. He said that while the plan expanded coverage, the costs "have been dramatically higher than expected."

Study says it's not so

"The cost of this achievement has been relatively modest and well within early projections of how much the state would have to spend to implement reform," it wrote.

An additional 432,000 state residents have obtained insurance under the plan, giving Massachusetts the lowest rate of uninsured residents in the nation, the foundation said. More people were insured by employers as well as by government-run programs.

"I would certainly give them a B-plus," said Len Nichols, a health economist at the New America Foundation, a nonpartisan think tank in Washington. Nichols was a health policy adviser for the Clinton administration.

But Pawlenty, in the interview, said that other studies of the Massachusetts plan have concluded that it failed to contain costs. He said that it benefitted from an infusion of federal money.

"I don't think anybody can credibly look at the Massachusetts experiment and say it has been successful in containing costs," he said.