WellPoint CEO optimistic about healthcare reform

* WellPoint CEO optimistic that 'real' reforms possible

* Says government-run system healthcare not affordable

By Gina Keating

LOS ANGELES, March 17 (Reuters) - WellPoint Inc (WLP.N) Chief Executive Angela Braly said on Tuesday she is "optimistic" the health insurance industry can reach substantive reforms demanded by President Barack Obama's administration to cover most or all Americans.

Obama aims to sign a bill this year making sweeping changes in the healthcare system, which is the world's most expensive but leaves 46 million Americans with no health insurance and keeps the United States behind other nations in important health measures such as life expectancy and infant mortality.

Speaking to business leaders at the Town Hall Los Angeles forum, Braly, who heads the largest U.S. health insurer by membership, said she found Obama "very charming" and agreed that "action is needed" on his "ambitious goals to get us closer to universal coverage."

"I think we have to get first to ... cost and quality questions in order to be able to make (universal coverage) realistic and sustainable," Braly told Reuters.

If the industry could cut the 30 percent of costs Braley estimates are not helping medical outcomes, "we could really afford to cover many more Americans, so I don't think it's unrealistic."

One stumbling block -- mandatory coverage for those with pre-existing medical conditions -- could be overcome by making the insured population as broad as possible, she said.

"You want to make that sure you don't create an environment we have in some places ... where people choose not to buy the healthcare coverage while they're well. They wait until they're sick," driving up premiums in markets with guaranteed coverage, she said.

She said, however, that "everybody is at the table (and) that gives me optimism that we can make this happen."

Obama last year proposed "a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage."

A single-payer system in which the government buys or provides insurance for everyone "simply is not a solution we can afford," Braly warned. "The healthcare system should not be all public or all private."

Braly suggested government could provide premium assistance to small businesses and people whose incomes are too high to qualify for public healthcare program but who struggle to afford private health insurance.

The government also "should equalize tax treatment for people who buy coverage on their own" by allowing them to purchase policies with pretax dollars, as do those who buy coverage through their employers, she said.

Braly declined to comment on a March 5 Financial Times report that WellPoint has put its pharmacy benefits management (PBM) business up for auction.

"What we said in one of the investor meetings was we look at the value of all of our assets and want to make sure we are using that value to create ... shareholder value and from that there are a lot of folks that made a big story of that," she said. (Reporting by Gina Keating; Editing by Gary Hill)