Health advocates' campaign just beginning

By Susan Heavey - Analysis

WASHINGTON (Reuters) - Proponents of healthcare reform may have found their ally in U.S. President-elect Barack Obama, but the real campaigning has just begun.

While all eyes are on the president's transition team as it begins evaluating the nation's struggling economy and two wars, consumer advocates, union groups and others are determined to keep affordable healthcare front and center.

"We are going to embark into an all-out campaign to try to get universal healthcare coverage and healthcare reform enacted," said Dennis Rivera, chair of the Service Employees International Union's (SEIU) healthcare division.

"Starting right now, we are hiring coordinators all over the country to run this campaign as if it was a presidential campaign and our candidate is basically going to be healthcare reform."

Healthcare remains a worry even as the economy falters. Still, when voters cast their ballots on Tuesday, just 9 percent said it was their top concern, behind the economy and the war in Iraq, according to CNN.

Most Americans receive their coverage through work or government programs such as Medicare and Medicaid, which insure the elderly, disabled and poor. Nearly 46 million have no insurance and hundreds of thousands more are losing it as unemployment reaches a 14-year high.

Many other Western countries have entirely government-run systems.

Experts say the sour economy simply highlights the precarious state of the nation's healthcare system.

"I think now is the time for a real effort on major healthcare reform," said Dr. Mark McClellan, a former economic and health official under both presidents Bill Clinton and George W. Bush.

He now heads the Brookings Institution's Engelberg Center for Health Care Reform.

"The economic downturn makes it more urgent that we make sure that we're spending our money well on healthcare," McClellan told Reuters.

The stakes are high as the $2.3 trillion healthcare industry accounts for about 16 percent of the U.S. economy. Sweeping reform will not be easy -- even for Democrats who have made healthcare a signature issue and won a bigger majority in Congress, as well as control of the White House.

SEIU's Rivera and other advocates said Obama must take bold steps in his first 100 days in office and introduce broad legislation to make use of his political momentum.

Reformers are keen to avoid the missteps of the early Clinton administration, when too many competing efforts and a lack of outreach to various interests doomed then-First Lady Hillary Clinton's plan, several experts said.

Democratic Sen. Edward Kennedy, a life-long supporter of expanded healthcare access, wants to see lawmakers united behind one bill and has spent months meeting with a variety of groups, including the National Federation of Independent Business, a staffer said.