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US healthcare debate gets vital backing

President Barack Obama’s signature drive to remake US health care was on track to clear a key Senate hurdle Saturday, as the last wavering Democrats agreed to vote to formally open debate on the bill.

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But those lawmakers, Senators Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, warned they wanted changes to core provisions in the 2,074-page plan and might side with Republicans in the future to defeat the measure.

Still, their support gave Democrats the 60 votes needed to prevail in a vote on whether to formally take up their legislation to extend coverage to some 31 million Americans who currently lack it.

The measure – which includes a government-backed insurance program to compete with private firms and restrictions on dropping care for pre-existing ailments – is estimated to cost 848 billion dollars through 2019 but cut the sky-high US budget deficit by 130 billion dollars over the same period.

Democrats had no margin for error: With support from two independents, they controlled exactly the 60 votes needed to ensure passage over united opposition from the 100-seat chamber’s 40 Republicans.

A successful final vote – expected a month away at the earliest – would force the Senate and the House of Representatives to reconcile their rival versions of the bill and vote again to send it to Obama.

Republicans hope to delay until midterms

Republicans, one of whom has vowed a “holy war” against the bill, hope to kill the bill or delay the battle into next year with the expectation that the 2010 midterm elections may make it harder for centrist Democrats to support it.

Landrieu and Lincoln added to the measure’s uncertain fate by saying they opposed the so-called “public option” government-backed plan and could side with Republicans in future procedural votes — effectively dooming the bill.

“There are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done,” said Landrieu.

“I’m promising my colleagues that I’m prepared to vote against moving to the next stage of consideration as long as a government-run public option is included,” said Lincoln.

Debate still focused on cost

As debate opened Saturday, Republican Minority Leader Mitch McConnell warned against passing “this staggering spending program at a time when many would argue our international bankers, the Chinese, are lecturing us about debt.”

Democratic Majority Leader Harry Reid shot back that McConnell should not “lecture us now on debt” after voting to spend hundreds of billions of dollars for the “war of choice” in Iraq under then-president George W. Bush.

The House of Representatives approved its own trillion-dollar version in a 220-215 squeaker on November 7 only after winning over a platoon of centrist Democrats by toughening restrictions on federal funds subsidizing abortions.

The Senate version does not include that stricter language, and changes several other key provisions of what would be the most sweeping overhaul of its kind in four decades.

Obama, whose job approval ratings have slipped below the critical 50-percent mark in a key public opinion poll, played golf at a military base outside Washington while the Senate pursued its often angry debate.

The United States is the world’s richest nation but the only industrialized democracy that does not provide health care coverage to all of its citizens, at a time when an estimated 36 million Americans have no health care whatsoever.

Several US presidents since Theodore Roosevelt in the early 1900s have sought to overcome the traditional US suspicion of a wider government role in health care.

Washington spends more than double what Britain, France, and Germany do per person on health care, but lags behind other countries in life expectancy and infant mortality, according to the Organization for Economic Cooperation and Development (OECD).