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Republicans were worried about the prospect of a government-run system, even if it wasn’t mandatory.

Though there was ample talk of bipartisanship and plenty of praise for the president’s initiative in bringing everyone involved in health care together to discuss the problem, this issue of government-run care was one of the major fault lines exposed during the day’s events.

Mr. Obama said that under his plan, “if somebody has insurance that they like, they should be able to keep that insurance. If they have a doctor that they like, they should be able to keep that doctor,” and they would pay less for this care.

Roger Hickey, co-director of the Campaign for America’s Future, praised Mr. Obama for pursuing “a public health insurance option.” He called it “key to expanding coverage, controlling costs, and improving quality in health care.”

“The president’s plan says that people will have the choice to keep the health insurance they have or they can enroll in the new public plan or an approved private plan,” Mr. Hickey said.

But Republicans consider this an interim step toward universal government-run care.

Mr. Grassley, during a question-and-answer session with Mr. Obama in the White House East Room after the breakout sessions, expressed a concern felt by many Republicans.

“There’s a lot of us that feel that the public option, that the government is an unfair competitor, and that we’re going to get an awful lot of crowd-out. And we have to keep what we have now strong and make it stronger,” Mr. Grassley said.

Senate Minority Leader Mitch McConnell of Kentucky and other leading Republican senators sent a letter to the president Wednesday laying out their opposition in some detail.

“Washington-run programs undermine market-based competition through their ability to impose price controls and shift costs to other purchasers. Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition,” the letter said.

“Ultimately, we would be left with a single government-run program controlling all of the market. This would take health care decisions out of the hands of doctors and patients and place them in the hands of another Washington bureaucracy.”

Rep. Roy Blunt, Missouri Republican, who is chairman of a Republican health care solutions working group, said in private conversation within earshot of a Washington Times reporter that the Obama administration appears committed to a government-run option for those who want to use it.

“I’m not sure how we get them to back off that,” he said.

In response to Mr. Grassley’s question, Mr. Obama said the thinking behind a public option is that it “gives consumers more choices and it helps … keep the private sector honest.”

But he said he understood a fear that “private insurance plans might end up feeling overwhelmed,” and promised to “pay attention” to this as the process goes forward.

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