The debate over the Obama administration plan has been heard -- often loudly -- in public meetings held by lawmakers.
This is the VOA Special English Economics Report.
President Obama is letting Congress write the details of his plan for what he calls health insurance reform. Congress is now on its August break. But members have been holding what are known as town hall meetings around the country to hear reaction. And they have been getting an earful from crowds for and against the plan.
SOUND: "This is not health reform, this is control! Control over our lives!"
The president, at his own meetings, pointed back to the 1990s.
BARACK OBAMA: "Every time we come close to passing health insurance reform, the special interests fight back with everything they've got. They use their influence. They use their political allies to scare and mislead the American people. They start running ads. This is what they always do."
But some objections are based on cost estimates from an independent agency, the Congressional Budget Office. Also, some people say they have not gotten enough details of the plan to be able to make up their minds.
Two goals are to expand health insurance to millions of Americans who do not have it, and to control rising costs for those who do. A public insurance plan is proposed to compete with private insurance companies. Republicans and other critics say the Democrats' idea of reforms would lead to socialized health care.
But one of the first groups to support the administration was the Pharmaceutical Research and Manufacturers of America. PhRMA is spending millions on advertising to support the plan.
The industry group has already promised to cut drug costs by 80 billion dollars over ten years. Critics want more. Some liberal lawmakers have proposed measures such as letting the government negotiate lower drug prices. But under the PhRMA deal, the chances for additional cost-saving measures are unclear.
Drugs that need a doctor's prescription became a bigger part of the debate over health care costs in 2003. Congress and President George W. Bush added prescription drugs to the Medicare insurance program for older Americans. That raised the costs of Medicare, which represented 15 percent of the federal budget last year.
But PhRMA says drug costs are only 10 percent of all health care costs in America. It also points out the high costs of developing new drugs.
Yet researchers from Stanford University say new treatments are often no better than existing ones, but are almost always more costly. Writing for the New England Journal of Medicine, they suggest a way to lower prices. They say the government should require drug makers to state, in their labeling information, how new medications compare with existing ones.
And that's the VOA Special English Economics Report, written by Mario Ritter. I'm Steve Ember.