Nelson avoids the stage during health care battle

WASHINGTON — The conference room doors swung open every few minutes, a mini political drama unfolding on the fifth floor of the Hart Senate Office Building.

One by one members of the Senate Finance Committee faced a gantlet of reporters straining for news about a health care overhaul. Amid the clamor that July morning, one senator opted for a more private exit.

Sen. Bill Nelson is Florida's most powerful Democrat in Washington, but he has remained on the margins of the health care debate. Nelson has said little as colleagues from much smaller states take the lead, instead focusing publicly on issues like pythons in the Everglades.

Today, Congress returns from its August break and, once again, all eyes will be on the Finance Committee, which will likely determine the success or failure of a health care overhaul. Restless advocates in Florida say Nelson needs to play a more active role this time around.

"He's shown no leadership at all. He's been hiding," said Marcia Wagshol, a 57-year-old liberal activist and accountant in Palm Beach County who pays $2,000 a month for family health insurance.

"Republicans are taking a tough stand and they are winning. The Democrats are being wimpy and doing nothing."

Many Democratic voters insist that a package must include a government-run insurance plan. This "public option" has dominated summer headlines as Republicans have amplified their opposition and as distortions have circulated at town halls and on the Internet, undercutting the call for wholesale overhaul of the nation's health care system.

President Barack Obama will try to regain control of the debate Wednesday night in a speech before a joint session of Congress. But even he may be willing to give up a full-fledged public option.

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Nelson, 66, predicted the idea was dead during a visit to Lakeland last week. "I want consensus so that we can have as many people as possible with health care coverage, and we cannot get the 60 votes in the Senate with any public option," he told the Lakeland Ledger.

"The public option is only one of hundreds of issues concerned with health care reform," he said. "Public option means different things to different people. Some people think of it as socialized medicine, but that type is not and has not ever been considered. Still any public option will not pass."

A few days earlier in Daytona Beach, Nelson told nearly 200 business and community leaders that he has advocated an "incremental approach" toward reform.

Nelson told the group he favors saving money through less duplicative medical testing, and said he would like to see insurance "exchanges" where individuals could join together for lower rates.

The senator declined to be interviewed for this story, saying through a spokesman that he would rather wait until the Finance Committee is closer to voting on its bill. He has relied on staff to signal personal opposition to a public option, pointing to problems with Florida's Citizens Property Insurance Corp. as a warning sign.

As much as liberal Democrats bash his cautious approach — Internet message boards are full of outrage and accusations he is too close to the insurance industry and its money — Nelson is not unlike many other legislators taking the safe route.

"Unless he is an ideologue who believes this is the be-all, end-all, there is simply no reason to weigh in with specifics until you know what the shape of the alternatives are going to be," said Norman J. Ornstein, a scholar at the American Enterprise Institute, a conservative think tank.

Ornstein said the public option has emerged, strangely, into the Holy Grail. When the discussion first began, he said, it was about getting insurance for the uninsured and covering those who were going from one job to another or were laid off.

Now, with the public option at the forefront, "the right has used it to scare people and the left has decided it's the only way you can get leverage over insurance companies," Ornstein said.

Many of those frightened by the prospect of a public option are older Americans, who have been convinced their own government-sponsored plan — Medicare — will be hurt. Fear is pervasive, despite attempts by Obama and others to counter distortions.

In Florida, home to an aging population (one that votes en masse), that could further entrench Nelson.

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So while others sweat the details, Nelson has continued to engage in media-friendly pursuits, like tackling the problem of Burmese pythons in the Everglades and Chinese drywall and continuing the fight against offshore oil drilling.

Nelson's health care posture has drawn attention from Democrats at the state and federal level. This summer, TV ads and petition drives were launched to press Nelson into action.

Last week, a group of activists dropped off petitions to his Fort Myers office, urging him to support broad principles, including a public option, espoused by the president.

Rebecca Brislain, 55, went along. Her daughter was laid off by a home health care company and was recently rehired part time. As a result, she can no longer afford health insurance. Brislain said the help her daughter needs is embodied in the public option.

"What you see on the news — the people protesting and shouting — doesn't represent the perspective of everybody," Brislain said. "We want to let him know there's a positive movement out there."

Brislain said she understood Nelson's reluctance to stake out too clear a position.

"I think he's waiting to see what the end result is," she said. But when told that only a few days earlier in Lakeland Nelson had closed the books on a public option, Brislain was less accommodating.

"The whole purpose of legislators coming back to their communities was to hear what people have to say," she said. "That's what the purpose of our visit to his office was. To rule anything out is premature. I hope he'll keep an open mind."

Alex Leary can be reached at leary@sptimes.com.