Wary of Dr. Sam : Jack Torry

There is no "death panel" in any health bill being considered by Congress. There's no coverage for illegal immigrants, and no Canadian-style, government-run system in which taxes would pay for everybody's health care.

But as President Barack Obama and backers of an ambitious plan to extend insurance to most Americans keep knocking down these and other horror stories, polls show that at least half the country is anxious about how Congress might rebuild the nation's health care.

For the past two weeks, television screens have been filled with images of angry people confronting members of Congress about the health plan. Although Democrats have dismissed much of the noise as the product of right-wing organizations, the protests suggest a growing uneasiness among a lot of Americans.

A Gallup survey released Tuesday shows that 49 percent disapprove of Obama's handling of health care, while 43 percent approve. Pollsters are reporting that the independents so crucial to Obama's victory last November are deserting him.

"If the plan really did half of what the critics said it would do, I could see why (Americans) would be concerned," said Ken Thorpe, a professor of health policy management at Emory University in Atlanta and a former Clinton administration official.

He accused opponents of reform of employing the "same old tired arguments we've seen for 50 years -- 'socialist government, government is going to cut off your benefits, death panels,' which is absurd."

Yet even as former Alaska Gov. Sarah Palin and other reform opponents have incorrectly charged that the bills would have government bureaucrats making end-of-life decisions, the anxiety about the measure cannot be completely explained by what Obama last week called "wild misrepresentations."

Instead, at a time when the annual federal budget deficit is expected to reach $1.8 trillion, voters seem increasingly nervous about lawmakers passing a health-care reform that could cost $1 trillion during the next decade.

They're not sure reform would help them. They worry about a bigger federal role in health care. And seniors are alarmed because most reform efforts call for billions of dollars in "savings" in Medicare.

One thing to remember is that most Americans already have some health coverage, said Ted Hollingsworth, a Washington lobbyist and former top aide to Sen. George V. Voinovich, R-Ohio. "So if this does not come across as cost containment -- which 100 percent of Americans want -- than you're swimming upstream for the benefit of only (a relative handful) of the people."

Hollingsworth also said, "Everybody wants reform, but they want to define what that means. I don't think anybody is particularly happy with the system, but people are increasingly aware that there are going to be winners and losers."

Ed Goeas, a Republican pollster in Washington who is working for Republican gubernatorial candidate John R. Kasich of Ohio, said: "There's a bigger issue than just health care. What I am seeing in state after state is the No. 1 issue is wasteful government spending."

Each of the plans being considered by the House and Senate would cost as much as $1 trillion during the next decade. Those costs come at a time when Americans are suffering from sticker shock from the $700 billion financial rescue plan last year and the $787 billion economic stimulus package this year.

The nonpartisan Congressional Budget Office, which calculates the cost of all bills before Congress, has concluded the House bill favored by Democratic leaders would add $239 billion to the federal deficit during the next decade.

House Democrats say their bill would be financed by surcharges on the wealthy and on certain small businesses. But some senators are pressing for a tax on the most expensive health insurance plans. Employees now get health plans tax-free from their employers.

"Even though the promise is it will be coming from rich folks, people know there is a limited supply of rich folks," said Thomas Miller, a health analyst for the American Enterprise Institute, a conservative research group in Washington.

"But secondly, there's a sense that we go through these political swings where there is an appetite for a little more government or a little less," Miller said. "We shot past 'a little more government,' and people are saying they're tapped out."

Almost everyone agrees on what's wrong with America's health system. While the U.S. has the most advanced hospitals and sophisticated drugs, the cost of health care continues to climb -- from $1.4 trillion in 2001 to a projected $3.1 trillion in 2012, according to the Henry J. Kaiser Family Foundation.

About 160 million Americans are insured through their employers, another 13 million buy their own insurance, and Medicare and Medicaid cover the elderly and poor, respectively. But 47 million Americans don't have coverage -- some by choice, some because they work for small companies that do not insure their workers, and others who cannot afford insurance.

Despite the intense arguments, there actually are some broad agreements. The health-insurance industry has promised to insure those with pre-existing conditions if Congress requires all Americans to buy insurance and drops a plan for the federal government to offer insurance, too. The pharmaceutical industry has pledged to reduce costs by $80 billion provided Congress drops plans to have the federal government negotiate drug prices.

Although Obama insisted at a town hall meeting last week in New Hampshire that "This is not about putting the government in charge of your health insurance," many argue that under any bill, the government will have a greater say in health care -- precisely what worries some Americans.

Obama and Democrats, for example, want a robust federal insurance option, which they maintain would force private insurers to reduce their premiums. House Democrats have called for a health commissioner who would have the authority to review plans offered by private employers. That prompted Miller to call the commissioner "the backdoor way to push people -- through regulation -- toward a dominant public plan."

But Thorpe dismisses fears that a public plan would overwhelm private insurers. "It depends on how you construct it," he said. "It could be yes or no. If you're only making it available to a small segment of the population, the answer is no."