Tony Garr sat at his desk in Nashville, thinking about the ways health insurance reform could make life easier for millions.
"I talk with people every day who are 62 or 63, they're just holding on with their fingernails, hoping they get to 65 before they get sick," Mr. Garr said Thursday, president of the Tennessee Health Care Campaign, an advocacy group for health care reform. "We want the opportunity for every American to be covered."
But opponents say that steady inflation of health care expenses means that government-funded insurance programs for small businesses and individuals could strain federal and state budgets.
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"You will be hard pressed to find anyone who doesn't think there needs to be some kind of health care reform," said Kevin Bloye, spokesman for the Georgia Hospital Association. "But we're concerned about the level of the federal government in the administration of health care."
The same debate raged for more than seven hours Thursday in Washington, D.C.
During a televised summit, President Barack Obama and his Democratic allies made their case that comprehensive health care changes would stimulate a faltering national economy. Republicans at the summit immediately clashed with the president on the idea.
The summit centered on four issues: health insurance reform, cost regulation, deficit reduction and coverage expansion. Fresh off orchestrating a 406-19 bipartisan passage of a jobs bill in Congress on Wednesday, President Obama called health care "one of the biggest drags on our economy."
"We all know this is urgent," he said.
In opening remarks for the GOP, Sen. Lamar Alexander, R-Tenn., quickly dashed any possibility of bipartisan consensus for the suggested reform plan when he called for President Obama to scratch his plan for a health care overhaul and head back to the drawing board.
"Our views represent the views of a great many American people," Sen. Alexander said during summit proceedings. "This is a car that can't be recalled and can't be fixed. ... We ought to start over."
After listening to the senator's remarks, President Obama admitted that the differences expressed in the opening moments of the summit could be too wide to overcome.
"It may turn out that there's too big of a gulf," he said.
That's how the debate appeared to some local health care officials as tempers flared and politicians from both parties repeated rigid policy positions.
"It seemed like a lot more grandstanding by both sides," said Dr. John McCarley, a physician at Nephrology Associates in Chattanooga. "We need to find a way to improve access to primary health care for people that don't have jobs and could not possibly get insurance. That's not going to happen in a few hours."
Still, one physician took another view to the president's attempt to keep the government transparent and debates subject to public scrutiny.
"If nothing else, it will clarify issues and both sides," said Dr. Clif Cleaveland, a retired physician from Chattanooga and former president of the American College of Physicians. "I would like to see this as a model for every other very complex issue, whether it's immigration or Afghanistan policy. It removes the sense that there are private discussions in Washington to which the public is not privy that determine the major issues."
Mary Thompson, spokeswoman for BlueCross BlueShield of Tennessee, also was encouraged by the debate.
"We believe in the need to expand access to health coverage and continue to support reform that is meaningful and sustainable," she said.