According to a late June CBS News poll, eighty-five percent of Americans felt that healthcare needed significant and real change. Over seventy percent backed a government-administered insurance plan that would compete against private insurance companies for potential customers under the age of sixty-five, exactly what President Barack Obama and Congressional Democrats are proposing.

Contrast this picture with the end of July polls that showed that more Americans disagree with Obama on healthcare than support him, as well as a small, but real, decline in Obama’s approval ratings. Now that the specifics are coming to the debate several constituencies are feeling shafted, although most people support significant healthcare reform. Disagreements over how to be equitable to private insurance companies, how to fund the bill, and how to implement the care make reform very difficult for DC politicians.

The bill put forward by Congressional Democrats, America’s Affordable Health Choices Act of 2009, plans to lower healthcare costs by curbing anticompetitive business behavior on the part of insurance and drug companies. Seeing as there have been hundreds of mergers among insurance companies in the past decade and now two companies own a third of the national healthcare market, it is not difficult to see how these power players will lose.

In addition, the bill calls for the elimination of the pre-existing conditions clause which insurance companies argue will make them charge unfairly high prices to the healthy in order to maintain profits. Lastly, although most people support reform such as moving to electronic health information technology systems that will not only reduce medical errors but may save the industry up to $80 billion per year according to a 2005 RAND study.

However, those profiting from the inefficiencies are against such change. According to the Washington Post, between January and March of this year health-care firms and their lobbyists spend $1.4 million a day, so there is bound to be resistance in the legislature regardless of the merits of the Democrat’s plan.

Funding for the healthcare reform has also been a huge subject of debate. The current bill in Congress calls for an increased tax on citizens making over $350,000, while at the same time providing a tax credit for low income families to help pay for healthcare costs. This has made some of the wealthy argue that they are already subsidizing the poor way too much, leading to class warfare. The bill will also reduce Medicare payments to hospitals that the government determines are not performing well, which makes some senior citizens apprehensive that they will be giving up part of the benefits they have earned through years of hard work.

Economic conservatives claim that the bill will increase the already overwhelming eleven trillion dollar national nationl debt. They deride the tax that will be levied on employers that fail to provide health insurance to their employees, arguing that this will force employers to reduce salaries in order to provide a benefit that the employee may not really want. They claim that even if it looks like the employer is paying for healthcare, it is really the employee that does so.

Economic liberals believe that the bill can do more to reduce the deficit by increasing the scope of tax increases to include those in the top 5% of income earners. In short, in order to keep healthcare reform at a reasonable price, either someone’s toes will be stepped on or the impact of the reform will have to be diminished.

Finally, the specifics of the care that will be tendered under the new reform arouse ire in key constituencies. Many social liberals want the new reform to include provisions for funding abortions and access to transgender care. They argue that the latter especially has not been provided adequately by the private insurance companies. Some social conservatives cite the Hyde Amendment which prohibits federal funding for abortion and erroneously feel that the bill may mandate sex changes.

Although the American Medical Association supports HR 3200, it finds it problematic that the bill does not call for significant medical liability reform. The association argues that frivolous lawsuits reduce overall access to quality care.

On the flipside, the ACLU and similar liberal organizations are against any stipulation to curtail liability reform citing the encroachment of patients’ freedoms and reduction of physician responsibility. Finally, most liberals hope for a government run public option. The public option, however, is a deal breaker for a majority of Republicans and some moderate Democrats.

Although most Americans agree that healthcare reform is needed, the change necessary to implement it will demand some compromise from all sides of the debate. The “Yes We Can” attitude President Obama ran on depends on having every American at the table. Until we are ready to do this, our Congressmen will continue to find themselves less than willing to institute the sweeping reforms America needs.