Margit Sande-Kerback is still not sure whether a government-run public insurance option should be part of President Obama's health care reform plan, but she agrees with the president that everyone should have access to quality and affordable health insurance.

"Either way, everybody needs coverage, so if that's the best way forward, that's what we've got to do," she said. "I just haven't seen enough to really be able to evaluate that."

Sande-Kerback, who is with the University of Hawai'i-Manoa John A. Burns School of Medicine, was among two dozen students and faculty members who watched Obama's speech to Congress yesterday from a campus auditorium in Kaka'ako.

While Obama was speaking to Congress, his remarks were also aimed at shaping public opinion among people watching at home or at small gatherings across the nation. At the UH medical school, most seemed sympathetic to the president's argument that the time for reform is now, but like many, they have questions about how he would achieve his goal of providing insurance to everyone without expanding the nation's budget deficit.

"I like, certainly, that he wants to do more preventative care and have insurance covering that," said Sande-Kerback, a program assistant at the school's program for medical education in East Asia. "I think that's just so logical and so important. If we had more emphasis on that, I definitely think we can keep costs for health care down.

"Health care is so extraordinarily expensive in this country and, he's right, we don't have better health care than other countries that are spending much less."

Damon Sakai, a UH associate professor of medicine and the associate director of the school's Office of Medical Education, said he liked that Obama tried to inspire Congress to find an answer.

"I like the way he reached out to both sides," he said. "The way he said, 'We all have different ideas.' But I also liked his strength in saying that 'These are some things I won't compromise on.' "

Sakai said he believes there is "tremendous room for improvement" in the nation's health care system.

"I think that there are a lot of great things that we do with health care in our country, and we want to make a good thing better," he said. "But there are also things that we know clearly need to be improved. I just see this as a great opportunity for us."

Sakai supports Obama's basic premise that everyone should have access to affordable health care. "It's hard to argue against," he said. "I think the problem is how to achieve it."

Amy Brown, a UH associate professor in the school's Department of Complementary and Alternative Medicine, cast the health care debate in terms of the federal government's priorities.

"This country shouldn't be spending billions fighting a Middle East war while people here die when we have the best medical care in the world," she said.

GOP NOT IMPRESSED

Local Republicans who watched the speech, however, said Obama simply tried to repackage a reform plan that is in jeopardy in Congress and with the public.

Jonah Ka'auwai, the state GOP chairman, said Obama failed to reject a public option that many Republicans believe will lead to a government takeover of health care. The president said a public option — funded by insurance premiums from those who participate in the plan, not the government — would provide choice for individuals and small businesses unable to find affordable private insurance.

But Ka'auwai said he does not believe a public option can survive without a government subsidy.

"I really believe the American people are not buying it," he said. "Obama didn't remove — and I think that's critical — he didn't remove the public option. And since he didn't remove that, it creates the potential for a government takeover of health care."

Ka'auwai also discounted Obama's mention of medical-malpractice insurance reform and the potential for state demonstration projects. Many Republicans have said that liability reform is necessary so doctors do not practice defensive medicine that can increase health care costs.

"It just baited the people who wanted to hear it, but it was not saying that he was actually going to get anything done," he said. "He said everything to everybody but didn't mean anything to anyone."

DEMOCRATS HOPEFUL

Several Democrats, meanwhile, gathered at party headquarters at Ward Warehouse to watch the speech.

Brian Schatz, the party's state chairman, said he believed it was necessary for Obama to dispel some of the myths surrounding health care reform and to explain his ideas. He said the president reached out to Republicans who may have suggestions but made it clear that opponents who only want to block his plan have no role in the conversation.

"I think his attempt to inject some civility into the debate was really critical," he said. "Hopefully we can have a reasoned conversation about the differences of opinion on this issue. There are smart and compassionate people on all sides of this debate, but there is also a segment of our society that has made the political calculation that they ought to kill this bill at all costs."