The White House and its allies scrambled Thursday to quash a growing liberal assault on a much-compromised health care proposal, hoping to keep President Barack Obama's top domestic priority from being crushed between the political left and right.
In Senate speeches, TV appearances, blogs and other outlets, Obama's supporters said the latest attacks are exaggerated and troubling, because Senate Democratic leaders can't spare a single vote in trying to overcome fierce GOP opposition.
But some prominent liberals, led by former presidential candidate Howard Dean, say the Senate bill is so diluted that it's worse than nothing at all. Powerful labor unions were equally disenchanted but urged lawmakers to press on, hoping to improve the bill in House-Senate negotiations.
"Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health care reform," Dean, a doctor and former Vermont governor and national Democratic Party chairman, said in an op-ed column in the Washington Post.
Top White House adviser David Axelrod disputed Dean's claims and urged party activists to embrace an important if imperfect bill.
"We're on the doorstep of doing something really meaningful," Axelrod said in an interview. No one is entirely satisfied with the bill, he said, but it includes long-sought health insurance regulations and other items too important to lose.
Former president Bill Clinton said in a statement it would be "a colossal blunder" to let the measure die. "America can't afford to let the perfect be the enemy of the good," he said. "Inaction leads to more uninsured Americans, more families struggling to keep up with skyrocketing premiums," and other woes.
Liberal disenchantment with Obama has been simmering for weeks, as he ordered 30,000 more troops to Afghanistan and declined to fight for a government-run health insurance option. It reached a boil this month when Senate leaders dropped the proposed "public option" from the health bill, and then jettisoned a bid to open Medicare to people 55 and older.
Dean, whose relationship with Obama is chilly, previously had endorsed the Senate bill, and his turnabout startled the political world. Many liberals still see him as a champion, and his brother, Jim, heads Democracy for America, a liberal group opposing the Senate bill in its current form.
Obama replaced Dean as Democratic Party chairman with Virginia Gov. Tim Kaine and, in a snub, didn't invite Dean to the announcement ceremony. Dean also signaled interest in a top post in the Obama administration, but received none.
With Obama preparing for a climate summit in Copenhagen, prominent Democrats hurried to rebut Dean.
Senate Democratic Whip Richard Durbin of Illinois said the bill "is not everything that I want it to be either," but it would give health insurance to 30 million Americans who now lack it.
Andy Stern, president of the Service Employees International Union, criticized the bill but urged the Senate to pass it so House negotiators can try for changes, such as removing a tax on high-cost health insurance plans. "It has to be improved, but we have no belief that these senators are going to do anything better," Stern told reporters.
While Dean's comments obviously bothered the White House, it's unclear whether they will influence lawmakers' votes. The chief Senate Democratic holdout, Ben Nelson of Nebraska, is focused on abortion language, which Dean did not address. The Senate's liberals stood by the bill on Thursday.
Dean's remarks and their reverberations on Web sites and blogs seem certain to stoke nervousness among Democrats running for the House, Senate, governorships and other posts next year. The GOP's conservative base appears fired up (although not necessarily unified), while the Democrats' liberal base looks increasingly dispirited, or downright angry.
The group MoveOn.org said it raised more than $1 million in 48 hours to conduct an "accountability campaign" against Sen. Joe Lieberman, a Connecticut independent who caucuses with Senate Democrats. Lieberman, who faces re-election in 2012, infuriated the left by demanding that Senate leaders drop the public insurance option and the Medicare expansion ideas from the bill.
Meanwhile, a new Wall Street Journal/NBC News poll showed Obama's approval rating below 50 percent for the first time. And voters, who recently have shown a clear preference for putting Democrats in control of Congress, are now split on the question.
Dean said he opposes the Senate bill because it would let insurance companies charge older people three times what it charges young people; fine Americans who don't buy insurance; and let up to 30 percent of premium payments go to executives' salaries.
Axelrod said Dean omitted key details. Insurance companies in some states charge elderly customers seven times more than young adults, he said. The Senate bill exempts low-income Americans from having to buy insurance, he said, and it limits executive pay more narrowly than Dean indicated.
If the bill will enrich insurance companies, as Dean says, then why is the industry "spending hundreds of millions of dollars to defeat it?" Axelrod said.
In an interview, Dean was unmoved. When he was governor, he said, Vermont sharply limited the surcharge that insurance companies could place on elderly people. As for claims that he's helping fragment the Democratic base, Dean said, the party "is not fractured at all." About 78 percent of Democrats think the bill should have a public insurance option, he said.
Republicans enjoyed the intraparty quarrels.
"If you live long enough, all things can happen," GOP Sen. John McCain, who lost to Obama last year, said in a Senate speech. "I now find myself in complete agreement with Dr. Howard Dean, who says that we should stop this bill in its tracks."
Associated Press reporters Sam Hananel, Liz Sidoti and Ken Thomas contributed to this report.