President Obama, and the Democrats, find themselves between a rock and a hard place.

If Obama's health care reform plan fails, a right-wing Republican party may well gain congressional control in 2010 and the presidency in 2012. White House Chief of Staff Rahm Emanuel, realizing this, seeks Democratic unity in passing a reform plan, any plan, to proclaim an Obama victory.

But, consider the calamitous repercussions of any law following the Baucus scheme, a bill written by health care insurance lobbyists solely to benefit the insurance industry. Simply put, the Baucus bill is terrible! It doesn't provide either universal or affordable care, the two major concerns for health care reform.

What will the people of this nation do upon realizing that:

-- there is no benefit for most employees receiving employer-paid insurance?

-- premiums will rise as new requirements imposed by the plan (e.g., the elimination of lifetime caps) raise the cost of insurance?

-- 95 percent of people cannot buy into a public option even if the House plan prevails?

-- they don't qualify for a subsidy to offset the mandated unaffordable insurance, yet must pay a penalty for not purchasing an individual policy?

-- without government cost controls, insurance companies can, and will, raise premiums, co-pays and deductibles?

-- without stronger federal regulation, insurance companies will continue to cherry-pick the healthier, greater profit-yielding subscribers by using techniques other than pre-existing conditions, denial of insurance for costly illness and lifetime caps on benefits?

-- insurance companies can still deny payment for claims?

-- the cost of drugs will not decrease because the administration has made a deal with large pharmaceutical corporations?

-- because only a few companies dominate the insurance market in the top 94 metropolitan areas, their choice for better benefits at lower costs are severely limited?

-- the 15 percent of seniors with Medicare Advantage have premiums increased or benefits decreased as Medicare cuts their HMO subsidies?

-- formerly beneficent employers cut benefits rather than pay the heavy taxes imposed on the "good" insurance plans they provide?

Ironically, it's not the Obama administration disputing these evaluations, but the insurance companies. The industry trade group America's Health Insurance Plans (North County Times, Oct. 13) cited its study purporting to show that "over time, [Baucus' plan] will add thousands of dollars to the cost of a typical policy." Their beef, of course, relates to weakened penalties to be levied against those choosing to remain uninsured. They raise the specter of a wellness/sickness roulette in which millions of uninsured wait until they become sick before signing up. The industry threatens a massive TV campaign, a new Harry and Louise scenario, to discredit the plan.

Their eleventh-hour attack may not work, but don't for a minute believe that during the four-year delay before 2013, when most features of any plan become effective, that the conservative Republican spin machine won't continue to hammer away at these points. The Republicans won't vote to overcome these defects, but they'll certainly point them out to propel a tsunami of discontent with a president who talks a good game but can't deliver.

Though progressives do not want a conservative Republican victory in either 2010 or 2012, it's unlikely they will walk the precincts with the same fervor that elected President Obama in 2008. Disaster looms.

Progressives cannot allow the president to sign such appalling legislation.

Their cherished aims of achieving universal care at affordable prices must not fail. The 45,000 deaths annually resulting from lack of health care so insurance company profits meet Wall Street expectations is unacceptable and immoral. It is not a progressive value and it is not an American value.

For the nation's sake and for its own, Congress should enter a marathon session, lock its doors against lobbyists and debate House and Senate versions of H.R. 676, John Conyers' single-payer proposal. The House Progressive Caucus convinced Speaker ancy Pelosi to allow a full floor vote on the bill. First, there must be a Congressional Budget Office score. Expectations are that it will cost appreciably less than the other bills in Congress.

Thus, all may not be lost. If, despite his reluctance for a single payer system, President Obama acknowledges the tremendous cost savings of a health care system without a private insurance industry, and accepts nothing less than a Medicare-for-all plan ---- a system that does provide universal care at a price the nation can afford, conservative Republican spin will twirl away in the contentment of people no longer threatened with medical bankruptcies. A population not living to their full genetic potential because of a lack of health care insurance will be a thing of the past.

Dr. Zoltan Lucas of Oceanside is a retired surgeon, a member of the Physicians for a National Health Plan and president of the Progressive Democrats of America North San Diego County