Democrat Barack Obama promised Wednesday an open process to enact universal health care, saying he has learned from the mistakes of rival Hillary Rodham Clinton's failed health care reform effort of 1993. Obama said Clinton's effort as first lady failed largely because most of the planning was done in secret and there was little effort to build political support. That left the final product vulnerable to an assault from drug and insurance companies that eventually doomed the effort. "We will convene an open process which the American people will be watching," Obama told about 50 people at an informal coffee. "What the president can do is shine a spotlight on the process and (involve) the American people and keep the pressure on and that is something that didn't happen. In many ways it didn't happen in '93."

Obama was describing his universal health care plan when someone at the event interrupted him to note that Clinton had led a massive effort in 1993 that failed. Obama took pains to draw a distinction, going as far as to recall commercials attacking her effort.

"It was a closed process and not everybody understood what was taking place, so when the insurance companies and the drug companies started running those 'Harry and Louise' ads, nobody really knew what was what. That's why the American people have to be involved."

After Clinton's plan was proposed, special interest groups ran the commercials, featuring a fictional couple worrying about losing their ability to pick their own doctors and warning that the government would take control of the health care system. Support for the health care expansion evaporated and the effort was eventually dropped.

Obama said the lesson to be learned was to involve the American people in the effort. Without political support, no health care expansion can be approved, he said.

He said he would announce outlines of a health care reform package in his first 100 days, then convene a bipartisan commission to draft details.

"We're going to have an open process and a firm deadline for making some decisions about how we are going to get this done."

Obama said he took a similar approach when he pushed for health care expansion as a member of the Illinois Legislature.

Obama was spending his day in Iowa focusing on health care issues, including broadening access to health care information made available to consumers.

Later, in Storm Lake, he called for greater transparency in the health care system.

"No decisions are more important than the ones we make about our health and you should have all the information you need to make the right ones," he said.

Obama said costs and quality vary widely between hospitals, but consumers have little access to that data. He would push for a "hospital report card" requiring the facilities to disclose details about their cost and services.

He also called for more information about prescription drug costs.

Written By MIKE GLOVER