Ivette Luna, left, leads demonstrators to denounce the profit-making and high executive salaries of private insurance companies outside a roundtable discussion yesterday sponsored by the industry trade group America’s Health Insurance Plans.

The Providence Journal / Bob Thayer

When the Clinton administration attempted to overhaul the health-care system in the 1990s, among the loudest voices raised in opposition was that of the health-insurance industry. The insurers financed the notorious “Harry and Louise” commercials that contributed to the Clinton plan’s failure.

“We’ve learned a lot since then,” said Karen Ignagni, the Rhode Island native and Providence College graduate who heads the industry trade group, now called America’s Health Insurance Plans or AHIP.

Now, as both presidential candidates have put forth proposals for health-care reform and public sentiment leans toward change, the health insurers say they want a different role in the debate –– that of helpful participant rather than opponent. Yesterday, AHIP held a “roundtable discussion” in Providence as the seventh stop in its Campaign for an American Solution, meetings to discuss what citizens want from their health-care system.

And the first thing the “listening tour” encountered was a protest. A group called Health Care for America Now!, comprising unions and other activists, gathered a dozen or so people under umbrellas outside the Foundry building. Their signs and fliers getting soggy in the rain, they denounced the profit-making and high executive salaries of private insurance companies.

“They’re insuring less people and making more money,” said Patrick Quinn, state director of the Service Employees International Union. “They’re part of the problem. They’re not the solution.”

Inside, at a discussion moderated by former Lt. Gov. Charles J. Fogarty, Ignagni spoke with eight people, most either public-employee union representatives or small-business owners.

Theresa Tanzi, a member of the executive committee of the National Organization for Women, said her husband, a podiatrist, offered health insurance to his employees –– but none could afford the premiums. Phil Papoojian said his small manufacturing company suddenly experienced a 26-percent increase in premiums.

The group discussed the merits of incentives for people to take care of their health or to see their doctors instead of going to the emergency room.

One of the participants, Karen Malcolm, executive director of Ocean State Action –– continuing the argument from the street –– said the “elephant in the room” was the administrative costs and high salaries at health-insurance companies. She noted that government programs such as Medicare and Medicaid operate with very low overhead.

Ignagni said that government programs, unlike private insurers, don’t offer such services as care coordination and disease management –– programs that most experts believe the health-care system needs. “It’s quite reasonable,” Ignagni said, “for the public to ask us to demonstrate our value.”

ffreyer@projo.com