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President Obama's trip to Raleigh on Wednesday is the latest indication of an intense and unusual political battle in the middle of summer in North Carolina – the fight over the president's plan to overhaul the nation's health care system.

It's July in a nonelection year, but the state's political machinery is fully engaged, complete with letter-writing campaigns and bus tours. Rallies, phone banks and door-to-door canvassing are under way, TV commercials fill airwaves, and petitions appear beside ripe tomatoes at farmers markets.

The flurry of activity comes as Obama tries to persuade Congress to pass a plan to revamp the health care system by the end of the year.

Though the health care debate is national, it is particularly loud in North Carolina, a state with a concentration of moderate Democrats that both sides see as persuadable, particularly Sen. Kay Hagan.

The state is also the home of some major players in the health care industry, including GlaxoSmithKline, one of the nation's largest pharmaceutical manufacturers. North Carolina, too, is seen as one of the nation's newest battleground states, having gone for Obama in November after voting Republican in the previous seven elections.

One recent night at Raleigh's RBC Center, critics of Obama's efforts were trying to fan opposition, literally.

The 350 people packed into the arena's club room were given fans with a drawing of a hand and the slogan: “Hands Off My Health Care.”

They heard speeches and watched videos comparing health care proposals by Obama and congressional Democrats to national health care plans in England and Canada. They were told to expect long waits to see doctors or undergo surgery. One video featured a news report from an Oregon TV station: A patient with advanced cancer was denied an experimental $4,000-per- month cancer drug but was told about the state's assisted suicide option law.

“Politicians want to control who lives and who dies,” said Dallas Woodhouse, head of the state chapter of Americans for Prosperity, a Raleigh-based conservative advocacy group.

Americans for Prosperity sponsored Tuesday's event and a similar one Wednesday at the Jesse Helms Center in Wingate. It has also planned a bus tour across the state in August to generate opposition to Obama's plan.

Participants were asked to focus their lobbying on Hagan and Democratic congressmen Bob Etheridge and Larry Kissell – whose 8th District stretches from central Charlotte to Fayetteville. All are seen as being on the fence.

The star of the event was Charlotte Mayor Pat McCrory, a Republican who lost the governor's race in 2008 and who might run again in 2012.

The health care system is in crisis, McCrory said. But, he stressed, a government-run system is not the answer.

“Have you ever gone to a DMV office lately?” he said of the motor-vehicle agency run by the state. “Can you imagine if that is how we distribute our medical needs in the future? It would be a disaster.”

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