If the final version of the health care legislation being hammered out in Congress requires all Americans to carry health insurance, Susan Breuer thinks it's only fair that the new law cover those who rely on her form of medical treatment: prayer.

" 'Why' isn't the question," Breuer said. It's "Why are we excluding it?"

A lifelong Christian Scientist, Breuer of San Mateo is a full-time practitioner, meaning she provides prayer professionally for the purposes of healing. Breuer was trained by a church-sanctioned teacher and is paid by those who come to her for healing.

With time running short for Congress to pass a health care bill by Christmas, Christian Scientists are lobbying lawmakers to include a provision that would ban discrimination against "religious and spiritual" health care and encourage private insurers to cover prayer as medical treatment.

Such a provision was passed by committees in both the House and the Senate this year, but was stripped from the House bill as well as the current version being debated in the Senate. But Christian Scientists are hoping they can still get the measure reinserted into the Senate bill, and ultimately locked into the final legislation.

They recognize they're facing an uphill battle, with the debate centering on such hot-button issues as restrictions on abortion coverage and whether a final bill should include a public option or a Medicare buy-in. But Christian Scientists say they see the acknowledgment of spiritual healing in a health overhaul bill as important to their religion and to others who may turn to prayer or other nontraditional healing methods as an alternative to medical care. These could include followers of some American Indian religions or those who seek care at holistic healing centers.

Advocates for public

"It's our intention that the health care bill recognizes the fact that medical care is not the only form of health care," said Eric Nelson, spokesman for the Christian Science church in Northern California and also a practitioner. "We are advocates, not just for Christian Scientists, but for the public at large."

Opponents of prayer coverage dismiss as ridiculous equating prayer with medical treatment and warn that including "spiritual" health care in the legislation could violate the separation of church and state.

"No one is denying them the freedom to practice their religion. But if they (Christian Scientists) get this in, other groups are going to say the same thing," said Dan Barker, co-president of the Freedom From Religion Foundation, a group of atheists and agnostics who promote separation of church and state. "All these tent-revival faith healers will say, 'What we're doing is medicine, and we want to charge for this.' "

Nelson said he does not believe the church's request violates that legal principle because it is not asking that any public funds pay for prayer.

Instead, they want their preferred form of care to be recognized without discrimination. The Internal Revenue Service already allows prayer sessions to be deducted on income tax forms as medical expenses, Nelson said.

Christian Scientists generally eschew traditional medical care in favor of healing through prayer, believing that genuine healing is rooted in God. That said, many Christian Scientists do carry health insurance and comply with state and federal laws, such as immunizing their children if they attend public school. They say the church allows members to make their own decisions about their health and finances, although a basic tenet of the religion is to rely on prayer for healing.

Practitioners typically charge $20 to $50 a day for a day of prayer or about the same as a co-payment for a medical doctor visit. They need not see their patients, who may be in another state or country, and may pray for more than one person throughout the day. Healing may come from a single session, but occasionally additional sessions are needed, practitioners say.

Prediction it will fail

Barker believes Christian Scientists will fail to persuade Congress to reinstate the provision into the bill but said the church is a force to be reckoned with.

"They have powerful connections with a lot of state legislators," he said. "They're a small group, but historically they've been very successful in lobbying. They're not going to give up."

Sen. Orrin Hatch, R-Utah, who is Mormon, had the support of Sen. John Kerry and the late Sen. Edward Kennedy, both Massachusetts Democrats, when he introduced the provision to ban discrimination against "spiritual" health care early in the summer. Boston is the headquarters of the Christian Science church, known formally at the Church of Christ, Scientist.

It was approved by two House committees and one Senate committee, but was dropped from the final House version and the bill under discussion in the Senate after critics called it unconstitutional.

The United States is home to more than 1,200 Christian Science congregations, about 185 of them in California. While the church will not reveal estimates on individual membership, they said congregations typically range from about 15 to more than 100 members.

Practitioners such as Breuer, who must have a proven track record of healing before becoming a professional, acknowledge that prayer services don't always work, but said traditional medical treatments don't always work either.

"We just have different methods," Breuer said.