Surprising perhaps no one, common ground was a scarce commodity at Thursday’s all-day health care summit in Washington. President Obama implored in his opening remarks, "Let’s talk about some areas where we disagree and see if we can bridge those gaps". But by the end of the session more than seven hours later, it was clearer than ever that the two parties have fundamentally — and irreconcilably — different views of how to go about fixing the nation’s health care system.
"We just can’t afford this," said House minority whip Eric Cantor, referring to the 2400 page, $125 billion a year healthcare plan, while John Boehner, the House Republican leader, called it "a new entitlement program that will bankrupt our country."
In contrast to the Democratic legislation, House Republicans have put forward a healthcare bill that does not set minimum national standards for health plans, does not require all Americans to buy coverage and does not provide subsidies to help them.
As a result, the bill is substantially less costly than the Democratic plans and does not include the tax hikes and Medicare cuts that Democrats are proposing to offset the cost of expanding coverage.
The GOP legislation, which many Republicans have touted as a more reasonable, incremental approach, would insure only 3 million additional people over the next decade compared with 30 million more in the Democratic legislation, the Congressional Budget Office has found.
"We’d love to have a five-page bill," Obama countered to the Republicans who arrived toting copies of the massive Senate-passed legislation. "It would save an awful lot of work. The reason we didn’t do it is because it turns out that baby steps don’t get you to the place where people need to go."
But the White House said the summit was not intended as a vehicle to start the healthcare debate all over again, and as such the Democratic leaders have apparently decided to go forward alone on health care, although it remains to be seen whether they will be able to muster enough of their own votes to get it done.
House Speaker Nancy Pelosi urged her colleagues to back a major overhaul of U.S. health care even if it threatens their political careers, a call to arms that underscores the issue’s massive role in this election year.
Lawmakers sometimes must enact policies that, even if unpopular at the moment, will help the public, Pelosi said in an interview being broadcast Sunday the ABC News program "This Week."
"We’re not here just to self-perpetuate our service in Congress," she said. "We’re here to do the job for the American people."
It took courage for Congress to pass Social Security and Medicare, which eventually became highly popular, she said, "and many of the same forces that were at work decades ago are at work again against this bill."
The procedural and political hurdles ahead are formidable, and with each new poll showing public confidence slipping away – even if for very disparate reasons – they know that time is not on their side.
Yet, they say, they believe that if they can pass the bill, they can sell it too. Once voters can look beyond the messy political process and deal making that it took to get this far, they may once again be able to focus on the actual substance of the legislation, which still enjoys broad support.
That will be a tough sell judging from the latest Gallup poll suggesting that if an agreement is not reached, Americans by a 49% to 42% margin oppose rather than favor Congress passing a healthcare bill similar to the one proposed by President Obama and Democrats in the House and Senate. By a larger 52% to 39% margin, Americans also oppose the Democrats in the Senate using a reconciliation procedure to avoid a possible Republican filibuster and pass a bill by a simple majority vote.
Washington Post’s Steven Pearlstein, At Summit, Republicans Prove They Aren’t Putting America’s Health First, appears to be quite dismayed by the insincerity and lack of concern for Americans’ health care needs as expressed on the GOP side:
I’m not sure what else was accomplished at Thursday’s Blair House summit, but surely one result is that we learned what Republican “leaders” really think about health care and health insurance.
The most important thing Republicans think is that if there are Americans who can’t afford the insurance policies that private insurers are willing to offer, then that’s their problem — there’s nothing the government or the rest of us should do about it.
“We just can’t afford this,” said Eric Cantor, the fresh-faced House minority whip from Virginia, while John Boehner, the House Republican leader, called it “a new entitlement program that will bankrupt our country.” What they were referring to, of course, was the $125 billion a year that Obama and his Democratic allies propose to spend in subsidies so tens of millions of low-income households can afford to buy health insurance and handle the co-payments. But if paying for those subsidies means raising taxes on high-income households with lots of investment profits, or capping a tax break for people with extravagant health insurance, or charging a modest fee on medical device makers that refuse to moderate future price increases, then Republicans are agin’ it.
That was their clear message Thursday. It was their message during all those years when their party controlled Congress and the White House and they did nothing and said nothing about the plight of the uninsured. And it is clear that they would continue to do nothing if, by some miracle, Democrats were to drop their plan or embark on a more modest approach. For Republicans, the uninsured remain invisible Americans, out of sight and out of mind.
Washington Post’s Dana Milbank, Professor Obama Schools Lawmakers On Health-Care Reform, takes a decidedly different approach, chastising President Obama for scolding Republicans too often and for taking too much of a leadership role:
Republicans had been hesitant to accept President Obama’s invitation to participate in Thursday’s White House health-care summit. Their hesitance turned out to be justified.
An equal number of Democratic and Republican lawmakers assembled around a table at Blair House, and each had a chance to speak during the seven-hour televised talkathon. But members of the opposition party may not have fully understood that they were stepping into Prof. Obama’s classroom, and that they were to be treated like his undisciplined pupils.
Obama controlled the microphone and the clock, and he used both skillfully to limit the Republicans’ time, to rebut their arguments and to always have the last word.
Among the first to have his knuckles rapped was Sen. John McCain (Ariz.). The 2008 Republican presidential nominee accused his former rival of “unsavory” dealmaking, of breaking his promise to put health-care negotiations on C-SPAN, of supporting a 2,400-page bill, of giving favors to lobbyists and special interests. He directed Obama to “go back to the beginning” with health-care reform.
“Let me just make this point, John,” the president said when the tirade ended. “We’re not campaigning anymore. The election’s over.” Teacher directed student to drop the “talking points” and “focus on the issues of how we actually get a bill done.”
Los Angeles Times Noam N. Levey and Janet Hook, Healthcare Summit Reveals Chasm Between Parties, suggest that the significance of today’s meeting is that it frees Democrats to go it alone on health care reform; they’ve done everything reasonably possible to work with Republicans to no avail, thus left to pursue a go-it-alone endgame:
Facing unbending Republican opposition to a healthcare overhaul, President Obama confronted a stark reality Thursday as his televised summit ended: If he and his Democratic allies in Congress want to reshape the nation’s healthcare system, they will have to do it by themselves.
What emerged with crystalline clarity were two parties with an unbridgeable disagreement over how to deal with the nation’s healthcare crisis.
Republican lawmakers remained staunchly against the Democratic bid to use the federal government to regulate health insurance, subsidize coverage for tens of millions of Americans and force changes in the way medical care is provided.
“There are some fundamental differences that we cannot paper over,” Senate Assistant Minority Leader Jon Kyl (R-Ariz.) told the president at the summit.
Obama acknowledged as much as he wrapped up the 7 1/2 -hour gathering. “I don’t know, frankly, if we can close that gap,” he said. “We cannot have another yearlong debate.”
By underscoring the ideological chasm separating the two parties, Obama’s summit set the stage for Democrats to pursue a go-it-alone endgame without any pretense of bipartisanship.
Time’s Karen Tumulty, Obama Finds No Common Ground at Health Care Summit, agrees, making the same point even more bluntly:
What was also made evident was that if the Democrats want to pass a health care bill this year, they are going to have to go it alone. And that they are preparing to do just that. Again and again, they brushed aside the Republicans who insisted that they should scrap the legislation that they have been working on for over a year and start all over again. Americans, said House Speaker Nancy Pelosi, “don’t have time for us to start from scratch. Many of them are at the end of the line.”
New York Times’ Paul Krugman, Afflicting the Afflicted, notes that even on elements of health care reform that Republicans claim to support — such as being denied insurance coverage because of preexisting conditions (real, or made up) — they offered remarkably little of substance:
What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.
One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.
In reality, House Republicans don’t have anything to offer to Americans with troubled medical histories. On the contrary, their big idea — allowing unrestricted competition across state lines — would lead to a race to the bottom. The states with the weakest regulations — for example, those that allow insurance companies to deny coverage to victims of domestic violence — would set the standards for the nation as a whole. The result would be to afflict the afflicted, to make the lives of Americans with pre-existing conditions even harder.
The White House says Obama, perhaps on Wednesday, will announce a "way forward" on health care. He, Pelosi, and Senate Democratic leaders have left little doubt that they hope to pass a Democratic-crafted bill under "budget reconciliation" rules that would bar Republican filibusters in the Senate. Yet it’s unclear whether Pelosi can muster the needed votes in the House.