To the Top of the Health Care Summit

http://prescriptions.blogs.nytimes.com/2010/02/25/blogging-the-health-care-summit/?hp

After much anticipation the Health Care Summit finally took place today at the Blair House. The President and Vice President were there alongside senior leadership from both parties in the Senate and the House as well as several members of both caucuses. What began as a simple talk on the topic of health care became a marathon meeting that lasted into the evening. Here is a look back at it and what to take away.

To begin the summit, President Obama opened things up with comments and statements on health care and the economy and how they are intertwined in the fact that they have an affect on individuals and families. To give things a personal feel, he mentioned wondering what life would have been like if he wasn’t an elected official with great health insurance when both of his daughters were very sick when they were young. This is a constant problem that average families face without the assurance of reliable health coverage. Continuing, the President stressed that there are common areas in both parties’ proposals for health care reform despite some major differences that do exist. Obama laid things out as such: “The basic concept is that we would set up an exchange, meaning a place where individuals and small businesses could go and get choice and competition for private health care plans, the same way that members of Congress get choice and competition for their health care plans,” he said. “For people who couldn’t afford it, we would provide some subsidies. But because the pool is larger, the costs we would be smaller, because they would be in a position to negotiate.”

To begin the discussions, Senator Lamar Alexander of Tennessee gave opening remarks for the Republicans. Senator Alexander stated more of the same of the GOP argument in terms of starting from scratch. Alexander warned against tax increases and spending cuts on Medicare and criticized a possible expansion of Medicaid as it would add too many people to the program. Senator Alexander also spoke out against the possible use of reconciliation by the Democrats. He continued to plug the opposition to the bill. Senate Majority Leader, Harry Reid, responded to these comments with his opinion and disputed some of what Senator Alexander said especially when it came to jamming through a bill with reconciliation as the only option the Democrats have on the table. He also brought up the fact that reconciliation has been used many times in the last 30 years; mostly by the Republicans.

President Obama and Senator Alexander then got in an exchange over what the Congressional Budget Office reported about premiums. Alexander claimed that they would rise in the individual market under the Democratic plan. Obama responded stating that the cost for families for the same coverage that they currently have would decrease by 14 to 20 percent. President Obama mentioned that he and the Democrats have acted upon implementing every cost containing measure to reduce health care costs. He acknowledged that Republican ideas are being discussed and could be added. The President also challenged Republicans to freely discuss their ideas and see what could be included in the proposed legislation.

Next to speak was Senator Tom Coburn. His case centered around the argument that Congress should focus on attacking waste and fraud and abuses in the health care system. Obama responded to Coburn’s statements with a reference to his argument being addressed in terms of addressing the waste, fraud, and abuse in health care.

President Obama returned the debate to framing the arguments as they should; not be a Democrats vs Republicans/Washington vs American families. In particular, Senator Kyl was called out by the President for his empty statements. Areas that Obama felt the two sides agreed on: allowing parents to continue dependent coverage of their adult children through the age of 25 or 26, barring insurance companies from suddenly revoking coverage through a process called “recission”, and barring insurers from denying coverage based on pre-existing conditions and ending annual and lifetime caps on benefits. By focusing on these agreements, Obama was trying to reason with the Republican Party that there is mutual interest to go ahead with reform.

This was followed by Congressman George Miller of California giving an example of how private insurance companies deny coverage; referencing pre-existing conditions. He further stated that under the current conditions he would be denied care as he has pre-existing conditions himself with two artificial hips, a kidney stone, and arthritis. In addition, he provided this as example against the high risk insurance pool that many Republicans have embraced. Congressman Miller was followed by Senator John McCain, who turned the clock back to 2008 and took a swing at Obama’s promise to change Washington. He criticized the special deals and multiple meetings along the way to this point. The President, not to sit there and let McCain throw mud at him, he returned with a simple statement including “The election is over.” This caused a nervous reaction from McCain. Vice President Joe Biden jumped into the conversation next quickly taking a dig at Republicans in regard to the fact they support multiple initiatives that the government would fix, but then state the government has no role to play and Washington should not get involved.

They would take a recess before restarting an hour later, but the President stopped before exiting for the break to describe that he thought a lot of good ideas and discussion were taking place. In addition, he highlighted strengths of the Democrats and weaknesses of the Republicans in terms of certain arguments.

Senator Mike Enzi from Wyoming talked first after the break about things he thought should be in the bill. Senator Jay Rockefeller of West Virginia paints a picture of the insurers as sharks who wait to get their prey when they least expect when it comes to denying coverage. Congressman Paul Ryan from Wisconsin came in next to criticize the Democrats from ignoring what clearly the American public wants and it is not a government takeover of healthcare. This would be followed by a short debate between President Obama and Senator McCain about Medicare Advantage especially pertaining to a state like Florida with a high elderly population and ensuring they are taken care of. The biggest issue though for McCain is he represents a state, Arizona, which also has a good size older population and criticized the fact that Floridians were given a special deal. Obama acknowledged that it needed to addressed and fixed.

Minority Leader John Boehner threw in a random scrap the bill statement to ensure that the Republicans were staying on their message of the day. But he would then turn to some actual debate with regard to the abortion part of the bill. He brought up the Stupak amendment in particular, which got much attention in the U.S. House. Senator McCain took over again and spoke about various medical malpractice lawsuits goading the President to remark about the Republicans picking and choosing when it is a good idea for the government to get involved. In response, Senator Dick Durbin pleas with the group to not make medical malpractice a major issue at hand. Granted it is important, but not the chief concern they should focus on.

Next Congressman Peter Roskam from Illinois uses the term “bread crumbs” to refer the Republican amendments “sprinkled” into the bill. Roskam is followed by Senator Christopher Dodd who highlighted how the uninsured subsequently affect the insured. Using statistics he spoke of roughly 14,000 citizens potentially losing their insurance on a daily basis and roughly 6 out of every 8 people will lose their lives because they let themselves become sicker without insurance or financial capabilities. Continuing, he projected that every state will have 10% more uninsured. Senator Mitch McConnell came up next reverting to the talking point of starting over. Speaker of the House Nancy Pelosi followed and targeted Congressman Boehner among others for false claims they had made. In particular, the fact there would be no cuts to benefits for elderly.

President Obama looks to draw the summit to a close. Obama outlines the agreed changes and reforms that both parties seem to see eye to eye on. The President, then, states that this debate cannot keep going this way and deadlines will set and matched. Acknowledging that this debate has gone on for several decades and if necessary the proper moves will be used (i.e. reconciliation and a simple Democratic majority vote).

After a day of back and forth debate, one thing is clear: there is still no true agreement. Democrats want this bill and reform and Republicans want certain things, but not this bill and want a full restart. The 2,000+ page bill was in front of multiple members on the Republican side and they referenced to its size more than once and used as a prop despite their claims they were not. President Obama took up the most time and rightfully so he looked to dissect each statement a Republican made to highlight to most importantly the American public the need and importance of the health care legislation. I cannot see things changing too much after today and it looks like before Easter reconciliation will have to be used and this bill will become a reality for those on the Democratic side of the aisle. Time will see what Republicans do, but today showed they are still firm in their opinions; whether right or wrong.