« TDS Co-Editor William Galston: The Republican Sprint Away From Sanity | Main | The Republican Civil War: Your Guide To This Year's Primaries »

ShareThis

Post-Summitry

This item by Ed Kilgore was originally published on February 25, 2010.

I generally agree with J.P. Green's take on today's health care summit, but would add a couple of points in an effort to answer his question: will this help pass health care reform?

I doubt too many Americans watched the whole seven-hour show, and it's unclear yet how it will be covered in the MSM (though I'm afraid the Obama-McCain exchange will soak up more attention that it really merited). But certainly the president and congressional Democrats did a good job of trying to explain the fundamentals of health care reform: why the system's broken; why an individual mandate, subsidies, and regulation of benefit levels are necessary to fix it; and why Republican panaceas such as interstate insurance sales, association health plans, health savings accounts, and state high-risk pools, won't help and will probably make things worse. Anyone who did watch big chunks of the summit probably understands by now that you can't just do the easy, popular stuff like banning exclusions of people with pre-existing conditions and let it go with that. You'd guess that a poll of people watching would rate the Democratic approach to health care reform as far superior to that of Republicans, and perhaps that impression will spread or seep through the media coverage.

The harder question is how the summit affects public opinion on the very key question of what comes next. From the president on down, Democrats frequently said there were many areas of fundamental bipartisan agreement, and Republicans frequently said it's time to start over and work on a bipartisan plan. You could listen to all that talk and conclude it's time for a new round of negotiations based on "common ground." If you listened more closely, you'd more likely conclude that Republicans object to the basic design of any plausible comprehensive health care reform initiative, and that "common ground" is confined to some broad goals that have never been in doubt, and to some details that could theoretically still be addressed, but that aren't game-changers for anybody. Any time Republicans seemed to sound too agreeable or friendly towards the president, one of their leaders (most notably House Minority Leader John Boehner) would reset the mood with some hammer-headed comments on "government takeover of health care " or "abortion subsidies," as though to remind all attendees that this is essentially an exercise in political theater.

The President's concluding comments indicated that he wanted to let the summitry marinate for a while, and see if some new progress could be made within four or six weeks. But at that point, he made clear, it would be time to act, which means the House passing the Senate bill and then the Senate and House enacting what would normally be a conference committee report via reconciliation (which, as Democrats kept explaining today, is hardly an unusual procedure for major legislation). If, as appears most likely, Republicans simply retreat to their "start over" demand, you can expect Obama to unilaterally endorse a few more of "their" ideas (perhaps a stronger interstate sales provision with stronger federal regulation, or something more tangible on medical malpractice reform than grants to states, or maybe one of Tom Coburn's fraud prevention or chronic disease management concepts), and then let the public decide who's been reasonable. Since it would have probably taken that long to work out differences among House and Senate Democrats anyway, nothing much will be lost by this kind of delay, and perhaps the summit will have somewhat disrupted the conservative demonization campaign over the entire legislation.

At the very least, opponents of health care reform can no longer credibly complain that they haven't been given a fair hearing for their "ideas" and their point of view. And Democrats have been given, and have largely taken advantage of, a fresh opportunity to get back to the basic arguments for health care reform.