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Health Care Summit Shows Time for Talking Is Done

4 years ago
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Now that all that rigamarole is over, let's move on to the inevitable.

I'm referring, of course, to the seven-hour shindig at Blair House on Thursday. The White House health care summit yielded few surprises. There was no bipartisan breakthrough -- or any sign of progress on that front. The meeting marked not the start of a process, but the end. It buried any notion that President Barack Obama and congressional Republicans can reach an accommodation on comprehensive health care reform.

But that's not to say the gabfest had no value. It clarified the situation. Though much of the conversation consisted of participants pushing pre-existing talking points, the debate made the obvious really obvious: Obama and his Republican foes are miles apart in ideological and policy terms. As the hours went by, Obama engaged in wonky exchanges with the Rs -- sometime calling them out on key factual disputes, such as whether the Congressional Budget Office said his overhaul would lead to higher premiums. (Obama got the better of that argument.) But all this back and forth kept illustrating the basic divide. The Republicans do not believe it is Washington's mission to take major action to challenge the insurance industry and extend coverage to most of the nation's citizens without health insurance. Instead, they want to move, as they repeatedly said, "step by step." But the Democrats believe that the only way to cure the health system of its ills is to adopt comprehensive change. Obama politely derided the GOP approach as one of "baby steps." He and his fellow Dems again and again explained what they see as the fundamental physics: to prohibit insurance firms from screwing people with pre-existing conditions, you have to place these consumers in large pools of the insured; to make the pools cost-effective, you have to extend coverage to people without insurance (including the young and the healthy); and to ensure that this is fair, you have to provide subsidies so that the low-income people brought into the pools can afford the plans.
The Rs don't think the Ds and government can handle such a big and expensive job. The Ds don't think the Rs and industry can remedy the problems with small measures. That's a mega-divide. It cannot be subjected to a split-the-difference compromise. It cannot be easily bridged. And everything else -- phony talk about a government takeover of health care, GOP complaints about the number of pages in the Democratic bill, calls for starting over, tussling over medical malpractice reform, debating the budget numbers, decrying carve-outs and special deals -- is just window dressing.

Throughout the day, Democrats claimed the two sides were not that far apart. But they are. (No doubt, this was a rhetorical ruse adopted by the Democrats to set up the Republicans as petulant obstructionists.) But Obama did refer to "philosophical differences." He even noted that he was unsure that common ground could be found. Long story short: it cannot.

This is a case of irreconcilable differences. The Republicans are not interested in tweaking the Democratic legislation so they can support it. The Democrats are not interested in trashing the two bills they have passed respectively in the House and Senate and replacing them with the Republicans' insurance industry-friendly proposals. (At the summit, the Ds routinely criticized insurance firms; Senator Jay Rockefeller denounced them as "rapacious." The Rs had nary a negative word about the industry.) So it's time for everyone to stop pretending. It is a clash of civilizations. No summit is going to change that.

The only question now is whether the congressional Democrats can unify behind Obama's plan -- which is essentially the Democratic Senate bill with a few tweaks to appease House Democrats -- and use the reconciliation procedure in the Senate (which will require merely 50 votes, not a filibuster-proof super-majority of 60 votes) to finish the job. Sure, the Republicans will squawk about this. But there's no other path for the Democrats: either they dump health care reform or do it themselves. This summit demonstrated the time for talking is done.

You can follow David Corn's postings and media appearances via Twiiter.

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