HEALTH CARE OVERHAUL SUMMIT CEMENTS DIFFERENCES from NPR 26FEB10

February 26, 2010

President Obama's made-for-TV health summit probably didn't change many minds. And it certainly didn't produce any bipartisan breakthroughs on Thursday. But it did clarify some of the biggest differences between Republicans and Democrats.

The 18 Republicans who attended the all-day meeting at Blair House, just across from the White House, were polite, but firm. The bills passed by the Democratic House and Senate last year are simply too big for them, and for the American people, to swallow.

"We've come to the conclusion we don't do comprehensive well," said Sen. Lamar Alexander, a Republican from Tennessee. "Our country is too big, too complicated, too decentralized for Washington; a few of us here, just to write a few rules about remaking 17 percent of the economy all at once."
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But Democrats were just as firm in response. They've tried addressing problems in health care piece by piece.

"The evidence shows that incremental reform not only does less, it costs more," said Sen. Ron Wyden, a Democrat from Oregon.

Democrats say that means that Republicans' ideas like capping damages in medical malpractice lawsuits, letting small businesses band together to buy insurance, and allowing insurance policies to be sold across state lines, by themselves, wouldn't do enough to address what really ails the health care system.

For their part, Democrats spent a lot of time telling stories about real people with real insurance problems.

Like this one from Rep. Louise Slaughter of New York: "I even had one constituent — you will not believe this, and I know you won't, but it's true — her sister died. This poor woman had no dentures. She wore her dead sister's teeth, which of course were uncomfortable and did not fit. You ever believe that in America that's where we would be?"

Republicans, though, like Rep. Dave Camp of Michigan, said the Democrats' bill doesn't focus enough on bringing costs down. "A lot of Americans say to me, if you're really interested in controlling costs, maybe you shouldn't be spending $1 trillion on health care, as the Senate and House bills do."

Democrats countered that their bill would actually reduce the deficit. And President Obama made it clear he would not bow to Republican demands that Democrats start over from the beginning.

"We cannot have another yearlong debate about this," Obama said.

Still, after the meeting was over, Senate Republican Whip Jon Kyl explained why Republicans wouldn't vote for the bill, no matter how many of their ideas are included.

"The whole concept of the bill, with its government mandates, its taxes, its spending and all of the other features of it, are what make it unacceptable to us and to the American people," he said.

House Majority Leader Steny Hoyer, a Democrat from Maryland, said he's not surprised at how little common ground there was to be found.

"I think the Republicans do not believe it's in their best interest to have a health care bill. At least a health care bill that includes everybody."

And Hoyer confirmed what might be the worst-kept secret in Washington: With any prospect of Republican support still nearly zero, Democrats are likely to turn to a short-cut procedure known as budget reconciliation. That will let them pass a health bill in the Senate with only 51 votes and no filibuster allowed. Republicans have been calling the procedure unusual and unfair, but Hoyer says that's hardly the case.

"Since 1980, I think reconciliation has been used 22 times; 16 by Republicans; more than two-thirds of the time; that's probably 70 percent of the time. For their tax bills, welfare reform, other pieces of legislation. And they act as if somehow this is a process that should not be used."

But even finding a majority of Democrats in the House and Senate still won't be easy. Health care remains one of the hardest political efforts there is.