Summit Standoff

The consensus among most pundits and reporters was summed up by The Wall Street Journal's Peggy Noonan in her column today: "Boy, that didn't work."

The White House expected a slam dunk, building on what it considered a triumph at the House Republican retreat in Baltimore a month ago, so it could convince rank-and-file Democrats that the time has come to get health reform done.

I was at the retreat in Baltimore, invited to do a session on health reform for members, and was in the room during that remarkable 70-minute exchange.

In the world of cable news, optics are everything. In Baltimore, the president was on stage, flanked by flags and behind a microphone and podium looking down on Republicans who were sitting around tables at lunch. The considerable substance of the dialogue was subordinate to the staging.

Yesterday, with everybody seated around a table at Blair House talking with each other as equals, it was clear that Republicans held their own on health care — an issue that they clearly are taking ownership of. Even though they received less than half the airtime, they used it to make coordinated arguments on behalf of a step-by-step approach to reform.

The summit was not the game-changer the White House hoped it would be.

The question now will be whether there is the political will to go forward with a smaller bill that very likely could pass this Congress, or whether the White House is going to continue to insist on passing a wildly unpopular, comprehensive overhaul of one-sixth of our economy that three out of four Americans reject.

President Obama opened the summit by saying that Republicans and Democrats are not far apart on health reform because they share concerns about growing deficits and rising health costs.

But the debate showed the two sides have very different approaches to solving those problems. The president's plan and the House and Senate bills rely on more regulation and scores of new government programs to control our wayward health sector; Republicans believe in providing incentives for more competition, consumer choice, and price transparency to force changes in the marketplace.

Politico summed it up well: "So the parties walked out of Blair House almost exactly the way they walked in — completely at odds over the best way to fix the health insurance system. There were modest efforts around the edges to find common ground — on reining in waste and fraud and keeping the deficit in check — but no broad agreements on the shape of reform."

I was actually in Little Rock, Arkansas, yesterday giving a speech so I watched the summit in pieces — for a while in the Little Rock airport. Late in the afternoon, I saw six or eight traveling businessmen sitting around a bar watching CNN's broadcast of the summit, clearly interested in the debate. The country still is paying attention. The details matter.

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So what's next? While the focus is on Majority Leader Harry Reid's determination to use the budget reconciliation process to jam a health reform bill through the Senate, the real drama is in the House.

Speaker Pelosi needs to convince rank-and-file members that they will have to swallow hard and pass the Senate bill so it can then be "fixed" through reconciliation. If she had the votes, the bill would be on the floor in a day. She doesn't.

The summit didn't move the needle. That said, the White House still is absolutely, positively determined to pass this legislation, so we await the next act.

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Single-payer setback: It didn't help the cause of single-payers who are in love with the Canadian health care system when the premier of Newfoundland secretly traveled to the United States for heart surgery.

Danny Williams, 60, made the situation worse in an interview after the surgery at Mount Sinai Medical Center in Miami, Florida. "This was my heart, my choice, and my health," he said from his condominium in Sarasota. "I did not sign away my right to get the best possible health care for myself when I entered politics."

Yikes! Tell that to the hundreds of thousands of Canadian citizens who can't afford to buy their way out of the Canadian health care system and must wait months and months for care — care that Premier Williams clearly didn't think made the grade as "the best possible care."

CLIP OF THE WEEK

Grace-Marie Turner on the Blair House summit

Between President Obama's "new" health plan and the Blair House health care summit, this week has been a busy one in the health reform debate. In this video, Grace-Marie Turner outlines the president's plan, compares his plan to the current House and Senate proposals, and discusses the impact of the health summit. Look for more original audio/video content from the Galen Institute in the future, in Health Policy Matters and on the Health Reform Hub!

HEALTH REFORM

A Better Prescription: AEI Scholars on Realistic Health Reform

Joseph Antos and Thomas P. Miller
American Enterprise Institute, 02/23/10

For more than six decades, the government has taken greater control over the health care system, bringing us to the unsatisfactory situation we have today, Antos and Miller write. It is time to level with the American people about what is possible and what is necessary in terms of health care reforms. There are three principles for a better-functioning system: place the money — and greater control — in consumers' hands; align expectations with reality; and create accountability in the health system. The goal of reform should be to make the health sector more competitive and more responsive to consumers so it can ultimately satisfy Americans' demands for appropriate care at the lowest cost. A market approach provides the tools by which the health system can become more effective, more efficient, and more responsive to patient needs. In contrast to the top-down hierarchy of government control, market mechanisms depend on two-way accountability to improve decision making on the part of both consumers and producers. Market-based reform offers rewards for innovation, excellence, and responsible behavior but recognizes that not all people have the same needs, preferences, and ability to pay. Read More »

The President's Health Reform Proposal: More Like $2.5 Trillion

James C. Capretta, Galen Institute and Ethics and Public Policy Center
The Heritage Foundation, 02/24/10

Administration officials have claimed that President Obama's updated health reform plan would cost $950 billion over a decade, is "fully paid for," and would cut the deficit in the short and long term. But each of these claims, which were also made about the House- and Senate-approved bills, rests on highly questionable assumptions, Capretta writes. A closer look at the President's plan shows that its costs are likely to come in well over $1 trillion over ten years. Further, ten full years of implementation would cost closer to $2.5 trillion, and the plan would make the nation's budget outlook much worse, not better. Read More »

Avoiding Side Effects in Implementing Health Insurance Reform

Mark V. Pauly, Ph.D., Wharton School, University of Pennsylvania
The New England Journal of Medicine, 01/27/10

The objective of health insurance reform should be to get people to obtain coverage with guaranteed renewability before they become high risk, Pauly writes. One step in this direction would be to add guaranteed renewability for coverage of a worker's family to small-group insurance. Another would be to implement strong incentives for obtaining coverage before one gets sick. Some of these could be carrots, such as larger subsidies for low-risk people to get them to buy in. Others could be sticks, such as increased premiums for people who decline coverage until they become high risk. The establishment of high-risk pools, adequately subsidized by general taxes but with higher-than-standard premiums and moderately limited coverage, may be all that is needed to get nearly everyone to do the right thing. Read More »

The Health Care Summit: A Chance to Start Over and Get It Right

Nina Owcharenko
The Heritage Foundation, 02/24/10

America's health care system is in need of change, but not change that consists of overhauling one-sixth of America's economy by centralizing health care decisions in Washington, Owcharenko writes. The President and Congress should change direction and focus on areas of incremental reform with bipartisan support: letting states take the lead rather than imposing a one-size-fits-all government solution; fixing the broken government health programs, not expanding them; creating tax fairness, not new tax inequities; and emphasizing targeted insurance reforms, not federal takeover. Read More »

Reviving the Health-Care Debate

Jeffrey S. Flier, Harvard and David Goldhill, GSN
The Wall Street Journal, 02/18/10

With the health reform juggernaut slowed to a crawl in Congress, and Democrats and Republicans meeting to search for common ground, this is an opportune time to re-examine the cause of dysfunction in our system, Flier and Goldhill write. One lesson of the past 40 years is that government, employers, and insurers cannot alone provide effective quality or cost discipline in health care. Asserting that we can maintain the status quo for the majority of Americans while extending insurance to everyone is irresponsible. Better aligned incentives will produce better health results at more sensible costs, and thus free resources to pay for the care for those in need. Read More »

GALEN IN THE NEWS

Obama's Health Plan — A Missed Chance

Grace-Marie Turner, Galen Institute
AOL News, 02/22/10

Instead of offering a genuinely fresh approach, President Obama on Monday unveiled his own health plan which essentially splits the difference between two bad partisan bills that are hugely unpopular with the American people, Turner writes. The key elements of the House and Senate bills — hundreds of billions in tax hikes, trillions in new health care spending, job-killing mandates on individuals and businesses, and onerous Washington regulations on one-sixth of the U.S. economy — are all in the president's plan. And while the Congressional Budget Office won't be able to estimate the bill's costs until it gets actual legislative language, the real price will be at least double the $1 trillion estimate. Read More »

Summit or Political Suicide?

Grace-Marie Turner, Galen Institute
National Review Online: Critical Condition, 02/25/10

Republicans had two missions at this week's health reform summit: 1) explain why the bills the Democrats propose would be so damaging to our health sector and to our economy, and 2) explain that Republicans want to start a process of targeted reforms that build on the strengths of our health care system, Turner writes. President Obama should agree to incremental steps through a targeted, smaller bill. Such an approach would garner bipartisan support and pass Congress. That is the only way the Democrats can avoid turning health reform and the Blair House summit into a political suicide mission. Read More »

INTERNATIONAL HEALTH SYSTEMS

Why Canadian Premier Seeks Health Care in U.S.

Sally C. Pipes, Pacific Research Institute
San Francisco Chronicle, 02/25/10

Danny Williams, the premier of the Canadian province of Newfoundland, traveled to the U.S. earlier this month to undergo heart valve surgery at Mount Sinai Medical Center in Miami. With his trip, Williams joined a long list of Canadians who have decided that they prefer American medicine to their own country's government-run health system when their lives are on the line, Pipes writes. "I did not sign away my right to get the best possible health care for myself when I entered politics," Williams said. Lawmakers should take Williams' case to heart, Pipes writes. Canada's experience shows that government health care leads to waiting lists, rationing and lower quality of care. Expanding government control over the U.S. health care system will diminish outcomes for American patients — as well as the occasional Canadian visitor. Read More »

Events

Grace-Marie Turner speaking on The Lars Larson Show
Nationally Syndicated Radio Broadcast
Friday, February 26, 2010
6:30pm EST

Better Care — Lower Costs: Exploring the Promise of Patient Engagement
Alliance for Health Reform Briefing
Friday, March 5, 2010
12:15 pm – 2:00pm
Washington, DC

First Annual CQ HealthBeat Conference
CQ-Roll Call Event
Tuesday, March 9, 2010
7:00 am – 1:30 pm
Washington, DC

Health Reform and Women's Health Issues
George Washington University Event
Tuesday, March 9, 2010
12:00 pm – 1:00 pm
Washington, DC

Health Care Round Table
Independence Institute and The Heartland Institute Event
Wednesday, March 10, 2010
2:00 pm – 5:00 pm
Denver, CO

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