Health Care Summit Examined President Obama hosted Thursday a bipartisan health care summit, in a bid to bridge deep divisions between the two parties on health care.
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Health Care Summit Examined

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Health Care Summit Examined

Health Care Summit Examined

Health Care Summit Examined

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President Obama hosted Thursday a bipartisan health care summit, in a bid to bridge deep divisions between the two parties on health care.


And for more on today's proceedings, I'm joined by NPR health policy correspondent Julie Rovner, who spent the day watching the summit. Hi, Julie.


SIEGEL: President Obama promised on the campaign trail that all the negotiations on the health care bill would be televised on C-SPAN. I watched some of it on C-SPAN. It didn't look like people negotiating a bill.

ROVNER: No, this is not what negotiations look like. This is what it looks like when you bring television cameras into a meeting of 40 members of Congress and the president and vice president. And try as the president did, everyone retreats to their talking points. This was 40 members of Congress with their talking points. A real negotiation, believe it or not, is a lot drier then even this meeting was, although probably a lot more substantive, and I have sat through my share of real negotiations on big bills.

SIEGEL: Now the stated goal of this meeting was to find some bipartisan consensus on the health bill. Any sign of that, that you saw?

ROVNER: Well, not really. You know, there are so many of the individual pieces where there is agreement between Democrats and Republicans, things like banning preexisting condition exclusions in health insurance, cracking down on fraud and abuse, having high risk pools for people with preexisting conditions enabling them to buy health insurance, even doing something about medical malpractice lawsuits. But I think there's something that we really did see clearly today and why - on why there's been so little bipartisan consensus, as we heard in Mara's story.

There is that fundamental philosophical disagreement about the role of government in the health care system. Democrats think that if what's broken is to be fixed, it will take a lot more government involvement. Republicans think there should be less government involvement. So even if Democrats were to add most of the Republicans' ideas that they agree on to the bill, the bill still has so much of a government influence that not many of those Republicans would be willing to vote for it.

SIEGEL: Now there were an awful lot of facts thrown around in that room in the statements by all the people there. Was one side any better with the truth than the other, do you think?

ROVNER: Well, it was awfully hard to keep score. It's interesting. Both sides were doing a lot of fact-checking and they were dozens of emails flying back and forth from the various fact-checkers. But, you know, mostly what was going on is that both sides were making selective use of facts that were sort of correct. Here's a good example: Very early on in the day, President Obama and Senator Lamar Alexander of Tennessee got into an argument about whether the Democrats' bill would raise or lower insurance premiums. Now Republicans say the bill would raise them, Democrats say the bill would lower them and both point to the Congressional Budget Office estimate to make their case.

SIEGEL: And who would you say is right?

ROVNER: Well, they both are, sort of. It turns out that for most people premiums would go down slightly because those people have group health insurance. For individuals, who are a small minority of how people get insurance, premiums would go up but that's because they would get better coverage, meaning they get more things covered. And for most of those individuals, they wouldn't pay more because the bill would give them help to pay those premiums. For the few people who wouldn't get help, the better coverage would probably mean they would pay less overall in total out-of-pocket cost for their medical bills because that better coverage would mean that they would actually...

SIEGEL: Cover more procedures and lower deductibles, yeah.

ROVNER: It would cover - that's right. Exactly. But so...

SIEGEL: So answer is, it's complicated.

ROVNER: Exactly.

SIEGEL: All the questions are complicated.

ROVNER: Well, right. Like the rest of health care, as president likes to say, is complicated.

SIEGEL: And where does this complicated matter go next?

ROVNER: Well, given that they didn't come out with a big bipartisan agreement, not that anyone expected they would, I suspect Democrats will now have to regroup and figure out how to pass a bill without Republican support. That's not a big surprise. They've been preparing for that pretty much for the last several weeks. It probably means using the budget reconciliation process, as Mara also gave reference to. It probably also means that the House is almost certainly going have to pass the Senate bill first. That's not talked about very much, but that's probably going to be a precursor to being able to use that process. That won't be easy either. It's going to be difficult to get those votes. And I think that that's going to have to begin as soon as tomorrow.

SIEGEL: NPR health policy correspondent Julie Rovner. Thank you, Julie.

ROVNER: You're very welcome.

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Bipartisanship Runs Aground At Health Care Summit

NPR Special: Analysis Of The Summit

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President Obama's face-to-face effort to forge a bipartisan agreement on health care overhaul appeared to fall short Thursday, as differences that have plagued the process for months re-emerged during a meeting at Washington's historic Blair House.

President Obama is flanked by House Speaker Nancy Pelosi, Vice President Joe Biden, Health and Human Services Secretary Kathleen Sebelius, Senate Minority Leader Mitch McConnell and House Minority Leader John Boehner at Thursday's health summit. Pablo Martinez Monsivais/AP hide caption

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Pablo Martinez Monsivais/AP

Although Democrats maintained that the two sides were actually close to a solution, Republicans insisted that neither they nor the American people can stomach the bill as it now exists.

"Mr. President, what we've been saying for a long time is, let's scrap the bill," House Republican Leader John Boehner said. "Let's start with a clean sheet of paper on those things that we can agree on."

Obama wrapped up the nearly seven-hour session by asking Republicans to do some "soul-searching." He held out some hope that compromise could be reached and that a bill could be finalized within a month to six weeks.

"And if we can't, then I think we ought to go ahead and make some decisions, and then that's what elections are for," the president said. "We have honest disagreements about the direction of the country, and we'll go ahead and test those out for the next several months till November."

Obama brought representatives of the two parties together in a televised meeting aimed at jump-starting the overhaul and rescuing his administration's central domestic policy initiative – though some observers saw it more as a precursor to a go-it-alone strategy articulated even before the meeting by a key Democrat.

Sen. Dick Durbin said that if nothing came of Thursday's meeting, Democrats would push forward for a vote on their health care plan without Republican support.

By the time the three dozen participants had finished a sometimes contentious exchange of views, no new consensus had emerged.

Sen. Lamar Alexander, a Republican from Tennessee, began by making a pitch that Democrats need to scale back — to address the health care problem a piece at a time.

"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," Alexander said.

But Sen. Ron Wyden, a Democrat from Oregon, said the piece-at-a-time policy has been tried — and failed.

"The evidence says incremental reform not only does less, it costs more," Wyden said.

The effort to transform health care in the United States has been more than a year in the making. As Democrats appeared to close in on a bill they could pass, they lost a Senate seat in Massachusetts — and the possibility of a 60-vote supermajority that would force the bill to a vote.

Since then, Republican lawmakers opposed to Democratic plans have been further emboldened by public opinion that is increasingly split over the issue.

A USA Today/Gallup survey released Thursday found Americans tilt 49-42 percent against Democrats forging ahead with health care overhaul without any Republican support.

GOP leaders have pushed to scrap the Democratic plan, saying most Americans are against it. They want a fresh start based on more cost control measures and an extension of coverage to about 3 million uninsured Americans.

Obama argued that the Democratic proposal would cover 10 times that many people — though he acknowledged that the additional cost might make it a tough sell.

"It may be that the other side just feels as if, you know what, it's just not worth our doing that," he said.

Democrats still hope to pass a bill that would extend coverage to more than 30 million people who are now uninsured. But the measure would come with a price tag of $1 trillion over the next decade and include a number of complicated provisions that in some cases would take years to phase in.

The president had appealed to both sides to give him at least a modest bill, a far cry from the major changes talked up in the early days of the administration just a year ago.

Three dozen lawmakers — including 22 invited directly by the White House and others handpicked by top congressional leaders — joined several administration officials at a square table in the Blair House.

Obama, moderating the meeting, consistently sought to establish common ground. He agreed with assertions by Oklahoma Republican Sen. Tom Coburn that waste and abuse now account for up to a third of the cost of entitlement programs like Medicare and Medicaid, and constitute a major barrier to more widespread insurance coverage.

Coburn said cost is the key to why millions of Americans remain uninsured.

Rep. Steny Hoyer of Maryland, the second-ranking Democrat in the House, said he thought Coburn had a point, but said proposals by Democrats addressed the kind of cost containment that Republicans support.

In the end, many of the participants argued passionately over details and personal preferences. Topics included how to handle coverage of pre-existing medical conditions; catastrophic illnesses; and the cost of medical malpractices.

Sen. Jon Kyl, a Republican from Arizona, said the two sides "cannot paper over" the most basic of rifts:

"We do not agree on the fundamental decision about who should be in charge," he said. "We all agree on eliminating waste, fraud and abuse. Of course we do. But it's how you go about it."

Written by NPR's Scott Neuman and Deborah Tedford, with additional reporting by Scott Horsley, Julie Rovner and The Associated Press.