The Appearance and The Reality

With healthcare reform facing its own blinding blizzard, President Obama needs something to kick start negotiations and bring attention to the issue. With his recent appearance before the Republicans as a stage – which got mostly rave reviews – the President sought to re-set the healthcare reform debate by announcing his intention to host a bipartisan healthcare summit with key Republican and Democrat leaders on February 25^th at Blair House.  

Similar to the so-called “Beer Summit” which he hosted over the summer, the “Healthcare Summit” is seeking to bring all key players to the table for an open discussion of their differences to find a way forward.  As a televised event, the spectacle represents an interesting venue especially given the partisanship which has dominated the tone of Congressional negotiations over the last year.  But, while the bipartisan meeting may seem like a good idea on paper, there are many on both sides of the aisle that remain skeptical of the summit’s potential.  To convince his conservative colleagues, Obama has signaled his willingness to involve new approaches to healthcare reform such as the long debated issue of medical malpractice reform. With tort reform back on the table, Obama is taking on issues where support within his own party is divided.  This exemplifies the tactical directions of the White House as it scrambles toward the mid-term elections in November.  For his more liberal colleagues, he is not backing away from a total “re-set”.  Rather, he has indicated that the proposals developed by the Democrats may well be pared back but the “start over” option is not an option.  On the positive side, it does give the appearance of an effort to engage in open discussions on a very difficult topic.

While the Healthcare Summit is viewed by some as an olive branch of sorts to Congressional Republicans who have opposed Obama’s healthcare reform plans, the real olive branches are being extended in the back rooms and corridors of power.  I’ve been saying for months that policy is made “in the middle”.  In fact, it seems that the public’s call for bipartisanship is creating significant momentum toward the middle by both sides of the aisle.  Despite all of the rancor and opinions on his leadership style – Rahm Emmanuel, the White House Chief of Staff, led a similar approach in the House where he served as a Member from Illinois and when he headed the Democratic Congressional Campaign Committee prior to the 2006 mid-term elections.  Democrats were widely successful in gaining seats throughout the country. 

The idea is to push forward bills that the people want and where general agreement is likely.  The result is the ability to point to success rather than long, drawn out debates.  The American public wants action and, seemingly, the Obama Administration gets it.  While some Washington pundits believe this is all for show, it appears that Obama and team are moving from sitting on the sidelines by letting the House and Senate leadership make proposals to potentially reaching out.

But, what’s the reality?  We should anticipate a flurry of proposals where agreement on healthcare reform holds a degree of consensus – cherry picking of good ideas, if you will.  We’re already seeing it on a number of other fronts from jobs proposals to financial reform and, back to healthcare which has been a dominate theme throughout 2009.  What that means – from my perspective – is a number of sliver solutions related to healthcare issues with reform occurring over a much longer period of time rather than simply going for a big bang approach. 

The tactic may have been undercut on Friday when Majority Leader Reid announced a pared down jobs bill.  While proposed approach clearly includes many of the touchstone issues held high by various Republicans, it also came about two hours after a similar announcement by Baucus (D-MT), Grassley (R-IA) and others that represented a bipartisan proposal.  The question looming on the Hill was if there’s all this talk about bipartisanship – what is Reid doing introducing a separate bill?  The silence of the White House was deafening.  The Reid jobs bill is clearly designed to either gain Republican support or call out their lack of support – which takes us full circle to the Healthcare Summit.  Whether or not this strategy works is an open question.  We have now seemingly entered a period where the partisans are discussing what bipartisanship means.  Who could believe it?  Only in Washington…

But, back to the Healthcare Summit.  It seems unlikely at this point in time that substantive changes will result from the meeting and it does have the potential for hardening disagreements between Republicans and Democrats.  The better path is for reasoned leaders to sit down in the quiet of their offices, engage in meaningful debate and discussions, compromise; and, move forward.  That’s the way it’s been done for hundreds of years and, from my perspective, we need to get back to the central core of how policy is made in order to break the gridlock which has captured healthcare reform and, potentially other very important issues facing the United States.  Healthcare reform remains a far too important issue from a social and economic standpoint to remain unresolved.  Yes, we – the public need to be involved.  But, we also need to trust and hold our leaders accountable.  So, all eyes will be on the Republican and Democratic lawmakers who will be participating in the Blair House Healthcare Summit.  Let’s hope they move from appearance to reality.  I’ll be reporting back on their progress – or, not…

Kevin Fickenscher, MD

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.