A bridge too far: Obama's health summit frees Democrats to move

The obituaries written for the health care summit held Thursday in Washington, D.C., were not long in coming. As many said, the meeting called by President Barack Obama did not manage to bridge the partisan divide on the issue of reform.

Yet something interesting did occur -- something unusual that transcended the shopworn political rhetoric expected and delivered by the leaders of both major parties. Amid the posturing, a real debate broke out, the likes of which this nation rarely sees.

And while the headlines centered on the failure to reach total consensus, the real surprise was how much the parties agreed on some common goals -- if not the details.

By their own testimony, the Republicans, often accused of being the Party of No, here said "yes" on the importance of reforming the system. They also expressed support on some of the particulars -- including a prohibition on dropping the coverage of people who are insured.

That agreements and differences were drawn so clearly owes much to the skill of Mr. Obama, who was masterful in presiding over the meeting. But credit also goes to the participants -- Republicans and Democrats -- who showed that toxic partisanship does not preclude a civil discussion.

No amount of good will, however, could ultimately bridge the divide. The two parties may seem close, but the chasm that separates them is deep. It is but the latest reiteration of an argument that is as old as the republic -- the role of the federal government in the life of the nation.

Republicans believe the remedy to a crisis they acknowledge is the free market. They insist that this is "government controlled" health care.

In truth, what is proposed makes the government a referee and rule-maker but not a player. The players would remain the private insurers. The public option, much desired by the left, has been jettisoned and with it any credible claim that this proposal is some sort of socialism.

Republican ideology, however, can barely admit any role for the government. Sen. Jon Kyl summed up the "fundamental difference" between Republicans and Democrats this way: "Does Washington know best about the coverage people should have, or should people have that choice themselves?"

The trouble with such red-meat populism is that it ignores reality: Millions of Americans have not had any choice; insurance companies have made their choices for them according to their bottom lines. Washington is called upon in myriad situations to do good by the people. If the politicians do not respond adequately, they can be voted out. The voters don't ever get to decide if insurance company executives stay on. GOP lawmakers did raise good points about the costs and taxes in the proposed legislation, but the costs of doing nothing are astronomical, too, and the Republicans are stuck with the estimate of the nonpartisan Congressional Budget Office, which said the bill passed by the Senate would trim the deficit by $130 billion over 10 years.

But the greatest defect in the reasoning of Republicans is not in cost containment -- they are right to push a crackdown on Medicare fraud, insurance across state lines and tort reform (even if they greatly exaggerate its benefits) -- it is in coverage. The whole point of health care reform is to cover millions of Americans who do not have insurance and are subsidized by everybody else, in a sort of hidden tax, and to reduce the spiraling, economy-destroying costs of health care.

The Republicans are very interested in the latter, not much in the former. Eschewing the power of government, they can only promise to cover another 3 million people, compared with 30 million in the Obama plan. That is a pathetic response to real human needs, one that shamefully turns can-do America into a can't-do health care nation.

The health summit was clarifying. Republicans insisted throughout that Americans have said clearly that they don't want this legislation. They have done no such thing. Even if government were to be run by polls -- which it never should be -- polls also indicate support for individual components of the plan. The Democrats must press on. There can be no starting over.

If health care reform can be advanced only by using a simple majority in the controversial Senate procedure known as reconciliation, then so be it. The Senate bill is the best vehicle left to do the job. As Mr. Obama found out Thursday, reaching out to the other side goes only so far.