Thursday, February 25, 2010

"Reset The Etch-a-Sketch" - Observations from the Feb. 25 White House Health Reform Summit

That line from Rep. Roskam was probably the most memorable quote from today's White House health reform summit. The multi-tasking Disease Management Care Blog kept notes in between the the day-job emails, snacks, calls, caffeine and documents while streaming C-SPAN3 into the bottom right corner of it's second monitor screen while manning the DMCB World Headquarters. In case you missed it, the video is here.

What else do the DMCB notes say?

To no one's surprise, none of the participants appeared to change their minds.

The Democrats stuck to their main point: the bills are big and complex because the provisions are interdependent as well as necessary. For example, if there is no mandate to expand the risk pools, there can be no guaranteed issue, which is why premium supports are necessary which is why taxes.... You get the picture.

The Republicans stuck to their calls for a 'do over,' quoting public opinion polls and pitching their usual counter-proposals. That's what accounted for the etch-a-sketch quote above, likening the current bills before Congress to a messy squiggle resulting from too much fiddling with the knobs.

Yet, the Dems had one big rhetorical advantage: their 'liberal' (pun intended) use of telling anecdotes, including children with menintitis, farmers with sticker-shock insurance bills and middle-class restaurant-owners with chronically ill babies. The Republicans, on the other hand, countered with the unaffordability of a perfect health care system, no matter how deeply we care and no matter how deeply we want it.

Dems vs. Repubs: a tie.

The President's considerable oratorical talent was pushed aside by the preoccupation of policing all of the point/counterpoint discussions. While he occasionally responded to Republican misstatements or showboating, the loyal opposition made their case in a respectful, policy-focused and sometimes surprisingly wonky manner.

Prez vs. Repubs: a tie here means the Repubs won this round by not being led into the trap of being portrayed as the "Party of No."

Other observations:

Media, Editorialists, Bloggers and other Commentariat: even though none of the participants seemed to change their minds and it's unlikely that many health policy adepts gained new insights, the Summit video and transcript is a quotation target-rich environment. The DMCB suspects much of it will be out of context.

Reconciliation? When raised, the Dems implied that there has been no decision regarding the parliamentary path to reconciling the President's proposal and passing the House and Senate bills. Their disingenuousness - acting like they'll be the last to realize what the rest of the country already knows - suggests they're aware that filibuster-busting "reconciliation option" has a LOT of baggage. This is a big big gamble in an election year and this was a key signal that they know it.

Democracy in Action: persons living outside of the U.S. (and maybe Great Britain) will undoubtedly marvel at the willingness of our members of Congress to repeatedly interrupt and attempt to correct the Leader of the Free World. The first generation DMCB thinks the quote is apropos: "Only In America."

Wellness/Care Coordination: Maybe it's because the proceedings were televised, but participants on both sides of the aisle pointed to several things they can agree on. A prominent one was wellness and care coordination as a means to control costs. The DMCB found that to be not only very gratifying but very insightful of our elected officials.

And some surreal moments:

After the President made his opening remarks, the Republicans turned to the folksy Lamar Alexander of Tennessee to be the first out of the gate. As the cameras panned around, it really appeared as if the House Speaker and the Senate Majority Leader were pointedly looking away. Maybe the DMCB is being over-sensitive to the depths of the partisan rancor.

Representative Louise Slaughter (D-NY) had her own anecdote involving dentures and seemed to imply that they should be included in the Medicare benefit.

Sen. Rockefeller (D-WV) described all health insurers as "rapacious" "sharks," and later seemed to agree that all Americans should be obliged to buy health insurance.

Senator Harkin (D-Iowa) said segregating groups into various risk pools with the premium differentials they entail is the kind of "segregation" that is unjustly discriminatory. Now that's a new one.

Last but not least, one Representative observed that never before had he seen so many from Congress act so well for so many television cameras. That prompted some chuckles, but it also speaks to what must be going on behind the scenes. If true, our country deserves better.


Etch-a-sketch image from Wikipedia


Doctor David said...

What does the DCMB think would have happened if the summit attendees would have assessed support for the Healthy Americans Act?

Jaan Sidorov said...

Y'know that is an EXCELLENT question. I think the fact that it didn't see the light of day is very telling.