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Gibbs to GOP: Nope, We're Not Starting Over on Health Care

But there may be something to gain at the president's forum.

12:25 PM, Feb 9, 2010 • By MARY KATHARINE HAM
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Senator Lamar Alexander of Tennessee, the No. 3 Republican in the Senate, said he and his colleagues were skeptical of “grand legislative policy schemes” and favored “a step-by-step approach” focused on lowering health costs for families and businesses.

“It is arrogant to imagine that 100 senators are wise enough to reform comprehensively a health care system that constitutes 17 percent of the world’s largest economy and affects 300 million Americans of disparate backgrounds and circumstances,” Mr. Alexander said.

Arnold Kling has some very specific conditions the GOP should demand be met before Obama's alleged negotiating session:

1. All Medicare savings must be used to shore up Medicare. None of those savings can be used to fund new insurance subsidies or entitlements. Medicare is unsustainable, and it is going to need every dollar that we can save, and more. There is nothing to spare for a new entitlement.

2. Medical savings accounts must not be killed.

3. Catastrophic health insurance must not be killed or heavily disadvantaged relative to comprehensive insurance.

4. All new subsidies that enable people to purchase health insurance must be on budget, rather than through insurance company regulations that are likely to result in cost-shifting.

5. The bill must provide for at least one of the following:

a. Interstate competition in health insurance.

b. greatly reduce (preferably eliminate) the tax inequity between obtaining health insurance on your own and getting it through your employer.

I think it's fairly obvious Democrats in leadership won't agree to most of these things. There is a significant ideological split on how to deal with health care's very real problems. But GOP solutions fit the national mood far better than Democratic ones. This one televised appearance by the president is not likely to turn the tide for Obamacare, but it could once again give the GOP a chance to pitch solid, incremental, market-oriented reforms in front of a national audience.

As the president says, the problem with health-care spending will have to be dealt with. The Democrats' current plan fails to deal with it, but there is hope that some of the GOP alternatives could. (It helps that Republicans are less ideologically inclined to fix spending problems with more spending.) Liberals were quite right in noting, when the health-care debate started, that the GOP hadn't spent a lot of time or focus on health care before Obamcare, thus lessening their credibility on the issue.

Why not use the president's forum to forge more of the necessary credibility to deal with it when the time comes—either in the event that Democrats acquiesce to more GOP ideas in a last-ditch effort to pass a bill, or when the thing is scrapped entirely? It worked last time. Now, even the NYT says the GOP has a "well-developed set of ideas." And, who am I to argue with the New York Times?

Update: The Politico elaborates on the theatrics involved, here, but I still say it's worth pitching conservative ideas as the Democrats' plan continues to unravel:

Obama hopes to walk into the Feb. 25 summit with an agreement in hand between House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid on a final Democratic bill, so they can move ahead with a reform package after the sit-down.

House Republican leaders delivered a letter to the White House Monday that included a list of pointed questions that they would like answered before the meeting at Blair House, such as whether Obama would give up on using reconciliation, a way to pass health reform in the Senate with just 51 votes.

“If the starting point for this meeting is the job-killing bills the American people have already soundly rejected, Republicans would rightly be reluctant to participate,” the letter read.

So what’s the point? A jaded Washington wondered how a single meeting — in front of live TV cameras, no less — could change the fundamentals of the debate.

Many concluded it won’t.

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