04/12/2010 05:12 am ET | Updated May 25, 2011

Can Obama's Health Summit Succeed?

President Obama has recently announced a health reform summit, to take place across the street from the White House, with the C-SPAN cameras rolling. He's invited Democratic and Republican leaders from Congress to this summit. Many cynics have dismissed the effort already, either pronouncing it less than worthless legislatively, or calling it some form of political Kabuki theater which will do no good even politically. I think these pronunciations (especially the latter one) are a bit premature, to say the least. Because either on a substantive level or a political level, I think there actually is a chance for some limited success for Obama in this exercise.

Now, I'm as weary as everyone else over the length of the battle on how to reform our nation's health system, and sympathize with those who say that so much has already been traded away that it's pointless to even pass what is currently on the table. But, as Obama keeps reminding us in the whole debate, if you consider the alternative -- passing nothing -- it's easy to see that this remains an even worse option for Democrats this year.

But let's concentrate on the summit itself. There are two yardsticks for success, here. The first is to actually get something done, and actually get something passed. The second is to position the Democrats politically for the midterm elections, no matter whether anything gets passed or not. The first one likely won't be achieved in a single day, although the summit could certainly be seen as Obama jumpstarting the process, if it does ultimately happen. The second one is easier to achieve, but may ultimately be rather worthless if Congress doesn't put anything on Obama's desk for him to sign.

To begin the discussion, here is President Obama himself, talking about the summit (which is scheduled for February 25th) during yesterday's visit to the White House press room.

To your question about the 25th, my hope is that this doesn't end up being political theater, as I think some of you have phrased it. I want a substantive discussion. We haven't refined exactly how the agenda is going to go that day. We want to talk with both the Democratic and Republican leaders to find out what they think would be most useful. I do want to make sure that there's some people like the Congressional Budget Office, for example, that are considered non-partisan, who can answer questions.

In this whole health care debate I'm reminded of the story that was told about Senator Moynihan, who was I guess in an argument with one of his colleagues, and his colleague was losing the argument so he got a little flustered and said to Senator Moynihan, "Well, I'm entitled to my own opinion." And Senator Moynihan said, "Well, you're entitled to your own opinion, but you're not entitled to your own facts." I think that's the key to a successful dialogue on the 25th or on health care.

Let's establish some common facts. Let's establish what the issues are, what the problems are, and let's test out in front of the American people what ideas work and what ideas don't. And if we can establish that factual accuracy about how different approaches would work, then I think we can make some progress. And it may be that some of the facts that come up are ones that make my party a little bit uncomfortable. So if it's established that by working seriously on medical malpractice and tort reform that we can reduce some of those costs, I've said from the beginning of this debate I'd be willing to work on that. On the other hand, if I'm told that that is only a fraction of the problem and that is not the biggest driver of health care costs, then I'm also going to insist, okay, let's look at that as one aspect of it, but what else are we willing to do?

And this is where it gets back to the point I was making earlier. Bipartisanship cannot mean simply that Democrats give up everything that they believe in, find the handful of things that Republicans have been advocating for and we do those things, and then we have bipartisanship. That's not how it works in any other realm of life. That's certainly not how it works in my marriage with Michelle, although I usually do give in most of the time. (Laughter.) But the -- there's got to be some give and take, and that's what I'm hoping can be accomplished. And I'm confident that's what the American people are looking for.

Now, allow me to translate (or paraphrase) what message the president is sending to the Republicans by all of this, because Obama puts it so politely that you may have missed what he is really signaling here.

This is not going to be just a forum for political speeches and ideology, by either side. Because, mark my words, we are not going to put up with demagoguery from the Republicans. I have called for Republicans to bring their ideas to the table, but this time we're going to demand they put some numbers on their proposals. We're going to have the C.B.O. sitting in as a referee, to let us know what the facts are when it comes to saving money. Because I am sick and tired of Republicans grandstanding, while at the same time refusing to put their ideas to the same test Democrats have -- getting them scored by the C.B.O. If the Republicans truly believe their ideas will work, then they will have to prove it by putting some real budgetary numbers to their plans, instead of just talking about them. Because I think we've had enough hot air on the issue, and I'd like to talk real, factual numbers with Republicans -- on live television, so the American public can see what is fact and what is fiction.

Obama also stated that he's not going to just "start over" on the whole process -- that what has already been accomplished by the House and Senate is going to be the starting point. This is good, because of where we currently are, legislatively.

Democrats in the House and Senate are currently playing the old Washington game of "You first..." / "No, no... after you." Both houses have passed a bill. These bills are different. But with 41 Republicans in the Senate, no bill which requires 60 votes to pass is going to have a chance, realistically. So the Senate bill has to be the foundation to build upon, if anything is going to pass. The House could pass the Senate bill unchanged, and it would go straight to the president's desk for his signature. But the House is balking at doing so, since the Senate bill is so flawed.

The obvious answer is to link this bill with what has been described as a "sidecar" bill -- one which fixes the most egregious problems with the Senate bill. The House and the Senate would have to pass this, but the Senate could do so using "reconciliation" rules, which only require 50 Democratic Senators (and Joe Biden) to vote for it. The impasse revolves around who goes first.

The House doesn't want to vote for the Senate bill without assurances that a sidecar will also pass (because once the House passes the Senate bill and the president signs it, it will become law). The Senate doesn't want to pass the sidecar without assurances that the House will pass both bills. So "who goes first" is the game they're currently playing. This -- the scheduling -- is one of the issues it would be fascinating to see resolved in the health summit, although I have to admit I have no idea what the chances are of this happening.

But the Democrats should present a unified front to the Republicans -- if Republicans don't join in honest negotiations, then Democrats should be resolved to passing both the Senate bill (in the House) and the sidecar bill (by reconciliation, in the Senate) -- with no input from Republicans whatsoever. The choice needs to be presented to the Republican leaders: you can either help us "fix" the Senate bill, and any worthwhile ideas you have that can be proven to save money will be included in the sidecar bill... or we are going to go ahead and do it without you.

Republicans should be given the political choice of going back to the voters and saying either: "The Democrats were going to ram this through, so we did the best we could to make it better with good Republican ideas," or to honestly make the case: "We're against doing anything, and the Democrats are the ones who refuse to be bipartisan by letting us write the bill."

That second one may sound like what Republicans want, but Republican leaders (as opposed to the rank and file) know that the "Party of No" label is a dangerous thing to have around their political necks all year. Moderate voters don't want to see total obstructionism, even if it delights the Republican base. And moderate voters are where a lot of elections are won and lost.

Of course, Republicans could gamble that obstructionism is a winning strategy for them this November, in which case they likely won't even show up to the summit in the first place -- because nothing could be gained by them doing so. But Obama should make it clear (as he did repeatedly in his answers to the press) that "bipartisanship" is simply not going to mean "Republicans write the bills," as it has so often in the past. And even if they don't show up, Obama should hold the meeting anyway -- with empty chairs where the Republicans should be, for the television cameras to see.

Republicans already know the danger of them showing up to the meeting is having their ideas proven to be minor reforms, at best. They must know that the numbers aren't going to show that their reform ideas will save more money than what Democrats have already proposed. This is why they're so scared to face the C.B.O. in the first place. And they know that if they propose ideas, and then vote against them when it comes time, that they are going to be seen as playing politics, instead of trying to make things better for the American public.

But no matter whether they show up or not, Obama -- just by proposing the meeting -- has successfully pulled the rug out from three major slogans the Republicans were planning on campaigning on this year -- (1) "Obama keeps saying we have no ideas, or tells us to shut up about them," (2) "Everything the Democrats do is behind closed doors, when Obama said he'd put it on C-SPAN," and (3) "We're the true deficit hawks and our ideas would save billions, if Democrats would only listen to us."

Obama is, in essence, saying to the Republicans: "Put up or shut up," which is quite a different thing. To put it another way, it's a game of "chicken." And Obama has actually shown a recent willingness (post-Massachusetts) to take this fight to the Republicans, and pin them with the obstructionist label. This worries Republicans, since it's always easier to fight against a caricature than someone who is actually fighting back.

So while seeing real results from the summit may take a while longer than one day, and while actual results are contingent upon Democrats at this point; it's certainly a worthwhile use of Obama's time to try. If Democrats in the House can agree to pass the Senate bill, and if Democrats in the Senate (only 50 of them, meaning the Liebermans and Nelsons would be irrelevant) can agree to fix their bill using reconciliation, then that is a path forward to success in the whole prolonged legislative battle. If Obama lets House members know he won't sign anything without a sidecar to accompany it, and if Obama lets Senate members know that he'll have their political back in defending the use of reconciliation, then he could actually move the process to the finish line.

It's certainly nothing to bet the farm on at this point -- but it's also better than nothing at all, which is now the only alternative. But while the chances for actual legislative success are impossible to predict at this point, the chances for Obama to position both himself and Democrats in a much better place for this year's midterms against the Republicans remains high. If health reform does not pass, the only way Democrats have a shot at avoiding massive losses in this year's congressional elections (short of, that is, the unemployment rate suddenly falling to 6.0 percent) is to paint Republicans as even more despicable then Democrats are to the electorate right now. That's not a very optimistic note to end on (it's actually pretty ugly, I must admit), but it's pretty close to being true. At this point, in other words, there's not a lot for Obama or the Democrats to lose by holding the health summit. Politically -- especially if the Republicans don't even show up -- they may even have something to gain by making the effort.


Chris Weigant blogs at:

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