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Seeds of the Summit

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We know that we are in the pundit minority but we do not think the health care summit was a failure. Our thought is that Democrats, Republicans, and Americans emerged winners. It was an extraordinary demonstration that getting opponents together, in front of the public, demonstrates the knowledge and empathy of these much-maligned officials, and even their ability to listen, when they have to. It set a standard that the public may well now insist on.

Readers of the Huffington Post know that both of us have studied Americans' views on health care reform for a long time. In a few days we will know what Americans think of health care reform after President Obama's televised health summit (it takes a few days for opinion to solidify).

But for now we can disclose what 1,700 Americans were thinking and hoping the evening before the summit: nearly 50% like Obama's proposal of federal pricing of health insurance premiums (but slightly would leave it to the states). Second, they are evenly split between the Obama plan and the Republican plan. But they credit the Democrats (more than the Republicans) with a sincere commitment to making the summit more than political theater. Still, a narrow majority are doubtful that health care reform will pass this year.

This is in keeping with our January survey in which Americans told us they want a bipartisan bill, and want the new Republican senator from Massachusetts, Scott Brown, to work with the Democrats for a compromise.

For the past nine months we have found Americans want health care reform, though they do not favor the current bills and the deals that were made to pass them.

A majority tell us they want Congress and the President to start over, and aim for a smaller health bill or a series of bills. They want exchanges, purchasing pools, administrative simplification, no denials due to pre-existing conditions, malpractice reform, efforts to reduce errors, waste, and fraud, and no federal funding for elective abortions.

Many are OK with expanding Medicaid and CHIP but most do not want any increased taxes or deficits. About 40% would pay a few hundred dollars a year if that would cover all the uninsured, and 50% are ok with higher taxes on million dollar incomes and on cigarettes. The others want the uninsured to be covered by savings that could be generated by reducing fraud, errors, waste, and defensive medicine.

Until recently Democratic leaders did not pay much attention to these data. Frankly, they have picked over the polls for signs of encouragement. We suspect they felt it was their duty to lead, as they pointed out that most Americans were not initially in favor of social security, the voting rights act, or Medicare. But when we asked in December if the Democratic leaders were "out in front" or "out of touch" Americans chose the latter by almost 2 to 1. But that was December, and this is now.

So we listened for signs of that in the televised healthcare summit. Most news reports described Obama as peeved or impatient. Frankly, we were impressed with Obama's patience and command of the facts (without a teleprompter or aides passing him notes).

We were also impressed by the graciousness of Senator Lamar Alexander (R, TN) - who was as right as Obama on the issue of premiums: they will rise if Obama's plan passes, though patients may also get better care in the process. Also impressive was the sincerity of senator/surgeon Tom Coburn (R, OK) with whom we both often disagree. It was interesting to see how Obama reached out to him. Maybe they are headed for a Ronald Reagan / Tip O'Neill friendship. It could only help.

While the meeting did not have much humor and warmth, neither was there much arrogance or condescension on either side. Obama looked exasperated a few times, but not "holier than thou," or "smarter than thou." The most awkward moment was when he reminded Senator McCain, "John, the election is over," which McCain defused by saying, "I am reminded of that every day!"

Republicans got less air time, but Obama was the host. Biden chaired a session, and as usual had plenty to say. He focused on health care costs destroying American business, forgetting that the 17% that is health care produces high-tech jobs, exports, and keeps people alive and working.

Curiously, Democratic health care warriors Waxman, Rangel, and Dingell were quiet, but Dingell effectively noted the five decades of struggle to pass health reform.

Maybe it's wishful thinking but it seemed there was some real listening going on (and some sincere olive branches, like the one from California Democrat Xavier Becerra), in addition to vote-counting.

Admittedly, Speaker Pelosi (D, CA) and the president refused to throw out the Obama plan and start over, or go step by step in a series of small bills, or to promise to meet halfway on coverage of the uninsured (the Republican plan would cover about 3 million, vs. 30 million in the Democrats' plan). But Obama did offer to work with Republicans to find a compromise on tort reform, and on allowing purchase of health insurance across state lines.

So we have not given up on health reform, even though the numbers in the House now look dicier than those in the Senate. We keep believing Congress will finally listen to what Americans are saying, especially in this, an election year.

One suggestion for the Republican leaders: after the summit, Obama advisor David Axelrod said the reason they oppose a fresh start is that it would mean indefinite delay. Republican leaders could be reassuring on this point by setting a goal of say, June 1, for a bipartisan health reform bill.

The televised summit showed both sides to be intelligent, engaged, passionate, and gracious. That's what elected officials are supposed to do. We are crossing our fingers that today was not just made-for-TV political theater. Too many lives - and livelihoods - depend on it.

S. Ward Casscells, MD is Tyson Distinguished Professor of Medicine (Cardiology) and Public Health, Vice President for External Affairs and Public Policy, The University of Texas Health at Houston.

John Zogby is Chairman of the Board and Chief Insights Officer at Zogby International, a public opinion, research, and business solutions firm with experience in more than 70 countries. He is also is the author of The Way We'll Be: The Zogby Report on the Transformation of the American Dream (Random House).