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S. Ward Casscells, MD Headshot
John Zogby Headshot

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).