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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).

 
 
 
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HUFFPOST SUPER USER
Easyrollins
09:54 AM on 03/01/2010
Health Care is just the first bastion of unfetter greed that has to end. The blood sucking privatizing of government services comes next, Financial reform is the real culprit draining the country of it's wealth, The rich has raped the middle class to near extinction, and seems to think that a two class systems of rich and poor is ideal. Colonizing the worlds working poor, with our manufacturing jobs was the first steps, too maximizing profit at the expense of the poor and middle class, But turning us into wage slaves, working only to pay corporations whatever the market will bear was next for every essential needs we have was next. Population control was to be handle by, the forces of have and have not. Either you could afford to live or you can not afford to live.
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HUFFPOST PUNDIT
cybersense
10:24 AM on 02/28/2010
We can't afford to take 1% cost of malpractise/tort. This reform would take away the justice from those who have been seriously harmed. Not by good doctors that are "trying" and have made a mistake - but by those who have issues that they do not tell us, like drug addiction, alcholism and other really bad
performace. For 1% savings - we want to take away an already reduced malpractise amount and even more chance for justice?

I think not! Next time, it could be you!
12:37 PM on 02/28/2010
Agree on the medical malpractice/tort "reform" canard. One of the most important items is that there be NO CAPS put on tort awards, especially as they relate to corporations. Corporations want awards capped so they can factor in having to pay as a "cost of doing business" rather than seeing there actions as wrong and taking responsibility to prevent them from happening.

Obama, don't play with medical malpractice as a political card in negotiations.
11:49 PM on 02/27/2010
An odd take on the healthcare summit by the two authors. The following may sum up:

"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."

In my opinion, this is wishful thinking. I think the bill as it stands (Senate bill) is pretty poor, but not for the same reasons as repubs. Repubs want to start over just to delay. They are not interested in meaningful healthcare reform. They certainly are not interested in things that, in my opinion, would make this bill much better - which includes much of what Zogby and his partner say the American people want in reform. Hopefully, some of this will be changed in reconciliation.

But let's get this done. We cannot afford to wait for repubs to get aboard when they have no intention of doing so.
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americanfabius
liberty loving Wisconsinite
03:48 AM on 02/28/2010
So you believe the health care bill (as it stands) is "pretty poor." but you want it to be passed anyway? Please, explain why. Your comment is a complete contradiction. You think the bill is poor; so do republicans (you're words, not mine), yet you hope it gets passed. So you toe the party line and sacrifice your opinions to support a political party that has convoluted this health care debate into a televised spectacle of arrogance?
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HUFFPOST PUNDIT
PatrickJ08
04:34 AM on 02/28/2010
If the house passed the senate bill as is, with no further changes, the average family's health insurance costs drop by 50% over the next 6 years.
12:26 PM on 02/28/2010
I see why you are confuse by my statement, so let me add what I left out of the previous post (and should have specified). The bill needs to be 'fixed' through reconciliation and incluede - a robust public option, improved subsidies, tax the rich/not the "cadillac tax, national not state exchanges, etc. It would be nice if medicare eligibility age was reduced to 55 or lower. As I unserstand it, all of these could be passed through reconciliation process in Senate if they improve the budget bottom line.

When I say let's get this done, I am saying Congress should go forward with reconciliation to fix the bill and then pass it..
02:38 PM on 02/27/2010
I understand the proposals to allow individuals to buy insurance across state lines, but I don’t see any incentive for insurance companies to sell across state lines (where health costs may be higher and they are not licensed in that state). An alternate proposal might be to establish a nationwide rate schedule based on gross household income. Some rate would be established (say 5%) for everyone making more than $20,000/year and 2% for others. Insurance providers would then receive tax breaks for movement from their current income profile toward the national income profile (to include all income groups). This incentive would motivate providers to gain market share across state lines (by becoming licensed in more states), would result in massive mergers and acquisitions at the expense of high cost providers, create more competition based on quality rather than cost (since presumably all survivors would eventually converge on a lower and similar cost structure), would potentially do away with Medicaid and Medicare, force everyone to at least pay something, and would force everyone to file a tax return(which is a good thing, along with reducing the size of the IRS). It would also forces the riche ( who will pay more but also have all the power) to pressure the system to reduce costs.
HUFFPOST SUPER USER
purplet
12:51 PM on 02/27/2010
not true- My office manager just went on medicare and so did a friend of mine The premiums are a third of private insurance- Get your facts straight- My brother works for the government- 27 yrs- and his insurance is much cheaper than if he was in the private markets.
What don't you get about the fact the majority of the voters voted for universal healthcare.
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HUFFPOST SUPER USER
dsws
No owning ideas. Limit only commercial use.
12:14 PM on 02/27/2010
"Our thought is that Democrats, Republicans, and Americans emerged winners."

Not a chance. It's a zero-sum game. Better for Americans is worse for Republicans, as long as they remain committed to that strategy. The only thing that will pry them loose from that strategy is losing in November, and this article provides no reason to think otherwise.
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HUFFPOST SUPER USER
MelanieMatthias
I am President Obama's biggest fan!
11:45 AM on 02/27/2010
Interesting take on the summit, gentlemen.
If you have the summit taped, I would suggest you go back through it and honestly count how many times each party flat out lied. If you can do that completely, with all honesty, then you will know the truth and have to change your opinion.
I walked outside today and was so refreshed by all purple snow piled in small shallow drifts across the parking lot where I need to mow the orange grass. The seagulls wheeled about in the pudding thick sky that was dripping grapefruit size donuts through the pink trees.
Saying a lie in a nice voice does not change the fact that it is a lie.
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HUFFPOST PUNDIT
PatrickJ08
04:37 AM on 02/28/2010
nicely put
07:27 AM on 02/27/2010
Cost of insurance can decrease, if healthcare cost decreases. It's possible with the many cost-effective delivery models. If NY State (or City) follows Grand Junction model, their cost reduces 40%.

http://www.huffingtonpost.com/ann-imse/how-to-fix-health-care_b_475916.html

Follow that practice and all current arguments on cost, universal coverage and access becomes moot .... nearly moot. Thirty years of experience to prove its sustainability. We know how to do it. It has been done in many places under different scenarios and models.

Authorities who need more studies are not interested in solving the problem and are spinning. These dinosaurs need to be removed. Exposing and monitoring practice-patterns and comparing statistics with local and national peers, will reduce over-utilization by 30% in the first year before any corrective action. Healthcare planners and administrators in 'high cost states' like those in the Northeast should read the above article.

After studies of various treatment parameters and comparative analysis made, the data should be published on-line. Local newspaper and TV stations should publicize the data. This should start a dialog in the community about how families and the community can help medical providers be more efficient in delivering care. This can be facilitated by Chamber of Commerce. Important aspect of good care is patients having effective family and social support during illness and at end of life.

Stick for cost-effective healthcare - lack of reimbursement for unnecessary treatment as defined by best practice patterns
12:19 PM on 02/27/2010
The question is how can we make the health care providers follow the patten of practice that is best in terms of costs and results ? Try ask your own physican to follow the practice and see what happens. It will probably take decades if not longer for the practitioners to comply. And who are the enforcers or regulators ? There are regional and various differences in the pattern of practice such as in major cities versus rural areas, major hospitals versus small hospitals. Besides, the for profit incentive is very strong in doctor's offices and hospitals and laboratories nowadays for them to change their pattern of practice according to the statistics. They have to pay their bills and staffs. How many millions of doctors we have out there and you want them to comply to a certain pattern of practice ? It is much easier said than done.
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HUFFPOST SUPER USER
dsws
No owning ideas. Limit only commercial use.
12:20 PM on 02/27/2010
So basically, if the other side unilaterally disarms and then we all join hands and sing kumbayah, everything will be great? Doesn't sound like a serious recommendation.
This user has chosen to opt out of the Badges program
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polishlogician
No sugar tonight in my tea..
03:20 AM on 02/27/2010
"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."

--reminds me of corporate retreats when we bring out the whiteboard and kill time as nothing changes, by Monday morning it's all forgotten, but it's "suppose to be" an excellent "team-building" exercise, sort of like getting stuck in traffic or waiting at the DMV with your fellow man. It's just a hassle of modern life. No one emerged a winner. Rah-rah!
08:46 PM on 02/26/2010
responsibility, self-determination, liberty, are unnecessary evils according to the Congress. Who said " crush the bourgeise(middle class) with taxation and inflation....here it comes, bend over! Medicaid and medicare are broke and social security has been used by Congress for a slush fund for years. Do you really want tham to takeover your health???????????????/
HUFFPOST SUPER USER
purplet
09:14 PM on 02/26/2010
YES
HUFFPOST SUPER USER
purplet
09:27 PM on 02/26/2010
Yes we do- 64 million people voted for Obama- who ran on Universal Healthcare-
10:51 PM on 02/26/2010
Let them try. They're in for a big surprise if the go forward with ObamaCare. There's some mighty angry folks out here. Pass this BS and you'll pay dearly in the next few months MARK MY WORDS.
12:07 PM on 02/27/2010
Substituting one bureaucracy (insurance companies) for another (the government) is not going to lower health care costs. Period. Empower the consumer.
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HUFFPOST SUPER USER
Janet Carter
08:14 PM on 02/26/2010
I agree 100 percent with this analysis of yesterday's summit. The Republicans have no desire to change health care in any way. The President is simply letting them have their say (publicly) and then he will do the right thing and push this thing through.
Jay Haney
My nuclear family imploded when I was 18. I've bee
07:11 PM on 02/26/2010
As my roommate put it, were you watching the same healthcare summit we were? The only winner on that one was El Presidente himself. Republicans put on their ugly by showing how they won't be satisfied until healthcare is dead. Democrats are still way too timid on taking a stand, which is probably why they followed Obama's lead. It will only be a winner for the American people when Americans actually get health reform.
06:45 PM on 02/26/2010
It the "Health Summit" was not a waste of time because it proved that it was a waste of breathe.
HUFFPOST SUPER USER
nevergiveup
01:28 PM on 02/27/2010
Another member of the GOP who hates public discourse among elected officials. You guys are so not into democracy.