While the health care reform effort itself lies on the operating table in critical condition, Democrats and Republicans are going through the motions of trying to be bipartisan, since that seems to be what the voters want.

Actually, as we reported in the January 13th Bucks Voices update and previously, it’s not clear what the voters want. Many want very contradictory things: unlimited health care and no additional taxes or higher premiums to pay for it, an end to preexisting conditions limits but no requirement to have continuous coverage, high quality care but no collection and distribution of comparative effectiveness research to doctors, government out of their medical care but keep its hands off “their” Medicare, preventing Medicare from bankrupting the federal budget but no premium increases or cuts to Medicare to achieve this, understandable health care benefits but no government regulations to require standards on covered benefits, disclosure, communications, etc., etc. The fact that voters show much ignorance over the proposed bills and contradictory wants about reform, suggests that if the Democrats can get a bill passed and then explained to the public, public opinion about it could turn around quickly.

On January 25 the AP reported on a Robert Wood Johnson Foundation survey taken between Nov. 28 and Dec. 20 which showed increased anxiety that the reforms would make things worse off than doing nothing. The facts of course say that doing nothing is by far the worst that could happen. (See the following AP story published on the msnbc site on Feb. 14: click here).While still reflecting a minority of respondents, the survey showed an increase in concerns over reforms in these areas, compared to a similar poll done last September:

− 33% said they believed their access to care would be worse if a health care overhaul occurred, a jump from 25 percent in the poll released last month. Thirteen percent said they thought they would have better access to care in a remade system, about the same as last month.

− 30.5% said their personal finances would be worse under a health care overhaul, compared to 24.5 percent last month. Eleven and a half percent said their personal finances would improve, compared to 14 percent last month.

− 35% said the country’s access to health care would be worse under a health care overhaul, compared to 30 percent last month. Around 38 percent said it would be better, around the same as last month.

− 42% said the country’s finances would suffer under a health care overhaul, compared with 34.6 percent last month. Thirty percent said matters would improve financially, compared to 32 percent last month.

It’s clear from these results that many people don’t understand (or don’t believe) that both the House and Senate bills would provide a huge expansions of cost subsidies to individuals and small employers, greatly expanded Medicaid coverage, guaranteed coverage from insurance carriers, greater competition through regulated insurance exchanges, better prescription and prevention benefits to at least the 75% of seniors under regular Medicare coverage, and many initiatives to improve quality and control long term costs.

President Obama has agreed to one last bipartisan effort by hosting a health care summit on Feb. 25. The invitation list includes House and Senate leadership, and the chairmen and ranking members of relevant committees. The House and Senate leaders, Pelosi, Reid, Boehner and McConnell to each choose another four members and one staffer specializing in health care policy to attend the meeting. C-Span junkies note: the meeting starts at 10:00 a.m. and will be broadcast live on TV.

Democrats claim they are trying to resolve the key differences between the bills already passed in the House and Senate and then post the “new” proposal on a website. They’ve asked the Republicans to do the same. However, not much progress seems to be occurring. According to the February 16^th New York Times:

“…the White House hinted on Tuesday that President Obama might post his own bill on the Internet before the bipartisan health care summit he is planning for Blair House next week…

During a news conference last week, Mr. Obama said he envisioned posting a merged House-Senate bill that would address his goals of controlling costs and expanding coverage…

But Mr. Obama may be running out of time. His press secretary, Robert Gibbs, was asked Monday if the president would simply post his own bill if the House and the Senate cannot come to terms. “Stay tuned,” Mr. Gibbs said.” (click here)

At the meeting, the President will moderate a discussion through four major topics: insurance reforms, cost containment, expanding coverage, and the impact health reform legislation will have on deficit reduction.

Republicans are trying to figure out what they might gain or lose as a party before deciding if they should commit to the meeting, despite the claims that they were always willing to work on a bipartisan solution (so long as it meant merely their own baby steps approach). If they accept the offer, they would have to make the agonizing decision of actually committing to specific proposals that could be also criticized by the experts, media pundits, and the public.

Many Republicans of course are speaking out against participating, at least not until the Democrats agree to “start over” with a blank slate. As reported on msnbc on Feb. 8:

“If we are to reach a bipartisan consensus, the White House can start by shelving the current health spending bill,” said Senate Minority Leader Mitch McConnell, R-KY

But House Majority Leader Steny Hoyer, D-Md., said his earlier efforts to reach out to Republicans “did not result in any serious follow through to work together in a bipartisan fashion.” (click here).

According to New York Times editorial writer, Ross Douthat, on Feb 15 (click here), there is not much incentive to compromise. “…both sides believe they’re on the verge of a comprehensive victory. The Republicans are convinced they’re inches away from killing off a fundamentally misguided piece of legislation, and the White House believes it’s still this close to passing the centerpiece of its domestic agenda. In that environment, all the incentives favor posturing and finger-pointing, rather than serious negotiation.”

Further, as Douthat points out, the two sides define bipartisanship and compromise differently. If the Democrats want to pass A through F major health reform elements, the Republicans want to do A and B. So the Democrats see compromise and doing A through perhaps D. But the Republicans see it as doing just the A and B things that “all sides can agree on.” We’ll leave it to you to decide which approach sound like compromise or meeting the other side half way.

Many of course argue that the Democrats, by chucking the single payer idea and later, even emasculating the public option in the House bill and scrapping it in the Senate bill altogether, have already compromised significantly. Douthat, a conservative, spouts the usual criticisms about the Democrats’ overly regulatory solution, but also notes that the Republicans have to come up with something more than tort reform and interstate purchasing and show some real interest in covering and subsidizing the uninsured.

At least three substantially different Republican approaches have been offered up, making their own effort to coalesce around one of them just as difficult as what the Dems have had to go through:

(1) Senator Judd Gregg’s recent proposal (which resembles that reduced-sized box of soap in the grocery store that’s labeled “new and improved”). It mandates individual coverage but only a minimum catastrophic plan. Otherwise, as Jon Walker at the FireDogLake website notes, the plan is very similar to the Senate bill, suggesting he is trying to have Republicans claim credit for the same thing and that if they are so similar, then they should be able to work out a compromise. (click here).

(2) Rep. Paul Ryan’s “now for something completely different” proposal, that might please some economists but which the public would never tolerate. A key element’s of Ryan’s proposal is replacing Medicare for those now under age 55 with vouchers only adjusted to general cost-of-living increases, as well as similarly capping annual increases to the government’s subsidy for those who still do get Medicare.

(3) House Minority Leader Boehner’s proposed bill from last November, which the CBO said would hardly make a dent in covering the uninsured, not end pre-existing conditions restrictions by insurance companies, nor get Medicare costs under control, or much else.

We’ve pointed out the flaws in this before, but conservatives keep harping on one of their centerpiece ideas - supposedly reducing costs by increasing competition among insurance companies across state lines (due to less regulation by state insurance commissions). The Feb. 13 New York Times has yet another article on the pros and cons of the subject: (click here).