America's health reform A waste of breath

IT IS tempting to dismiss the bipartisan health-reform summit convened by Barack Obama on Thursday February 25th as a colossal waste of time. After all, the gabfest involving senior Congressional leaders from both parties lasted well over six hours, with no tangible results. Neither side moved one jot on any issue of substance and not one vote is likely to have changed on either side as a result of the summit.
And yet, the televised gathering was not pointless. For one thing, the sight of America's leading politicians sitting together amiably for an entire day to discuss a matter as inflammatory as health reform (think "death panels") was itself heartening. Surprisingly, given the bitter partisan wrangling of late, they did so in a manner that was mostly civil and substantive. Towards the end of the long day, Joe Barton, a House Republican from Texas, even declared that he had never seen "so many members of the House and Senate behave so well for so long before so many television cameras."
From the Republican point of view, the event accomplished two important things. First, Mr Obama was unable to outwit and outcharm them on camera, as he had done brilliantly during a televised exchange with House Republicans in late January. Mitch McConnell and John Boehner, their stridently partisan leaders in the Senate and the House, wisely allowed other Republicans —more charismatic and competent, it must be noted—to do most of the talking. That allowed them to say no to Mr Obama's plans without appearing, as is often the accusation with Republicans, merely the "Party of No". Mr McConnell even admitted afterwards that "I would not call it a waste of time."

The event went less well for Mr Obama. After a year of dithering, he unveiled his own grand plan for reforming health care on the eve of the summit. This scheme closely resembles a health-reform bill passed by the Senate just before Christmas (the House passed a substantially different version earlier, and the two bills now need to be reconciled into a final health law). The big question before the summit was whether Mr Obama would really be open to modifying his plan to embrace Republican ideas, or whether the event was merely a sham.
In the event, Mr Obama appeared to make some progress on bipartisanship. He listened intently to Republican ideas—except the oft-repeated one to scrap Democratic efforts and just "start over"—and was often seen scribbling notes. At the end of the summit, he reviewed a number of areas where he believed the two parties had similar goals, and he asked the Republicans to think of ways to bridge the divide on them. Among those ripe for co-operation, he declared, were tort reform, inter-state competition in health insurance, the creation of insurance exchanges and tackling fraud in Medicare (a government health scheme for the elderly).
This is not likely to herald the start of a new, incremental and heart-warmingly bipartisan approach to health reform, however. For one thing, Republicans made it clear that they are not willing to do anything to help Mr Obama pass health reform quickly. Mr Obama, for his part, made plain that he was willing to entertain Republican notions only as add-ons to his existing bill, not as an entirely new approach.
Rumours swirled during the summit that if Mr Obama's big plan (which aims to extend health insurance to some 30m uninsured punters) fails to pass, he may then put forward a less ambitious scheme covering only half that number. But Kathleen Sebelius, the administration's health secretary, denied this after the summit. Mr Obama himself rejected the incremental approach. He insisted, with some justification, that "baby steps" will not work because the pieces of the health-reform puzzle are tightly interlinked.
If so, that leaves Mr Obama with only one course of action: to push through some version of his health plan without Republican votes. It will be very difficult with only Democratic votes, given that moderates and progressives in his own caucus have misgivings. Ramming a sweeping health law through Congress on a highly partisan basis using procedural wheezes, Republicans repeatedly warned, will prove unpopular. Despite those obstacles, though, Mr Obama now seems ready for battle.
That points to the biggest reason to think the summit was not a waste of time: it made clear that Mr Obama, after months of sitting on the sidelines, now has steel in his spine. If Republicans do not come up with a reasonable set of compromise measures over the next few weeks to add to his plan, he says that he intends to forge ahead anyway. The final verdict, he insisted, will come from the voters: "We've got to go ahead and make some decisions, and then that's what elections are for."