Loosing the late Ted Kennedy’s safe senate seat to the Republicans was an astounding shock to the Democrats, it suddenly torpedoed their supermajority in the upper house which allowed them until then to pass their bills and their other legislative initiatives relatively easily, it reflected very negatively on their fortunes.  During the upcoming mid term congressional election, it was also looked upon by many people as a kind of vote of confidence in the president himself, the way he was handling his job and his ability to cope with the glut of foreign and domestic problems he is facing, and one of the earliest casualties of the Democrat’s misfortune was the two health care reform bills the one in the House and the one in the Senate. Which had by that time and after a lot of efforts reached a stage when they had to be reconciled into one final version which would then go to the President for his signature.  But for the time being it had to go to the shelf only to emerge few weeks later as the main topic of the discussions in a meeting which was suggested by thePpresident, to be presided by him in the presence of the Democratic and Republican leaderships of congress plus few high officials from certain government departments which are concerned with health care reform, the President called the meeting he was convening, a summit.

Few days before the President’s inauguration in January 2009, I wrote in this blog that the moment the president is going to walk into the oval office he would be faced with a mountain of problems which were going to exert a great deal of pressure on him and his ability to deliver on the promises of change he repeatedly made during the Summer of the long presidential campaign.  The new President was young and very intelligent and seemed to be serious and honest about what he was talking about and one of the most important promises he made was that he would start very early on during his presidency with a very active attempt at reforming he country’s heath care system which he referred to as a very early priority and on top of his domestic agenda.  Many people shared this hope because of the many problems the system is facing and the sad state it had fallen into in spite of the hundreds of billons of dollars the country is pouring into, in fact it gulped in 2009 almost 16% of the country’s GDP and this is why the president made its reform one of his main priorities and started to work on it immediately after his inauguration, but he must have assumed that it was to be an easy task because of the big majorities of his own party the Democrats enjoyed in both Houses of Congress, but it was not an easy task, because by now almost a year in the exercise nothing has happened.

This is my second posting to the hanoudiletter on health care reform, the first was few months ago when the public debate started. P resident Obama told CBS in June, the status quo is untenable, our health care system is rife with skewed incentives, it gives us a whole bunch of care that may or may not be making us happier, it generates too many specialists and not enough primary care physicians, it is bankrupting families, bankrupting business and bankrupting our government a the state and federal levels, things are going to have to change.  In late July he said, obviously the system is not working too well for too many people and that we ought to be doing much better, the United States spends thousands of billions of dollars on providing health care and medical help to the people, but in spite of those hundreds of billions the system has become a black hole, this country spends more to get less than just about every other industrialized country.  The United States spends more than any other industrialized nations in medically preventable diseases yet it ranks 18 behind those countries.  So what is happening and why things are so bad in the health care system and why had it deteriorated into this moral and fiscal mess?

Change is imperative and urgent, but every thing else is negotiable, like, is the whole system going to be tackled at once or is it going to be done step by step?  What is the nature and degree of the reforms which have to be introduced?  How are these changes going to be financed?  All these questions and many others are open to discussion that is why a debate about them is necessary, but the debate has to be conducted in an objective and a civilized way and not in anger or violently which was not the case, because the debates which were going at the grassroots were held in town houses in the presence of members of congress which was in a recess during the summer months.  These discussions were very often tense and heated which did not augur well for the future of the reform at any rate the real and more serious debate moved to Washington when congress returned to the capital after its summer recess and started to grapple with the problem of health care reform an exercise which lasted for almost a year at the end of which there were two bills from each house, which needed to be reconciled with each other into one approved by the two chambers.  Then needed the President’s signature to enact into law, but the special election in Massachusetts on the 19th of January turned every thing upside down.

The problem which is making it so difficult to reach an acceptable solution to the plethora of maladies, which are pervading the health care system is in fact the suffocating and serious polarization of the political and cultural environment of this society.  The Democrats in Congress were treating the issue as something which belongs to them and their party, they emboldened by the robust majorities the had in both the senate and the house which encouraged them to sort of neglect the other main party-the Republicans- who in their turn raised a very strong wall of opposition to practically every move the Democrats undertake, but they were still able on the eve of last Christmas to pass their bill which opened the way to recon ciliate it with the slightly smaller house bill which has also been endorsed few days earlier which would open the way to send a unified bill to the president for his signature.  But Massachusetts changed the whole rules of the game and for the next few days they were so stunned with the enormity of their loss they seemed to be unable to decide on what to next, the health reform work was put on the shelf but before the end of the week the president started talking about the problems of the economy which was in an worse shape than the health care system and the need to do something urgent about which should be dealt with in a bipartisan effort.  On January 29, he met with few Republican legislators from the house in Baltimore to try reach a consensus, but the meeting didn’t seem to break the logjam so few days later he came out with the idea of a summit.

The meeting the President was suggesting was to be a 6 hours televised exercise on Thursday February 25, when 20 Democrats face 17 Republicans all of them would be chosen from the leaderships of both parties in congress plus four senior officials from departments which have jurisdiction on the topic under discussion.  During the meeting the President would be challenging the two parties to reach a consensus on health care reform to open the way for solving a problem which has defied the efforts of a lot of people for almost half a century.  The summit started at 10 AM in Blair house across the street from the White House, but the omens were not very encouraging.  It was a day long nationally televised affair a 7 hour and 15 minutes show which ended without a deal to break the impasse between the two parties.  Mr. Obama outlined his reform plan but Republicans said it was not acceptable and called for a fresh start.  The president and his allies want to expand health coverage to include millions of uninsured Americans. The Republicans said it was "pretty clear" that Democrats and Mr. Obama wanted to revive the healthcare bill passed by the Senate last December but now stalled in Congress.

After the recent special Massachusetts elections and the loss of the critical senate seat I said, What is Next.  This time the question is, what was the real purpose of the summit and what is next?

Najeeb Hanoudi
Friday, February 26, 2009
Southfied/Michigan
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