President Obama has sounded the train whistle signaling that health care reform is his fast-moving vehicle.  A new, revised bill will be attached to the annual budget reconciliation measure, which requires a simple majority vote for passage.  After his healthcare summit, the President urged Congress to “finish its work” and vote on a new revision of comprehensive health care legislation.  In an effort to include Republican ideas, the bill will include state grants for medical-malpractice reform, and measures to curb waste in Medicare.  Senate Democrats will send the revised measure to the Congressional Budget Office for a cost estimate that will be presented to the public.

Yet, politicos and politicians are saying that health care reform via “reconciliation” is not in the best interest of voters. They are focused on the process, rather than on the policy.

Here’s a brief history of reconciliation: Since 1982, major changes to the health care laws have been passed through the budget reconciliation process.  It’s a good provision that was designed to keep spending and taxes within the parameters of the budget blueprint, a task made easier by an expedited process that prohibits filibusters and limits debates to 20 hours. This change also had the effect of lowering the threshold for action from the 60 votes necessary to close debate to a simple majority.

Key measures that have changed health care laws through reconciliation bills are: the 1985 Consolidated Budget Reconciliation Act (COBRA), which allowed laid-off workers to continue their employer-sponsored coverage; and the Budget Act of 1997, which created the Children’s Health Insurance Reform.  In fact, 17 of 22 bills passed under the reconciliation process have been pushed by a Republican-controlled Congress or under a Republican President.  In 1996, reconciliation was used to enact other sweeping welfare reform via the Republicans’ Contract with America.  Again, in 2001 and 2003, Republicans used reconciliation to pass President Bush’s tax cuts.  So, there is a precedent.  In fact, what is in play in the basic notion that majority rules.

Soon, the Senate leadership will pass another bill by inserting it into the text of the budget reconciliation bill. This tactic is a legitimate alternative to the standard rules for lengthy debate time, disabling filibusters and the 60-vote threshold for action.  .

There also is a pesky notion that Congress has been rushing and that reform is being jammed down America’s (and industry’s) throats.  Here is the true story: In 2008 and 2009, the Senate Health, Education, Labor, and Pension Committee held 14 bipartisan  roundtables, 13 hearings and 20 walkthroughs.  In June and July of 2009, the committee spent 13 days and more than 56 hours marking up health care legislation.  Further, the Senate Finance Committee held over 50 meetings and 17 roundtables, summits, and hearings.  Even with that said, some folks cry about unfairness to the minority in Congress.  No need to feel bitter or rushed anymore: this process has been a thoughtful one.  And with regard to the fear of a “federal takeover of health care,” the proposal is actually not a government-run program, but a state-run health insurance exchange.  It will create choice and competition in health care.

The truths are out there.  The government is not a monster designed to squash our liberties.  Perhaps with an understanding of the legislative process, voters might become more engaged, willing to promote positive policy ideas and less fearful of or angry about change.

As for health care reform, the majority in Congress supports it, they have worked on developing ideas with the public for a year or more, the President has put his name on the overhaul, and with a simple majority vote in both bodies, a bill will be enacted and signed into law.  While it’s not the most streamlined bill, and while it does not provide a public option, these are the rules, just as we had them under the Republican majority.  So, let’s play by them:  know what the substantive issues are at play by reading, listening and talking to the sources.

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The path to enacting significant legislative measures in the Congress has become a war of words.  Let’s be honest, the American people are at risk with political logjam.  We are facing tough economic times and look to leaders to offer creative and results-oriented ideas to the electorate.  We have needed a decisive march to the end goal of making government work for the people through a demonstrative series of compromises.  After all, the political system establishes a majority and a minority so that parties will work together.  This means that our legislators and the voters must be deeply engaged, responsive and understood.

The President’s health care summit at the Blair House in Washington sought to step aside the war of words, roadblocks and ideally break the barriers that have stalled comprehensive health care reform.  We heard a lot from our officials in DC…repeated critical mantras outside the scope of the agenda, budgetary inaccuracies, a sense of urgency and hope, and a repeated attempt to deconstruct criticisms.  While I was impressed with the smarts of the President and Senator Tom Coburn (R-OK), it was clear that Sens. Lamar Alexander (R-TN) or Mitch McConnell (R-KY), John Barrasso (R-WY), as well as Reps. John Boehner (R-OH) and Paul Ryan (R-WI) wanted to stage a political theater featuring a “broken government,” a “federal takeover” of health care, and ultimately a lack of urgency to reform health care.

As a former congressional staffer, I spent many late nights drumming up talking points, stump speeches and message pieces.  I drafted them to advocate for key ideas and to be a supportive player with like-minded colleagues on the issues.  I understood it as a tool to identify a position and stand by it.  Now, I see it as a way to engage beyond emphasis, but a tool to propagandize important concepts that stall movement.  The President asked for a conversation before the American people and got a lot of red-faced speakers using the technique of argumentum ad nauseam.  With the cameras rolling, the invitees took their sides and used continuous repetition so that media outlets can replay it for the American people to accept as fact.  Advocating for legislation has grown from mere emphasis of subtle concepts to flashing headlines, bold bylines, and ultimately a real fear spreading among concerned voters who are not deeply engaged in the dialogue.

The summit was widely known as a last-ditch effort by the President to place his leadership stamp on health care reform.  Reform means change.  Voters must understand what stake they have in the process and what is at issue for them.  That is why a televised working summit was a smart idea. Let’s see what happened

The Republicans and the health care industry as a band of bad boy opponents have sought to trap the President in an impasse.  In making opening remarks, Senator Alexander likened the health care bill to a “car that can’t be recalled and fixed and we ought to start over.”  Kudos go to the legislative aide from Tennessee for selecting the car analogy.  It sounds appropriate given the current problems with Toyota, but it does not add to the discussion one bit.  In fact, I find it frustrating and am sure many others do too.  The President duly offered that the Senator was entitled to his own opinions, but not to his own facts.  The President was gracious to appreciate the Senator’s time and also smart to isolate the reality that there is really one set of facts regarding the health care issues.  By doing so, this should have kept the momentum moving forward.  However, more finger pointing opened the door to more criticisms.  The President offered the only reasonable response possible that going “through a list of things they don’t like” won’t get much done.  The notion of hammering the negative only sends a message of animosity and unwillingness to stand for any reform.

The President defended the transparency of talks by letting Senator John McCain (R-AZ) know that they are no longer campaigning and it’s time to stop stumping a straight talk speech at the summit.  As the Republican rival in the 2008 presidential race, McCain told the President that the bill was flawed with “deal-making,” a stand against special interests.  The Senator knows that compromise does not come with the wave of a magical legislative fairy’s wand.  It requires sitting down and hashing out important differences and outlining ideas that they can agree on.  The President let McCain know that “the election is over.” And McCain said “I’m reminded of that every day.”  I wish McCain had articulated a positive proposal, a hint toward reform, or anything other than a total shutdown.  McCain could have offered a serious exchange on the legislative ideas.  Now that is the straight talk I want to hear.

I won’t rehash the whole set of various talking points from the summit for you.  You can watch a feed on the White House’s website or even CNN without interruptions.  If you have not, I encourage you, and then let me know what dialogue you expect from our leaders.  The summit exposed the spectrum of dialogue—impassioned off-key talking points, speeches, and some real exchange of ideas to agree upon in a reform package.  The President stated his intent to discuss an agenda of reform, to see what officials can agree on and where to move forward on those differing ideas.  To me, that is deliberative good work.  I learned a lot in the working session about the Congressional Budget Office scoring, proposed cost increases, and Medicare Advantage.  I do not support “jamming (the bill) through on..a partisan vote” as Senator Alexander rejected in his opening statement.   But, there have been many opportunities to make a stand for being a team player and real actor in reforming our flawed system of health care.  That is why there will likely be no scrapping the measures backed by the President and the Majority to start over.  This move would reward road-blockers, validate the effect of pesky sound bites that scare seniors, and wind the debate in a dead end once again.

I say it is time to take a giant leap toward the passing the bill in the annual reconciliation measure that requires a simple majority vote.  Congress will have some work to secure that vote, but that is why the Majority earned its position and leadership.  The President wanted to clarify for the American people what the debate is all about.  Negative talking points get in the way.  The gaps toward change were exposed to show that talking points for serious election-year politicking does not lead to common ground.  An attempt was made to have a discussion actually a discussion and not just trading talking points. Now is the time that the legislators enact health care changes.  I am ready to move past words and see some action!

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