AS THE schoolmaster-like moderator of the healthcare summit debate yesterday, President Barack Obama pleaded with ill-tempered congressmen to concentrate on areas of agreement, but to little effect.
Thirty-six men and five women spent six hours debating the most contentious issue in US politics across the street from the White House where the biggest novelty in the first hours of the gathering was a proposal from the Republican senator Tom Coburn for the deployment of “undercover patients” to reveal fraud in government-funded Medicare and Medicaid programmes.
For the most part, Democrats reiterated the iniquities of the present system while Republicans pleaded for competition, competition, competition as the best way to reduce healthcare costs which are twice as high as medical expenditure in other industrialised countries.
Political opponents fired barrages of statistics and poll results to justify their arguments.
Mr Obama recalled sitting in hospital emergency rooms thinking how lucky he was to have insurance when his daughters were ill. When his mother was dying from ovarian cancer she spent the last months of her life on the telephone in her hospital room arguing with insurance companies to reimburse her costs.
The Democratic representative from California, George Miller, provoked laughter when he expressed his good fortune at being covered by the congressional plan: “I have arthritis, a kidney stone and two hip replacements,” Mr Miller said. “In the private insurance market, I’m dead.”
Senate majority leader Harry Reid told how insurance companies refused to pay $90,000 (€66,000) for surgery on a cleft palate for a constituent’s newborn. “This shouldn’t happen to anyone in America. He had health insurance. He paid his premiums,” Senator Reid said.
Representative John Boehner, the House minority leader, made a point for the television cameras by sitting behind a stack of some 2,000 pages – the draft Senate Bill. Republicans harp on the sheer size of the Bill, but when Mr Obama published an 11-page proposal to bridge differences between Senate and House Bills on Monday, Mr Boehner said it was too short.
The Republicans chose Senator Lamar Alexander of Tennessee to make their opening statement. “We have to start by taking the current Bill and putting it on the shelf and starting from a clean sheet of paper,” Senator Alexander said.
By lowering the threshold where poor Americans become eligible for government-provided Medicaid, the Bill would “dump 15 to 18 million Americans into a Meidcaid programme that none of us would want to be a part of because 50 per cent of doctors won’t see new patients,” Senator Alexander said. “It’s like giving someone a ticket to a bus line where the buses only run half the time.”
The perfidy of Washington was a constant Republican refrain. “Our country is too big, too complicated, too decentralised for Washington . . . just to write a few rules about remaking 17 per cent of the economy all at once,” Senator Alexander said. “That sort of thinking works in the classroom but it doesn’t work very well in our big, complicated country.”
Mr Obama later chided Republican senator Jon Kyl for a similar statement, saying, “Any time the question is posed as ‘does Washington know better?’ We are tipping the scales because we all know people are pretty angry with Washington.”
Quoting Alexis de Tocqueville’s warning that “the greatest threat to American democracy would be the tyranny of the majority,” Senator Alexander demanded that Democrats renounce the idea of using a parliamentary procedure known as reconciliation “to run the healthcare Bill through the Senate like a freight train”.
It was widely assumed that Democrats will use reconciliation, which requires only a simple majority of 51 votes in the Senate, if yesterday’s summit fails. Mr Obama refused to exclude that option, saying the summit was meant to concentrate on finding points of agreement, not on process.
In one of several tense exchanges, former presidential candidate Senator John McCain said the draft Bill was “produced behind closed doors, with unsavoury deal-making – the ‘Louisiana purchase’, the ‘cornhusker kickback’, the carve-out for seniors in Florida”.
Senator McCain called on the president to “remove all the special deals for special interests and treat all Americans the same”.
The normally unflappable president grew slightly testy: “We are not campaigning anymore John,” he said. “The election is over.”