Healthcare summit: five questions

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The healthcare summit at Blair House in Washington is beginning. (Can you feel the rotation of the Earth slowing?) The parties, the president, Democratic and Republican members of Congress, their staffs, are taking their places in a room that suspiciously resembles a conference room at airport hotel. We have six hours to go — a break for lunch notwithstanding. (The lunch is buffet-style, which allows for individual choice. No big-government mandates here.) But what should viewers expect? And what should they be looking for? Here are some questions that demand answers. And as they say in D.C., this is for guidance purposes only: 1. Will these be real negotiations or is this Kabuki theater?

Here’s the most important point: None of this is new. Despite the assertion by the White House and Democrats that this summit marks a new phase of the healthcare debate, the bulk of the ideas have been around since last year. The players have been talking (or not talking as the case may be) for as long as a year. Even the plan set forth by Obama earlier this week is largely a rehash of the bills that have already passed the House and Senate (insurance exchanges, expanded Medicaid, protecting consumers with preexisting conditions) — and the Republican concepts (tort reform, selling insurance across state lines) aren’t fresh either.

2.What kind of deal could be struck?

Remember, none of this binding. Even if both sides were to make concessions — which is highly unlikely — there would be no formal commitment to act on them. In fact, multiple stories in the media today suggest that Democrats are already looking past this summit to final negotiations on the Hill as to what the ultimate package will entail. Moreover, the members in the room, especially the Republicans, aren’t moderate deal-makers. Sen. Olympia Snowe (R-Maine) was not invited. Instead, they’re the ones who can make the GOP case to the American people that Congress needs to start over on healthcare. Hard to strike a deal, by the way, if that’s the starting point.

3. Is this about winning? Isn’t everything in Washington? Here’s the thing: It’s possible both sides can walk away with what they’re looking for — which isn’t always the same as winning, of course. Obama and the Democrats are hoping to make a better case for reform than they have in the last eight months and paint the Republicans as lacking concrete ideas. Republicans are hoping that the continued focus on healthcare as the economy struggles will further the Democrats’ downward slide in popularity among voters. 4. Who has more to lose?

You could argue the Democrats, because the GOP doesn’t have that much at stake. If a bill ends up passing, the Republicans hope to use it as a millstone around the necks of Democratic candidates in this year’s congressional elections. Democrats, on the other hand, have invested so much in this bill, and in this process, that failure doesn’t seem to be a desirable option. Indeed, the White House has convinced Democrats on the Hill that, politically, not passing a bill at this point would be worse than passing one.

5.What’s the endgame? For Republicans, it’s simple. Paint the president’s plan as a big-government takeover that will bankrupt the country. (Expect the 2,000-word bill to be dropped with a thud on the table early on.) Democrats and the president need to convince a skeptical public that not only is an overhaul bill necessary — and that it won’t explode the deficit - but that they should be entitled to ram part of the bill through the Senate using the reconciliation process, which requires a simple majority vote, rather than with 60 votes. -- James Oliphant