Healthcare summit: paging Dr. Sutton

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It’s time to walk into the weeds a bit. We’ve hit the first discussion topic: cost containment. Sen. Tom Coburn (R-Okla.), a physician, is making a case for cost containment focused on preventive care and medical malpractice reform.

He is suggesting that healthcare costs could be shaved a third if more attention is paid to creating incentives for doctors to treat patients in a more proactive way, to limiting lawsuits, and to eliminating waste in Medicare.

He referenced the bank robber Willie Sutton, saying “Let’s go where the money is.” He also is advocating better nutrition for children, which is something that everyone in the room would be happy to agree on.

The tort-reform gambit was long expected. But the Democratic version of lawsuit reform in the current bills is not nearly as sweeping as what the Republicans desire. While many observers have suggested that Democrats could reach a compromise with Republicans on this issue, it would be unlikely to be as far-reaching as senators such as Coburn would like.

And it’s unlikely that such a deal, even if reached, would be sufficient to spur Republicans to support the overall legislation.

Obama countered by saying the Democratic bill is out to eliminate fraud and abuse in Medicare — in fact, the bill relies on those savings to help finance an expansion of coverage.

Rep. Steny H. Hoyer (D-Md.) agreed with Coburn that a third of healthcare dollars spent aren’t being used “efficiently.” And he agreed with Coburn, saying that the bill needs to focus on “wellness” not “sickness.” But now he has shifted the discussion from talking about costs to the healthcare system to costs to the individual, focusing on establishing larger insurance-purchasing pools, capping out-of-pocket expenses, eliminating discrimination for preexisting conditions, and closing the Medicare “doughnut” hole.

So, in a sense, Coburn and Hoyer are talking past each other. And we’ve had our first “public option” sighting — a phrase we thought was on the list of verboten topics today.

-- James Oliphant