Highlights of the White House health care summit

The White House health care summit included breakout sessions where lawmakers and stakeholders in the health care debate explored ways to expand coverage to uninsured Americans and rein in spiraling medical costs. Highlights of the discussions in each session:

Moderator Nancy-Ann DeParle, selected Monday to lead the White House Office for Health Reform, opened her session by acknowledging her status as a newcomer, telling the group: "I showed up about 10 minutes ago, so if I seem a little dazed and confused, you'll know why."

Then she set a goal for the group of a dozen lawmakers and representatives from medical organizations, advocacy groups and business interests that gathered around a conference table in the Eisenhower Executive Office Building: "It would be great if all of us could walk out of this room feeling like partners."

The 90-minute session was amicable enough that the group largely succeeded at that, prompting Rep. Jim Cooper, D-Tenn., to speculate that the cordial discussion might make people "wonder why health reform is so hard."

But the group also skimmed across a range of thorny problems that made clear how difficult it will be to reform the system. Among the problems they discussed: disparities in the costs of health care around the country, soaring medical malpractice costs, the high costs of health insurance, uneven standards of care, huge costs for prescription drugs, shortages of medical professionals.

From all sides - Republican, Democrat, business, labor, and others - came the vow that the health care problem now is too huge for the reform effort to end in failure again, as happened when President Bill Clinton attempted sweeping reforms in the early 1990s.

"There is tremendous urgency to this time get it right," said Nancy Nielsen, president of the American Medical Association.

There was a healthy dose of pragmatism in the room as well.

"Every president comes into office thinking that he or she has got a mandate and they're going to do great things," said Rep. Joe Barton, R-Texas. "... The president said the status quo isn't going to win this time. I hope he's right, but some of us have been around tables ... where the status quo did win."

- By Nancy Benac

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Participants meeting in the White House State Dining Room agreed on the importance of prevention, but they disagreed on whether the government should offer a health insurance plan for middle-class families to compete with private insurers.

There were no objections to requiring everyone to get health insurance: through an employer, a government program, or on their own. As a candidate, Obama opposed such a mandate, except for children. He argued it would be too costly.

How to pay to extend health care coverage to all - a cost that could exceed $1 trillion over 10 years - left participants scratching their heads. Someone suggested tobacco taxes, for starters.

Sen. Orrin Hatch, R-Utah, urged everyone in the room to pray for his colleague, Sen. Edward Kennedy, D-Mass., who is under treatment for brain cancer. Kennedy is seen as a key player in getting Democratic-leaning interest groups, from unions to liberal advocacy groups, to agree to a health care compromise bill.

"I pray for him every day," said Hatch. "We need that type of leadership on both sides every day."

Eleven of the 20 participants were members of Congress. The others represented business, patients, unions, insurers, and hospitals.

Ken Powell, CEO of General Mills, came with an idea that generated interest. His company offers several preventive coverage packages, tailored specifically to people with one of four conditions: asthma, diabetes, cardiovascular problems and back pain.

Such innovations are part of the reason why any health care overhaul should respect the role of employers, said Powell.

"We think we're good at it," he said.

- By Ricardo Alonso-Zaldivar

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In one of four sessions in the Eisenhower Executive Office Building, Sen. Ron Wyden, D-Oregon, said the administration must find ways to reduce federal spending on health care procedures that have "little or no value." If not, the American people will not trust ideas to spend more for expanded health care coverage.

"We're spending enough on health care. We're just not spending it in the right places," Wyden said.

Wyden also urged elimination of tax breaks for the wealthy who have "high-perk" health plans that cover unique procedures, including cosmetic work. He claimed ending the tax breaks would generate as much as $250 billion.

But several others at the breakout session he attended disagreed, with some doubting many of those plans existed and others saying current health plans shouldn't be punished.

Donna Shalala, who served for eight years as President Bill Clinton's health and human services secretary, said greater health care savings can be found with a new system for paying doctors, who now receive more if they perform more procedures.

The country must shift to a system focusing on results based on broad treatment of the patient, to help make care affordable, she said.

Obama won't see resistance on health care reform from big and small businesses, U.S. Chamber of Commerce President Thomas Donahue said. "There is a vigorous understanding within all parties that improvements are needed," he said.

But Donahue cautioned that reducing health care costs and limiting procedures will leave a hole in the economy from business lost. "We should think what else we're going to put back in there," he said.

- By Brett Blackledge

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Participants in another executive office building session agreed that action must be taken now to make health care better and cheaper for more Americans. But glaring differences in philosophy and approach quickly emerged.

Some liberals focused on the uninsured and chastised insurance companies and drug makers.

"It is insane that 56 million Americans today do not have access to a doctor," declared Sen. Bernie Sanders, I-Vt., using a figure cited by the National Association of Community Health Centers.

Republicans talked up the need for more competition.

"Competition does work. It makes everything better," said Rep. Roy Blunt, R-Mo. He said he feared that giving people the option of a government insurance plan - something President Barack Obama has proposed - would reduce competition.

Moderator Ezekiel Emanuel, a physician and the brother of White House chief of staff Rahm Emanuel, noted the agreement on the need to cut costs and make health care more efficient. But, he asked, how do we do that?

Several people started talking at once, all saying different things.

Jeff Kindler, head of Pfizer Inc., suggested making more health data public so that people could make more informed choices. That seemed like a good idea to many in the room.

But when Emanuel asked whether the government should pay to collect the data, the consensus dissolved, with Democrats saying yes and Republicans demurring.

Among those in the room was Chip Kahn, who now heads the Federation of American Hospitals. During former President Bill Clinton's first term, Kahn was a key staffer with the Health Insurance Association of America and helped conceive the "Harry and Louise" ads that contributed to the failure of Clinton's health reform initiative.

Emanuel had one question for Kahn: "Are you going to run an ad? That's what we really want to know."

Kahn didn't answer that question but said that his group, which represents for-profit hospitals, was ready to play a positive role in health care reform.

- By Erica Werner

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President Barack Obama's budget chief, Peter Orszag, told another session in the Eisenhower Executive Office Building that cutting the growth rate of health care spending is the key to reform.

To illustrate his point, Orszag said that if officials could cut the growth rate by one percentage point each year, they would have saved the entire cost of running the federal government by 2050.

"Do not discount even the small changes in growth rate. That is the entire ball game," he said.

Democratic Sen. Tom Harkin of Iowa repeated his complaint that the country lacks a health care system, only a "sick care system" that doesn't do enough to focus on prevention. Democratic Sen. Barbara Mikulski of Maryland seized on that point, arguing that the discussion should be broadened beyond health care procedures to include making the country healthier, so fewer procedures would be needed.

Eric Cantor, the No. 2 Republican leader in the House, reminded those in the room that their ideas have to be paid for.

"The dose of reality is what can we afford, especially given the economic times that we're in," Cantor said. He said the focus should be on existing programs rather than creating new ones.

Joe Hansen of the United Food and Commercial Workers International Union cautioned against making the issue political: "If we stick with ideology here, we're doomed. We'll never get anything done."

Dan Danner of the National Federation of Independent Business, which opposed earlier government health plans, joined in the call for apolitical solutions: "The status quo is no longer acceptable."

--By Associated Press writer Philip Elliott.