Elmer Smith: Health care won't get fixed on TV

A YEAR of partisan wranglingwas condensed into six hours of political theater yesterday at the Blair House health-care summit.

Those of you who made it to the end were rewarded with a CliffNotes version of government in action, or was that inaction? If you expected the great compromise of 2010 to emerge from this scrum, you haven't been paying attention.

It was the first time many of us got to hear leaders of both parties in an open debate across the philosophical gulf that divides them. Give them credit. Even with the occasional sniping, there was more light than heat in this made-for-TV drama. It was, at times, revealing.

But it doesn't matter. Everybody at the square table and all of us who watched at home knew we were seeing the final act in this discordant opera.

They can sing their ecumenical hymns till their throats get sore. This is not about consensus. Republicans can whine about the tyranny of the majority. Democrats can grouse about Republican obstructionism.

But we don't care and they know it.

Republicans know that it doesn't matter if this thing passes in a budget reconciliation or if they all get in a circle and arm-wrestle over it. Democrats know that if it doesn't pass this year, the blame will fall squarely on their shoulders.

As it should. If we don't get health-care reform this year, it will be because the president and Democratic leaders failed. This is their fight to win or lose.

Democrats had the mandate and the majority to get this job done. It was their No. 1 domestic-policy priority. Now, it's time to deliver.

They have to cut the deficit while providing insurance to at least 30 million more Americans. They have to increase the number of healthy people in the pool and, at a minimum, cover every child in America.

Democrats have to produce a bill that enshrines the principle that health care is a right in America and that no one should face financial ruin for trying to get healthy or stay healthy.

Republicans don't have to do jack. They can and no doubt will increase their numbers in the midterm election by merely being against what is, even though they are part of what is.

If Democrats pass their plan without them, Republicans will win points by claiming that bipartisanship got kicked to the curb. If it doesn't pass, they can argue credibly that Democrats can't govern.

"The biggest danger for [Democrats] is to be perceived as ineffectual," U.S. Rep. Chaka Fattah told me this week.

"The ball is in our court. We have the second-largest majority either party has had in the last 39 years."

Fattah has been a longtime advocate of passing the reform through budget reconciliation. Reconciliation is a Senate process that allows legislation to pass with a simple majority and keeps the minority party from using the fillibuster to smother it to death in an endless barrage of verbiage.

Predictably, Senate Republican leader Mitch McConnell yesterday called on Democrats to "renounce ramming it through" by reconciliation.

But Republicans use it extensively when it suits their purpose. They used it in 1996 to end welfare as we know it. McConnell had no problem voting for that historic legislation when Republicans were "ramming it through."

A Republican-controlled Senate used it to create COBRA, which allows workers to retain employer-provided health plans for up to 18 months after they leave the job.

"Reconciliation is in the same part of the rules that allow fillibuster," Fattah said. "You can't be for one and not the other.

"They want us to throw our hand in. They want unilateral disarmament."

That's their issue. Ours is that health-care costs are bankrupting us and draining the national treasury.

Americans who are losing their health care by the thousands every day "don't want to hear about process," House Speaker Nancy Pelosi said yesterday.

"They want to hear about results."

Send e-mail to smithel@phillynews.com or call 215-854-2512. For recent columns: http://go.philly.com/smith.