DonkeySmall It appears clear after last week's health care summit that President Obama and his fellow Democrats have no choice but to go it alone if they want to pass a reform bill anytime soon, no matter how bad the current proposal might be.

This is sure one lousy way to make policy, especially since it involves one of the biggest and fastest-growing segments of our economy. But with Republicans working to stall and then kill any effort at reform since the debate first began, what did they expect?

Perhaps they thought the Democrats, spineless and fragmented, would grow discouraged and give up. If so, they may yet be right. But I don't believe they will. The Democrats are too close to give up now, and have gone too far to go home empty-handed.

The Republicans played their part in last week's televised charade perfectly. President Obama's goal in convening the summit was to demonstrate to the American public that Republicans really have no interest in crafting a comprehensive bill that will make sure everyone has health insurance coverage. That's exactly what the summit showed.

Some Republicans, such as sore loser John McCain, fixated on the flawed process that produced the current House and Senate measures, decrying the lack of transparency in crafting the legislation and blasting the special deals cut to secure enough votes for passage.

Others focused on meaningless side issues, such as the length of the bill, going so far as to have a copy stacked high on their desk as a "prop."

Outside the Beltway, most people don't care about these issues. They care about getting coverage if they don't have it, keeping it if they do, and forcing down the costs to make it affordable for all.

That's why it was both sad and shocking to hear so many blindly insist the system is not irreparably broken, despite the fact that tens of millions are already uninsured, and that those who have coverage are an illness or layoff away from losing their policies.

Republicans also harped on the need for cost control, but they have little credibility in this area. After all, when they passed the Medicare prescription drug coverage bill, they refused to allow Uncle Sam to leverage the government's considerable buying power to negotiate for lower prices, or to allow importation of cheaper alternatives from Canada.

Indeed, their version of "cost control" was to leave behind a devastating donut hole--a gap right in the middle of coverage that many seniors could not get past, forcing many either to spend considerable sums from their own pockets or go without needed medicines for catastrophic or chronic conditions.

Bottom line, the Obama summit spotlighted the fundamental difference between the parties on health reform--with the Democrats seeing universal care as a right, and the Republicans seeing it as a privilege.

Despite calls for bipartisanship, it isn't clear there is any room to compromise when one party insists we need fundamental, comprehensive reform and the other party insists the opposite. Where do you go from there?

Still, going the reconciliation route--in which the House will grudgingly adopt the Senate's version (without a public option), after which the Senate will make slight changes to its measure by a simple majority vote--is very risky. I can't recall any major piece of legislation passing Congress with absolutely no support from the opposing party.

But the Democrats are caught between a rock and a hard place. If they fold their tents and fail to force through a bill, they will be lambasted for wasting more than a year of time and all of President Obama's political capital on a dead-end. Plus it's unlikely we'd see another attempt at comprehensive reform for one or even two decades.

Yet if they do ram a bill through without any Republican support, and the public doesn't care for the new law (mainly, forcing people to buy coverage from the private carriers they all mistrust, if not detest), Democrats could very well be run out of town come November, handing control of Congress back to the Republicans.

It's not a pretty choice. But I believe this is the road they will travel. They will pass a bill one way or another in the next couple of months, for better or worse.

How do you folks think this all turn out?

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Democrats Will Ram Through Health Reform Bill

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