Time for president to lead

Hope for a bipartisan bill on comprehensive health-care reform appears all but dead. The time has come for President Obama, who has left many key details of reform to Congress, to actually take the lead on his top domestic policy initiative, one that the nation so desperately needs to succeed.

Congressional Republicans apparently have decided to put political gamesmanship above a genuine give and take, sensing that they can inflict a crippling political wound on the still-young administration. They don’t want to help Obama score a political win that could give him momentum on other issues, so they’re determined to stop him on health care reform, no matter what it looks like.

The last hope for compromise, a potential deal between Democratic and GOP negotiators on the Senate Finance Committee, looks to have hit a dead end, given recent statements by that committee’s top Republican, Charles Grassley of Iowa. Not only did Grassley decline in a town meeting to debunk misinformation about “death panels,” he said this week that he wouldn’t vote for a bill that didn’t have wide GOP support, even if it contained all the provisions he wanted. That sounds like someone toeing the party line, not someone motivated to make a deal.

But Republicans aren’t Obama’s only problem. He also faces a revolt from the far left of his own party, which has drawn a line in the sand over having a government-run insurance option — a provision unlikely to gain a filibuster-proof majority in the Senate.

A group of more than 50 House Democrats reportedly has demanded not only a public option, but one with reimbursement rates that aren’t negotiated with providers, but are based on Medicare rates dictated by Congress. But those rates already pay doctors and hospitals less than the cost of services. It’s especially bad in states like Washington, where rates are lower because of a flawed formula established years ago.

Democratic Rep. Rick Larsen, at his town hall meeting in Everett last week, correctly pointed out that such a plan would keep providers here from accepting patients on the public option, making it “no option at all.”

Details like this matter, and they need to be ironed out soon if reform is to pass this year.

The debate has become a spinout of claims by competing interests, fueled by politics, the complexity of health care and deliberate distortions. If the president wants to get health-care reform on track, he’s going to have to take the wheel.

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