Republicans to Obama: We Have Better Idea on Health

President Barack Obama argued Thursday that a sweeping overhaul of the nation's broken healthcare system is imperative for the nation's future economic vitality, setting off an immediate clash in an extraordinary live-on-TV summit with Republicans who want far more modest changes. "We believe we have a better idea," retorted GOP Sen. Lamar Alexander.

With the daylong policy debate available from start to finish to a divided public, Obama and Democratic leaders cast the healthcare reform they want as critical to tackling an issue that's even more pressing to many Americans — the still-hurting economy.

After opening the summit with hugs and handshakes, Obama declared that even as politicians focus on propelling economic growth, they must also address "one of the biggest drags on our economy."

"We all know that this is urgent," he said.

Obama lamented the partisan bickering that has resulted in a stalemate over Democratic legislation to extend coverage to more than 30 million people who are now uninsured. "Politics I think ended up trumping practical common sense," he said.

And yet, even as he pleaded for cooperation — and "actually a discussion, and not just us trading talking points" — he acknowledged agreement may not be possible. "I don't know that those gaps can be bridged," Obama said. "If not, at least we will have better clarified for the American people what the debate is all about."

His skepticism was vindicated as soon as the first Republican spoke — in opposition to the mammoth bills that passed the House and Senate.

Alexander said Congress and the administration should start over with small steps including medical malpractice reform, allowing Americans to purchase insurance across state lines and expanding health savings accounts.

"Our views represent the views of a great many American people," he said.

With those opposing positions well staked out before the meeting and no signs of them changing, the president and his Democratic allies prepared to move on alone.

One option is passing a comprehensive plan without GOP support, by using Senate budget reconciliation rules that would disallow GOP filibusters.

Another is going smaller.

A month after the Massachusetts election that cost Democrats their Senate supermajority, the White House has developed a slimmed-down healthcare proposal so the president will know what the impact will be if he has to pull back in the new political environment, according to a Democratic official familiar with the discussions.

Before that, the Democrats are planning to move forward with a comprehensive plan without GOP support, barring surprise developments at the summit.

The official who described the slimmed-down fallback position spoke on condition of anonymity because the discussions were private. That official could not provide details, but Democrats have looked at approaches including expanding Medicaid and allowing children to stay on their parents' health plans until around age 26.

The slimmer backup plan was first reported by The Wall Street Journal.

At Thursday's summit, meanwhile, House Speaker Nancy Pelosi declared, "Inaction and incrementalism are simply unacceptable."

Obama himself hinted at a Democrats-only strategy. When asked by reporters as he walked to Blair House if he had a Plan B, he responded: "I've always got plans."