The White House Health Care Summit has concluded. Unsurprisingly, Republicans continued to hit on tort reform as the way to lower our health care costs all afternoon. And they continued to be wrong. But a few more themes came up that are worth debunking.

First, Republicans kept insisting that if only average Americans had more "skin in the game" when it came to health care costs, those costs would go down. In particular, they tout health savings accounts as a solution.

In reality, health savings accounts are junk insurance, nothing but insurance company sponsored scams, good for the rich, like the Republican Members of Congress at the summit, but not for the rest of us:

Health savings accounts by definition favor the wealthy and/or the healthy. For those that never go to the doctor, or who can afford the high out-of-pocket costs incurred when using health savings accounts (you need to pay $1,050 as an individual or $2,100 for a family before your insurance will cover the rest), health savings accounts are great. Wealthy and/or healthy individuals can put a bit of money away, tax free, into their health savings account and then draw from it to pay their astronomical out-of-pocket costs when they decide to go see a doctor. If you're healthy, the doctor's visit doesn't happen very often. If you're wealthy, who cares if it happens very often, you can afford it.

For the rest of us, however, health savings accounts don't work. If we get sick and see the doctor often, we have to pay those huge costs often; that means we have to save a lot of money in that health savings account. For those on fixed incomes, or even those just barely scraping by (and that's a lot of us in today's economic climate), putting away even $4,000 in a health savings account is out of the question. Health savings accounts don't work for the same reason tax credits don't work: Those who don't have a lot of cash to save are forced to put away money they don't have a bit at a time to pay for their care. With tax credits, they get repaid at the end of the year. With health savings accounts, they don't pay taxes on that money. But either way, they need to save over the course of a year to get that payoff. For a lot of folks, this just isn't a realistic option - there's simply nothing to spare.

As the President pointed out, Republicans might feel differently about health savings accounts if they made $40,000 per year instead of the hundreds of thousands they make as Members of Congress.

Another perpetual Republican talking point was the wonders that would occur if only we could buy insurance across state lines.

In the Republican fantasy land, consumers would be able to buy cheaper or better insurance from another state. Here's what reality would look like:

Insurance is currently regulated by states. California, for instance, says all insurers have to cover treatments for lead poisoning, while other states let insurers decide whether to cover lead poisoning, and leaves lead poisoning coverage — or its absence — as a surprise for customers who find that they have lead poisoning. Here's a list (pdf) of which states mandate which treatments.

The result of this is that an Alabama plan can't be sold in, say, Oregon, because the Alabama plan doesn't conform to Oregon's regulations. A lot of liberals want that to change: It makes more sense, they say, for insurance to be regulated by the federal government. That way the product is standard across all the states.

Conservatives want the opposite: They want insurers to be able to cluster in one state, follow that state's regulations and sell the product to everyone in the country. In practice, that means we will have a single national insurance standard. But that standard will be decided by South Dakota. Or, if South Dakota doesn't give the insurers the freedom they want, it'll be decided by Wyoming. Or whoever.

This is exactly what happened in the credit card industry, which is regulated in accordance with conservative wishes. In 1980, Bill Janklow, the governor of South Dakota, made a deal with Citibank: If Citibank would move its credit card business to South Dakota, the governor would literally let Citibank write South Dakota's credit card regulations. You can read Janklow's recollections of the pact here.

Citibank wrote an absurdly pro-credit card law, the legislature passed it, and soon all the credit card companies were heading to South Dakota. And that's exactly what would happen with health-care insurance. The industry would put its money into buying the legislature of a small, conservative, economically depressed state. The deal would be simple: Let us write the regulations and we'll bring thousands of jobs and lots of tax dollars to you. Someone will take it. The result will be an uncommonly tiny legislature in an uncommonly small state that answers to an uncommonly conservative electorate that will decide what insurance will look like for the rest of the nation.

It's a race to the bottom, selling our health to the lowest insurance company bidder. It's not a solution that makes us more healthy or lowers our cost - CBO said selling insurance across state lines wouldn't expand coverage at all and would only save $12 billion over 10 years, a fraction of what real health care reform would save.

Finally, Republicans continually made the point that the American public doesn't want health reform. As Nancy Pelosi said, there have been so many lies about the health care bills, it's a wonder anyone likes them. And it's important to stand up for popular things - like a public option - to make it better. But that doesn't mean the American people don't want reform.

By huge majorities, they want the major parts of health reform, and they want Congress to plow ahead and pass a good bill:

The latest Kaiser Health Tracking Poll is only the latest in a series showing the elements of health reform are popular:

Other parts of reform are really popular too, like the public option.

And majorities want comprehensive health reform passed:

And even more will be disappointed or angry if reform doesn't pass:

The Republicans didn't bring a plan to the summit today. Instead, they brought stale, easily-debunked talking points. They tried to prove that giving good health care to Americans was a bad idea, but they failed. And in the end, they resorted to the same slogans they've been repeating for a year now - start over, blank slate, incremental reform.

We've heard from the other side and found they have no plan to solve the greatest problem facing the nation. Now it's time to finish the job and finish it right.

The morning portion of the White House health care summit is over. From Republicans, who refused to bring a unified health care plan to the summit because they don't believe in a comprehensive health care solution, we heard lots of talk on a few main themes.

Multiple Republican attendees, Senator Lamar Alexander chief among them, alleged that the Democratic health care plan would raise insurance costs for people. This is the same thing the insurance industry claimed in their widely-discredited report after the Senate Finance Committee passed their bill.

Alexander and other Republicans repeating the talking point are wrong. Ezra Klein fact-checks the issue:

Yes, the CBO found health-care reform would reduce premiums. The issue gets confused because it also found that access to subsidies would encourage people to buy more comprehensive insurance, which would mean that the value of their insurance would be higher after reform than before it. But that's not the same as insurance becoming more expensive: The fact that I could buy a nicer car after getting a better job suggests that cars are becoming pricier. The bottom line is that if you're comparing two plans that are exactly the same, costs go down after reform.

You can find a full rundown of the report here.

The Wall Street Journal agrees, and here's some more from Ezra from 2009.

And guess what. The health care plans Republicans have proposed in the past would raise premiums for those of us who are sick, and lower premiums for others only because the coverage would be worse.

Democratic plans would lower costs and give better coverage, Republican plans would do the opposite. I hope we can put this false talking point to rest.

Next, almost every Republican speaker mentioned tort reform as a solution to the health care crisis. They couldn't be more wrong. Multiple studies and CBO scores have shown that tort reform would make only a small dent in health care costs, if at all.

The Washington Independent has a great rundown of the issue:

Annual jury awards and legal settlements involving doctors amounts to “a drop in the bucket” in a country that spends $2.3 trillion annually on health care, Amitabh Chandra, another Harvard University economist, recently told Bloomberg News. Chandra estimated the cost of jury awards at about $12 per person in the U.S., or about $3.6 billion. Insurer WellPoint Inc. has also said that liability awards are not what’s driving premiums.

And a 2004 report by the Congressional Budget Office said medical malpractice makes up only 2 percent of U.S. health spending. Even “significant reductions” would do little to curb health-care expenses, it concluded.

A study by Bloomberg also found that the proportion of medical malpractice verdicts among the top jury awards in the U.S. declined over the last 20 years. “Of the top 25 awards so far this year, only one was a malpractice case.” Moreover, at least 30 states now cap damages in medical lawsuits.

Another data point, Texas is a state that has passed harsh tort reform laws, and it still has some of the highest health care costs in the country:

The experience of Texas in capping damage awards is a good example. Contrary to Perry’s claims, a recent analysis by Atul Gawande in the New Yorker found that while Texas tort reforms led to a cap on pain-and-suffering awards at two hundred and fifty thousand dollars, which led to a dramatic decline in lawsuits, McAllen, Texas is one of the most expensive health care markets in the country. In 2006, “Medicare spent fifteen thousand dollars per person enrolled in McAllen, he finds, which is almost twice the national average — although the average town resident earns only $12,000 a year. “Medicare spends three thousand dollars more per person here than the average person earns.”

Tort reform isn't going to bring down costs. If Republicans are actually concerned about bringing down costs, they'll have to bring another idea to the table.

Other ideas Republicans brought to the table this morning are already in the health care bill proposed by Democrats.

Finally, a note on reconciliation. Republicans have tried all morning to paint reconciliation as some kind of out-of-the-ordinary, radical procedure. It's not. It's used regularly and it's been used to pass sweeping legislation before like Bush's tax cuts or Bill Clinton's welfare reform. And in fact, the Republicans at the summit have voted for these big programs using reconciliation in the past.

A careful analysis of the reconciliation process shows that it's perfectly suited for finishing health reform right and fixing the Senate bill. In fact, "the way in which virtually all of health reform, with very, very limited exceptions, has happened over the past 30 years has been the reconciliation process."

With these talking points debunked, we'll see what Republicans bring to the table in the afternoon. I'm hoping for real solutions, but I'm not holding my breath.

The White House summit has started. Follow it live here:

Today, over a million people marched on Washington.

Five hundred people were physically in DC. They met Melanie's March - a group of health insurance company abuse survivors who walked for eight days and 135 miles from Philadelphia, PA to the nation's capitol in honor of Melanie Shouse, an Obama volunteer and health care activist who died because she didn't have affordable health care - at Union Station and walked the last leg together to Capitol Hill.

We arrived at Dirksen Senate Office Building for a rally with Majority Leader Reid, among others:

And we laid carnations symbolizing every life lost because we don't have health reform over the course of the eight day march - one thousand in all.

Inside the halls of power, we heard from Senators Reid, Dodd, Harkin, Casey, and Sherrod Brown, Representative Andrews, SEIU President Andy Stern, Families USA head Ron Pollack, and more.

These Senators and Representatives also heard directly from insurance company abuse survivors. People like Regina Holliday, who's husband, dying of cancer, was kicked out of hospital after hospital because their insurance company wouldn't cover his care. Or Marcus Grimes, who's blind because he couldn't pay the $3,000 it would have taken to save his eyesight and he didn't have coverage. And they heard from Steve Hart, Melanie Shouse's life partner, who said, "The worst part about losing Melanie was that she would be here today if health care in this country was fixed."

These people sent the message Senator Reid directly: It's time to listen to the people and not the insurance companies. It's time to get health reform done right.

Senator Reid, accepting 30,000 condolences collected upon Melanie Shouse's death, said he would take the names and messages with him to the White House summit on health reform tomorrow. And he told the crowd that we're going to get reform done.

While we were marching, one million people were backing us up. Led by MoveOn.org, the virtual march on DC has succeeded in sending over 1 million messages to Congress since 8 am this morning, tying up phone lines and fax machines all over Capitol Hill. And the calls and faxes keep coming in!

Today, the people marched. It's time for the leadership and Congress to deliver.

Yesterday, Republican leaders finally confirmed that they weren't going to bring a health care bill to the President's summit tomorrow. Why? Because they don't actually want to reform health care (emphasis added):

The Senate GOP leadership is brushing off Dan Pfeiffer’s demand this morning that Republicans clarify whether they’ll produce a bill in advance of the summit, and won’t put forth a “comprehensive proposal,” aides say.

This morning on the White House blog, Pfeiffer challenged GOP leaders to say whether they’d be bringing a bill to the summit. “The Senate Republicans have yet to post any kind of plan,” Pfeiffer wrote, adding that “we continue to await word from them.”

Asked for comment, a senior Senate GOP aide emailed:

We fundamentally disagree with a comprehensive proposal to reform health care. We think a step by step approach on areas where we agree is the best path forward. We will not be posting a comprehensive alternative to commence a staring contest.

Of course, health care advocates have known this all along. Republicans have no solutions to the crisis in our health care system because they don't view it as a system in crisis.

However, the position that health care in this country doesn't need fundamental reform is a dangerous position to take. Never mind that every day we go without reform, 6,821 more people lose their health insurance [pdf], 2,548 more people file for bankruptcy because they got sick, and 60 more people die [pdf] because they don't have the coverage they need. Declaring that as a party Republicans "fundamentally disagree with a comprehensive proposal to reform health care" is radically out of step with the American people.

The latest Kaiser Health Tracking Poll is only the latest in a series showing the elements of health reform are popular:

Other parts of reform are really popular too, like the public option.

And majorities want comprehensive health reform passed:

And even more will be disappointed or angry if reform doesn't pass:

If Republicans think going with nothing is going to win them broad support, they haven't been reading their polling.

Democrats need to work to make sure the reform that passes works for everyone in America and has the popular elements in it - they must pass health care that works for us and pass it now. Today, we're helping to put in 1 million message to Congress to send them that message, and Melanie's March is arriving in DC to a huge rally with Senators attending the summit, so we'll get to tell that message to these Senators in person.

Getting health reform done right is more than good policy for the country, it's popular, too. And it will show America that Democrats won't accept the party of NO's strategy.

NEWS

Anthem Blue Cross plans to go ahead with rate hikes in California - LA Times

Executives at the health insurer and its parent firm, WellPoint, defend increases of as much as 39% in a hearing before an Assembly panel. The changes are slated to go into effect May 1.

Senate Dems warm to reconciliation - Politico

An idea that seemed toxic only weeks ago — using a parliamentary tactic to ram health reform through the Senate — is gaining acceptance among moderate Democrats who have resisted the strategy but now say GOP opposition may force their hands.

Health Care No Stranger To Reconciliation Process - NPR

To reconcile or not to reconcile — when it comes to a health overhaul bill, that seems to be the biggest argument of the moment.

Republicans plan to stress private-sector alternatives to the president's plan - Washington Post

Republicans are preparing to use Thursday's White House health-care summit to sell their own ideas for using the private marketplace to expand coverage and reduce costs, but they remain wary of fumbling away what they believe is an advantage on the issue heading into this year's critical midterm elections.

Democrats on track to revive healthcare overhaul - LA Times

Party lawmakers, energized by President Obama's blueprint and summit plans, are getting behind the strategy of passing the Senate's bill and using budget reconciliation to prevent a GOP filibuster.

Obama backs bill to boost competition among health insurers - CSM

The Obama administration said Tuesday it supports House legislation to remove the antitrust exemption for health insurers that's been in place since 1945. More competition is the goal, though not all agree that would be the outcome.

They walked through the rain:

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