GOP sees little outreach in health care debate

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By Jon Ward

A year ago, two Republican lawmakers - one a crusty, outspoken conservative senator who is a close personal friend of President Obama; the other, a bright-eyed, wonkish Midwestern congressman - were invigorated by the new president-elect's promise to welcome different ideas on how to fix the nation's health care system.

Now Sen. Tom Coburn, Oklahoma Republican, and Rep. Paul D. Ryan, Wisconsin Republican, are convinced that Mr. Obama's promise isn't playing out in practice.

"What we need in this country is the kind of leadership he said he was going to give," said Mr. Coburn, "which is that you bring both sides together and try to work something that is amenable to the whole country, that you can give the good solid middle to support.

"We haven't seen that yet," he said.

That, however, is as harsh a criticism as Mr. Coburn is willing to offer of Mr. Obama, who he considers a friend from their days together in the Senate. The friendship is reciprocated by the president, who invited Mr. Coburn to the White House soon after his inauguration for a one-on-one meeting.

The still-evolving Democratic reform blueprints in Congress embrace many liberal policies, notably a government-created "public" insurance option and - in the House version, at least - a tax on the rich to help pay for the push for universal coverage.

By contrast, the bills are noticeably silent on some signature Republican ideas, including medical-malpractice tort reform, individual-directed health savings accounts and letting individual states take the lead in testing out innovations in cost-cutting measures and expanding coverage.

Mr. Coburn refuses to pin the lack of bipartisanship entirely on the president, suggesting Democratic leaders in Congress share more of the blame.

"I'd be disappointed if [the president] is directing it. My assumption is to think positive things about him, instead of negative," he said.

For Mr. Ryan, who is respected by Democrats as a serious lawmaker and who co-sponsored with Mr. Coburn an alternative reform bill in May, optimism about the inclusiveness of the drafting process proved to be short-lived.