GOP sees little outreach in health care debate

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.

Mr. Ryan said it was during a conversation with House Ways and Means Committee Chairman Charles B. Rangel, New York Democrat, early in the summer that he realizedthe administration and the Democratic leaders in Congress had “no intention” of compromise.

“He basically told us, ‘Look, we want to do it our way. We want the public plan. We want it this way. We have the votes. We’re going to do it this way. We’d love to have you join us. But if you don’t want to join us, you don’t need to,’ ” Mr. Ryan said.

A spokesman for Mr. Rangel did not return phone calls or e-mails.

The White House disputes the charge that Republican ideas have not been included in the health care negotiations. It says 160 GOP amendments were included in the bill drafted by the Senate Health, Education, Labor and Pensions Committee, and that outreach fulfills Mr. Obama’s promise.

“Democrats or Republicans, we welcome good ideas,” Mr. Obama said shortly before taking office in January. “One of the things that I think I’m trying to communicate in this process is for everybody to get past the habit that sometimes occurs in Washington of, ‘Whose idea is it? What ideological corner does it come from?’

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