When the President of the United States, allegedly possessed of the best bully pulpit in the free world, needs to go on the Super Bowl pre-game show to attract a big audience, you know that something has gone horribly, horribly wrong.

We can't solve that problem here at HealthBlawg, but perhaps we can address the issue that Obama put on the table during the pre-game show: transparency in health reform negotiations.

From the New York Times:

“I want to come back and have a large meeting, Republicans and Democrats, to go through systematically all the best ideas that are out there and move it forward,” Mr. Obama said in the interview from the White House Library.

Mr. Obama challenged Republicans to attend the meeting with their plans for lowering the cost of health insurance and expanding coverage to more than 30 million uninsured Americans. Republican leaders said they welcomed the opportunity and called on Democrats to start the debate from scratch, which the president said he would not do.

The move by Mr. Obama comes after weeks in which the administration has appeared uncertain about how to proceed on his top domestic priority since Republicans captured the Senate seat previously held by Senator Edward M. Kennedy. House and Senate Democrats had been increasingly at odds over what the bill should say, how to move ahead tactically and, in some cases, whether to continue at all.

The idea for the bipartisan meeting, set for Feb. 25, was reached in recent weeks, aides said, as part of the White House strategy to intensify its push to engage Congressional Republicans in policy negotiations, share the burden of governing and put more scrutiny on Republican initiatives.

Mr. Obama’s announcement came after he surprised his rivals in late January by requesting that a session with House Republicans be open to cameras. That meeting produced a spirited 90-minute question-and-answer session with the president that many in the White House viewed as a critical success for Mr. Obama.

In making the gesture on Sunday, Mr. Obama is in effect calling the hand of Republicans who had chastised him for not honoring a campaign pledge to hold health care deliberations in the open, broadcast by C-Span, and for not allowing Republicans at the bargaining table.

It seems to be incredibly late in the day to be extending a hand across the aisle — and issuing a challenge at the same time — in this way.  At the White House health care summit last fall, Obama seemed much more in control, saying, essentially, "You know what I want; send me a bill I can sign."  That seemed much more Presidential than issuing a challenge during the Super Bowl pre-game show.

The fallout from Senator Scott Brown's election is felt in this episode, as in numerous other episodes inside and outside the Beltway in the past couple of weeks, yet we really don't have a handle on Brown yet.  He could well end up being as much a thorn in the side of the GOP as Lieberman is in the side of the Democratic Party.

Pelosi's desire to turn to small bits and pieces of health care legislation seems sensible, and is consistent with the HealthBlawger's now-tired cry of "incrementalism, baby!" when it comes to health reform, but it is a far cry from the vision set forth by Candidate Obama.  There is value to getting something done, but there is also value in setting forth a vision of the future from the Oval Office.  Is Obama gearing up for another installment of Health Reform Fight Club, or does he want to get something done?  Is he going to be satisfied with the Speaker's patchwork of small steps, or will he push for a broader reform package?  Is Obama now more open to transparency in the process only because of the Scott Brown factor?  Will his strategy of "outing" Republicans as "the party of no" succeed or backfire?  Is it too late to change course, or does the American public's collective memory only go back as far as Super Sunday?

Tune in again next week . . . .

David Harlow
The Harlow Group LLC
Health Care Law and Consulting