House Minority Leader John Boehner (R-OH) and Republican Whip Eric Cantor (R-VA) have written a letter to President Obama asking him to abandon the current health care reform bills and eliminate “the possibility of reconciliation” before convening his February 25th health summit:

If the starting point for this meeting is the job-killing bills the American people have already soundly rejected, Republicans would rightly be reluctant to participate. Assuming the President is sincere about moving forward in a bipartisan way, does that mean he has taken off the table the idea of relying solely on Democratic votes and jamming through health care reform by way of reconciliation?

Given the GOP’s reluctance to negotiate on health care reform and the Democrats’ repeated overtures at bipartisanship, Obama shouldn’t abandon a legislative tactic that subjects legislation to a simple majority vote. After all, reconciliation was designed to help bring spending and revenues in line with the fiscal policy and lower the deficit — which health reform would undoubtedly accomplish.

The GOP has repeatedly used the reconciliation process to enact its agenda. In 2001 and 2003, Republicans broke with tradition and used the reconciliation to “enact a large tax cut that greatly increased federal deficits and debt.” During the 1990s, Republicans pushed through key provisions of their signature legislative agenda, the Contract with America, using budget reconciliation.

As rising GOP star Rep. Paul Ryan (R-WI) pointed out in April, Democrats have the “right” to pass health care reform through the reconciliation process. “It is their right. It is what they can do,” Ryan admitted. In June, former Senate Majority Leader Bill Frist (R-TN) said of the reconciliation process, “But it’s legal, it’s ethical, you can do it. And it has been suggested and accepted by the administration, pretty directly that if it came down to it, they’re going to drive this thing through a fifty-vote door. ”

Rep. Tom Price’s (R-GA) reaction to President Obama’s February 25th health care summit pretty much sums up the Republican response: accuse the Democrats and the President of not reaching out, while they’re reaching out.

In other words, break the Olive Branch in half and pretend that the term compromise — which, the Merriam-Webster dictionary defines as “settlement of differences by arbitration or by consent reached by mutual concessions — really requires Democrats to abandon their plans and accept the Republican proposals.

From Price’s priceless statement:

It seems the only play the President knows how to run is a hollow PR blitz. Republicans welcome honest discussion, but this event reeks of political gamesmanship. Throughout this debate, Republicans have been stiff-armed from participating, our plans ignored, and our ideas blatantly misrepresented. It’s quite telling that only now, once the President’s plan is considered to be on political life support, does the White House seek input from Republicans.

The fact that the President has indicated he is still completely wedded to a government takeover of health care demonstrates that despite the rhetoric, he just hasn’t gotten the message from the American people. Americans have no interest in handing personal medical decisions to the government and are sick of Washington’s unchecked growth and power.

The only constructive discussions will start with a blank sheet of paper. The American people have soundly rejected the President’s big-government approach to health care, and tinkering at the margins of it will not bring about bipartisan consensus. Enacting positive health care reform still remains possible, but it will require the President to accept that his plan is a non-starter with the American people.

The truth is, Republicans are lucky to receive any hearing at all. After all, Sen. Max Baucus (D-MT) attempted to reach a bipartisan health care bill for months, only to produce produce a fairly watered down proposal that every Republican — with the exception of Sen. Olympia Snowe (R-ME) — abandoned. As Baucus remarked some months later, “we worked very hard to get a bipartisan bill. That side of the aisle started working with us but gradually they began to bleed politically,” Baucus said. They realized “that they would do a better chance in the 2010 elections by just not working with us, but just attack attack attack attack attack and try to score political points to defeat any honest effort to get health care reform.”

This is a take-two for bipartisanship and it’s up to the Republicans to meet the Democrats half way. They can either turn the event into “a hollow PR blitz” that “reeks of political gamesmanship” or abandon all of the government-takeover nonsense and figure out how to make reform work. The summit will be what Republicans make of it.

Business analysts are predicting that if Congress fails to pass health care reform, health insurers and providers react to skyrocketing health care costs by merging into ever-larger companies. The industry will “seek its own answers to a push by government and the private sector to rein in costs, said Curtis Lane, senior managing director at MTS Health Partners, a New York-based equity fund.” “An aging U.S. population will spur demand for services and, at the same time, boost pressure to control spending, he said“:

One solution will be increased consolidation, with companies led by WellPoint Inc., the biggest U.S. insurer by enrollment, and Community Health Systems Inc., the largest publicly traded hospital chain, scooping up rivals unable to “spread rising costs across fewer customers,” said Paul Keckley, of the Deloitte Center for Health Solutions.

The health-care market “certainly seems to favor bigger, innovative, scalable companies,” said Keckley, executive director of the Washington-based center, in a phone interview. Drugmakers facing the loss of patent protection on top-selling medicines “were looking at decelerating revenues, with or without reform,” he said.

Of course, it’s unclear that mergers amongst insurers or provider networks will help contain health care costs. We have seen over 400 health care mergers in the last 10 years, while premiums have risen “nearly eight times faster than average U.S. incomes.” Today, one in six “metropolitan areas in a 2008 study of more than 300 U.S. markets [are already] dominated by a single health insurer that controls at least 70% of consumers enrolled in health maintenance organizations or preferred provider organizations.”

Similarly, in areas where hospitals have “too strong a market presence to be excluded from insurer networks,” they dictate prices to insurers, which in turn, pass on the cost to the beneficiary in the form of higher premiums. And, if an insurer feels like it’s getting squeezed by the provider, it may dump its beneficiaries (by pricing them out of their policies) and take its business elsewhere. Greater provider consolidation will likely accelerate this trend.

So the future looks grim without health care reform. Projections of increased consolidation are just another reason to push Democrats to repeal the insurers’ anti trust exemption and get the job done on health care reform.

Yesterday, President Obama finally set a course for health care reform and announced a “televised meeting with Republican and Democratic congressional leaders” to find a bipartisan solution to controlling health care costs and extending coverage to the uninsured. White House aides stressed that the President was not scraping the existing health care bills and promised that Obama would move forward with reform with or without Republican support. “This is not starting over,” one White House official said. “Don’t make any mistake about that. We are coming with our plan. They can bring their plan.”

The summit will allow Democrats to scrub clean the process of reform and give Republicans what they’ve been demanding all along — another seat at the health care negotiating table. Here is my prediction: Republicans will repackage their existing health care plans and present them to the President with a TV salesman’s pitch: a common sense approach to fixing the nation’s health care ills, at half the cost of all previous reform efforts. Act now and they’ll throw in a free copy of Going Rogue.

The plan will allow healthier Americans to purchase porous coverage across state lines with government tax credits and push the millions of Americans with chronic conditions into high-cost high-risk pools. Republicans will proclaim that owning one’s own health care policy is the silver bullet to solving the country’s health care crisis and promise to slow Medicare and Medicaid spending by privatizing both programs. With step by step improvements, everyone will have some kind of health insurance, they’ll argue. Eventually.

The President will insist that any health care reform must build on the current employer-based system and rely large risk pools to spread the risks and costs of health care insurance across a large group. He will remind Republicans that the House and Senate health care bills already include many Republican health care ideas like high risk pools, selling policies across state lines (in the form of more regulated compacts), high deductible policies for younger Americans, employer-sponsored wellness programs, tax credits for small businesses, and allowing younger Americans to stay on their parents’ health care plans as dependents.

Republicans will insist that their plan is an all-or-nothing deal; carving out little bits and incorporating it into a larger plan is not their flavor of bipartisanship. The only way they’ll jump on board is if Democrats accept their plan. As Rep. Eric Cantor (R-VA) has already explained, “unless the President and Speaker Pelosi are willing to scrap their government take over and hit the reset button, there’s not much to talk about.” Republicans took a similar approach to Obama’s first health care conference in March 2009, demanding that Democrats abandon the public option before convening any real negotiations.

The President will explain that the House and Senate health care bills regulate insurer competition without eliminating private companies or expanding government control, much like the Massachusetts health care reform. This will trigger Sen. Scott Brown’s (R-MA) effort to awkwardly distance himself from the plan he ran on and still supports. He’ll say that he’s an independent who doesn’t think that Massachusetts should have to pay for other states’ reform efforts. He may even highlight the state’s success in achieving a 98% insurance rate and the popularity of reform, although that would run the risk of suggesting that reform could work without resorting to death panels. Before sitting down, he’ll explain that Massachusetts’ success in expanding health insurance coverage should not be used as a template for the nation because even if it worked there, there is no guarantee that it will work everywhere. He’ll throw his support behind the Republican’s untested health care ownership scheme.

The summit will close with some inspiring remarks from the President, but at the end of the day, it will be up to the Republicans to meet the Democrats half way. Obama would have taken his steps towards bipartisanship, he may even make some concessions on tort reform. But this will be the Republicans’ final opportunity to embrace the rather moderate package of reforms. If they still insist on starting over, they’re effectively taking themselves out of the process and giving the reins to the Democrats. From there, Reid and Pelosi can either build momentum for passing the Senate health care bill alongside a package of fixes, pass a smaller package “around those elements in the package that people agree on” or (less likely) adopt a compromise that resembles Sen. Ron Wyden’s (D-OR) health care bill.

The summit will give both sides the opportunity to publicly rehash their health care rhetoric. It’s what Obama chooses to do after February 25th that’s important.