The general issues of health care reform – reducing costs, expanding access and improving the quality of health care – served as the main topic of the break-out sessions of the White House health care reform summit on March 5th.

The five break-out sessions included insurance and business interests, labor and community leaders, health care associations and members of Congress from both parties.

The participants in one of the meetings, moderated by White House Domestic Policy Director Melody Barnes, generally agreed on some basic issues: improving health care information technology, expanding health care infrastructure, increasing the number of health professionals, investing in preventative medicine, requiring coverage for preexisting conditions and addressing questions related to portability.

Sharper divisions emerged over the issue of providing a public health care option for individuals and families who find the private market too expensive or do not have access to adequate coverage from private insurers.

Blue Cross Blue Shield CEO Scott Serota described creating or expanding a public health insurance option as creating a new ‘government bureaucracy’ that would make the private market unsustainable. Serota failed to explain why the private market, whose promoters insist is always more efficient than public programs, would have such a difficult time competing with a public plan.

Service Employees International Union Healthcare Chair Dennis Rivera suggested that competition between a public plan and the private market would be beneficial. ‘That competition is going to drive the cost down,’ he stated.

Rep. Jan Schakowsky (D-Ill.) added that it is the private market that has a lot to explain with regard to rising costs and the lack of coverage. She also dismissed Serota’s ‘bureaucracy’ claim, pointing out that compared to private insurers, Medicare, for example, has a very low overhead that makes it far more efficient than the corporate bureaucracies that are driving up prices.

Sen. Sheldon Whitehouse (D-R.I.) added, ‘We’re past the Harry and Louise moment,’ recalling the ad campaign funded by the private insurance industry back in the early 1990s to help block the Clinton’s administration’s efforts at health care reform. ‘We’re at the Thelma and Louise moment,’ he said. ‘We’re in the car heading for the cliff. Everybody understands that.’

‘Insurance coverage has got to be meaningful,’ stated Rep. Allyson Schwartz (D-Penn.). Private insurers impose long waiting periods at the beginning of a plan, refuse to provide coverage for people with preexisting conditions or boot off people who have serious illnesses or health problems. These issues have to be reformed in order to make insurance ‘meaningful,’ she noted.

Planned Parenthood President Cecile Richards noted that for many younger working-class women, family planning clinics are their first interaction with the country’s health care system. Expanding access to this type of care should be a serious concern for any health care reform agenda, she stated.

Sen. Byron Dorgan (D-N.D.) urged passage of reform that emphasized preventative care, addressed the desperate need to to provide care for Native Americans, and added that Congress must pass a law to allow the re-importation of FDA-approved prescription drugs in order to lower costs.

To this, Sen. Orrin Hatch (R-Utah) agreed that preventative care could get a huge boost by eliminating barriers to stem cell research erected by the Bush administration, but without explanation described the re-importation bill as ‘B.S.’

Others expressed concerns about imposing mandates on coverage, or requiring individuals and/or employers to buy insurance coverage or get access to a public plan. While she said she understands that requiring people get coverage increases the size of the pool and can reduce costs, Rep. Jo Ann Emerson (R-Mo.) stated that she believes people won’t like the government ordering them to get insurance. The concept has to be modified in order to be made palatable, she recommended.