WASHINGTON — A determined President Obama, calling for an “up or down” vote on his health care reform proposal, is depending on his Democrat colleagues to pass a measure that has already been rejected by Republicans.

“I believe the United States Congress owes the American people a final vote on health care reform,” the president said, insisting that there is no need — as demanded by Republicans — to return to the drawing board. “Everything there is to say about health care has been said, and just about everybody has said it. Now is the time to make a decision about how to finally reform health care so that it works.”

However, to attain passage, reconciliation, a parliamentary maneuver which would carry the measure to victory through a simple majority vote, is needed.

“Reform has already passed the House with a majority; it has already passed the Senate with a super majority of 60 votes — now it deserves the same kind of up or down vote that was cast on welfare reform, that was cast on the Children’s Health Insurance Program, that was used for Cobra health coverage for the unemployed and for both tax cuts — all of which had to pass Congress with nothing more than a simple majority.”

Despite rejections by Republicans, Obama has offered to incorporate some of that political party’s own proposals for reforming health care, including one that would encourage the use of tax-advantaged medical savings accounts and increasing payments to doctors who treat Medicaid patients. The president has signaled he is open to another Republican idea that would have health care professionals pose as patients in undercover stings to root out fraud.

Industry groups are also speaking out on what they envision for changes in the health care system.

“Even prior to the beginning of the current health care reform debate, NACDS has urged the inclusion of pro-patient, pro-pharmacy priorities in any health care reform legislation,” says association president and chief executive officer Steve Anderson. “We remain focused on empowering patients to benefit from pharmacy’s role as the face of neighborhood health care.

“There is broad support for improving lives through prevention and chronic disease management and for reducing overall health care costs, and that is what happens when community pharmacies help patients take the right medications in the right ways.”

At the Generic Pharmaceutical Association, president and CEO Kathleen Jaeger believes the White House has ignored the savings potential of generic drugs in its proposal, particularly with its plan to ban “pay-for-delay” deals between brand manufacturers and generic drug companies.

“We are perplexed as to why the president has failed to recognize that increasing access to generic and biogeneric medicines will significantly reduce health care costs while also strengthening patients’ ability to receive quality care,” she comments. “Time is running out to make sure all Americans have access to high quality affordable medicines.

“Yet, the White House seems undeterred in its push to ban pro-competitive patent settlements, which have successfully brought generic medicines to more Americans.”

In pressing the need for passage, Obama has reiterated that his proposal gives Americans more control over their health insurance and health care and that it builds on the current system under which most individuals secure health insurance from their employer.

However, he adds that insurers would no longer be able to deny coverage over pre-existing conditions, that they would no longer be able to drop a person because he or she became sick and that insurers would no longer be able to demand excessive out-of-pocket
payments.

Although Republicans assert they welcome Obama’s interest in their suggestions for reform, they also generally dismiss the gesture as meaningless if Democrats remain intent on pushing through what they see as expansive and expensive legislation that would result in higher taxes and reduced federal spending on Medicare.

“It’s always welcome, inserting Republican ideas,” comments Sen. Olympia Snowe (R-Maine). “But it does not ameliorate other issues. The basic legislation is not going to change. That continues to be troubling.”

Meanwhile, a recent Kaiser Family Foundation poll offers an updated view on public attitudes toward health care reform. Majorities of Americans say they’re “disappointed” or “frustrated” by the “delays” in the reform process; about a third say they’re “relieved,” “anxious” or “angry.”

Majorities of Democrats and independents say they feel disappointed or frustrated, while relieved tops the list among Republicans.

Asked by Kaiser how they would feel if Congress decided to stop work on health care reform, about six in 10 say they’d have a negative reaction — 20% say they’d be “angry,” 38% “disappointed.” About four in 10 are more positive, saying they’d be “relieved” (24%) or “happy” (14%).