ATLANTA – If Wednesday's luncheon at the 2009 annual meeting of the Biotechnology Industry Organization (Washington), which featured political heavyweights from both sides of the political aisle, could be looked at as a preview to the healthcare reform debate, then the U.S. is in for some interesting and rousing discussions in the coming months.

The Republican party was represented by Karl Rove, a chief advisor for the Bush administration, and former Sen. William Frist. The Democrats were represented by former Vermont Governor and former Democratic Chairman Howard Dean and former Senator Tom Daschle, who at one time was on tap to be head of Health and Human Services for the Obama administration – until controversy regarding unpaid taxes forced him to resign his candidacy (Medical Device Daily, Feb. 4, 2009).

The debate, which was held at the Georgia World Congress Center here in Atlanta, was moderated by Susan Dentzer Editor-in-Chief of public healthcare policy magazine Health Affairs.

The quartet debated for nearly an hour (45 minutes to be exact) over proposals by the Obama administration to incorporate a public health insurance component along with today's already private system.

To kick off the debate, each "heavyweight" was asked where they thought Harry and Louise were – two characters that were used in a series of television spots opposing government sponsored universal healthcare coverage back in the early 90s.

While most agreed that the characters would be singing a different tune this time around – there was debate regarding exactly what that tune would be.

"If you ask them what they're most concerned about, it's the $12,900 they pay each year for healthcare," Frist told the audience.

Frist went on to criticize the reported $1.2 trillion Obama's healthcare plan calls for – and said that Harry and Louise just might take exception to the figure considering the current climate of the economy.

"The couples are saying its costing $1.2 trillion more - but is it going to cost me less," Frist questioned.

Dean said that the couple would more than likely want to see changes – mostly the addition of a public healthcare system to the existing private system.

But Rove countered Dean as he would throughout the debate, and said "That's if the things you don't do to the system don't change or disrupt what people enjoy and that's what the public option would do."

The price of such a change as the Obama administration is proposing is like a specter that dominated the majority of the conversation.

Daschle gave it support by saying if the government had to make an investment in the short term to build infrastructure in the long-term" he would support such a measure.

Dean said he was interested in having a 10% carbon tax to help offset the cost of the administration's healthcare proposal. Dean's proposal somewhat mirrors Reps. Jeff Flake (R-Arizona) and Bob Inglis (R-South Carolina) who had proposed a carbon tax as an alternative to the Democrat's cap-and-trade legislation.

"People in America don't like taxes but they'll pay them if you tell them what the [taxes are specifically] for," Dean said.

Rove simply said that Dean's proposal was a "terrible idea."

"Someone has to stand up for the working man," Rove said doing a bit of political posturing. "Who pays for the majority of the healthcare plan? Public taxes not corporate taxes . . . Do Americans want that?"

Daschle disagreed slightly with the former Democratic chair's carbon tax proposal saying that a better alternative needed to be sought out.

"If we tell people they're going to have to pay more money for healthcare . . . this is going to fail," Daschle said.

Another topic that came up was if Democrats — since they have the clear majority — would use reconciliation, a measure that is a legislative process of the U.S. Senate intended to allow a contentious budget bill to be considered without being subject to filibuster.

If it were used, Democrats would only need a simple majority of 50 votes to get a healthcare reform bill through the Senate.

"I think we should demand not going to the 50 vote but to the 60 vote route," Frist said.

Daschle said he agrees to a certain degree. "If the Republicans say we will not filibuster we will not use reconciliation."

"I'm not going to get into the process or reconciliation. That's something for the Washington Post to comment on," Dean quipped.

Dentzer then asked the group what they thought would happen with a healthcare reform bill by this time next year.

Daschle said he saw it passing with a public plan component but that everyone needed to recognize this was going to be "too big" to implement overnight and would take time.

"A bill will not pass this year but it will pass next year," Frist said.

Dean said that some form of healthcare reform will pass this year and it will have a public plan it."

Dentzer then quickly asked "does that mean that it will pass by reconciliation?" But Dean did not answer the question and again said he wouldn't comment on the process.

"A public plan is a very bad plan," Rove told the audience when he was asked what he predicts will happen by this time next year. "If there's a public plan it will not have Republican support."

He added that he would rather see a plan with tax equity – or any plan that's paid for without putting additional taxes on the American people.

Rove said what the Republican Party needs to do now is develop a plan and get something on the table for the country to look at.

"The Republicans can't defeat something with nothing," he said.

While still a rousing debate, Wednesday's discussion was a lot more civil than some of the current discussions in Washington.

"We might not be able to bring civility back to Washington but we can have it for 45 minutes in Atlanta," Dentzer said.