Two hours before President Obama opened his health care summit, and two blocks away, a couple dozen reporters gathered at the invitation of The Christian Science Monitor for a breakfast at which the reform proposal's doom was foreshadowed.

The guests for the group interview were Bill McInturff, a Republican pollster whose firm advised John McCain in his presidential campaign and lists dozens of other congressional Republicans among its clients, and Newt Gingrich, who became speaker of the House largely by leading the fight in 1994 to kill the Clintons' effort at health reform.

McInturff came armed with his latest poll. The numbers are striking. By 52 percent to 40 percent, the voters he surveyed oppose the health care bills developed by the administration and congressional Democrats, with more than twice as many strongly opposed as are strongly supportive.

By a similar margin, 54 percent to 42 percent, they support the Republican argument for starting over and focusing on smaller pieces of legislation embodying areas of bipartisan agreement, rather than merging the more comprehensive reform bills passed by the House and Senate and sending a measure to the president soon.

A bit later in the day, during the session at Blair House, Obama cited other polls showing broad support for provisions in the pending bills that would change insurance rules to tear down barriers for those with pre-existing illnesses and remove the caps on benefit payments.

But armed with McInturff's evidence that those who have been following the debate most closely and those most likely to vote in November are swinging to the Republican side of the argument - just as they did in 1994 - the GOP legislators at Obama's summit resisted his efforts to draw them onto common ground.

While Sen. Max Baucus of Montana, the Democratic chairman of the Finance Committee, argued that amp"the gaps in my judgment are not that greatamp" between Republican and Democratic approaches, Jon Kyl of Arizona, the No. 2 man on the Senate GOP side, insisted that "there are some fundamental differences between us here that we cannot paper over."

As the day-long discussion continued, it became clear that one of those differences involves the question of who sets the standards for health insurance and medical care. Obama and the Democrats would give that authority to Washington, which already exercises it when it comes to Medicare recipients and veterans. Republicans insist it should be in the hands of patients, doctors and insurers in the private marketplace, or scattered among the 50 states.

Another basic difference was highlighted by Obama when he contrasted the 3 million uninsured Americans who might get coverage from the main Republican alternative bill with the 31 million made eligible for insurance by the Democrats.

This contrast, which looks to be the biggest vulnerability in the Republican position in this debate, may be an eroding advantage for the Democrats. McInturff's poll found twice as many people say that making health care more affordable is an important goal, as opposed to giving priority to providing health care coverage for more Americans.

A major Republican objective during the summit was to discredit the Democratic claim that the House and Senate plans would reduce budget deficits and cut health care premiums. At the outset, Obama called this an "urgent" need and Sen. Lamar Alexander of Tennessee, leading off for the Republicans, argued vehemently that the plan endorsed by the White House would fail that objective.

This is an issue on which the public verdict will be crucial. Only if voters become persuaded that their insurance costs will go down will they likely support Obama's legislation.

Nothing from the summit suggests that Obama is going to find Republican backing for his version of health care reform. A month from now, he is probably going to try to use a budget maneuver called reconciliation to pass the proposal with simple majorities in the House and Senate. A Gallup poll says the public tilts against this tactic, and as of today Obama is not assured of the votes to make it work.

In any case, as the president said at summit's end, the issue will go to the voters in November.



David Broder writes for the Washington Post Writers Group. Contact him at davidbroder@washpost.com or 1150 15th St. N.W., Washington, D.C. 20071.