With much glad handing and enthusiastic rounds of applause, President Barack Obama's March White House forum on health care reform concluded with a general air of optimism. But are things really different this time around? EBA caught up with attendants to find out.

Behind closed doors

More than 150 industry insiders - including business leaders, insurance executives, doctors and representatives from both sides of the aisle - gathered in the East Room for what Obama called "the hottest ticket in town." After the President's opening statement, during which he promised a transparent and inclusive reform process, participants moved to five separate locations for breakout discussions. The groups were divided almost evenly between members of Congress and industry representatives. Moderators initiated questions such as, "What do you think of an employer mandate or an individual mandate?" says Helen Darling, president of the National Business Group on Health.

While people would often sidestep the moderator's question and use the opportunity to address whatever topic was most important to them, Darling says the atmosphere remained "cordial and collaborative." The most important aspect of the meetings may have been simply having everyone in the room together, she says.

"Getting that many important people in a group is very unusual. Usually there's a smaller group and the more powerful people dominate. They sort of say what they say and then they leave," she says. "They had to sit there. They couldn't just come in, make a statement and leave - [a statement] that was written by somebody else. So in that sense, it was more genuine, I think, than some of these things are."

In Dan Danner's discussion, co-moderated by Office of Management and Budget Director Peter Orszag, there wasn't much give and take between participants. "It was a lot of interesting perspective, but there wasn't really a lot of debate," says Danner, president and CEO of the National Federation of Independent Business. "I don't think there was any attempt to come to consensus among the group or anything. It was more just hearing from everyone there what their priorities and concerns were."

As far as passing health care legislation this year, consensus may not be necessary, says Paul Fronstin, senior research associate with the Employee Benefit Research Institute. Obama already has a health care proposal, Montana's Max Baucus, chairman of the Senate Finance Committee, released a similar proposal, and Democrats control the House of Representatives. "It's almost a done deal, regardless of what the industry thinks," says Fronstin, who did not attend the forum. "But, that's not very collegial."

Achieving bipartisan support won't be easy, says Fronstin. "It's going to be tough, and it may be for different reasons," he says. "It may be because Republicans don't buy into what he's trying to do, or maybe because they don't want to pay for it. Or both."

Nevertheless, Darling saw some evidence of collaboration at the forum. "I think people are trying to focus on the higher-level thinking. Not go immediately to their differences, but to start with their similarities where there's consensus, where there's agreement," she says. "I think it's unique. Now, maybe that exists in some other policy domain, but I've never seen it in health care before like this."

A new spirit

As far as Darling can remember, this is the first time a president has invited so many stakeholders to discuss health care reform on the ground level. It's a strategy she can get on board with. "I think it's superb," she says.

With dozens of Congressional lawmakers in attendance - 33 Democrats, 15 Republicans and one Independent participating - the environment could have easily become combative and divisive. Becky Patton of the American Nurses Association says that was not the case. "The attitude is significantly different," she said as she left the White House. "You have Republicans sitting next to Democrats, all talking about the need to make the change, and how now is really the time to do this."

Darling recalls a previous health care action passed by Congress where Democrats and Republicans worked together. The Catastrophic Coverage Act, passed under President Ronald Reagan, expanded Medicare - but was repealed 16 months later. "That was the closest that I'd seen where a law had actually been passed and there was this kind of collaboration," says Darling. "But it didn't start out this way. It started out much more combatively and more like we're going to kind of duke it out. It was just totally different ... The spirit of this event, the comments of all the people who were asked to comment, were so much more cooperative and collaborative than you ever see."

NFIB was one of the organizations against the Clinton-era heath care proposals. "We felt very strongly at the time that to do nothing was a better alternative than to pass what they were talking about then," says Danner. "We're very much hopeful now. We don't think the status quo is acceptable any longer and we really hope that something gets done to help small businesses find and afford health care."

What now

The White House forum doesn't automatically increase the likelihood of comprehensive health care legislation passing this year, but Fronstin says it can't hurt.

"I think it shows how committed this administration is to getting something done and getting something done soon," he says. "And the fact is, they want to involve as many interested parties as possible and I think that's why they're holding this."

It was clear that participants were not in agreement on issues such as offering a government-run solution versus a private sector solution, but Danner says the majority agreed that reform can't wait.

"I think that there is overall a very strong commitment from across the spectrum that now is the time to do something on health care and 'do nothing' is no longer an option," according to Danner. "I think it is clearly a little more complicated when you get to the 'what.' And I don't think there was broad agreement on the 'what,' at least in our group."

Darling remains encouraged. "I thought it was fascinating. I thought it was very inspirational, and I'm very optimistic that we could in fact have national health care reform this year," she says.

She is also optimistic about what reform measures could mean for business. "I think the most exciting thing for business is the attention that's being paid to controlling costs is unique," she says. "That is really unusual."

During his closing remarks, Obama unexpectedly called on Danner. "Give us the business perspective," he said, seeking Danner out in the crowd.

"We do think that small business has a key role in this debate, and for them cost is the top issue. We very much look forward to finding a solution together that works for America's job creators," Danner responded.

So, was it a good sign for business that Danner was singled out for comment? "Well I hope! We'll see," he says. "It's a long way between the initial discussion and actually getting something done."

However, the White House has kept in touch. In mid-April Danner met with Nancy-Ann DeParle, director of the newly-created Office of Health Reform.

Blog post

Check out the video of our talk with the American Nurses Association's Becky Patton outside the White House on our blog. Visit benefits-explained.blogspot.com and search for Patton.