Support for Health Care Reform Gains Support from Left and Middle

Health care reform is likely to pass the House of Representatives as early as this weekend or beginning of next week. The vote will be close. The methodology may open questions concerning legitimacy. But health care reform is likely to pass.

Consider: Liberals are falling into line. Some may have assumed this was a given, but some on the left oppose President Barack Obama’s health care reform package for failing to go far enough. They want their single payer system or their public option and don’t want to settle for anything less. Unless, it seems, anything less is nothing at all.

That, at least, is the explanation Representative Dennis Kucinich gave today when he switched his position and announced he’d vote “yes” on the President’s health care reform bill. As Sabrina Eaton of the Cleveland Plain Dealer writes about her home town Congressman, Representative Kucinich “acknowledged this morning that his choice now is to either vote ‘no’ on principle, and thereby possibly block the biggest (though imperfect) advance in health coverage in decades, or compromise for the good of the estimated 30 million more Americans who could gain insurance.”

More evidence: the opinion shows on MSNBC. Virtually all of the talking heads in their liberal line-up speak of the need for Democrats to pass the current version of health care reform even though it lacks their beloved government-run health plan. Even former Governor Howard Dean, speaking to a pro-health care reform march in Washington DC last week, was arguing for the legislation he often criticized , proclaiming, “We deserve a vote! Are you for the insurance companies or are you for the American people?”

The left, in short, has fallen into place. Liberals will not kill health care reform.

But liberals alone will not pass health care reform, either. That feat requires the support of moderate Democrats. And while centrists may not be rushing to support the current health care reform, at least a few are stepping forward. Representative James Oberstar was among the moderate Democrats who were following Representative Bart Stupak in opposing the Obama Administration’s health care reform bill over abortion language. This group of 12 (now, presumably fewer) Democrats, were holding out for the more restrictive abortion language in the House’s version of health care reform. Representative Oberstar today announced he would support the President’s health care reform bill saying “On balance, it does what we need to do,” according to the Minnesota Independent. Another pro-life Democrat, Representative Dale Kildee, a close ally and friend of Representative Stupak also announced his support of the Administration’s health care legislation today. According to the New York Times, Representative Kildee said “he was satisfied that the provisions in the health care bill passed by the Senate would prevent the use of federal money for insurance coverage of abortions.”

The U.S. Conference of Catholic Bishops and anti-abortion groups like the National Right to Life Committee have been the driving force behind the more restrictive abortion language included in the House bill.  As reported by McClatchy Newspapers, the Bishops believe the Senate abortion language would “open the door to federal financing” of the procedure. But today a group of 60 nuns, leaders of orders comprised of 59,000 Catholic nuns sent a letter to House members urging them to pass the Senate health care reform bill. According to the Associated Press. in their letter, the nuns claim that “despite false claims to the contrary, the Senate bill will not provide taxpayer funding for elective abortions.”

Whether the split between bishops and nuns will be enough turn all of Representative Stupak’s faction into supporters of health care reform is unlikely. But as Katie Connolly notes in her post on the Newsweek magazine, “Having high-profile support from a key Catholic group nudges fence-sitters in (the Stupak) group toward a yes vote. At the very least the (nuns) letter damages the validity of Stupak’s argument.

(What’s ironic about the fight over how health care reform addresses abortion is that, as a practical matter, both the House and Senate versions of health care reform are victories for anti-abortion advocates.)

Passage of health care reform is not a done deal. Momentum is not victory. Patrick O’connor of Politico.com provides an excellent summary of the challenge Speaker Nancy Pelosi faces in assembling 216 votes to in support of health care reform. And even if the bill passes in the House of Representatives, who really knows what will happen in the Senate? Given the twists and turns of our story so far, anything could happen.

But with liberals falling in line and moderates slowly coming to support President Obama’s health care reform package, passage is certainly more likely today than it was yesterday. For those who consider this the ruin of American ideals, the end of quality health care in this country and the demise of the health insurance industry, my advice is to take a deep breath.

There’s thousands of regulations yet to come. There’s plenty of opportunity for Congress to tweak the reforms for the better. And there’s always the adaptability of American business. Somehow these things have a way of working out. Careers continue. The country endures. Health care reform, 2010 style, is unlikely to be any different.

Health Care Reform Makes It Clear: Howard Dean is No Ted Kennedy

Dr. Howard Dean was governor of Vermont for 12 years. He was a front runner briefly during the 2004 presidential campaign. He became chair of the Democratic National Committee. And now he is demonstrating why he failed for Governor and why Democrat are better off having him as the “former” chair of their party.

As Democrats in the Senate struggle to cobble together a super-majority in support of health care reform, Governor Dean is busy throwing bricks into the room. Upset that the legislation likely to emerge from the Senate will contain neither a government-run health plan nor the ability for 55-to-64 year olds to buy-in to Medicare, Governor Dean is urging defeat of the bill. The reason, according to a report by the Associated Press, the Senate health care reform bill is “an insurance company’s dream.” Which is malarkey. I don’t know any insurance carriers happy with the direction of health care reform in Washington. As the AP reports White House spokesman Robert Gibbs putting it, “If this is an insurance company’s dream, I don’t think the insurance companies have gotten the memo.”

Governor Dean asserts that “You will be forced to buy insurance. If you don’t you’ll pay a fine.” True enough, although in the Senate bill the fine is $750, far less than the cost of coverage. Then he goes on to assert that insurance companies would not be prohibited from denying coverage for preexisting conditions. And that older Americans would pay more than their younger neighbors for coverage.

Let’s look at the substance of the Governor’s complaints. Does he seriously believe that whatever health care reform bill emerges from Congress will allow health insurance companies to deny applicants for coverage? If so, he’s the only pundit in the country who does. Even Republicans support guarantee issue of health insurance coverage.

As for older people paying more for coverage than younger people, he’s right. Both legislation passed by the House and being considered in the Senate allow carriers some flexibility in setting rates by age. But both bills substantially reduce the differential that exists today. In California, for example, a 64 year old can expect to pay six times more than a 19 year old for the same coverage. (Anthem Blue Cross offers a $3500 deductible PPO that costs a single 19 year old in Los Angeles $110 per month and his 64 year old neighbor $664 a month). Under the legislation being considered in the Senate, the ratio would could be no more than 3-to-1. The House bill limits the differential to 2-to-1. Governor Dean never complained about this premium spread before. Now that the public option is likely to be cut from the Senate bill, a 3-to-1 limit on premiums becomes a decisive factor for him?

Governor Dean’s attack on the Senate bill is a loud reminder of how much Senator Edward Kennedy is missed in Washington. Senator Kennedy was as liberal, if not more liberal, than Governor Dean. The difference is that Senator Kennedy accomplished a great many things on the national stage. Governor Dean has accomplished nothing nationally. Senator Kennedy was successful in large part because he recognized the need to seize progress when and where he could. He knew there would be future opportunities. Even more importantly, he understood that, in broad terms, America becomes more progressive over time. Consider: it wasn’t that long ago that the fight was over whether the government should provide a medical safety net for older citizens. Republicans called Medicare socialism. Now they defend the program.

There’s a lot in the current health care reform bill I don’t like. There’s a lot about the status quo I don’t like either. What is infuriating about Governor Dean’s attack on the bill is that it is as nonsensical as those of the right. His “insurance company dream” is to the left what former-Governor Sarah Palin’s “death panels” are to the right – ideology masquerading as dire warnings.

Liberals in Congress will probably come around to supporting what they consider a watered down, insufficient health care reform bill. Liberals outside of Congress, like the former Governor from Vermont, will call on them to defeat the bill and start over. Underlying their logic is apparantly the belief that it’s possible to pass an even more liberal Congress.

What liberals like Governor Dean need to realize is that moderate Senators like Ben Nelson and Blanche Lincoln are just a part of the party as liberals like Senators Jay Rockefeller and Charles Schumer. I suppose Governor Dean could recruit liberals to run for the Senate in Nebraska, Arkansas, Indiana, Louisiana and other states from which moderate Democrats hail. There’s only one problem. Liberals don’t get elected to the Senate from those states. Not in 2010.

Members of Congress understand the need for compromise. They may not like it, but they accept that their less-than-liberal colleagues represent their constituencies. Those on the sidelines have the freedom to ignore such realities and to throw bricks with abandon. These ideologues won’t solve many problems, but I guess the brick throwing makes them feel better.

Senator Kennedy understood the need to work with those less liberal than himself, to keep issues alive by passing significant reforms that may not be all he wanted to achieve, but laid the groundwork for future efforts. Governor Dean is blind to this approach. But then, Howard Dean is no Ted Kennedy. Never was. Never will be.

Daschle Withdrawal Could Be Bad News for Reasonable Reform

There are some who will celebrate former Senator Tom Daschle’s decision to withdraw his nomination as Secretary of Health and Human Services and as Director of the White House Office on Health Reform. They should not. Even for those who disagree with his approach to reform — and I certainly disagreed with significant portions of it — the withdrawal is bad news.

First, because Senator Daschle is bright, very bright. And anyone tackling substantial changes to a system as complex, critical and impactful as America’s health care system better be very bright.

Second, unlike many bright people, Senator Daschle is a proven political pragmatist.  He understands the need for buy-in from competing interests and for compromise. This doesn’t mean he doesn’t have principles and a philosophy. He has both. But he also has a commitment to getting reform passed, which means he’d listen to and, where possible, incorporate the ideas of those who oppose his philosophy.

Third, Senator Daschle knows Congress and is trusted by the President. This would enable him to effectively influence the former and to ably represent the latter. Without his presence, reformers in Congress may have more sway and President Barack Obama will have a less forceful voice in negotiations.

Fourth, the individual(s) nominated in his stead may lack any of these strengths. One of the names floated, for example, is former Governor and Democratic National Committee Chair Howard Dean. Governor Dean, a doctor by profession, showed himself to be a smart organizer as head of the DNC. There were also plenty of times, both at the DNC and a presidential candidate in 2002, that he demonstrated a more ideological and erratic approach to issues like heatlh care reform than Senator Daschle.

There are others President Obama could turn to for leadership on health care reform. None are likely to possess the leadership traits possessed by Senator Daschle.

Senator Daschle’s tax return errors says more about the complexity of the country’s tax code than it does about his character. Those who oppose his approach to health care reform may find themselves nostalgic for his approach before long.