Health Politics

Health bloggers were so busy linking to David Leonhardt's excellent New York Times Magazine piece on the lessons about cost and quality drawn from Intermountain Healthcare that we nearly overlooked another piece in the magazine -- a profile of conservative activist Dick Armey -- that tells another, more alarming, story about the politics and ideology of health reform.

Armey and FreedomWorks had a hand in the angry and chaotic town hall meetings of last summer. (Freedomworks isn't the same as the Tea Party, but they overlap.) And health care, for Armey, isn't just about health or care.  It's a vehicle for the rise of the right. The economic conservative far right. The right that wants to stop government in its tracks. Or shrink it. The right that believes the American way is all about the rights of individuals, not the needs of community. And of course, the "rights" of individuals have to do with things like the flat tax, not health coverage. The right to health care, however, doesn't seem to figure in here too much.

There were enough live-bloggers and Twitterers, and news alerts about the House health care vote on Saturday night that we decided not to add to the cyber-din. But that doesn't mean we weren't curled up on the bedroom floor, glued to the television, Blackberry in hand, trying to carry on five or six email conversations with people we've known for years, who also savored this moment. (Probably none of my email pals were simultaneously running up and down stairs from bedroom to kitchen during particularly windy speeches baking a basketball-themed birthday cake for a nine-year old but that's not strictly relevant). We are all too well aware of the obstacles remaining in the Senate, and we will post an update on that shortly. But watching that vote, seeing the satisfaction -- not political satisfaction, something deeper -- replace the exhaustion etched on Nancy Pelosi's face, was a remarkable moment. Long time coming.

One of the emails I got after the vote was from Len Nichols, the director of our health policy program (aka my boss). Len loves political courage. He loves bipartisanship. He also has a particularly soft spot for New Orleans. So naturally, Len was pretty impressed with Anh "Joseph" Cao, the sole Republican with whatever the Vietnamese-American equivalent of "chutzpah" is to vote for the Democratic health reform bill.

Today was a big day for the House's health reform efforts.

The AARP, the American Medical Association and the American Cancer Society Cancer Action Network publicly announced their support for the Affordable Health Care For America Act (H.R. 3972) (and, particularly for the doctors, the Medicare Physician Payment Reform Act (H.R. 3961) aka the "doc fix.")

Today was the first time that the AARP has put its "full weight behind a comprehensive health reform package," the AARP statement says. "We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors," said AARP CEO Barry Rand. "We've read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage."

Last night, the Congressional Budget Office released a preliminary analysis of the House Republican health care bill. The bill focuses mostly on cost and repackages a lot of the conservative ideas that have been around for years (and never came to fruition even while Republicans held the torch.)

According to the CBO, by 2019, the Republican bill would only extend health coverage to three million more Americans and reduce the federal deficit by $68 billion. In comparison, by 2019, the House Democratic bill would insure 36 million more Americans and reduce the federal deficit by $104 billion.

David Rogers, now with POLITICO, formerly of the Wall Street Journal, may be the least chatty reporter in Washington (trust me, I sat about 5 feet away from him for 12 years in the Senate Press Gallery... although I suppose if you averaged his taciturnity with my extroversion, you would have had two average chat-ers). He's also one of the best and clearest-thinking. He has institutional memory and historical context often lacking in the 24/7 rush-rush of much of the media today. So while so many people are hyperventilating about whether two off-year GOP gubernatorial wins will spell doom for health reform, David comes up with this reassuring and well-reported story, "Dems want to seize historic moment."

Health care is big for House Democrats: big like Social Security in the '30s and civil rights in the '60s, big like the war stories retold now in party caucuses as lawmakers grapple with the floor vote that is just days away.

All politicians live in the present -- or risk perishing, as seen Tuesday night. But history also sits on the shoulders of Democrats these days, and having failed to act on health care in 1994 -- and then having lost power -- they feel an almost inexorable push to seize this moment before it slips away.

The AP reports that the AARP is ready to announce it's support for the Democratic health reform legislation in the House. The endorsment from the influential retiree's lobby should provide a big boost as House Democrats are expected to vote on H.R. 3962 Saturday evening. Streaming video of the AARP announcement, set to begin at 11:30 a.m., is available below.

Meanwhile, the American Medical Association will announce it's position on the House bill's at 12 p.m. More on that after we get off the call.

There isn't a lot that can make us grimace more than a headline that says that Harry Reid is talking about allowing health care reform to spill into 2010. Just typing the words hurt.

Forget about the fact that it is just not good for our collective mental health. ("Our" meaning everybody that is working on health care reform... right, left, up, down, and definitely those poor folks at the CBO ) It's not good politics.

Doesn't anybody out there remember the month of August?

The longer the debate drags on, the more enemies of reform can tear down and attack and confuse. They've already started.

Today is a national "Women's Day of Action" for health reform, part of the National Women's Law Center (NWLC) campaign, Being a Woman Is Not A Pre-Existing Condition. The campaign works to educate women about the disparities they face in the current health care system and urge them to fight for reform. The day of action features a rally in D.C. where women can share their stories and an online action network that offers information and a portal to contact Congress and demand health reform.

(We are refiling this post to make the paragraph about the SEC a little clearer for our readers.)

"The American people and I are asking a serious question and one that deserves a straight answer -- why are health insurance costs going up each year?" Sen. Jay Rockefeller (D-WV) questioned in a letter (part 1 and part 2) to H. Edward Hanway, the CEO of CIGNA, yesterday. "Are they spending it to make people well when they are sick and keep them healthy? Or is the money they charge going to profits, to executive salaries, and to figuring out how to deny care to people when they really need it?"

Sen. Rockefeller explains:

An early draft of the House Republicans' health care bill is available at BNA. The Republican bill is much more limited in scope than the current House health reform bill, and is focused primarily on cost -- which represents only one aspect of the problems plaguing our current health care system.The bill repackages a lot of the conservative ideas that have been floating around for years -- and which didn't even get enacted when the Republicans were in control of Congress and the White House.

The bill will not end insurance company discrimination against high risk individuals nor will it provide subsidies to help the uninsured purchase coverage, according to Politico:

Boehner hasn't released the full details of the bill but has said that it would make it easier to buy insurance across state lines, impose strict limits on medical malpractice lawsuits and allow individuals and small businesses to pool their resources to buy insurance as a group. That is designed to boost their purchasing power to help lower individual premiums.