Obama's Health Care Snowe Job

“Now is not the time to pat ourselves on the back”, the President proclaimed. "Now is not the time to offer ourselves congratulations." How right he was. If only he really meant it.

He was reacting, of course, to the so-called “bipartisan” health care bill that had passed the Senate Finance Committee a few hours earlier. It is astonishing that he could tout this bill, which bears little resemblance to the principles he outlined in his address to a joint session of Congress a few short weeks ago, as “a critical milestone” that brings us “closer than ever before to passing health reform.” Equally astonishing that in Obama’s mind the support of a single Republican Senator – Olympia Snowe – apparently qualifies the bill as “bipartisan”.

It becomes more apparent with every passing day that Obama lacks an ideological commitment to serious health care reform. I don't buy the alternative argument that he simply lacks the political savvy to translate campaign promises into legislation, even with the benefit of substantial majorities in both Houses of Congress. If that is the case, then he has been out-maneuvered at every turn by the proponents of the status quo. Polls show that a majority of Americans favor either a single payer system or a strong public option. Had Obama shared that view, the obvious negotiating strategy, and one that would have had broad public support, would have been to push for a single payer system and “settle” for a public option. But Obama and Max Baucus, the Senate Finance Committee Chairman, effectively took not only the single payer solution but also the public option off the table even before sitting down to negotiate.

When Obama returned from vacation on September 1 he had to confront a growing groundswell of criticism from progressive Democrats dissatisfied by his failure to press for the public option they view as an essential element of health care reform. Obama's carefully crafted response was to re-affirm that he “favored” the public option as one possible means of cost containment. Not "demanded", "favored". Most seemed to overlook the choice of words, but the signal to Baucus, Grassley et al was clear.

Obama has tried to justify abandoning the public option by stressing the value of “bipartisanship”, as if bipartisanship was a goal in itself. What we are witnessing is not even bipartisanship; it is the triumph of special interests over the interests of the American people – in other words, business as usual. But to take the analysis a stage further, why should bipartisanship be a goal in the first place? Why should Obama care whether or not the Republicans support health care reform? Instead of attempting to schmooze the special interests, Obama should have played hardball with the Democrats and made clear to the so-called "bluedogs", many of whom rode into Congress on Obama's coattails, that they should get behind the party's platform or fend for themselves in the 2010 elections. The legislative process is partisan to its core, and that’s a good thing. Our democracy is founded on the principle that the electorate can chose between parties of differing philosophies and the prevailing party then has a mandate to implement the policies on which it ran. Perhaps Obama genuinely believes that a majority supports bipartisanship as an end, or even as a means to an end. But if so, he is missing a very fundamental distinction between bipartisanship and civility. People are not disenchanted when their elected representatives fight to promote the policies on which they were elected. That’s what they expect them to do. It is the terms of engagement that voters don’t like; the shrillness of the debate; the rhetoric intended to scare or confuse, rather than to inform; the personal attacks; above all, the pervasive and corrupting influence of money.

There is a saying in Washington that “elections have consequences”.  Many people expected that this over-used cliche might actually gain some currency following the election of a candidate ostensibly dedicated to “change”. But that is not what we have seen, at least in the case of the health care debate, where special interests have demonstrated that their grip on the legislative process remains as firm as ever, especially in the case of the Senate Finance Committee. The Committee Chairman, Max Baucus, is the leading Congressional beneficiary of health industry largesse. Between 2003 and 2008 he reportedly pocketed an astonishing $3 million in campaign contributions, with half of that total coming in the last two years after he assumed the Committee Chairmanship. Baucus delegated preparation of the initial draft of the bill, the “Chairman’s mark”, to the so-called “Gang of Six”; three Democrats (Baucus-MT, Conrad-ND and Bingaman-NM and) and three Republicans (Grassley-IA, Snowe-ME and Enzi-WY). This neutralized the Democratic majority on the Committee as a whole, and effectively assured an industry-friendly bill.  In a travesty of the democratic process, Baucus excluded Senators from the most populous states – like Chuck Schumer of New York.  The Gang of Six between them represent less than 3 percent of the nation’s population.

However, the special interests received their usual attentions and favors.  Candidate Obama had criticized the influence of the drug companies on Capitol Hill, but President Obama secretly negotiated a deal with Big Pharma to block Congressional action to allow the Government to negotiate drug prices, undercutting the efforts of Congressional Democrats to rein in prescription drug costs. (Two Democrats, Menendez of New Jersey and Carper of Delaware, subsequently put their mouths where their money comes from and joined Baucus in voting against an amendment that would have generated savings in drug prices. Menendez, a self-proclaimed advocate of health care reform, has reportedly taken $1.2 million in campaign contributions from the health care sector.) To say that the health insurance lobby was closely involved in the drafting would be an understatement.  Much of the bill was reportedly drafted by one Liz Fowler, Baucus' senior adviser on healthcare matters.  Prior to working for Baucus,  Fowler was the Vice President of Public Policy for Wellpoint; she recently traded jobs with Baucus’ former adviser. And union and business lobbies teamed up to defeat the Wyden Free Choice amendment, which would have allowed employees dissatisfied with their company health insurance plan to shop around; Baucus ensured that the amendment was thrown out on spurious technical grounds. About the only special interest not represented was the American people, including the 45,000 who, according to Harvard University researchers, will die this year because they don’t have adequate health insurance.

Which brings me back to Olympia Snowe. Obama's plaudits were apparently insufficient gratitude for her meaningless vote in favor of the bill she herself helped write (a vote, she stressed, she may in any event reverse when the bill comes to the Senate floor.) The Finance Committee bill must now be merged with the Health Committee bill, which includes a public option. This critical process will be led by a committee comprised of Harry Reid, the Majority Leader, Max Baucus and Chris Dodd, the two Committee Chairmen, and – you guessed it, Olympia Snowe. That is the reward she extracted in return for her vote. Press reports suggest that she is expected to play a significant role in the process and that Harry Reid will go to substantial lengths to keep her happy. Am I alone in thinking that Snowe’s hard won and grudging “support” for the bill was in fact a carefully orchestrated strategem to plant a Republican Trojan horse at the center of the merger process? Whatever the answer, Snowe’s inclusion means that at least two of the four principals involved in merging the legislation – Max Baucus and Olympia Snowe – are on the record as opposing the public option. Don’t hold your breath over how this one will turn out.

“Now is the time to work even harder to get this done.” Inspiring words from the President, and you can be sure he at least will be doing his bit and working harder than ever. Working harder than ever to ensure that no Democrat will have the temerity to offend Olympia Snowe by pressing for a public option and working harder to persuade the electorate that whatever watered-down proposals emerge from this appalling and unseemly process somehow resemble the genuine health care reform candidate Obama promised us. The latter goal may exceed even Obama’s much vaunted powers of persuasion.