Reform Update: Consistently Inconsistent
by: Kevin Phillips | posted October 29, 2009
There is a joke going around Washington, D.C. right now that goes something like this: There are White House staffers who are so in awe of President Obama that they believe healthcare reform should be, “if thou shalt simply touch the hem of his holy robe, thou shalt be healed.”
That one-liner doesn’t stray far from the prayers muttered on both sides of the political aisle that healthcare reform (or insurance reform, if you prefer) comes to some sort of resolution soon. Any sort. Do it or not, just be over. Being tired, frustrated and self-preserving do not mix well for meaningful legislation.
I spent a couple of days this week in D.C. making the rounds among those who are living and breathing the minutiae of reform every day. Among them, the leadership of the AHA, the ABA, the AMA, AHIP, AHRQ, CMS, conservative and liberal think tank thinkers, Senate healthcare legislative and legal staffers and some random tourists at Old Ebbitt. I only mention that litany of alphabet soup and others to make this point: the only thing consistent about their responses to variations of “what’s going to happen next in healthcare reform?” is the inconsistency of their projections.
As you read news stories reporting on the status and future of the current drafts of legislation, keep this in mind: the reporter is writing what that particular person told him at that moment in time. There’s nothing more to it than that. Even if factually correct, what’s said in this morning’s article is different by this afternoon. And even then, the perspective is different from “expert” to “expert.”
Here’s an example. I heard a status update from representatives of each of the above on Monday and early Tuesday – and then the legislative path took another unforeseen turn on Tuesday afternoon when Senator Lieberman (yes, he’s still officially a Democrat) said he’ll filibuster any bill that includes a public option. So much for a cornerstone of both the Senate Finance and House versions. Even the opt-out clause won’t satisfy him (or Olympia Snowe).
What is known is that it’s too early to plan a vacation around a Rose Garden signing ceremony. Some claim by Thanksgiving. Others say December 31 (because Congress will use every possible moment). Some believe we’ve moved into the dangerous territory of a vote taking place in the 2010 election year, January at the earliest. It’s rumored that the Senate and House will run their bills simultaneously and then shmush them (a D.C. term) together in conference committee. It’s also rumored that they won’t do that because the Senate’s ability to pass a version overrides anything the House passes.
In short, after 10 months of discussion, no one in the know actually knows what is going to happen. Reform is not a done deal. A timeline is not set. Language is not final. Business and Labor are split and have neutralized each other. Serious cost-containment is not on the table largely due to industry association clout. The Democrats are splintered on reform without a consistent message or platform – while the GOP is united behind one word: “no.”
So, if you want to influence the process one way or another, there is still opportunity. It’s anticipated that the outcry we heard from the public in August will be nothing compared to November and early December. We’ll see.
As they say in the ER, all bleeding stops eventually.
P.S. One final tip. Don’t waste time culling through what is now 2,000+ pages of draft legislation in order to analyze it. What is included today is going to be different from what is in a version for the floor vote. If you want to track the legislation every day, the best place for you to do that in a non-partisan, factual, straightforward way is to check out the Kaiser Family Foundation Web site. They keep up with side-by-side comparisons, too, of what’s in each bill.