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Friday, December 25, 2009

If We Don't Fix the Senate's Miserable Health Bill, the Repercussions Could Last for Decades

Calling the Senate's health bill a "awesome achievement" like Paul Krugman did is to encourage the preservation of a hideously broken system.

With Monday morning's 1 a.m. 60-40 vote, the Senate's health care bill took another step towards passage, prompting a fresh round of public celebrations. "I think it's very exciting," HHS Secretary Kathleen Sebelius told HuffPost. "It's a big day."

Even many of those with serious reservations about the bill were slipping on their party hats. "Make no mistake about it," said SEIU president Andy Stern, "for working Americans, this vote signals progress."

And Paul Krugman, while calling the legislation "a seriously flawed bill we'll spend years if not decades fixing," applauded it as "an awesome achievement."

This typifies the current thinking of the "Don't let the perfect be the enemy of the good" crowd. Unfortunately, there are three faulty premises at work in this line of reasoning. First, that those who oppose the bill do so because it's not perfect (as opposed to because it's a hot health care mess). Second, that the bill is, well, good (as opposed to a total victory for Pharma and the insurance industry -- witness the spectacular spike in health care stocks following Monday's vote).

Third is the premise that this is as good a bill as we can get right now, and we can always go back and improve it later.

It doesn't work that way. We heard the same kinds of sentiments about No Child Left Behind when it passed in 2001. Backers on both sides of the aisle had problems with it, but both sides celebrated it as a major step forward -- and promised to make it better in the future.

"The agreement we reached reflects the best thinking of both sides," said Sen. Joe Lieberman.

"This was a reform bill. We can't have reform without resources, and that will be the next step," said Sen. Tom Daschle.

"This is a good bill... And there are going to be many additional steps that will be necessary along the way, but all of us are committed to following in those steps," said Sen. Ted Kennedy, the primary Democratic co-sponsor of the bill.

But despite the widespread commitment to taking the "many additional steps" needed, the steps were never taken, the resources were never allocated, the bill was never improved, and, indeed, is now generally regarded as a disaster (or, as Bill Clinton put it last year, "a train wreck").

In an ominous sign of things to come, Vicki Reggie Kennedy, Sen. Kennedy's widow, made many of the same arguments that were used in support of No Child Left Behind in her Washington Post op-ed promoting passage of the current health care bill.

It's a moving piece of writing -- and nobody doubts her late husband's heartfelt dedication to health care reform. But nobody doubted his dedication to education reform, either.

If the miserable Senate health care bill becomes the law of the land, it's only going to encourage the preservation of a hideously broken system. Just how broken the system is is summed up in the fate of Byron Dorgan's drug re-importation amendment.

This is an idea that Obama co-sponsored when he was in the Senate and unequivocally championed on the campaign trail: "We'll allow the safe re-importation of low-cost drugs from countries like Canada."

But when Dorgan introduced an amendment that would do just that, the White House, sticking to the deal it made with the pharmaceutical industry, lobbied against it -- and the commissioner of the supposedly non-political FDA just happened to release a letter citing "significant safety concerns" about all those dangerous drugs from Canada. Big Pharma's many congressional lackeys trumpeted the letter and the amendment was killed.

But that didn't stop David Axelrod from insisting in an interview with John King this weekend that "the president supports safe re-importation of drugs into this country. There's no reason why Americans should pay a premium for the pharmaceuticals that people in other countries pay less for."

No reason other than our broken system surrendering to the special interests.

From start to finish, the insurance and drug industries -- and their army of lobbyists -- had control over the process that resulted in a bill that is reform in name only. The postmortems of how they pulled it off have already begun. On Sunday, the Chicago Tribune published an exhaustive front-page analysis by Northwestern University's Medill News Service and the Center for Responsive Politics of how it was done. The main culprit: "a revolving door between Capitol Hill staffers and lobbying jobs for companies with a stake in health care legislation."

The study found that 13 former congressmen and 166 congressional staffers were actively engaged in lobbying their former colleagues on the bill. The companies they were working for -- some 338 of them -- spent $635 million on lobbying. It was money extremely well spent -- delivering a bill that, by forcing people to buy a shoddy product in a market with no real competition, enshrines into law the public subsidy of private profit.

As we approach the end of Obama's first year in office, this public subsidizing of private profit is becoming something of a habit. It is, after all, exactly what the White House did with the banks. Just as he did with insurance companies, Obama talked tough to the bankers in public but, when push came to shove, he ended up shoving public money onto their privately-held balance sheets.

This is not just bad policy, it's bad politics.

Sharp-eyed opponents are already seizing on the opportunity to rebrand Obama and the Democrats as the party beholden to special interests.

Sunday night, just before the post-midnight vote was taken, John McCain took to the Senate floor and, hearkening back to his days as a crusader for campaign finance reform, lambasted Obama and the Democrats' "negotiations with the special interests," adding: "We should have set up a tent out in front and put Persian rugs in front of it. That's the way that this has been conducted. So the special interests were taken care of, then we had to take care of special senators."

This kind of populist rhetoric resonates with voters across the board, including independents. If Democrats cede this turf by celebrating a bill that is a victory for special interests and special senators, look for a lot more of this kind of rhetoric in the run-up to 2010.

President Bush brought us preemptive war. President Obama's specialty seems to be preemptive compromise. He gave the farm away to Pharma, and then had to keep on giving when Lieberman, Nelson, and the other industry-backed Senators came calling.

There are many reasons for hoping the current Senate bill doesn't become law. But the biggest reason of all is the desperate need for a DC pattern interrupt. The desperate need to draw a line in the sand against the continued domination of our democracy -- and the continued undermining of the public interest -- by special interests.


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