A missed opportunity on health care reform

By Mary Claire Kendall

Sen. Ben Nelson (D-Neb.) must be smarting now that Democrats are talking about pulling the plug on the “deal” they crafted just for him and his State of Nebraska as the price of his support for Obamacare, now polling at W’s lows and and threatening the loss of Ted Kennedy’s seat—a provision that would exempt Nebraska from paying for the Medicaid expansion designed to cover currently uninsured low-income folks.

“Get as much gunk out of the Senate bill as possible. That Nebraska thing is really hurting us,” Bill Clinton told House Democrats in a closed-door speech during their annual “retreat” this year at Capital Visitor Center, far from the spa resort in colonial Williamsburg they usually decamp to. (Washington Post, 1/16/10)

Before they cut that deal, the White House brazenly threatened to hurt Nelson, a coalition of physicians [1] allege in a lawsuit, by putting Offutt Air Force Base on the Base Realignment and Closure Commission (BRAC) list, slating it for closure, unless Sen. Nelson voted the right way.

Offutt AFB, Strategic Air Command headquarters, employs approximately 10,000 military and federal employees in Southeastern Nebraska. (So, Americans might not have jobs—either by an Act of God, an Act of Obama, or an Act of Financial Recklessness, if you don’t believe Lloyd Blankfein’s version of events—but they’ll have health care to deal with the resulting ulcers.)

Nelson’s was just one of many tailor-made deals that—Clinton’s right—are patently unfair to everyone else not in on the fix. Sen. Nelson, recognizing the obvious injustice, now says he wants to scratch the Nebraska provision but then replace it with a much more expensive provision that would exempt every state from the costs of expanded Medicaid coverage.

Problem is, Obama’s contention that health care reform would save money would then, finally and irrevocably, be exempted from reality, since Nelson’s “solution” to other states’ legitimate grumbling would explode costs, making former Comptroller of the Treasury David Walker’s quip at the budget commission’s opening hearing last month that “Harry and Louise” have morphed into “Thelma and Louise” a fitting summation of the year-long health care “debate.”

And, to think, the mess Democrats find themselves in was all so unnecessary.

If they had taken a cue from the Republicans, who contrary to repeated false assertions by Democrats that they were only obstructionists, did, in fact, offer an excellent alternative: It’s called the Patients’ Choice Act (PCA)—co-sponsored by Sens. Tom Coburn (R-Okla.) and Richard Burr (R-N.C.) and Reps. Paul Ryan (R-Wisc.) and Devin Nunes (R-Calif.)—that in contrast to the Democrats’ Patient Protection and Affordable Care Act, would achieve universal coverage and create a true insurance market, thus removing anti-competitive inequities currently plaguing the system.

And, most brilliantly, it transforms Medicaid from its current third-rate status to a first-class, stigma-free health care system for low-income, making it the natural corollary to Republican-crafted welfare reform Bill Clinton smartly co-opted in one of the crowning achievements of his presidency. Plus, it saves money and tackles health care’s structural deficiencies [2] by realigning “how nearly $1 trillion, currently assumed under law, is spent by involving individual beneficiaries in a way that decelerates the healthcare spending growth rate, through a carefully calibrated template and formula that emphasizes health outcomes…”

States would save $1 trillion and the federal government $300 million, thus responding to voters’ most pressing concern—to contain exploding health care costs.

Not only that, Democrats could have counted on Sen. Nelson’s vote without resorting to such unseemly tactics. And, today’s effort, sailing in the perfect storm to save Ted Kennedy’s seat, wouldn’t seem like Mission Impossible.

Mary Claire Kendall is a Washington, D.C.-based journalist and screenwriter.


I wrote this piece as Democrats were heading into the "perfect storm" in Massachusetts in their ultimately fruitless attempt to retain the Senate seat of the late Ted Kennedy... Scott Brown ran as the 41st vote against Barack Obama's costly yet ineffective healthcare legislation... when groundbreaking legislation is contemplated, steamrolling support is never the way... This article, first published in Daily Caller, was posted at http://devinnunes.blogspot.com/2010/01/missed-opportunity-on-health-care_21.html , Congressman Devin Nunes' blog.