Thursday, January 21, 2010

A missed opportunity on health care reform

By Mary Claire Kendall
The Daily Caller
January 19, 2010

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

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

Before they cut that deal, the White House brazenly threatened to hurtNelson, a coalition of physicians allege in a lawsuit, by puttingOffutt Air Force Base on the Base Realignment and Closure Commission(BRAC) list, slating it for closure, unless Sen. Nelson voted the rightway. Offutt AFB, Strategic Air Command headquarters, employsapproximately 10,000 military and federal employees in SoutheasternNebraska. (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’tbelieve Lloyd Blankfein’s version of events—but they’ll have healthcare to deal with the resulting ulcers.)

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

Problem is, Obama’s contention that health care reform would save moneywould then, finally and irrevocably, be exempted from reality, sinceNelson’s “solution” to other states’ legitimate grumbling would explodecosts, making former Comptroller of the Treasury David Walker’s quip atthe budget commission’s opening hearing last month that “Harry andLouise” have morphed into “Thelma and Louise” a fitting summation ofthe 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 repeatedfalse 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 RichardBurr (R-N.C.) and Reps. Paul Ryan (R-Wisc.) and Devin Nunes(R-Calif.)—that in contrast to the Democrats’ Patient Protection andAffordable Care Act, would achieve universal coverage and create a trueinsurance market, thus removing anti-competitive inequities currentlyplaguing the system.

And, most brilliantly, it transformsMedicaid from its current third-rate status to a first-class,stigma-free health care system for low-income, making it the naturalcorollary to Republican-crafted welfare reform Bill Clinton smartlyco-opted in one of the crowning achievements of his presidency. Plus,it saves money and tackles health care’s structural deficiencies [2] byrealigning “how nearly $1 trillion, currently assumed under law, isspent by involving individual beneficiaries in a way that deceleratesthe healthcare spending growth rate, through a carefully calibratedtemplate 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 explodinghealth care costs.

Not only that, Democrats could havecounted on Sen. Nelson’s vote without resorting to such unseemlytactics. And, today’s effort, sailing in the perfect storm to save TedKennedy’s seat, wouldn’t seem like Mission Impossible.

Mary Claire Kendall is a Washington, D.C.-based journalist and screenwriter, working with Providence Productions in LA.

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