Health Care 2009: Meet the Cast

kevin

@ November 18, 2008

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The upcoming fight over comprehensive health care reform is liable to be one of the most explosive political fights since, well, Hillarycare. And this time, it's got a bigger cast with bigger egos and even higher stakes. Who are these titans of legislation, these gatekeepers of treatment? Let's find out...

Ted Kennedy (D-MA)

No discussion could hope to begin without the Liberal Lion. A man haunted by his past sins and personal tragedy, he dedicated his life to improving others' as a way to redeem himself. But one goal has always eluded him, and now he's working under a death sentence. Just today, he vowed to introduce a Universal Health Care bill in 2009. And this time, he's got nothing left to lose...

His ideal plan: True Single Payer (European style UHC)
His priority: Universality. Getting everyone covered is essential.

Max Baucus (D-MT)

A true enigma. Who is Max Baucus, you may ask? He's chair of arguably the most powerful committee in that venerable institution of the Senate: The Finance Committee. He stands atop his position master of all he surveys, gatekeeper to any bill passing. A silent stalwart, he could strangle any initiative in its infancy. But who is this man? A corrupt, decrepit husk of a man, fully owned by lobbyists, or a master manipulator who's been biding his time?

He's been called 'K-Street's favorite Democrat', 'Bad Max', and 'The High Plains Grifter' (by The Nation, The American Prospect, and The Washington Post, respectively). Even the centrist New Republic called for stripping him of his chairmanship. He was instrumental in passing Bush's tax cut and the 2005 bankruptcy bill that's still causing trouble today. Worse, he raises millions from the very industries he's supposed to be regulating.

But has this inimitable villain had a change of heart? Just recently, he proposed a plan for moving forward, and it looks... a lot like the Clinton 2008 plan. Mandates everyone gets health care of some kind, offers a public insurance option equivalent to Medicare. Almost identical in fact. But is it his goal, or his strong stake to be bargained down into pork-laden uselessness?

His ideal plan: Clinton 2008
His priority: Getting rich off industry donors

Barack Obama (D)

No need for a picture here. As an unfortunate result of having to gin up differences between himself and Sen. Clinton (D-NY), he staked out an argument against mandates. Most believe that this was sheer political posturing, but if it's a deeply-held belief, he could face a very public battle with the Congress...

His ideal plan: The one he put out during the primary (?). Clinton 2008 - Mandates
His priority: Getting it done. He desperately needs to avoid a Hillarycare debacle.

Hillary Clinton (D-NY)

Veteran of the brutal 1994 fight that bears her name, it's been long thought that she'd eventually be playing a critical role in the passage of the bill, it's beginning to seem that her major contribution was shaping the debate. And unquestionably she did, her 2008 plan is the outline for any bill's structure. But being lured from the Senate with the tempting post of Secretary of State, she might end up sidelined for the legislative battle. A possible mistake, she's undoubtedly a shrewd ally and someone I'd want fighting this fight.

Her ideal plan: Clinton 2008
Her priority: Finishing her nearly two decade fight victorious

Piyush "Bobby" Jindal (R-LA)

The swarthy, mysterious newcomer... He's recently burst onto the scene with a bold, stunning Medicaid proposal in his home state. Rather than normal Republican dogma that the problem with health care is overuse of treatment caused by insulation of the patient from prices, he takes a different tack. Doctors are paid a fixed rate per patient, with bonuses not from the number of treatments, but of the longterm outcomes. It's very similar to Britain's National Health Service system, and, arguably, both more bold and more socialist than the leading Democratic plans! However, details are currently very vague, and could certainly shift the actual implementation in good or bad ways.

Notable other figures:

Moderate Republican senators such as Snowe, Lugar, and Specter.

'Blue Dog' Democratic senators such as Nelson and Salazar.

Klein, Ezra. The American Prospect. http://www.prospect.org/cs/articles?article=the_sleeper_of_the_senate

Pictures primarily from Wikipedia

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Filed under: health care | policy

jesse @ November 18, 2008 10:52 PM

Is there really going to be an upcoming fight on health care reform? I would have thought that it would be a pretty low priority on the agenda in the face of the economic problems and the wars... is there some indication to the contrary?

kevin @ November 19, 2008 11:52 AM

In retrospect I should have clarified that more. made his domestic priorities clear: First economy, then energy, then health care. However, the president doesn't make laws, as we all learned in high school government.

Basically the answer is that key Senators really, really want it to happen, and since the Senate is where the fight will eventually be, this matters. Additionally, Ted Kennedy is dying of a brain tumor, and it needs to get passed in Obama's first term, and ideally before the 2010 elections ramp up. All the players remember 1994 when reform failed and then Newt Gingrich used it as a springboard for huge gains in Congress.

The Senate is where the real action on health care is, since you basically need 60 votes to pass anything. Just yesterday he announced the formation of three working groups on health care, led by Tom Harkin, Barbara Mikulski, and Hillary Clinton. Max Baucus has been preparing for a year, and has recently kicked it into high gear. Here's his opening statement at this morning's hearings on health care and the economy (via Ezra Klein):

"We are clearly facing a significant recession. That economic challenge commands a significant investment of government resources. Some say that we will have to choose between fixing the economy and enacting comprehensive health reform.

I reject that false choice. I say, we can and should do both. We can walk and chew gum at the same time. Not only can we, but we have to.

Health care reform is not a distraction from addressing the economy. Health care reform is central to restoring America’s economy.

The costs of inaction, both in human terms and financial terms, are greater than the costs of reform. "

kevin @ November 20, 2008 12:10 PM

More encouraging signs:
Tom Daschle as Health and Human Services secretary. You don't appoint a former Senate Majority Leader to run a health care bureaucracy. You appoint him to help shephard a plan through the Senate.

By far the biggest, from today's New York Times, insurance companies are on board:

"The health insurance industry said Wednesday that it would support a health care overhaul requiring insurers to accept all customers, regardless of illness or disability. But in return, the industry said, Congress should require all Americans to have coverage.

The proposals, put forward by the insurers’ two main trade associations, have the potential to reshape and advance the debate over universal health insurance just as President-elect Barack Obama prepares to take office."

Acceptance regardless of preexisting conditions is absolutely key, because they're one of the main causes of health care being so shitty.

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