OP-ED

Health Care Reform and the Art of Partisan Politics

The last time the US Senate held a vote on Christmas eve, it was 1895. In that one, lawmakers said it was OK for former Confederate army soldiers to serve in the military. The vote was hailed as a milestone in the slow national reconciliation following the Civil War.

No one was talking about national reconciliation following last week’s Christmas Eve Senate vote on health care reform. A bill was passed with unanimous support by Democrats, against the wishes of 40 resolute, disdainful Republicans.

The vote—and the long, vitriolic “debate” that preceded it—obliterated any remaining vestiges of collegiality and bipartisanship in the chamber…not to mention turning off those who see the issue to be complex and worthy of careful thought.

After struggling for decades to implement modest, incremental improvements to the nation’s fractured health insurance system, the Dems decided this was their best chance to do it up right. They weren’t going blow it, no matter what. So they cobbled together 60 votes–securing the last one in a particularly tawdry cash deal with a Senator from Nebraska–and then hunkered down.

There were 3 votes last week. Each one went down exactly the same way. 100 elected officials had their heels dug in for a week on the biggest piece of social legislation since John Travolta’s bell bottoms were banned in Boston.

Republican Senator Olympia Snowe of Maine, a moderate who has crossed the aisle many times in the past on health care and other issues, told the New York Times she was “extremely disappointed” with the process.

Once Democrats closed ranks, she said, “there was zero opportunity to amend the bill or modify it. Democrats had no incentive to reach across the aisle.”

And when the deed was done, Senate Majority Leader Harry Reid actually chastised the GOP for deciding “to stand on the sidelines rather than participate in great and greatly needed social change.” This comment, in this particular context, is the moral equivalent of an end-zone celebration worthy of 15 yards for unsportsmanlike conduct.

Whatever, the spectacle represented a new nadir in the nation’s 3-decade spiral towards an utterly polarized political system. Before last week in fact, there had never been a completely partisan vote on a social issue of such magnitude, or on major legislation of any sort, according to several Congressional historians.

The health reform bill, should it become law, would be social policy change comparable in scope to the formation of Social Security in 1935 and Medicare in 1965. Those landmark bills had substantial bipartisan support in both chambers of Congress. In the case of Medicare for example, the Senate vote of 68 to 21 featured 13 Republicans and 55 Democrats in favor, and 7 Democrats and 14 Republicans in opposition.

Even the 2003 expansion of Medicare to include a prescription drug benefit was passed with modest Democratic support.

And there is little chance the partisan divide will end any time soon. The battle will continue right through the 2010 and even 2012 election cycles, as Democrats try to rally support for the bill and Republicans look for every possible chance to say “we told you so.”

Reid, for example, has begun describing the fiasco as a battle of good vs. evil, with private insurers cast as the bad guys. “I don’t see this as 60 Democrats versus 40 Republicans,” Reid said. “I see it as 60 leaders who stood up to insurance companies and stood up for working families all across America.”

Reid’s colleagues were quick to pile on. Ohio Senator Sherrod Brown said the privates were “just one step ahead of the sheriff,” and California Senator Dianne Feinstein said the industry “lacks a moral compass.”

That’ll cost ya’ another 15 yards, fellas.

Anyone care to bet how the vote will go down on financial regulation, climate change and immigration?

Glenn Laffel is the Senior Vice President of Clinical Affairs at Practice Fusion.

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CarolTim TowersExhaustedMDNateMargalit Gur-Arie Recent comment authors
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Carol
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The big question is, “Who won?” The clear answer is: The health insurance companies and the health fascists. The health insurance companies get tens of millions of involuntary new “customers,” and the health fascists get to jam their cult ideology down everyone’s throats, enforced by fines in both cases.

Nate
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Nate

“I don’t have a problem with people getting rich through honest enterprise.” Everything about Al Gores campaign has been dishonest, have you not heard of the Hockey Stick and manipulated weather stations? I would have no problem ifit was honest but it is far from it, he is getting rich from fraud and corruption. Please use the inteligence we all know you have, I never said climate change was lies, I said Al Gore’s claims where lies, you should be able to tell the difference between what I said and what you falsely claimed to try and dminish my argument.… Read more »

Margalit Gur-Arie
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Margalit Gur-Arie

Nate, if Al Gore is amassing wealth based on something he thinks is right, that would be capitalism at its best and you should probably applaud him. I don’t have a problem with people getting rich through honest enterprise. Do you? Of course the problem is that you are referring to climate changes as lies. I’m not sure why folks of the right wing persuasion decided to ignore science on this one. Do you think it has something to do with the organized corporate activities I mentioned above? If we are all up in arms about saddling the next generations… Read more »

Tim Towers
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Gentlemen: I see I have stumbled upon a Blog of highly educated individuals. I am not going to even try and have an intellectual conversation with you, quite frankly because I don’t come from the same background. I am one of the common men. What I would like to share with you is what some of us think about how to handle the Health Care situation that the majority of the country has clearly stated they do not want. We are going to start by protesting a Representatives office in Rock Hill, SC and have started a nationwide pledge to… Read more »

Nate
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Nate

Margalit what is your opinion of those that push climate control and immigration? I ofter hear you rail against the capitilists side but can’t recall you ever being appalled by the lies and corruption it fights. Al Gore is making himself a billionaire off AGW and it is built on complete lies. He is gladly destroying millions of jobs and harming this country for his personal profit, does that not bother you at all? If Al Gore is willing to go to the level he has to make himself rich what level of counter measures do you find acceptable to… Read more »

Margalit Gur-Arie
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Margalit Gur-Arie

jd, the Barrons were a bunch of individuals who exploited a completely new situation where a nation was being forged, on an entire continent, at very short order. Yes, they were corrupt and ruthless and they managed to corrupt a government that just emerged from civil war and was equally clueless as to how to manage this experiment. Presidents were getting assassinated in office and I guess the entire nation was making the rules up as they were going along. In their defense though, while the Barrons were amassing fortunes, so was the country at large. The unbridled capitalism may… Read more »

ExhaustedMD
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ExhaustedMD

This is not about helping the general public get better health care, this is about special interests and a political body that is so out of touch with the true dynamics to the problems of health care, this legislative action borders on plain evil to me. And, the commenters here show no better insight than what I read at political blog sites and discussions with a broad spectrum of people in my interactions as doctor, colleague, neighbor, and citizen. There is no true, invested representation going on in Washington, DC, people. Just a bunch of selfish, ignorant, greedy, and clueless… Read more »

Nate
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Nate

Big Gov lobbies and the unions for starters. Forced unionization and mandatory participation in Gov plans.
Just becuase the nation took a few steps down the road of socialism doesn’t mean we sit back while we take the path to full blown Socialism/Communism.
The sooner we turn around and get back to what made us the greatest country the better off our grandchildren will be. We can’t undo all the damage the left has done but we owe it to the future to get started.

Jd
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Jd

Nate, you live in a socialist country. Unless you’re older than I think you are, you have lived in a socialist country your whole life. The mainstream public debate isn’t about whether we have egalitarian redistribution but how much and what forms. Likewise, the debate isn’t about whether government should provide a safety net and domestic programs, but what kind and how large.

Jd
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Jd

Margalit, I’m sorry but that is totally unpersuasive. What lobbies are uniting to oppress the people in a manner or degree beyond that to which Big Oil and the Robber Barons of the railroads didn’t 100 to 150 years ago?

Margalit Gur-Arie
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Margalit Gur-Arie

jd, the Gilded Age was what Madison would refer to as a “convulsion”. It was a time of great turmoil and it propelled this country from an agrarian, civil war thorn nation into a super power. Industrial revolutions are traumatic, but even during the worst times, American workers’ wages were double those in Europe and almost 40 million immigrants preferred this country to the “old country”. The most interesting phenomena was, in my opinion, the ability of the system to regenerate and fix itself. The Gilded Age was followed by Roosevelt and the Progressive era. What is frightening today is… Read more »

Nate
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Nate

What Matt is suffering is his unability to force the rest of the country into his communist programs. We aren’t England, France, or Japan nor do we strive to be. Not sure why you liberals can’t accept this. We designed this country so it couldn’t be hijacked by people thinking like Matt. If CA or MA want a French healthcare system you could have one tomorrow. The problem is Matt doesn’t want to pay for it, he wants to force those that disagree to also pay into his failure to be. This is why Communist and Socialist oppress their people… Read more »

jd
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jd

Margalit, I suggest you read about the history of America in the Gilded Age. Your take on the system working well for the average American until recently doesn’t hold up. Special interests didn’t need cell phones to corrupt the government, or merely influence it in their favor.

Margalit Gur-Arie
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Margalit Gur-Arie

Matt, It’s not the filibuster or the cloture that are not democratic and it’s not the constitutional system that is at fault either. Unlike Europe, in addition to the Constitution, this country was founded on a pure Capitalist theory, and until now, it was served well by it. When America’s corporations were doing well, America’s people were doing well. In a flat new world, this alignment of interest is not so clear anymore, but that’s a different story. If you haven’t already, please read Federalist #10. It is pretty amazing how Madison anticipated the problems we are facing today and… Read more »

jd
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jd

archon41, you haven’t really been paying attention. All of us on this site who want to expand coverage also believe we overutilize care in many places…primarily specialist care and testing/imaging. The goal is to use less of that stuff for everyone, which means we can bring more into the system without increasing capacity. The point you make has some validity for primary care, where we don’t have a surplus of practitioners now and there will be more demand placed on the system. Thus, there will be some scarcity until new primary care physicians are trained. But, even here, there is… Read more »