By John Brummett
Senate Democrats are thinking about passing health care reform with only a majority vote.
That’s big news. It could mean that federally mandated universal health care with a public health insurance component could be coming down your alley by the end of this calendar year.
It’s all about the Senate. The House is a cinch for the Democrats. Nancy Pelosi has their back over there.
This way, Senate Democrats would need no Republicans. And, by following a process requiring only 51 votes in a hundred instead of the towering 60 to break a filibuster, they also could let as many as seven or eight of their center-right Democrats go their own ways to tend to any personal qualms or, more likely, political fears.
Even with all that, they could still give President Obama the only victory he’s likely to get this year, save that early stimulus, the victorious spoils of which have not yet been realized. He’s not going to get that carbon tax and he’s not going to be able to pay off the unions with card check.
Health care would trump all that. It would be a signature. It’s only been 60 years since Harry Truman gave it a shot.
The pundit talk in Washington is that cramming health reform down Republicans’ throats could be risky for Democrats. But Republicans haven’t been receptive to Obama’s conciliatory overtures. Anyway, the tactic is less risky than the policy.
If health care reform passes and makes positive changes for people in our health care financing morass, Democrats will reap the benefit whether they got 51 votes or 60. And vice versa.
Process matters to political animals. Product matters to people. So if you trust the value of your product, then don’t sweat so much the process.
Here’s the operative circumstance: The Senate in the modern day has evolved into a culture in which only a super-majority of 60 votes can pass anything substantial. That’s because the minority party invariably invokes a filibuster — a passive one, not a dramatic one like Jimmy Stewart’s — and it takes 60 votes to end that filibuster.
Except. . .
Budget and budget reconciliation measures require only a majority vote. So, if they wanted, Senate Democrats could pass a budget outline encompassing the necessary additional money for health care reform. Then they could plug the vast public policy particulars into that plan — reconciling, it’s called — and get all this accomplished with 51 votes.
Republicans are aghast, naturally.
Michael B. Enzi, Republican senator from Wyoming, said such a move by Senate Democrats would be a “declaration of war.” Business lobbyists and health care industry lobbyists say it would be horrid to impose such massive reform without reaching out to the other side, meaning to them.
But reaching out hasn’t much worked and wars sometimes need to be declared and fought before they can be won.
Anyway, Ronald Reagan did this budget-reconciliation trick all the time in 1981. George W. Bush passed his infamous tax cuts with it. Bill Clinton availed himself of it for welfare reform.
Now it’s Barack’s turn. This is why we have elections.
There is one problem. The Senate operates on budget reconciliation under a Byrd Rule, which says budget bills may not contain “extraneous matter” that doesn’t actually spend money.
Some elements of reform, such as guidelines on pre-existing coverage, don’t actually spend money. Objections can be raised. The parliamentarian has to rule. Sixty votes — the dreaded 60 votes — are needed to waive a rule.
Some Democrats worry we’d end up with a “Swiss cheese” reform bill. But if the issue is cheese with holes or no bite at all . . .
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John Brummett is an award-winning columnist for the Arkansas News Bureau in Little Rock and author of “High Wire,” a book about Bill Clinton’s first year as president. His e-mail address is jbrummett@arkansasnews.com.
April 27th, 2009 at 3:31 pm
Health care has been a constant worry to my family, since I got laid off from my job. I now realize that Insurance companies are run by a bunch of Automatons, who have no conscious or thought for human beings. Even now the battle to survive the Health care morass is not for the people who pay the exorbitant fees for service, but for the stockholders and elitists who run the for-profit business machine. Have you ever been denied drugs, because it was too expensive. Where insurance companies have ignored doctors prescriptions. Who have lied to you in some context or other, so they can benefit their own bottom line. Money!
Before I didn’t understand what Universal health care–or a single payer system was? But now I am in total in agreement with its principles? Wellbeing should be for every legal American, no matter the circumstances?
The Single payer method is a huge reservoir of money, hopefully minus the middleman, who extracts his pound of flesh from the insured? As I see it, we don’t need insurance companies anymore, nor billing businesses and an enormous amount of companies who are intermediates. We need the US federal government to run the whole matrix like in Europe. It will be a direct line to the health care providers, eye and dental, care, hospitals and specialists. We also need politicians who are honest and don’t have a too-close a relationship with corporate America, Insurance companies, drug companies, and the special interest lobby?
THE PEOPLE can do this? They can fight for the Single payer system? Universal health care cannot be any worse than medical services already have, with sick people being denied assistance and medicine. Americans pay more for their pharmaceuticals, than the majority if not all nations around the world. Hundreds of sick people having to wait for unrealistic hours, in overcrowded hospitals including senior citizens to be seen. This is very wrong, although the wealthy individuals will disagree, because they always have the money to see a physician? Now that Democrats have made it a mandatory issue, we should contact them and demand the Single payer system and not listen to the critics, who always have something to gain. In the next few months we are going to get bombarded, with millions of dollars in Health insurance ads, determined to disintegrate any earthly chance at all? Americans must receive decent health care–without the worry of big premiums and co-pays. With Universal health care–it is not FREE–it’s just you pay the government through extra taxes as in civilized foreign countries? Under Republican administration tied mostly to the Insurance industry, you will never see the chance. In UHC everybody pays into the system to receive decent medical care benefits.
Years ago I was vacationing in London, and by some remote chance taken sick. At the Hospital I was amazed not be asked for my Drivers license or passport. When addressing the doctor his words are clearly in my mind as if it was yesterday. with a sigh, the Indian doctor said.” We are here to provide a service if you are not well. There are no costs for this..? Yet in America we are hounded for our identification, so the wolves at the debt collection offices, can hunt you down like a common criminal. Not satisfied with that, they can take us to court, where they can place a lien on your home or any assets we might have?
If you watch the Wall Street exchange marquee the only companies that have rising stocks in this economic downturn are generally Health Insurance companies. Just as they write off the sick, with pre-existing conditions–LET US WRITE THE INSURANCE COMPANIES OFF? Give them a taste of their own medicine–so to speak? .They have monopolized the American people for far too long. They have manipulated our legislators as they are now. Let’s send them packing. This is probably the only chance we have in altering the future of health care. President Obama can make this country whole and give American employers a chance to fight competition from other lands. The American car makers will not have to combat their namesake from Europe, because they will be on equal footing. Health in America is a trillion dollar industry that has gone stagnant? With most of the money being absorbed by obsolete insurance companies. Other major issues should be placed at the back, except for illegal immigration. Only the mass importation of cheap foreign labor causes escalating taxes in the United States. This is another well designed method to be an impediment to health care for legal citizens, as illegal immigrants get their medical services for free in the emergency room.
Only Americans voters have this unique power to place in front of the politicians, a single payer system. For without it, medical care will become a burden to big and small businesses, until they can no longer afford the rising costs. Just following the usual health insurance companies path, for it will just be another extra cost from the average Americans wages to insure his family. With a national insurance little will be wasted, and fraud will be easier to recognize for every man, women and child who wants freedom from sickness and years of financial worry.