HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, June 19, 2008

Health Reform and the Senate Finance Committee

Ezra Klein continues his praise for Prepare to Launch and Senator Max Baucus' efforts to raise awareness of health reform and what type of support such reform needs from the Senate Finance Committee.  He writes,

Whether anyone is actually more prepared today than they were two days ago is debatable. The various sessions of the Senate Finance Committee's "Prepare for Launch" Health Summit were informative enough but offered nothing the senators hadn't heard in previous testimony or read in memos from staff. No legislation was proposed, and no votes were taken. None of the senators set forth their reform plans or laid out the considerations that would drive their decisions.

Even so, it was arguably the most promising day for health reformers in a decade. The Finance Committee asserted its jurisdiction over crafting and passing a health-reform bill. And the committee's centrist chair, Max Baucus, asserted his commitment to the effort. If health reform is to pass, both of those things will need to be more than assertions; they will need to be proven true. . . .

So health-care reform requires a Finance Committee -- and a Finance Committee chairman -- interested and invested in passing a bill. In 1993, there was no such chairman. Many think that the original sin of the Clinton health-reform effort was Clinton's decision to choose Lloyd Bentsen, the canny chair of the Finance Committee, as his secretary of the Treasury, thus depriving the committee of his leadership. In his place came the mercurial, touchy Daniel Patrick Moynihan. Moynihan had many virtues, but he did not like the Clintons and did not want to do health reform. His intransigence and general lack of enthusiasm was crucial to emboldening the opposition and killing the bill. When Moynihan appeared on "Meet the Press" on September 19, 1993, three days before President Clinton was to give his speech calling for universal health care, and flatly stated that "there is no health-care crisis" and Clinton was using "fantasy numbers," it was an early sign that the effort was doomed. . . .

This time around, however, Baucus has given health reformers reason for optimism. He has staffed up, hiring Liz Fowler, a well-regarded health-policy staffer with immense Hill experience. He's held a series of hearings on the need to reform the system, inviting experts to testify on everything from the explosion in costs to the failures of the insurance market. More importantly, his statements at these hearings have been invariably action-oriented. He opened a recent session by saying, "Today let us talk again about health-care reform. Let us hear from the experts about how to do it right. And let us plan, next year, to actually do something about it."

Yesterday's "Prepare to Launch" event was his initiative and served as another opportunity for him to signal that he wanted to pass health reform through his committee. "Congress must prepare for the work of reforming the health-care system," he said in his opening statement. "We must develop common understandings of our system, the good and the bad, so we're ready to work towards reform." Questioning Federal Reserve Chairman Ben Bernanke after Bernanke's bloodless presentation, Baucus asked him to "drill down" on what would happen if the Senate didn't get health costs under control, prompting Bernanke to offer a dark vision of fiscal meltdown. Where most of the panel sessions featured two senators presiding over a panel of experts, Baucus hosted a viewing of the PBS Frontline documentary, Sick, which looks at other nations' health care systems and declares "When it comes to providing health care for people our nation is a fourth-rate power." Introducing the film, Baucus mused, "We Americans can be a bit smug. We figure we can't learn from everyone else because we're the biggest and the best. But I think the time has come for America to learn a bit from these other countries."

The final event of the day was a roundtable discussion among the members that was, by turns, hopeful, tetchy, and constructive. The content, however, was secondary to the optics. This was the whole of the relevant committee, sitting in a single room, talking through health reform. It was a photo op, yes, but a promising one. By publicly asserting jurisdiction on health reform, the Finance Committee is also taking responsibility for it. If the effort fails, it will be on their heads. And none will receive more blame then Baucus. Summing it up, Baucus said, "I don't know of anything more daunting than trying to solve health care. But hey, we're masochists! It's why we signed up for this job." . . .

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