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Missteps toward health care reform

Post by Patrick O'Callahan on March 16, 2010 at 7:35 pm |
March 16, 2010 5:37 pm

This editorial will appear in tomorrow’s print edition.

This country needs health care reform. Medical coverage must be extended to the tens of millions of Americans who don’t have it. But the details matter, and so does the way Congress makes the key decisions.

It’s a bad sign that House Speaker Nancy Pelosi is talking about using a procedural gimmick that would let House Democrats vote to pass a bill while pretending that they didn’t vote to pass it.

The scheme arises from the fact that Democrats in the House and Senate weren’t able to agree on the particulars of a reform package while the Democrats still held a filibuster-proof majority in the Senate.
Now the House must approve the Senate bill in its entirety in order to fast-track the issue to “reconciliation,” a process the Democrats want to use to produce a compromise bill not subject to filibuster.

Since so many Democrats don’t want their fingerprints on the Senate bill, Pelosi says she may smuggle it (our words, not hers) through a floor vote with a measure stating that it is “deemed” to have passed. The word – normally used more honestly – would presumably let lawmakers claim that deeming isn’t approving and they aren’t necessarily the ones who did the deeming.

Pelosi, at least, is honest about the subterfuge: She’s inclined toward using the deeming maneuver on the Senate package because there are “a lot of people who don’t want to vote for it.”

Come on. Americans aren’t idiots. Members of Congress ought to be able to explain a tactical vote for a measure they don’t like for the sake of getting a measure they prefer more. Deeming may be suitable for housekeeping bills, but a dodge like this has no place in legislating a massive overhaul of American health care.

This is part of a larger problem: haste. Democrats leaders are rushing to send President Obama a bill before Congress takes its Easter break. Yet rank-and-file lawmakers, not to mention the public, don’t know the details of the package likely to be thrown at them in a matter of days with a demand from leadership for immediate passage.

Only the broad outlines of the “compromise” have been released pending Congressional Budget Office cost analysis. The big picture is familiar: Individual mandate to carry health insurance, subsidies for the poor, no denial of insurance to the sick, etc.

But there are indications that Obama and Democratic leaders have lost interest in cost control – the disciplinary component needed to protect the public from medical hyperinflation and keep the system from collapsing under the weight of its own expenses.

The most serious cost-control provision we’ve seen so far has been the Senate’s proposal for a tax on lavish, inflation-driving “Cadillac” health plans. In the compromise plan, that measure appears to have been gutted under pressure from unions, whose members – especially in government jobs – tend to enjoy the most generous coverage in America.

Legislation as important as this shouldn’t be rushed through in the dead of night without allowing Americans a chance to read the fine print – or knowing exactly where their representatives stood on the crucial votes.

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