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Republican Candidates Stake Out Support For Repealing Health Care Reform

While Minority Leader Mitch McConnell (R-KY) refuses to acknowledge that Republicans plan to campaign on a platform of repealing health reform, several GOP candidates have already begun questioning the constitutionality of the pending legislation. For instance, at least 8 of the 13 attorneys general challenging the the so-called Nebraska Compromise are running for re-election or aspiring to a higher office. Most recently, Jane Norton — a former Lt. Governor who is running to unseat Sen. Michael Bennet (D-CO) — endorsed Colorado Attorney General’s John Suthers’ efforts to invalidate reform and announced her opposition to the individual mandate:

One of the constitutional things, thank God we have an Attorney General, John Suthers, who is banning with 13 other Attorneys General to say, let’s look at this so-called health reform bill. Because I do not personally think that the individual mandate is constitutional. Nor do I think giving sweetheart deals to other states at the expense of other states is constitutional. So we have to just keep the pressure up and make sure that we are encouraging like-minded folks.

Watch it:

If support for dismantling health care reform will become a litmus test for conservative candidates, Norton — who served as a liaison on health insurance reform for the Governor’s office — may be in for an embarrassing campaign. In 2007, Norton appeared to endorse Selvoy M. Fillerup’s Chronic Condition: Critical Care for America’s Collapsing Healthcare System, a health care book that promoted the individual mandate. “Initially, government must mandate that everyone will be insured,” Fillerup writes on page 147, explaining that the mandate is part of several “fundamentals” of reform. On the book’s back cover — a spot usually reserved for endorsements — Norton is quoted as saying, “You…have challenged our thinking.”

Last Sunday, Former House Speaker Newt Gingrich predicted that “every Republican running in ‘10 and again in ‘12 will run on an absolute pledge to repeal this bill.” “I think it’ll be a major campaign theme,” he said.

The Case Against Allowing C-SPAN Cameras Into Health Reform Negotiations

C-SPANC-SPAN CEO Brian Lamb is challenging Democrats to keep their campaign promise and “open all important negotiations, including any conference committee meetings, to electronic media.” “President Obama, Senate and House leaders, many of your rank-and-file members, and the nation’s editorial pages have all talked about the value of transparent discussions on reforming the nation’s health care system,” Lamb says in a letter to Congress. “Now that the process moves to the critical stage of reconciliation between the Chambers, we respectfully request that you allow the public full access, through television, to legislation that will affect the lives of every single American.”

At first glance, Lamb’s request sounds reasonable, even righteous. After all, C-SPAN is grounded in the belief that transparency produces superior legislation. And maybe a certain level of transparency does. But if one actually considers the tone and tenor of the televised health care debate of 2009, filming the conference negotiations seems counterproductive.

The C-SPAN letter itself betrays this reality. “Since the initial introduction of America’s Affordable Health Care Act of 2009, in the House and the Patient Protection and Affordable Care Act in the Senate, C-SPAN has televised literally hundreds of hours of committee hearings, mark ups and floor debate on these bills for the public to see,” it reminds us. On the whole, C-SPAN’s coverage informed and entertained the viewer. But did it improve the underlying bill?

Consider the Senate floor debate. Rather than filling the 24 days of televised discussions with constructive and informative amendments, Democrats and Republicans recycled charts and talking points like re-usable shopping bags. Lawmakers spent days debating the Medicare cuts they supported in years past, denouncing scientific research, and introducing sense of the Senate resolutions promising to provide and protect America’s most active constituency — seniors. Senators from both party played to the cameras. Grandstanding, launching unnecessary rhetorical attacks, but barely tweaking the bill on the Senate floor. The real substantive change, if you’ll recall, came in the form of Reid’s amendment (and when he merged the two Senate bills). At times, the rhetoric on the floor sounded like cable news chatter. The real discussions and compromises — Sens. Lieberman’s and Nelsons objections, for instance — were reserved for private discussions; incidentally, the two Senators didn’t appear on the Senate floor until the 60-vote deal was struck.

It’s no exaggeration to claim that health care reform is only possible because of the ritualistic ping-pong back and forth that occurs through private conversations. Lawmakers eschew substantive televised negotiations because the reality of politics doesn’t square with the promises of the campaign trail; negotiations give lawmakers a conciliatory hue that’s unwelcome in the current political climate of machismo.

The introduction of cameras into the daily White House press briefings, for instance, hasn’t produced a better understanding of administration policy or more informative media coverage. Rather, it created an additional opportunity for political theater and posturing. “It has turned into a theater of the absurd,” Mike McCurry, President Bill Clinton’s press secretary, told the New York Times. “Reporters can be perfectly civil and launch good, hard-hitting questions” in private…then in the briefing room two minutes later, “they turn into barbarians,” President George W. Bush’s first press secretary Ari Fleischer added. In the modern media environment, even small inconsequential events or statements are often transformed into meta narratives or political attacks that can alter the behavior of politicians in ways that serve to undermine the legislative process, the article claims, noting the atmosphere of mutual mistrust that characterizes the interactions between the public, lawmakers, and the press.

Turning the conference committee into another Senate floor debate won’t improve health reform legislation. The televised conference hearings will become a drawn out theatrical sideshow — the real discussions will still occur behind closed doors.

The public should have ample opportunity to review the final product before the vote, but when it comes to legislating, transparency is overrated. Changing Washington’s political culture requires far deeper systematic reforms than C-SPAN television. The hard politics isn’t pretty enough for TV.

Update

Ezra Klein is “conflicted over C-SPAN’s request to televise all negotiations related to the merging of the House and Senate bills” but points out that “What C-SPAN is offering isn’t transparency. It’s the illusion of transparency.”


Update

,Matt Yglesias agrees that “letting TV cameras into conference committee negotiations is a terrible idea.”

Recession-Inspired Slowdown In Health Spending Bolsters Case For Health Care Reform

Recession 2008A new report from the Center on Medicare and Medicaid Studies (CMS) finds that the economic recession has accomplished what generations of lawmakers have only dreamed of — slowing the growth of national health expenditures. As Americans lose their jobs and employer-sponsored health care coverage, thousands are turning to government-run health care programs like Medicaid or (if they can afford it) the extended COBRA coverage. Others simply forgo needed treatments, prescriptions and doctor visits. “The data show a slowdown in health spending across the board — but at the same time, a shift in the composition of spending, including from private to public access,” the report found:

Amid one of the worst economic recession in recent history, U.S. health spending grew 4.4 percent in 2008, its slowest rate in nearly 50 years. However, overall health spending, which reached $2.3 trillion in 2008 — $7,681 per person — still increased faster than the overall economy…Health spending constituted 16.2 percent of the Gross Domestic Product (GDP), increasing from 15.9 percent the year before.

In other words, health care costs are decreasing for all the wrong reasons. After all, this dip in spending did not result from some shrewd new efficiency measures or payment reform mechanisms. Policy makers have not implemented reforms that decreased the utilization of unnecessary (and in many cases harmful) care or reduced fraud and waste from the system. Rather, Americans are spending less on health care because they have less money to spend overall. Health expenditures are still increasing faster than the overall economy and are projected to reach 25% by 2025 — an unsustainable percentage of spending that would leave some 50 million Americans uninsured and millions more underinsured.

The report signifies the importance of adequately funding public programs, offering uninsured Americans more affordable coverage, and improving the efficiency of health care delivery. As Jeanne Lambrew – Director, HHS Office of Health Reform — has pointed out in Congressional testimony, public programs “fill certain cracks in the system.” “Altogether, these programs insure over one-fourth of the population and finance 45 percent of the health system, including the safety net programs that directly pay for services for vulnerable populations.” The Senate bill would strengthen public health, increase coverage, and bring down health care costs by eliminating waste, investing in payment reform, and tackling overtreatment (hopefully offsetting the increases in utilization of the newly insured). It would start to bend the cost curve over the long term by transforming the system, not pricing millions out of coverage.

The most conservative government estimates conclude that the Senate health bill would reduce national health care expenditures by at least 0.3% by 2019. Had the nation adopted comprehensive reform earlier, today’s national expenditures would be even lower. A recent report from the Commonwealth Fund, for instance, points out that “If President Nixon’s health reform plans had been enacted in 1975 and slowed the annual rate of spending by 1.5 percentage points a year, today we would be spending 10.7 percent of GDP on health care….Even if Nixon reforms had slowed spending growth by “only” 1 percentage point a year, health spending as a percent of GDP would have been $1.9 trillion in 2010, or 12.7 percent of GDP—a savings of 5 percent of GDP.” Similarly, “Even if we had acted as late as 1995 under President Clinton, health spending in 2010 would be $2.1 trillion, or 14.2 percent of GDP.”

REPORT: Attorneys General Challenging Constitutionality Of Health Reform Awash In Cash From Health Industry

Campaign ContributionsSince Democrats secured 60 votes to pass health care reform legislation — and passage became inevitable — prominent conservatives relaunched an under-the-radar campaign to invalidate reform through the legal system. On the eve of the final health care vote in the Senate, Sens. Jim DeMint (R-SC) and John Ensign (R-NV) invoked a “constitutional point of order” to allow the Senate to rule by majority vote on whether the “Democrat health care takeover bill” is unconstitutional.” Legislatures in approximately 14 states — organized by the American Legislative Exchange Council [ALEC], a “business-friendly conservative group that coordinates activity among statehouses — have also introduced initiatives to ratify constitutional amendments that would repeal all or parts of the pending health care reform legislation and Attorneys General in at least 13 states are challenging a deal secured by Sen. Ben Nelson (D-NE) to fund Nebraska’s Medicaid expansion for perpetuity.

Yesterday, Sen. Orrin Hatch (R-UT), (along with two co-authors from the Family Research Council and the American Civil Union) penned an op-ed in the Wall Street Journal explaining “Why the Health-Care Bills Are Unconstitutional.” “The policy issues may be coming to an end, but the legal issues are certain to continue because key provisions of this dangerous legislation are unconstitutional,” they wrote, and went on to challenge the constitutionality of the individual mandate, the so-called sweet heart deal for Nebraska, and the requirements for states to establish health insurance exchanges and insurance regulations.

The effort may prove a strong political recruitment tool for conservative activists, but the legal reasoning has little support beyond the right edge of the Republican party — and the health care industry. Several weeks ago, the New York Times reported that “The states where the [constitutional] amendment has been introduced are also places where the health care industry has spent heavily on political contributions.” The industry has also contributed heavily to the campaigns of at least 7 of the 13 attorneys general threatening to sue the federal government over the Nebraska provision. (Campaign finance data was not readily accessible for the other 6 attorneys general.)

An analysis conducted by the Wonk Room of available campaign finance disclosures for AGs from South Carolina, Washington, Michigan, North Dakota, Pennsylvania, Utah and Idaho reveals that the health industry contributed heavily to their campaigns:

South Carolina Attorney General Henry McMaster ~ $15,000
- Blue Cross Blue Shield of South Carolina: $3,500
- Columbia Clinic: $3,500
- SC Healthcare PAC: $3,500
- Commander Health: $2,500
- Medco Health Solutions: $1,000
- Skylyn Medical Associates PAC: $1,000
- Bayer: $500

Washington Attorney General Rob McKenna ~ $24,645
- GlaxoSmithCline: $3,200
- Johnson & Johnson: $3,095
- Bristol-Myers Squibb: $3,000
- Premera Blue Cross: $2,800
- Eli Lilly: $2,400
- Amgen: $1,600
- Regence Blue Shield: $1,600
- Wyeth: $1,600
- Pfizer: $1,250
- PHRMA: $1,100
- Astrazeneca: $1,500
- MedcoHealth Solutions: $1,000
- Bayer: $500

Michigan Attorney General Mike Cox ~ $12,600
- Pfizer Michigan PAC: $6,100
- Blue Cross Blue Shield of Michigan: $3,000
- Aetna PAC: $2,500
- United Health Group Inc PAC: $1,000

North Dakota Attorney General Wayne Stenehjem ~ $20,700
- Pfizer PAC: $10,000
- GlaxoSmithKline PAC: $4,000
- Purdue Pharmacy Pac: $2,650
- Medco Health PAC: $1,750
- Eli Lilly PAC: $1,000
- Merck PAC: $1,000
- Johnson & Johnson PAC: $300

Pennsylvania Attorney General Tom Corbett ~ $24,300
- Pfizer PAC: $10,300
- Eli Lilly and Company PAC: $5,000
- Aetna Inc. PAC: $3,500
- United Health Group Inc: $2,500
- Blue Cross Voice PAC: $2,000
- Merck PAC: $500
- Cigna Corporation PAC: $500

Utah Attorney General Mark Shurtleff ~ $9,500
- Selecthealth: $5,000
- Pfizer PAC: $2,500
- Regence BlueCross BlueShield of Utah: $2,000

Idaho Attorney General Lawrence Wasden ~ $10,100
- PHRMA: $4,500
- Idaho Life and Health Industry: $3,250
- Caremark RX: $1000
- Regence Blue Shield: $500
- Pfizer: $450
- Blue Cross of Idaho: $400

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