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Opinion: What healthcare pork looks like

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This article was originally on a blog post platform and may be missing photos, graphics or links. See About archive blog posts.

By now you’ve no doubt encountered some of the sputtering outrage over the deals that Senate Majority Leader Harry Reid (D-Nev.) struck on healthcare reform to solidify the supermajority needed to overcome a GOP filibuster. The Times editorial board added its voice to the tut-tut-tutting chorus today, focusing on Nebraska Democrat Ben Nelson’s abortion deal and the carve-outs awarded for Medicare costs; the Wall Street Journal’s board, meanwhile, zeroed in on the exemptions some senators negotiated to a new excise tax on expensive health policies.

One thing all these stories fail to convey, though, is that the vast majority of the deals appear to be for senators’ personal healthcare causes. Reid’s lengthy amendment, which spliced the various compromises into the bill, includes proposals by:

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  • Ron Wyden (D-Ore.) to let lower-income workers opt out of their employers’ health insurance plan in exchange for a voucher that they could spend on an individual policy sold through the new exchange;
  • Kay Hagen (D-N.C.) to improve diabetes care by measuring preventive care, risk factors and treatment outcomes;
  • Debbie Stabenow (D-Mich.) to create National Centers of Excellence for the treatment of depression;
  • Dick Durbin (D-Ill.) to create a congenital heart disease surveillance project;
  • Russ Feingold (D-Wis.) to reauthorize grants for public-access defibrillation programs;
  • Amy Klobuchar (D-Minn.) to promote public awareness about breast cancer risks for young women;
  • Mark Udall (D-Colo.) to authorize training grants for physicians in rural areas;
  • Tom Harkin (D-Iowa) to authorize grants for preventive medicine and public health training programs;
  • and Arlen Specter (D-Pa.) to speed the development of treatments for rare diseases.

Other provisions whose provenance I couldn’t determine right away dealt with family nurse practitioner training, grants for wellness programs in small businesses and university-based support for pregnant and parenting teens and young women.

This isn’t quite the same as funding bridges to nowhere. Wyden in particular gains no parochial advantage with his initiative. And even those who have the interests of home-state medical centers in mind are still promoting public health. Still, the Senate healthcare reform legislation is starting to look a bit like a highway bill. And that’s not a good thing.

-- Jon Healey

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