What healthcare pork looks like
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:
- 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
Photo: Sen. Harry Reid. Credit: EPA / Michael Reynolds
if those are pork, then i am a pumpkin pie. most of those programs cited are the stuff of public health and consumer health education--both of which we need. pork is doing something for your constituency --and only for your constituency. most or all of the programs cited are broad-based in their impact--as they should be!
Posted by: bill copeland | December 22, 2009 at 02:19 PM
@Bill -- I agree with that in all but one respect. To me, "pork" isn't about grabbing dollars; it's about individual members of Congress circumventing formal legislative channels to dictate policy. As much as we might like the sound of these projects, shouldn't they be subject to hearings and the development of a public record on their merits? I know that some of them have gotten at least a little scrutiny -- Wyden offered his proposal as an amendment in the Senate Finance Committee, only to withdraw it before a vote. Shouldn't they all be vetted before they become law?
Posted by: Jon Healey | December 22, 2009 at 03:52 PM
How about Bill Nelson's Medicare Advantage for Floridians which was grandfathered in, or Dodd's hosptal and Ben Nelson's permanent Medicaid for only his state plus other biggies. What a biased report.
Posted by: john, new york | December 22, 2009 at 05:02 PM
SENATE HEALTHCARE REFORM EFFORT AND THE OUTLAW JOSEY WALES
Like the majority of voters, I found this week was particularly challenging. Senate Majority leader Harry Reid and his democratic allies were able to consummate enough deals to reach their goal of passing something that most of the nation did not want. So rather than spending any additional time or focus on Harry Reid and his Senate friends I decided to enjoy an old movie classic and temporarily rid myself of the stress.
Frankly, I have always enjoyed this great western produced by Clint Eastwood, in 1976, The Outlaw Josey Wales. Once again I found myself pulled in to the film with its colorful cast of characters. Josey Wales, Fletcher the bounty hunter, Red Legs, Senator, Ten Bears, Lone Watie, Jamie, Carpetbagger and many others. I relaxed but couldn't help taking note of the various players and their dialogues. In fact I found some of their words most enlightening and helpful in understanding this past week. I have chosen a few passages and listed them below, to help you understand, in a small way, what has just happened in Washington, D.C.
The Senator, "Fletcher, The wars over. Our side won the war. Now we must busy ourselves winning the peace.
Fletcher, "There's another old saying, Senator, Don't piss down my back and tell me its raining."
Josey Wales, "I ain't promising you nothing extra. I'm just giving you life and you're giving me life. And I'm saying that men can live together without butchering one another."
Ten Bears, "It's sad that governments are chiefed by the double tongues. There is iron in your words of life for all Comanche to see, and so there is iron in your words of life. No signed paper can hold the iron. It must come from men. The words of Ten Bears carries the same iron of life and death. It is good that warriors such as we meet in the struggle of life…or death. It shall be life."
Josey Wales," Now remember, when things look bad and it looks like you're not going to make it, then you gotta get mean. I mean plumb, mad-dog mean. Cause if you lose your head and you give up then you neither live nor win. That's just the way it is."
Dr. Alan Phillips
Posted by: Dr. Alan Phillips | December 22, 2009 at 08:51 PM
The Headline should read John uses tax payers money to buy favors from prostitutes . With Reid being the John using taxpayer’s money and the known members of the Senate being the prostitute to be bought.
Posted by: Taxpayer | December 23, 2009 at 10:28 PM
All I need to know to understand that the so called "Health-care Reform" is a crock is to know that Congress themselves won't be subject to it. This is a bad idea executed in a horrible way, and when it turns out bad, remember this: "I told you so."
Posted by: redc1c4 | December 24, 2009 at 11:46 AM
@redc1c4 -- Where does this "Congress won't be subject to it" meme come from? I hear it time and again, and it's unfounded. Members of Congress obtain insurance through the Federal Employee Health Benefits Program. See http://www.opm.gov/insure/health/index.asp for a description. It's analogous to the exchanges that the bill would establish -- a program that lets participants choose from a menu of plans offered by competing private insurers.
I'm not sure what people want members of Congress to do - become uninsured so they could participate in the new exchanges as individuals? The bill wouldn't force anyone to do that. It's possible that some companies will stop providing group plans and dump their workers into the exchanges. That hasn't happened to any meaningful degree in Massachusetts, though.
Posted by: Jon Healey | December 24, 2009 at 12:02 PM
Why is this article criticizing preventative care, especially for diabetes? Type 2 diabetes is the #1 preventable disease in the United States and educating the public to eat well and exercise regularly to prevent not only diabetes, but heart disease and a myriad of various related diseases, is the best thing we can do for health care. If we eliminate the causes of disease, we eliminate the disease. Clearly the author of this article wasn't seeing the big picture in terms of long care savings on health care.
Posted by: Ashley | December 25, 2009 at 01:26 AM
Mr. Healey, I agree with the comment you made about all should be vetted. The ones you mentioned are all worthy causes health care-wise but...like you said should be investigated. I do however disagree with the metaphor of "highway bill". I see it as a runaway freight train without brakes, lol. Thank you for the article.
Posted by: Kathy | December 25, 2009 at 03:06 AM
I see. The Senatorial perquisites include philanthropic gestures with other people's money. That might be noble if it were their money, but it isn't.
Posted by: sailhardy | December 25, 2009 at 11:08 AM
Am I really the only one that understood this article?
The author is not criticizing the list of "pork". He is, I believe, criticizing all of those who's knee-jerk reaction is to assume that all pork is bad pork.
Clearly, to a one, the items listed are positive, health related, necessary additions to the bill, and this was the intention of the author. He was not criticizing them (ahem, Ashley).
Many people also suffer from the incorrect belief that all lobbyists are bad, greedy and evil. Of course, many lobbyists are advocating for good things like climate and environmental protection, workplace safety, etc. Not all lobbyists are money grubbing evil doers; similarly, not all "pork" is necessarily bad.
Interesting though, the fact that most of the criticism in Washington and from the TV pundits for the deal making comes from the Republican right. It was of course, the right's petulant recalcitrance and unwillingness to do anything to help craft this bill that necessitated the Democratic super-majority, empowering Nelson and his ilk to act greedily and unprofessionally as they did. If just a few republicans acted reasonably by contributing to and voting for the bill, the deal makers on the left would have been powerless, and the bill would have been immeasurably better.
Posted by: JA | December 25, 2009 at 03:02 PM
This group of 'lawmakers' simply does not have the collective wisdom required to lead this nation. I would ask everyone to think, carefully, when they vote next time. Voting out all encumbents and 'resetting' this democracy, at this point, can do us no harm.
Posted by: andrew nelson | December 26, 2009 at 06:42 PM
The only thing that will cure "pork" is to add term limits, balanced budget and line item veto to the constitution.
Posted by: chatmandu | December 27, 2009 at 09:07 AM
But most of these "pet" causes already have tons of funding.
"promote public awareness about breast cancer risks for young women;"
Is there a woman alive in the US that doesn't know about breast cancer? All those pink ribbons haven't been ignore, I'm pretty sure.
None of these projects are anything but PR and focus groups. There's no actual funding for science, just for more pals of pols.
Posted by: Belinda Gomez | December 28, 2009 at 12:07 PM
I can see it now … over the Holiday break the President entertains the Senate and the House power leaders. The conversation goes something like this ….
President … If you want to destroy this legislation keep up the Liberal Whining else if you want to have a win, win, agree to pass this legislation less the Liberal Extreme requirements then go to your homes and win some more seats so that we can pass our entire agenda .
Congressional leaders … in unison say … Thank you Mr. President that is a Great Idea.
President … Well ladies and gentlemen that appears to conclude our Community Organizational meeting for this year. Have a Happy Holiday and Happy New Year. G-d bless us all, G-d bless America, G-d bless the World.
So it is said so it will be written.
Minutes of Community Organizational Meeting taken by …
Hillary Rodham Clinton.
Secretary of State.
Posted by: Gordon Potik | December 28, 2009 at 12:50 PM