Are Southern Democrats holding up health care reform?

DavidPriceHCANsign.jpgOver the past week, health care reform advocates and progressive bloggers have expressed outrage over the announcement by conservative-leaning Democrats in Congress -- including Southern lawmakers -- opposing President Obama's proposal for a public insurance option.

But a closer look shows that some Southern Democrats are in fact promoting the public option, in which a government-run health plan would provide an alternative to private insurance. The approach, which has the backing of President Obama, would create pressure to hold down health care prices, encourage innovation and improve health quality, as Igor Volsky at Think Progress has noted.

Last week, members of the moderate, pro-business New Democrat Coalition held a meeting with their colleagues in the conservative Democratic Blue Dog Coalition to discuss the public option -- more specifically, their belief (shared by Republicans) that any public option would disrupt the private health insurance market, Politico reports:

The group is targeting Education and Labor Committee Chairman George Miller (D-Calif.), Ways and Means Committee Chairman Charles Rangel (D-N.Y.) and Energy and Commerce Committee Chairman Henry Waxman (D-Calif.), who are writing the House health care bill.

"The committees don't really understand where their members are," said one senior Democratic aide. "A lot of moderates really do have problems right now. How you define a level playing field with the public option is very critical."

The New Democrat Coalition has a total of 69 members, 16 of whom are from Southern states.* There are a total of 51 Blue Dogs, 21 of whom are from the South.** Together, members of the two groups represent 102 votes -- more than a third of the entire Democratic caucus, Politico observes:

Few expect the group to remain that cohesive, but a shared set of principles will give the bulk of both caucuses something to rally around.

But there are serious questions about to what degree the members' principles on health care are actually shared. There are cracks in the Democratic coalition opposing a public option, and key ones are in the South.

Those cracks were apparent in the recent announcement by Rep. Jim Cooper of Tennessee -- vice chair of the Blue Dog Health Care Task Force -- that he supports a public option without a so-called "trigger." Under the trigger system, the public option would come into play only if all else fails. As Ryan Grim reported at Huffington Post:

"I'm for a public option. I like Chuck Schumer's approach. It does not have a trigger in it," said Rep. Jim Cooper (Tenn.) ... .

... Cooper told constituents at a town hall on health care almost exactly the same thing. "We should be for it, just like President Obama's letter says," Cooper told a voter in response to a question about the public option under consideration as part of the health care reform.

A graduate of the University of North Carolina and Harvard Law School, Cooper has taught health care policy at Vanderbilt University for over a decade, so his views on the topic carry some weight.

But Cooper is not the only Blue Dog who has publicly embraced the public option without any trigger. In all, 20 members of the conservative coalition signed a pledge of support written by the reform coalition Health Care for American Now for just such a policy, Huffington Post notes. The other Southern Blue Dogs who signed the pledge were Berry of Arkansas, Bishop of Georgia, Chandler of Kentucky, and Ross of Arkansas.

A few days after Cooper made his remarks in support of the public health care option, the Blue Dog Coalition released a statement saying it would support such an option only in the case that private insurers fail to meet set coverage goals. But a senior staffer for the group told Huffington Post that the group was staking out a negotiating position rather than drawing a hard line.

Another Southern Democrat who recently surprised some constituents with his position on health care reform was Rep. David Price of North Carolina's 4th District. A moderate who helped found the New Democrat Coalition, he left that group before the start of the latest 111th Congress. Price recently signed the HCAN pledge in favor of the public health care option, along with his fellow North Carolina Democratic Congressmen Brad Miller and G.K. Butterfield.

In the fast-shifting debate over health care reform, one thing that is certain is that the insurance industry is adamantly opposed to the public option -- and that the industry is a major force when it comes to campaign contributions.

In the 2008 election cycle alone, the insurance industry contributed almost $47 million to federal candidates, with 55% of that money going to Republicans, according to the Center for Responsive Politics' Open Secrets database. So far in the 2010 cycle, it's contributed more than $2.2 million, most of it to Democrats.

The top recipient of the industry's campaign cash in this cycle at $39,000 is Earl Pomeroy (D-N.D.), a Blue Dog who serves on the Ways and Means Subcommittee on Health and co-chairs the bipartisan Rural Health Care Coalition. In second place at $33,050 is Ron Kind of Wisconsin, the vice chair of the New Democrats who also serves on the Ways and Means Health Subcommittee.

But so far, Southern Democrats don't appear to be raking it in from the insurance industry. The first Southern Democrat to appear on CRP's list of recipients of the industry's cash this cycle is Kosmas, the New Democrat from Florida, who got $12,757, putting her in 21st place. The next is Boyd, the Florida Blue Dog, who takes 36th place with $9,000.

Meanwhile, Heath Shuler -- the North Carolina Congressman who serves as the Blue Dogs' whip -- has reportedly received nothing from the industry this cycle. He received $18,500 in the 2008 cycle, which put him in 234th place among his fellow House members.

* * *

* New Democrats from the South are John Barrow (Ga.-12), Bobby Bright (Ala.-02), Gerry Connolly (Va.-11), Artur Davis (Ala.-07), Bob Etheridge (N.C.-02), Charles Gonzalez (Texas-20), Parker Griffith (Ala.-05), Ron Klein (Fla.-22), Suzanne Kosmas (Fla.-24), Mike McIntyre (N.C.-07), Kendrick Meek (Fla.-17), Charlie Melancon (La.-03), Jim Moran (Va.-08), David Scott (Ga.-13), Debbie Wasserman Schultz (Fla.-20) and Vic Snyder (Ark.-02)

** Blue Dogs from the South are John Barrow (Ga.-12), Marion Berry (Ark.-01), Sanford Bishop (Ga.-02), Allen Boyd (Fla.-02), Bobby Bright (Ala.-02), Ben Chandler (Ky.-06), Travis Childers (Miss.-01), Jim Cooper (Tenn.-05), Henry Cuellar (Texas-28), Lincoln Davis (Tenn.-04), Bart Gordon (Tenn.-06), Parker Griffith (Ala.-05), Mike McIntyre (N.C.-07), Charlie Melancon (La.-03), Glenn Nye (Va.-02), Mike Ross (Ark-04), David Scott (Ga.-13), Heath Shuler (N.C.-11), John Tanner (Tenn.-08) and Gene Taylor (Miss.-04).

(Photo of Rep. David Price with the HCAN principles by TriangleNC, who reported on his signing them at DailyKos.)

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re: Are Southern Democrats holding up health care reform?

I wish you wouldn't use a headline that implies that Southern Democrats are NOT supporting the public option, especially with a picture of my Congressman, who does support the public option. People who see your RSS feeds (e.g., me) get an impression that requires a careful reading of the text to fix.

And having just had a good conversation with David Price a couple of weeks ago, I know that he's on our side. All good people need to know that.

-- ge, chapel hill

re: Are Southern Democrats holding up health care reform?

The moneyed influence by the health corps(e?)shout loudly why we need public financing of campaigns. They will deprive the people of health care for all, all in the name of bottom line profits for the wealthy, poor kids be damned.

Public campaign financing and universal single payer health care are the only way that humanity will be served. Why should corporations get socialism's benefits (business breaks, tax loopholes and subsidies) by taxpayers through government, but not the taxpayers for themselves through government?

re: Are Southern Democrats holding up health care reform?

I sit on the board with Utah association of Health underwriters and http://www.BenefitsManager.net as well as http://www.HealthInsuranceSource.net for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year that seems all too familiar on the federal level. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a "no loss" or "no gain" over competing carriers in the insurance exchange portal which is http://www.UtahInsuranceExchange.info. On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that need to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.
In http://www.UtahInsuranceExchange.info which is the beginning of a state sponsored program addresses issues on a local state level that the federal level might look at. Coming from an underwriting background I know where the dime falls. I am of the opinion that large waste occurs from providers billing for procedures that developed "no outcome". Insurance carriers are not the only bad guys on the block. In most of our purchasing decisions....don't we pay ONLY when we know that we will get a desired outcome? Why is it if you ask the doctor how much a particular test or procedure is he doesn't know? Shouldn't providers be held to a transparent cost standard?
You must be in the health care business from some interaction point to make statements of fact in the face of historical changes. When you are in the system from any touch point (insurance, provider, hospital, Medicare or patient) you get the “real issues” because of real time experience.
I often quote the Switzerland health care system as an example of tough questions that we will have to face at some point down the time line. Did you know that premature babies are not resuscitate upon birth if they cannot draw breath? Did you also know that is the same with “senior care” experiencing system failure or failures? They don't extend life of a senior with multiple failures like intubation as example. Anyone in the business of paying claims knows that the single most expensive bills in what we call “shock loss” is within NICU for newborns and seniors in acute / intensive care / hospital.
The Swiss apparently made decisions made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or to define when to incubate, resuscitate a newborn or a senior? To define the conditions and rules of practice? With a litigious society I think not. This is why we need tort reform. Without tort reform medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. With health insurance carriers it translates to about 10% of every premium dollar collected.
I don't think we are hearing about tort reform because most of the house and senate on the federal level are lawyers and have practicing law firm interests / ownership. In the healthcare system there is no total innocence. Insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their door with no insurance. The lawyers are there to stir the pot and promise lavish fortune at the end of the PERCEIVED misery chain. Am I saying we don’t need them? No, but I am saying there is clear and documented abuse of the legal system that awards outlandish claims in the millions for a $20,000 mistake. Ambulance chasers being the most abusive. What about those that educate their clients on defraud and then use the legal system to pirate insurers?

re: Are Southern Democrats holding up health care reform?

I signed on to find the source of a recent summary of data about the southern states--ostensibly from the Institute for Southern Studies - dated 6/18/09. Despite a long Google search I can't seem to find the exact link/source to cite. Here's an excerpt:

Estimated number of uninsured U.S. residents in 2009: 52 million

Increase in that number since 2007: 6 million

Increase in uninsured people in the 13 Southern states* between 2007 and 2009: 2,416,000.

Can someone on this site help? Thanks.

Then I happened to read the post by Bill Palich who, despite his credentials, must have learned scare tactics from Rick Scott, the notorious former head of Columbia-HCA and spokesperson for the anti-reform "swift boaters."

Countries with single payer systems--of which Switzerland would not be my first choice--run humane programs. If one wants to see rationed care, take a look at at our current system--approximately 52 million--including millions of children--lack access to preventive care and therapeutic treatment.

18,000 adults between 19-64 die each year in the US because due to uninsurance. That's six times the death toll of 9/11. Do you think the Swiss or the French or the Canadians or the Taiwanese would put up with that travesty?

Malpractice insurance is less expensive in Canada. Patients have a right to sue and penalties are levied of course, but awards ar capped. There are no expensive awards for future medical care for the victim.

Don't get me started on the inequities and disparities of our system. Private for-profit insurers drain an estimated 20-30 cents out of every health care dollar--money that should be devoted to care.

re: Are Southern Democrats holding up health care reform?

Does anybody have any experience with these North Carolina Lawyers ?