Are Democrats Singing a New Tune?

With Tuesday’s critical vote on Senate Finance, Democrats seemed to be singing a new tune. More optimistic than ever that healthcare reform might pass before year’s end, many across town were tuning their radio dials and listening to the hottest new group in town – Harry and the South Capitol Street Band.  

With a major hurdle now out of the way, the spotlight shifts, and the debate will become more cloistered in the back chambers of the Senate.  Majority Leader Harry Reid (D-NV) will now assume leadership by bringing together Chris Dodd (D-CT), the representative for the Senate HELP Committee, and Max Baucus (D-MT) of Senate Finance.  It is now Reid’s responsibility to decide which parts of each bill will be included in the final version sent to the Senate floor. 

To illustrate how critical a role the Senate Majority Leader plays, less than 24 hours following the Senate Finance Committee vote, senior White House aides were seen on Capitol Hill talking up the results.  White House Chief of Staff Rahm Emmanuel, Director of the White House Office of Health Reform Nancy-Ann DeParle, OMB Director Peter Orszag, White House Director of Legislative Affairs Phil Schiliro, and White House Senate Liaison Shawn Maher all attended meetings on the Hill.  So much attention in such a short span of time speaks to the importance of the issue to the Obama Administration.  The White House is clearly pulling out its most powerful tools and people to help guide a final bill through the Senate process.  Compounding the problems are Senator Reid’s own polls which show him in the challenge of his career.  There is much to be gained and much to be lost over the next couple of weeks for Reid, Obama, the Democrats, and the Republicans – to say nothing about the American people.

To achieve the single vote from across the aisle, the Senate Finance Committee pieced together an intricate, winning formula that both Democrats and at least one Republican supported.  With too much change on the Senate Finance formula however, Reid could easily lose support from the coy, savvy Senator from , Olympia Snowe.

The Democrats must come to the floor with a joint plan that can withstand the scrutiny of all perspectives – Democrats, Republicans, hospitals, insurers, doctors, consumer advocates, insert-influential-policy-group-here group, as well as the Moderate Democrats.  As I’ve said before, history changing policy comes from the middle.  We’re seeing it now in . 

The main two sticking points at this juncture are the debates over cost and a publicly funded insurance option. Nearly all Republicans and most moderate Democrats are weary of voting for a combined healthcare plan that is too expensive or will increase the federal deficit.  Meanwhile, liberal Democrats (both Senate and House) are set on including a public option, which the HELP bill includes. I anticipate that the definition of “public option” will be modified as part of the process. 

Kevin Fickenscher, MD

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Perot Systems or its affiliates.