The Yogi Berra Truism Rings True!!

Among the many truisms offered by an American icon – Yogi Berra – was the following observation, “It ain’t over till it’s over.”  It’s hard to believe that, though it’s been a long debate, the easy part has only just ended. With the House bill passing, the healthcare reform debate now shifts to the Senate where it still faces very difficult challenges.

As I have discussed previously, the onus for creating a sensible compromise that can meet the litmus test for obtaining 60 votes required for the bill to pass now falls on the shoulders of Majority Leader Harry Reid (D-NV). With the passage of the Senate Finance Committee’s healthcare plan in October, Senator Reid is tasked with melding the Senate Finance plan with the Senate Health, Education, Labor, and Pensions (HELP) Committee proposals into a combined healthcare bill.  And, more importantly, any successful bill must ameliorate the cost of healthcare, increase access, deal with coverage concerns, and meet a host of other requirements of many moderate Senators. Given the discussions over the last several weeks, the task almost seems insurmountable.

Despite the fact that there is not yet a draft of the proposed Senate healthcare reform bill, Reid announced plans on Tuesday to open debate on the Senate floor next week. Gaining new urgency following the House vote, Democrat leaders are pronouncing that they hope to pass a final proposal by the end of the year.  The back office chatter is “no way” – without intervention (i.e. The White House).  Many insiders view Senate passage as a mid-January feat, not a pre-holiday treat.  While Senate action before the holidays would be a step forward in the debate, my bet is that final House-Senate Joint Conference negotiations will spill over into 2010 much to the disappointment of President Obama. Beginning 2010 with an ongoing debate is difficult, since next year will quickly begin to focus on the much anticipated mid-term November elections.  The Administration is certainly not pleased with the slow moving Senate.

To compound the problem, as I outlined in a past Report , Reid must garner the 60 votes in advance of the vote merely to open debate on the matter. A key early test will be the degree of Democrat unity on the topic. With Republican Senators Mitch McConnell (R-KY) and National Republican Senatorial Campaign Committee Chairman John Cornyn (R-TX) promising to target any swing-state Democrats who support the procedural motion, many are closely watching if Reid can convince his colleagues to band together on the vote.

Regardless, Reid set a new Christmas deadline last week for the chamber to deliver a final bill. Warning that Senators and staff member should be prepared to work 6 days a week in December, Reid and the Democrat leaders are awaiting a Congressional Budget Office estimate on the final bill before releasing it to the public. With the House of Representatives package on the table, all eyes shift back to the Senate as it prepares to take up debate on the nation’s most compressive healthcare reform discussion since the mid 1960s.  

Kevin Fickenscher, MD

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