The Health Care Debate – Perfect v. Good

Ever since the health care debate started this past summer, I have been trying to figure out how to express my thoughts on this controversial topic. Part of my hesitancy to post was due to my own uncertainty concerning the proposals and part was due to the fact that I was struggling on how to express my thoughts in a concise cohesive fashion. As I have researched it; listened to the talking heads; listened to the common man and even listened to health professionals, I have come to the conclusion that the topic is too confusing to even be summed up in one post, let alone in the 15 second sound bites that you hear on the evening news.

That made me think of something I heard recently from some of the democrats who were calling for compromise regarding the health care bill. They said that you can’t let the perfect be the enemy of the good. In other words, just because something is not perfect does not mean it shouldn’t be pursued. Rather if it is still good and better than the alternative of doing nothing, then indeed, it is worth pursuing even if it may not be the ideal. I am sort of viewing my post along those lines. This is not going to be a perfectly thought out position, nor is it going to be some treatise on the bill. Rather, here are some general thoughts about health care in general and how they relate to the proposed bills.

First of all, something needs to be done. Nothing makes me more frustrated in the health care debate than to hear conservatives say things such as “If it’s not broke, don’t fix it.” This insinuates that the current system works. For the average American who has a good health care plan through their employer, yes it does work and the people who make that comment are generally (if not always) in that category. Unfortunately, the number of people in that category continues to shrink.

As an attorney in practice for myself, I am thankful that my wife’s work provides coverage for us (at a cost), but frankly, there are many times my wife Jen and I look at each other and say to one another, “what are we paying this for?” Everything health related that we do use seems to either not be covered (like chiropractic care or medical massage both of which Jen requires for her bad shoulder) or if it is covered, they come with such large co-pays that we wonder if we would actually save money by not paying for the insurance and just paying the service as we need it. The only thing that prevents us from doing so is the chance at some major medical need arising where we would need the coverage. I hear other people saying similar things regarding coverage and co-pays. All this means to me that he current cost of health care has gotten too far out of control. Along those lines something clearly needs to be done.

Second, just because the Senate passed a bill on Christmas Eve does not mean that passage of the bill is a certainty. They are MANY differences between the House and Senate versions and for those of you who need some brushing up on your Government 101, the bill will now go into conference between the two chambers to try and hash out a deal. If a compromise is reached (and I emphasize IF), the bill then goes back to both chambers for a simple up or down vote. No more amendments are allowed once it comes out of conference.

You will now be hearing a lot in the news about the conference that will be meeting between the House and Senate to try and work out the differences. For instance, one of the major hurdles is abortion and the so-called Stupak amendment. Congressman Stupak (D-MI) offered an amendment to the House version of the bill that would prohibit federal dollars from being spent to cover abortions. The amendment passed in the House and therefore was added to the bill. It was largely believed that many moderate house democrats, like Congressman Stupak, were unwilling to vote for the bill as a whole if the amendment was not added. A similar amendment was introduced in the Senate by Senator Ben Nelson (D-NE) but it was never added and therefore is not part of the Senate bill.

Another major difference between the bills is the existence of a public option. The House bill provides for a government insurance option that people would be able to purchase based on income level. At certain income levels, it would become an entitlement. The Senate bill does not provide for such an option. Instead it mandates everyone carry insurance and provides some tax credits and some public funding to make it affordable for people to buy policies from private insurers. Whether the conference can come to some resolution on these and many other differences will decide the ultimate fate of the health care bill.

Thirdly, like I said above something needs to be done and I think that the bills that have been proposed are a step in the right direction. First of all, both bills require insurance companies to accept applicants with pre-existing conditions and not disqualify them from coverage. Additionally, they require coverage for certain preventative screenings which will actually cut long term health care costs if problems are detected earlier. These are things that have been sorely needed for some time now.

Along these lines, I hope that it will make health insurance companies think more about their customers than their shareholders as has been the case in the last several decades. Another line that conservatives spout that makes me cringe is when they decry “government run health care” as meaning the decision about someone’s health will not be made by the patient and the doctor but by some government bureaucrat. The problem with this argument is that it assumes the current system allows for medical decisions to be made by the doctor and patient when in fact it is made by some insurance company bureaucrat. So what’s really the difference? At least the government bureaucrat won’t be answering to next quarter’s profit and loss statement and what that will do to stock prices.

So those are some of my thoughts for now. I’ll try and be better about posting as the bills go through conference. As for my next post, since I still consider myself a Republican, I’ll post where I think they went wrong in the long term on this health care debate – so keep checking in.

Reflections on Ted Kennedy

Unless you were completely hiding under a rock this week, you know by now that Massachusetts Senator Ted Kennedy passed away Tuesday of this week. His passing made me think a lot about my political pilgrimage as my reaction to his death was clearly not what it would have been 10 years ago. Don’t get me wrong, I would never have celebrated someone’s death, but I used to tell a joke in reference to his future passing. It went – “When Ted Kennedy dies, they won’t elect a new senator in Massachusetts, they’ll just stuff him & sit him in his senate chair & keep voting the way the liberal faction of the democrats would want.”

Obviously, the joke was filled with sarcasm, but as I think of it now, it certainly wasn’t a respectful way to talk about a man who served as a senator for well over half his life just like a similar comment would have been inappropriate from the left to say about an arch conservative like Jesse Helms. It is this lasting legacy that Ted Kennedy has left on me. Once, I considered him to be the punch line of jokes about the liberals in this country, but now my perspective has changed. While I still enjoy good political humor, I now view it as just that – humor. I don’t let it mold my thinking of the individual about which the joke is being told.

I think too often those of us on the different ends allow political humor to shape our image of the people on the “other side.” It reminds me of a story I put in my political essay on my view of the 2008 election regarding an incident that happened while I was in college. The story I wrote at the time follows: A friend of mine who was a fellow political science major had returned from a summer internship back at his home in Maine. It was with US Senator George Mitchell, who was the Democratic Majority Leader at the time. Upon learning this and knowing we were both conservatives, I asked him how he was able to work with them for the whole summer. His response was simple, “Karl, even though we disagree with their policies, they love this country just like we do.”

Think about that the next time you tell a joke about people in this country on the other side of the political spectrum. I’m not saying that we shouldn’t have a good laugh with some political humor; just don’t let the caricature created in the joke affect your image of the real person.

One of the books that I read a couple years ago that really got me thinking about this was No Excuses: Concessions of a Serial Campaigner by Bob Schrum. Bob Schrum was a clear liberal and was a campaign worker/advisor/manger for virtually every democratic presidential candidate from Jimmy Carter to John Kerry. He was one of Ted Kennedy’s closest advisors in his ill-fated attempt to take the democratic nomination from Jimmy Carter in 1980. I read the book as a staunch conservative because I just love the idea of a book that is sort of an Inside Baseball approach to politics, no matter which side it is. However, as I read the book, I was struck with how it showed the humanity of the politicians in the book and the fact that they love America even if we disagree with them. Even though I disagreed with many of the policies that Schrum and his candidates were proposing, I found that I had to respect their love of country.

The amazing thing is that the politicians themselves seem unfazed by the caricatures we place on them. I was watching MSNBC’s Morning Joe the day the news broke of Senator Kennedy’s death and I was fascinated by a conversation between Bob Schrum and Pat Buchanan about Ted Kennedy and his relationship with those on the right. Here you had two commentators now on completely opposite sides of the political spectrum talking about Senator Kennedy and how Kennedy and Buchanan used to battle oratorically over policy, yet at the end of the day they could still respect one another and share a laugh about what the other was saying about them.

In other words, they weren’t letting the words of the debate shape their respect for the person. That will be my lasting impression of Senator Ted Kennedy. While I disagreed with many things he stood for, I truly believed he loved his country and wanted what he thought was best for it. He also respected those on the other side of the aisle and was willing to try and work with them. Let that be our goal in life as it relates to politics. Fervently advocate for what you believe in, but respect others and ultimately try and find what is best for our great country.

Random Thoughts

It has been a while since I posted on this blog and with everything that has happened in the past couple of months, I figured I drop a few random thoughts.

Sonia Sotomayor: When I last posted it was to give my thoughts on the nomination of Sonia Sotomayor to the US Supreme Court. At that time, I took the position that I thought she should be confirmed and that the Republicans should avoid a big nomination fight. So I was pleased that she was confirmed as the first Hispanic justice on the high court. As I said in my last post, I am sure that the worst case scenario for conservatives is that the balance of power will remain as is.

Republicans and the Hispanic Vote: In my last post, I also indicated that I wanted to do a post regarding the growing Hispanic vote and what that means for the Republicans. I still plan on doing that in more detail in the future, but for now I was glad to see that, except for a wayward comment by Newt Gingrich, the Republicans seemed fair in their treatment of her and those that voted against her clearly did so on ideological grounds. In other words, I do not think that the Republicans did anything in the confirmation vote that would specifically turn off the Hispanic vote.

However, on a bad note, the Republicans lost their only Hispanic member in the Senate with the resignation of Mel Martinez. I have already begun doing some research on the Hispanic vote for the Republicans and I will write about it as we head into next year’s mid-term elections. However, suffice it to say if Republicans do not figure out how to begin to make more inroads into the Hispanic vote, they will be a minority party for many years.

Health Care: At this point I am still doing a lot of research on the current health care bill(s) pending in Congress and I really have not decided what my position is on the controversial bill. I do know that something needs to be done, but I want to know more about the current proposals before I decide if they are appropriate. My wife, who is a nurse, has given me plenty of suggested reading. If any of you would like to add to this list, feel free to let me know. In the meantime, I have contacted my local Congressman Patrick Murphy (D-PA) and requested a meeting to discuss what the bill means for those with disabilities – an issue that is obviously close to my heart.

At this point, I will hold off on my other thoughts regarding the bill, but there is one thing that has me very fired up and that is some of the out right misinformation that is being given about the bill. It is one thing for someone who is advocating for or against a certain measure to misstate a fact or get some statistics mixed up, but with the debate on this bill it seems as though advocates on the right such as Sarah Palin have crafted an outright lie as a way of stoking the right into a frenzy about the bill.

By now you may have heard of Sarah Palin referring to a “death panel” that her down syndrome son would have to face if the current bill is passed. It has caused many on the right to become very fired up about this bill. Now I know that there are other reasons why the town hall meetings that congressmen have been holding have been so contentious, but Ms. Palin’s comments certainly did not help.

So what is the truth? There is a provision in the House bill which would reimburse doctors who have a consultation with their patient about making end of life decisions. It is a voluntary consultation for the patient and the patient and their own personal physician ultimately make the decision about that end of life care. It is being supported by The American Medical Association, the National Hospice and Palliative Care Organization and Consumers Union. Additionally, AARP has come out and called the claims false as well and will take out print media ads to say so. However, it is this provision that the right is now using to say that there would be a “death panel.”

An interesting note, as an attorney I have helped numerous clients prepare living wills which make these same end of life health care decisions. Sometimes the client is uncertain about various parts of the living will, so I counsel them to consider it with their family and their doctor. With the proposed provision, the client would then be able to make an appointment with their doctor to discuss the living will and it would be paid for so that the client would not have to pay for such an appointment.

What bothers me most about this misinformation is that it is so blatantly false that the only explanation for it is that the right is trying to use it to anger its base and get them to oppose the bill even more ferociously. For those of you who read my essay on the 2008 election and why I supported Barack Obama, one of the reasons I gave was that I was sick and tired of the way the right campaigned in elections and issues. While both sides can debate in a divisive manner, in my opinion the conservatives have been more guilty, at least recently, of trying to use distraction, misinformation and division in politics. President Obama clearly tried to “change the tone in Washington,” but it seems clear to me that many of the Republicans are not willing to let that happen.

It is obvious that the tone has not changed in this debate and many Republicans are of a mindset that they just want to “win.” They do not care about the hearth care crisis in America. Well as long as they just try to use the issue to damage President Obama’s approval ratings rather than actually come up with a solution, this is one Republican vote that they will NOT win back. I want statesmen right now, not individuals who are just trying to see how they can win some seats back in Congress next year. A note to you Republicans who are trying to win the “issue” so you can win an election: by being more divisive you only further alienate those of us in the middle. You may “fire up” your base and you may actually win a few seats back in the House, but at what cost?

Like I said, I am unsure on how I feel about the health care reform bill as a whole, but I know something needs to be done. As someone watching the action from the sidelines, it appears to me as though President Obama is actually trying to craft a solution while the Republicans are just trying to turn back the clock to 1993-94 all over again. I wish that Congress would put aside some of the party labels every once in awhile on a very serious domestic issue and come up with one bi-partisan solution and rather than try and use every issue for political advantage. We see Congress unite when there is a serious foreign threat to our country. Why can’t they behave the same way for a serious domestic threat?

I’m not saying that Republicans should give the President whatever he wants, but they should pull their heads out of the sand and realize that there is a health care crisis in this country. If there is a crisis, then shouldn’t something be done about it? And if something should be done, isn’t there some common ground that can be reached? No, instead the party to which I have belonged for my adult life is more content to just sit back and try to play political football with the issue in order to score some points and possibly help their chances in the next election. That is not statesmanship, it is politics at its worst.

Please Republicans in Congress, will more than a handful of moderate Senators step up to the table and have a meaningful conversation about how to solve an issue which does threaten our economic vitality? I know I would feel better as a citizen if both parties hashed out a plan that most could agree upon.

My Thoughts on the Nomination of Sonia Sotomayor

It has been a couple of weeks since President Obama nominated Sonia Sotomayor to replace Justice David Souter on the United States Supreme Court. Since the President’s announcement, conservatives have been divided in their reaction to the nomination. The Republican conservative base, including many in the conservative media and even some Congressmen, have urged a fight and want to see the Republican Senators even threaten a filibuster of the nomination. However, Republican Senators themselves have been guarded in their approach and, at least in public statements, seem to be willing to allow Judge Sotomayor to have her say at the upcoming confirmation hearings before they decide how to vote. For both ideological and practical reasons, count me in the latter group.

First off, for ideological reasons I firmly believe that it is the Senate’s job to confirm qualified jurists to the federal bench. In other words, it is not the Senate’s job to step in and make an ideological determination about whether the candidate is one that will rule the way they want on various cases. I began feeling this way in the 1980’s when Supreme Court nominations began to turn into the elaborate process they are today. It used to be that the Senate only did look at the qualifications of the candidate and did not even hold public hearings where the nominee was questioned on a whole host of issues.

Everything changed in 1987 with the nomination of Robert Bork. Democrats and liberals began attacking Judge Bork because of his record and eventually the Senate voted against his nomination to the High Court. None of the reasoning provided by those who voted against him had to do with his qualifications, instead it was entirely on his judicial philosophy and ideology. In fact, if you looked at Judge Bork’s qualifications, he was one of the most qualified nominees ever to the Supreme Court. At that time, I advocated the responsibility of the Senate should not be getting into the ideology of a nominee, but simply determine whether the candidate was qualified or not. For me to now oppose a nominee solely on ideology would be hypocritical.

So how do Sonia Sotomayor’s qualifications add up? She certainly has a resume that suggests she is qualified. She was nominated to the US District Court by the first President Bush and then nominated to the US Court of Appeals by President Clinton. She has been serving on the appellate court for eleven years. I am interested to see how she “performs” under the intense questioning of the Senate Judiciary Committee. The Supreme Court deals with some of the most complex legal issues in the land and we need individuals on the High Court of the highest intellectual ability to grapple with these issues. While I do not think that the Senators should consider ideology, I believe that the hearings are helpful in the process. They provide for an opportunity to judge the intellectual prowess and judgment of the nominee. In a sense, they act as a public job interview for the position. For this reason, I will continue to reserve judgment.

However, there are also some practical reasons why I believe that the Republican Senators should be wary of a big nomination fight. First of all, it is a fight that they cannot win. For the Republicans to successfully filibuster, they will need all 40 Republican Senators to vote in favor of the filibuster, something which is very unlikely when you consider that there are still a couple moderate Republican Senators. However, even if all current Republican Senators vote in favor of a filibuster, then the Democrats can still get the required 60 votes to break the filibuster if they manage to get Al Franken seated in the still contested Minnesota election. At this point, short of a new revelation about her or a very poor performance at the Judiciary Committee Hearings, it appears as though Judge Sotomayor will become the next Associate Justice to the Supreme Court and to fight it simply to make a point seems fruitless.

The second practicality that I think suggests that the Republicans should avoid an ugly confirmation battle is the effect such a fight would have on their voting interests within the Hispanic community. It has been well reported that Sonia Sotomayor is the first person of Hispanic heritage to be nominated to the Supreme Court and I think the Republicans would be foolish to attack her and potentially alienate another minority voting block. Over the years, Republicans have struggled to win any support in a national election among the African-American community, and that was before Barack Obama ran for president. With many Republicans taking a tough stand on immigration issues, the support for Republicans among Hispanics has been eroding as well. In my next post, I think I will go into more detail about the shifting electorate among Hispanic Americans and what that means for the future of American politics, but suffice it to say, the Republicans cannot afford to have huge margins in the two most significant minority voting blocks in the country.

Finally, in the essay I wrote in preparation for the 2008 election, I pointed out the fact that any justices appointed by President Obama will not change the current make up of the Supreme Court. That is the case with this nomination. Retiring is a liberal member of the court in Justice David Souter and it appears as though Judge Sotomayor is probably similar in ideology. So even if Judge Sotomayor is confirmed and has a reliable liberal voting record, there will still be four conservatives, four liberals and a moderate-to-conservative in Justice Kennedy. I’ll take my chances with that breakdown.

We shall see how the Sotomayor confirmation plays out and I will continue to post my thoughts, but for now, I think the Republicans in the Senate would be best served sitting back and allowing the confirmation to play out and react only if something comes out that would call her qualifications into question.