Gag Reflex

Associate Press

WASHINGTON - The little town of Libby, Mont., isn't mentioned by name in the Senate's mammoth health care bill, but it's one of the big winners in the legislation, thanks to the influence of Finance Committee Chairman Max Baucus, D-Mont. After pushing for years for help for residents of the area, thousands of whom suffer from asbestos-related illnesses from a now-closed mineral mining operation, Baucus inserted language in a package of last-minute amendments that grants them access to Medicare benefits.

He didn't advertise the change, and it takes a close read of the bill to find it...Here's a look at some other winners in the latest version of the legislation, which was expected to survive an initial test vote in the Senate around 1 a.m. Monday.

WINNERS

• Nebraska, Louisiana, Vermont and Massachusetts. These states are getting more federal help paying for a proposed Medicaid expansion than other states are. In the case of Nebraska — represented by Sen. Ben Nelson, who's providing the critical 60th vote for the legislation to pass — the federal government is picking up 100 percent of the tab for the expansion, in perpetuity.
• Beneficiaries of Medicare Advantage plans — the private managed-care plans within Medicare — in Florida. Hundreds of thousands of them will have their benefits grandfathered in thanks to a provision tailored by Sen. Bill Nelson, D-Fla., that also affects a much smaller number of seniors in a few other states.
• Longshoremen. They were added to the list of workers in high-risk professions who are shielded from the full impact of a proposed new tax on high-value insurance plans.
• A handful of physician-owned hospitals being built around the country — including one in Bellevue, Neb. — which would be permitted to get referrals from the doctors who own them, avoiding a new ban in the Senate bill that will apply to hospitals built in the future. Chalk up another win for Nelson.

--"Who wins, who loses in Senate health bill," Associated Press, as reported on msnbc.com (12.20.09)

I am a supporter of healthcare reform legislation. More, I support universal health care. Most of you know that. And I have been understanding and patient with our federal sausage-making legislative process. I understand that healthcare reform will be an iterative process, probably taking several legislative steps to achieve something inclusive enough, fair enough, and cost accountable. And for the first step we have to be satisfied with some basic healthcare coverage reforms and a significant increase in inclusiveness. Cost containment and reduction will necessarily be addressed in a later step. You've heard this before.

But with such a critical, weighty social policy issue as this, I expected the political maneuvering and negotiating tactics to be based on principled policy differences reflecting the ideological spectrum, and honest differences about the most pragmatic approaches to implementing needed change. I didn't expect open, unabashed pork-barrel exploitation and abuse of position and process from Democrats for whom this legislation is so important as a policy matter and measure of the administration's success--especially with the vote count teetering on the crumbling edge of success or failure. And it was mostly the "pragmatic," moderate Democrats, the swing votes, that most "pragmatically" exploited their position and the situation. I'm just sick.

By 2003, the Iraq War, and considering everything else a polarized and polarizing Bush administration and Republican Party had wrought, I was fully disabused of any lingering sense of identity as a moderate Republican. But yes, I had also undergone some changes in social views and policy orientation on my own. I would thereafter be a registered independent--and I have been. But over recent years, it's been clear that my policy advocacy relates mostly to universal education and health care, and well-regulated commercial (including financial) markets, the financial system, and the warming global environment. Shouldn't I just admit that I am a perfect fit with the Democratic Party, and likely the liberal Democrats at that?

Perhaps. But as I look back over this ugly healthcare legislative process--the progress achieved, and all that remains to be done--please do not allow me to forget for a moment what a bunch of self-interested, power-mongering scumbags our federal legislators are, regardless of political party affiliation. Statesmanship and stewardship of the national interest is now fully captive to the narrow political interest of those who live and work only to be re-elected again. But it has always been so, you say. Yes, but not to this extreme degree, not in matters this important to society.

So please do me a favor. Don't allow me to ever think thoughts about being a registered Democrat or Republican, or anything else. I'm counting on you, really. For now, I necessarily function without clear identity at the margin of organized politics, much as I necessarily function without clear identity at the margin of organized religion. It's how my gag reflex works.

http://www.msnbc.msn.com/id/34502819/ns/politics-health_care_reform/