A Health-Care Rift Between Old Allies
One of the intriguing mysteries of this year is why the initial broad support from American business for overhauling the health-care system has not translated into more than a handful of votes from Republicans in the House and Senate.
As a rule, when the business community decides it wants something in Washington, Republicans listen and respond. Much of their funding comes from the corporate sector, and their philosophy attunes them to the bottom-line concerns of those who live in the world of market competition.
When this year's health-care debate began, there was every reason to think that much of the corporate world had moved off the opposition that helped doom the Clinton reforms of 1993-94. In the intervening years, medical insurance bills for companies, as well as for individuals, had soared far faster than inflation, forcing many firms to cut back their employees' coverage or even abandon it.
The auto companies and many others complained that they were losing sales to foreign competitors who did not face the cost of health insurance and that they were paying the price in their bottom line. The Obama White House recognized the opening and reached out to business, striking deals with hospitals, pharmaceuticals and doctors.
In the past few days, such notable Republicans as former Senate majority leader Bill Frist, former Wisconsin governor and Health and Human Services secretary Tommy Thompson, and California Gov. Arnold Schwarzenegger all have urged their party to back reform, rather than settle for the status quo.
But far more common in the Capitol is what I heard from Rep. Roy Blunt of Missouri, the former GOP whip. "There has been no real pressure from business" to move the legislation forward, he said, and growing skepticism about what business can expect from any reforms. "The House and Senate [Democratic] leaders say they are not bound by any agreements the White House has made," Blunt said.
Rep. Fred Upton of Michigan, a moderate Republican with close ties to business, said, "I've not been lobbied" by any corporate supporters of reform. "They are preoccupied by deficits and debt."
Smart lobbyists such as Reagan White House chief of staff Ken Duberstein, former representative Vin Weber and Karen Ignagni, who represents the health-care insurers, offer various reasons for the seeming gap between business and the GOP. Weber and Duberstein both said they hear congressional Republicans expressing distaste for the business groups that have cut deals with Obama. Ignagni said that more and more business executives have grown leery that they may be stuck with the bill for Democratic plans.
Spokesmen for the Business Roundtable and the Committee for Economic Development, two corporate groups that early on called for reform, said many others in business worry about the cost of the program and the possibility that it will segue into a single-payer, government-controlled scheme. As a matter of principle, others oppose mandates for employers to provide insurance or for individuals to buy it.
And several of these people, after asking to speak off the record, made the point that while business has no choice but to make its best accommodation with Democrats, congressional Republicans are motivated primarily by a desire to reverse those Democratic majorities.
"They remember how defeating Clinton's health reform set the stage for taking over Congress in 1994," said one pro-reform consumer lobbyist. "Their gamble is that history can repeat itself."
It is not a single factor, then, that explains why many parts of business and the Republicans don't seem to be on the same page. Some of the pro-reform business groups have had second thoughts as the shape of the proposed legislation has become clearer. Few business leaders are lobbying actively for the bills nearing floor votes, and such key players as the U.S. Chamber of Commerce are vocally opposed.
And congressional Republicans are rejecting the pro-reform arguments from business, either because they scorn their erstwhile allies who are making deals with the Democrats or because they have decided that "just say no" may offer them more political rewards.