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Rushing health reform could be a death wish

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By Kathleen Parker
Wednesday, March 17, 2010

As Democrats consider shoving health-care reform through the House with a process known as "deem and pass," it is helpful to return to square one and ask: What, again, is the rush?

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A year ago, when reform work got underway, Democrats were hell-bent on passing legislation before year's end. Because? There was no way, Democrats believed, that they could accomplish such far-reaching reform in an election year. The Senate bill, which still doesn't have enough votes in the House to pass, barely squeaked through on Christmas Eve.

Now the new deadline for a final package is Easter break. This time the thinking goes: If Congress doesn't get a bill to the president before politicians head home, there will be no health-care reform for 10 more years. Come April, their energies are needed on other pressing concerns, such as reelection.

Meanwhile, the zoo in the living room demands attention. If the bill is so unpopular that it must be passed long before Election Day, could there be a problem with the legislation?

If health-care reform as proposed were so good for the nation, why wouldn't legislators prefer to run on rather than away from that record? If you can't run on the strength of the laws you pass, then either you shouldn't be running or you shouldn't be passing.

Yet, now House Speaker Nancy Pelosi is considering ways to allow House members to pass the Senate bill without actually voting for it so that vulnerable Democrats can deny responsibility for a bill they don't like and don't support. Is this sane?

More to the point, is it constitutional?

Some experts say yes; others say no. A thorough vetting would consume this space, but basically, the "deem and pass" maneuver accomplishes the same thing as if the House approved the Senate bill with tweaks through the reconciliation process. Rather than voting on the Senate bill, the House passes a package of changes to the bill. Thus the bill is "deemed" to have passed. Got that?

The benefit is that come election time, House members who didn't vote for the bill can say, "Hey, don't look at me, I didn't vote for it." And voters, whom lawmakers apparently deem mentally challenged, will give legislators a pass. This is called implausible optimism.

Deem and pass -- or sneak and sprint -- may be legal, but is it right?

It's right only if your goal is to beat a deadline and pass something -- anything -- regardless of how imperfect the result. Even the majority of Americans who oppose the bill don't know the half of it, because almost no one does.

What they do know is that health-care reform reeks of maneuvering and the kind of compromises that involve sacks of cash. The latest proposed strategy merely underscores the past year's by-hook-or-by-crook legislative approach.

Even recent attention to "sweetheart deals" has failed to improve the product. President Obama initially said he wanted state-specific deals removed, but now the White House has backed off, saying that if more than one state theoretically could benefit from a deal, then the program is okay.

Theoretically, that could cover just about anything -- and everything. Certainly, such an approach helps justify sweeteners such as the "Frontier States" amendment that raises Medicare reimbursements for some rural states at a cost of $2 billion over 10 years.

The deal was added to the Senate bill between its exit from the Finance Committee and the Christmas Eve vote. Coincidentally, it happens to benefit two powerful Democratic committee chairmen -- North Dakota's Kent Conrad (budget) and Montana's Max Baucus (finance). Other states deemed worthy of special treatment according to what is essentially an artificial creation -- half of each state's counties must have six or fewer persons per square mile (and bite their fingernails?) -- are Wyoming, South Dakota and Utah. Just 51 hospitals will receive the entire $2 billion, Centers for Medicare and Medicaid Services data show.

A sweetheart deal is a sweetheart deal by any other name.

Given the procedural complications, the clear lack of House support, and a raft of dubious dealmaking, slowing down wouldn't be the worst thing to happen to health-care reform. There's no dishonor in admitting that one was in too big a hurry. But rushing to do the wrong thing is, in a word, idiotic.

kathleenparker@washpost.com


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