Friday, December 4, 2009

Reform Rx – End Results Count Most

Senator Barbara Mikulski’s amendment to the Senate’s health care bill to promote and expand preventive healthcare for women passed yesterday on a 61 to 39 vote.

The amendment is in part a political reaction to the controversy that arose over the U.S. Preventive Services Task Force’s updated guidelines regarding mammograms for women in their 40s. The conservative fear machine spun the Task Force report into an ugly specter of rationing. Both Senators Snowe and Collins voted with the Democrats on the amendment which received a great deal of coverage similar to that from Health Leaders Media:

The amendment, which calls for coverage of screening procedures, such as mammographies and Pap smears, would also cover cervical cancer, postpartum depression, heart disease and diabetes. The amendment received some bipartisan support with three Republicans—Sen. Olympia Snowe (ME), Sen. Susan Collins (ME), and David Vitter (LA)—voting for it.

We can expect Senators Snowe and Collins to vote for several amendments during the course of the debate on issues on which they are routinely lauded as moderates. Amendment debates and occasional supportive votes on all of these matters may create an impression of moderation but in the end, voting for final legislation that contains substantive health care reform with a robust public option is the vote that counts.

That final vote needs to be where we focus considerable effort to influence our Senators to a greater degree than the insurance industry. What we do not want is Senators Snowe and Collins to earn moderate accolades for voting on a bunch of amendments and then voting down the final bill because of cost, government control, or public option opposition. We cannot afford to be cheated in the end with their explanation of “I worked so hard to improve the bill but the gosh darn Democrats just made it impossible in the end to support in good conscience because of blah, blah, blah...”

And we also must avoid a watered down bill that is not substantive or carrying a robust public option because Senators Snowe and Collins traded a few amendment votes along the way in exchange for the watering down of other key provisions. Those means would not justify the ends.

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