Undernews is the online report of the Progressive Review, edited by Sam Smith, who has covered Washington during all or part of one quarter of America's presidencies and edited alternative journals since 1964. The Review has been on the web since 1995. See main page for full contents

February 23, 2009


Robert Pear, NY Times - Since last fall, many of the leading figures in the nation's long-running health care debate have been meeting secretly in a Senate hearing room. Now, with the blessing of the Senate's leading proponent of universal health insurance, Edward M. Kennedy, they appear to be inching toward a consensus that could reshape the debate.

The 20 people who regularly attend the meetings on Capitol Hill include lobbyists for AARP, Aetna, the A.F.L.-C.I.O., the American Cancer Society, the American Medical Association, America's Health Insurance Plans, the Business Roundtable, Easter Seals, the National Federation of Independent Business, the Pharmaceutical Research and Manufacturers of America, and the United States Chamber of Commerce.

The talks, which are taking place behind closed doors, are unusual. Lobbyists for a wide range of interest groups - some of which were involved in defeating national health legislation in 1993-4 - are meeting with the staff of Mr. Kennedy, Democrat of Massachusetts, in a search for common ground.

Mr. Kennedy is fighting brain cancer, and participants in the talks said his illness had added urgency to the discussions.

While President Obama is not directly represented in the talks, the White House has been kept informed and is encouraging the Senate effort as a way to get the ball rolling on health legislation.

Kennedy aides summarized discussions of the stakeholders, known as the "workhorse group," in a recent memorandum obtained by The New York Times.

"While there was some diversity of views," it said, "the sense of the room is that an individual obligation to purchase insurance should be part of reform if that obligation is coupled with effective mechanisms to make coverage meaningful and affordable."

The ideas discussed include a proposal to penalize people who fail to comply with the "individual obligation" to have insurance.

The proposal for an individual mandate was one of the few policy disagreements between Mr. Obama and Hillary Rodham Clinton in their fight for the Democratic presidential nomination. She wanted to require everyone to have and maintain insurance. He said he wanted to "ensure affordable coverage for all," but would initially apply the mandate only to children. . .

While a fragile consensus is slowly emerging, it is not unanimous. The Business Roundtable, representing big corporations, would place "an obligation on all Americans to have health insurance coverage" and says the government should offer financial aid to help low-income people buy it.

On the other hand, James P. Gelfand, senior manager of health policy at the United States Chamber of Commerce, said: "Forcing individuals to purchase insurance in the current market would be a disaster. Before we even have that discussion, we need to make health care more affordable and improve its quality."

Don McCanne, MD, Physicians for a National Health Policy - In this time of transparency and change, when we have an open window of opportunity to finally fix our very sick health care system, we are reverting to a closed door process dominated by the most powerful lobbyists in the nation whose interests take precedence over the American patient?!

Robert Pear reports that they are inching toward a consensus, but read his description of the memorandum prepared by director of the health staff of Senator Kennedy's Health, Education, Labor and Pensions Committee. They have agreed on almost nothing. "the sense of the room is that an individual obligation to purchase insurance should be part of reform" is as close as they have come, and, even there, there is no agreement on what that coverage should be and on how you would enforce it. . .

Have these people no decency? A few in the room do, but they are overpowered by those who. . . Well, you know. People can go broke and die for all they care, as long as we keep our public institutions out of their private businesses.

Unions for Single Payer - The Seattle City Council has joined the growing nationwide movement of cities, counties, and state legislatures to urge Congress to pass HR 676, national single payer healthcare, introduced by Congressman John Conyers (D-MI). Seattle joined 24 other cities and counties and 18 states passing similar resolutions. I

Other city councils calling for the bill's passage include those in Baltimore, Boston, Chicago, Detroit, San Francisco and Louisville, Ky. The U.S. Conference of Mayors at its June meeting in Miami passed a similar resolution.


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