If Democrats are disappointed by Joe Lieberman’s threat to filibuster any healthcare reform bill that includes a public option, they shouldn't be. Despite all of his past promises to support universal healthcare, nothing was more predictable than the Connecticut senator's fealty to the insurance and pharmaceutical lobbyists.
Much the same can be said of Sen. Evan Bayh, who emerged from hiding on healthcare to announce that he too plans to filibuster against reform with the Republicans, regardless of what his constituents and Americans in general plainly want. Like Lieberman, his state is home to powerful corporations that want reform killed -- and like Lieberman, his wife has brought home very big paychecks from those same interests. . (UPDATE: A report published in a South Bend paper Thursday night says Bayh may now support a floor debate.)
The Lieberman family's financial ties to the health industry are no secret, yet their full extent remains unknown. During her husband's 2006 reelection campaign, Hadassah Lieberman's employment as a "senior counselor" to Hill & Knowlton, one of the world’s biggest lobbying firms, briefly erupted as an issue, especially because the clients she served were in the controversial pharmaceutical and insurance sectors. Exactly what she did for those clients has never been disclosed.
At the time she joined the public relations and lobbying conglomerate in the spring of 2005, she expressed the touching hope that she would somehow be able to help those in need. "I have had a lifelong commitment to helping people gain better healthcare," she said in a press release. "I am excited about the opportunity to work with the talented team at Hill & Knowlton to counsel a terrific stable of clients toward that same goal." Less than a year later, having pocketed $77,000 in salary, she quit without explanation -- just as her husband was facing a tough primary that he would eventually lose. Throughout the campaign, Hadassah Lieberman, her husband and their spokespersons explicitly refused to discuss her professional activities, except to note that she had not been required to register as a lobbyist.
But her stint at Hill & Knowlton was merely one episode in a professional lifetime devoted to the corporate health sector. For most of the past three decades, Hadassah Lieberman has been employed by either pharmaceutical companies or the lobbying firms that represent them -- starting with nearly a decade in the "public affairs department" at Hoffman-LaRoche from 1972-81, followed by stints at Pfizer, where she spent four years as "director of policy, planning and communications," and APCO Associates, a major lobbying firm where she served as a "senior associate" in its large healthcare division before retiring in 1998.
She went back to work when she joined H&K, an outfit that became notorious for its billion-dollar defense of the tobacco industry. Not long after her contract began, Sen. Lieberman introduced legislation vastly extending patent protection for pharmaceutical companies -- notably including GlaxoSmithKline, a top client of his wife's firm.
The best that can be said about the Lieberman family's conflict of interest is that it appears to have ended in 2005 -- while the Bayh family continues to collect enormous amounts of money from the same health insurance and drug companies that will benefit from her husband’s actions. Indeed, the smell of ethical rot arising from the Bayh household is even worse than the self-serving aroma that surrounds the Liebermans.
Susan Bayh was invited to join the board of Wellpoint back in 1998, when the Indiana-based company was still called Anthem Insurance and had not yet completed the mergers that made it the largest health insurer in America (and gave it monopoly status in many regions of the country). According to her official biography on Wellpoint's filings with the Securities and Exchange Commission, her qualifications to sit on the board of a billion-dollar corporation were minimal, to put it politely. She was 38 years old, teaching law at a local university, with limited experience as a corporate attorney at Eli Lilly & Co., the big pharmaceutical company that is also headquartered in Indiana. But then her husband, Evan, after two terms as governor, had just been elected to the United States Senate.
Susan Bayh's compensation from Wellpoint, including the stock options that she has exercised repeatedly over the past 10 years, has reached an estimated $2 million, including last year's director salary of over $300,000. She is the only director who, according to the most recent SEC filing, actually owns no shares in the company, because she sells as soon as her options become available. In January 2007, she exercised her options to acquire 3,333 shares of Wellpoint for an estimated cost of $147,000 -- and sold them the same day for an estimated price of $260,000, netting a tidy sum of $113,000. She repeated the same process five months later for a net profit of $136,000, and then seven months after that, selling another 1,430 shares for $123,000. That represented profits of nearly $400,000 on top of her salary.
Evidently Susan Bayh is most interested in accumulating wealth, and so far she has done a fine job. The Bayhs are now worth somewhere between $5 million and $10 million, an amount that was not scrimped from Evan's salary in the Senate. In 2007 he reassured a Fort Wayne newspaper in sonorous tones that sounded Liebermanesque: "I can honestly tell you that if my wife did not have a job, none, I can't think of a single decision I've made that would be any different. I look at what's best for our state and our country and my own conscience. My integrity matters more to me than anything, so I always do what's right for the people who put their trust in me."
Compared with Bayh's lucre from Wellpoint and the other corporations whose boards she graces, the earnings of Hadassah Lieberman appear paltry. Yet even though she has retired, for now, from counseling the pharma and insurance industries, the devotion to public health she has long proclaimed is still tinged with hypocrisy. Upon leaving Hill & Knowlton, Hadassah joined Susan G. Komen for the Cure, the world’s largest breast cancer charity, as a paid "ambassador." Again, it isn't clear what she does besides posing for photo ops in places from Brazil to Israel, but as a Komen advocate she is supposed to be trying to prevent women from losing their lives.
So perhaps someone should point out to her what will happen if her husband kills healthcare reform this year. Millions of uninsured and underinsured women will continue to delay or simply fail to get preventive medical care, including mammography, because they cannot afford those procedures. Thousands of them will die as a direct result of that foregone care, just as thousands die each year from lack of insurance. The swiftest way to save those women from breast cancer is health insurance reform -- and the filibuster will be their death sentence.
It's almost a given at this point: Any time a Congressional Republican's commenting on the Democrats' healthcare reform bills, they'll likely bring up their length. Some will just mention the 2,074 pages in the Senate version, others will tally the amount of dollars spent per word, some will tell you it's longer than "War and Peace." It's a way to suggest that the bill is impenetrable, that Democrats are sneaking big changes into it -- and that it's bound to increase the size of the federal government, not to mention taxes.
Part of what they're saying is true -- the bill is quite long; the House's version is probably the longest produced in the past 10 years. But "War and Peace" is almost twice as wordy, and the Republicans have gotten pretty verbose recently, too.
The Associated Press noted Tuesday that the Senate bill comes in at 318,512 words, while the House's contains 319,145. "War and Peace," by contrast, ranges from 560,000 to 670,000. And when it was taken out of the legislative format and published in the Congressional Record, the Senate version took up only 209 pages.
OpenCongress.org also did some analysis of the measure, especially as compared to other legislation from the past 10 years. Turns out five of the ten longest bills in that period were written by Republicans.
In fact, while the House's healthcare reform proposal was the longest, a bill authored by Rep. Don Young, R-Alaska, was only 68 words behind. A 2005 appropriations bill sponsored by Rep. James Kolbe, R-Ariz., came in fourth at 296,111 words and one of the centerpieces of former President Bush's agenda, the No Child Left Behind Act, was sixth behind the strength of its 274,559 words. Minority Leader John Boehner, now spearheading the message that the Democrats' bills are too hefty, was the sponsor.
Liberals are frustrated these days, and they have reason to be. They helped Democrats win a theoretically filibuster-proof majority in the Senate, and now the part of the reform bill they prize most highly faces death at the hands of members of the Democratic caucus.
A healthcare reform bill that includes a version of the so-called public option -- a new insurance provider run by the government -- passed its first test in the Senate this weekend. It was a bittersweet moment, though, as at the same time, it was becoming increasingly evident that Democrats won't have the 60 votes needed to break a Republican filibuster if the final legislation still includes a public option. Sen. Joe Lieberman, I-Conn., had already declared his intention to support a filibuster if it came to that, and he's been digging himself in further; Sens. Blanche Lincoln of Arkansas, Mary Landrieu of Louisiana and Ben Nelson of Nebraska could well join Lieberman.
Some liberals, though, have a solution in mind, a silver bullet to save the public option. Led principally by the blog Firedoglake, with encouragement from DailyKos and even former Democratic National Committee Chairman Howard Dean, they're calling on Senate Majority Leader Harry Reid to use a heretofore obscure procedure known as budget reconciliation that forecloses the possibility of a filibuster and would theoretically allow him to pass a bill that includes a public option with only 51 votes.
But as with so much in politics, especially when it comes to Senate procedure, things are not nearly so simple. In fact, if Reid did try using reconciliation, he could end up having to remove key parts of the legislation, not to mention hurting his party politically and losing an extra couple of votes in the Senate -- and, having done all that, he might well find out that he still needed 60 votes in order to get a public option approved.
Reid has ruled out the idea for now, saying last week, "I'm not using reconciliation." And other senators, like Sen. Tom Harkin, D-Iowa, agree with their leader, believing the procedure would end up doing more harm than good. An aide to a senior Democrat, who asked for anonymity in order to discuss the issue more freely, told Salon, "This isn't like a two-week delay, or a three-week delay. This fundamentally changes what we have promised to the American people, and it's risky, and I'm not talking about a little bit of fucking risk, I'm talking about a lot of risk ... It puts universal coverage at risk ... [and] risks allowing insurance companies to discriminate against those with preexisting conditions."
And of those pushing for the use of reconciliation, the aide concluded, "A bunch of people that watched 'Schoolhouse Rock' growing up think that they understand how the Senate works, and they don’t."
The problem is that budget reconciliation isn't really supposed to be used to make policy. Instead, as the Congressional Research Service's Robert Keith said in a 2008 report, reconciliation "is a procedure ... by which Congress implements budget resolution policies affecting mainly permanent spending and revenue programs." In the procedure's early years, however, it was used to circumvent the filibuster on provisions unrelated to that purpose. So in the 1980s, then-Minority Leader Robert Byrd led the Senate in a crackdown. What resulted was the Byrd Rule, which prohibits the Senate "from considering extraneous matter as part of a reconciliation bill."
The definition of "extraneous matter" is fairly broad, and subject to interpretation -- during the Bush administration, Republicans passed tax cuts using reconciliation -- but it generally includes any provision that fails one of these six criteria, as listed in Keith's CRS report:
Even if a provision violates one of these rules, it won't automatically be stricken from a bill. In order for that to happen, a senator has to take action, generally by raising a point of order. Then, the chair (the majority leader or a designee) rules on whether to sustain that point of order and remove the offending part of the bill. That may seem like an easy victory in the making -- Reid rules that the public option passes the Byrd Rule's tests, and that's that -- but that's not necessarily the case.
Liberals argue that the public option could survive the Byrd Rule, pointing to tax cuts that Republicans passed using reconciliation during the Bush administration as precedent, and arguing that the public option would pass the tests anyway because it would theoretically decrease the federal deficit.
They may have a point, but it doesn't much matter -- the only thing that does is the opinion of Alan Frumin, the Senate parliamentarian. Technically, Reid isn't required to abide by Frumin's judgment, but according to Robert Dove, who served twice as Senate parliamentarian, he will anyway. "It's not that they have to [listen to the parliamentarian]," Dove told Salon, "but absolutely they do ... The past history is that the view of the parliamentarian becomes the ruling of the chair."
If Reid did rule the public option out of order under the Byrd Rule, the whole point of using reconciliation would be rendered moot. The only way to overturn the chair's ruling in such a case would be with a three-fifths vote of the Senate -- that is, with the same 60 votes the majority leader would need to round up in order to defeat a filibuster. In that eventuality, there's no way Reid could get the supermajority; Lieberman would certainly abandon him, and moderate Democrats might too. Plus, Byrd has already expressed his distaste for the idea of using reconciliation for health reform, and could be expected to vote to support the rule that bears his name.
Dove wouldn't speculate on what Frumin might decide, or give his own view on the matter, but aides from both parties have met with him, and Reid's office made "preliminary inquiries" about the public option, the aide to a senior Democrat told Salon. No one's offering much detail about what Frumin said, but the fact that Reid has taken reconciliation off the table could well have something to do with those meetings.
The public option might not be the only thing dropped from a bill that's pushed through the Senate using the procedure. Republicans would almost certainly object as often as possible to elements in the legislation, and they'd win many of those battles -- maybe even the war. "If you're a Republican, your job in reconciliation is to do two things: One, to put Democrats in an untenable position to have to vote for or against things that are going to bite them in the ass when they run for re-election; but more importantly, your thing is to find provisions where if you snip that out, it's going to bring down the entire bill," the aide to the senior Democrat said.
Ultimately, passing a reform bill with reconciliation is "feasible," Dove says, but the resulting legislation "would not be pretty, and it couldn't contain a lot of things that people want to be in it."
Under legislation approved Monday night by Baltimore's city council, crisis pregnancy centers that do not offer referrals for abortion or birth control would be required to post signs saying as much. It seems like such a reasonable plea for transparency! After all, these types of centers are infamous for engaging in religiously- and politically-motivated deception of pregnant women -- and yet, if the city's mayor signs the measure, it will be the very first law of its kind in the U.S.
Time and again, we've written about how crisis pregnancy centers masquerade as legitimate healthcare facilities and target young, poor and minority women by offering free pregnancy tests and counseling. In reality, these centers, which are often staffed by unqualified volunteers, provide medical misinformation as a means of coercing women into going through with a pregnancy and, in some cases, to give the baby up for adoption (to a good Christian family, natch). Some clinics have been found to delay pregnancy test results so they can first subject patients to graphic anti-abortion imagery and propaganda.
This measure is bolstered by more than crisis pregnancy centers' well-established reputation nationwide: Last year, the NARAL Pro-Choice Fund sent staff members into 11 Maryland centers in particular to pose as potential patients and reported that "every CPC visited provided misleading or, in some cases completely false, information" about abortion and birth control." For good measure, the clinics also threw in "emotionally manipulative counseling" (for example, one worker told an investigator, "You need to come meet your baby before deciding what to do"). Worse yet, many clinics "purposefully schedule sonogram appointments two-three weeks after the initial appointment to ensure that there will be a heartbeat and that the pregnancy is larger than a grain of rice." (If you're short on outrage today, I highly recommend reading the report in its entirety.)
What makes these centers so pernicious is that they calculatedly project "an aura of medical authority," as the NARAL report puts it, when in reality they are largely "amateur-run." This measure aims to chip away at that facade. Frankly, the legislation could go much farther and actually require them to cop to the totality of their dishonesty -- these clinics should be happy they're getting off so easy.
In case anyone was still wondering, Sen. Joe Lieberman, I-Conn., tells the Wall Street Journal in an article published Tuesday that he opposes all possible forms of a public option, and he's going to be "stubborn" about it.
The Journal's Gerald Seib asked Lieberman if he could support some compromise form of the public option -- if not the one currently in the Senate bill, which allows states to opt out, then perhaps the "trigger" plan advanced by Sen. Olympia Snowe, R-Maine? The answer, reportedly, was no to all possibilities. Asked whether any form of a public option would lead to his voting to support a filibuster, Lieberman replied, "correct."
On a related topic, in the Daily Beast, Peter Beinart has an interesting article exploring Lieberman's history and his current stance. Beinart asks why, given his record as a liberal on domestic policy, the senator's staking out the position he is, and has this answer:
For close to a decade, he got nearly perfect scores from the American Public Health Association, which backs a single-payer health-care system, and in lieu of that, the “public option.” Now, all of a sudden, he’s so outraged by a public option that he’s threatening to filibuster any bill that contains it. The arguments he makes on behalf of his new position are remarkably weak: He says the public option will raise costs, even though the Congressional Budget Office has said no such thing, and even though logic suggests that by competing with private insurers, a government plan will actually drive costs down. Some have accused Lieberman of shifting right in order to win backing from the insurance industry in preparation for a 2012 reelection run. But, in fact, he gets relatively little insurance money, and Connecticut politicos mostly think he won’t run.
So why is he doing this? Because he’s bitter. According to former staffers and associates, he was upset by his dismal showing in the 2004 Democratic presidential primary. And he was enraged by the tepid support he got from many party leaders in 2006, when he lost the Democratic primary to an anti-war activist and won reelection as an independent. Gradually, this personal alienation has eaten away at his liberal domestic views. His staff has grown markedly more conservative in recent years, and his closest friends in Congress are now Republicans John McCain and Lindsey Graham. For Lieberman, the personal has become political, and it has pushed him further to the right.
Women have a simple plan for responding to the unpopular new guidelines on breast cancer screenings: ignore them. A Gallup poll shows that 76 percent of women disagree with the recommendation that women hold off on mammograms until age 50, and a whopping 84 percent of those between age 35 and 49 intend to reject the advice entirely. Women are going to get their mammograms when they damn well please.
The telephone poll of 1,136 women suggests that the objection to the U.S. Preventive Services Task Force's guidelines arises from a mistrust of the panel's motivations. Seventy-six percent of women believe the decision was based on cost, not science. That's no surprise considering that the results were released amid a contentious debate about healthcare reform and that the recommendations have been poorly communicated to the public. As Cristine Russell writes in the Atlantic, the panel's intent may have been to deliver the message "that individualized, informed decision making should replace blanket guidelines for universal, routine mammography screening of women in their 40s" -- but it failed spectacularly on that front.
No matter your personal take on the new mammogram guidelines, one thing is certain: There is a critical lack of information on the topic. The Gallup poll found that 40 percent of women believe that a 40-year-old woman has a 20 to 50 percent chance of developing cancer over the next decade, when her actual risk is only 1.4 percent. Clearly, we need to strike a better balance between effective awareness-raising -- like pink ribbon campaigns -- and communicating nuanced medical fact.
The Senate vote on Democrats' healthcare reform bill Saturday night was close -- maybe too close. Majority Leader Harry Reid won an important victory, no doubt, but he had only the 60 votes needed to invoke cloture and move the legislation to the floor, no more. He may not have all 60 when the next cloture motion, the one to break a Republican filibuster and force an up-or-down vote, comes around.
One member of the Senate's Democratic caucus, Sen. Joe Lieberman, I-Conn., has already said he intends to support a filibuster if the bill includes a public option. And he's not the only one saying something like that -- Sens. Blanche Lincoln of Arkansas and Ben Nelson of Nebraska are also talking defection.
That means that unless Reid can work out some sort of deal, he'll need to look for votes elsewhere: specifically, across the aisle. The New York Times reported Monday that he's already done that; along with the White House, he's courting Maine's two senators, Republicans Susan Collins and Olympia Snowe. Both voted with their party on Saturday, but both have also shown signs that they're willing to defect for the right bill. Snowe, for instance, became the only Republican to have voted for any of the Democrats' proposals when she supported the Finance Committee's version of reform legislation.
And Collins is quoted in the Times as saying, "“I have ruled out voting for this bill, but I still very much want to vote for a bill and that is why I am continuing to have discussions. I still cling to the belief that it is possible for a group of us to come together and rewrite the bill in a way that would cause it to have greater support.”
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