Health Care: All Eyes on the Senate

On the Health Care front, things are now getting very
interesting.

In a huge victory for President Barack Obama and
House Speaker Nancy Pelosi, the House passed its
version of Health Care reform on a narrow 220-215
roll call vote.

As expected, this one came down to the wire, with 219
Democrats and one Republican voting "yes" and
176 Republicans and 39 rural, small-state Democrats
voting "no".

On paper, the House bill appears to be significant reform.
Among other things, it includes a government-sponsored
Public Option, a requirement that by 2013 all those not
covered by insurance purchase it, requirements that all
but the smallest employers offer coverage to their
employees, and an end to denial of claims and coverage
by insurers on the grounds of "pre-existing medical
conditions".

The House bill also goes further in that it also vastly
restricts premium rating by age, gender and geography
and ends the anti-trust exemption for the Health
Insurance industry.

But now comes the hard part.

This whole thing now has to go to the Senate, where
Harry Reid has to do the almost impossible.

He has to reconcile two diametrically opposite Senate
versions of the Health Care bill - one from the Health,
Education and Labor Committee that, with the exception
of a Public Option, tracks fairly closely with the House
version, with another from the Senate Finance
Committee that, with the exception of a coverage mandate,
does little to extend coverage to the uninsured or make
"health care" more affordable.

And it is this "internal reconciliation" debate inside the
Senate where the Health Care battle will be ultimately
won or lost.

And, I think it will go down to ultimate defeat. Here's why:

First of all, the "lowering of expectations" has already begun.
Senator Reid has already stated that the Senate's debate will
not start until after Thanksgiving and that final action will most
likely slip until early next year. That means that the insurance
companies, Big Pharma, the hospital chains and the AMA still
have time to hand out yet more campaign donations to stop
reform.

Second, the Republican leadership is already on record as
saying that they will accept no bill that does not preserve the
health and viability of the for-profit health insurance industry.
That means no public option. No rate regulation. No limits
on claim or coverage denials. No removal of the anti-trust
exemption. In short, no changes at all except the coverage
mandate, which will provide 30 million new customers
for the industry.

You have to give them credit. Once bought, they stay bought.

So, to get the necessary 60 votes to end debate and get
something passed, Reid is going to have to go hunting
among the "Blue Dogs" - Senators such as Max Baucus,
Ben Nelson, Byron Dorgan, Kent Conrad, and others.

Good luck with that.

These Senators have been the recipients of record
contributions from both the Health Insurance industry
and Big Pharma, and it's inconceivable that they would
stiff their benefactors. And ideologically, they might as
well be Republicans, with their insistence on "fiscal
responsibility" and " the private sector knows best".

Coming from small isolated states with little industry
or other mass employment, it's not hard to understand
their point of view. And it's also easy to understand how
Big Money from Big Interests can sway
them.

Where they're from they don't see a lot of that.

And that means it's a done deal. In America,
Organized Money always beats a disorganized public.
But, there's always a chance.

Which is what will make this upcoming debate so
interesting.