Reid Disses David Broder

In his opening floor remarks Saturday morning, Sen. Mitch McConnell cited this David Broder column from the Washington Post on Obamacare, headlined, “A budget buster in the making.”

Reid responded with the familiar criticism that McConnell has no business talking about fiscal responsibility when McConnell supported President Bush’s reckless spending on Iraq. Then Reid scoffed at Broder, who he dismissed as “a man who has been retired for many years, and writes a column once and awhile.”

What to Expect in the Senate Today

The Senate has just open for business this Saturday morning to consider the motion to proceed that would require 60 votes to pass, and thus allow the 2,074-page health care bill to get to the floor. There will be 10 hours of debate, followed by a vote at 8 p.m. So far, we don’t know what the outcome will be, becuase Democratic Sens. Blanche Lincoln and Mary Landrieu have not announced their intentions.

Here’s the debating schedule that Harry Reid announced this morning:

10 am-6pm: Each party controling alternating hours, with Democrats controlling the first hour.

6-6:30 p.m. Democrats’ time.

6:30-7:15 p.m. Republicans’ time.

7:15-7:30 p.m. Democrats’ time.

7:30-8 p.m. Time controlled by leaders Harry Reid and Mitch McConnell.

8 p.m. Roll call vote on the motion to proceed.

The proceedings are being broadcast on CSPAN-2. I’ll be updating this blog with breaking news or other items I find interesting and amusing. If you want more blow-by-blow reaction, you can follow me on Twitter at: http://twitter.com/philipaklein .

McCain is Not Scozzafava, and Palin Won’t Be Branded a “Sell-Out”

Daniel Larison, in response to Bill Kristol’s suggestion that Palin campaign for McCain in the Arizona Senate primary, writes:

Were she to side openly with McCain in a primary against Hayworth, whose views match up a lot more closely with her supporters’ views, she would be seen as imitating McCain’s worst habits. She would be considered a worse sell-out than McCain. She would be doing exactly the opposite of what she did in NY-23. Her intervention may have failed to elect Hoffman, but rank-and-file conservatives generally loved her for it anyway. She would fritter all that away if she backed McCain. In exchange for the contempt and disaffection of the people who currently adore her, she would win the enduring affection of editors at The Weekly Standard. McCain seems to be satisfied with this, but I doubt it would be enough for Palin.

There is not much nuance to Larison’s thinking here. It’s completely absurd to compare the NY-23 Congressional race to the Arizona Senate primary, because beyond the broad outlines — a race between an establishment candidate and a conservative insurgent — there are few similarities. Scozzafava was not a moderate, she was a liberal who ultimately endorsed the Democrat anyway. It was not a matter of one issue — she held liberal views on abortion, pledged to vote for “card check,” and called the cops on a reporter who asked whether she would vote for a health care bill that raised taxes. McCain is pro-life. He has been firmly against “card check” to the point where he has actually blocked the nomination of Craig Becker to serve on the National Labor Relations Board (Becker is an SEIU lawyer who has written that “card check” could be implemented by the NLRB without Congressional action). He voted against the economic stimulus bill. And he has been adamantly against the health care bill. There’s also the distinction between losing a single House seat and losing a Senate seat that could mean the difference between giving Obama a rubber stamp in the Senate or perhaps gaining a few seats next year to be able to effectively block anything major that Obama proposes. And while it was realistic to think that Hoffman could have a chance of winning, there’s less reason to believe that J.D. Hayworth — who couldn’t win a Congressional race — could win statewide. Now, I’ve had my share of issues with McCain over the years and am not going to argue that he’s a perfect conservative. And for those who see immigration as such a crucial issue to them that they have to support Hayworth as a matter of conscience, I’m not going to tell them not to. But for Larison to sugeest that for Palin to keep in the good graces of her base, she has to back the more conservative candidate in every single race, no matter what other circumstances are in play, is totally ludicrous.

If there’s one thing I’ve learned about Palin supporters — especially when I’ve criticized her — it’s that they are generally very forgiving of her and willing to cut her a lot of slack. Ever since she burst onto the scene, I’ve been trying, to no avail, to argue that we shouldn’t compare her to Ronald Reagan when he spent decades studying conservative philosophy and defending it and served two terms as governor of California, and she has a very slim governing record and it’s unclear whether she’s really a committed small government conservative. Even though I avoid the personal vitriol that has consumed much of the anti-Palin commentary and try to raise what I see as fair questions about her qualifications to be president, her acceptance of pork spending, her initial support for the “Bridge to Nowhere,” etc., I’m brandished an elitist RINO who should shut up and go back to my brie and chablis. This is a long way of saying that it would take a lot more than backing McCain over Hayworth for Palin’s supporters to view her as a “sell-out.”

The Threat to Medical Innovation

Earlier today, I attended a panel discussion at the Cato Institute about one of the most important aspects of health care that has gotten very little coverage during the current debate — medical innovation.

Raymond Raad, a resident in psychiatry at New York Presbyterian Hospital/Weill Cornell Medical Center and co-author of a new Cato study, presented evidence showing that the United States leads the world in the development of drugs, medical devices, and other advanced treatments. For instance, between 1969 and 2008, 57 of the 97 Nobel Prizes in medicine and physiology — or nearly 60 percent — were awarded to people who did their research in the U.S., and nine of the top 10 medical innovations between 1975 and 2000 were developed here. But these achievements aren’t reflected in rankings of different health care systems that typically show the U.S. faring poorly and provide fodder to those pushing for government-run health care. This even though once these products are developed in the U.S., they become widely available and improve health care outcomes around the world.

Raad argued that one of the big dangers of health care legislation is that expanding the role of government and trying to impose price controls could change incentives to innovate. When the government is such a large consumer of health care, it has tremendous influence over whether some innovations succeed. As an example, Raad noted how government stunted the growth of specialty hospitals by not allowing Medicare money to spent at them. Specialty hospitals are smaller institutions formed by doctors to focus on one type of illness, such as heart disease. They can deliver better health outcomes and a more personalized experience for patients than giant factory hospitals that benefit from their tax-exempt non-profit status even as they rake in billions of dollars. Raad explained that some of the most common and important medical innovations –such as CT scans — were quite controversial when first introduced, and thus putting more constraints on the market could prevent wider use of new products that may ultimately prove beneficial.

Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins University Bloomberg School of Public Health, described himself as the liberal on the panel. He emphasized the importance of universal access to new medical innovations, and argued that it was “naive” to talk about where innovations originated, since they all tend to be developed on a multi-national basis in many stages. He also showed that the pace of medical innovation has slowed in recent years, in both the U.S. and Europe, and said that it’s important to do something to change incentives that are currently in place. Currently, large drug companies spend just 12 percent to 15 percent of their outlays on researching and developing new drugs, and 30 percent on marketing them. 

John Calfee of the American Enterprise Institute suggested several reasons to worry about in the current health care bills. He said they would increase the costs to both the public and private sector well beyond what Congressional Budget Office is projecting. And he warned that it would be difficult for government to resist the temptation to impose price controls on products that were very expensive relative to their marginal costs. For instance, once drugs are developed, the cost to manufacture each additional pill is small relative to the price charged for the drug. But imposing such controls would reduce profits and thus the incentives of drug companies.

Obama Gallup Rating Drops to Below 50%

For the first time of his administration, President Obama’s job approval rating has dropped to 49 percent in the Gallup poll. While it has been hovering in the low 50s for months now, the drop below 50 percent in the most well-known poll is an important symbolic moment that will add to the narrative that Obama is losing the support of the American people. The news comes just as Congress is hoping to enter the homestretch on health care, his top domestic priority. Click on the link for some historical context of other presidents.

Nelson to Vote to Advance Health Care Bill

Sen. Ben Nelson said that he would vote to allow the Senate health care bill to move to the floor for debate, even though he said yesterday that the abortion language in the bill is not acceptable to him.

His decision leaves Sens. Blanche Lincoln and Mary Landrieu as the remaining holdouts.

“Throughout my Senate career I have consistently rejected efforts to obstruct,” Nelson said in a statement. “That’s what the vote on the motion to proceed is all about.”

He continuted:  

“It is not for or against the new Senate health care bill released Wednesday. 

“It is only to begin debate and an opportunity to make improvements. If you don’t like a bill why block your own opportunity to amend it?

“As we have seen before, obstructionists are inviting a move toward reconciliation by opposing this first procedural vote. Let’s be clear. That route shrinks debate and amendments, eliminates bipartisanship and needs only 50 votes to pass a bill.

“In the end, far more Washington-run health care policies win, but Nebraskans lose.

“In my first reading, I support parts of the bill and oppose others I will work to fix. If that’s not possible, I will oppose the second cloture motion–needing 60 votes–to end debate, and oppose the final bill.

“But I won’t slam the doors of the Senate in the face of Nebraskans now. They want the health care system fixed. The Senate owes them a full and open debate to try to do so.”

The problem, as his co-Senator from Nebraska Mike Johanns noted yesterday, is that once the bill gets to the floor, there will need to be 60 votes to change the abortion language. And there simply aren’t that many pro-life votes in the Senate. So this really was a key test of his professed anti-abortion views.

Jim Antle wrote about the moment of truth facing pro-life Democrats on our main site.

AHIP Opposes Senate Health Bill

America’s Health Insurance Plans, the industry trade group that has tried to remain in the good graces of the Obama administration and Democtrats in Congress on health care legislation, today issued a statement opposing the Senate bill. 

“The promise of health care reform is that it will provide all Americans coverage, allow them to keep their coverage if they like it, and bends the cost curve to put the system on a sustainable path,” AHIP’s president, Karen Ignagni, said. “These are the standards by which any reform bill should be judged, and the Senate bill falls short of meeting them.”

Ignagni specifically attacks the $6.7 billion annual tax on health insurers and warns that the introduction of a government-plan will shift more costs to those who obtain insurance privately. She also criticizes the $117 billion in cuts to Medicare Advantage.

But AHIP is no fan of free markets, as it is pushing for an even stronger government mandate that would force individuals to purchase its product in exchange for agreeing to cover those with preexisting conditions.

The question is whether AHIP will actively begin to campaign against Democratic legislation, and even if so, whether it’s too late for that to make a difference.

Poll Shows Blanche Lincoln Senate Seat at Risk if She Votes for Health Care Bill

The White House has been trying to convince red state Democrats that it would be worse for their reelection chances if no health care bill passed and President Obama were seen as a failure, then if they could tout an acheivement. They note that Democrats killed health care legislation in 1994 and still lost Congress anyway.

But a new Zogby poll finds that Sen. Blanche Lincoln, one of a few Democrats who has not yet committed to voting to bring health care legislation to the Senate floor, would face a much tougher reelection fight in Arkansas in 2010 if she were to vote for the bill.

The poll finds that as it is, Lincoln holds a thin 41 percent to 39 percent lead over her potential Republican challenger, State Senator Gilbert Baker. But when pollsters followed up and asked how their support would change if Lincoln voted for the health care bill, suddenly it’s Baker who enjoys a comfortable 49 percent to 37 percent lead. Overall, that’s a 14-point swing against her just based on the health care vote.

Arkansans oppose the health care bill by an overwhelming 64 percent to 29 percent margin, and after pollsters explained what was in the legislation, that number grew to 68 percent to 26 percent.

A vote for the health care bill, in short, would be toxic for her reelection chances. It’s certainly something she must be thinking about as the Senate prepares for a Saturday night procedural vote to move the bill to the floor, which Republicans are sure to use against her as a vote for the bill itself.

Sen. Johanns Calls Reid’s Abortion Language a “Bookkeeping Gimmick”

Sen. Mike Johanns of Nebraska said in a Thursday conference call that Harry Reid’s abortion language in the Senate health care bill was merely a “bookkeeping gimmick” that would not prevent federal funding for abortion.

Under the language approved by the House of Representatives, nobody could use federal subsidies toward the purchase of a policy that covered abortion. But under pressure from pro-choice groups, Reid placed language in the Senate bill that would work out a complicated formula aimed at segregating funds so that women who received federal subsidies could still purchase policies with abortion services as long as the subsidies didn’t support the cost of the abortion coverage.

“It’s a bookkeeping gimmick,” Johanns said. “The same argument was made on the House side and it was just aggressively rejected by the pro-life community and by those House members who stood up.

He explained, “A premium is a premium. The government is going to have its dollars in that and this idea that somehow you’re segregating that just isn’t going to past muster. You just can’t draw that line in a bookkeeping entry, and they know it. What they’re trying to do is to provide some cover to pro-life members, but the pro-life community has aggressively rejected that.”

Johanns also warned that if Reid gets the necessary 60 votes on Saturday’s motion to bring the bill to the Senate floor in its current form, that the abortion language will not get changed. Once the bill is on the floor, it would take 60 votes to amend it, and there aren’t that many pro-life votes in the Senate. That’s why he said it was crucial to stop the bill from moving to the floor in the first place.   

“The real key vote here is on the motion to proceed if you’re pro-life,” he said.