Baucus Watch, Part V

Smoke signals—when exactly will health reform happen?

As chairman of the Senate Finance Committee, Senator Max Baucus holds the keys to health-care reform; any health-care legislation must pass through his committee. So what he says or doesn’t say is important to those following the twists and turns of the congressional effort to fix our health-care system. This is the fifth of an occasional series of posts on the senator’s pronouncements and how the media has covered them. The entire series is archived here.

Anyone who has ever covered Washington, or a state house, for that matter, knows that the pols don’t always say what they mean or mean what they say. The semantic games they play send signals to lobbyists, the press, and the public about this or that piece of legislation. And those pols who have been around a long time are very, very good at the game.

There seemed to be something for everyone in Max Baucus’s latest remarks to a group of health policy researchers this week about the future of health care reform. They reminded me of the old Clairol commercials: Does she or…or doesn’t she? (Hair color so natural only her hairdresser knows for sure.) Will reform happen this year, or won’t it? Only Max Baucus knows for sure…or does he?

A headline in a recent Washington Times story, “Health care reform not No. 1 on Hill”, signaled that maybe reform will be put on hold because, as Baucus said, “Why might reform not happen this year? As is often the case, the new administration and the new Congress face competing priorities. These priorities compete for time on the agenda and attention in the press and in public. The president’s dance card is indeed full.”

The Times reported that Baucus also said he is committed to passing legislation this year, although several obstacles remain; as examples he cited the bad economy, the wars in Iraq and Afghanistan, the budget deficit, and efforts to wean the U.S. from foreign oil. But the senator said that, even if reform is pushed back to 2010 or later, voters did give Congress and the White House a clear mandate to change the system.

The Hill put another spin on the senator’s comments with this headline: “Baucus says healthcare reform will require more government spending.” The Hill quoted Baucus: “Getting health reform legislation this year is my top priority—-No. 1. Certainly this session of the new Congress, not next session of this Congress, because we have to get momentum to really make this work.”

The Hill story went into some detail about what Baucus said on the topic of costs. “We cannot and should not anticipate savings in every year of the budget window, nor should we claim that we will be able to pay for healthcare reform,” he cautioned, while speaking of bending the growth curve of health spending. “If we can’t generate savings, then reform is not likely to happen.” No mention of the possible pushback to 2010 in The Hill. Instead, the story noted that “Baucus went so far as to describe the enactment of health reform in 2009 as ‘nearly inevitable’” but gave itself an out by saying that those remarks came before president’s pick for health chief, Tom Daschle, resigned.

One thing Baucus has been consistent about is his aversion for a single payer system, and CQ presented that message to its readers. CQ reported that, when a questioner asked about single payer, Baucus said: “It may come later but it’s not going to happen in America [any time soon].”

“We’re a different country. We’re constituted differently than European countries,” Baucus said. “There’s more of an entrepreneurial sense [in the United States]. So we’ve got to come up with a uniquely American result. And a uniquely American result will be a combination of public and private insurance.”

FYI: Bill Clinton also used the words “uniquely American” to describe his proposed reform plan in 1993.

Baucus isn’t the only pol serving up tea leaves. I was thoroughly confused by a comment from Rep. Pete Stark of California, who chairs a crucial health subcommittee. A few weeks ago, when the House voted to expand the State Children’s Health Insurance Program, the San Francisco Chronicle said that “Stark predicted the reform legislation would be enacted by September, despite up-front costs that could be as high as $150 billion a year.” But wait a minute. Didn’t Stark say in December that reform might have to wait until early 2010? At that time, he said lawmakers had too many pressing priorities on the economy and other smaller-scale health issues to move quickly on a large health bill in 2009—at least that’s what The Hill and other outlets reported.

There you have it—Baucus (and Stark) every which way, offering hope or despair to friend and foe of health reform. It sure would be great if the media could remind the health politicos what they have previously said and clue us in when the signals change.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.