Rush Limbaugh, Fox News, and others recently launched a smear campaign against a provision in the stimulus bill designed to gather research that will help doctors and patients choose the treatments that work the best, and avoid unnecessary spending. This, said Fox, “appear [s]to set the stage for health care rationing for seniors, new limits on medical research, and new rules guiding decisions doctors can make about your health care.”
At an event this morning at the Kaiser Family Foundation, I asked Senator Chuck Grassley (R-Iowa)—who, as the ranking minority member of the Senate Finance Committee, arguably has more influence on the fate of health reform than any other member of his party—whether such distortions from the right-wing noise machine will make it harder to get the bipartisan compromise he says he wants. Though the senator endorsed this kind of effectiveness research, he paradoxically also encouraged conservative commentators to keep doing what they’re doing:
“I think they ought to hype them right now because people’s attention needs to be brought to it, and that’s the only way you’re going to get their attention. When the dust settles, they won’t have a leg to stand on and we will have and we will have a study and a tool that will be useful for doctors to use but not to dictate medicine.”
This should unnerve those who remember the collapse of President Clinton’s reform effort in the early nineties. One of the major reasons his efforts foundered was that the interest groups who opposed the plan were able to stoke fears of “government-run health care” through a sustained media campaign. The issues in health reform are especially susceptible to alarmism, because they’re extremely complicated to understand and tap into deep-seated fears that people won’t get care when they need it most.
If Grassley is serious about the bipartisan reform he says he wants, he should remember the effect of the now-infamous “Harry and Louise” ads the health insurance industry ran against the Clinton plan. “The government may force us to choose from a few plans designed by government bureaucrats,” an ominous voice intoned as a couple sit at their kitchen table wading through health insurance paper work. Chip Kahn, one of the architects of this commercial, says that they didn’t intend for this advertisement to sink health reform, but rather help insurers negotiate a better deal. But in the political climate of the time, it activated public suspicion that, ultimately, overwhelmed the reform effort.
This morning, Senator Grassley also made a policy statement that suggests he may be less helpful in reaching bipartisan consensus than reform advocates have hoped. He previously made very clear that he opposes a public health insurance plan that could compete alongside private insurance and bring down costs—a top priority for progressives. But when asked how he would make the market more competitive in a place like Iowa, where one insurer controls more than 50 percent of the market, he suggested allowing insurers to sell policies across state lines—a key plank in Senator McCain’s health reform proposal when he was the Republican presidential nominee. This would make it very hard for a federal plan that would create the kind of state-by-state “exchanges” that give consumers the information they need to get the best premiums and coverage package.
Senator Grassley was generally enthusiastic about reform and bipartisanship, but these comments suggest we’ll have to wait and see exactly what kind of role he will play.
Lester Feder is a freelance reporter based in Washington, D.C., and a research scientist at George Washington University School of Public Health.