Five players in the health care reform - per Politico
04 05 09 - 12:19
The five faces to watch for in debate over care
By CARRIE BUDOFF BROWN - Politico
One of the most feared figures in the health care reform debate isn’t an Old Bull committee chairman or a hard-nosed White House chief of staff. He’s a bespectacled, former academic from the Brookings Institution.
Doug Elmendorf is now director of the Congressional Budget Office, where he’s charged with pricing the various reform proposals. Nothing moves without being “scored” by his office, and an unfavorable assessment of a program’s cost can be tantamount to defeat.
He’s one of five people you may have never heard of who could affect the course of health care reform.
The Scorekeeper: Doug Elmendorf
Consider the CBO director as the Oz and the umpire of health care lawmaking.
Elmendorf and his team of anonymous analysts will issue the authoritative, nonpartisan, independent price tags on the programs. What they say often goes.
The Clinton administration learned that the hard way. In 1994, as it tried to move a massive overhaul through Congress, then-CBO chief Robert Reischauer delivered repeated blows to the plan by questioning its cost estimates. It went down in flames.
The measure of Elmendorf’s clout was apparent during a February hearing when Senate Finance Committee Chairman Max Baucus (D-Mont.) seemed to both court and curse him and his band of CBO bean counters.
“We hope this is the beginning of a beautiful friendship,” the chairman said sweetly at one point.
Only to add later: “In my judgment, you’re not God. You might be Moses, but not God.”
Elmendorf tried to demur. CBO simply provides technical direction, he said, “but as you understand, the hard decisions will be yours.”
To which Baucus shot back: “No. That’s incorrect. The hard decisions will be ours, both of us, you and me.”
The Organizer: Dennis Rivera
Rivera runs a war room that’s now the epicenter of the left-wing mobilization in support of the reform legislation.
From the ground floor of the Service Employees International Union headquarters in Washington, Rivera is preparing for the moment a bill drops.
At that point, he must make sure the right members of Congress are contacted, the right message is delivered, and his shaky coalition of industry, labor and consumers stays intact.
“We are running a political campaign, and our candidate is basically health care reform,” said Rivera, head of SEIU Health Care.
Rivera and his team have been laying the groundwork for months, with a war room staff of more than 50 and more than 400 organizers in the field.
They have developed profiles on more than 100 members of Congress, collecting mounds of data on voting records, district demographics and health statistics — and influential allies — “people closest to them who could, at some point, talk to them and be more persuasive than us,” Rivera said, citing clergy, former staff members and business leaders.
With a reputation for getting the job done, Rivera helped SEIU become the most aggressive and ubiquitous player in the health care debate, forging unorthodox partnerships if that’s what’s required to win.
The union has forged marriages of necessity with pharmaceuticals, insurers and hospitals. Rivera talks to his new allies several times a week, if not every day, and will play a key role in deciding how closely they all move forward together.
The Backroom Operator: Liz Fowler
If you drew an organizational chart of major players in the Senate health care negotiations, Fowler would be the chief operating officer.
As a senior aide to Baucus, she directs the Finance Committee health care staff, enforces deadlines on drafting bill language and coordinates with the White House and other lawmakers. She also troubleshoots, identifying policy and political problems before they ripen.
“My job is to get from point A to point B,” said Fowler, who’s training for four triathlons this summer in between her long days on Capitol Hill.
Fowler learned as a sophomore at the University of Pennsylvania that the United States was the only industrialized country without universal health care, and she decided then to dedicate her professional life to the work.
She first worked for Baucus from 2001 through 2005, playing a key role in negotiating the Medicare Part D prescription drug program. Feeling burned out, she left for the private sector but rejoined Baucus in 2008, sensing that a Democratic-controlled Congress would make progress on overhauling the health care system.
Baucus and Fowler spent a year putting the senator in a position to pursue reform, including holding hearings last summer and issuing a white paper in November. They deliberately avoided releasing legislation in order to send a signal of openness and avoid early attacks.
“People know when Liz is speaking, she is speaking for Baucus,” said Dean Rosen, the health policy adviser to former Senate Majority Leader Bill Frist (R-Tenn.).
The Money Cop: Earl Devaney
A former Secret Service agent, Devaney has very little to do with health care reform — directly, at least.
But as the guy tasked with minimizing fraud and waste in the $787 billion economic stimulus legislation, one of the single largest government expenditures in American history, Devaney is poised to influence the debate.
Here’s why: President Barack Obama and Democrats are proposing a health care fix that could exceed $1 trillion over 10 years — perhaps more, according to some estimates.
If Devaney finds egregious examples of wasteful spending on the stimulus front, his work could prove damaging to the president politically and may very well sour the public appetite for a government-heavy approach to health care.
It’s a bleed-over effect that has already been on display.
When the AIG bonuses erupted into a firestorm in mid-March, health care insiders viewed the development ominously. Obama’s approval ratings dipped to the lowest point of his presidency, and the public was outraged at the way the company, the administration and Congress bungled it.
The Storyteller: Jane Doe
Health care is about to enter the heart-tugging phase.
Groups on the right and left have been quietly building arsenals of narrators — people who can sear the American conscience with personal stories.
The American Cancer Society collects cases through a call center in Texas. The SEIU gathers stories by congressional district. And Conservatives for Patients’ Rights, an organization poised to oppose the Obama plan, sent a former CNN reporter to Britain and Canada to produce a documentary on outrages in the European system that critics claim the White House plan will mimic.
The last major health care reform effort in the 1990s was defined by Harry and Louise, the fictional middle-class couple featured in an insurance industry ad. And an extraordinarily complex bill went down amid a flurry of 30-second ads.
Given the fragmented media environment, a singular TV ad may not hold as much sway as it did in the early ’90s. But that doesn’t mean either side plans to pass up the tool.
Conservatives for Patients’ Rights was the first to use it, releasing a 60-second spot featuring Dr. Brian Day, a past president of the Canadian Medical Association, describing how patients in the country are “languishing and suffering on waiting lists.”
Expect to see Day lobbying members of Congress — and many more stories from both sides in the weeks to come.