At the startof the debate in the Senate last week on legislation regulating health plans,Phil Gramm, a conservative Republican from Texas, blasted the Democratic billbecause "the one thing it does not provide is more freedom." DoesGramm believe that freedom currently reigns in the U.S. health care system?Actually, it does to a degree-for the insurance companies. They're free to telldoctors and patients what to do, and they're free of retribution should theyact negligently, for patients are prevented by law from suing negligent HMOsthat cause injury or death. Gramm wascorrect in that freedom is indeed at issue. Under the Democratic bill, a womanin an HMO could choose a gynecologist as her primary care doctor. But Republicansvoted against this. In fact, Gramm and his GOP colleagues opposed a string ofDemocratic provisions that would provide consumers more options, such as thechoice of staying in the hospital after a mastectomy, the choice of retaininga doctor for a few months if forced to switch health plans and the choice ofgoing to the closest E.R. Republicans, however, argued that his package representedintrusive government and would cost too much. To cover their cheeks, though,the Republicans did vote for their own mastectomy hospital-stay provision.
The tussleover the patient bill of rights-an initiative that, after all, is a rather modeststab at health care reform, considering that it would do nothing for the 43million Americans who have no access to health insurance-revealed the emptinessof right-wing rhetoric about "freedom." In this instance, more governmentrules would stop corporations from curtailing the freedom of consumers. Shouldhealth plans be free to overrule doctors on questions of treatment? Free toorder doctors not to discuss certain treatments with their patients? Shouldinsurance companies be free to submit complaints to a review panel hand-pickedby the company, rather than one of independent experts? What value comes fromthe protection of such freedoms?
Gramm shouldhave been more honest. It is not freedom in the abstract that he was serving.It was the freedom of corporations to act however the market will allow them.It would have been instructive for the public if the debate in Washington hadforthrightly addressed the fundamental question at hand: Can government be enlistedto force corporations to act responsibly, especially on life-and-death matters?Behind a wall of rhetoric, Republicans rushed to the defense of insurance companiesand HMOs, entities not generally popular with the public. The Republicans mustbe assuming that the mild measures they did pass will let them claim they indeedcare about patients-and survive the inevitable Democratic propaganda. It's acynical ploy. The GOPers claim the Democrats are wrong to interject the governmentinto health care-and then they approve watered-down, copycat legislation thatdoes little to redress the problem but enough to ward off political criticism.If only the Republicans would act on Gramm's true beliefs and declare: Patientsof this nation, you're on your own; let the market decide, let (corporate) freedomrule. That's essentially the party's position. But it has neither the guts northe stupidity to say so. Bile and Guts On the subjectof guts and stupidity, we turn to Sen. Bob Smith of New Hampshire. As his RepublicanParty was helping the health insurance industry, Smith was whipping his partyfor its lack of ideological forthrightness. In an overly ballyhooed speech onthe Senate floor, this presidential candidate-a presidential candidate who neverscored above the margin of error in a poll-left the Republican Party, wailingthat it was under the control of wimps. "Maybe [the GOP] is a party inthe sense of wearing hats and blowing whistles," he griped. "Thisis not a political party that means anything." His chief complaint wasnot that the Republicans behaved hypocritically on the health care bill, butthat the party does not take seriously its own stands on two other issues: abortionand gun control. Ponder Smith'sstand for a moment. All the leading presidential candidates of the GOP opposeabortion rights in some form or another and in Congress the Republicans havepassed legislation to outlaw late-term abortions-a move that only PresidentClinton's veto thwarted. Regarding guns, the House Republicans last month succeededin smothering a Democratic gun control initiative. Yet this is not enough forSmith. He's peeved that the party does not excommunicate from its ranks politicianswho are pro-choice and that it does not strive to roll back the modest gun controlregulation now on the books. He wants the Republicans to be a party run andpeopled by gun-toting mullahs.
Smith triedto sell his departure as an act of principle. It must be, for he will not profitcareer-wise from it. He did receive his moment in the media sun, and is freeto run for president as the candidate of the wacky-right U.S. Taxpayers Party.But how many voters are waiting to rally around his platform of guns for all,abortions for none, U.S. out of the UN and abolition of the Dept. of Education?Grant Smith one cheer for provoking media chatter about third parties-we needmore of them-and independent presidential campaigns-we could use more of these,as long as they're Perot-free. But Smith is not going to pose any more of apolitical threat on his own than he did as a flopping GOP candidate.
Smith'sresignation afforded conservatives an opportunity to bitch about George W. andthe Republican establishment's pay-now-examine-later embrace of its most prominentbrand name. ("After four months of a Bush Republican Party, the only measurableresult we've got is that Republicans have one fewer senator in Congress, whichis not a good start," the never-elected-to-anything conservative activistand presidential candidate Gary Bauer cleverly cracked.) Yet Smith jumped whennobody was pushing. His departure from the Bush-happy outfit says more aboutthe grouser than the party he left behind.
In caseyou're tempted to think that Smith is at least a principled right-wing extremist-andsome critics of the Democratic/Republican duopoly tried to tag Smith as a conscientiousobjector to politics as usual-consider that last week Smith was awarded a "goldenleash" award by the campaign finance reform advocates of Public Campaign.The nonprofit group reported that between 1993 and 1998, Smith, who chairedthe Senate subcommittee in charge of toxic waste cleanup, collected $323,944in campaign contributions from industries-such as oil, gas, chemical, miningand insurance-that want to see cleanup laws weakened. Coincidentally or not-youmake the call-Smith has pushed for legislation that would lower the amount thatpolluters have to pay for toxic site cleanups. He is not a crusader for straightforwardpolitics and honest government; he is a crank-too cranky for even the GOP-who'slooking to make common cause with other cranks. Cherchez Les Femmes Okay, GeorgeW. Bush-the soon-to-be $100 Million Man-has a lock on the Republican presidentialnomination and Al Gore, despite a couple of missteps, still has most of theDemocrats behind him. Done deals. So whattime is it? Time to talk about running mates. In the hyperspeed campaign of2000 (by election day we'll be ready to boot out of office whoever is elected)it's not too early to consider number twos. When Rep. John Kasich bailed outof the GOP presidential race last week and endorsed W, pundits wondered if hewas angling for the second spot on the ticket. That day, I had breakfast with Sen. Dianne Feinstein, a Democrat from California, and a group of reporters.She told us that "the time is right" for a woman vice president andacknowledged that should the GOPers nominate a YY for veep (hint, hint: ElizabethDole), the Democrats would have to follow suit. (For those of you looking thatfar ahead, the Republican convention next August occurs before the Democraticconvention.) But DiFi expressed minimal interest in being the Dems' designatedwoman, and her aides have been telling California reporters for weeks that shereally, really, is not keen on the job. Which presents a problem forher party.
Asked whatother Democrat-in-heels might serve as slate-mate to Gore or Bill Bradley, Feinsteinnamed not a one. She said that any of the Democratic women senators could dothe job and that there are Democratic women in the House and in the administrationwho would make good picks. But she identified none because, other than herself,there are no obvious or near-obvious candidates. Her fellow female senators-BarbaraBoxer (too erratic), Mary Landrieu (too new), Blanche Lambert-Lincoln (too new,too), Barbara Mikulski (too mean) and Patty Murray (too nondescript)-are notstrong contenders. No one in this pack has the Feinstein combo of cultivatedgravitas, nonthreatening manner and middling politics. And can you cite a Democraticcongresswoman or governor who has national standing? Scoping in the House raisesthe discomfiting specter of Geraldine Ferraro, a congresswoman who was far fromready for primetime when Walter Mondale placed her on the Democratic ticketin 1984. The only female Democratic governor is Jeanne Shaheen of New Hampshire,and Democrats in her state have complained about her clumsy handling of taxand education issues. One possibility mentioned by whoever it is who does thissort of mentioning is Kathleen Kennedy Townsend, the lieutenant governor ofMaryland and daughter of Bobby. Yet it would seem a stretch if the Democraticpresidential nominee chooses a lieutenant governor.
Feinstein,alas, may be the only Democratic woman who fits the conventional bill. But onone front, she does not, for she's Jewish, an untested quality in national politics.(That is, if you don't count Arlen Specter's over-in-a-blink run for the GOPnomination last time.) If she is successfully courted for the task, she mayhave to give up her Senate seat, which would be good news for the disarray-riddenCalifornia Republicans. (It's possible Feinstein could run for both vice presidentand Senate. Then, if she and her running mate won, she would resign from theSenate and California Gov. Gray Davis would appoint her successor.)
Sure, complainit's too soon to be handicapping the veepstakes. But Bush's $36 million I-Am-Meroar is drowning out the Republican contest, and Gore's awkward and messy campaignis too damn painful to watch. With all the attention Campaign 2000 has received,it feels as if it should almost be over and done with. Aren't you by now sickof Bush and Gore? It's a relief, if temporary, to look at who's next in line.