Art of compromise not forgotten
WASHINGTON – When John Breaux retired from the Senate last year, many assumed that the let’s-make-a-deal approach he had perfected in his 18 years of service had vanished with him. In an increasingly partisan and polarized Congress, the bargaining skills Breaux had displayed seemed relics of another time.
It turns out that we underestimated the conservative Democrat from Louisiana, the canny Cajun whose willingness to negotiate across party lines had made him a valuable ally to both Republican and Democratic presidents.
In retirement to a Washington consultant’s role, Breaux has resurfaced as the sparkplug of a “Ceasefire on Health Care” campaign that already has achieved a few small successes and is aiming for much bigger breakthroughs in the effort to rescue America’s dysfunctional medical delivery system.
In an interview last week, Breaux said the seeds of the project were sown in a speech he made at Louisiana State University while still serving in the Senate. He complained then that the CNN program “Crossfire” (which has since been axed) appeared to operate on the principle that “the more the guests disagree, the more successful the program will be.
“Why not,” he asked, “try a program where the moderator would invite people of opposing philosophies to seek common ground?”
In retirement, Breaux said, he decided to undertake that role himself in the area of health care, believing that it is the most pressing domestic problem.
With logistical support from Jim Thurber and his colleagues at American University’s Center for Congressional and Presidential Studies and financing from drug maker Pfizer Inc., Breaux is organizing forums where advocates of contrasting approaches to health care can discuss possible solutions.
The first, which I attended on Capitol Hill on June 29, celebrated the pending congressional approval of a small bipartisan bill to authorize a five-year, $25 million pilot program for “patient navigators,” who would assist people having trouble gaining access to the health care system.
The “navigators” would provide referrals to clinics and specialists, inform patients about clinical trials they might enter, ensure early diagnosis and treatment, coordinate with insurers and recruit community volunteers to do similar tasks.
It’s all pretty basic, but connecting to the right medical facility can be a daunting task for people without much income, education or language skills. The interesting thing about the bill – which turned out to be the first piece of health care legislation signed by President Bush this year – is its sponsorship: Democrat Bob Menendez of New Jersey and Republican Deborah Pryce of Ohio, both part of the leadership of the opposing party caucuses. Their collaboration on this measure is exactly the pattern Breaux’s initiative is designed to encourage.
Next week (July 21), Breaux’s guests at a National Press Club forum will be two celebrated antagonists from the failed 1993-94 effort at health care reform, Sen. Hillary Rodham Clinton and former House Speaker Newt Gingrich. The two have found common ground now in support of accelerating the use of information technology in hospitals and medical practices. Breaux hopes to nudge them into discussing the question of mandates – the requirement that companies or individuals purchase health insurance, the very issue on which the Clinton plan foundered.
Down the road, another odd pairing, Republican Sen. Orrin Hatch of Utah and Democratic Sen. Ron Wyden of Oregon, will discuss their effort to build consensus on the next steps in health reform through a series of grass-roots discussions.
All this may sound too good to be true, but there is reason to think the climate of partisanship may be changing. The pressures to break the long stalemate on health care are rising. Costs are out of control, savaging the budgets of governments, businesses and families. Medicaid and Medicare are in fiscal crisis. And more and more Americans are losing their health insurance.
On June 30, four Senate heavyweights – Republican chairmen Chuck Grassley of Iowa and Mike Enzi of Wyoming, and the ranking Democrats on their committees, Max Baucus of Montana and Ted Kennedy of Massachusetts – introduced a pair of bills to address two of the fundamental problems in the health care system. One would put the government squarely behind the effort to bring information technology into the struggle to reduce medical costs and eliminate clinical errors. The other would begin rewarding health care providers who can demonstrate improved quality of care.
As Breaux understands, only systemic reform will save the health care system. But, as he says, “meantime, incremental steps make sense,” and bipartisanship is essential for their passage.