If you can stand a little technical detail about how the Federal
Government, through Health and Human Services Secretary Mike Leavitt,
has started traipsing through our <a
href=”http://bluemassgroup.com/showDiary.do?diaryId=1425″>delicate
health care negotiations with oversized galoshes, do see <a
href=”http://www.hcfama.org/blog/2006/02/guide-for-perplexed-federal-waiver.html”>John
McDonough’s post at the Healthy Blog. After giving all the detail,
John asks, “Now the question is: do we knuckle under to blatant,
ideologically-driven, federal interference in a state prerogative or —
do we stand up for the right of our Commonwealth to determine our own
health system?”
Well, with time winding down on this thing pretty quickly, the question
for us is this: How and where should public pressure be applied? In
other words, pro-reform folks need to find out: A. “Ears”: Who’s
listening? And B. “Power”: can they do anything about it? First
I’ll break down the players, and then we’ll discuss whether they’re
listening to calls for reform, and whether they have the power to do
anything about it.
The players are:
- Our state legislators (especially the conferees, but certainly
your local Senator and Rep as well) - Senate President Travaglini and Speaker of the MA House DiMasi
- Gov. Romney
- HHS Secretary Leavitt (i.e. the Bush Administration)
- National legislators, especially Sens. Kennedy and Kerry
So let’s see how this works:
- As for the state legislators, they definitely have more ears
than power at this point, but they’ve got both. Letters and
phone calls (617-722-2000) will certainly have a positive effect on the
final outcome, regardless of what is accomplished or when. They can put
pressure on leaders and conferees as well to expand MassHealth, or find
a state-based workaround. - DiMasi and Travaglini: More power than ears.
According to the State House News article quote by McDonough, they both
sound pretty dug in at this point, Trav against expansion of Medicaid,
DiMasi for. The <a
href=”http://www.boston.com/news/globe/editorial_opinion/editorials/articles/2006/02/09/health_compromise_now”>Globe
editorial page has asked for a compromise on this that seems pretty
meager to me. - Gov. Romney: Well… Leavitt seems to have Romney’s back on this
one, but does Mitt want to leave MA without what should be his
signature accomplishment? Does he not care at all? What a waste of
effort, if he’s not actually serious about getting something passed. Power
… and maybe bigger ears than we imagine. (Especially if he
gets a haircut.) - Leavitt: Well, he claims to have power of review, and
he’s in the Bush administration, which is famously deaf. Or is
it? The Globe’s front page story Sunday says “GOP fears backlash on
Bush budget“. Is that our cue? And perhaps… - Kennedy and Kerry might help out with this one, especially TK?
After all, Teddy helped negotiate the deadline of July 1 for the
Massachusetts Medicaid waiver with HHS to begin with. Now, obviously
the Dems are in the minority, but: - Leavitt’s hostility to MA’s Medicaid expansion clearly has a
lot to do with BushCo’s desire to cut (hell, dismantle) Medicaid, - that hostility is provoking bipartisan outrage,
- Kennedy’s been around the block, and likely knows some ways to
apply pressure to executive branch agencies. In fact, I would guess
that he’s already got something in the works.
So, I would guess that our Senators have ears and
probably more power than we realize.
Phone calls, faxes, and letters certainly can’t hurt to any of these
folks, but it might be worthwhile to ask your state legislators and US
Senators what’s going on; and maybe even Our Gov might be willing to
cut a deal if he hears enough noise. We’ll see.
