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Among the three principals currently working to combine two Senate committee bills on health reform, the strongest advocate for creation of a "public option" government insurance plan (which private insurers strongly oppose on competitive grounds) happens to represent the state of Connecticut. And the state of Connecticut happens to be home to the insurance industry generally and to health insurance giants Aetna and Cigna HealthCare in particular.
The senator in question, Democrat Chris Dodd, has during the past 20 years received $2.3 million in contributions from the insurance industry—more than any member of the House or Senate except John McCain, R-Ariz. During that same period, Dodd has received $774,000 from health insurers, ranking second only to House Minority Leader John Boehner, R-Ohio. On the public option, McCain and Boehner are giving insurers much better value than Dodd. McCain has said a public option "would sooner or later take over and overwhelm the health care system." Boehner not only opposes the public option, he claims never to have met anyone outside of Congress and the Obama administration who favors it. "This thing is about as unpopular as a garlic milkshake," he said.
(Boehner must not get out much. A tracking poll by the Kaiser Family Foundation found that support for "a government-administered public health insurance option similar to Medicare" hovered just below 60 percent during the previous three months. A September New York Times/CBS News poll found more support than opposition to the public plan even among Republicans.)
In the past, Dodd has been such a steadfast friend to the insurance industry that Ralph Nader tagged him "the senator from Aetna." In 2002 Dodd authored a bill securing a federal bailout for insurers in the event of a terrorist attack. After Hurricane Katrina in 2005, he urged a similar insurance bailout in the event of a natural disaster. But as a senior member of the Senate health committee sitting in for the ailing (now deceased) Sen. Ted Kennedy, D-Mass., Dodd defied the insurance lobby by winning committee passage for the public option.
Afterward, Karen Ignani, president of America's Health Insurance Plans, called the public option "a roadblock to [health] reform," which at that point AHIP was still supporting. (The insurers have since declared their opposition to the Senate finance committee bill, which lacks a public option.) But Dodd continued to lend the public option vigorous support. "A public option is necessary," Dodd said Oct. 18 on NBC's Meet the Press. "My hope," he continued, "is that when we bring these two bills together over the next number of days that we'll present to the Senate an option that includes that strong public option." Even if the public option doesn't make it into the health reform bill brought to the Senate floor, Dodd said, "we have a good, good chance of including the public option" by amendment.
Did I mention that Dodd's in serious danger of losing next year's re-election bid, largely because of a "Friends of Angelo" mortgage he received from Countrywide Financial chief Angelo Mozilo? (The Senate ethics committee cleared Dodd of any wrongdoing but nonetheless chided him, telling Dodd, "[Y]ou should have exercised more vigilance in your dealings with Countrywide in order to avoid the appearance that you were receiving preferential treatment.")
Dodd's need to undergo ritual purification may help explain his willingness to go the extra mile for the public option. Dodd "has tried to distance himself from K Street," Roll Call observed in July. "He is taking positions to show that he's not bought and paid for," an unnamed financial industry lobbyist complained to the newspaper. Dodd's re-election campaign, clearly tickled by that, sent out an e-mail mocking "THOSE POOR LOBBYISTS" with a video showing a grimacing fellow with loosened tie accompanied by audio of a bawling infant. "I'm sorry that he is working so hard on consumer protections and health care reform instead of big giveaways to the financial and health care industries," the e-mail chortled.
Note, however, that the e-mail contained no mocking references to insurers. Dodd must take care that in advancing his dear friend Ted Kennedy's public option, he avoid the gaudy rhetorical denunciation of insurance companies that has lately become commonplace in Washington. "I am going to fight for a strong public option," he promised Daily Kos readers on Oct. 9. "I am by no means ready to back down." No need to spell out who he'd be backing down from.
Dodd must know that if he fights the good fight and loses, his reputation won't likely suffer, because the odds are against any robust public option making it into the final bill. Might this knowledge corrupt his effort? Dodd did not, as it happens, succeed Kennedy as chairman of the Senate health committee. He chose instead to remain chairman of the banking committee. The health committee's actual chairman, Sen. Tom Harkin, D-Iowa, is less directly involved in negotiations over the bill with majority leader Harry Reid, D-Nev., and finance committee chair Max Baucus, D-Mont. Harkin is at least as steadfast as Dodd in his personal support for the public option, but he lacks Dodd's professional need to take the insurance industry into account. (Over the past 20 years Harkin has received $168,000 from health insurers. That ranks him in the Senate's bottom 50.) Perhaps it would be better for public-option advocates were Harkin taking the lead instead of Dodd.
But while Dodd has little to lose should the public option fail, he has much to gain should it succeed. It could help Dodd shed the stink of Angelo Mozilo and re-establish his credentials as a consumer champion. For the moment, that's probably a stronger imperative than pleasing a bunch of insurance executives in Hartford. Harkin has no comparable need to redeem himself. So maybe Dodd's the right man for the job after all.