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Pay to play
The health care industry donates millions of dollars to Baucus, most of it flowing in since 2001, when he and Sen. Chuck Grassley, R-Iowa, began swapping the chairmanship of the Senate Finance Committee. Since 1989, according to the Center for Responsive Politics, Baucus has raised more than $3.8 million from the industry, the fifth highest recipient behind only Barack Obama, John McCain, John Kerry and Arlen Specter. Health professionals have contributed more than $1.3 million to Baucus, and the pharmaceutical industry more than $1 million.
Renewed scrutiny of those contributions came this summer when talk of health care reform intensified, and it became clear that the Baucus-led negotiations in the Senate Finance Committee would be the linchpin. Lee Newspapers reported that, when combined with Baucus' Glacier PAC (political action committee), the senator raised about $3.4 million between 2003 and 2008 alone. That money comes from groups and individuals associated with drug companies, insurers, hospitals, medical supply firms, health service companies and other health professionals, and it amounted to about $1,500 per day. The Lee report began a slew of probes into who fills Baucus' coffers, casting doubt over the senator's loyalties and drawing sharp criticism from the left.
Asked by the Independent why he didn't, at least in recent years, reject money from the health care industry if he knew he'd be integral to its reform, Baucus said: "For every one of my 30 years in the Senate, I've only been influenced by one thing: What's right for Montana, and what is right for the nation. It's the same for health care reform. Money plays absolutely no role in any of my decision making."
Baucus reportedly began refusing contributions from health care political action committees—but not lobbyists or corporate executives—after June 1.
But Baucus' health care ties extend beyond money. The Sunlight Foundation revealed that five of Baucus' former staffers currently represent a total of 27 different organizations in the health care industry. The organizations include some of the industry's top lobbyists, like Pharmaceutical Manufacturers and Researchers of America (PhRMA), America's Health Insurance Plans (AHIP), Amgen, and GE Health Care. The staffers-turned-lobbyists include two former chiefs of staff, David Castagnetti and Jeff Forbes, and one former legislative assistant, Scott Olsen.
The Washington Post reported the extent to which this "revolving door" between government and private health care companies might influence the crafters of health care legislation. In early July the paper found that the nation's largest insurers, hospitals and medical groups had hired more than 350 former government staffers and retired members of Congress to influence their old bosses and colleagues. Nearly half of the insiders, the Post reported, previously worked for key committees and lawmakers, including Baucus and Grassley, the ranking Republican on the Senate Finance Committee. The Post also reported that the health care industry spends more than $1.4 million per day on lobbying as its future profits hang in the balance.
"When all is said and done," says Sidney Wolfe, director of Public Citizen and one of the country's leading single-payer advocates, "the legislation on health insurance will be legislation that is satisfactory, if not delightful, to industries such as the pharmaceutical industry and health insurance industry. But at the same time as it does that, it will not take care of the serious problem of having 48 or 49 million people uninsured, and another 25 million people underinsured, and no possibility of legislation that will be framed in such a way that it is affordable to have health insurance for people in this country."
Progressives blame the health care industry's tremendous influence, especially on Baucus, as they hear of the Senate working toward watered down legislation as opposed to real change.
"I think that Max has been a person—probably the best example of a person—who uses nebulous terms like bipartisanship to mask doing the bidding of big money interests," says political columnist David Sirota, who worked as a strategist for Gov. Brian Schweitzer's 2004 campaign. "Any proposal that comes through his committee—and particularly on health care—that takes on big money interests, you can basically guarantee that Max Baucus will try to water it down in the name of 'bipartisanship.'
"What's fascinating about this time right now," Sirota continues, "is that the argument is negated by the math in the Senate. You used to be able to make a credible argument that you need bipartisanship in order to pass anything. And now that argument is over. It's really undebatable that it's over. It's just a matter of arithmetic. There are 60 Senate votes. Max has a majority of Democrats on the Finance Committee. So what I think you're seeing now is that Max's formula underneath the deception has hit a brick wall. He can't credibly argue that he needs to water down good policy to achieve bipartisanship, because mathematically bipartisanship is not necessary."
The most egregious example of Baucus kowtowing to his donors, critics say, is his blunt dismissal of a single-payer health insurance plan, a nationalized health insurance program that would essentially replace the current health insurance industry. Baucus says he spent more than a year studying every option for health care reform, including single-payer.
"While carefully considering the single-payer system," he says, "it became clear that it is not a solution that could get the 60 votes health care reform legislation needs to pass the Senate."
But single-payer advocates call his reasoning disingenuous—or worse.
"Politically impossible means that he doesn't have the courage to have it be seriously considered...," says Wolfe. "Politically impossible, on this kind of issue, is just an acknowledgement of extreme cowardice."
Whatever the reason, the exclusion of single-payer from the negotiating table limits the scope of the debate and will ultimately hurt the final bill.
"The public value of hearing and giving full consideration to both single-payer and the standard, current system is that one informs the other," says Pat Williams, who served as Montana's representative in the House from 1979 to 1997 and worked on the last attempt to pass health care reform during the Clinton administration.
Baucus' rejection of single-payer may show a certain spinelessness. Or, as the senator contends, it may reflect a commitment to finding middle ground in the face of knotty political realities. Either way, the dichotomy shouldn't surprise those familiar with Baucus' career.