Mark Warner's Perilous Fork in the Road

One of my favorite poems has always been Robert Frost’s “The Road Not Traveled.” In that poem, the narrator describes coming to a fork in the road. Although both paths appear equally pleasant and leafy, the narrator must choose which path to take. Knowing he may never pass that way again, the direction he takes will have consequences for the rest of his life. And that's the thing about difficult choices. They have consequences.

When it comes to the difficult choices about health care reform, our junior senator, Mark Warner, faces just such a fork in the road. Whichever choice he makes will have consequences, not just for his personal ambition but also for the fortunes of his party, his nation and his state. That’s a lot resting on his shoulders and those of his colleagues in Congress.

Senator Warner has aligned himself with the Senate’s conservative Democrats, who are allied with the House’s Blue Dog caucus, especially on health care reform.

Before going further, let's acknowledge that Mark Warner always was a pro-business centrist. Virginians not only understood this but embraced it. As governor, he led from the center and was largely successful because he applied good business practices to Virginia and put its fiscal house back in order, restoring its AAA bond rating and balancing its budgets. But as governor, he also found ways to balance the best practices of business with meeting the needs of Virginia’s ordinary citizens. He was successful because he did not sacrifice the well-being of the neediest on an altar of fiscal conservatism. Instead, he found a way to balance the two sets of priorities so that all Virginians benefited from the commonwealth’s prosperity.

Now, however, the nation is in an economic crisis that is the most severe since the Great Depression of the 1930s.

At the same time, we are facing a crisis of our health care system and it urgently needs reform. To reform it in a way that provides near universal coverage is going to require a lot of spending. That goes against the grain of cautious, centrist, business oriented politicians, such as Warner. But the alternative is a health care delivery system whose costs put such a strain on the economy that it will threaten our recovery. Our health care costs are far higher and our medical outcomes are far worse than those of the rest of the industrialized first world. It would seem to be a no-brainer. We are paying more money for less quality of care than countries like Canada, France, Germany, and even Taiwan.

And the problems have been exacerbated by the climbing unemployment rate because so many people’s health insurance is tied to their employers. With the loss of jobs comes a loss of health care coverage.

To my mind, the best solution would be a single payer system not tied to one’s employer. But I understand that that solution is unpalatable to the vast majority of Americans despite the fact that it actually works very well in other countries, regardless of how much the far right in this country tries to discredit it.

It’s important to note, though, that the single payer option is the solution of choice on the left end of the spectrum, supported by liberals like Dennis Kucinich and Bernie Sanders in the Senate and John Conyers, Tammy Baldwin, and Elliott Engel in the House.

On the right, especially among Republicans, the solution would not have any public option and would depend solely on market-based solutions with little government interference. It would depend on encouraging consumers to purchase private insurance plans and give them a tax cut to do so (every right wing solution to any problem depends on the so-called free market and a tax cut and little else).

The reason I am pointing that out is because it’s important to note that the plans currently under discussion in the Senate and the House are varieties of centrist compromise that would still be based largely on private insurance companies and employer based options. They are neither single payer options nor socialized medicine. What is under discussion is various ways to fund the plans, including a government subsidy only to those who couldn’t afford to purchase insurance, penalties for large businesses who don't cover employees, insurance pools and tax breaks to small businesses to encourage them to purchase insurance for their workers, and a public option for those who truly can’t afford a private plan even with a subsidy.

Supporters also hope a public option would provide more competition to the private insurers to get them to keep premiums low and provide better coverage. There would also be stricter regulations to ensure that insurers don't deny coverage to those with pre-existing conditions or cancel coverage for those who get sick. That is the plan of the true centrists. It’s the one progressives don’t necessarily favor, but are willing to support to get to the goal of near universal coverage.

Mark Warner does not support that plan. He has aligned himself with the conservative Democrats in the Senate, led by Max Baucus, and the Blue Dogs in the House, led by Jim Matheson and Mike Ross. They are neither moderate nor centrist – they are conservative. That’s the first thing you need to remember.

Now, let’s examine what those congressional Democratic conservatives stand for.

Both groups oppose the public option. Neither group has an appetite to fund health care reform by taxing the wealthiest one percent of the nation. Yet the Senate conservative Democrats, and their Republican allies, have no similar reluctance to tax the health benefits of those who currently have “generous insurance plans.” In fact, most of those on whom that tax burden will fall are fire fighters, police officers, government workers, and those who are professionals and middle managers. In other words, the middle and working classes will bear the burden with additional taxes, with the upward distribution of wealth once again preserved for the most fortunate – those with friends in high places.

In addition, without the public option, Americans would be mandated to buy health insurance from private providers, unless their employers provide it. Not only would this not actually help ordinary citizens, it would simply be an unfunded mandate on them. And it would create a windfall profit for insurance companies, who would reap even greater benefit under this so-called reform, as even this article in Business Week points out.

Although the Senate supports regional co-ops instead of the public option, we have even less evidence that these would work on a national level than we do that a single payer system would be effective. There are a few such co-ops operating in some states with various degrees of success but it is hard to say whether that model would translate well elsewhere. Certainly, if you object to risky and costly experiments, the regional co-ops would qualify for that description even more than the public option would.

There are many good reasons for supporting the more progressive health care reform plans out there. But for the Blue Dogs in Congress and the conservative Democrats in the Senate one very good reason is that their financial ties to the insurance industry are, by now, also very well documented, as this Washington Post article, for example, demonstrates regarding Mike Ross:

Ross has received nearly $1 million in contributions from the health-care sector and insurance industry during his five terms in Congress, according to an analysis by the Center for Responsive Politics, which tracks campaign contributions. The lawmaker founded Ross Pharmacy of Prescott, Ark., which he and his wife sold in 2007. The couple received $100,000 to $1 million in dividends last year from the sale, according to House financial disclosure forms.

Records of political fundraisers since 2008 compiled by the Sunlight Foundation, a Washington-based watchdog group, show a steady schedule of events for Ross sponsored by the health industry or lobbying firms that represent health-care companies. They include two "health-care lunches" at Capitol Hill restaurants in May 2008 and March 2009, as well as receptions sponsored by Patton Boggs and other major lobbying firms.

Further, the above mentioned Business Week also points out Mark Warner’s connections to UnitedHealth. Here’s the telling quote:

UnitedHealth's relationship with Democratic Senator Mark R. Warner of Virginia illustrates the industry's subtle role. Elected last fall, Warner, a former governor of his state and a wealthy ex-businessman, received a choice assignment as the Senate Democrats' liaison to business. The rookie senator landed in the center of a high-visibility political drama—and in a position to earn the gratitude of a health insurance industry that has donated more than $19 million to federal candidates since 2007, 56% of which has gone to Democrats.

UnitedHealth has periodically served as a valuable extension of Warner's office, providing research and analysis to support his initiatives. Corporations and trade groups play this role in all kinds of contexts, but few do it with the effectiveness of the insurers. In June, Warner introduced legislation expanding government-backed Medicare and Medicaid coverage for hospice stays for the terminally ill and other treatment in life's final stages. The issue isn't a top UnitedHealth priority. But the corporation wanted to help Warner with his argument that in the long run, better hospice coverage would save money. UnitedHealth prepared a report for lawmakers finding that 27% of Medicare's budget is now spent during the last year of older patients' lives, often on questionable hospital tests and procedures. Expanded hospice coverage and other services could save $18 billion over 10 years, UnitedHealth asserted.

When Warner went to the Senate floor on June 15 to offer his bill, he cited those exact figures. He thanked the company for its support and put a letter from UnitedHealth applauding him in the Congressional Record.

If voters are angry with Democrats and disillusioned by politics, it’s because after two election cycles of successfully running against lobbyists, special interests, and the culture of corruption, powerful Democrats are beginning to look exactly like those they replaced

The only way for those Democrats to stanch that anger and disillusionment and keep their own seats at the midterms is to take the road less traveled, less profitable, and ultimately more moral. It’s to stand with the ordinary working people and the middle class rather than with the powerful and wealthy special interests who usually managed to turn legislation to their advantage, regardless of which party is in power.

If they don’t, they could face dire consequences at the election polls sooner rather than later. Indeed, Ben Tribbett makes that prediction in a tweet, where he predicts that those who don’t support a public option, including Warner, Webb, Boucher, Connolly, Perriello, and Glenn Nye will all lose their seats in the midterms. But I believe electoral disaster could come even sooner than that in Virginia.

That’s because the very first election where fallout from anger at the Democrats for failing to get health care reform right will be right here in Virginia. The gubernatorial race is the canary in the mining shaft. It's the forerunner to the midterms in two years. And here is where there is a double irony for Mark Warner especially.

Currently, Creigh Deeds and Jody Wagner are running hard as Virginia Democrats in the mold of Mark Warner. How ironic, then, it would be if Warner’s own actions helped to kill the health care reform and take down with it Deeds and Wagner at home and then the Virginia Democrats in Congress a year later. Even if Warner were to survive it based on his personal popularity, that would spell the end of any ambitions he has on the national stage.

But that’s the choice he has to make as he stands at this fork in the road. Choose wisely, Mark. Your future and ours depend on it!