The GOP Sinks Health Care; Bob Smith's a Crank

At the start of the debate in the Senate last week on legislation regulating health plans, Phil Gramm, a conservative Republican from Texas, blasted the Democratic bill because "the one thing it does not provide is more freedom." Does Gramm believe that freedom currently reigns in the U.S. health care system? Actually, it does to a degree?for the insurance companies. They're free to tell doctors and patients what to do, and they're free of retribution should they act negligently, for patients are prevented by law from suing negligent HMOs that cause injury or death. Gramm was correct in that freedom is indeed at issue. Under the Democratic bill, a woman in an HMO could choose a gynecologist as her primary care doctor. But Republicans voted against this. In fact, Gramm and his GOP colleagues opposed a string of Democratic provisions that would provide consumers more options, such as the choice of staying in the hospital after a mastectomy, the choice of retaining a doctor for a few months if forced to switch health plans and the choice of going to the closest E.R. Republicans, however, argued that his package represented intrusive government and would cost too much. To cover their cheeks, though, the Republicans did vote for their own mastectomy hospital-stay provision.

The tussle over the patient bill of rights?an initiative that, after all, is a rather modest stab at health care reform, considering that it would do nothing for the 43 million Americans who have no access to health insurance?revealed the emptiness of right-wing rhetoric about "freedom." In this instance, more government rules would stop corporations from curtailing the freedom of consumers. Should health plans be free to overrule doctors on questions of treatment? Free to order doctors not to discuss certain treatments with their patients? Should insurance companies be free to submit complaints to a review panel hand-picked by the company, rather than one of independent experts? What value comes from the protection of such freedoms?

Gramm should have been more honest. It is not freedom in the abstract that he was serving. It was the freedom of corporations to act however the market will allow them. It would have been instructive for the public if the debate in Washington had forthrightly addressed the fundamental question at hand: Can government be enlisted to force corporations to act responsibly, especially on life-and-death matters? Behind a wall of rhetoric, Republicans rushed to the defense of insurance companies and HMOs, entities not generally popular with the public. The Republicans must be assuming that the mild measures they did pass will let them claim they indeed care about patients?and survive the inevitable Democratic propaganda. It's a cynical ploy. The GOPers claim the Democrats are wrong to interject the government into health care?and then they approve watered-down, copycat legislation that does little to redress the problem but enough to ward off political criticism. If only the Republicans would act on Gramm's true beliefs and declare: Patients of this nation, you're on your own; let the market decide, let (corporate) freedom rule. That's essentially the party's position. But it has neither the guts nor the stupidity to say so. Bile and Guts On the subject of guts and stupidity, we turn to Sen. Bob Smith of New Hampshire. As his Republican Party was helping the health insurance industry, Smith was whipping his party for its lack of ideological forthrightness. In an overly ballyhooed speech on the Senate floor, this presidential candidate?a presidential candidate who never scored above the margin of error in a poll?left the Republican Party, wailing that it was under the control of wimps. "Maybe [the GOP] is a party in the sense of wearing hats and blowing whistles," he griped. "This is not a political party that means anything." His chief complaint was not that the Republicans behaved hypocritically on the health care bill, but that the party does not take seriously its own stands on two other issues: abortion and gun control. Ponder Smith's stand for a moment. All the leading presidential candidates of the GOP oppose abortion rights in some form or another and in Congress the Republicans have passed legislation to outlaw late-term abortions?a move that only President Clinton's veto thwarted. Regarding guns, the House Republicans last month succeeded in smothering a Democratic gun control initiative. Yet this is not enough for Smith. He's peeved that the party does not excommunicate from its ranks politicians who are pro-choice and that it does not strive to roll back the modest gun control regulation now on the books. He wants the Republicans to be a party run and peopled by gun-toting mullahs.

Smith tried to sell his departure as an act of principle. It must be, for he will not profit career-wise from it. He did receive his moment in the media sun, and is free to run for president as the candidate of the wacky-right U.S. Taxpayers Party. But how many voters are waiting to rally around his platform of guns for all, abortions for none, U.S. out of the UN and abolition of the Dept. of Education? Grant Smith one cheer for provoking media chatter about third parties?we need more of them?and independent presidential campaigns?we could use more of these, as long as they're Perot-free. But Smith is not going to pose any more of a political threat on his own than he did as a flopping GOP candidate.

Smith's resignation afforded conservatives an opportunity to bitch about George W. and the Republican establishment's pay-now-examine-later embrace of its most prominent brand name. ("After four months of a Bush Republican Party, the only measurable result we've got is that Republicans have one fewer senator in Congress, which is not a good start," the never-elected-to-anything conservative activist and presidential candidate Gary Bauer cleverly cracked.) Yet Smith jumped when nobody was pushing. His departure from the Bush-happy outfit says more about the grouser than the party he left behind.

In case you're tempted to think that Smith is at least a principled right-wing extremist?and some critics of the Democratic/Republican duopoly tried to tag Smith as a conscientious objector to politics as usual?consider that last week Smith was awarded a "golden leash" award by the campaign finance reform advocates of Public Campaign. The nonprofit group reported that between 1993 and 1998, Smith, who chaired the Senate subcommittee in charge of toxic waste cleanup, collected $323,944 in campaign contributions from industries?such as oil, gas, chemical, mining and insurance?that want to see cleanup laws weakened. Coincidentally or not?you make the call?Smith has pushed for legislation that would lower the amount that polluters have to pay for toxic site cleanups. He is not a crusader for straightforward politics and honest government; he is a crank?too cranky for even the GOP?who's looking to make common cause with other cranks. Cherchez Les Femmes Okay, George W. Bush?the soon-to-be $100 Million Man?has a lock on the Republican presidential nomination and Al Gore, despite a couple of missteps, still has most of the Democrats behind him. Done deals. So what time is it? Time to talk about running mates. In the hyperspeed campaign of 2000 (by election day we'll be ready to boot out of office whoever is elected) it's not too early to consider number twos. When Rep. John Kasich bailed out of the GOP presidential race last week and endorsed W, pundits wondered if he was angling for the second spot on the ticket. That day, I had breakfast with Sen. Dianne Feinstein, a Democrat from California, and a group of reporters. She told us that "the time is right" for a woman vice president and acknowledged that should the GOPers nominate a YY for veep (hint, hint: Elizabeth Dole), the Democrats would have to follow suit. (For those of you looking that far ahead, the Republican convention next August occurs before the Democratic convention.) But DiFi expressed minimal interest in being the Dems' designated woman, and her aides have been telling California reporters for weeks that she really, really, is not keen on the job. Which presents a problem for her party.

Asked what other Democrat-in-heels might serve as slate-mate to Gore or Bill Bradley, Feinstein named not a one. She said that any of the Democratic women senators could do the job and that there are Democratic women in the House and in the administration who would make good picks. But she identified none because, other than herself, there are no obvious or near-obvious candidates. Her fellow female senators?Barbara Boxer (too erratic), Mary Landrieu (too new), Blanche Lambert-Lincoln (too new, too), Barbara Mikulski (too mean) and Patty Murray (too nondescript)?are not strong contenders. No one in this pack has the Feinstein combo of cultivated gravitas, nonthreatening manner and middling politics. And can you cite a Democratic congresswoman or governor who has national standing? Scoping in the House raises the discomfiting specter of Geraldine Ferraro, a congresswoman who was far from ready for primetime when Walter Mondale placed her on the Democratic ticket in 1984. The only female Democratic governor is Jeanne Shaheen of New Hampshire, and Democrats in her state have complained about her clumsy handling of tax and education issues. One possibility mentioned by whoever it is who does this sort of mentioning is Kathleen Kennedy Townsend, the lieutenant governor of Maryland and daughter of Bobby. Yet it would seem a stretch if the Democratic presidential nominee chooses a lieutenant governor.

Feinstein, alas, may be the only Democratic woman who fits the conventional bill. But on one front, she does not, for she's Jewish, an untested quality in national politics. (That is, if you don't count Arlen Specter's over-in-a-blink run for the GOP nomination last time.) If she is successfully courted for the task, she may have to give up her Senate seat, which would be good news for the disarray-ridden California Republicans. (It's possible Feinstein could run for both vice president and Senate. Then, if she and her running mate won, she would resign from the Senate and California Gov. Gray Davis would appoint her successor.)

Sure, complain it's too soon to be handicapping the veepstakes. But Bush's $36 million I-Am-Me roar is drowning out the Republican contest, and Gore's awkward and messy campaign is too damn painful to watch. With all the attention Campaign 2000 has received, it feels as if it should almost be over and done with. Aren't you by now sick of Bush and Gore? It's a relief, if temporary, to look at who's next in line.