Health Care

Specter's Switch Doesn't Change Health Care

by Tim Foley

categories: Comparative Effectiveness Research, Obama And Congress

Published April 28, 2009 @ 10:56AM PT

The political world is reeling from the news that long-time moderate Republican Senator Arlen Spectator is switching parties. When Al Franken is inevitably seated, that gives the magical number of 60 votes to the Democrats – enough to defeat a filibuster if the vote proceeds on party lines. Although this undoubtedly changes the politics of Pennsylvania and the Senate, Specter’s switch won’t have much of an impact on health care reform.

Why not? Well, simply put, if health care reform couldn’t get Specter’s vote to begin with, we’d be in serious trouble. Reform and the notion of universal health care isn’t one of Specter’s signature issues – most of his focus has been on crime, law enforcement, veterans and most famously, his work on the Senate Judiciary Committee. But he’s also been a tireless crusader for public health and medical research, dovetailing with his own experiences as a twice-over lymphoma survivor. The National Institute of Health has few champions as dedicated as Sen. Specter, whether it was for more money for cancer research, Alzheimer’s, psoriasis, diabetes and a whole host of chronic diseases. While the moderates of the Senate, including Specter, were looking for ways to cut money out of the stimulus bill (largely for the P.R. effect of saying they’d done so), Specter made a point of adding money back in for cancer research. Sure enough, his statement explaining his switch to the Democratic Party mentions – what else – medical research through the NIH as one of his top issued: “NIH funding has saved or lengthened thousands of lives, including mine, and much more needs to be done.”  So although not a health care crusader at heart, his interests aren't far off.

In Specter’s campaign material in the 1990s, he proudly asserted that he helped defeat Clinton’s health care plan. But Specter has been on the side of the reformers for a number of key health care votes lately, including expanding SCHIP, allowing for negotiated drug prices for Medicare Part D (an issue bound to come up this year), allowing the reimportation of pharmaceuticals from Canada and, of course, the stimulus bill itself. He's also one of the co-sponsors for the Wyden-Bennett plan for universal health care.  He hasn’t bought into all of the Democratic principles for reform and notably toed the party line on comparative effectiveness research – yes that’s right, he was simultaneously arguing for more medical research and less research to determine whether medical treatments were effective. But suffice to say, as one of the few moderate Republicans left in the Senate and with his deep passion for medical research, his was a vote we were counting on already.

Switching from a Republican with an independent streak to a Democrat with an independent streak will impact any number of issues coming up in the Senate, and Specter has a huge incentive to vote in the Democratic bloc since he now must compete in the Democratic primary. His statement warns, “My change in party affiliation does not mean that I will be a party-line voter any more for the Democrats that I have been for the Republican,” but the danger was never quite that Specter would be an automatic vote for a filibuster in the case of health care reform anyway. It was that, much like the process for the stimulus bill that unfolded, he’d join with a handful of moderates including Sens. Nelson, Conrad, who knows, maybe even Evan Bayh to force the compromise to bend to their will. With a date set for when budget reconciliation rules apply to health care legislation taking the filibuster out of commission, the larger problem is still that reformers won’t be able to agree with reformers, or will squabble with the fiscal conservatives gun shy at such at the cost of health care reform, no matter how long-term cost effective. If reform falls apart this time, that will likely be why. If so, it doesn’t matter that Arlen Specter, fiscal conservative, has a (D-PA) after his name instead of an (R-PA).

I expect lots of justified excitement and buzz among progressives about the possibilities of Sen. Specter no longer having to mute his support for causes he’d previously championed but are now out of favor with the right wing of the G.O.P. There’s huge potential for Democrats in Congress. But the basic calculus for health care reform passing the Senate this year remains unchanged.

(Photo credit:  musicFIRSTcoalition on Flickr.)