The Only Road to Real Healthcare Reform 11/8/2009
Posted by Michael Zahara on Nov 8, 2009
In the 1980’s, America was stuck with a huge dilemma. The Department of Defense had an inventory of bases, hospitals, and other military facilities in the US that were draining budgets by the hundreds of millions and were not sustainable or needed.
Most were World War II/Cold War facilities that had outgrown their usefulness as the military’s mission had changed and modernized. Costs to maintain these installations were consuming enormous amounts of money with no end in sight, yet no one in Congress of either party could stomach saying no to communities and civilian employees and suppliers, to defense contractors, to lobbyists and donors, and to special interests across the political spectrum from little home-based daycare providers to United States Steel.
Sounds remarkably familiar to what we’re dealing with over healthcare ‘reform’ today, doesn’t it?
The concept of what eventually became BRAC, the Defense Base Closure and Realignment Act of 1990 actually began 30 years earlier in the 1960’s under President Kennedy. The military had been routinely closing stations with no local involvement, little notice to Congress, and no apparent rhyme or reason. It had gotten so bad that that after much posturing, President Carter was able to pass Section 2687, Title 10 of the US Code that stopped the rampant base closings without Congressional approval.
The result was no closings between 1977 and 1987. That decade allowed for some breathing room and forced everyone to the table to compromise and hammer out a deal that all could live with. But alas, it wasn’t a perfect deal, and the first round in 1988, lead by then Defense Secretary, Dick Cheney, collapsed.
He was trouble long before becoming VP
Many Democrats of the day felt that then Secretary Cheney had unfairly targeted bases in their districts and he almost certainly did do that.
I’ll admit, I didn’t think then that we could ever resolve these issues, the same way I feel about healthcare ‘reform’ today, but the political dynamics, forced by economic realities, changed further in the late 1980’s.
Just as with healthcare today, base closings had to be done.
President George HW Bush was forced to come up with stronger legislation in 1990-1991 and managed to come up with the BRAC formula we work with today. This has the Secretary of Defense submit lists of facilities to be closed and then handing the matter off to a newly seated Base Closing and Realignment and Commission with each new round. New commissioners prevent stagnation and appointed inertia. Rounds were held in 1988, 1991, 1993, 1995 & 2005.
The primary job of each newly seated commission is to ensure that the goals are not deviated from for political or any other consideration. They hold public hearings, weigh merits of the recommendations, and then it is for the President and Congress to either vote up or down-there can be no adjusting by either. Stated in the legislation is this mission: ‘to make independent recommendations to the President based on its review…’ with criteria developed by the Secretary and approved by Congress.
Lobbyists and congressional staffers may not add or delete anything, but may offer testimony to the commission. A brilliant masterstroke of corralling those who are only influence driven in Washington.
However, Congress being Congress, some found it difficult to allow processes they themselves created to give them political cover, to work properly and there have been intermittent times when members would try to nullify what the BRAC decided was the correct course of action.
Ironically, the last member of Congress to actually attempt to overturn a BRAC recommendation was current Transportation Secretary, Ray La Hood, then a Peoria Illinois based Congressman. He tried nullifying the 2005 round’s recommendations and was soundly defeated on a simple voice vote in the US House in October of 2005.
The US House instinctively knew not to mess with what was working and what was protecting all of them. A GOP Congressman was shot down by a GOP House.
Despite occasional interruptions like that, the BRAC concept has proven a successful vehicle to deal with complex, politically unpalatable decisions.
Again, sound familiar? It’s very much like what we’re dealing with and are in need of within the current healthcare ‘reform’ debate.
One difference however is the greatly increased amount of lobbying money and special interests influence just 21 years after the first BRAC.
It was bad then, it’s surreal today. More than 13,000 separate people ply the halls of Congress trying to influences 535 elected people, thousands more do the research and prep. In the neighborhood of 3 billion dollars, just on direct industry-to-representative lobbying, is expected this year.
The key to BRAC that how the closings were handled by USDOD was not a one-size-fits-all proposition as San Francisco’s Presidio proved when literally hundreds of interest groups and individuals fought over what to do with it. How each community handled things were as different as the fabric of America is, but they all handled it because decisions and responsibilities were shared, information flowed freely, and transitioning was given the time it needed to achieve success. In some places it was a few years, in others, we’re still transitioning from 1990’s closings.
Nobody was left abandoned; every opportunity and chance was given and taken to make transition a success.
That’s something the current healthcare ‘reform’ debate clearly needs. Though it took Congress and the Executive Branch nearly 30 years to come up with a formula that worked, let’s hope that our current leaders can do with healthcare, like they did with BRAC, much sooner.
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The commission most of us are familiar with is the National Commission on Terrorist Attacks upon the United States, commonly known as the 9/11 Commission.
Both Congress and President Bush were aware that though they knew our Intelligence and Defense had failed us, that citizens as well as leaders needed a sober analysis of what went wrong and what changes that needed to be made.
In retrospect, more thoughtful consideration should have been given to who was chosen as original chair as Henry Kissinger, was forced to resign and former Senator George Mitchell left his appointment, rather than severing ties with his law firm. There was criticism of their effort and the final report, but they enjoyed a complete disassociation from the President and Congress and largely operated without interference from either.
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I worked on the Telecommunications Act of 1996 for Ameritech and SBC Communications. They fed and drank us like kings; I gained 10 pounds and the Telecom industry was high-fiving themselves claiming that we had just written a bill all on our own without any member of Congress touching the legislation! Of course, a decade later, they were back before Congress telling us how terribly unfair the whole 1996 Act was to them!
And they wrote the whole damn thing!
This is the major problem that needs to be overcome. Congressmen and Senators do not write their own bills anymore; few even know how to put pen to paper or finger to keyboard anymore. Corrupted staffers have entirely too much power today and routinely insert sentences and exclusions without their own members even knowing what they did! Lobbyists come in with their own exclusions already written, ready to be inserted; some are so powerful that they assert and insert all on their own!
They now write 2000 page bills expressly so that no one can read them before they are voted on.
This has to be addressed first because with healthcare reform what’s moving through Congress at this point doesn’t ‘reform’ anything because Congress simply does not have the will or fortitude to create what is necessary to truly reform our nation’s healthcare system.
Their own staffers and lobbyists simply will not allow for them to do what is necessary—this is why an independent commission to move us toward healthcare reform is so critically necessary.
K Street is the Avenue of Influence in DC
Members themselves have no ability to say no, to pause, to consider, to contemplate. They want to be all things to all people, they need to raise enormous amounts of money each day in order to be re-elected. The concept of the citizen legislator died decades ago.
The Founders intended the House to be the raucous body and the Senate to be the more calm and rational one. They were quite correct about how they set things up, but none of them could have imagined that the powerful would wield so much power today.
Our Congress is not populated by intellectual, much less deliberative giants, and that’s a good thing and as the Founders intended; but they also intended a public service toward the common good, not an exclusive industry protection good, but a civic tradition where even the most common man could and would be heard and his issues fully considered.
The horse-trading of politics has been with us since the ancient Greeks invented Democracy, but in modern societies, it is incumbent upon us to ensure that there is some high level of equilibrium and fairness so that there may be a leveling of the playing field between those with deep pockets and those without.
We’re not ensuring that today in Washington DC.
My equal protections to petition my own government are negated by monied interests who are more ‘equal’ than I am today and you’re seeing this again within the healthcare ‘reform’ effort as Congress tries to do in a few months, what took 30 years to achieve with military base closings.
A 220-215 win in the US House is indicative of the landmines ahead rather than the unity necessary to pass something so all-encompassing; the US Senate will be that much tougher.
An independent commission to assess the problems, come up with the solutions, and write the bills, is the only way true and real reform is possible.
Today, there is not one iota of ‘reform’ in the current healthcare ‘reform’ effort; a symptom and a diagnosis of exactly why we must move this to an independent commission.
Next Sunday, Part Two: What an independent commission’s mission should be, how it should be structured, and what they’re likely to achieve.

Mike Zahara
11082009
www.WatchDogWag.com
