Quietly, this article has remained on the Top 10 Most Emailed list at NYTimes.com for 5 days since it was first posted on the 24th. It appeared in the print edition on the 25th. However, before it arrived on doorsteps, it had already run up the list of most emailed articles. Here is the opening paragraph, setting the context for the story.

A quiet revolution is transforming how medical care is delivered in this country, and it has very little to do with the sweeping health care legislation that President Obama just signed into law.

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Washington State Attorney General Rob McKenna has decided to get in the health care game by joining a lawsuit against the federal government claiming that the recently passed health care reform is unconstitutional. As a result, in the wake of euphoria among reform proponents, AG McKenna is facing a bit of a torrent of criticism, which even he appears to admit is more than he had bargained for. KING 5 tries to lay out both sides here.

But, is he on to something?

Well, from a legal perspective, it depends on who you ask. So, for questions like these, I turn to a mainstream constitutional society called the American Constitution Society for Law and Politics. This group bases their analysis on the Constitution, without frills or extrapolations, but also considers the more than 200 years of case law and Supreme Court decisions which clearly adapt the underlying document to the times in which we live. They describe themselves like this:

The American Constitution Society embraces the progress our nation has made toward full embodiment of the Constitution’s core values. ACS believes that law can and should be a force for improving the lives of all people. We are revitalizing and transforming legal and policy debates in classrooms, courtrooms, legislatures and the media, and we are building a diverse and dynamic network of progressives committed to justice. Through these efforts, ACS will ensure that the institutions of American law reflect the highest values of our nation and serve the needs of its people.

And, what they say is this.

The paper concludes that the mandate is lawful and clearly so – pursuant either to Congress’ authority to “regulate commerce among the several states,” or to its authority to “lay and collect taxes to provide for the General Welfare.” With respect to Congress‟ interstate commerce authority, the goals that drive this legislation – including achieving universal coverage, eliminating adverse selection, eliminating pre-existing conditions as a prerequisite for coverage, facilitating broad-scale pooling of individuals not covered by group health plans, and radically reducing costly emergency room visits by uninsured individuals – are eminently lawful objects for the exercise of that power. In the context of current health insurance market circumstances and the framework of the legislation, the use of an individual mandate, structured as it is to ensure affordability for all who are subject to it, is likewise an eminently rational and well-supported (“necessary and proper” in the words of Article I, §8) means for achieving these goals.

But, don’t take my word for it. They lay out an extensive explanation here. Have a look and see what you think.

Nate Silver at fivethirtyeight.com has an interesting post up today highlighting the weight of the words used by both the pro-reform and anti- sides of the debate.

For instance, here is a shot of the most commonly used words collected by Gallup when soliciting the reasons why the 45% of Americans support reform.




And, here are the words chosen by the 48% of Americans who, if given the opportunity, would tell their member of Congress to vote against the bill.




If you want to see Gallup’s numbers for yourself, take a look.

Looks like the votes are lined up in the House this week in support of the Senate backed health reform bill. Obama has really upped his effort behind the bill in the last few weeks by making his case directly to voters in places like Ohio, a critical swing state.

Between now and then, here are a couple of important reads making buzz. First, this piece by local Seattle Times columnist, Danny Westneat, shines a light on compensation among insurance companies here in the state. Just as interesting is his follow up piece out today.

And, this read by David Brooks on Obama, which includes comments on health care. As Chris Cillizza of the Washington Post says, “David Brooks reinforces his status as the most thoughtful political columnist out there” with this piece. This is the piece of the week – if you don’t read another piece of analysis this week, this is the one you don’t want to miss.

We’re gearing back up for some news from the Legislature and the federal reform “end game” coming up. So, start checking back in! We’ll have some more great info, including some polling we’ve completed on health reform in Puget Sound.

Download the full briefing memo here.

Download the full briefing memo here.

For those curious about Rep. Brian Baird’s vote to break with his party, the New York Times created a couple of graphics today which help to illustrate just how much of an aberration Baird was.

This map, graphically detailing the nation’s no and yes votes, shows the overwhelmingly rural make-up of the health care bill’s opponents.

Meanwhile this chart goes into a little further detail, and reveals Baird to be one of just three no-voting, non-freshman Democrats whose districts were carried by Obama and aren’t part of the Blue Dog coalition. The others are Rep. Artur Davis (D-Ala.) and Rep. Dennis Kucinich (D-Ohio), arguably the most liberal member in the House.

In the first press event since the passage of the House health bill, H.R. 3962, Speaker of the House Nancy Pelosi joined Congressmen Jim McDermott (WA-7) and Jay Inslee (WA-1) at Seattle’s Swedish Medical Center. That bill passed 220-215 in the House on Saturday.



“It’s important that we would come here, to Swedish, on the first public hearing for many of us since this legislation passed,” said Pelosi. “I say appropriate because Swedish has been in the lead, and what is being said here is nothing to be taken for granted. When we’re talking about admiration among healthcare professionals… when we’re talking about a Medical Home, when we’re talking about reducing infections, Swedish has been in the lead.”

The press event was not without disruption, though both were minor. A woman tried to enter the press briefing while McDermott spoke, shouting, “I have Stage 4 kidney cancer – arrest me!” At the end of the conference, a man shouted to Pelosi, “Please don’t send me to jail for not buying health insurance.”

Both were in reference to the health insurance mandate that is part of the bill. Pelosi responded to a question about the mandate, saying, “Well, the point is that we want to make sure people have access to healthcare.”

When pressed, she continued, “I think the legislation is very fair in this respect. It gives people an opportunity to have healthcare, access to quality healthcare. If they can’t afford it, it provides subsidies for them to do so. But do you think it’s fair if somebody says, I’m just not going to have any if I get sick and I’ll just go to the emergency room and hand the bill to [taxpayers]?”

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In a previous post, DJ asked the question:

What are the practical economic impacts of the Stupak amendment limiting coverage of abortions? There are some persuasive politics at play, but will this have a measurable “real world” impact on plans, providers or patients?

Let’s take a look. Read the rest of this entry »