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I'm a Software Engineer by trade but like to consider myself an all around geek.  This blog is a place where you'll find my thoughts on a number of different things I'm passionate about.  More often than not though that list tends to include: Technology, Social Media and the Web in general, Geek Culture (TV/Movies/SciFi), Space Exploration, Music/A Cappella.

(Any opinions, etc. expressed here are purely my own.)

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Entries in healthcare (1)

Monday
Mar222010

Poli-Sci in me Geeks Out

In college I actually minored in political science and even before that I've always been kind of a poli-sci nerd. Essentially that means generally interested/fascinated in how the structures of of government actually produce policy and the effects of the structure and process on the quality of that policy.

Since it is 2010 I will just assume that everyone on the planet has by now heard that last night the United States House or Representatives passed a Healthcare Reform Bill. In fact technically it was the previously passed Senate version of the bill. Which brings us to our first piece of interesting maneuvering. How did is it that the House just passes the Senate bill and it become law? Isn't there usually two versions and a conference bill?

Typically yes the House and Senate will often produce their own versions of a bill and then the differences between those must be cleared up in conference committee. In this case House leaders decided they could get the Senate Bill passed and since the passed the exact verbatim Senate Bill no conference required straight to the President's desk.

Yesterday I spent much of the evening (see I said I was a nerd) watching CSPAN's coverage of the House floor and I have to say it was fairly fascinating to watch the maneuvering, strategy, and calculation that goes on in something as "simple" as managing floor time. Rules are created giving each party an allotted amount of time to slice up as they choose to allow their members to speak on a bill. What's interesting is when that time dwindles you will see a particular side reserve their time in an attempt to sort of get the last word or make the other side speak. There was very obviously some calculations going on on both sides.

Another interesting moment was around the normally fairly generic so-called "unanimous consent agreements" these can be used for a host of things but they are one way to allow a member to insert their speech into the record when the party doesn't have floor time for all members to give speeches. Yesterday you saw certain members of both sides attempt to use the request as a mini speech and insert their own commentary into the request. The chair of course was having none of that and anything deemed to be oratory in nature would be charged back to that parties allotment of time.

Of course there were numerous attempt to restore order to the chamber, parliamentary inquiries, reminders to heed the gavel when a member's time expires, stay out of the well/aisle during speeches, no doubt the chair (the person who stands up top and serves as the presiding officer of the chamber during debate, the position typically rotates among junior members) was busy yesterday for sure. At one point there was even a moment where a Democrat made a speech and the Republicans felt that the other side was making unfair accusations about the conduct so they had the Clerk actually review the member's words to see if any untrue accusations had been made. Eventually the member withdrew his remarks to clear the impasse none the less another of the arcane procedures you see pulled out of the quiver for intense debates like this.

As for the content of the bill itself there were numerous accusations about various kick-backs, bribes, pork, on and on that went into the bill. I think that we need to remember that the way the actual system is setup in fact encourages these practices of incentivising a particular state for example to vote a certain way. As the federal government has grown in size, influence and power in the modern era the States have tended to feel their power and influence weaken. Congress has become a place where they can still make their influence known. If your state's representative or senator wields considerable influences (as they no doubt will if they have been around for decades) that leverage can be used to secure all kinds of different things for a particular state. This is the nature of federalism and the tug of war between the interest of the states and the interests of the federal government.

Unless we alter the system itself these practices will never change. Yes the process is ugly, loud, and particualr obnoxious (which is to say nothing of the deplorable level of civil discourse in this country when we have to restore to racial slurs, outbursts, and spitting on our elected officials) but at the end of the day the benchmark must be does the end product do more harm than good? This was in fact the goal of the framers the structure of Congress is actually designed to slow the process of creating policy down to a grinding snails pace by design. Given he very nature that we have, relative to most systems, strong states the process of making law will always require some give and take. Show me a major piece of legislation that hasn't included various add-ons and hasn't on the whole been essentially a giant compromise. You can argue that you don't like how the process works but that is how it works and how it was designed to work.

Was this compromise worth it? From what I've read I generally have to believe that yes it was. It's astonishing that this country has remained the only democracy on the planet not to provide its citizens with affordable health care. No one should die, or be bankrupt out of their home, due to procedural hurdles. This law forbids insurance companies from denying coverage based on preexisting conditions, it also eliminates lifetime caps on total spending on care. I believe those two things alone will save lives, and one life saved should be enough is those to changes are proven out thousands will likely be saved.

We can debate the bill on its merits but as ugly as the process maybe the fact is that it does work as designed passage of this bill is proof of that. Which isn't to say changes to the process couldn't or shouldn't be made. For example I generally favor term limits on members of Congress in both houses but that is probably another post. 

I don't claim to be an expert or have all the answers just a poli-sci geek geeking out a bit.