By Bertha Cooper
Sequim (Wash.) Gazette, March 18, 2015
Most of us have heard the saying that watching legislation being made is like watching sausage being made. The image brings to my mind watching pigs being sacrificed and seeing some parts going to fine cuts of pork for those that can afford it and less desirable, unappetizing parts being ground into sausage for just about everyone’s breakfast.
The implication is that the process of making laws is a lot like making sausage and so revolting that we would lose our faith in the quality of the final product, that is, if we haven’t already.
I resent this analogy typically used by politicians involved in the process and all-knowing pundits. It comes across too much as an insider reflection that separates us ordinary folk from elite law makers and observers and, I think, might cover up things they don’t want us to know.
After all, we call our legislative process democracy, which should be a transparent process that can be audited at any point by the voting public.
Groups or individuals who wish to influence public policy are at a significant disadvantage when they do not have access to the process. As much as they keep their eye on the process around their bill and attempt to use the system to make their case, they cannot know the deals that are made behind the scenes.
Case in point is an example that dashed the hopes of a singularly dedicated group, Healthcare for All/WA (HCFA-WA), that has been working for over a decade to improve access to health care while reducing health care costs not only for the government, but for the individual and family.
Following the implementation of the Affordable Care Act (Obamacare), they started working with the state Legislature to activate a provision that would allow a waiver to the State of Washington to enact a version of the single payer system that would provide for health care for all Washington residents.
2015 was no different and another bill (HB 1025), sponsored by 23 legislators, one of whom was Steve Tharinger from our district, was submitted to the House. A public hearing for the bill was scheduled for Feb. 20 before the House Health and Wellness Committee on which Tharinger and Kevin Van De Wege, our other representative, sit.
Both Tharinger and Van De Wege have said that there wasn’t a snowball’s chance on Hurricane Ridge in 2015 that it would pass during this legislature session. Still, the group persisted as many do (think women’s right to vote) because they did want to keep the issue before the Legislature for passage in 2016 or 2017.
In order to understand what’s going on in this story, it is important to remember that payment of our nation’s health care system is through commercial insurance predominantly provided as an employee benefit, government payers such as Medicare, Medicaid and Tricare and commercial insurance purchased by individuals through Obamacare.
HCFA-WA’s idea is to eliminate commercial health care insurance for the most part and move to a less complicated single payer system. To make their point, the group pulled together businesses owners and representatives to testify at the hearing to the economic value of a single payer plan to businesses.
A related bill (HB 1967) was put forth by Health and Wellness Committee asking for a different waiver provided for in Obamacare around Feb. 1. “HCFA-WA only learned about the Bill one week before their scheduled testimony on HB 1025,” according to Patrick Noonan, a member of HCFA-WA who would provide testimony.
The new bill introduced by the committee (HB 1967) would “permit employers to integrate employer health care arrangements with individual market policies and to authorize alternative structures for those participating in medical assistance.” In other words, the bill supported the existing American method of insurance policies for health care and effectively silences any effort toward single payer in the near future years.
The public hearing for the new bill with three sponsors was held on Feb. 11 and executive action was taken on Feb. 17, three days before the scheduled hearing at which HCFA-WA would appear. The Health and Wellness Committee passed the new legislation with a majority, which included Tharinger and Van De Wege, and was sent to appropriations on a relative fast track.
I could have burst into tears hearing this all too familiar story of the long-suffering boyfriend or girlfriend that waited for years only to be left standing at the altar except this bride or groom of democracy was ruthlessly sent into obscurity without so much as an explanation. Sure there was a public hearing for the new bill, but who knew?
Who on the Health and Wellness Committee could not take the time to say we are going in another direction? And why not? No one seemed to have the interest or courtesy to tell this group or, as it turns out, to listen to any more they had to say.
Grind to a humiliating halt
HCFA-WA’s time at the Feb. 20 hearing was reduced to 10 minutes. One HCFA-WA participant reported that they were first on the agenda and although Tharinger and Van De Wege were present, very few legislators were. Other legislators arrived at a leisurely pace during the presentations. Once seated, many of the few made no pretense to listen and turned their attention instead to their electronic device or each other.
There was nothing subtle about the message; they were not interested. Noonan had driven from the Olympic Peninsula and stayed the night so he could participate in the legislative process. He lamented, “The path was already decided,” and added, “I was embarrassed for us and I was embarrassed for them. Mostly, I was embarrassed for democracy.”
So why do it; why waste their time and the time of interested citizens? My guess is that the Health and Wellness committee of the House needed to document that they gave 10 minutes to HCFA-WA in compliance of some sort of rule.
The point is not whether one supports the bill or not; it’s more that the process should allow for transparency and inclusion of differing views. Things that have to be hidden in the sausage can’t be good. In the end, the group and presenters were not allowed at the table making the sausage.
I can’t help but think that someone more influential than this low-budget, nonprofit group was at the table and will get the fine cut of pork.
Bertha D. Cooper is retired from a 40-plus year career as a health care administrator focusing on the delivery system as a whole. She still does occasional consulting. She is a featured columnist at the Sequim Gazette. Reach her at firstname.lastname@example.org.