Health care’s 5 points of fight

A doctor checks blood pressure.

The economic stimulus package is shaping up as something of a precursor for health care reform.

With Congress eyeing billions of dollars in health care spending to prop up the nation’s crumbling economy, the economic stimulus package is shaping up as something of a precursor for health care reform.

So as lawmakers squabble over what will become the building blocks of comprehensive reform, Politico takes a look at the course ahead, with five guideposts to watch — crucial harbingers of where insiders see the health care reform debate headed.

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The economy

 Surely a key factor in nearly every congressional decision this year, the economy will also likely play an outsize role in health care reform. The bad news for reformers is that, no matter what it does, it could spawn trouble.

An improving economy would make it easier for congressional budget hawks, especially House Blue Dog Democrats, to cause mischief as their party leaders work to pass what are sure to be expensive reforms.

Likewise, if the economic tailspin continues even after an $800 billion-plus stimulus, President Barack Obama’s approval rating could plummet and sap him of political capital needed to pass tremendously complicated reforms.  

But with those challenges comes opportunity. If the economy remains in the tank, reformers could seize the high ground by successfully packaging health care reform as the next step in the nation’s economic recovery — a direction in which supporters have been moving recently. 

“If they can make that sell to the public, then that’s a sign they’re off to the races,” said a Democratic health care lobbyist. 

If the stimulus, which all parties seem to agree will pass soon in one form or another, is credited with putting the economy on the path to recovery, the new president will have plenty of firepower to take on his detractors.  

“This town runs on the presidential approval rating, and if halfway through his first year he’s credited with taking bold action to stabilize the economy, that’s going to transform their ability to get health care done,” said one health care industry insider. 

Turf war?

 In the Senate, health care reform must pass through a pair of critical committees, chaired by a couple of Democratic heavyweights: the Finance Committee, by Max Baucus of Montana; the Health, Education, Labor and Pensions Committee, by Edward M. Kennedy of Massachusetts. And observers have wondered for months whether the two will team up behind one bill or go it alone.

Those looking to slow reform are eager for the duo to introduce separate bills that create a turf war — a distraction that could encourage more competing proposals.

Not surprisingly, Kennedy made it clear last year that he would prefer a single bill backed by Obama, while Baucus has said he’s less concerned with procedure than with getting reform passed.

But aides in both camps have indicated they’re working together; some of the strongest evidence came last week, when the two chairmen sent a joint letter to the president “to affirm our continuing commitment to enacting comprehensive health care reform this year.”

The letter came after former Senate Majority Leader Tom Daschle (D-S.D.) withdrew as Obama’s nominee for secretary of Health and Human Services when his tax problems surfaced publicly.