The Importance of Health to Health Care Reform

“I am healthy and ready to go after health care reform.” That is how Henry Waxman, chairman of the House Energy & Commerce Committee and the prime mover of health care legislation in the House, answered the first question posed to him by Atlantic Media’s Political Director Ron Brownstein during a book-signing event hosted by the National Journal July 8. The question—“How is your health?”—was timely, after Waxman was hospitalized in California after fainting while at work in his district office.

Waxman certainly looked, as Brownstein put it, “tan, rested and ready” back in Washington, and there is no reason to doubt that he will indeed drive the reform debate through to completion. (We’ve written a lot more about what Waxman’s said that will entail, including his declaration that PhRMA’s deal with the Finance Committee doesn’t apply to him, and look for more in The RPM Report next week.)

Still, Waxman’s fainting spell is only the latest reminder of the role that the health of several key legislators has already played in the health care reform debate.

The prime example, of course, is the absence of Sen. Edward Kennedy (D-Mass.) from the day-to-day work on health care while undergoing treatment for brain cancer. It will never be possible to say for sure how Kennedy’s absence will end up changing what does or does not happen in the final legislation, but 18 months ago it would have been inconceivable that major health care expansion would happen without Kennedy playing a central role in cutting the final deals. He will not play that role in 2009.

Another senior Democrat, California Rep. Pete Stark was hospitalized with pneumonia earlier this year, forcing him to participate via telephone in the White House’s summit on health care in March. He joked then that his first-hand experience with the health care system would help shape his legislation. Stark is back on the job, but, for someone who has been one of the loudest voices in health policy on Capitol Hill for more than two decades, he has been surprisingly quiet thus far.

There are other cases where health issues have already shaped the reform debate. Indeed, Waxman’s central role was secured only after he launched a successful campaign to unseat Michigan Democrat John Dingell as chair of the Energy & Commerce Committee; Dingell’s perceived frailty was in issue in that fight.

A similar dynamic contributed to the departure of West Virginia’s Robert Byrd as chair of the Senate Appropriations Committee at the start of the year. That change makes it more feasible for the Democratic leadership in the Senate to hold the threat of using the budget reconciliation process to ram a bill through without fear of a filibuster. (Read more here.)

While that threat may prove to be a bluff, it does underscore the importance of every single vote in the Senate, and many reform advocates are already fretting about the challenge of ensuring that both Kennedy and Byrd can be present in the Senate chamber when the key votes are cast.

With 535 members and an average age of 57, its not surprising that there are health care emergencies in the House and Senate. Getting sick, after all, is a fact of life—the hard reality that makes health care reform such a potent political issue.

Still, the health issues of prominent Democratic leaders underscores the sense that the current debate may be their last chance to deliver legislation on an issue many of them have worked on for 30 years or more.

In Waxman’s case, there are other reminders. During the National Journal event, he twice cited former House Health Subcommittee Chair Paul Rogers as one of his heroes and mentors. Waxman was one of hundreds to attend Rogers’ funeral at the Washington National Cathedral last October.

We’re betting it didn’t take a fainting spell to remind Waxman that his time to shape health reform is limited.