Today's Senate debate on HR 3590

Though today's vote on the 2074-page Patient Protection and Affordability Act is not a vote on the bill itself but on whether to open debate on the bill, the debate that takes place will be about the content of the bill. (Got that?) From Noam N. Levey of the LA Times:

Republican lawmakers have kept up a steady effort to make it more difficult for conservative Democrats to vote to open debate, casting the parliamentary move as a referendum on the healthcare bill itself.

This "vote is something we need to look at as a vote that's not some sort of . . . a procedural vote," Sen. Judd Gregg (R-N.H.) said on the Senate floor Friday. "It's a substantive vote on whether or not we're going to fundamentally change the way healthcare is delivered in this country."

But Nelson firmly rejected that characterization.

"It is only to begin debate and an opportunity to make improvements," he said in a statement Friday. "If you don't like a bill, why block your own opportunity to amend it? . . . I won't slam the doors of the Senate in the face of Nebraskans now. They want the healthcare system fixed. The Senate owes them a full and open debate to try to do so."

The Hill has a preview of today's debate. According to this report, Sen. Tom Coburn has dropped his threat to have the bill read aloud on the floor because the Dem's have generously agreed to allow a day and a half's debate on the bill (which just happens to be the amount of time that it would take to read it0.

Another Republican senator said Coburn was satisfied by Democrats’ willingness to give the GOP Friday and most of Saturday to examine the legislation and air their concerns during floor speeches.

The AP report puts it slightly differently:

WASHINGTON (AP) - Republican Senator Tom Coburn is backing off his threat to require that the Senate read the 2,074-page health care bill because some GOP colleagues aren't supporting the effort.

The Oklahoma lawmaker said there's uncertainty about whether reading the bill during Thanksgiving week would be productive. He also said that if the Republicans do decide to tie up the Senate for the dozens of hours it would take, six GOP colleagues have committed to pitching in on reading duty.

Coburn also said in an interview with The Associated Press that he questions whether Americans who might be listening in would understand a line-by-line reading.

I'm sure vast portions of it would be incomprehensible to most Americans, myself included, but that would make its own point: that something this enormous and complex needs to be analyzed and explicated over a period of weeks and months rather than days or hours.

But at least the two parties have found something they can agree on: they don't want work to cut into their Thanksgiving vacation:

The bipartisan agreement to wrap up the preliminary floor procedures by Saturday means that lawmakers can catch flights back to their home states later in the day or the following morning.

See The Hill story for the various arguments expected to be used by the GOP against this insanity. Excerpts:

Republicans will criticize the bill for cutting Medicare, adding to the federal deficit and raising taxes on the middle class.

Sen. Chuck Grassley (Iowa), senior Republican on the Senate Finance Committee, plans to highlight findings from the Joint Committee on Taxation showing that in the year 2019, 77 percent of the tax increases in the Finance Committee healthcare reform bill would be borne by middle-class taxpayers. [. . .]

Sen. Judd Gregg (N.H.), senior Republican on the Senate Budget Committee, will emphasize an analysis from his staff showing that once fully implemented the true cost of the healthcare bill will amount to $2.5 trillion. He argues the bill is “front-loaded” with tax hikes and spending cuts in the first few years and that most new spending provisions go into effect after 2014, minimizing the cost over the 2010-2019 period analyzed by the Congressional Budget Office (CBO).

The Hill sees the new mammogram guidelines as a potential "wild card" in the debate and senators are already trying to use them to their advantage. Republicans will try to brand the recommendations as the work of death panels and Dem's will call them alarmists and liars.

It's true that rationing will be an unavoidable reality under a government-controlled medical system. And there will be less flexibility and less recourse for patients who want or need to deviate from standards necessarily established by panels for tests, treatments, and drugs. So though I don't see the new recommendations as a conspiracy against women, there is some truth buried in the "death panel" charges; under nationalized healthcare there will be rationing, panels, guidelines, and government-made decisions over who gets what kind of care and who doesn't. And if the government doesn't want you to get a mammogram until age fifty, that will be what happens.

But take heart: If Harry Reid has anything to say about it, there will be continuous mammography for all. He is opposed to breast cancer and the meanies who want to deprive us of as many mammograms as our little hearts desire:

"It is so outrageous the word we have gotten recently on mammograms," said Senate Majority Leader Harry Reid in a press conference on health reform. "Women should be able to go get a mammogram and not have to wait until they are 50 years old."

And he's basing this on his intense scrutiny of the studies that led to the revised recommendation, right? Therein lies one of the problems with government-run healthcare. Decisions that should be made by doctors and patients are interfered with by politicians and bureaucrats.

Reid is "quietly confident" that he has 60 votes and hopes for some GOP defections:

Reid is holding out hope that he can persuade one or two Republicans to support the bill.

“I have had conversations during the past few days, past vew weeks with Sen. Snowe. I’ve spoken to Sen. Collins,” Reid said Thursday in reference to Republican Maine Sens. Olympia Snowe and Susan Collins. “We reach out to our Republican colleagues, and would like to work with them, but everyone should understand: We’re going to do a bill.”

Olympia Snowe has apparently decided not to take any calls from history this time around:

Snowe, however, has told colleagues that she will vote Saturday evening against the motion to begin debate on the healthcare bill.

And Collins spoke out against the bill in a floor speech late Friday afternoon.

“We hope that we don’t have to do it with Democrats, but if we have to, we will,” Reid said Thursday.

Mitch McConnell calls them irresponsible:

Senate Republican Leader Mitch McConnell (R-Ky.) said the Senate should focus on other must-pass bills.

“Why are we trying to do this -- pass this 2,000-page bill that, as several senators have indicated, the American people oppose -- when we ought to be addressing the matters that are clearly needed and urgent?” McConnell said.

“Look at the items out there for the rest of the year. The provisions of the Patriot Act are expiring. We haven't finished the appropriation bills. The majority wants to extend the debt ceiling,” he added.

Healthcare reform isn't the top priority of the people, either:

Deficit reduction has remained number one for voters ever since President Obama listed his four top budget priorities in a speech to Congress in February. Forty-two percent (42%) say cutting the deficit in half by the end of the president's first term is most important, followed by 24% who say health care reform should be the top priority.

See your government in action on C-SPAN beginning at 9:45 ET.

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