Senator Edward M. Kennedy's office has begun convening a series of meetings involving a wide array of healthcare specialists to begin laying the groundwork for a new attempt to provide universal healthcare, according to participants.
The discussions signal that Kennedy, who instructed aides to begin holding the meetings while he is in Massachusetts undergoing treatment for brain cancer, intends to work vigorously to build bipartisan support for a major healthcare initiative when he returns to Washington in the fall.
Those involved in the discussions said Kennedy believes it is extremely important to move as quickly as possible on overhauling the healthcare system after the next president takes office in January in order to capitalize on the momentum behind a new administration.
Kennedy was an early endorser of Senator Barack Obama, the presumptive Democratic presidential nominee who is also a member of the Committee on Health, Education, Labor and Pensions, which Kennedy chairs.
Obama's Senate staff has attended the roundtable discussions. If Obama is elected, Kennedy's effort to identify points of agreement among senators could smooth the way for the new administration to press ahead on universal healthcare, which Obama has promised to implement within four years.
The last time a national healthcare plan was attempted, under President Clinton in 1993, the presidential panel charged with devising a proposal was widely criticized for not consulting enough with Congress, and protracted disagreements erupted, delaying its progress for months and ultimately resulting in its demise. Kennedy's effort appears to be designed to identify areas of common ground between Democrats and Republicans, business and labor, providers and insurers, and others before the new president takes office.
"The senator is trying to learn from health reform attempts in the past and to build a fair amount of consensus among his Senate colleagues, House colleagues, and the Obama campaign . . . and find a strategy that could carry with some momentum into the new administration," said Dr. Jay Himmelstein, a health policy specialist at University of Massachusetts Medical School and a former Kennedy staff member who has been involved in the talks.
The initiative also suggests that Kennedy, who has made healthcare his signature issue in his 45-year Senate career and who is fighting an aggressive brain tumor, is considering his legacy as a new administration arrives in Washington - a moment many see as the best chance for widespread changes in the healthcare system in 15 years.
"You have got to think this will be the Ted Kennedy Health Reform Act, because he's a beloved figure and he's championed the issue for so long," said John Rother, policy director for the AARP, which has been involved in the discussions. "There are a lot of unknowns right now, but what we do know obviously is he is very close to Obama, and he also has quite a network of health policy experts that he can draw from."
Melissa Wagoner, spokeswoman for Kennedy, added that "Making sure each American has access to quality, affordable healthcare is the cause of Senator Kennedy's life."
Kennedy played a critical role in helping Massachusetts create a healthcare overhaul proposal in 2006 by aiding the state in obtaining the federal money needed to subsidize it. It appears he is now looking to Massachusetts to help shape the debate in Washington. Earlier this year, Kennedy recruited John McDonough, executive director of Health Care For All in Boston and a major player in the Massachusetts healthcare overhaul debate, to lead the new health initiative.
Aides to Kennedy have also assembled a network of Massachusetts advisers, including healthcare lawyers, economists, nonprofit leaders, doctors, and health insurers who may be asked to work on specific aspects of a national plan. At a recent meeting in Boston, the group discussed how different elements of the Massachusetts approach might work on a national level.
Rob Restuccia, executive director of the national healthcare advocacy group Community Catalyst and one of those who attended, said the group considered questions such as whether the Massachusetts Health Connector, the quasi-public entity that helps uninsured people obtain coverage, might be structured on a national level.
"I believe we will have a great story to tell about how national health reform can learn from what we've done in Massachusetts," said Jarrett Barrios, president of the Blue Cross Blue Shield of Massachusetts Foundation, who also attended one of the meetings.
Kennedy is not alone in trying to get a head start on the healthcare debate. Senator Max Baucus, a Democrat from Montana and chairman of the Senate Finance Committee, held a healthcare summit in mid-June, and a bipartisan proposal to make private insurance accessible to all Americans has been put forward by Senator Ron Wyden, a Democrat from Oregon, and Robert Bennett, a Republican from Utah.
Intraparty disputes were one reason Clinton's 1993 proposal foundered. Back then, Daniel Patrick Moynihan, the Democratic chairman of the Senate Finance Committee, dismissed the financing of Clinton's plan as "fantasy" just before the president presented it to Congress.
Ron Pollack, executive director of Families USA, a healthcare consumer advocacy group, said Kennedy was trying to avoid division by having senior staff members meet with their counterparts on Baucus's committee.
"If the two committees are working cooperatively together and developing a common legislative proposal, it means that the process is less likely to get bogged down because of jurisdictional and substantive differences," he said.
Even though health costs have soared along with the number of uninsured over the past 15 years, the defeat of the Clinton health overhaul plan was so politically devastating to the administration and to efforts to enact universal health insurance law that nothing approaching such a large-scale effort has been tried since. One purpose of the roundtable discussions, participants said, is to educate Senate staff on broad issues that have not been seriously debated in years.
Kennedy's committee has held two meetings so far - one with healthcare coalitions, the other with physicians' groups. Eight more will be held by the end of the month. The meetings are attended by aides for committee members of both parties, said Craig Orfield, a spokesman for Senator Mike Enzi of Wyoming, the ranking Republican on the committee.
Whether the two parties and myriad interest groups can overcome their differences over the next year remains to be seen, but several of those participating in the discussions expressed optimism about that possibility.
"There's been talk about the healthcare crisis for years, but I think in the last year and a half, the system is failing so many people and becoming so costly, that I don't think there's anybody who doesn't understand there's got to be fundamental changes to the system," Orfield said.