With the Congressional debate over health care reaching a crescendo, I find myself particularly baffled by the behavior of two influential Senators. Why, I wonder, would Sen. Max Baucus, a Democrat from Montana, and Sen. Charles Grassley, a Republican from Iowa, oppose a public health insurance option that could compete with private insurers? Baucus, after all, has worked closely on health-care reform with Senator Edward Kennedy, a stout supporter of a public option. And Grassley, who has taken the lead in investigating doctors on the take from pharmaceutical and medical device companies, must surely understand the corrosive influence of the for-profit motive in health care.

Grassley says he opposes a public plan for fear it would eventually put private insurance plans out of business, according to an excellent overview of the debate in The New York Review of Books. But isn’t that the idea? Are we not the only developed country in the western hemisphere that permits for-profit health insurance? Why should Grassley and Baucus care so much about the fate of for-profit medicine?

Here’s one reason why: both Senators have received tons of money from PACs and individuals representing the health-care industry in recent years. Indeed, the two or three top industries contributing to Grassley and Baucus’s campaign chests from 2003 to 2008 are, you guessed it, insurance companies and health professionals. According to the Center for Responsive Politics, health professionals donated $812,077 to Grassley between 2003 and 2008, while insurance companies gave him a total of $643,643. Similarly, health professionals contributed $851,141 to Max Baucus over the same period of time, while insurance companies gave him $784,185. (Pharmaceutical companies, who are similarly opposed to a public health option because it will eat into their profits) also contributed $852,813 to Baucus’ war chest during the same years).

And if you look at the top individual donors to these Senators, you see the same pattern: on both Grassley and Baucus’s top 20 list, you will find the American Hospital Association, the American Health Care Association (which represents nursing homes), a number of health insurers, such as Blue Cross/Blue Shield and Aetna, and several organizations representing medical professionals. As I noted in a previous blog, many doctors don’t want a public health option because it will eat into their profits, since Medicare and Medicaid tend to reimburse doctors (and pharmaceutical companies) at lower rates than private insurers do.

Now you can view this as just one more sad illustration of the power that moneyed interests have over our Congressional leaders. But if I were a voter in Montana or Iowa worried about paying my medical bills, I might want to pick up the phone and ask Senator Baucus or Grassley just who exactly they are representing: me or corporate America?

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