The DC insider take on who's who in health care. In their profiles, most are long on "consensus," short on constituent and human need. Are these folks part of the problem? Can they be part of a single-payer solution? Most are Senate staffers, where Sen. Bernie Sanders (I-VT) has introduced a version of HR 676, S703, which also needs co-sponsors.
by Stephen Langel and Katie Kindelan, CongressNow Staff and Roll Call Staff; posted at Roll Call, March 31
While President Barack Obama has made reform of the nation's health care system one of his priorities, the real work tends to get done in the legislative trenches. The responsibility for reaching an elusive bipartisan deal will fall to a number of talented legislative staff in both chambers. Here are 10 Hill staffers who will play a crucial role in whatever health care legislation is enacted.
David Bowen, staff director for Senate Health, Education, Labor and Pensions Committee, majority staff
Age: 43
Birthplace: Summit, N.J.
Education: B.S., Brown University; Ph.D., neurobiology, University of California at San Francisco
Bowen serves as Sen. Edward Kennedy's (D-Mass.) "alter ego," taking an approach to developing policy that is based on deal-making and team building.
"I look to Sen. Kennedy as an example," Bowen said. "Throughout his Senate career, he has found his way around legislative obstacles once seen as insurmountable." And for many of those obstacles, Bowen added, he has found a way to turn "what others perceived as an obstacle into a path forward."
David Nexon, now the No. 2 at AdvaMed, the medical device trade association and Bowenís predecessor at the committee, agreed that Bowen takes such an approach. In following Kennedyís lead, Bowen goes into negotiations knowing that he needs to seek common ground in order to develop a lasting deal on policy, Nexon said. And the way to do that is to focus on broad goals rather than narrow policy differences.
Conservative health lobbyists agree. Bowen is "willing to listen to both sides and work to find common ground in order to promote good public policy," one lobbyist said.
Bowen also enjoys his work as a mentor to junior staff.
"The thing I'm most proud of is when former fellows, interns and other colleagues come up to me long after they have left the office and say that working here was the best professional experience of their career," he said. The desire to mentor comes from his own experience as a fellow in Kennedyís office, he added.
Chuck Clapton, health policy director for the HELP Committee's minority health policy office
Age: 40
Birthplace: Boston
Education: B.A., Boston College; J.D., Catholic University's Columbus School of Law
Clapton is the top health care staffer in the HELP minority office and works closely with the majority in finding health care compromises.
Clapton coordinates the health activities of the minority staff and assists his boss, Sen. Mike Enzi (R-Wyo.), in developing policy positions on health reform.
Clapton's cooperative approach follows the lead of his boss, who has a history of working closely with Kennedy and who believes in the 80/20 rule. That means negotiators first identify the 80 percent of a topic where there is agreement, and then try to find a compromise on the remaining 20 percent.
Like many other health care staffers, Clapton points to the Medicare Prescription Drug, Improvement and Modernization Act as his greatest accomplishment. Enacting the Medicare Modernization Act is "the most significant change to Medicare in a generation," he said, and demonstrates the potential to use a "competitive, market-based structure to deliver a high-quality health care benefit in a cost-effective way." (blog editor's note: You might remember that this legislation prohibits the Federal government from negotiating discounts with drug companies and was characterized by Former US Comptroller General David M. Walker as "...probably the most fiscally irresponsible piece of legislation since the 1960s... because we promise way more than we can afford to keep.")
Clapton is seen as a strong asset to the HELP minority because of his experience working in health care in both chambers, one insurance lobbyist said.
Debbie Curtis, chief of staff to Rep. Pete Stark (D-Calif.); professional staff, House Ways and Means Subcommittee on Health
Age: 42
Birthplace: Arlington, Va.
Education: B.A., Boston University
Curtis is quick to minimize the influential role she has played for more than a decade in setting health policy agenda on Capitol Hill.
"I am part of a talented team on the Ways and Means Committee working to pursue better health care policy," Curtis said. "We shine by the policy we accomplish."
Lobbyists say Curtis does not give herself enough credit for the many policy items she has shepherded through the House, from securing preventive benefits in Medicare to passing both the Children's Health and Medicare Protection Act of 2007 and the Patients' Bill of Rights.
"She's like a great player-manager in baseball," said a Democratic health care lobbyist. "She brings out the best in her boss and then can take the field and pitch a no-hitter."
Curtis says achieving health care reform will hinge on both securing a public health insurance option and the willingness of all stakeholders to approach the issue with an open mind.
"Success hinges on consensus and the ability to maintain the momentum President Obama has clearly given to health care reform," Curtis said. "It will be the difference in our ability to put together what is a very large bill in a time frame that is not very long."
Liz Fowler, senior counsel and chief health counsel to Senate Finance Chairman Max Baucus (D-Mont.)
Age: 42
Birthplace: Taipei, Taiwan
Education: B.A., University of Pennsylvania; Ph.D., Johns Hopkins School of Public Health; J.D., University of Minnesota
Fowler leads the Finance Democrats' health care team. She coordinates health care reform efforts and works closely with the staff of ranking member Chuck Grassley (R-Iowa), along with Senate and House leadership.
The role requires Fowler to be a troubleshooter. "It is my job to find that common ground and mend fences if they need to be mended," she said.
That skill was put to the test when Fowler helped pass the Medicare Modernization Act, which provided a prescription drug benefit for seniors and was one of the hallmark health care accomplishments of the Bush administration. (blog editor's note: see above under Clapton)
This effort was "personally and professionally, one of the most challenging times in my life," Fowler said, because the issues were so complex and Democrats found themselves left out of much of the Republican-led negotiations.
Fowler believes the biggest challenge this year will be "getting the numbers to work" by ensuring that the votes are there to pass health care reform.
Various health care lobbyists cited Fowler's work on the prescription drug benefit as an example of her skill in finding compromises.
Still, Fowler's willingness to work with Republicans and the Bush administration on the MMA could be a hindrance to future negotiations, said one Senate Democratic aide, who added that many Democrats felt that Baucus undercut Senate leadership by reaching a deal with the Bush administration.
"I think a lot of old-timers are going to remember the fights over the MMA," the staffer said.
Mark Hayes, health policy director and chief health counsel for the Senate Finance Committee Republican staff
Age: 42
Birthplace: Shelbina, Mo.
Education: B.S., pharmacy, University of Missouri-Kansas City; J.D., American University's Washington College of Law
Hayes is the lead health care adviser to Iowa Republican Sen. Chuck Grassley, the ranking member of the Finance Committee, and he prepares his boss for negotiations with Chairman Max Baucus (D-Mont.) on a number of issues, including the ongoing health care reform effort.
Hayes, who also serves as a resource for other Republican committee members, has so much authority that one former Senate Democratic aide referred to him as the "101st Senator."
In working to forge a deal on health care, Hayes says he tries to step back and look at the big picture, figuring out policy differences among members and a way to bridge the gaps between them.
Like his Democratic counterpart, Hayes counts passage of the prescription drug benefit as his greatest health care accomplishment.
He served as the principal Republican staff person responsible for moving the drug benefit through committee and into law, at a time when the GOP was in the majority.
In moving his bosses' agenda forward, Hayes uses his ability to explain complex issues in easy-to-understand language, a health insurance lobbyist said. His preparation is also an asset, said Dean Rosen, the former health care adviser to then-Majority Leader Bill Frist (R-Tenn.). (blog editor's note: the Hospital Corp. of America heir) "Almost no staff person comes to a debate more prepared than Mark Hayes," added Rosen, who now is a lobbyist at Mehlman Vogel Castagnetti (blog editor's note: a firm that carries more than $2.25 million in contracts with pharmaceutical and insurance corporations, according to OpenSecrets.org)
Kate Leone, senior health counsel to Senate Majority Leader Harry Reid (D-Nev.)
Age: 37
Birthplace: Princeton, N.J.
Education: B.A., Cornell University, American studies; J.D., Columbia University
While Leone may see herself as a troubleshooter -- watching for potential problems within the Democratic caucus -- her health care peers view her as a deal-maker.
Leone, said one health care activist, is "more of a realist than an activist" who's not interested at "tilting at windmills." This approach is necessary because part of her job is to balance the various interests of the Senate Democratic Conference.
A Senate Democratic aide agrees. "I think she is going to want to guide any health reform to whatever is best for the caucus, not for what's best for certain Members' legacies." (blog editor's note: And what about what's best for the American people?)
The aide added that one of Leone's greatest strengths is to know where the caucus is on any particular issue, where individual Members are and where she can lose a Senator or two without hurting the legislationís overall goal.
Leone says her greatest accomplishment in health care thus far is helping to pass a slew of bills in 2006, including shortfalls in funding for the State Children's Health Insurance Program and problems with the Medicare program -- issues that had been long stalled in Congress.
Liz Murray, senior policy adviser to House Majority Leader Steny Hoyer (D-Md.)
Age: 33
Birthplace: Rochester, N.Y.
Education: B.A., Yale University; M.P.P., Harvard University, Kennedy School of Government
Murray has spent her entire career focused on health care issues. And lobbyists say it shows, describing her as someone with unmatched expertise on the issues and an ability to bring people together to get things done.
"People in my job need to be willing to meet with everyone to bring as many viewpoints back to our bosses as possible," Murray said. "The most productive meetings are ones in which people are informed and can speak to their issue, as a lobbyist but also from the perspective of an everyday American." (blog editor's note: What would she hear about health care if she listened to everyday Americans directly? Even when you call it something scary like "socialized medicine," most Americans support single payer!)
In her 10 years on Capitol Hill, Murray points to President Barack Obama's signing this year of the State Children's Health Insurance Program bill as her proudest achievement to date.
She sees today's health care debate as the greatest opportunity so far for real reform because the public is finally ready for more certainty and affordability in their health care services, and an inspirational president who has made the issue a priority.
"This debate is going to have so many varied interests," said a health care lobbyist who is following the debate closely. "Liz will be the one to build consensus." (blog editor's note: This begs a serious question: consensus among whom? Constitutents? Most Americans back a single payer system. And a majority of one of the most important class of stakeholders--health care professionals--do as well. It's sad to hear the phrase "varied interests" and immediately decode it as "not us".)
Karen Nelson, deputy committee staff director for health for the House Energy and Commerce Committee
Birthplace: Elgin, Ill.
Education: B.A., Cornell University, graduate work at Harvard University
Nelson brings more than 30 years of health care and legislative experience to her role as the top health care staffer on the House Energy and Commerce Committee, including 18 years with Chairman Henry Waxman (D-Calif.).
Lobbyists say it shows in her ability to harness a talented staff and execute her bossís legislative priorities.
"Karen is the heart and soul of the health team," said Rich Tarplin, a Democratic lobbyist and former Clinton health care administration official. "She applies strong policy expertise with strategic ability and strong management skills to get things done."
Nelson has had a hand in almost every piece of major health care legislation to pass through the chamber in the past three decades, from holding the earliest hearings on the AIDS epidemic to developing a food labeling system and securing the Hatch-Waxman provisions that brought generic drugs to market in the 1980s.
"It helps to work for a Member who's both very dedicated to the issues and a skilled legislator," Nelson said. "That, and having a talented and able staff who can define solutions to problems and move legislation forward."
Nelson says high on the agenda for the committee this year is securing a health care reform bill that will meet the goals laid out by the president and largely shared by the Caucus and members of the committee.
"Our job is to find consensus around the goals of quality, affordable coverage for all Americans," she said, "and move that legislation forward."
Bill Pewen, senior health policy adviser to Sen. Olympia Snowe (R-Maine)
Age: 52
Birthplace: Pasadena, Calif.
Education: B.S., health education, Southern Oregon State University; M.P.H., epidemiology, University of Pittsburgh; Ph.D., infectious diseases and microbiology, University of Pittsburgh
During a time of closely divided government, moderates in both parties are in high demand. Snowe is one of the leading Republican moderates, and Pewen is the leader of her health care shop.
Pewen says he likes the role Snowe plays. "I appreciate representing a Member who has worked to bridge divides and build consensus, as that is critical to making reform sustainable over the long term."
Snowe's unique position as a key vote to help Democrats reach the magic filibuster-proof 60 votes puts Pewen in demand and makes for an intense schedule. "He definitely has his hand in nearly everything," one Senate Democratic aide said. "He is the only person I know who carries two BlackBerrys."
Pewen's role was apparent in the fight over health information technology, where the results of his central role in ensuring more stringent privacy protections for electronic medical records were included in the economic stimulus package.
Specifically, Pewen made certain that the bill included a provision requiring that certain unintentional disclosures of patient medical data be considered breaches and thus subject to penalties.
Wendell Primus, senior policy adviser for budget and health to Speaker Nancy Pelosi (D-Calif.)
Age: 62
Birthplace: Eldora, Iowa
Education: B.A., Ph.D., economics, Iowa State University
Primus encompasses the mind of a policy wonk with the political skills acquired through a 30-year career on Capitol Hill. Now, as the Speaker's right-hand man on one of the top issues before Congress, lobbyists say Primus has hit his career stride.
"Throughout his career, this is the job where Iíve seen him be the most impressive," said a longtime health care lobbyist.
Primus began his legislative career on the House Ways and Means Committee, working on issues from income security and welfare reform to Medicare.
He began working for Pelosi four years ago, and today he oversees the complex task of moving legislation from the committee table to the president's desk.
"My role is to advise the Speaker on health care reform and manage legislation at the staff level," Primus said. "Itís making sure that all the bases are touched, from policy development and cost estimates to the press and various stakeholders."
Primus will no doubt play a leading role in crafting legislation aimed at achieving the ambitious overhaul of the current health care system both the Speaker and the president have called for.
"It is a tremendous challenge and opportunity all wrapped into one," he said. "This, how we get health care costs under control, should be a bipartisan issue."
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