The politics of diabetes

While the sequestration drama has again revealed partisan gamesmanship, legislators in Olympia have every bit the skill of operating with suspected “politics first” motives.

One case involves an issue that doesn’t pack the punch of a 20 percent pay cut. It could potentially touch 11.6 million, the number (PDF) of Americans the Centers for Disease Control and Prevention estimates has diabetes.

State Sen. Nathan Schlicher, D-Gig Harbor, was the chief sponsor of a bill, SB 5423, that would have three state agencies dealing with diabetes coordinate their efforts to report every two years to the governor how much diabetes is costing state agencies, the effectiveness of existing diabetes programs, a report of agency cooperation and ideas for legislative action to help with costs.

The bill had bipartisan support and was cosponsored by three other members of the Senate Health Care Committee, including Republican Chairwoman Randi Becker, R-Eatonville, and Sen. Barbara Bailey, R-Oak Harbor.

On Feb. 19 the bill had a hearing in front of the committee. Steward Perry, a Kentuckian volunteer with the American Diabetes Association, was there to discuss the impact of a similar bill in his state. He didn’t point to tangible changes, saying the first report had just been given to Kentucky’s Legislature.

The night before the Feb. 21 executive session, where members would have voted whether to send the bill to the Rules Committee, the bill was still on the agenda. By the time the meeting started it was gone. John Stang, writing for Crosscut, said Becker told him the agenda was crowded and some bill had to be removed. Schlicher noted later that the committee ended a half hour early.

And in the committee there was more than a crowded agenda as reasons given to kill the bill. The diabetes legislation got a full conversation, thanks to the bill’s sponsor a year ago, state Sen. Karen Keiser, D-Kent. Keiser made a rapid motion to send the bill to Rules with a “do pass” recommendation and was quickly seconded. That’s when the fun began.

RANDI BECKER
We will go to recess
KAREN KEISER
Madame Chair?
RANDI BECKER
We will go to recess.
KAREN KEISER
I do not, I do not, I object. We cannot go to recess when a motion is on the table.
RANDI BECKER
We’re going to recess. (pause) We’re going to recess.

The committee was away for awhile, then the TVW recording returns in the middle of a dispute over whether they were voting or going to have a roll call vote. Becker asked for those in favor and those not and the “Nays” were a committed bunch, much louder than the “Ayes.”

Becker then said the committee was adjourned, to which Keiser said adjourning is not appropriate. Becker said it was and then adjourned the committee for 26 seconds, coming back saying there is a disagreement over procedure.

Keiser and Schlicher both urged passage of the bill.

Bruce Dammeier, R-Puyallup, said he appreciated the sentiment around the bills’ impact on patients, but that at its heart it was a bill about state agency cooperation. “I believe that we owe our new governor a chance to have his agencies act on this,” he said. “The governor has talked a lot about lean management and about breaking down silos, I think that’s exactly what this bill purports to do, but I don’t think it is necessary to do it statutorily.”

Becker then said the bill was discussed a lot the night before “when we broke for caucus.”

For those not familiar with the Legislature, breaking for caucus means each party steps away from the floor to meet among themselves and discuss legislation and strategy. Typically that means Democrats meet among Democrats and Republicans meet among Republicans. In the state Senate it’s Democrats and the Majority Coalition, made up of Republicans and Democrats Tim Sheldon and Rodney Tom. Becker reiterated Dammeier’s point about agency silos and said passing legislation might actually put unnecessary restraints on the agencies.

Going to caucus, though, gets to Stang’s suspicions.

“Schlicher — who was appointed to his seat — faces his first election in November against Rep Jan Angel, R-Port Orchard. The rookie Schlicher has a sparse record of passed bills compared to the veteran Angel. Becker denied that the bill was killed for reasons related to the upcoming Schlicher-Angel race.“

That Schlicher was the sponsor of the bill could be interpreted as politics, too. Keiser sponsored it last year. Her bill would have established a public-private partnership to do much the same as Schlicher’s bill, and it would have expired in 2014. The bill made it out of the Senate Committee on Health & Long-Term Care and died in Ways & Means. Keiser said this year in committee that the problems that stalled last year’s bill were worked out.

Schlicher said the thought behind having him be the sponsor this year was to have a physician run some of the hurdles for what had been a non-controversial health care bill until Feb. 21. He cited his support for a Becker bill, ESB 5305, which requires hospitals to report when a patient is being treated for a stab or gunshot wound, whether the patient is conscious or not. Existing law only required the reporting when patients were unconscious. Schlicher said Democrats traditionally did not favor that requirement, but his status as a doctor helped persuade his caucus otherwise. The bill passed the Senate 49-0.

There is no proof or testimony yet that the diabetes bill was killed for political reasons. A House version of the bill, HB 1795, passed out of the Appropriations Subcommittee on Health & Human Services in an 8-1 vote the day after it died in the Senate. The House bill is in Rules on that side of the capitol, but it would need to go through the Senate again.

And Schlicher said the governor’s office has expressed support for the idea, so it may get the treatment Republicans in the state Senate are calling for.