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Nancy Pelosi: Healthcare Reform Leader, Lightning Rod

 |  By jcantlupe@healthleadersmedia.com  
   December 02, 2010

 "I knew this fight was important…Working together, we proved the cynics wrong."

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is Nancy Pelosi's story.

She's 70 years old, wears impeccable Armani suits and white pearls, is a grandmother of six, and steered healthcare legislation that she says was as momentous as the passage of Social Security or Medicare. And when healthcare reform was finally adopted, House Speaker Nancy Pelosi got a call from the President of the United States, who said he was more overjoyed about that legislative victory than when he won the nation's highest office.

In effect, Pelosi told Barack Obama: Don't be silly.

"After the final votes were cast, I received a call from President Obama, who told me he was happier at that moment than the night he was elected," Pelosi tells HealthLeaders Media. "My response: I was happy as well, but not as happy as when the President won the election. Because without that election, we wouldn't have made it this far."

If history books say that healthcare reform came about under President Obama's watch, it certainly came about in great measure because of Pelosi, for better or worse.

The longtime San Francisco Democrat became an unbridled force, pressuring yet sweet-talking her way toward making healthcare reform a reality.

She is often a lightening rod for criticism from opponents because of her mostly assertive and sharp-edged liberal style, making her one of the most disliked of politicians who oppose her. But her supporters say she has an uncanny ability of marshalling the forces within her party; and that she did, to get passage of healthcare reform. While others historically have failed dramatically over the years in trying to piece together a comprehensive healthcare package, Pelosi was a key driver of the administration's plan, and even though its passage was not inevitable, and despite the disappearance of some prized elements during the unwieldy debate process, it reached a destination.

"There were several months when naysayers said we should give up and claim that health reform was dead," Pelosi said. "But I knew this fight was important; I never stopped believing we could get this done and I recognized that it would require every ounce of effort, commitment, hard work, and cooperation to reach our goal. Working together, we proved the cynics wrong."

In the months since the enactment of the legislation, Pelosi says she is pleased how it has moved forward. "Health reform has evolved in a way that benefits all Americans," she says. "Through the legislation we created a Patients' Bill of Rights—correcting some of the worst anti-consumer practices of the insurance industry," Pelosi says.  She ticks off the impact: Insurers can no longer deny coverage to children with pre-existing conditions, no longer drop someone's coverage when they get sick; young adults can stay on their parents' insurance until age 26; senior citizens are getting checks to help close the Medicare prescription "doughnut hole."

As Pelosi moves forward, once again a target of conservatives, and with the Democrats' continued hold of the House uncertain, healthcare reform has become a major refrain for whatever song she is singing about her accomplishments. The impact of its legislative journey is certain to spill over on any political races for some time to come.

As a representative of one of the most liberal districts in the country for more than 20 years, Pelosi is the first woman to be Speaker of the House, third in line to the presidency. The daughter of a Baltimore mayor and congressman, Pelosi, however, often describes herself in terms of being a mother of five and grandmother of six. In talking about being a grandmother, she once told 60 Minutes: "It's great. It's fabulous. It was my goal in life and now I've achieved it."

Politically, through February and March while Washington was besieged by blizzards, the Californian had her finest hours. She moved healthcare reform legislation through twists and turns, trying to get votes, displeasing the Republicans. As the volume of criticism against her increased, she intensified her focus.

"Without question, the most significant moment of the debate came at the end: passage of health insurance reform," she says.

Before the Obama administration, history hadn't been kind to passage of any kind of healthcare reform. The effort eluded President Bill Clinton and longtime Sen. Ted Kennedy, among others. Even when Obama seemed to be retreating, Pelosi kept pushing.

When top House Democrats considered giving up, Pelosi was quoted in terms that almost sounded like Winston Churchill during World War II. "We will go through the gate. If the gate is closed, we will go over the fence," Pelosi said. "If the fence is too high, we will pole vault in. If that doesn't work, we will parachute in. But we are going to get healthcare reform passed for the American people."

Vice President Joseph Biden declared Pelosi more powerful and successful than Obama or himself in terms of the healthcare reform. At one point during a campaign event in Philadelphia, Biden took issue with comments by Rep. Allyson Schwartz, D-PA, who referred to Pelosi as "the most powerful woman in American politics."

"I would rephrase that: the most powerful person in American politics," Biden said. "The single most successful, the single most persuasive, the single most strategic leader I have ever worked with is Nancy Pelosi." The vice president dubbed Pelosi the "mother of healthcare."

Despite such praise, even some Democrats avoided her; but she has continued to raise millions of dollars for Democratic incumbents. Pelosi says she's unfazed by GOP attacks that focus on her and healthcare reform.

"This is the Republican Party's agenda—and the American people will not stand by and allow Republican leaders to return us to the failed policies that left too many uninsured and too many without access to the care and treatment they need to lead healthy lives," she stated to HealthLeaders Media before the mid-term elections.

As Republicans began to make inroads this fall, Pelosi refused to discuss her future, or the state of the Democratic Party, but said, "health insurance reform moved America to a new direction." She added, "America is better off because of our work."

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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