(Updated with Video from FamiliesUSA. You can sign their petition in support of SCHIP here. – promoted by Brian Leubitz)

Arnold Schwarzenegger has been fairly good on SCHIP issues. A little slow, but fairly good. Back in August, he wrote a letter with Governor Eliot Spitzer (D-NY) opposing limiting rule changes in SCHIP. While the letter (PDF) stops short of supporting the program passed by Congress (it hadn’t been passed at the time), he has shown support on several occasions in the past.

Well, now the president has vetoed SCHIP. It didn’t take the president very long, I suppose he really, really fears creating any “middle class entitlements”.  So, it is no longer enough to simply enough to merely voice his support for SCHIP, and to decry a potential veto. I know, I know, time is tight with your upcoming vacation to China, but can’t you squeeze some time in for the kids? The time is now, he must actively lobby to garner the final 16 votes needed in the house to override this veto. In fact, there are enough votes in California alone to override. 18 California Republicans voted against the bill, so there’s a place to start. The only GOP holdout, Mary Bono, is praying that the SCHIP vote masks the rest of her reactionary voting record.

While Arnold seems to have lost some of his patina of being outside of the system for California Republicans, he still holds some allure outside of the state. So, even if he isn’t successful with 16 of the CA’s Republican Congressmen, he should be working on those from other states. Use some of that “post-partisan” rock stardom for the good of the nation, you know?  Leaders from groups around the state and the nation are looking to Arnold to lead on this issue. The AARP was particularly vocal on pressuring Arnold. And FamiliesUSA, who supported this video, is working overtime to pressure any and all votes in support of SCHIP. Arnold should be as well. Once again, it is Arnold who must decide if his legacy will be that of just another Republican to katybar the doors to progress, or of a leader who reaches across lines and uses his political capital for the good of the state, and the nation.

This is more of a national story, but considering the importance of the health care debate in California, I think this is a significant development.

WASHINGTON, April 16 – AARP, the lobby for older Americans, announced Monday that it would become a major participant in the nation’s health insurance market, offering a health maintenance organization to Medicare recipients and several other products to people 50 to 64 years old.

The products for people under 65 include a managed care plan, known as a preferred provider organization, and a high-deductible insurance policy that could be used with a health savings account.

When the new coverage becomes available next year, AARP will be the largest provider of private insurance to Medicare recipients. In addition to the new H.M.O., AARP will continue providing prescription drug coverage and policies to supplement Medicare, known as Medigap coverage.

William D. Novelli, the chief executive of AARP, said, “In launching these initiatives, we are driven by our mission to create a healthier America.”

This is the equivalent of the Sierra Club buying an oil company.

I suppose it’s to be expected that the AARP, a major power broker with a keen interest in seeing responsible health care legislation coming out of Congress, would step into the breach with the failure to pass that legislation.  But once you put this interest group into the insurance industry, it’s going to be phenomenally hard, next to impossible, for them to be a part of any health care solution that marginalizes or removes the insurance industry.

Pete Stark preferred to look on the bright side:

Representative Pete Stark, Democrat of California and chairman of the House Ways and Means subcommittee on health, welcomed AARP executives to the Medicare managed care market. “If they provide quality care at a fair price,” Mr. Stark said in an interview, “they could be a wonderful addition.”

But Judith A. Stein, director of the Center for Medicare Advocacy, a nonprofit group that counsels people on Medicare, said, “The new arrangements with insurance companies create a tremendous number of potential conflicts for AARP, which is a powerhouse, perceived as the most important voice for older people.” […]

“AARP will not be perceived as a truly independent advocate on Medicare if it’s making hefty profits by selling insurance products that provide Medicare coverage,” Ms. Stein said. “AARP’s role in this market could give a big boost to the privatization of Medicare.”

The conflicts of interest here are enormous.  The insurance industry has a definitive interest in their own survival.  Yet we know that a for-profit manager of health care is always going to be more concerned with profit than caring for patients.  In fact, the AARP tipped their hand within the article, saying that they would not be able to deny coverage to everyone between the ages of 50 and 64 (that should read “We won’t cover really sick people”).  Kevin Drum writes:

One of the great arguments among universal healthcare advocates is whether to press for a system that continues to make use of private insurance companies or to press for a purer single-payer system that gets rid of insurance companies altogether. The argument for working with the insurance industry is a political one: if we try to eliminate a role for insurance companies they’ll fight us tooth and nail, and that’s the last thing we need. Universal healthcare has enough powerful enemies as it is. The argument for pure single-payer is mostly (though not exclusively) economic: in our current system, healthcare administration uses up about 30% of all healthcare dollars, compared to 10% or less in countries with national systems […]

I think they’ll fight national healthcare just as hard no matter what the plan is, because the private health insurance industry is so big that even a reduced role means an enormous loss of revenue for them. What’s more, I think they’ll also judge (correctly) that even a reduced role is just the camel’s nose under the tent that will eventually lead to the end of private insurance entirely.

So trying to make nice with the insurance industry is a mug’s game. They just aren’t ever going to be on our side, and frankly, I don’t blame them. All that said, however, the fight against the entrenched interests of the insurance industry gets a lot harder when an organization that might have provided significant lobbying muscle for a single-payer system is depending on a private insurance business line for a big chunk of its revenue. It’s definitely not pleasant news for the good guys.

Obviously, the AARP as an entity cannot be stopped from forming a corporation and making a profit.  And generally they’ve been good on health care.  But you can’t very well act to change the system when you’re part of the system.  Also, because they’re such a political force, lawmakers are going to be a little more wary of shutting down the HMO of such a big benefactor.