Another Republican for Reform: Bush Medicare Chief Likes Baucus Bill

Add another name to the parade of high-profile Republicans who have endorsed efforts by President Obama and congressional Democrats to achieve health reform. The latest is Thomas Scully, who ran the Centers for Medicare and Medicaid Services (CMS) during former president George W. Bush's first term.

"Health reform in general is way overdue and we ought to do it," Scully told me in an interview. He supports the approach taken by the Senate Finance Committee, chaired by Montana Democrat Max Baucus. If the bill produced by that committee became law, Scully said, "the world would be a better place."

Scully follows another Republican CMS chief, Mark McClellan, in endorsing Obama's drive to expand coverage and curb rising costs. Other prominent Republicans coming out for the Baucus bill or reform in principle include former Senate Republican leaders Bob Dole, Howard Baker and Bill Frist; California Gov. Arnold Schwarzenegger, and former health and human services secretaries Tommy Thompson and Louis Sullivan. New York City Mayor Michael Bloomberg, a Republican turned independent, also is a supporter.

Scully said he's "very supportive" of the Baucus bill becoming law, but wondered, "Is the political process going to allow that to happen?" He said he is concerned the bill will be pushed to the left on the Senate floor and in conference committee negotiations with the House. And the final compromise, he said, "will be impossible to stop."

The Baucus bill is expected to attract between zero and one Republican when it comes up for a vote, expected on Tuesday. "Some Republicans are going to oppose it for purely political reasons," Scully acknowledged. But he said others have substantive reasons -- "they're worried about where it goes from here. If they thought the Baucus bill was the final product, they could probably live with it."

Scully opposes the creation of a new government-run insurance plan to compete with private policies. In a perfect world, he'd like to see Congress first pass insurance reforms, such as a ban on denying coverage to people with pre-existing conditions, and phase in a requirement that almost all Americans buy insurance. He's got his own ideas on financing expanded coverage (he'd like to see limits on how much can be deducted for expensive insurance plans) and he wishes the whole project were not happening at a time of such high deficits.

All that said, Scully added, "I am a fan of health reform. I think we ought to do it. And I think Senator Baucus's bill is a pretty reasonable package."

I asked Scully if the GOP is risking a "party of no" label with its near-solid opposition to reform bills on the table. "I'm out of politics. I don't worry about my party," he said. "I hope it happens. And I hope it's reasonable."