House Speaker Nancy Pelosi tours Seattle's Swedish after health-care vote

Just two days after shepherding a landmark health-care bill through the U.S. House, Speaker Nancy Pelosi visited Seattle on Monday to see how one hospital is already delivering care in much the same way as the bill encourages.

In her first public appearance since the House vote Saturday, the California Democrat toured Swedish Medical Center flanked by two of her Democratic colleagues, Reps. Jim McDermott of Seattle and Jay Inslee of Bainbridge Island.

Swedish, the area's largest health-care system, has won notice for many quality innovations. Earlier this year, it opened a new primary-care clinic in Ballard that is the nation's first created from scratch to follow the "medical home" model. At the clinic, caregivers coordinate patient care relying on scientifically proven therapies — a type of health-care system that Congress is trying to promote.

Pelosi, McDermott and Inslee briefly toured Swedish's sixth-floor intensive-care unit before holding a news conference to tout the House health-care bill. The visit was arranged by McDermott's office and was finalized only late Sunday.

The House bill, which would cost $1.1 trillion over 10 years and extend insurance coverage to 36 million uninsured Americans, passed on a narrow 220-215 vote. An alternate bill faces tough odds in the Senate.

During Monday's visit, Pelosi defended the inclusion of an amendment to the House bill that would ban abortion coverage in any government-run insurance plan and certain private plans that accept government subsidies. She said it was tough to unite 220 members of Congress on a bill that was acceptable to each while extending coverage to almost all Americans.

All but one member of the state's Democratic delegation voted for the bill. The lone exception was Rep. Brian Baird of Vancouver.

Baird, one of 39 House Democrats to cross party lines, has said he voted no because of lingering concerns about how the bill would affect premiums for people who already have coverage.

Economists and budget analysts have said that expanding the nation's pool of insured people would help keep premiums lower than they would be without the changes. However, the Congressional Budget Office had not completed its analysis of the issue, Baird has said.

He also objected to the strict limit placed on amendments allowed to the bill.

Washington's three Republicans — Reps. Dave Reichert of Auburn, Doc Hastings of Pasco and Cathy McMorris Rodgers of Spokane — all voted against the bill.

The House bill would set up a government health plan that would compete for individual customers against commercial insurers.

"The public option is the best way to keep insurance companies honest," Pelosi said. A public option, however, faces tough opposition in the Senate, where Sen. Joe Lieberman of Connecticut has pledged to filibuster any plan that contains government-run insurance.

Perhaps even more significantly, the bill would shift Medicare away from paying doctors on a per-procedure basis and instead reward them for quality care. It also would erase a payment disparity that has financially penalized Medicare providers in Washington and elsewhere compared to high-cost states such as Florida.

"Two years from now, the entire Medicare payment system will reflect quality and efficiency," Inslee said.

Pelosi's visit was book ended by two small rallies outside of Swedish's campus on First Hill. Three people stood outside the main entrance demanding restoration of budget cuts to the Basic Health Plan, the popular state-subsidized insurance program that has more than 60,000 residents on a waiting list.

Later, on the other end of the entrance, more than two dozen opponents of the health-care legislation in Congress held signs reading, "Stop Socialism," and "Keep Fed Out of Med."

Kyung Song: 206-464-2423 or ksong@seattletimes.com