Maverick's mission dims GOP allegiance Physician in Congress campaigns for HMO limits with Democrats

July 23, 1998|By Jonathan Weisman | Jonathan Weisman,SUN NATIONAL STAFF

WASHINGTON -- Private grumbling in GOP circles had already reached a roar when the lone House Republican maverick on this year's hottest issue appeared at a rally with President Clinton to promote the Democratic position.

But when Iowa plastic surgeon Greg Ganske stepped up to the podium with a blown-up full-color photo of a deformed infant, the complainers had to pause.

The child's gaping cleft palate had left a livid gash across his lip and a pained, anguished expression on his face.

It could easily be remedied by surgery, Ganske said, but too many health maintenance organizations are dismissing such treatment as "cosmetic" and unnecessary.

With that, Ganske demonstrated why GOP leaders have to be careful when they complain about his support for the Democratic drive to protect patients who depend on managed health care.

"For heaven's sake, insurance should mean something," the slight, soft-spoken surgeon told a hushed crowd, displaying a passion the GOP finds difficult to combat.

"People who pay good money for their HMO should not have to rely on charity so their child can have a normal face."

It was a dramatic performance by a man who, with his influential support for the Democratic position, has become the House Republicans' nightmare on the hot-button issue of managed care.

GOP leaders labored for months to craft a patients' protection bill that would satisfy the demands of lawmakers seeking tough health insurance controls without alienating conservatives who bridle at regulating the insurance market.

Republicans hope to ram their legislation through the House tomorrow, without a single hearing or a chance for opponents to amend it.

But they did not bargain on Ganske, usually a loyal GOP foot soldier now working furiously to derail his party's delicate compromise.

"People know I've been a good Republican. I've tried to get a bipartisan solution to this issue, not to turn it into a political problem," Ganske protested.

"But I think I support the best bill, the [Democrats'] Patients' Bill of Rights. If I get a fair vote on the floor, I can win, and that's what we ought to do."

Ganske campaigns virtually alone in his party, laboring against a united business opposition, a well-financed insurance industry, and a GOP leadership bent on maintaining party unity on the highest-profile issue of this congressional election year.

He has been belittled by colleagues behind closed doors. He has been driven from his prominent perch on the bipartisan Medicare reform commission.

"If I keep getting beaten down on this issue, I'll be so short you won't be able to see me behind this podium," he joked, displaying his wry sense of humor for the benefit of the Democratic audience at last week's rally with Clinton.

Ganske is considered very unlikely to prevail over his GOP opponents, at least not this week.

But the Iowan has credentials that have prevented even the most partisan Republicans from attacking him publicly: a medical degree, a history of selfless good works, a swing district that leans Democratic, and a home state vital to any politician's presidential ambitions.

And while he may be a lonely man in the GOP cloakroom these days, Ganske's sincerity on the issue is difficult for his opponents to challenge.

While his colleagues are junketing, Ganske often spends his congressional recesses performing free reconstructive surgeries in far-flung reaches of the Third World.

On a trip to Peru in August 1996, he contracted post-viral encephalitis that nearly took his life. He vividly recalls awaking during his eight-day hospitalization to find a priest at his bedside.

Three weeks later, he was back in Washington, with a cot in his office to rest between votes and hearings.

"He is a true believer. You are dealing with his life here," said Rep. Benjamin L. Cardin, a Baltimore Democrat who is among Ganske's closest allies.

"You can make a martyr out of somebody like that very quickly," Cardin added, explaining why Ganske is so difficult to attack.

In public, the GOP has given Ganske wide berth.

"There are people who are upset with him, who wish he was not cavorting with some of the people he's cavorting with," said Rep. Ray LaHood, an Illinois Republican.

"But to be honest, I've never heard anybody say, 'He's a real SOB. He should be kicked out of the [Republican] conference.'

"The fact is, he's a doctor. He has standing on this issue, and he feels very passionately about it."

Behind the scenes, some colleagues are not mincing words, decrying a Republican who was swept to power in the 1994 anti-Clinton surge, then voted for most of GOP's conservative agenda contained in its "Contract with America," but has now found himself allied with some of the most liberal members of Congress.

The undercurrent of GOP discontent with Ganske finally became so uncomfortable he resigned last week from Congress' prominent commission examining Medicare reform.

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