Let me read this quote back to you. You said, "It is arrogant to imagine that 100 senators are wise enough to reform comprehensively a health-care system that constitutes 17 percent of the world's largest economy and affects 300 million Americans of disparate backgrounds and circumstances." Yet you also co-sponsored the Wyden-Bennett health-care plan, which was a much more radical reform than anything the Senate is currently considering.
I made an entire speech on this subject. I’ve come to the conclusion that the Senate doesn’t do comprehensive well. Watching the immigration bill and cap-and-trade and health care all fall beneath their own weight, I’ve come to believe we need to go step by step. On health care, I think that means just doing cost.
On the question of comprehensive versus incremental reform, the premise of Wyden-Bennett is that we need to solve this problem or it will overwhelm us. And I don’t know anyone who believes we can handle cost in a non-comprehensive fashion. I don’t disagree with the premise that the Senate is broken, but if you guys aren’t going to fix these problems, then who will?
That would be the conclusion that a lot of people will come to. The way professors and academicians and lawyers approach a problem is to try to rationalize large areas of society and come to a general conclusion. But most people don’t live and work that way. If your roof has a leak in it, you don’t have a comprehensive plan for a new house; you fix the leak.
In health care, Republicans have suggested six specific steps in legislative form that would reduce cost. You can have a small-business health plan without reforming the whole system. Another step would be allowing insurance to be purchased across state lines. Another would be some form of legislation on medical malpractice. You might think of pilot programs.
But with all due respect, those solutions, and I’ve looked at them, are miniscule in comparison to the size of the problem. The thing about fixing the hole in your roof is that you actually have to fix it. These would fix a small fraction of the whole and the water would still get in and eventually your house will be ruined. In the House, your colleague Paul Ryan has come out with a plan that does deal with the cost problem, but it’s enormous, and it’s radical. Wyden-Bennett also dealt with cost, but it too was big and radical. Both of these were more radical than what the Senate is proposing.
You make a good argument, but let’s come back to another example. In 2005, at the end of a budget hearing, I was so discouraged looking at the federal budget and thinking that all we’d be paying for were war and health care and Social Security and debt and we wouldn’t be investing in ourselves, that I walked down to the National Academies and asked if you can tell me the 10 things we could do to ensure America retains our competitiveness. And we did two-thirds of them. That succeeded. Republicans have four steps on clean energy. It’s not cap-and-trade, but it’s four steps.
But you thought Wyden-Bennett was a good starting point. I understand you wanted to change it. But that was much more radical, including getting rid of Medicaid. So how do you square that with your belief that small groups of legislators shouldn’t attempt to reform this sector?
The Wyden-Bennett bill was simpler, with fewer surprises, and more straightforward. I liked it because it was bipartisan. I wouldn’t have voted for it. But over the past two years, I’ve looked at all these issues and come to the conclusion that the policy skeptics are right. We don’t do comprehensive well in the Senate. It’s not because we don’t do our job well. It’s because we’re such a complicated country.