Is There a Deal to be Made on Health Care? An Interview With Sen. Lindsey Graham.
Earlier this week, Sen. Lindsey Graham was the sole Republican on the Senate Judiciary Committee to vote in favor of Sonia Sotomayor. A few days later, he co-signed an op-ed in The Washington Post with seven Senate Democrats and four other Senate Republicans that began, “We refuse to let partisanship kill health reform.” If there’s a deal to be made on health care, he’ll probably be at the center of it. Earlier this week, I spoke with Graham about the pitfalls of bipartisanship, the Wyden-Bennett bill, and what an eventual deal on health-care reform might look like. A shortened version of the interview appeared in the Outlook session. This longer transcript was lightly edited for clarity.
Is there a deal to be made here?
The bargain that will eventually be made is that Republicans will give in to the idea that every American should have coverage, and it should be mandated. There’s resistance to that because it runs counter to some of the doctrine. Democrats need to understand that there won’t be a public option any time soon, if ever. The public option in many ways has become what “amnesty” was for immigration reform, or “privatization” was for Social Security. Every big issue gets boiled down to one phrase.
Walk me through your thinking on that. The public option would be competing on a level playing field with private insurers, it’s limited in who can purchase it. Why can’t this be the compromise?
My belief is that no private-sector entity can survive over a long period of time competing against the government. The public option will be written by politicians. It will be generous. Nobody in my business worries about the bottom line. Eventually, the public option will dominate the marketplace because the political forces in the public sector are different than the economic forces in the private sector. Eventually, the private sector will give way.
You know, we already have Medicaid and Medicare. The private sector covers the middle. If a public option becomes part of that mix, you’ll have the whole deal covered by the government. That’s why I’m against it. And what I’d like to do long-term is enhance the options available to the retirement community and reform Medicare.
We need to come to grip with the fact that our entitlements programs are unsustainable. We talk about one trillion dollars for health-care reform, but what about the 36 trillion unfunded liability on Medicare? Do you know that 78 percent, I think it is, of Part B premiums are subsidized by the government? Every American on Medicare pays $96 a month. That’s 25 percent of the cost of the service. Why should the government subsidize my health-care premium when I retire? I’ll have money available. I think we should look at that.
If you could start from scratch, would you scrap Medicare?
No! Medicare was a safety net for those seniors who couldn’t afford coverage. I buy into the idea of everyone having health coverage. You can have the public-private partnership in retirement. You can have a government-run system for those who are needy. But above that it’s best for the private sector to cover people. There’s still a government role. Look at the Wyden-Bennett bill. The government helps people buy their health care in the private sector. To me, that’s proper. I don’t mind helping people be covered in retirement. We’re not going to get rid of Medicare and there’s no reason to get rid of it. We just need to be sure it’s a well-run program and we can afford it.
The negotiations in the Senate are becoming more poisonous. One of the difficulties, though, has been that people are having trouble distinguishing between those who want to strike a deal on health-care reform and those who really want to kill the bill. How do you tell the difference between a senator looking for Obama’s “waterloo” and people who want their ideas more developed in the legislation?
I think that over time you’ll tell them apart. You gotta flush them out. There’s two ways to fix a hard problem in Washington. You make people afraid of opposing you or you get them rewarded for helping you. There’s no fear for opposing Obama’s public option, and the reward is for opposing it. Right now, Republicans feel no political exposure from opposing the president’s health-care initiative.
One of the things that’s caused bipartisanship to fall into some disrepute is that bipartisan compromise doesn’t generally mean that the final bill incorporates the unique insights of both sides, but that it trims the ambitions of the legislation. It makes a bill smaller rather than better. Is there anywhere that you can see that not happening on health care?
That’s exactly right. I think health care is so personal. Climate change is more of a theoretical problem. The immigration problem is complex but people who aren’t in a border state don’t live with the consequences of it day in and day out like they do with health care. But every year we fail to reform the health-care system is another year where neither the government nor the private sector can pay the bill. The growth rate of medical costs is unsustainable in the private and public sector and that’s why there will be a bipartisan solution eventually. The Republican and Democratic parties won’t be able to say “no” forever without the public rebelling.
Where could a compromise make the bill more rather than less ambitious?
The number one thing you gotta remember is you can’t look at health care as if nothing else has happened in the last seven months. We’ve had a downturn in the economy. We’ve spent a lot of money. The stimulus has been successfully attacked for being more government than jobs. Deficit politics are taking center stage in a way I’ve never seen. If you come out with a plan that has government involvement Republicans don’t like and adds money to the deficit you’re going nowhere.
I think there’s a consensus around three things right now. That health care is unsustainable as it is and everybody deserves to have some coverage. That we’re spending enough and can spend it wiser. And that we’re afraid of losing choice and we don’t want the government to come in and ration care. Those things have stuck on health care. And you can’t underestimate the power of deficit politics. Any bill that’s revenue neutral is going to get some attention. Any bill that covers everybody is going to be easier to support than one that relies on darwinism.
If the deficit politics are so powerful, where do you specifically see an opportunity for cost savings? Where can the curve be bent?
The basic problem with health care is this: Have you ever asked a doctor how much it costs to get a treatment? I haven’t either. You ever gone to a hospital and asked how much they charge for surgery? When I go to buy a car I go to four or five dealers. Somehow we gotta get people believing that once you pay the deductible it still matters how much money you spend. Third-party payment is unique to health care. It makes the consumer two or three steps removed from their purchase. Cost containment to me is trying to tie the consumer to the service.
The car example is interesting. When I go to get a car I can walk out of the dealership of I don’t like the prices. But if I have a pulmonary embolism and am on a gurney, it’s hard to comparison shop, or to have anyone do it for me. And so we generally give that power to the doctor.
Can I be my own critic here? Lindsey Graham is wrong when he suggested a health care purchase is the same as buying a car. I realize that. We have an entitlement mentality to health care that we don’t have with a car. There is no belief in America that everyone deserves cable television. When someone says they don’t have cable TV, I don’t worry much. If they don’t have health-care coverage, I do worry. We have to understand that a hybrid system has to be built around health care. Most Americans understand we’re going to cover the poor and the elderly and the downtrodden. Every American family should have some form of coverage so they don’t become bankrupt if it becomes sick. But we also got to be okay with the idea that health-care choices and spending still is real money. That’s the problem I think. Real money is still being used here.
One reason that people don’t know how much is spent is that their employer pays for their health care. One of the reasons that Wyden-Bennett saves money is that it begins to unwind the employer-based system and let people see the full cost of care. But the White House started this process by saying that if you like what you have, it won’t change, which is to say that the employer-based system won’t change. And Republicans have made a lot of hay of CBO projections saying that people’s health-care coverage could change because they would choose something outside what their employer offers.
I think Wyden-Bennett is a start in the right direction. Employers who offer health care are in a constant battle with insurers and their employees about the cost. You sign your employees up and the insurance company is going to make money and it becomes your becomes your biggest growing obligation as a company and you can’t control the cost. Thus you have some employers who just begin to dump employees. What Wyden-Bennett does that’s important is that it changes the tax code and takes that money that employers pay and gives it to me. It becomes my choice, and my bottom line comes much more clearly into focus. If I gave you and your family x amount of dollars to purchase health care, you’d be able to go shop around and make a choice and if the incentives were such that you could actually benefit from those choices, you’d make those choices.
But what about the political impediments to that?
You got Republicans arguing give everybody a tax credit. We’re schizophrenic. How many of our bills say we’ll give a tax credit and you go buy the health care you want it? But then we attack Democrats for doing away with employer health care. It makes no sense. Now, they want to give it to the government. We want to give people choices. Wyden-Bennett is a middle ground. We say we’ll do away with the employer’s tax benefits and give that money to the individual but you have to agree that every individual has to be covered and there is a basic plan that has to be covered. That’s where it breaks down on our side.
Speaking of Wyden-Bennett, which you’ve co-sponsored, you co-signed an op-ed with Sen. Ron Wyden, Sen. Bob Bennett, and nine other co-sponsors of the Healthy Americans Act that said the bill was proof that partisanship need not kill health-care reform. If that bill came to the floor tomorrow. Would you vote for it?
Yes. There are a couple of things I’d like to see changed, if possible. But yes.
One of the things that’s been complicated about that process is that many of the other co-sponsors don’t offer that same answer.
There are some people on the Wyden-Bennett bill who are probably there for political cover, because they need to be for something. But that’s a good thing, not a bad thing. You’ve rejected the idea of saying “no” as a safe harbor for you politically. The encouraging thing about this op-ed piece is not so much that everyone would vote for the bill as is. It’s that 15 people see the benefit of trying versus just saying “no.” And some of them are in states that are very blue or very red.
You know, this is not smart politics for Ron Wyden. He comes from [Oregon,] a very blue state. He’s getting the crap kicked out of him. I wanted to jump on this bill like I wanted a hole in my head. But he is so persistent. He was willing to say to Bennett and me and others that he’ll get off the public option. I wanted to help him. A guy like him is necessary. A guy like [Utah's Robert] Bennett is necessary. There’s a comfort zone in politics where you just say no to the other side and it’ll be okay. But the country is changing. Those who step out of that zone will be rewarded. We’re a ways off yet, on immigration and health care and Social Security. But the day is coming when the people like Ron Wyden will be seen as the solution and not the problem.
Photo credit: Melina Mara — The Washington Post Photo .
Comment By Mr. Ehrenthal of ECHealthInsurance Fame and Familiarity:
I am going to ignore most comments as Mr. Graham’s character which I can hardly attest to but I will say he comes off very well in the article perhaps it is indeed a stringer. But certainly his words are clear and concise and discuss the policy in such a way that summarizes the severity of the situation and how dangerous the impediments to it are namely Joe Senator trying to please the Rush Limbaugh base. Or Al Senator trying to appease the Hollywood crowd.
Still Medicare and Medicaid are going to bankrupt the nation at no one has the “intestinal fortitude” to quote Mr. Hulk Hogan to get in the way of the speeding train. Mr. Graham pretends to be the person and perhaps he is. But in the meantime the real question is what the heck to do right now if you have no health insurance and are waiting for a magical Washington bean. At http://www.ECHealthInsurance.com we have tackled these goals albeit only for Florida and made health care available to every single Floridian if they will just get off of their ottomans and put down their remote controls and walk their behinds into our office or even pick up the phone and call us as we have found the utopian health care plan which was really there all along and they call it the County Health Plan. Its usually free and its amazing and if you don’t qualify then you were probably trying to get something for free that you should be paying for anyways. Either that or you should be on Medicaid. Perhaps one day we will shed our wide reaching flashlight onto your state and identify all the free health plans in it but should you feel inspired perhaps you can tell your neighbors to investigate the current plans which I can assure them is actually better then most of the schlock that we sell.
uuiq.com/
Hearing-Guide.com – Online consumer information on hearing aids, hearing loss & deafness
Agents Insurance Marketing, excellent refined
insurance agent mailing lists, insurance links, plus reports &
articles
YogaEbook.com – You deserve it! Come and get it! Learn to live the yoga lifestyle of relaxation, meditation, exercise and spiritual attainment. Free Articles, Free eBooks and more.
Continue Reading
