POLITICS APRIL 2, 2009
It would be something of an understatement to say that liberals don’t trust Representative Jim Cooper, the Democrat from Tennessee. That’s particularly true for liberals (like me) who remember the fight over health care reform in 1993 and 1994, when Cooper championed a centrist alternative to the Clinton health care plan. One former Clinton staffer has said “no Democrat did more to destroy our chances in that fight than Jim Cooper”--a verdict many experts share. More recently, Cooper lobbied then-President Elect Obama to convene a fiscal responsibility summit and then voted against the Democratic stimulus package in the House, although he would go on to vote in favor of a modified version.
A few weeks after that vote, I had a chance to interview Cooper at his Capitol Hill office. We didn’t talk about history. Instead, we talked about the present--and future--of two issues. One was the budget, which many of Cooper’s fellow centrists were attacking for its higher spending and tax levels. The other issue was health care, on which Cooper is once again seeking to play a major role.
Cooper remains a leading member of the Blue Dog coalition--which is to say, he remains very much the centrist, particularly on fiscal issues. Among other things, he thinks Americans as a whole--and, presumably, liberals in particular--pay insufficient attention to the generational inequities of Social Security. I didn’t agree with those stances before we met, and I don’t agree with them now.
But Cooper said some unexpected things, too. In what seemed (at least to me) like a shot at Obama’s centrist critics, he endorsed the president’s budget principles strongly, both for its honesty and its ambition. He dismissed concerns over short-term deficits, arguing that they were necessary to revive the economy, and threw around terms like “Rooseveltian,” suggesting it was essential Obama “think big” in his first year.
On health care, Cooper made a strong case for the bipartisan bill Senator Ron Wyden has been championing since late 2006 and that Cooper himself embraced, as an original House co-sponsor, last year. Since Wyden’s bill isn’t exactly popular on the left--it lacks a public plan option, among other things--this probably won’t win him too many friends there.
But Cooper suggested that the Wyden measure is, in some respects, more liberal than what Obama himself had proposed on the campaign trail. And he happens to be right about that, since the Wyden bill would achieve full universal coverage right away. Cooper also made surprisingly favorable comments about generous benefit levels and the role of a public insurance plan.
A partial transcript of our interview is here. I say “partial” because I cleaned up some prose and took out a few things, particularly at the end where we got into the sort of detailed health policy discussion that would test the attention span of even devoted Treatment readers.
COHN: A lot of centrists have said they’re not happy with the budget--that it’s too much taxing and spending. What’s your position?
COOPER: I love the honesty of the budget. It’s ugly, but finally we’re telling the truth about war costs. Finally we’re telling the truth about AMT. Finally we’re telling the truth about all these other things that Bush put off budget.
I also like the ambition of the budget. We need to think in Rooseveltian terms here. Think big. Succeed. Be willing to experiment. This is the most exciting time I’ve ever been in politics or could imagine being in politics.
Now, it’s still not perfect. We have to be more careful about our means.
We just got poll results from something the Peterson Foundation did that said 40 percent of highly educated Americans--business leaders, professors, folks like that--are in complete denial about our fiscal situation. They have no idea. And I’m using my colorful words to describe it--I can get you the exact thing Peter Hart found--but if that many highly educated folks can’t grasp it, then we have a lot of work to do.
COHN: What are they in denial about?
COOPER: The fact that money doesn’t grow on trees. Basically, what’s unsustainable, according to every economist in America, they think is sustainable. So just more of the same. What, me worry about tomorrow? That’s the Alfred E. Neuman approach. I guess people have forgotten about him today. Is MAD magazine still going? Surely it is. It was a staple of my youth. You don’t even know Alfred E. Neuman.
COHN: No, I do know Alfred E. Neuman. I just don’t know if MAD magazine is still around.
COOPER: I’m dating myself, I guess.
I think the job of leadership is to expand what can be talked about and to get consensus on the nature of the problem and that is most of the job. Because once you do that, once you have diagnosis, treatment options are obvious.
I’ll paraphrase the Einstein quote: “The most powerful force on Earth, it’s not nuclear power, it’s compound interest.” A lot of folks don’t realize how it’s working against us.
A common assumption is that if you borrowed from yourself, then you don’t owe it. Well, there’s an inner-generational component to that that I worry about. So oftentimes, they only report publicly held debt, not total borrowing. But, just because we borrowed it from Social Security, that doesn’t mean it’s free.
There are some other fundamentals we’ve gotten wrong. Most of my folks back home think Social Security and Medicare are sacred commitments stronger than the strongest contract. And yet if you look at the details here in Washington, they’re not even promises. They’re scheduled benefits. I think we need to do all that we can to make sure those benefits are real.
COHN: Peter Orszag and the administration, they’ve been very clear about their conception of the fiscal problem--that if there were ten parts to this problem, health care would be one through eight basically, or one through nine, or one through seven, however you want to put it. And Social Security is something to be dealt with less urgently and less radically. Do you agree with that?
COOPER: I think they’re right, that health care is one through seven. But I think that responsible policymakers should have a wide scope of interest and look at all entitlement programs. Look at all spending to see if it’s working or not. Look at all tax expenditures to see if they’re working or not. So even though I’m not even on any of the relevant committees, I spend most of my time looking at this stuff. It’s important for the future of the country.
COHN: Listening to the quotes from the Senate, it’s clear they are just spooked by the level of spending. It doesn’t matter if it’s off set, it doesn’t matter if it’s responsible. Are you comfortable with it as long as it’s fiscally sound? In other words, as long as there are off sets to pay for it?
COOPER: Well, their upset and dismay only show that they were clueless about previous budgets that they had voted on. Similar spending has been going on for years, it was just off budget.
We’ve been funding the wars. We’ve been funding AMT. We’ve been funding the SGR. We’ve been funding this and that. But they weren’t adding it up.
This budget adds it up. And it puts it on budget. Due to the stimulus, there is some additional spending, but mostly every economist from Greg Mankiw, to Martin Feldstein, to more traditional economists, to more liberal economists like Paul Krugman say this is necessary to spur economic growth, and that should be the mantra of both parties.
Without economic growth, we’re all in trouble. We somehow have to prime the pump, get growth restored. So I think what President Obama is proposing, with the help of Peter Orszag, is a great blueprint for America.
For folks who complain about particular parts, you need to remind them, none of this tells an authorizing committee they have to do it. It just says this is the size hole you have to fill, if you have a better way to fill the hole, do it.
It’s like a blueprint for a house. It doesn’t say which is the master bedroom and which is the kitchen. It just says, these are the size of the rooms, you figure it out. You decorate the house.
COHN: What’s your vision for health care reform?
COOPER: I’m excited because there’s a way to cover everybody without a tax increase and do it in a completely bipartisan fashion. This isn’t a pipe dream. This is a drafted, introduced, scored bill, and it’s called “The Healthy Americans Act.” It’s the Wyden-Bennett bill.
It’s amazing because it’s already there. The other approaches may be brilliant but they’re late to the party. We need to get this done in the first few months of the Obama administration while he has the maximum clout. Because, as you know, with two-and-a-half trillion in health spending, that precisely equals two-and-a-half trillion of vested interests. You don’t want to change a penny of it no matter how wasteful or even harmful that it is.
That’s the challenge, breaking through that logjam. I mentioned earlier that with a bold agenda sometimes you need more centrist means to achieve particular items so you don’t use all your political capital. I think Wyden-Bennett is perfectly positioned to do that. Now I’m not saying it should be called Wyden-Bennett. Call it Kennedy-Baucus-Waxman; call it Obama. Put plenty of amendments on it, that’s fine. But the core of it seems to be to get it pretty much right.
COHN: What do you consider the core? I’m one of those rare people that thinks the distance between that and what’s coming out of the White House is not as vast as it’s been made out to be. What are the basic principles that appeal to you?
COOPER: The principles fit almost perfectly. I was just reading the Obama principles this afternoon and it’s almost like an exact fit. Only Wyden-Bennett is probably more liberal than the principles.
If you get down to it, the universality principle doesn’t say we need to cover everybody in the short-run. Wyden-Bennett goes ahead and puts in an individual mandate, and the employer mandate. So it gets the job done and that should satisfy some of our more liberal friends.
Some other elements I thought Wyden-Bennett was more robust about, but don’t underestimate Barack. I think he’s giving us a little leeway; he’s giving us a little time. But not too much time, because we can’t mess this up.
We have to get it right and if I were he, I would be searching for a landmark domestic accomplishment. This is the only good news I can see anywhere on the horizon, and there’s no other massive benefit like this that’s essentially available for free.
COHN: There are a couple of points important to people on the left. One is this public plan option. Some advocates--and I think I’m one of them--have described it as “a secret way into single-payer.” Maybe that’s true and maybe that’s not. But others, like Jacob Hacker, have made another point with which I also agree: that a public plan serves an important function as a check on private insurers, to make sure they behave. I realize, of course, that you have to create a level playing field, so that the competition between the public plan and private alternatives is fair. Where do you stand on all of this?
COOPER: Well, I think you just solved the puzzle right there. If there’s a level playing field, there shouldn’t be any problem. There shouldn’t be some huge ideological divide. But a lot of it boils down to honest accounting. It should be a fair and square deal so that you know that you’re not going to lose if you compete against the public plan.
The public plan shouldn’t get fat, dumb, and happy and exploit patients just because it can get away with it. Defining and preserving the level playing field is the key.
COHN: OK, but let me press you on this. When you say level playing field, what do you mean exactly? If public and private plans are allowed to compete fairly, it’s possible one side will win out. The public plan might really get everybody--or it might be that the public plan dies and everybody goes to the private plans? Would be you comfortable with that?
COOPER: I’m happy whatever the outcome is. I just want to make sure we have a level playing field. I think what you see over time is that no system has ever produced a permanent winner in anything. Even if you’re state champion, you’re going to be knocked off your perch in a few years by the team that’s hungry or faster or better. That’s the way I view it. And congratulations if you’re state champion. It’s a process of ferment, that’s what leads to greatness. And that’s essentially the market system as I see it.
COHN: What about, what should the benefit levels be? This is a big controversy. You often hear--from Wyden, from Obama--that everybody should have health care as good as a member of Congress. That’s a pretty rich benefit package. Although, in some ways it’s not. It’s an interesting…
COOPER: Great, I get a Blue Cross standard option. It’s defined. It’s the Tennessee Blue Cross plan. I think de facto there’s already a benefits package that has grown up over time organically, and I think the real problem with benefits will be going forward with new technology and things like that. But we don’t have to face that in the immediate future and right now it’s pretty much set.
I get Blue Cross standard option and I get to pay, what is it? $540 a year so that if I get a heart attack in the Capitol, some medic will look after me. Great. I think that’s a doable deal for everybody.
But what a lot of folks don’t want to face is the fact that, as a federal employee, the boss is helping pay three-quarters of the coverage. But you and I both know that’s an economic illusion. That effectively comes out of the worker’s pay. The workers pay for everything.
This is one of the things I hope Democrats will help people understand. That workers pay for it all. Getting more economic reality there would help put us on a more sustainable footing.
COHN: That leads right into my next question. What do you think about the tax exclusion? Wyden-Bennett gets rid of the break. It modifies it--
COOPER: It limits it. And redistributes it. The key here is redistribution. That’s not a pretty word sometimes. But if you’re going to spend two hundred billion. …
COHN: I may do a story saying you’re in favor of redistribution.
COOPER: Go ahead, you’re welcome. I’ve said it in my own slideshows and speeches. If you’re going to spend $200 billion a year, should the highest paid employees of the largest companies get most of the benefit? No. No one in Congress has ever voted for this.
Democrat or Republican, no one has ever said they supported it; it just grew organically, since World War II. It doesn’t need to be eliminated or reduced, but rearranged so that every human being gets a fair piece of that pie. Fortunately there’s enough to go around today.
COHN: I assume if you’re for Wyden-Bennett, you’re for guaranteed issue ...
COOPER: Oh yeah. It would be completely unlike any individual insurance market.
COHN: You’re in for some kind of pooling arrangement when people can get …
COOPER: Oh yeah. That’s what insurance is all about. Real insurance.
COHN: I took that for granted so …
COOPER: But, see, there are a lot of folks that want to use today’s individual market as a straw man and say, “Oh, you’d be pitching workers into that. And that’s not right.”
This is an amazing opportunity here to give workers more choice and better benefits and have it be more affordable. You know the wastes that we’ve been engaging in with today’s massive inefficient system.
We’re just so lucky to have a new program that is not treating people like guinea pigs but basically sharing a federal perk with workers nationwide. What is it? Ten to 14 million federal employees and retirees have been able to shop from this annual menu, and why can’t everyone shop from this menu?
Here you have to be careful. Federal employees don’t want others to be on their same menu, so you have to create a new menu because everybody’s jealous of what they’ve got. This is a very doable deal.
But this is a very doable deal. This is so much more doable and more exciting than it was in the ’90s because so many things have matured. Probably I’m one of them. But the data have matured. When I ran for Congress again I said “I’m older, I’m wiser, I’m balder.”
COHN: Aren’t we all?
COOPER: It happens. It just happens. There’s a greater understanding of some of these things. So I think you’re going to see less foolishness in the debate, more grappling with the issues.
COHN: You’re on board with getting a bill done this year that covers everybody?
COOPER: It could be done by June. It’s already introduced. … We have the third ranking Republican leader in the Senate on this bill, Lamar Alexander. Now the longer we wait, the more opportunity there will be for Republicans to play games with this, but they are onboard, genuinely and sincerely onboard. This isn’t a token three Senators that happen to be from Maine or Pennsylvania. This is the real deal. There’s real economics in this bill. As I sometimes oversimplify it, it’s achieving a Democratic goal, coverage for all, using the market-based mechanisms, which Republicans claim they like. Well, this gives them a chance to live up to what they claim. So many people haven’t gotten the message that, so many newspaper guys say, “The stimulus bill is the largest bill in American history.” You know what was eight times larger? The Medicare Part D benefit. Eight times larger. And it’s still 7.8 trillion dollars unpaid for. That’s perhaps the most irresponsible thing ever passed by Congress. We have an opportunity here to be genuinely centrist, genuinely responsible, have this fully paid for.
Jonathan Cohn is a senior editor of The New Republic.