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An Interview With Sen. Ron Wyden

Few in the U.S. Senate have thought as long, or as hard, about health-care reform as Sen. Ron Wyden. And none have come up with as many innovative ideas for aiding the system. Wyden's latest contribution to the debate, the Free Choice Act (which Jon Cohn explains here), seeks to shine light on the flip side of health-care reform: It's all well and good to ensure that people who like what they have can keep it, but what about guaranteeing that people who don't like what they have can change it? I spoke to Sen. Wyden earlier today. An edited transcript follows.

Tell me a bit about the bill. What are you trying to add to health-care reform?

I think as Americans listen to this discussion, it's going to come down to a few important issues. One of the first will obviously be, "What does this mean for my premiums?" The second is, "Are we getting more choices?" And I think we need something like our Free Choice proposal so that people will look at some of these bills and feel that they really do increase their choices.

What it says is that over a five-year transition period, everybody would have choices because they could get into the exchange. If a worker wants a choice beyond what the employer is giving them now, an employer voucher would be available that would cover 65 percent of an individual's premiums for the lowest cost plans in the exchange, and 70 percent of a family's. [For comparison's sake, in 2008, employers paid an average of 73 percent of the premiums for a family plan -- Ezra.]

One of the main principles of health-care reform right now is that if you like what you have, you can keep it. This bill seems to be based on the opposite principle: If you don't like what you have, you can change it.

What we tried to do in this proposal is show the sweet spot between blowing the employer-based system to pieces and, on the other hand, simply saying that we will not try to improve it. The president's promise that we will be sensitive to not changing what people have is not incompatible with being able to choose some better.

When you tell people they can have access to a full menu of choices like members of Congress have, that's out of the park in terms of positive reaction. But if you're a congressperson and you're with Blue Cross one year and then all of a sudden you decide you want to go with Aetna, your transition is seamless. Someone in the private sector wouldn't even get that choice. We're trying to give it to them.

One of the things that interests me about this proposal is that it's not about changing the health-care system for the uninsured. It's about changing the health-care system for the insured.

That's exactly right. What I asked [CBO Director Doug] Elmendorf this morning is that if you're an employee and you already have coverage, what's in this for you? And his response was, well, not a whole lot.

For health-care reform to be credible, Americans have got to see tangible changes and feel differently about how the health-care system works for them and their family. If it's possible to say that you are going to see more choices for your health-care coverage soon, that will be positive. But if the Congress passes a bill and most people continue to see double-digit premium hikes and are told they'll have more choices but don't, then that won't be helpful to the cause of reform.

By Ezra Klein  |  July 16, 2009; 3:51 PM ET
Categories:  Health Reform , Interviews  
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What has been the insurance industry's reaction to Wyden-Bennett? Are they for it? Against it? Lukewarm?

It still seems like that plan is better than what the House is putting forward. Why are so many people resistant to it? Is the public option that important?

Posted by: SteveCA1 | July 16, 2009 4:35 PM | Report abuse

For the life of me I can't see why choice of insurance is desirable. Choice of physician, that I can see, but we already have that in Medicare and we do not have that in any of the private insurance choices Wyden would give us.

Why would anyone want a choice of insurance if everyone had a good plan? You could add to your good plan, but if everyone at least had the good plan, we would have a giant _effective_ insurance pool.

Furthermore how does Wyden's bill raise medical loss ratios, reduce paperwork, make private isurance companies more responsive, lower drug cost? All these would be accomplished by HR676.

Also how does Wyden's bill improve medical practice? Get physicians to join together a la Mayo, eliminate fee for service, .....

It appears to me that it will give one a lot of choices--all of them bad.

Posted by: lensch | July 16, 2009 10:03 PM | Report abuse

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