Network News

X My Profile
View More Activity

The Primacy of Congress

PH2009090102084.jpg

The problem with David Brooks's column today isn't that it's wrong on the specifics. It's not, really. It would be good if the health-care proposals on the table accorded more closely with the views of the most ambitious experts. But Brooks's explanation of why health-care reform differs from this technocratic ideal is misleading to his reader. He argues that the health-care reform proposals on the table are insufficiently ambitious because of some intellectual oversight on the part of the White House. If only they read more white papers! That's simply not true: This particular White House contains more expertise on the economics of health care than any in memory. What they don't possess is the capacity to change the incentives of Congress.

Take the simplest way to both pay for health-care reform and cut health-care costs: reforming the employer tax exclusion. House Democrats quickly shot that down, no Republicans offered their vote in exchange for the policy, and the Senate Democratic Leadership eventually killed the idea. What was the White House to do?

Or take the Wyden-Bennett bill, which Brooks brings up as an ambitious alternative. When this process began, that bill had eight Republican co-sponsors. Now it has, in reality, five, and only two of them, to my knowledge, have committed to voting for it. What was the White House to do?

Or take the "Gang of Six" process, which pared health-care reform back significantly. Max Baucus, chairman of the Senate Finance Committee and thus the gatekeeper for legislation involving Medicaid, Medicare or new revenues, wanted to pull the bill into a backroom and negotiate its shape with a few of his closest friends. What was the White House to do?

To put it more simply, Congress writes and passes legislation. The president cannot write legislation or pass it. What is the White House to do about that?

The president does not have the power to substantially change the dynamics of Congress on health-care reform, or big bills in general. If they did, Clinton would have passed health-care reform, as would Nixon and Truman and FDR. But what Brooks tells his readers today is that this is, in fact, Obama's fault. It is a lack of presidential audacity as opposed to congressional will. But this is worse than untrue: It's damaging. It feeds the persistent delusion that the fix to our problems is a different president or a better White House strategy. And so we change our presidents, and the White House revamps its tactics, but we do not solve these problems. If you don't have a competent driver, buying a bunch of new cars doesn't end your transportation woes.

The president cannot pass legislation over Congress. But Congress can pass legislation over the president. That's how our system is constructed, but you wouldn't know it from the way we report on it.

Photo credit: By Charles Dharapak — Associated Press

By Ezra Klein  |  September 4, 2009; 4:37 PM ET
Categories:  Congress , Health Reform  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   Del.icio.us   StumbleUpon   Technorati   Google Buzz   Previous: Gang of Six Has a 'Productive' Chat
Next: More on the Deficit Double-Standard

Comments

One nitpick: your car analogy would make a lot more sense in reverse. You can keep changing the driver, but if the car is a junker, you're going nowhere fast. I mean, that's what we're all obsessed with, right? Changing the driver?

Otherwise, great post, although I know you must be getting tired of repeating this particular point. I think congressional reform is the great 21st century challenge for the American government. Doing something like killing the filibuster, in one sense, would be an even greater victory than fixing health care or fighting global warming, because it would reinvigorate the nation's political system and give it the ability to confront all these other challenges more directly.

Posted by: WHSTCL | September 4, 2009 5:23 PM | Report abuse

In other words, our system is constructed to make it hard to pass legislation that the people don't want.

Posted by: tomtildrum | September 4, 2009 5:27 PM | Report abuse

One thing I've wondered though - why is the intense focus on the presidency so universal in the national political dialogue? I can understand why television pundits would rather talk about a celebrity than a legislative body, but it seems that this is an error that is committed almost equally across the political spectrum and disturbingly often by (supposedly) more sober members of the print media. Is it laziness or boredom with politics that is anything besides a test of wills? Or is it just more comforting to believe that the people running the country actually affect our lives, rather than being almost completely constrained by the intersection of stagnant institutions with demographics that take decades, not years or months, to shift perceptibly?

Posted by: WHSTCL | September 4, 2009 5:33 PM | Report abuse

Upon further reflection, I guess it's easier to feel betrayed than powerless.

Posted by: WHSTCL | September 4, 2009 5:38 PM | Report abuse

"House Democrats quickly shot that down, no Republicans offered their vote in exchange for the policy, and the Senate Democratic Leadership eventually killed the idea. What was the White House to do?"

Well of course the Republicans are not going to sign on to the full package just because Obama would be willing to *raise* taxes! Some Republicans would probably sign on to a tax increase as part of a grand bargain to help pay for other things they'd like but in isolation it's a bug, not a feature. Get real.

"Or take the Wyden-Bennett bill, which Brooks brings up as an ambitious alternative. When this process began, that bill had eight Republican co-sponsors. Now it has, in reality, five, and only two of them, to my knowledge, have committed to voting for it. What was the White House to do?"

Well two firm Republican votes and the prospect of five (and perhaps more) is, by my count, a lot more support than any of the current Dem. bills have garnered. So who between you is the naive technocrat and who the realist?

Posted by: tbass1 | September 4, 2009 5:46 PM | Report abuse

"Take the simplest way to both pay for health-care reform and cut health-care costs: reforming the employer tax exclusion."

I may have missed the answer to this in previous posts, but I don't understand how reforming the employer tax exclusion bends the cost curve long term.

Taxing employer-based health insurance disincents employers from offering it to their employees. That's fine by me to the extent that it frees domestic businesses from having to compete at a disadvantage against some foreign businesses who don't have to insure their employees (because some foreign governments cover it).

But as more domestic businesses drop coverage, the tax base must shrink, until ultimately we have individual coverage coast-to-coast, and no remaining tax revenue to help make it affordable for anyone who needs assistance. This scenario may appeal to Krauthammer, but it strikes me more as a rearrangement of deck chairs than a promising way to contain costs overall.

What am I missing here?

Posted by: onebeing | September 4, 2009 6:20 PM | Report abuse

"The [P]resident does not have the power to substantially change the dynamics of Congress on health-care reform, or big bills in general. [...] If you don't have a competent driver, buying a bunch of new cars doesn't end your transportation woes."

True. But that's both the starting and ending point. Consider the dynamic if a President were to remind Congress that he can veto any bill that doesn't meet goals while maintaining budgetary limitations. It sound counter-intuitive, but the President seems to gain ground by vetoing any bill which doesn't both help matters and meet budgetary limits.

It's a good time for a long weekend.

Posted by: rmgregory | September 4, 2009 6:38 PM | Report abuse

I wouldn't know it, but now I do. Another fine post.

re: "This particular White House contains more expertise on the economics of health care than any in memory. What they don't possess is the capacity to change the incentives of Congress."

So what then are Congress' incentives? My thought is fat cash, procured legally, from (primarily) corporate interests. Am I wrong here, or is it something elese?

Posted by: PabloManriquez | September 4, 2009 7:09 PM | Report abuse

Hey legislatively, the president has little power save the veto, but he can make life a hell on earth, especially for members of his own party, by campaigning against them, especially in the house, if they don't support his agenda. He can raise money for primary opponents, get on the bully pulpit and castigate them for turning their backs on the agenda the american people voted for. He as the head of the party can deny them funds for re-election. He does have some levers of power through the executive branch to deny them some of the perks that he has control over. This is real power, and he should use it to get his way. Bush and the repiglicans were not shy about this kind of hardball politics...

Posted by: srw3 | September 4, 2009 7:18 PM | Report abuse

I'm glad to see this point made Ezra, please keep addressing this theme. The executive is one of three powers, and no president gets to buck a Congress that doesn't want to allow it, not for long, not in the end.

I know there's a lot of doubt about Obama's skill at using his one-third piece of the leverage, but I will quietly wait a good couple of years yet to make that judgement, despite the wavering nature of daily appearances. I think he plays his limited power over a very long hand. Time will tell.

Posted by: wapomadness | September 4, 2009 7:25 PM | Report abuse

"Take the simplest way to both pay for health-care reform and cut health-care costs: reforming the employer tax exclusion."

No, the simplest way is HR676 which simply gives an improved Medicare to every man, woman, and child in the US.

And it would solve many other problems automatically, universal coverage, pre-existing, portability, more competitive business, better data gathering and a central organization to tackle the hard problems of reforming medical practice.

And it is no less impossible than taxing health insurance.

Posted by: lensch | September 4, 2009 7:50 PM | Report abuse

I think David Brooks is evil incarnate. He hides behind that smug milquetoast demeanor while almost all his ideas are disingenuous. He's made argument after argument why all of the mainstream proposals are terrible. I am convinced if Wyden-Bennett were a serious possibility he would be railing against it. But knowing it can't happen he's decided to use it to beat Obama over the head. They should get Kristol back. He makes no pretense of being reasonable.

Posted by: bmull | September 4, 2009 10:37 PM | Report abuse

"...you wouldn't know it from the way we report on it."

Indeed.

What of the
Primacy of Corporations
when they pass legislation over Congress?:

http://www.pbs.org/moyers/journal/09042009/watch2.html

"Next week, the Supreme Court reconvenes early for a special hearing on the constitutionality of campaign finance limits for corporations. To hear the arguments, Bill Moyers sits down with Trevor Potter, president and general counsel of The Campaign Legal Center and a former chairman of the Federal Election Commission, and Floyd Abrams, a First Amendment attorney."

Posted by: perhapsnot1 | September 5, 2009 1:05 AM | Report abuse

Ezra you miss here something - what is the point of Barack Obama saying that he is ready to be a single term Persident when he cannot withstand the tantrums of Congress? Implicit to Brooks column is to stand for what is right for Americans and not to worry about Congress.

Imagine a scenario where Obama unfailingly backs Wayden - Bennett bill; he says whether it passes or not, whether it attracts Republicans or not; that is the bill he wants.

Really if the bill does not 'bend the curve' what is the point for Obama to sign it? I understand the lure of 'incrementalism of Ted Kennedy style'. What Brooks is indirectly implying is the need of heroism to withstanding the bul*sh*t of Congress; to shred the non-sense going on in those chambers under the pretext of 'sausage making'.

Today the Congress is like a deer frozen in headlight; incapable of doing anything which this country needs badly. The way our constitution is, it is the White House which is expected to lead the way in such situations. It is a right thing for Congress to clip wayward policies of a White House (e.g. when Barack bills disregard costs); but then we also need the White House to release the current logjam in the Congress.

Hopefully that is what the President speech next week will do.

Posted by: umesh409 | September 5, 2009 6:58 AM | Report abuse

onebeing writes " the tax base must shrink " The Wyden Bennett calls for a employer contribution of 3 to 26 percent see the CBO 17 page brief (click Attachments) costs to buy insurance get lowered because of state sized regional exchanges where the government pools the money into a single fund then adjusts it and moves it thru to the paying private insurers i.e. yer giant risk pool. Ezra are you saying that a plan that lowers everyones premiums has no chance of passing? I think that a plan that increases everyones premiums has no chance of passing. Lack of cost control is also scaring seniors not without cause. Sam likes Green Eggs and Ham doesn't he in the end after he trys it. What you leave out is what happens with wide spread public support and a good score from the CBO. Rewriting the exclusion harms no one taxes do not increase on the middle class they increase only if you hold a plan with better benefits than what members of congress are eligible for. The congress will love Green Eggs and Ham if the public demands they do so in fact they will claim they secretly supported it the whole time and Brooks is right the President can be a conduit for that kind of change. Mice are not capable of change men with vision are. Wyden Bennett Healthy American's Act matches a market to a multiple provider health care reality it's a stroke of genius. No more unfunded mandates no expansion of unsustainable Medicaid everyone in no one out quality insurance for every citizen north south east and west.

http://cboblog.cbo.gov/?p=91

Posted by: DougHuffman | September 5, 2009 4:02 PM | Report abuse

"He argues that the health-care reform proposals on the table are insufficiently ambitious because of some intellectual oversight on the part of the White House"

No, he argues that the President publicly committed himself to making no substantial changes when he said you could keep your current insurance. He brings up the white papers and such as evidence that there are real plans out there that could get wide support, but that violate that flawed principle.

Posted by: staticvars | September 7, 2009 12:28 AM | Report abuse

*****
This is real power, and he should use it to get his way. Bush and the repiglicans were not shy about this kind of hardball politics...

Posted by: srw3

******

You know Ezra,

So long as you have responders representing the progressive wing who feel they have to call Republicans "repiglicans" and YOU do not take them out behind the woodshed and wash their mouths out ... muzzle them ... or sideline them and tell them to stay the heck out of your party go form one of their own?

Nobody on the right OR in the middle will want to have anything to do with you.

Insulting foul-mouthed progressives hurt your cause and make it only a case of who we revile more ... conservatives or progressives.
But do not have any doubt that the vast majority of the middle reviles you BOTH and find BOTH neo-cons and progressives repulsive.

Your choice Ezra ... sideline the foul-mouthed insulters.
Or watch your progressive agenda get flushed down the toilet along with your toilet mouthed friends.

Posted by: chromenhawk | September 7, 2009 7:32 AM | Report abuse

The Democrats have the votes to do whatever they want in congress.

Blaming the republicans for something passing or not passing is not only ill-informed, it's wrong.

The Democrats have the ball, a 50 point lead, and if they don't pass a bill, it's because they lacked the courage to do so.

Republicans don't even enter into this conversation.

Posted by: Ombudsman1 | September 7, 2009 6:25 PM | Report abuse

Uhh...LBJ Erza? Civil rights bill, Medicare??

The president has more power than you imply.

Posted by: MedioGringo | September 7, 2009 8:30 PM | Report abuse

The comments to this entry are closed.

 
 
RSS Feed
Subscribe to The Post

© 2010 The Washington Post Company