Congressman Henry Waxman (D-CA) is the chairman of the Energy and Commerce Committee, an influential committee in the House, which has jurisdiction over health care legislation. Last week, he paneled a discussion at UCLA on climate change. Later, he was gracious enough to sit down with me for an interview. Below is our discussion:
Kathleen Wells: What would you say are the most essential elements that Americans must keep in mind when they are thinking about health care reform?
Congressman Waxman: Two main goals in health care legislation have to be to have universal coverage of all Americans and to figure out how to help hold down the health care costs that are increasing far beyond the inflation rate in our economy. Those are the two challenges. I think one cannot be done without the other and we [should] do both of them together.
I think President Obama put together an outstanding proposal that should give most Americans a sense of assurance that he is not going to have a radical change, but will have more that will allow people to keep what they have in terms of their private insurance and Medicare. And, in addition to that, make a lot of important changes in health care delivery and health care priorities with a greater emphasis on prevention and enable those people who don't have insurance to be able to get their insurance by stopping the insurance practices that have kept them from being insured and helping them economically if they are lower income, so that they will be able to afford insurance.
Kathleen Wells: Who do you think is driving the confusion in this debate and why?
Congressman Waxman: I think most of the confusion being driven right now, this month, has been from the right wing and the Republican Party. They don't want President Obama to have a victory on any issue. They have been against everything he has proposed.
Kathleen Wells: Why is that?
Congressman Waxman: I think they have made a political decision that their best chance to pick up the Congress and to get power again is to be able to run in 2010 and say that Obama didn't accomplish anything. And they are doing their best to make sure that happens. It's the same playbook they used in 1993/1994 against [then President] Clinton and the Democrats. After they helped defeat his [Clinton's] health care package and tried to demonize him in every way they could, they were able to pick up control in the House and Senate in the 1994 elections. So, they are trying to play that same old playbook.
Kathleen Wells: Are you are saying it is pure politics and has nothing to do with the American people's interest?
Congressman Waxman: I think it is pure politics. If there were genuine concerns about the interest of the American people, they [Republicans] would be playing a more active role. In the House, the Republicans wouldn't engage with us. In the Senate, there have been more efforts, in the Senate Finance Committee particularly, for bipartisanship and we will see if that is going to be successful.
Kathleen Wells: Progressives are getting frustrated with this bipartisanship upon which the President is insisting. Do you have any thoughts on that?
Congressman Waxman: I think the best way to approach all important issues is to work on a bipartisanship basis. It so happens that if the bill needs 60 votes to get through the Senate, we don't really have 60 votes even though we have 60 Democrats. There are two Democratic Senators who may not physically be able to show up for a vote on cloiture, Senator [Ted] Kennedy and Senator [Robert] Byrd. [Note: This interview was conducted just hours before Senator Kennedy's August 25, 2009 death.]
So, I think it is in our interest to try to work on a bipartisan basis. I wish we had bipartisan support in the House, although we don't need Republican votes in the House to pass a bill. But I hope the Senate does get a bipartisan bill and then we get into conference and work out the final result. But if they cannot produce a bipartisan bill, there are procedures that the Democrats may be able to use in the Senate that may be difficult, but could produce a simple majority Democratic vote victory under a procedure called "Reconciliation to the Budget Act." It's tricky and it's not the ideal way to go, but if the rules permit it, that's what we will have to do.
Kathleen Wells: This is such a contentious issue. Why do you think President Obama is raising it now, so early during his administration?
Congressman Waxman: President Obama campaigned on the issue that he was going to make major changes, and that he wasn't going to work around the edges. He wanted to be a president to transform our country in many important ways and one of the issues he raised over and over again was to reform health care. His election was a mandate to do that. You can contrast that with President George W. Bush that [sic] claimed he had a mandate after his re-election in 2004 to reform social security, but he never even mentioned it in his campaign.
President Obama wants to do this. He knows it's important for the future of the American people, for the values of giving everybody a fair chance in our society and to recognizing that there is a safety net that will hold people's dignity intact. And he knows it's important for our economy to reform the health care system. So, he has taken on this issue and I admire him greatly for doing it.
Kathleen Wells: Many Americans are concerned that the largest beneficiaries of health care reform are going to be the insurance companies and the pharmaceutical companies. Can you assure them that will not happen?
Congressman Waxman: Well, I think the insurance companies are going to make a lot of money because they are going to have many new customers who will be looking to get insurance coverage. I think the hospitals, the doctors and other health care providers are going to make more money from all the people who will be eligible for health care services. I think in some ways we ought to look at that as a good thing because people will get health care services and more people will have jobs.
But the biggest winner in my view will be the American people. So many uninsured Americans have been blocked from getting health insurance coverage because they have pre-existing medical conditions and insurance companies have been able to get away with denying them coverage because of those medical problems. So, many people can't afford health insurance, especially if their employers don't provide it and we need to give them a chance to get heath care coverage in order to give the system a chance to reform itself and try to hold down the cost.
If we did nothing, we would continue with a system that is the most expensive health care system in the whole world and, yet, we have 46-50 million people without insurance. As people lose their jobs, they lose their health insurance
Kathleen Wells: Are there any misconceptions or falsehoods that you'd like to address that are being promulgated out there regarding health care reform?
Congressman Waxman: I said to you that I thought the right wing and the Republicans were leading the charge against this for political purposes. I think the best example of that is the disgusting claim that they have made that somewhere in any of the bills that there is a government panel that will bring death to people who they don't feel they can afford to keep alive any longer. Nothing could be a more despicable lie because that is not in any bill at all. In our committee, we had an amendment that was urged by the conservative Democrats (and agreed to by many of us that are liberal) that we should pay health care providers to counsel people about what options that they may have at the end of life. And for the right wing to say those are death panels is pretty despicable.
The other thing that I find pretty disgusting is that they are scaring the seniors by telling them that they are not going to have health insurance - it is going to be rationed. But we are not going to change the Medicare system. No one is going to lose benefits under the Medicare system. We are going to try and make changes in Medicare to stop overpaying some of the insurance companies and providers that have been making too much money for what they do in order to have money for other purposes.
One of the areas that I'd like to see a change is what we pay to the pharmaceutical companies. They have been getting away with a windfall. We want to take that windfall back and use the money to close the donut hole, which threatens many seniors who have high pharmaceutical costs that they have to take on.
Kathleen Wells: Is that addressed in your bill?
Congressman Waxman: Yes. In our bill, we require the drug companies to give the same discount that they used to have to give to people who are receiving both Medicare and Medicaid. And that will amount to billions of dollars each year to be used to close the donut hole for the pharmaceutical coverage. I know that pharmaceutical companies are looking forward to making a lot of money because when there are more people covered, they will have more people buying their drugs. But that to me means that there is a greater urgency that we negotiate the prices with them. If millions of people are going to be buying drugs, we ought to use the buying clout of millions of people to get lower prices, not [to] just enrich the drug companies.
Kathleen Wells: Why is the President trying to make health care reform a cornerstone, a legacy of his administration?
Congressman Waxman: He set out three essential areas for domestic reform. There are three very important issues.
He wants health care reform so all Americans will be covered and we can hold down the cost so that it will be affordable. He wants changes in the energy area, dealing with trying to become less dependent on foreign oil as well as transforming our economy with millions of new jobs and reducing the carbon emissions that are causing global warming and climate change. That is an essential issue and it's a big one. Both of these are big ones. The third one he has is education reform. Because we don't live up to our values in America and every child does not have the opportunity for an education that will help that child succeed to the fullest extent possible in their lives. That has always been a promise of America and I think the president believes in that promise and wants to keep it.