Snowe: 'I'm still struggling with affordability'

Saturday, October 17, 2009 | 7:07 p.m. CDT; updated 7:36 p.m. CDT, Saturday, October 17, 2009

WASHINGTON — When Sen. Olympia Snowe of Maine became the first congressional Republican to cast a vote for health care reform, she also became the most influential Republican on the issue.

Holding on to her vote is a priority for Senate Majority Leader Harry Reid. "He is prepared to do what he can to keep her on board," Reid spokesperson Jim Manley said last week. Snowe spoke with The Washington Post's Ezra Klein on Thursday about the death of bipartisanship and the future of health care reform efforts. Edited excerpts:

Q: You were the only Republican to support the Senate Finance Committee's bill. What do you see in the bill that your colleagues don't?

A: Well, it's hard to speak for others. Could be a philosophical difference or a policy difference. They would have liked more time, and I don't disagree with that. In the "Gang of Six," when the deadline was Sept. 15, we wanted to continue instead of ending at that point, but the chairman felt he had to move forward. There are a lot of issues. I said in the committee the other day I still have concerns.

Q: You mentioned the "Gang of Six," the bipartisan group of senators on the committee who negotiated on the legislation. Looking back, do you consider that process a success or a failure?

A: It was an outstanding process. I think that if the American people had had a window into those deliberations, people would have felt very encouraged. It's a rarity today in many ways to have that opportunity to sit down with your colleagues, face to face, several days a week for multiple hours, just working through issues. It didn't culminate in agreement, but it did establish the foundation and essence for the legislation that was ultimately reported to the Senate Finance Committee.

Q: When President Obama was elected, there was a real hope that the country would be entering a less partisan, more cooperative era. Was that an unrealistic expectation?

A: It shouldn't be. I think the art of legislating has somewhat been lost here in Congress. It generally just boils down to simple talking points and sound bites, rather than really immersing ourselves in the substance and complexities of any given issue. You really have to take the time to examine all facets of it. People question that this took several months. It should have taken longer, frankly.

Q: Was it strange to turn on the TV in August and hear Glenn Beck spinning wild tales about "death panels"?

A: I was stunned. And I still am stunned. It's reflective of the discourse. People want us to reform the health care system, but they're not sure we can get it right. And that's understandable, to be honest with you. I don't think Congress has lived up to the standards that elected officials in the U.S. Congress should have in these monumental times. If I think back to Social Security and Medicare, for example, they did garner broader support in terms of passage.

Q: Medicare and Social Security were much more liberal than anything we're discussing now, and they still had much more bipartisan support. Are we dealing with a different political system?

A: Unfortunately, the political system today preys more on people's fears than their hopes. We have an impending crisis, and we can't seem to muster the political capacity or will to forge political consensus. I don't expect it to be easy, but I would expect there would be more willingness to work together.

Q: What are your concerns going forward?

A: I'm still struggling with affordability. The Congressional Budget Office has produced charts showing that the American people will achieve savings, but we have to make sure that is the case. I also struggle with the individual mandate. It could be my libertarian streak. I understand the rationale and the need to bring everybody into the system, but until we're sure the system will work, I'm reluctant to impose those fees.

Q: If the bill passed $900 billion, but did so in a deficit-neutral way, could you support that?

A: Yes, if you could do it in a neutral way. I was talking to Senator (Debbie) Stabenow (D-Mich.) the other day about bringing some of these benefits forward in some way.

Q: So they would begin before 2013?

A: Maybe a transitional tax credit that gives people a means to access health insurance. We did that in the Medicare prescription drug benefit — we gave them a drug card worth $600 before the full program was implemented. It was a transitional benefit. Otherwise, people will be wondering why they're not realizing benefits sooner. But we'd need money for that.

I also think we should include something on medical malpractice. I can't imagine why we wouldn't. Maine has a very successful dispute-resolution process. It's been in force for 25 years. That's one dimension that has contributed significantly to rising costs.

Q: You've been supportive of a "trigger" proposal that would create a public option if insurance didn't prove affordable over the next few years. Why wait?

A: We need a lever to force the industry to drive down prices. If the goal of the public option is to ensure the industry performs, then the same could be true of a trigger mechanism. That lever could be equally potent in providing the maximum incentive to the industry to perform. The CBO has said we'd realize $15 billion in savings. I think that would be preferable to giving a disproportionate advantage to government. There's not an incentive for the government to be very efficient at what it does. It can do it, and sometimes we need to rely on it. But I don't think it would be preferable, if we could accomplish the goal in other ways.

Q: What's the one idea that you'd most like to see in the bill, but that you don't think is politically feasible?

A: I don't know that I have anything in that category. I believe we should build upon the current system. I'm traditional in my approach towards reforming health care.

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