Outlook: After health care, we need Senate reform

 Ezra Klein
Ezra Klein (The Washington Post)
Ezra Klein
Washington Post domestic and economic policy blogger
Monday, December 28, 2009; 12:00 PM

Ezra Klein, Washington Post domestic and economic policy blogger, was online Monday, Dec. 28 at Noon ET to discuss his Outlook article titled "After health care, we need Senate reform."


End to Filibuster: Why does it take a "bill" to amend or remove the filibuster? As part of the rules, can't an incoming senate majority leader just remove them?

Ezra Klein: Not really. or at least, not exclusively. On the first day of a new Congress, rules need to be adopted with 51 votes. if you decided to roll over the minority and kill the filibuster, the minority would use the rest of the rules to shut down the Senate (everything runs on unanimous consent in the Senate, so it's not an idle threat).

Now, you could rebuild all the rules such that the Senate is a totally different institution and the minority is powerless. But that would be a huge media war, not to mention that you probably couldn't get 51 votes for it. But I think -- and think is an important word there -- that it's theoretically possible.


Rhinebeck, N.Y.: In your opinion piece on the need to do away with the filibuster you bemoaned the polarized political climate as the basis for your argument but you failed to point out that the original medicare bill (passed in LBJ's term) with huge bipartisan support. Could it be that the Democratic party abused the temporary power position it enjoyed in the way in which it presented the 2009 health insurance regulatory reform bill, and maybe the criticism should be with the Democrats?

washingtonpost.com: After health care, we need Senate reform (Post, Dec. 27)

Ezra Klein: I fear you're thinking about this backwards. The fact that Medicare and Social Security passed with bipartisan support despite being far, far, far more statist and expensive and ideologically pure than health-care reform shows how impossible it is to find bipartisan votes in the modern Senate, not that Democrats didn't do a good job of it.

After all, what you probably would have told them to do to get bipartisan support is build an incremental plan with no public option that relies on the private sector and that reduces the deficit. They did that. But the problem is that there's no room for substantive compromise because there's no room for compromise: Republicans want to win in 2010, and you don't win by helping the majority party achieve something popular and important.

Another way to say this is that Richard Nixon proposed a much more expansive, aggressive, and liberal health-care reform than Barack Obama did. The Republican Party of the 60s and 70s was a different institution than it is today. So were the Democrats, for that matter.


Hastings-on-Hudson, N.Y.: Ezra -- I appreciated your history/background of the filibuster issue. But what do you think are the chances of any kind of reform taking place, when the great majority of Americans don't really understand how the Senate works, and hence will not bring pressure to bear to change it?

Ezra Klein: Low.


Ruidoso, N.M.: I heard Mark Shields mention that on the reconciliation between House and Senate versions of the health care bills the conference report only needs to be passed by a majority vote, that no filibuster is possible. Is this true? Are there any catches? Thank you.

Ezra Klein: Nope. The filibuster can be used against the conference report.


Scottsdale, Ariz.: Everyone talks about fixing the stupid filibuster rule in the Senate -- but no one ever does it. What are the real chances of someone actually correcting this anti-democratic system?

Ezra Klein: It's worth saying that the filibuster has been changed fairly frequently over time. Before 1917, for instance, there was no way to break a filibuster. One senator could hold the floor forever, in theory. Then Woodrow Wilson instituted cloture, which allowed 67 senators to break a filibuster. In 1975, we lowered that to 60 senators. These things do change, and it's instructive, I think, that the historical trend has been towards limiting the filibuster, not strengthening it.


Goose and gander: So would you be as happy with a majority rule Senate that is controlled by an ever more conservative Republican party? What would regulations of health insurance companies look like under that scenario never mind a multitude of social policy changes?

Ezra Klein: Yes. It's important to state this clearly: The filibuster is bad no matter who controls the Senate. That does not mean that there won't be periods when the Senate is used to make laws I disagree with. There will be. But the underlying principle here is the importance of majority rule: If Americans want more conservative policy, they should be able to enact that outcome by voting in a solid majority of conservative senators. And if that policy is bad, they should be able to vote in legislators who can, with a majority vote, repeal that policy.

Right now, we have elections that are about how little the majority was able to accomplish. We tend to blame the majority for that even as it's not their fault. I'd much prefer elections based on what the majority actually did accomplish.


Detroit, Mich.: What's been so disconcerting to someone who up until recently was a pro-choice Republican (Snowe, Collins supporter) wasn't the fact that they voted against HCR but rather how they filibustered it. Why are Snowe and Collins so comfortable doing this, and in some ways aren't they at the end of the day just as much liable as a DeMint or Coburn?

Ezra Klein: In some ways, you could argue that they're more liable, as they know better, and have the freedom to vote differently. But party pressure is a powerful thing. You need the favor of your party to wield power in the Senate, to become chair of committees, to remain on committees that you like, to raise money, to fend off primary challenges, and much more. These are also your friends, your political allies, the people who come to stump for you when you run for reelection. So there's social pressure too. It is a lot easier to vote with your party than against it, particularly on such a controversial issue.


Denver, Colo.: Ezra, let's say HCR passes in the next few weeks. I keep hearing that the next items on the agenda are financial regulation, "jobs," and "the deficit." When (if ever) will the Senate take up Cap and Trade? What happens to the House's ACES bill if the Senate doesn't do anything on Cap and Trade by the end of this Congress? How long can a bill passed by the House sit on the shelf waiting for the Senate to take it up?

Ezra Klein: There are a lot of conservative Democrats saying they don't want to do cap-and-trade in 2010, and I'd bet you that a lot of pollsters and strategists are saying the same thing. I'd be very surprised to see action until after the election, at this point. As for the House's bill, my understanding is that it remains passed, and Senate can take up the question at a time of its choosing.


St. Pete, Fla.: Ezra - Thanks for all your great work.

Andrew Sprung over at xpostfactoid has argued that repealing the filibuster would empower those seeking to roll back provisions of health reform (assuming it is enacted), and imperil crucial regulations within the package.

Do you think that this is something legitimate to fear?

Ezra Klein: Maybe it would. Again, I'm fairly comfortable with letting democracy take its course. But this is why I favor plans to roll the filibuster back 6 or 8 years from today -- you need to get the questions of process out of the immediate context of the moment.


Herndon, Va.: As a moderate I happen to like the Senates rules specifically because they help retard radical change typically not supported by a majority of Americans. Rasmussen polling consistently shows 40 percent +/- want the current health care bill but the Dems pushed it through any way. This isn't a partisan issue for me - I would have been no happier had the Republican right pushed through some of their more radical plans, either.

Ezra Klein: People have very strange ideas about public opinion, and what it means. At various times in the process, the bill was popular. For most of the time, a majority of the population supported the bill or a bill that went even further. But as the bill took longer and longer, as more and more lies got told, as we had shouting matches over death panels and rationing late-stage bribery, it got less popular. So does that mean it's unpopular? What about the fact that if you describe its basic provisions, they're popular?

We have a representative democracy precisely because this stuff is hard and open to demagoguery. The pity is that so many of our representatives moonlight as demagogues. But suggesting that nothing can ever be done unless it is popular after eight months in the pressure cooker of our incredibly polarized political system is to say that nothing can ever be done. And I don't know how long we can go ignoring our problems.


Pittsburgh, Pa.: Are we better off with a gridlocked Senate? Do we really want more legislation? The Senate was able to quickly come to bipartisan agreement on the TARP bailout. The result a trillion dollar bill.

The framers of the Constitution purposely designed the process to be inefficient, the amendment process is proof. Is the government that governs least the one that governs best? At least it minimizes the unintended consequences of legislation.

Ezra Klein: Huh? TARP hasn't been a trillion dollars. It'll be a could hundred billion at the end. More to the point, it probably prevented a second Great Depression. And this is rather what I mean: If we come to a system when we can barely act in an emergency, we will come to a day when we actually can't act in an emergency. And then we're in trouble.

As for the Framer's, if they had wanted a 60-vote Senate, they would have created one. They didn't. The 60-vote Senate is a modern invention. If you're interested in their wisdom, then go back to their model, which is that legislation passes with 51 votes.


Westchester County, N.Y.: Do you think that we are entering an era when government is essentially paralyzed? I mean, all I hear from Republican politicians is that once a health-care bill is passed, their main objective in 2010 is to kill it.

Is this kind of obstruction a precedent? And if so, how dangerous is it?

Ezra Klein: Pretty dangerous, I'd say. This was the easy part of health-care reform. Coverage expansions and the easy stuff on cost. The hard stuff still needs to be done, or the government, and the country more broadly, will go bankrupt. But Republicans have been pretty clear that they will not be party to anything hard or unpopular. California is in a similar situation, and they're pretty much in fiscal collapse now.


Kalorama Triangle, D.C.: Ezra, you say "On the first day of a new Congress, rules need to be adopted with 51 votes." Where do you get that? I don't see anything like that in the Senate rules. Rule V states: "The rules of the Senate shall continue from one Congress to the next Congress unless they are changed as provided in these rules."

Ezra Klein: It has to do with how the chair rules, etc. There's a good CRS report on this topic (at least, I think it's CRS).


Dallas, Tex.: Isn't the filibuster an inherently pro-conservative tool? You and others have said that it prevents the government from "governing." but really it prevents Congress from legislating. From a progressive perspective, that is bad, as they generally want more government action (e.g. regulations/subsidies), while conservatives theoretically want to avoid most expansions of government. From this perspective, conservatives would be very foolish to give up the filibuster.

Ezra Klein: I think that's right, using "conservative" in its Burkean sense as someone who prefers the status quo. But I don't think that's true for modern conservatives. They want to reform Social Security and change Medicare, they want create a voucherized education system and spread health savings accounts across the land. They'll presumably want to get 60 votes to repeal health-care reform in 2010. They want to do as much as the Democrats do, so the filibuster hurts them, as well.


Orlando, Fla.: Hi Ezra,

Two questions about health care, from my hand surgeon father. First, how much does this bill affect Medicare reimbursement for specialty as opposed to primary care procedures? Second, is it true that this bill will cause a flight of doctors from Medicare?

Ezra Klein: 1) Somewhat, but not very much. It very slightly decreases specialty reimbursement to somewhat increase primary care reimbursement, which is good. 2) No.

As a general point, in the future, doctors will have to make less than they currently expect to make. And I don't mean less in term of the health-care reform bill's minimal tweaks. I mean really quite a bit less or the country goes totally bankrupt. I don't know how we get from here to there -- maybe we actually do go bankrupt -- but the terror from doctors when faced with even minimal reimbursement changes does not bode well.


Silver Sprng, Md.: Mr. Klein, your spontaneous responses to today's questions are as clear and trenchant as your excellent article. Thank you! I look forward to more.

Ezra Klein: More questions like this one, please.


Re: Rhinebeck and Bipartisanship: Ezra, My favored response to the moans about the partisanship-ness of the Senate Democrats in the face of the partisanship-ness of the Senate Republicans is to point out that the gold old days featured Republicans such as Jim Jeffords, Lincoln Chafee and Arlen Specter, and featured Democrats like Strom Thurmond, Jesse Helms and Phil Gramm.

Ezra Klein: Yep, a big part of the story of polarization is that not all Democrats used to vote with liberals and not all Republicans used to vote with conservatives. A Northern Republicans was a lot more liberal than a Southern Democrat, and this kept the party's from solidifying into the powerful and virtually uncrossable structures they are now.


San Francisco, Calif.: Thank you so much for your series interviewing senators on the "filibuster." How far are we from the "average" senator feeling the need to address the topic publicly? Also, might there be a better term than "filibuster" for labeling the problem?

Ezra Klein: Fairly far, I think. What you need isn't for some Democrats to get frustrated. You need for both parties to tire of a status quo in which they cannot fulfill their governing promises. You need, in short, for the Congress to want to work, and for it to want that badly enough to overcome short-term partisan incentives. That's why it makes sense to push filibuster reform forward into the future.


Data Point: According to MedPac, 96.8 percent of the physicians in the U.S. will accept new Medicare patients.

Ezra Klein: Yep.


Ezra Klein: Thanks, folks!


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