Both Senators admit that the politics around Medicare are fraught (or, as Coburn put it in a Thursday press conference, “the politics up here stink”). But they still contend that now is the right time, in terms of policy, to move forward on Medicare reform. “We’re trying to stimulate that national debate, that adult conve rsation, about a very real problem that whether you’re a Republican or Democrat, old or young, you know is out there,” says Burr.
Burr and I spoke this afternoon about why he thinks now is the right time for Medicare reform, how his proposal differs from those that came before it, and whether there’s the appetite for a Medicare debate in an election year. What follows is a transcript of our discussion, lightly edited for clarify and content.
Sarah Kliff: Tell me about your interest in pursuing Medicare reform right now. Why is now the right time to pursue big entitlement reform?
Sen. Richard Burr: I’ve been working in health care for 18 years. I’m probably the only member that serves on the Finance Committee and HELP [Health, Education, Labor and Pension] Committee so I’ve got every piece of health care up here. But it’s the urgency of the financial situation in Medicare right now. I can’t think of anything that’s more important, except maybe jobs and the economy.
SK: Rep. Ryan and Sen. Wyden have specifically said this coming year isn’t the right time to pursue legislation on Medicare reform, because of the election and the politics, and that they’re waiting until 2013 to introduce legislation. Why do you disagree?
RB: Unless they don’t believe the actuaries’ figures, I don’t know how you can push it off. I don’t know how financially push it off.
SK: What about the political landscape that they tend to see as an obstacle?
RB: If we did everything based on the political landscape, we would do less than we do do today, which is not much. The truth is we’ve got to take on some tough political issues and have a resolution to them.
SK: How do you expect your colleagues to react to your proposal? Have you run this by them yet?
RB: We haven’t, although they’ll probably know by lunch time. We’ll have part of our caucus that is excited about actually taking on something that needs to be fixed. We’ll have some that think that health care is not their interest, but they’re willing to engage and watch. And we’ll have some that are politically less risky, who will say how in the world can you do this? And we’ll have to make the case for what we’re doing.
SK: I’m curious about the assumption, in your legislation, that the Affordable Care Act stays in place. You’ve endorsed repealing that law, as have all your Republican colleagues up here. Does this legislation concede that the health overhaul won’t be repealed?
RB: You’ve got a court decision that will be made, there are many cases that will decide its future. I think to suggest that in this legislation that we were going to abolish it would taint the process, make people we only created this to get rid of that. The reason we did this was to make Medicare sustainable.
SK: One last question: What’s your game plan with this moving forward? You said you’ll introduce it to your colleagues today. What should we expect?
RB: In coming months we’ll work with stakeholders, members of Congress to refine it from a blueprint to legislative language and before the end of the year, we’ll introduce it and hopefully have an adult debate up here and in the country.
SK: Do you think there’s appetite in the Senate for a debate about Medicare in an election year?
RB: I think there there will be an appetite if, in fact, seniors across the country say ‘wait a minute, if this is going bankrupt, why aren’t we doing something?’
SK: But most polls tend to find seniors are very resistant to changing Medicare.
RB: They don’t, but I don’t think it’s ever been presented in a way that highlighted the imminent decline in our ability to provide that service.