Video: The death of free choice?

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    >> if wyden should put it on the floor.

    >> yeah, i know it's totally nuts, but actually competition it drives prices down. nuts! former white house aide, specializing in economic health care policies, and author of a tremendous book, i recommend you read it "the tyranny of bad ideas," and think about this at a time when congress is supporting outdated financial systems and health care systems with special influence against all tax players as we watch the unemployment rate explode higher. you wonder why? because congress refuses to update the systems. and the panel back. this is washington post white house reporter, and she is probably the best source and educated on wyden 's choice amendment. matt, the tyranny of bad ideas. why on earth would politicians elected by americans and paid by americans out of their tax dollars choose not even to bother voting on allowing an updating as something as absurd as an outdated system?

    >> well, wyden 's proposal would basically let folks -- if there were not certain choices offered by the employers, it would let the employer just essentially give the cash to the employee that they would have spent on them and let that employee use that as a voucher in the new insurance exchanges, which they will have dozens and dozens of insurance choices. why we should say the 175 million people that get their health care from employers and it's shrinking, and the businesses themselves don't want to be in this any more. it's emblematic of the big ideas of the big business .

    >> and it's not even a mystery for that reason, ezra, quickly, big labor and business have control of congress until the american people come up with a way to start funneling their own way to bribe the politicians and work for them instead?

    >> well, it gives a little chuckle, a little small chuckle for a second and says there has got to be some wisdom in that. i thought that was a telling instance in how this debate is going forth. employers get a lot of power over their employees, because they control their health care . unions get a lot of bargaining power because they say we are the ones that will get you health care . they see keep it the way it is, keep it this way.

    >> yeah, keep us in power.

    >> yeah, and he says there has to be some wisdom in it, yeah, and there is, for them. but that is not the only question?

    >> yeah, matt, walk us through your analysis of why -- i laugh because it strikes me, and it's funny to me, i'm sorry. why is this idea so dead?

    >> business, especially led by the human resources chiefs that run the empires of the companies like to have the big ben afits empires that they run, and then we move beyond being locked into the employer. and we are the only country in the world, the only wealthy nation that ties health insurance to your job. that's bad for business . it's bad for entrepreneurship. have you a lot of folks that don't start businesses because if they have preexisting conditions in their family they cannot afford to go outside the employer setting. that was the big break -through idea that sadly, business business and turns out the big unions are resisting.

    >> meanwhile, unemployment is at a 26-year record, and the politicians are supporting this broken system.

    >> if we were in america, to do this all over again, and start from scratch, we probably -- we may not have an employer-based system today. if we were to start all over from scratch. and the country realized if they are going to enact health care reform that works they have to build upon their country's systems, and organizations and make it work a lot better.

    >> members of this committee on both sides of the aisle understand the importance of choice and competition. choice is what generates competition, and competition holds down health care costs for our people. but yet we have stripped this bill, colleagues, of choice and competition. a typical american who works for a mid-sized company, if they are getting hammered by their insurer, they are stuck.

    >> ezra, why are our politicians, and what does it say about america that we are such wussys where we can't have a makeover in the banking system or health care systems ?

    >> what senator baucus, it's interesting. he said if we could do it all over again, we sure would not use my bill. and he is right. but what others have been trying to offer is a bridge between a system that doesn't work and one that does. and there is a difference. it's one that has been underplayed in the debate between a health care expansion where we put more money into the system so it reaches more people and a health care reform . one of the things about wyden 's plan is that it's a reform. it moves you towards a different system. if we think this does not work, we change it. the one where we funnel money to people that don't have it now and put them in a closed off space so they can get insurance in the system, but for awful us, the bulk of us, we don't change it at all, that's an expansion. it won't hold down the cost long term, because the problem is the system is inefficient and cost too much money and then we will not change it and spend more money, and you are making it less cruel and covering more money, but you are not reforming it.

    >> the brief if we continue down the road and refuse to update so many of the outdated systems that hold us hostage at this point?

    >> if we don't move past the employer, that's bad for business . it's bad for workers and families, because it's going to be insecure. and ceos at big companies, they will tell you they don't want to be at the center of the welfare state , and so the fact that businesses as a whole cannot make the shift to support the option so people can choose outside the employer set something crazy.

    >> let me read the senator's statement from this morning. we will take a break. and christina is patiently waiting for the conversation on the jobs market. to wrap things up is the latest from the senator's office.

    >>> matt, thank you, a pleasure to make your acquaintance, even if it's by way of television connections.

    >>> lots more to come here

updated 10/2/2009 1:07:00 PM ET 2009-10-02T17:07:00

Even as Republicans pummel President Barack Obama's health care proposals, some GOP leaders worry their party is being hurt by a Democratic counterattack: Where is your plan?

Republican leaders chose not to draft their own comprehensive bill, focusing instead on attacking Democrats' plans as too costly and bureaucratic. Some prominent Republicans now fear they are getting tagged as the "party of no," and they want the GOP to offer more solutions to the nation's health care problems.

Louisiana Gov. Bobby Jindal, a potential GOP presidential contender in 2012, said it's time for Republicans "to pivot and say, in addition to emphasizing what we oppose, here are our proposals" for health care. The two parties can agree on some important improvements, he said in an interview Thursday, but Democrats must trim their proposed costs.

Democrats, meanwhile, see a rare chance to go on the offensive in the debate, which has sometimes seemed dominated by fiery attacks on Obama's proposals.

"The Grand Old Party's coffers are empty when it comes to health care reform," Sen. Richard Durbin of Illinois, the Democrats' second-ranking Senate leader, said Thursday.

A new CBS-New York Times poll found that only 14 percent of Americans think Republicans have clearly explained their plans to change the health care system, while 76 percent do not. Obama's numbers were better, though not stellar: 37 percent yes, 55 percent no.

Aware of the criticisms, House Republican leaders have compiled lists of bills and principles that various colleagues have offered this year. But even the whole list combined doesn't match the breadth and detail of the massive Democratic-crafted health care bills that have moved through five congressional committees and may soon reach the House and Senate floors in some form.

'Skimpy outlines?'
Democrats scoff at the Republican proposals, calling them skimpy outlines that would do little if anything to make health care more affordable and efficient. The Republicans' repeated calls for health-related tax cuts, without credible spending cuts to offset them, would dramatically increase the deficit, Democrats say. They note that no major GOP proposal has been subjected to scrutiny by the nonpartisan Congressional Budget Office, which has given cost estimates for the Democratic proposals.

Speaking to union activists recently about health care, Obama taunted his Republican critics. "What's your answer?" he asked. "What's your solution?"

"You know what?" he continued. "They don't have one."

Senate Minority Leader Mitch McConnell, R-Ky., told reporters Friday that Republicans have not offered their own bill because "we're not in the majority. The majority has the responsibility to go forward."

Republicans will offer numerous amendments, including efforts to limit medical malpractice suits, when a health care bill reaches the Senate floor this month, he said.

Image: McConnell
Chip Somodevilla  /  Getty Images
Senate Minority Leader Mitch McConnell.
Privately, Republican lawmakers have debated the pros and cons of offering their own comprehensive legislation in the Democratic-controlled Congress. A leader on the issue, Rep. Roy Blunt, R-Mo., said on June 17, "I guarantee you, we will bring you a bill that costs far less, far less than the Democrats' and will provide better results for the American people."

A month later, Blunt seemed to have changed his mind.

"Our bill is never going to get to the floor," he wrote in a blog, "so why confuse the focus? We clearly have principles; we could have language, but why start diverting attention from this really bad piece of work they've got to whatever we're offering right now?"

Eventually, other Republican leaders in Congress agreed with that analysis.

Several Republicans in Congress have introduced narrow bills — many calling for tax cuts — that have gone nowhere in Congress and generated scant notice. That's just fine with some conservative activists.

"We have plenty of time to work next year on sensible and targeted health reform in a bipartisan way," Weekly Standard editor William Kristol recently wrote. "But first we need to get rid of Obamacare."

Few detailed ideas Video: Controversy over Grayson comments grows
With Republicans offering few detailed ideas, some Democrats have ascribed sinister motives. Rep. Alan Grayson, D-Fla., caused an uproar when he said in a House speech that Republicans want sick Americans to "die quickly."

Perhaps the most comprehensive list of GOP health proposals is in the "Republican Solutions Handbook" assembled by the House Republican Conference, although it covers only one page.

The first two items in this Republican plan would pursue long-standing conservative goals: limit medical malpractice suits filed by "overzealous trial lawyers" and devote more resources to stopping "waste, fraud and abuse" in Medicare and Medicaid.

Proposed tax cuts, meant to help Americans buy health insurance, would go to workers without employer-provided health plans and to low-income people. The GOP plan also would encourage businesses that provide health insurance to automatically enroll all employees, who could opt out if they wanted.

Blunt's official Web site lists more than 20 bills introduced by Republicans, which have virtually no chance of passage. Some touch on the same topic, such as reining in medical malpractice lawsuits.

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Several call for tax cuts. One, by Rep. Edward Royce, R-Calif., would allow up to $500 of unused benefits in a health flexible spending account to be carried to the next year without tax penalties. Another would allow tax breaks on insurance premiums for long-term care.

Such bills are neither comprehensive nor offset by spending cuts or revenue increases, said Rep. Chris Van Hollen, D-Md., a member of the House Democratic leadership team.

Republicans "are afraid to put anything on the table," he said, "because the American people would see it doesn't address the problem."

Van Hollen predicted the Republicans will fail if they think they "can beat something with nothing."

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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