Matthew Holt

Yet another reason to abolish the Senate

Ezra Klein, feeling a little soft, interviews Kent Conrad—he of the co-op feed stores for health care idea.

My take on the interview is that I seriously believe Conrad's entire knowledge of health care comes from his time being lectured on the vagaries of Medicare reimbursement by a local rural hospital lobbyist, his one visit to a co-op seed store where he found the farmers chatting happily, and his reading the cliff notes (prepared by his staff) of TR Reid's good but not too sophisticated book focusing on the Beveridge v Bismarck distinction—which is high school civics lesson stuff.

Yet he gets to meet 61 times with the Gang of six that was really going to get it all right before time ran out, and he gets to make policy!

And you wonder why the Senate should be abolished.

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12 replies »

  1. Abolish the Senate and give its duties to the House. The very idea of the delegation from Rhode Island and North Dakota having an equal voice to the delegation from California and Texas is beyond absurd, it’s insane. No wonder nothing ever gets done in Washington. The Senate’s purpose since day one has always been to obstruct the will of the people as expressed by the House. It wasn’t a good idea when the Constitution was written and it’s not a good idea now. Abolish the Senate and turn its wing of the Capitol Bldg. into a museum of the obstruction of American democracy.

  2. I think that my former Senator, Ted Kennedy, actually knew some stuff about health care policy, but he was an exception. Damn, I miss him.

  3. No need to eliminate the Senate. Instead, start another branch of government that is halfway between the judicial and congress. This branch would have no other power than to strike down laws that are on the books.
    Soon enough we’d have a body of law that the average person can actually understand, and then we can abolish lawyers.

  4. The subject matter of the lack of knowledge of legislators on health care issues is a good example of the need for term limits. It seems clear that people with genuine and current experience have to come into the legislature to bring the current issues and needs of citizens the earnest attention they deserve. Without this, we are willing victims of a body which cares often only to preserve incumbent position and privilege. Power corrupts, and power over time exponentially increases corruption. Let’s give some power to people who are motivated and willing to use it productively and stop the decades of parasitic behavior and deceptive rhetoric. It seems too clear that this government will not address the tough but critical problems (the cost of new technology, increasing life span, etc.) with any subtle change in healthcare policy. On the other hand, it is likely that with a major shift in health care policy, “leaders” are just as likely to damage what has been good about our health care for decades. It is interesting how, as if divinely inspired, the government awakens believing it can clean up billions in fraud, find revolutionary efficiencies, etc. after decades of acknowledged waste. If Medicare carries so much fraud and abuse, then why haven’t we long since addressed it more effectively. Private insurers, despite their negative aspects, have the experience and personnel, and suffer the consequences of poor management (much more directly than the government). It seems to me common-sense stricter guidelines for insurance behavior is a no-brainer, regardless of what other measures we decide to take. If the insurance lobby is really that strong in stalling such basic regulations, it is more the fault of corrupt, self-serving Congressmen/women than the insurance companies simply trying to run a complex business effectively. If the government can’t regulate, it surely shouldn’t operate an industry. Heaven help us.

  5. I’ve always said that forcing Congress to buy their health insurance in the individual market would get us to health reform way quicker than anything else.
    Edwards proposed this and Obama should enforce it

  6. Once you remove them from their Senate jobs (and the federal employee health paln) they might get a better idea as to why we need meaningful reform.

  7. I met with my Senator’s “District Director” last month to discuss health care…the guy was absolutely clueless about anything beyond “Medicare for all” and the “Public Option”. His contribution to the discussion was to tell us that his recent visit to the emergency room at our largest public hospital was an “eyeopening experience”.
    If that is any indication of the quality of legislative staffs, it’s hard to see how we will ever get meaning reform.

  8. I suspect that the vast majority of health care “experts” in the U.S. Congress, regardless of their party affiliation or ideology, are essentially clueless about many aspects of health care policy. For example, how many of them have actually read the Dartmouth Atlas or have more than a superficial understanding of the methodology? How many of them understand the delegated model of physician practice, or can name 3 states where such practices have achieved significant market penetration? For example, I’m sure the ultra-sanctimonious Rep. Henry Waxman (D-CA) has a pretty deep understanding of Medcaid eligibility rules (he has a been a key member of the House committee that oversees Medicaid policy for more than 2 decades) but he seems rather clueless about delivery systems.
    Skeptic

  9. But if you abolish the Senate that would mean Harry Reid running around Nevada all day, no thanks keep him in Washington!

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