"Sometimes I think of this as like reentry into the earth's atmosphere," Cooper says of the difficulty of enacting reform. "You either go in too deep and you burn up or you bounce off the atmosphere and you're in outer space forever. You have to find the window to come in.
"There's an opportunity here to get things right. But the emotions are turned up so high both on the left and on the right, there's increasingly little dialogue. We're inviting everyone in who wants to talk to me about health care and, as you can see, we're all full right now," he says, laughing and waving his arm at the empty office. "None of the Tea Party folks have accepted our invitation to come in and talk about it, and likewise many of our friends on the left have not exactly wanted to talk about it. I think I'm approachable. I'm basically a nerd."
Cooper is desperate to explain himself. He thinks he's badly misunderstood on this issue, especially by liberals who don't trust our Blue Dog Democrat at all. No obstructionist, he says he's actually the pragmatic one holding out the only true solution to the problem. He wonders why everyone doesn't see it the same way. Cooper's touting the legislation known as Wyden-Bennett after Senate sponsors Ron Wyden, D-Ore., and Bob Bennett, R-Utah. Among its co-sponsors is Lamar Alexander. Cooper describes it as "a beacon of hope out there." He sees it as a Third Way harnessing both the Democrats' dream of universal coverage and Republican love of market forces.Liberals don't like the bill because it lacks a public option, but Cooper says he's not opposed to adding one. He points out that, unlike the alternatives, his bill would achieve universal coverage right away. He signed on as an original House sponsor last year. Wyden-Bennett effectively blows up employer-based insurance. People would buy coverage for themselves through national or state health insurance exchanges. Since they would pay the full price, people would become more cost conscious, sign up for more cost-effective plans and spend less. The bill would tax Cadillac health plans for the wealthy. Employees moving out of worker health plans supposedly would get pay raises matching the cost of their new, outside plan. The bill had been largely ignored in the national debate, but it's beginning to gain notice as the more popular options bog down. It's the only bill that nonpartisan Congressional Budget Office has said wouldn't add to the deficit.
"Somewhere in the area of Wyden-Bennett is probably where the center is," says Cooper. He insists he remains confident Congress will act this year on some form of reform and, he says, Wyden-Bennett is the proposal with the best chance of winning the 60 votes needed to stop a Senate filibuster.
"I liken it to frontier times when pioneers settled near a salt lick. That's why Nashville was settled. That's the place in the forest where both the animals and the people gathered because they had to have salt. Well, a centrist compromise on health care reform is a lot like a salt lick. That's where people gather because that's where the salt is. It's got to work for everybody. That's fundamental. And it can't be a purely partisan approach and succeed or half the country is going to be deeply suspicious of it. We can have partisan fights on other issues. But this one is separate, it seems to me."
Here are excerpts from our interview in which Cooper displays his well-known wonkiness, bemoans the collapse of civil public discourse, and admits to a certain annoyance at his liberal critics. "It is deeply frustrating," he confesses. "I don't have any ulcers yet. I'm good at biting my tongue."
Q: Everyone seems to think health care reform is in trouble. What's your view?
Cooper: Well, I'm a substance guy. Everybody wants to talk politics. I prefer to talk substance. There are a number of policy goals that people are trying to achieve. There is only one way that I have seen that achieves those goals, and we're not allowed to talk about that bill. That's the Wyden-Bennett bill. ... Our bill was ready on inauguration day. Our bill was already bipartisan. Our bill had no new taxes in it. But it's not an easy bill. The best way to describe it politically is this: If you think the choice is between ice cream and spinach, spinach loses. But if you think the choice is between castor oil and spinach, spinach wins. And there is no free lunch here. There is no easy answer. So as I think of these approaches, the spinach approach probably makes more sense. We all know, we've been taught by our parents and grandparents that you need a healthy diet. In legislative terms, that's basically what this bill does.
Q: Stop. What do you mean no new taxes? Explain how you would tax health benefits?
Cooper: We suggest that the existing tax break should grow with inflation as opposed to growing in unlimited fashion. With any other tax break in America that's fully indexed, that's considered the dream scenario. It's only in health care where things have grown at inflation plus 2 ½ percent for 30 or 40 years that people even think this might not be good idea. What it would do is put us on a glide path toward cost constraint and slowing the growth of health spending. That's really the key. Basically nobody would be reduced. We'd get a glide path. Instead of growing at 8 percent a year, it would grow at say 6 percent a year. If we could reduce the growth rate by 1 or 2 percent, we'd solve two-thirds of our problem.
The average family of four today pays about $12,000 a year for coverage or $1,000 a month. You could say that, at $15,000 or $17,000, you get a tax break. And that tax break would grow at the rate of inflation. It just wouldn't grow in the current unlimited fashion. When I was on TV the other day on Face the Nation, they talked about a Goldman Sachs plan that's $40,000 a year. Those investment bankers would have to pay a tax on the difference between $15,000 and $40,000. Why should average taxpayers be subsidizing investment bankers? That's the odd thing about this tax break. It's skewed to the highest-end beneficiaries so it's very regressive. And it basically favors the highest-paid workers at the largest, richest firms. This is a very gentle way of reigning in the excess. There may be another way to do it. But nobody's seen it yet. If it's this approach versus some of these other approaches, they're like castor oil. I think spinach tastes pretty good by comparison.
Q: Your bill has no public option, though. Are you against the public option?
Cooper: We could have a public option. For better or for worse, this has become a litmus test for Democrats as well as Republicans. It's almost become a theological issue. Some liken it to the holy trinity, which has actually started wars, but people still have difficulty explaining. How can you have three in one and one in three? This is a very difficult concept but a very important concept. It's a little bit similar to public option. There are many different ways to define it. And we can come up with a definition that works and keeps insurance companies honest and establishes some sort of benchmark so people know they're getting fair pricing. That's really the goal. Now, there are some folks out there who really just want single-payer. That's fine. They're entitled to want that, but President Obama said if you started with a clean slate, he'd be for single-payer. But he's not starting with a clean slate. So basically there's no serious single-payer legislation in the Congress.
Q: Do you think people are coming around to your point of view?
Cooper: Now people are realizing, hey, there isn't any ice cream in this debate. Spinach wins. How are we going to get 60 votes in the Senate? How are we going to get the support we need nationwide? Help me understand if there's another approach. I've been doing this for 20 years and I haven't seen it.
Q: What if health care reform collapses while you're insisting on the Wyden-Bennett bill? Do you deserve blame then?
Cooper: Well, while I prefer Wyden-Bennett, and it is a beacon of hope out there, I like what the president has set as guidelines: That it be deficit neutral in the next 10 years, that it bend the cost curve in the right direction and that it works. Those are simple and clear guidelines, and guess what? None of the four congressional bills meet those guidelines. None of them. They didn't even try to meet the guidelines. We don't know what Senate Finance is going to do. But we know what Wyden-Bennett does. It meets the guidelines. The House bill leaves out of coverage 17 million people. And this is what liberals are for? Whereas the Wyden-Bennett bill, according to CBO, doesn't leave out anybody. Why is a bill that leaves out 17 million people a favorite of liberals versus a bill that doesn't leave out anybody? Something funny is going on here and I think it's a lack of focus on substance. These are all things that can be figured out pretty easily especially in the information age, but there's a resistance to understanding this.
Q: What's your reaction to the mobs that have been showing up at town hall meetings?
Cooper: I wouldn't call them mobs. I'd call them concerned citizens. I think the key is to have a civil discussion. Nashville was voted the friendliest city in America a few years ago. Southern hospitality is a strong tradition that we need to keep up. It's understandable that some people are concerned and worried. I gave a speech at my son's graduation at MBA. Have you seen the movie Cool Hand Luke? There's a famous scene where the guy says, what we have here is a failure to communicate. That's what we have nationwide. Poor Walter Cronkite died. I actually think we got better news back then. In the news half hour, there was 28 minutes of news and it was real news. Today, if you're a conservative you watch Fox and if you're a liberal you watch MSNBC. ... We've lost a common reality. We're getting a lot of anger. What I said in the graduation speech is, there's some people who are making a profit today by raising your blood pressure. That's called hypertension. That can kill you. Why do we want to encourage that? That's why calmness is good. We need reasoned consideration.
Q: If Obama declared tomorrow that Wyden-Bennett was the way to go, wouldn't the opponents of reform attack it too?
Cooper: Yes but then they'd have to attack Lindsey Graham and Bob Bennett and Mike Crapo and Lamar Alexander, and there are bunch of others who are not quite brave enough to sign on yet. It's a lot easier to know what you're against instead of knowing what you're for. Undeniably, if you're for something, you become a target. But this is a pretty grounded approach. It's not new. It's been out there for years, but it's a fundamental reform.
Q: OK then, why can't the White House see the light?
Cooper: They have over-learned the lesson from the Clinton years, which is let Congress do it. That's misreading the lessons of history, and I'm one of the few survivors. I think the lesson is not authorship. It's craftsmanship and what works. You'll never get real leadership out of Congress. Most people will tell you there's been no good work by a committee since the King James Bible was translated in 1611. You could add a public option to Wyden-Bennett. It was only designed to be a chassis not a finished product. But with a chassis you can add fenders. You can add wheels, anything you want.
Q: Comment on the frustration you must feel because a lot of people see you as an obstructionist here and as someone not offering a viable solution.
Cooper: People are entitled to their opinions. But I have been working in a constructive, positive fashion on this for a long, long time, perhaps longer than anyone else in Congress. So I think there is a positive way here to get this done, and I don't think I'm being an obstructionist. I've had the earliest bill to meet the president's guidelines, and the only bill that meets his guidelines. Am I to be faulted for that? I think that's a positive contribution to the debate. An obstructionist would be a critic who had no positive alternative, and I have always had a positive alternative dating back to 1992. This is not obstructionism. This is helping guide the debate toward a direction where we might actually be able to achieve something. ... It is deeply frustrating. I don't have any ulcers yet. I'm good at biting my tongue. If there were more calm voices, there would be more success.