On Thursday night, after she gave a lecture on “Saving Market Capitalism”, the Daily Gazette spoke with Alice Rivlin about healthcare, the economy, and the Obama presidency. Rivlin (Bryn Mawr ’52) is currently a fellow at the Brookings Institute and on the board of directors of the New York Stock Exchange. She was the first Director of the Congressional Budget Office, and served as the Director of the Office of Management and Budget in Bill Clinton’s cabinet.
Daily Gazette: Thank you so much for speaking with the Gazette. I have a couple of questions, some of which were brought up in the lecture. The first one is about healthcare: I know you’re part of an organization that is working to find healthcare solutions that don’t involve legislation, that involve transforming the way Americans live their lives…
Alice Rivlin: Yes, that is a commission set up by the Robert Wood Johnson Foundation and I have been co-chairing it. It’s focused not on healthcare but on health, and on lifestyles and other good things, exercise, better nutrition, early childhood things and so forth.
DG: So you’re working for preventative care? That would be a cheaper solution to our healthcare woes, surely, than other options?
Rivlin: You know it’s funny, you would think so. But it isn’t necessarily cheaper over the long run. People who are healthier live longer and pleasanter lives but that means they will use the healthcare system longer.
DG: So we should want people to smoke?
Rivlin: You don’t want people to smoke because it’s not a pleasant way to die and you die too young. But smokers do save the health system money. Now there are some preventative things that do save money. Take diabetes. Diabetes is almost invariably, if not preventable, at least controllable. If you eat right and exercise, you can control your blood sugar pretty well. And then the terribly unpleasant things that happen to diabetics if they don’t control their blood sugar, like losing their fingers and toes, don’t happen. And that saves money.
DG: In the lecture you spoke about how, if healthcare costs continue to rise at the current rate, they could bankrupt the nation. You said that you don’t think we need a public option, and that tax increases and the elimination of inefficiencies will be sufficient to pay for us to ensure all Americans. But if healthcare really threatens to bankrupt the nation, can we afford to ensure all Americans without utilizing a public option?
Rivlin: Well I think so, but we don’t know for sure, we’ll have to find out. But there are certainly a lot of things we can do to make the system more efficient over time. We’ll have to figure out what they are and then do them. It’s not clear that you have to have a public option or even that a public option will be cheaper. It might be cheaper, but it’s not a foregone conclusion.
DG: Thanks. Well then let me transition to something completely different. In the lecture you spoke about your belief in bipartisanship. Aren’t you being overly optimistic, when supposed moderates like Senator Chuck Grassly talk about death panels…
Rivlin: That was a big mistake.
DG: But then there was the South Carolina Senator who said if we can break Obama on healthcare we could end his presidency right here, and plenty of others. In the face of all this hostility, are there really bipartisan solutions?
Rivlin: For bipartisan solutions, first of all, you don’t need 100% of either party. You need a majority. And I think you can get that. That has to be an article of faith, but I believe there is a sensible majority, and that most people, and the polls bear this out, that most people are not extremists. And especially when you can take enough time to explain a problem you very often get moderate solutions. And we’ve done some focus groups and some experiments: when you get a group of people together and talk about healthcare and the deficit and talk to them about, well, what do we actually do, it’s surprising how often a centrist solution comes out.
DG: I understand how theoretically Americans are moderate and can listen to both sides. It just doesn’t seem to always be borne out. I remember when the time came for a stimulus, and America was at its very worst, the stimulus had to be curbed and curbed and curbed, and every person in Congress added their own separate measures for their own separate constituencies…
Rivlin: But it passed.
DG: It passed.
Rivlin: It wasn’t perfect. But it did get the support of the Congress and it is working, it is helping. You know I can be an optimist because I lived through the budget wars of the 1990’s, when we actually balanced the budget. We had a surplus! That took, it wasn’t exactly bipartisan cooperation, it was bipartisan negotiation. The Republicans controlled Congress at that moment, and they were for balancing the budget but they wanted to do it in a different way than the Democrats did. And you know, we had to give on some things and they had to give on some things. So there was a lot of angry talk but eventually we got a balanced budget.
DG: A lot of people on the left have been criticizing Obama because he’s too conciliatory to the Republicans. Do you think then, that Obama’s approach is fundamentally the right one?
Rivlin: I do. I think it’s the only one. Liberals who say “Public option or nothing” are going to get nothing. That’s not helpful.
DG: Thanks so much for speaking with us.
Rivlin: You’re very welcome.
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