Outcomes-based financing: Possibility and promise in global health


Outcomes-based financing: Possibility and promise in global health



Institutional Reform Proposals

Thank you for inviting me to testify before your subcommittees this morning to discuss institutional reform proposals for the 105th Congress. I applaud your effort to initiate a bipartisan discussion of rules and procedures months before the November elections. Typically all of the discussion about House rules takes place within party committees. Indeed, I had opportunities earlier this Congress to meet with both the Republican Task Force on Committee Review and the Democratic Caucus Committee on Organization, Study, and Review. Both are engaged in important work which can serve the broader interests of the House. But your hearings are a refreshing departure from the practice of exclusively partisan consideration of rules changes; I encourage you to make the most of the opportunity by recommending changes in rules and procedures appropriate and desirable whichever party organizes the next House.

There are two reasons in particular why I hope you view your charge in this way. First, I believe the era of extended one-party control of the House is over. The forty-year Democratic reign in unlikely to be repeated by either party, which is certainly good news for the House as an institution. Permanent majorities and minorities breed institutional pathologies that damage both the operation and reputation of Congress. Competitive national elections for the House, and more frequent changes in party control, provide the conditions under which a responsible and effective legislative body can be nurtured. Second, the policy problems that will confront Congress and the president over the next decade or more make it virtually impossible for one party to govern alone. The agenda is replete with issues whose solution requires imposing losses rather than distributing benefits. Restructuring our social insurance programs, for example, will be politically impossible without substantial numbers of members from both sides of the aisle agreeing to a policy response. Some degree of bipartisanship will be essential if any progress is to be made by the federal government.

The 104th Congress has been notable for its intense and bitter partisanship. Some degree of polarization between the parties was inevitable, given the dramatic end to Democratic rule in the November 1994 elections, the increasing nationalization of congressional elections, the huge membership turnover in the 1992 and 1994 elections, the centrality of the Contract with America and the ambitious agenda of the new Republican majority, and the high-stakes negotiations between the Democratic President and Republican Congress. But healthy competition between cohesive parties has degenerated into bombastic, mean-spirited, often ugly confrontation. A high priority of your deliberation on congressional reform should be reintroducing civility into the House, perhaps beginning by reestablishing routine contact between the parties, both at the leadership and rank-and-file level, and then by dealing directly with those sources of partisan conflict whose roots lie within the House itself.

Before proceeding to a discussion of specific reforms, let me say that the Republican majority deserves credit for moving boldly and decisively on an extraordinary range of congressional reforms long overdue in the House. This is not the place to review in detail what was accomplished at the beginning of the 104th Congress. I will simply summarize by saying important and much-needed steps were taken to centralize power within the party leadership, to consolidate and streamline the committee system, and to restructure and downsize the administrative and staff support systems. I believe there is widespread recognition on both sides of the aisle that most of these reforms were necessary and that they should remain a part of the rules of the House if the Democrats return to the majority. These include the reduction in the number of committees and subcommittees and of the assignments allowed each member; the strengthening of the Speaker vis-a-vis committee chairs; the strengthening of committee chairs vis-a-vis subcommittees; the shift from joint to sequential multiple referrals; the reorganization of House administrative offices; the reduction in committee staff and the consolidation of committee funding procedures; and, of course, the application of federal laws to Congress through the Congressional Accountability Act. More controversial but also likely to be retained by a new House majority include a ban on proxy voting and term limits for committee and subcommittee chairs and the Speaker.

In their determination to move quickly on the promises embedded in their Contract with America, the Republican majority put a premium on aggressive agenda setting, timely action, and party discipline. In pursuit of their broader objectives, they developed a top-down partisan management of the House that often short circuited the deliberative process, especially in committees. Committees were sometimes circumvented entirely as legislation was taken directly to the floor; hearings were often abbreviated or eliminated entirely; markups were elaborately choreographed in advance and then rushed to completion in pro forma sessions; major changes were made in legislation by the leadership after committees had reported; task forces were used to develop party positions apart from the committees of jurisdiction. All in all, it was a remarkable demonstration of party trumping committee. But timely action on the Republican agenda was achieved at substantial costs. There was often insufficient time, opportunity, and discretion for committees to craft the details of legislation and weigh the impact on diverse constituencies. That produced more than one example of sloppy drafting, embarrassment, and unfavorable public reaction. Committee members felt left out as the House acted more like a parliamentary body than one chamber of a bicameral legislature in a separated system of government.

It seems clear now that the Republican majority overreacted to the old regime’s defects. While the Democratic leadership before the 1994 elections was too deferential to individual members and committees, the Republican leadership has gone too far in the other direction. The challenge always is finding the appropriate balance between such competing values as representation and policy making, deliberation and timely action. I think you need to give the committees more breathing room to exercise their comparative advantage, including opportunities for members of both parties to engage in serious and informed discussion. That argues for fewer party task forces and more regular order. It also suggests caution in using the ad hoc committee authority that now exists in House Rules. This should be a mechanism to use once or twice during a session on major issues that spill over several standing committees, not a routine device to circumvent standing committees.

I support the recommendations of the Task Force on Committee Review to make further reductions in the number of subcommittees and to enforce more aggressively the limitations on member assignments. A more ambitious consolidation and jurisdictional realignment of the committee system is still much-needed, and the Task Force may be right that the best way to approach this problem is to launch another Hoover-style commission that tackles simultaneously executive branch and congressional committee reorganization. Until a major reform of the committee system is achieved, one that strictly limits members’ committee assignments, the ban on proxy voting will continue to make life difficult for committee chairs while aggravating the minority. I am not sure the ban is worth the cost in frayed tempers and more intense partisanship.

A number of other steps could be taken to encourage more constructive relations between the parties. The administrative offices of the House, which now report only to the Speaker, might be made accountable to a bipartisan leadership group. The minority party should be given control of minority committee contingent Web pages; House rules should be altered to give the minority the right to post its own pages, thereby adapting for the Internet age the current rule that allows minority views in committee reports. The supermajority requirement for adopting tax increases should be repealed. In general it is bad practice to rig the rules in a majoritarian body to protect a particular policy position. This provision not only provokes party acrimony; it has also been somewhat of an embarrassment to the Republicans when they felt obliged to waive or ignore the rule. Finally, it would be useful to initiate some bipartisan discussion of how to bridge the parties’ differences over how best to conduct floor amending activity. It is not clear that the Republicans’ route for avoiding highly restrictive rules (ad hoc negotiation of time agreements for a select number of floor amendments) is necessarily an improvement over using the Rules Committee in advance to decide which amendments will be in order. Of course, both restrictive rules and these amendment time limits raise he ire of the minority. All I am suggesting here is a good-faith effort to discuss and possibly resolve differences.

I was pleased to see the Task Force on Committee Review address the need for further reform of the ethics process but I doubt whether its recommendations are sufficient to deal with the problems that have emerged in recent years. Increasingly partisan and ideological war is being waged by means other than elections. It is now standard practice to accuse one’s opponents of unethical or illegal conduct, with or without a factual basis for the charge. And those charges are increasingly likely to be amplified by the mass media, making it all the more difficult for an official body inside the House to have the independence and credibility to weigh those charges. Neither a jury system nor fines for “frivolous” charges are likely to do the trick. I believe the time has come for the House (and the Senate) to establish an independent ethics commission to (in the words of Dennis Thompson, author of the Brookings’ study, Ethics in Congress) “investigate charges against members to determine whether there is substantial, credible evidence that a violation of the chamber’s ethics rules has occurred.” The current political atmosphere is too poisonous to allow the Ethics Committee to do the job by itself.

Finally, it goes without saying that no program of congressional reform will be complete without attending to the campaign finance system. This is not the time for a full discussion of that exceedingly difficult issue. I would simply urge you to recommend the establishment of a bipartisan commission to begin to deal with the seemingly intractable issues.