By Ezra Klein  |  October 16, 2009; 5:42 PM ET
 
My final question to Olympia Snowe was a bit of a throwaway. But it yielded the most telling answer of the interview.

What’s the single idea you’d most like to see in the bill but that you don’t think is politically feasible?

That’s a good question. You mean politically feasible?

Yeah. Like single-payer, for some people, or Wyden-Bennett for others. A big idea you’d like to see included but is currently outside the range of discussion.

I don’t know that I have anything in that category. I believe we should build upon the current system. We don’t want to disrupt that. I’m traditional in my approach towards reforming health care. Given the size and the amount of money we spend on it, I think it would be far too disruptive to upend the system. I think it’s preferable to build on what has worked well in our system and change the egregious practices in the insurance industry.

For all the talk of Olympia Snowe's relative liberalism, this is a very conservative answer. It's not necessarily a Republican answer, or a Tea Partier's answer, but it's a small-c conservative answer: It's respectful of tradition, wary of unintended consequences, and suspicious of excessive ambition.

That goes for the bill as well. John McCain wanted to blow up the employer tax exclusion, replace it with a completely different tax credit, and rebuild the American health-care system around the individual marketplace. Liberals want to take the employer-based system and replace it with a single-payer solution. Ron Wyden and Bob Bennett want to cash out all employer plans and put everyone into new marketplaces of their design.

Comparatively, the health-care reform plan we're likely to get is extremely conservative. It builds on the employer-based system, and because that system seems to work better than the individual market, puts in place some new structures to give folks on the individual and small-group markets the same advantages (size, scale and competition, mainly) that seem to have worked for large employers. As I've noted before, the basic structure of the plan actually looks a lot like the plan proposed by moderate Republicans in 1994. Only this year, Democrats are proposing it.

That's not how I'd do health-care reform if I were made czar. I would do something very disruptive, because I don't think that the parts of our health-care system that are working relatively well are working very well in any absolute sense. But then, I'm not a conservative. Nor are a lot of the people voting for this bill. But we have a conservative system of government (in that it's very hard to change the status quo), and they've designed health-care reform to be sensitive to that fact.