MR. DAVID GREGORY: This Sunday: It's do or die for the president's
massive healthcare reform.
(Videotape)
PRES. BARACK OBAMA: We have finally reached the point where inaction is
no longer an option, where the choice to defer reform is nothing more
than a decision to defend the status quo. And I will not defend the
status quo.
(End videotape)
MR. GREGORY: But the toughest obstacles remain over taxes, coverage and
overall cost. Will the president's August deadline be met, and what will
the final bills look like? With us, the administration's point person on
health care, Health and Human Services Secretary Kathleen Sebelius. Then,
the view from the Senate's top Republican, Mitch McConnell. Will
healthcare reform be bipartisan? And why is he preparing to vote against
the nomination of Judge Sonia Sotomayor for the Supreme Court?
Plus, our roundtable weighs in on this high stakes political moment for
the president on health care and the economy. Joining us: Paul Gigot,
editorial page editor of the Wall Street Journal; John Harwood of CNBC
and The New York Times; Richard Wolffe, author of "Renegade: The Making
of a President"; and Michele Norris, host of NPR's "All Things
Considered."
And finally, in our MEET THE PRESS Minute, we remember legendary newsman
Walter Cronkite.
(Videotape, November 22, 1998)
MR. WALTER CRONKITE: The emotional aspect of it hit me when I had to say
that the president was dead.
(End videotape)
MR. DAVID GREGORY: But first, secretary of Health and Human Services,
Kathleen Sebelius.
Welcome back to MEET THE PRESS.
SEC'Y KATHLEEN SEBELIUS: Thank you. Nice to be here.
MR. GREGORY: I thought we'd frame our discussion by going through what
the president says must be included in healthcare reform if he's going to
accept it. Now, this is what you said on that topic back in June on PBS:
"It really has to lower costs, cover Americans, drive quality and be paid
for." So let's go through that.
SEC'Y SEBELIUS: OK.
MR. GREGORY: And I want to start with that first principle of lowering
costs. Most people may not know how expensive health care really is; $2.5
trillion per year, 16 percent of our economy. Here was the president on
that score on Thursday.
(Videotape, Thursday)
PRES. OBAMA: Even as we rescue this economy from this crisis, I believe
we have to rebuild an even better economy than we had before. That means
finally controlling the healthcare costs that are driving this nation
into debt.
(End videotape)
MR. GREGORY: Controlling those healthcare costs. But on that very day,
just hours before the president spoke, there was this from Capitol Hill
from the nonpartisan director of the Congressional Budget Office. He's
kind of the umpire for these plans. He says this: "Congress' chief budget
scorekeeper cast a new cloud over Democratic efforts to overhaul the
nation's healthcare system, telling lawmakers Thursday that the main
proposals being considered would fail to contain costs--one of the
primary goals--and could actually worsen the problem of rapidly
escalating medical spending. `We do not see the sort of fundamental
changes that would be necessary to reduce the trajectory of federal
health spending by a significant amount,' Douglas Elmendorf, director of
the CBO, told the Senate Budget Committee. `On the contrary, the
legislation significantly expands the federal responsibility for
healthcare costs.'" So if lowering costs is the rationale, the president
can't support what's going through Congress right now, can he?
SEC'Y SEBELIUS: Well, as you know, David, first of all, this is a work in
progress. The good news is the House and Senate are actively working and
share the president's goal that overall costs have to come down for
everyone. So they have an initial report on one of the initial bills that
says in the long term this doesn't bend the cost curve enough. The
president has a proposal that he hopes will be incorporated where MedPAC,
an independent group of providers, will help to lower the Medicare costs
long term. But he's very committed to this, and I think it will be part
of the package going forward. About 16 of the recommendations are already
in the legislation in the House and Senate, and we want to include some
more.
MR. GREGORY: But wait, but this is a huge blow, it seems like, on the
face of it. If the priority is lowering costs, you've got the person
who's in charge with a nonpartisan way of looking at these saying it's
not going to contain costs. That was goal number one. It doesn't appear
to be getting achieved through this.
SEC'Y SEBELIUS: Well, I think, I think, first of all, it's clear that
this will bring costs down to a degree. It won't do enough over time, and
I think we'll incorporate that. But I think you got to start from ground
zero, which is the status quo is absolutely unsustainable. We have costs
ratcheting up at this alarming rate, 16 percent of our GDP; every
business, every family, every organization, every government is paying
more and getting less. We live sicker, die younger and spend more than
any nation.
MR. GREGORY: Well, but that's fine. But you want to spend a trillion
dollars to bring costs down, and that the CBO is saying you won't bring
costs down. And all you're saying in response to that is, "Well, no, they
actually will"? I don't understand the disconnect here.
SEC'Y SEBELIUS: No, I think, I think that more will be done, the House
and Senate are committed to working with the president with that.
MR. GREGORY: All right. Well, what is the president committed to doing in
terms of saying to both the House and the Senate leaders working on this,
"You've got to control costs"? Because it seems to me this was a wake-up
call, was it not?
SEC'Y SEBELIUS: Well, he's been doing that all along. He's very engaged
and involved. And I think the Senate and the House members want to do
this. This is a, a sort of initial scoring, if you will. The House is
still...
MR. GREGORY: Was it a wake-up call to the president?
SEC'Y SEBELIUS: Well, I think, I think we know now that more has to be
done. As I say, he's got a proposal on the table that he hopes Congress
will take a serious look at.
What I think is, is somewhat disingenuous, though, is that the last real
health reform put on the table, the incorporation of Medicare Part B,
wasn't paid for at all and is part of the cost driver. We have some
initiatives that are under way that we know we need to reform. There's no
scoring at this point, no cost savings at all for the prevention and
wellness investments that we know will pay off long term. So we'll
continue to work on this and...
MR. GREGORY: So this isn't ready yet?
SEC'Y SEBELIUS: No.
MR. GREGORY: In other words, this is not ready, this does not meet the
president's goals yet?
SEC'Y SEBELIUS: Well, we don't have the bill even out of the Senate
Finance Committee, that's still under way, the bipartisan effort that's
going on. The House is still on markup. This is a work in progress. And I
think the House leaders and Senate leaders share the president's goal
that costs will come down.
MR. GREGORY: Right. So the message here, the bottom line from the
president to leaders working on this in the Congress is, "You had better
lower costs before this gets to me."
SEC'Y SEBELIUS: Well, it isn't that the president is scolding anyone.
MR. GREGORY: Right.
SEC'Y SEBELIUS: He's congratulating them for the work and saying we...
MR. GREGORY: But it's his goal.
SEC'Y SEBELIUS: Well, we need to keep...
MR. GREGORY: But, Madam Secretary, it's his goal.
SEC'Y SEBELIUS: I understand.
MR. GREGORY: He said it's got to lower costs...
SEC'Y SEBELIUS: Yes.
MR. GREGORY: ...and you're not contradicting the idea that the CBO says
it's not.
SEC'Y SEBELIUS: Well, we have gone, I think, a long way to, again,
incorporating what the CBO director said needed to be in the bill. Many
of those elements, the vast majority are already in the bill. And I think
we need to take another step in terms of--and it's probably the, the
MedPAC idea, making sure that an independent group a step removed from
Congress is able to continue to watch that cost curve and help us drive
quality. I mean, that's what we're really trying to do.
MR. GREGORY: Right. And we'll get to that in a minute.
SEC'Y SEBELIUS: Out of the...
MR. GREGORY: But in other words, an independent group watches costs after
it's been passed...
SEC'Y SEBELIUS: No, no, no.
MR. GREGORY: ...to try to contain them?
SEC'Y SEBELIUS: It, it's part of the changes that we need so that we go
ahead and implement a number of the recommendations, the cost-cutting
recommendations that have been made year after year but Congress has
failed to implement them.
MR. GREGORY: Let me get to the other priority here, which is
coverage of Americans.
SEC'Y SEBELIUS: Right.
MR. GREGORY: Forty-seven million Americans, roughly, uninsured right now.
Is universal coverage the priority?
SEC'Y SEBELIUS: It isn't the priority, it's one of the priorities: cost,
quality, coverage. All three have to be part of this fundamental reform.
MR. GREGORY: So if there are, say, millions of Americans who are left
uninsured, it would not stop the president from signing a healthcare
reform bill?
SEC'Y SEBELIUS: Well, I think that it--one of his goals, again, it, it's
not one or the other. He wants a bill that covers all Americans, that
offers affordable, quality coverage to all Americans.
MR. GREGORY: We have some experience with universal health care now in
Massachusetts...
SEC'Y SEBELIUS: That's right.
MR. GREGORY: ...and they're taking a hard look at that, because on the
issue of costs it doesn't appear to be going so well. This is how the
Wall Street Journal reported it on Friday: "In 2006, Massachusetts
adopted a healthcare law that was attain near-universal health insurance
coverage...[b]ut the plan has done little to control costs, which are now
33 percent higher than the U.S. average and projected to grow faster than
the rest of the country." Is that another flashing red light here?
SEC'Y SEBELIUS: Well, I think--I've had a lot of discussions with the
Massachusetts individuals, including the head of their retail
association, who was very involved in passing the bill. He said they made
a fundamental mistake, they did this as two steps; they went for
universal coverage, now they have a group back at the table revisiting
the costs. What the president has said from the outset is we need to do
them both together. We need to have this as a comprehensive reform that
both covers all Americans, but also lowers costs.
MR. GREGORY: But what are you doing to anticipate the result that you've
already seen here, which is universal coverage, covering more people,
subsidizing more people to get insurance...
SEC'Y SEBELIUS: That's right.
MR. GREGORY: ...drives up costs, does not bend the cost curve.
SEC'Y SEBELIUS: Well, not unless you incorporate that at the outset, and
that's why 16 of these proposals are already in. We're going after fraud
and abuse in a, in a fundamentally different way. We know there are
billions of dollars stolen out of the system every year. It's why the
president insistent on the public option. One of the ways to lower
costs...
MR. GREGORY: The idea--public option of a government plan that competes
with private insurance plans.
SEC'Y SEBELIUS: Competing. We have insurance companies right now who pick
and choose not only who gets covered, but basically with monopolies in
many parts of the country, drive the costs up. We need some competition
in the system to bring those costs down.
MR. GREGORY: Right. Because a public plan would necessarily be less
expensive.
SEC'Y SEBELIUS: Competition will lower costs.
MR. GREGORY: Right. But a public plan would necessarily, for it to, to
work, would be less expensive for consumers.
SEC'Y SEBELIUS: Well, I think it will...
MR. GREGORY: Right.
SEC'Y SEBELIUS: ...I think it will lower the overhead costs that are
often 30 cents on the dollar, give some affordable options to small
business owners and self-employed Americans and help jump-start this
economy.
MR. GREGORY: So why wouldn't everybody go to a public plan, then? If it's
less expensive, why wouldn't everybody choose that?
SEC'Y SEBELIUS: Well, I think that a lot of people have coverage they
like. I think what you'll see is private insurers will be competitive.
They will have innovative practices, they'll compete for benefit plans
that may be more attractive. That's what we want in a marketplace.
MR. GREGORY: All right. Let's talk about quality. And you mentioned, if I
like my insurance, I'm going to be able to hold on to it. That's what the
president talked about in his weekly radio address. Listen to that.
(Videotape, Saturday)
PRES. OBAMA: Under our proposal, if you like your doctor, you keep your
doctor. If you like your current insurance, you keep that insurance.
Period, end of story.
(End videotape)
MR. GREGORY: But is that truth in advertising? The AP did an analysis of
this, and this is what they reported Saturday: "It's a pledge beyond
Obama's control. His plan leaves companies free” to charge their health
plans, rather, "to change their health plans in ways that workers may
not like or to drop insurance altogether." If an employer says, "We can't
afford what we've got," a small business owner, they can change whether
the employee likes it of not.
SEC'Y SEBELIUS: Well, David, that is the--that's exactly what's happening
in this marketplace. We have 12,000 Americans each and every day losing
coverage. We have small business owners, over half of whom used to offer
coverage, who don't anymore, who are being priced out of the marketplace.
What the president is talking about is stabilizing employer coverage,
making it easier for small employers to, first of all, offer coverage.
MR. GREGORY: Mm-hmm.
SEC'Y SEBELIUS: A lot of them tell me, "We can't compete for good
employees because they'll go down the street to somebody who's got health
benefits when I can't offer them." We got people locked into their job
who would like to start a small business or work for somebody else. We
have parents terrified when their kids graduate from college, happy day,
but they're suddenly uninsured and some of them uninsurable. We have a
system that absolutely doesn't work.
MR. GREGORY: But it doesn't address the fact that if you like your
insurance you may not be able to keep it, like the president says.
SEC'Y SEBELIUS: Well, the employer market would be more stable in a new
reformed healthcare system than it is right now, and that's really what
the president is talking about, where employers would have help and
incentives to offer coverage to their employees. Small employers would
have a tax incentive and be excluded from the pay or play, be able to
stabilize that marketplace and be far more competitive than they are
right now.
MR. GREGORY: You can't have it all, though. The president said no free
lunches.
SEC'Y SEBELIUS: That's right.
MR. GREGORY: And what I have not heard from the president and I wonder
what you would say to Americans, what is it that they have to sacrifice
in order to achieve this goal of universal coverage?
SEC'Y SEBELIUS: Well, I think both the House and Senate bills are
contemplating some responsibility that both--that everyone would, would
have a, a responsibility to have health insurance, that business owners
would have a responsibility to provide health insurance and that the
government would do their fair share. We're also hoping that that
personal responsibility extends to lifestyle; that in order to have a
healthier America, a more productive America, we need to make some basic
changes in what we eat, how much we exercise, getting our kids up off the
couch, turning off the video games.
MR. GREGORY: Right.
SEC'Y SEBELIUS: But that's a personal responsibility that all of us can
take.
MR. GREGORY: But the government, in this plan, would say there are
certain things we're not going to pay for. Do Americans have to accept
the fact that there's going to be some limit to what gets paid for?
SEC'Y SEBELIUS: There's limits right now. Insurance companies pick and
choose every day who gets what benefits, who gets what drugs, whether or
not you get the procedure your doctor ordered. This notion that we're
going to somehow ration in the--rationing is going on each and every day
and it's done in the private market. I think what has to happen is we
know about 30 percent of the tests that are done don't make us any
healthier. We know that there are areas in the country where there's a
redundancy of medical procedures, people readmitted to the hospital,
other areas where there's high quality, low-cost care. That's what we
want every American to have access to.
MR. GREGORY: Let's talk about how you're--the, the, the other principle
here, the president says it's got to be paid for, it can't add to the
deficit. Let's talk about how you want to do that. The House plan would
levy a surtax on the richest Americans, and there's some concern about
that even among Democrats. This was The New York Times' analysis on
Saturday: "Representative Jared Polis, a freshman Democrat from
Colorado...said he worried that the new taxes `could cost jobs in the
middle of a recession.' To help finance coverage of the uninsured, the
House bill would impose a surtax on high-income people and a payroll
tax--as much as 8 percent of wages--on employers who do not provide
health insurance to workers...In a letter to the House speaker, Nancy
Pelosi, Mr. Polis and 20 other freshman Democrats said they were
`extremely concerned that the proposed method of paying for healthcare
reform will negatively impact small businesses, the backbone of the
American economy.'" Does the president support a surtax on the richest
Americans to get this health care paid for?
SEC'Y SEBELIUS: What the president supports is paying for this bill. He
has said that it will not add a dime to the deficit, that we won't pass
it along.
MR. GREGORY: But does he support this?
SEC'Y SEBELIUS: He knows that the House has a plan to pay for it. That's
very good news. The Senate has a...
MR. GREGORY: But why won't he commit, Madam Secretary? Why can't the
American people know what it is he'll support? This is a very concrete
plan that is now moving its way through the House.
SEC'Y SEBELIUS: I understand, David. But as you know, there are basically
five different plans in Congress right now and there are a variety of
ways. What's the good news, this Congress and this president are
committed to paying for this over time. In the last bill, the Medicare
bill in 2003, billions of dollars of new drug benefits were provided for
America's seniors. That's good news, they needed the drug benefit. Not a
dime was paid for, not an effort to put any money on the table. so we are
committed to paying...
MR. GREGORY: But we're talking about this plan, we're talking about this
plan. But...
SEC'Y SEBELIUS: And it will be paid for.
MR. GREGORY: You say you're committed, but you won't say whether you
support this surtax.
SEC'Y SEBELIUS: Well, I think the ideas are in play.
MR. GREGORY: All right.
SEC'Y SEBELIUS: This is a very legitimate way to go forward. The Senate
is working on some other ideas.
MR. GREGORY: Right.
SEC'Y SEBELIUS: The president has put forward his ideas. In all the
plans, more than half the money to pay for this proposal is already in
the system. It's money that is misdirected now to efforts that don't work
very well. So a lot of the money is really coming from savings and
efficiencies from fraud and abuse from other areas and being directed to
high quality, lower cost care.
MR. GREGORY: Does the president believe if everybody benefits under
healthcare reform, everybody should pay?
SEC'Y SEBELIUS: Absolutely. Absolutely.
MR. GREGORY: He does? Then why is it he doesn't support taxing benefits
for employees?
SEC'Y SEBELIUS: Well, he's always said from the outset that he's--back to
the notion that you should keep your coverage if you have it, that that
may dismantle the private market, that it is the incentive given to
employers to provide coverage. And what he--180 million Americans have
coverage through their employee workplace, and a tax on those benefits
may dismantle that market and then have people lose their coverage. So
he's reluctant to move in that direction without...
MR. GREGORY: Even though that's consistent with the idea of if everybody
benefits, everybody pays.
SEC'Y SEBELIUS: Well, I understand.
MR. GREGORY: He thinks that upper-income Americans should shoulder most
of the burden.
SEC'Y SEBELIUS: Well, not most of the burden. As I say, half the money in
all the plans is already in the, in the system. There are a variety of
proposals to raise revenue. The House has one that's a very legitimate
proposal. The Senate is working on others.
MR. GREGORY: Right.
SEC'Y SEBELIUS: The Senate Finance Committee hasn't come out with their
proposal. He talked about a cap on, on itemized deductions that he still
thinks is a very legitimate way to go.
MR. GREGORY: Right.
SEC'Y SEBELIUS: So there are a variety of proposals on this. But it will
be paid for, it, it will not add to the deficit, and that's very good
news.
MR. GREGORY: On timing, will the president meet his deadline? There are
Democrats who say, "We shouldn't have a fixed deadline to do this by the
August recess, we need more time." What will his bottom line be?
SEC'Y SEBELIUS: Well, I think he's, he's very clearly urging the House
and Senate to stay at the table and work. They're working very hard. The
August recess is looming. The bills are--the good news is, you know, that
this week America's doctors, through the American Medical Association,
endorsed the health reform bills. The nurses have endorsed the health
reform bills. The hospitals and drug companies and others are at the
table.
MR. GREGORY: Right.
SEC'Y SEBELIUS: And we think this can be done. The House and Senate are
on track and on time, and we think that he...
MR. GREGORY: He's urging, but not demanding.
SEC'Y SEBELIUS: Well, I, I--he isn't a member of the House or the Senate.
MR. GREGORY: Right.
SEC'Y SEBELIUS: He's saying this is an important issue. It may be the
single most important issue to get our economy back on track, and the
status quo cannot work. It doesn't work. It's bankrupting this country.
MR. GREGORY: But it looks like that deadline could slip.
SEC'Y SEBELIUS: Well, hopefully they'll get it done before the August
recess.
MR. GREGORY: Before you go, on the issue of swine flu, which is still
moving throughout the country and around the world, the fall is a big
concern.
SEC'Y SEBELIUS: That's right.
MR. GREGORY: Will there be a vaccine ready, if necessary, and how big of
a hit do you think we'll feel in flu season?
SEC'Y SEBELIUS: Well, we, we don't know how big a hit. We're watching the
Southern Hemisphere, which right now is in flu season, and H1N1 is
moving. So far it hasn't gotten more lethal, but the cases continue to
grow. We're on track to have a vaccine ready by mid-October. We need to
make sure it's safe, and so clinical trials will begin. And we need to
make sure it's, it's effective against this new novel strain. So that's
what's happening in the meantime. And if the scientists say it's a go, by
mid-October we will have a vaccine available and start with the priority
communities.
MR. GREGORY: We will leave it there. Secretary Sebelius...
SEC'Y SEBELIUS: Thanks.
MR. GREGORY: ...thank you very much for being here.
SEC'Y SEBELIUS: Nice to be with you.
MR. GREGORY: Up next, the other side of the healthcare debate and a look
at the upcoming vote on Supreme Court nominee Judge Sonia Sotomayor.
We'll be joined by the Senate Republican leader Mitch McConnell. Plus,
insights and analysis from our political roundtable, coming up only on
MEET THE PRESS.
(Announcements)
MR. GREGORY: The view from the other side with the Senate's top
Republican, Mitch McConnell, after this brief commercial break.
MR. DAVID GREGORY: Joining us now, the Senate's top Republican, Senator
Mitch McConnell.
Welcome back to MEET THE PRESS.
SEN. MITCH McCONNELL (R-KY): Glad to be with you, David.
MR. GREGORY: We just heard from the secretary of Health and Human
Services, and I thought a couple of significant points, the first on
timing. Is the president going to get a bill out of the House and Senate
by the August recess?
SEN. McCONNELL: Well, I don't think he ought to get the particular bills
that we've seen out of either the House or the Senate before August,
because they're really not the right way to go. I mean, what's going on
here, David, it's perfectly clear, this is the same kind of rush and
spend strategy we saw on the stimulus bill. We're going to have a deficit
this year, $1.8 trillion, that's bigger than the deficit of the last five
years combined. They passed a budget that puts us on the path to double
the national debt in five years, triple it in 10. And here comes health
care on top of it. As you just pointed out with Secretary Sebelius, CBO
says it's a quarter of a trillion dollars that will not be paid for. And even
if you look at the pay force, they're taking it out of the backs of
senior citizens and small businesses. This is a bill that shouldn't pass
at any point, either before the August recess or later in the year. What
we need to come up with is a truly bipartisan proposal.
MR. GREGORY: Will they get what they, what they're working on now,
though? Do you think they'll get it passed?
SEN. McCONNELL: Well, I certainly hope not. I don't think this particular
measure ought to pass either the House or the Senate, because it's not
good for the country.
MR. GREGORY: And that's the big factor here in terms of cost. Did you
hear from Secretary Sebelius, who certainly recognized the fact that the
CBO said that increased costs over time undermined their goal. The
president would have to really drive some specific cost-cutting before
signing on to these measures.
SEN. McCONNELL: Well, if you're going to do something as comprehensive as
the president wants to do and you're going to pay for it, and you, you
ought to pay for it, there are no easy choices. And this is what they're
grappling with right now.
Let me, let me just tell you what I think, David, if I may, is flawed
about the whole approach. They don't seem to grant that we have the
finest health care in the world now. We need to focus on the two problems
that we have, cost and access, not sort of scrap the entire healthcare
system of the United States. It's laughingly said around the Senate,
"Where would the Canadians go for quality health care?" John McCain and
John Cornyn and I were down at MD Anderson in Houston, one of the world's
famous cancer hospitals, a couple of weeks ago, having a meeting with
their healthcare professionals. They take care of patients from 90
countries who come to Houston to save their lives. We have quality health
care now. Surveys indicate that Americans overwhelmingly like the
quality.
MR. GREGORY: Right.
SEN. McCONNELL: So let's focus on access and cost and not try to scrap
the whole system.
MR. GREGORY: Well, but wait a minute. You, you say that we have the best
healthcare system in the world, you say it as a matter of fact.
SEN. McCONNELL: Mm-hmm.
MR. GREGORY: But it seems to be a matter of debate. You just mentioned
access. You've got 47 million people who are uninsured.
SEN. McCONNELL: Mm-hmm.
MR. GREGORY: And there are experts, including one expert who is now an
Obama adviser, who actually writes about this idea that it's a myth that
it's the best health care in the world.
SEN. McCONNELL: Mm-hmm.
MR. GREGORY: And this is what he wrote along with another expert last
fall, saying: "It's a myth that America has the best health care in the
world. The United States is number one only in one sense, the amount we
shell out for health care. We have the most expensive system in the world
per capita, but we lag many developed countries on virtually every health
statistic you can name"; life expectancy, infant mortality, obesity,
death rate from prostate cancer, heart attack recovery. That's the best
system in the world?
SEN. McCONNELL: That's one expert. If you look at the surveys and ask the
American people what they think, they don't think quality is a problem.
They think cost is a problem and access is a problem.
Let's look at access, the people who are uninsured that you mentioned. A
better way to begin to deal with that problem is to equalize the tax
treatment. Right now if you're running a business and you provide health
care for your employees, it's deductible on your corporate tax return.
But if you're an individual buying health care on the open market, it's
not deductible to you. We ought to equalize the tax treatment. Another
cost item we seriously ought to address, that the administration only
pays lip service to and some of the proposals kicking around in Congress
actually discourage, are these wellness efforts that we've seen on
display, for example, at the Safeway company, which through their own
efforts have targeted the five biggest categories of preventable
disease--smoking, obesity, high cholesterol, high blood pressure and lack
of exercise--and incentivized their employees to improve their personal
behavior in all of those areas and capped their costs. They never
mentioned junk lawsuits against doctors and hospitals. We're spending
billions every year, billions in junk lawsuits defending, in defensive
medicine, defending all these lawsuits. They don't want to do anything
about that.
MR. GREGORY: And yet you say that the time is now to act. You think
something must be done.
SEN. McCONNELL: Oh, absolutely. I'm not in favor of doing nothing. We
have a cost problem and we have an access problem. We do not have a
quality problem.
MR. GREGORY: Do you think it's a moral issue that 47 million Americans go
without health insurance?
SEN. McCONNELL: Well, they don't go without health care. It's not the
most efficient way to provide it. As we know, the doctors in the
hospitals are sworn to provide health care. We all agree it is not the
most efficient way to provide health care to find somebody only in the
emergency room and then pass those costs on to those who are paying for
insurance. So it is important, I think, to reduce the number of
uninsured. The question is, what is the best way to do that? The
proposals over in the House, according to CBO, not only aren't paid for,
they don't really dramatically increase the--decrease the number of
uninsured.
MR. GREGORY: Ted Kennedy, a driving force behind healthcare
legislation--Senator Kennedy, obviously, suffering from brain cancer.
He's on the cover of Newsweek magazine, he's written an essay, and in it
he writes this: "Quality care shouldn't depend on your financial
resources, or the type of job you have, or the medical condition you
face. Every American should be able to get the same treatment that U.S.
senators are entitled to. This is the cause of my life. It's a key reason
that I defied my illness last summer to speak at the Democratic
Convention in Denver--to support Barack Obama, but also to make sure, as
I said, that we will break the old gridlock and guarantee that every
American...will have decent, quality health care as a fundamental right
and not just a privilege." Is he a driving force in this debate that will
prevail, in the end?
SEN. McCONNELL: Well, we all love Ted Kennedy and we wish him well and
hope for his recovery. But we don't necessarily agree that his particular
prescription is going to bring about quality health care for Americans,
for all Americans. We'd all like to do that. The problem is the direction
in which the Democratic majority seems to want to go and the president
wants to go would basically put the government in charge of our health
care. We've had an experience with that already with government-run
automobile companies. Ford Motor Company makes automobiles in my
hometown. The CEO called me up recently and he said, "We're doing
reasonably well compared to everybody else in this recession. People
appreciate the fact that we haven't taken any money from the government.
But we've got a problem. The government now runs the finance companies of
GM and Chrysler. And since they're running the finance companies, they're
undercutting us on the financing of our automobiles." Sound familiar?
When Secretary Sebelius says that there will be more competition if you
have a government-run insurance company, there will be no competition.
The government will, with the backstop of the taxpayers, undercut the
1,300 or so health insurance companies we have. We won't have any
competition at all. Pretty soon the doctors and the hospitals will all be
working for the government. And the notion that this'll be cheaper, I'm
reminded of what the humorist P.J. O'Rourke said: "If you think that
health care is expensive now, wait till it's free."
MR. GREGORY: Although it's pretty expensive now.
SEN. McCONNELL: It is.
MR. GREGORY: And there are issues like rationing the, the Republicans
bring up that goes on now, when private insurance companies say you can't
have certain things covered. That already exists.
SEN. McCONNELL: Yeah. Not like it would if you had a government plan. I
had a friend of mine in Florida who called up recently and said he'd just
lost a friend of his in Canada because the government decided he was too
old for a certain kind of procedure, and apparently he didn't have the
money or the ability to get down to the United States for quality health
care. I don't think that's the direction the American people want us to
go, David.
MR. GREGORY: Final point on this, and that's political tactics here.
SEN. McCONNELL: Mm-hmm.
MR. GREGORY: This is what the Washington Post reported Saturday: "[The]
main goal [of Republicans] is to slow down the pace of legislation in
Congress in the hope of fomenting wider opposition. `If we're able to
stop Obama on this, it will be his Waterloo,' Senator Jim DeMint said
during a conference call with conservative activists. `It will break
him.'" Is this constructive opposition?
SEN. McCONNELL: Look, my goal is not to stop the president, my goal is to
get the right kind of health care for America. And the direction in which
the president and the majority in the House and Senate want to take this
is the wrong direction. What we hope to do is to have enough time here
for people to truly understand what's going on. As you know, David,
they're having a hard time--our Democratic friends are having a hard time
selling this to their own members, a very difficult time, because it's a
flawed approach and the wrong direction in which to go.
MR. GREGORY: Let me move on to the economy.
SEN. McCONNELL: Mm-hmm.
MR. GREGORY: You have said that the stimulus plan was a failure. Critics
on the left have said it's simply too small, there needs to be more
stimulus.
SEN. McCONNELL: Mm-hmm.
MR. GREGORY: Paul Krugman, columnist for The New York Times, liberal
economist, wrote this on July 9th: "Policymakers should stay calm in the
face of disappointing early results, recognizing that the plan will take
time to deliver its full benefit. But they should also be prepared to add
to the stimulus now that it's clear that the first round wasn't big
enough. ... Republicans--and some Democrats--have treated any bad news as
evidence of failure, rather than as a reason to make the policy
stronger."
SEN. McCONNELL: We've got an old saying down home that there's no
education in the second kick of a mule. We've seen what happened with the
first stimulus. The president said "Rush and spend it, pass it, we'll,
we'll hold unemployment to 8 percent," which now pretty clear we're going
to 10. In my state it's almost 11. By any measurable index, the stimulus
package has been a failure.
MR. GREGORY: Mm-hmm.
SEN. McCONNELL: And we are adding, as I indicated earlier, dramatic
amounts of money to the deficit. We're spending, David, $100 million a
day in interest on the stimulus that we passed back in January--February.
The rush and spend was what they told us; pass it and we'll hold
unemployment to 8 percent. By any objective standard, this has been a
failure.
MR. GREGORY: You have announced that you will oppose Judge Sonia
Sotomayor for the Supreme Court. Why?
SEN. McCONNELL: I think her personal story is remarkable. I myself am
married to an immigrant who came to this country not speaking a word of
English and who ended up in the president's Cabinet. I'm a big fan of her
career, the way she rose from humble beginnings and went to fine schools
and had a, a marvelous career. The--but the problem is, as the president
himself indicated in opposing Justice Roberts and Justice Alito, both of
whom he opposed, and he filibustered Justice Alito, we're looking for
judges here who're going to be, as Chief Justice Roberts said, an umpire,
call the balls and strikes. And what I worry about with regard to Judge
Sotomayor is that her personal views, which she's expressed quite
frequently, lead me to believe that she's--lacks the objectivity that you
would prefer to have in a member of the Supreme Court. And by the way,
there's no appeal from the Supreme Court. It, it's the last word.
MR. GREGORY: Do you see anything stopping her confirmation?
SEN. McCONNELL: Oh, I'm not going to predict the outcome. I, I'm, I'm
just...
MR. GREGORY: But there will be Republican support.
SEN. McCONNELL: There, there were three Republicans announce their
support Friday. As I said, she's, she's an outstanding individual and
should be commended for her lifetime of public service.
MR. GREGORY: Before you go, it's been a disturbing development overnight,
a U.S. soldier captured by the Taliban and they've made a videotape
showing him speaking about the hardships of the war. What's troubling, as
you see this at a time of ramped-up commitment of troops to Afghanistan?
What's troubling to you about seeing, seeing that video at this point?
SEN. McCONNELL: Oh, I'm sorry, I thought you were going to show it.
MR. GREGORY: No.
SEN. McCONNELL: The, the president's doing the right thing in both Iraq
and Afghanistan. It's regretful that this soldier has been captured, but
it illustrates, again, the nature of the enemy, that they would try to
coerce an American soldier into saying bad things about his country or
to, or to suggest that we ought to stop the effort in Afghanistan. The
president, in my view--I want to--happy to say something nice about him
here, something supportive. I think he's done the right thing in both
Iraq and Afghanistan. He's recognized that being on offense in both those
countries has kept us safe. And it's just regretful that this soldier has
been captured.
MR. GREGORY: Senator McConnell, thank you very much for being here this
morning.
SEN. McCONNELL: Thank you.
MR. GREGORY: And up next, a crucial moment for the Obama administration
on both health care and the economy. Our political roundtable weighs in:
Paul Gigot, John Harwood, Richard Wolffe and Michele Norris. Plus, our
MEET THE PRESS Minute, remembering Walter Cronkite, after this brief
station break.
MR. DAVID GREGORY: And we're back now with our roundtable: Paul Gigot and
Richard Wolffe, Michele Norris and John Harwood. Welcome to all of you.
All right, tomorrow marks six months in office for President Obama. John
Harwood, this is do or die time, as I've been saying, on healthcare
reform. And to me the biggest issue, and you heard it addressed with
Secretary Sebelius, is whether or not the number one goal of containing
costs over time will be achieved. The CBO said this week, Congressional
Budget Office, said not with the plans you've got in Congress so far. How
can the president stand behind these plans?
MR. JOHN HARWOOD: Well, I think you're going to see some adjustment in
the plan. You already saw, since Doug Elmendorf spoke on the Hill, a
ramped-up effort to get this MedPAC idea, an independent commission that
would say no to some of the spending that's now taking place in the
system. And I think you've got a live conversation ongoing within the
administration, within the--between the two parties on Capitol Hill about
whether, in fact, you ultimately finance part of this package by taxing
health benefits, which is one proposal that would both raise revenue and
could bend the cost curve. Health economists agree on that.
MR. GREGORY: Hm.
MR. HARWOOD: It's very politically touchy. Labor unions are against it.
Are the Democrats going to go there and try to strike a deal with
Republicans? We don't know yet.
MR. GREGORY: We know, for one thing, that the president's in campaign
mode. He was campaigning this week for Governor Corzine in New Jersey,
who's got a tough race for re-election there this year; also campaigning
for health care. This is what he said.
(Videotape, Thursday)
PRES. OBAMA: We have talked and talked and talked about fixing health
care for decades, and we have finally reached a point where inaction is
no longer an option, where the choice to defer reform is nothing more
than a decision to defend the status quo. And I will not defend the
status quo. We are going to change healthcare reform.
(End videotape)
MR. GREGORY: So, Paul Gigot, is he a president who has, has got the
reigns here, or does he appear defensive?
MR. PAUL GIGOT: Oh, well, he's still popular, but he is in a rush to get
this done in August for a couple of reasons. One, because his own--the
popularity of his own agenda is falling. He's personally more popular
than his, than his agenda is, particularly on health care and the
economy, and they're worried that if they don't pass this by August it's
going to be more difficult in the fall because a lot more Democrats are
going to see his approval rating fall, particularly if unemployment
rises. It's now 9.5 percent, it's probably going to get to 10. More and
more Democrats are going to get jittery about the 2010 elections. And
they're also worried about this House bill...
MR. GREGORY: Right.
MR. GIGOT: ...which has enormous tax increases in it. And if that hangs
out there in August, it's going to be a real opportunity for a lot of
people.
MR. GREGORY: You wrote about that this week on the editorial page of the
Wall Street Journal, highest tax rates...
MR. GIGOT: Higher than France if you combine state and federal.
MR. GREGORY: Right.
MR. GIGOT: Higher than France, higher than all but three European
countries, top marginal income tax rate, upper 50s. That's very dangerous
for the economy at this time, and a lot of Democrats are nervous about
it.
MR. GREGORY: Right. Because it's not just Republicans.
MS. MICHELE NORRIS: Right.
MR. GREGORY: I mean, you heard Senator McConnell. Obviously, Republicans
aren't going anywhere, which is another problem in terms of getting
bipartisan support, if there's going to be any Republican support. But
it's Democrats who look at this and say, "Hey, we're in the middle of a
recession, we've got to go campaign next year. Should we be raising taxes
to this extent?"
MS. NORRIS: That's one of the things that has been so interesting about
this is the president is having a hard time selling this plan to members
of his own party. I thought it was really interesting to see him just on
that clip now and hear the Barack Obama that we heard on the campaign
trail. I mean, you know, he usually sounds much more measured right now.
But it's a little bit--if you're following this, he's sort of all over
the place right now. He's talking about health care, but he's also doing
all kinds of other things. And so the message is, is, you know, people
make the, the legitimate criticism that he's not putting as much into
this as perhaps he could. And with all the horse trading going on on the
Hill right now...
MR. GREGORY: Right.
MS. NORRIS: ...the, the danger is that when you see this kind of
last-minute horse trading, arm twisting going on, it usually makes
legislation worse instead of better.
MR. GREGORY: You know...
MS. NORRIS: We saw that with the, with the climate change bill.
MR. GREGORY: Richard Wolffe, take this on. I mean, the conventional
wisdom here is that he's on the ropes here on health care. Is that
overstated?
MR. RICHARD WOLFFE: No, I think it's a challenge. And the longer it goes
on--Paul is right not about the polls, but about delay has always killed
health care. So the longer this delays, the worse his authority gets. But
he is going to try and step this up now.
MR. GREGORY: Right.
MR. WOLFFE: Can he get--do it just by being in campaign mode? The answer
is no. He has to give Democrats the tools to go sell this program. He has
to do some arm twisting. He has to be like LBJ here and get involved,
especially with his own Democrats. And while this is a debate about tax
and spend and budget curves, while he's being conventional, he's going to
struggle. He has to go out and say this is about gimmicky politics. He's
the outsider. He's the authentic voice.
MR. GREGORY: Right.
MR. WOLFFE: And people are paying more and getting less. If he puts it on
those terms, he has a path. Right now he's not on that path.
MR. GREGORY: You're shake, you're shake...
MR. HARWOOD: (Unintelligible)...does he meet his own test? In--he's put
out the test that cost control is the first principle. He knows that's a
more popular thing to talk about, he's also for it. But if you--if his
own bill, if the Democrats' own bill doesn't meet his test, how does he
go vigorously sell it and make it work?
MR. WOLFFE: The test becomes about what is affordable. You know, in the
campaign they realized that health care wasn't its own issue, it was an
economic pocketbook issue. So while they're talking about budgets or the
uninsured--they don't talk about the uninsured anymore, they don't really
talk about universal coverage at all--they need to make this about what
people can afford and what they're getting for health care. Anything
else, while it's the Beltway discussion, is going to kill it.
MS. NORRIS: But outside of the Beltway there's an interesting data point
here that people involved in the process talk about, the fact that some
90 percent of the people who voted actually have health insurance and
three-quarters of them are satisfied with what they got. And there's
different ways of looking at that. And one way to look at that is to say
that perhaps there is not the public mandate for this that would dictate
this sort of rush to legislation, and that's going to make it harder to
make that point and sell that when they, when they...(unintelligible).
MR. GIGOT: I agree with that. But he's making the same mistake that he
made on the stimulus. And he got away with it on the stimulus because it
was first bill and it was early and the economy was in bad shape. But
he's governing from the left. He's turned over. He's subcontracted out a
lot of his agenda to the committee chairmen, predominantly liberals, on
Capitol Hill, and they're driving this from the, from the left. That's
why you see these, these extraordinary cost and these extraordinary
taxes. There is a better way to govern through the center out, the way
Bill Clinton did on welfare reform, where he could get Republicans pass
tax credits to help the uninsured, get those Republican votes, deal with
the tax exclusion that John McCain suggested in the campaign, that John
just talked about. But he won't do that because he knows that will upset
his political left.
MR. GREGORY: Let's, let's add the economy into this. And again, all about
jobs. This week a remarkable figure, the deficit topped a trillion
dollars for the year. And looking at unemployment, the idea of the long,
hard slog here, The New York Times did an analysis, going inside the
numbers. Beyond the unemployment late, if you factor in people who are
working part-time who want to work full-time or those who are, who are
not now looking for a job, look at those states where unemployment gets
us into the high double digits here.
John, if you combine the economy and health care, this is about Obama
performance. If he doesn't, if he doesn't get health care, if he doesn't
change the dynamic on the economy, this is the blueprint for a Republican
opposition to him in 2010.
MR. HARWOOD: Yes. And this is the issue on which the timing gets very,
very tough for Barack Obama. Even if you do everything right on the
economy--and the administration would not concede Paul's point that they
made the mistake on the stimulus--even if that's working and the
economy's in the process of returning to positive GDP growth,
unemployment, by their own estimation, is going to continue to rise in
the top 10 percent. How do you get the public to accept that this is
going to work in the long run when they're seeing these scary numbers
and, and seeing in some states, like Michigan, where unemployment's 15
percent? And that's why Senator McConnell's argument that he made with
you is pretty powerful. Look at this size of this deficit, over a
trillion dollars, and now here comes health care. If you look at the
polls, the issue of spending and the deficit are where the
administration's most vulnerable.
MR. GREGORY: Well, doesn't that get to the point which is, why do all of
this right now?
MR. WOLFFE: Well, I don't think they've got a whole lot of choice here. I
mean, the economy was falling off a cliff and they, you know, some White
House officials told me...
MR. GREGORY: Vice President Biden didn't want it--didn't think it was a
good idea to go for healthcare reform right now.
MR. WOLFFE: Right. But, well, the question is whether health care can be
this pocketbook economic issue.
MR. GREGORY: Yeah.
MR. WOLFFE: But interesting, John raised Michigan, OK? There--the White
House has just done some polling in Michigan. Their internal polls show
the president's numbers holding up really well in Michigan. He's above 60
percent with independents, who are supposed to have left him. Now, how
can that be? What is this guy doing right now? The answer for the White
House is he's looking like he's doing everything. And as long as he's
doing that, people give him a pass because they know the economy wasn't
his doing. On the other hand, how long are they going to be patient? And
the question is, as they go into 2010, unemployment, according to the
Fed, is still going to be above 9 percent or thereabouts. That's a very
tough situation.
MR. GIGOT: And, David, the uncertainty of the Obama agenda hangs over the
economy, because you're talking about rearranging 18 percent of GDP with
health care. You're talking about the uncertainty of a huge cap and trade
tax on energy. You're talking about what are union rules going to be
like? All of that reduces the risk taking, the, the borrowing and lending
that we need in this economy to really get it fired again.
MR. GREGORY: All right, we talk about health care, we talk about the
economy, it just leads you to start thinking about the campaign and
opposition from Hillary Clinton, and then all of the questions about the
secretary of state, who is now in India. She's sort of off the injured
list here and her elbow's in better shape, and so she was in India on a
diplomatic mission over this weekend. This is what the AP wrote on
Wednesday about Hillary Clinton falling off center stage: "Eclipsed by a
globe-trotting president, a foreign policy-savvy vice president, a bevy
of special envoys, Secretary of State Hillary Rodham Clinton is
struggling to re-emerge this week as the Obama administration's
diplomatic heavyweight. Clinton is trying to retake center stage as the
top foreign policy force of the U.S. government after four frustrating
low-profile weeks during which a fractured elbow forced her to cancel two
overseas trips. Her diminishing presence abroad and at home, followed by
her starling public criticism of the White House this week for delaying a
major State Department appointment, has prompted a flurry of speculation
whether her influence is waning inside President Barack Obama's Cabinet."
The counterpoint to that, Michele, people saying she has been quieter but
a huge force on foreign policy.
MS. NORRIS: I think too much, perhaps, is made of this continuing Obama
vs. Clinton narrative. I mean, when, people suggesting that she's not
taking center stage, she's a secretary of state. The secretary of state
generally does not take center stage. The president normally takes center
stage. I think what you see with Hillary Clinton in India is a very savvy
politician with the agenda that she set out: meeting first with the
business leaders, the symbolic things that she's doing, staying in the
hotel that was the site of the, the horrible situation there in Mumbai
and also, at the same time, applying pressure in Pakistan. I think what
you see there is a very smart politician, and I think too much is made of
the fact that she's below the radar.
MR. GREGORY: Richard...
MR. HARWOOD: You tell me, David, how does somebody retake center stage
when they work for Barack Obama?
MS. NORRIS: Yeah.
MR. GREGORY: Right...(unintelligible).
MR. HARWOOD: As, as, as present and visible he is around the world. And
so much of what has been important so far in the Obama foreign policy is
his attempt to repair America's relationship with the rest of the world.
I think where Hillary Clinton's influence is likely to be felt is in that
tough bargaining as we move forward with Iran, for example...
MR. GREGORY: Mm-hmm.
MR. HARWOOD: ...on curtailing the nuclear program.
MR. GREGORY: Also, Richard, Peggy Noonan suggests on, on the op-ed page
of the Wall Street Journal that she's, she's waiting.
MR. WOLFFE: Oh, yeah.
MR. GREGORY: She knows how to wait. If there are excesses in this
administration, if there are mistakes, she will be there as a Democratic
alternative.
MR. WOLFFE: Yeah. And I don't think anyone doubts that the Clintons have
a bigger strategy in mind. But all the reports from inside the White
House that I hear say the principals respect each other enormously.
MR. GREGORY: Yeah.
MR. WOLFFE: There is still a lot of rancor and petty rivalry between the
staff on both sides, both sides, and they end up arguing about the
ambassador to Liechtenstein and who spoke when, and it really is small
fry when there are big things to do...
MR. GREGORY: Right.
MR. WOLFFE: ...like terrorism, global warming. This is her agenda, and
it's a big one, but she isn't president.
MR. GREGORY: All right. I want to end here, we just got a couple minutes
left, on more of a personal note here. I had a great honor this week, I
took my son to the All-Star Game in St. Louis. We had a terrific time.
And I thought baseball did something really great, and we have some video
of it. Before the game they had the All-Stars Among Us, people who engage
in community service, who are giving to other people. They lined up
there, all the presidents' taped messages, and then look at this: All the
players descended on them during a round of applause to shake their hand
and pay tribute to them. And, you know, as a dad sitting in the stands I
thought, you know what, I love--this is what's wholesome about baseball.
And it's a lot easier, Paul, than having to answer my, my son's questions
about who has taken steroids and who hasn't. That's tough.
MR. GIGOT: No, it was a great moment for, for, for professional sports
and it, you know, it gives the lie to the fact that what we sometimes
think, which is that all of these athletes are spoiled and wealthy and
all--have all of these problems, most of them are actually solid
citizens. And it's a great lesson for kids because, as we know, they're
all role models.
MR. GREGORY: Right. And it is--again, you've got these moments where you
think about where can you take your children? You know, this was an area
where all the presidents contributed, all the former presidents, and
President Obama threw out that first pitch. A little shaky, but
nevertheless, he was there.
MS. NORRIS: He was proud of it.
MR. GIGOT: He got it there.
MR. GREGORY: He got it there. He got it there. That was the point. But
these do become important moments, again, balancing these influences for
our children.
MS. NORRIS: It--you know, the symbolism there was, I thought, very, very
striking, because, you know, our sons and our daughters...
MR. GREGORY: Right.
MS. NORRIS: ...worship the people that play on the field and on the
court. And when you can introduce them to real role models and people who
are actually serving their community--you know, much was made of
community service...
MR. GREGORY: Right.
MS. NORRIS: ...and not in a good way, during the campaign.
MR. GREGORY: Right.
MS. NORRIS: I think we saw a very different side of it there.
MR. GREGORY: This helps. All right, we're going to leave it there. Thank
you all very much.
And up next, our MEET THE PRESS Minute: Remembering Walter Cronkite, the
legendary CBS newsman who died this week at the age of 92.
MR. DAVID GREGORY: And in our MEET THE PRESS Minute this morning, he was
known as the most trusted man in America. For decades, Walter Cronkite
delivered the news to millions and told it "the way it is." He was one of
the first reporters on the battlefield in World War II, announced to the
country that the first man had landed on the moon, concluded the war in
Vietnam could not be won and broke the news that a young president had
been assassinated.
(Videotape)
MR. CRONKITE: The flash, apparently official, President Kennedy died at 1
PM Central Standard Time.
(End videotape)
MR. GREGORY: Thirty-five years after that fateful day, Cronkite appeared
right here on MEET THE PRESS to reflect on the significance of that
moment to the nation and to him personally.
(Videotape, November 22, 1998)
MR. CRONKITE: It was a terrible, a terrible time. The--for me, the,
the--as we reporters do, our adrenaline pumps and you're concerned with
covering the story for a while; but then the emotional aspect of it hit
me when I had to say that the president was dead.
(End videotape)
MR. GREGORY: Walter Cronkite died this week at the age of 92. His family
and all his friends and colleagues at CBS News are in our thoughts and
prayers.
MR. DAVID GREGORY: As a reminder, the rebroadcast of MEET THE PRESS now
airs on MSNBC every Sunday afternoon at 2 PM Eastern time, 2 PM Eastern,
in place of our usual 5 PM reair.
That's all for today. We'll be back next week. If it's Sunday, it's MEET
THE PRESS.