Video: Gregory, Guthrie on future of health reform

  1. Closed captioning of: Gregory, Guthrie on future of health reform

    >> all right, david . let's talk about health care reform . is it dead in washington , d.c., or shall it rise again sr.

    >> i think obviously, there is a huge fear it will notarize again. but rahm emanuel calling up to the house and senate leadership, trying to figure out what is it you can pass, what can you put together? a couple of different options here. do they break it apart? try to pass this piece meal? talk of the budget reconciliation process which has a lot of problems. it's certainly an option. is there a chance that the house could pass the senate bill and then pass what they call a corrections bill? the real issue here is where are the votes? what are they able to do? the president set the tone by saying let's coalesce about the things we can agree on and then move forward. the real issue is speed. they don't have the time to spend a couple of months on this, when the president starting today in ohio wants to talk exclusively about jobs as he sets up the state of the union .

    >> can i add to that?

    >> no, you can't. stop interrupting.

    >> oh, joe. that sweater is your softer side, and, yet, that was kind of tough.

    >> okay, go ahead, savannah. i'm sorry.

    >> i just wanted to affirm what david said, but also point out if they can't get the house to pass the senate bill as is, and that's really unclear at this moment whether they have the votes to do it, and they end up pursuing the scaled-down health care bill, don't expect them to rush that through. i think -- i'm hearing from many senior aides what they would do in that case is set health care aside for a few months, because they want to focus on jobs, jobs, jobs. whatever that scaled down would be, the bipartisan effort, that's not something they would put front and center right away. they would just table it for a while.

    >> have either of you two heard any suggestions that the white house is -- is nervous now about what's going on? they've always been no drama obama team. whatev whenever you tell them that they need a course correction, they say you're bed wetters. whether it com when it comes to massachusetts , message received, we really have to change our game?

    >> i think there is a lot of talk in the white house about how to recalibrate the message, recalibrating legislatively is adjusting to the new math and a lot of people pointed out they still have an 18-seat majority in the senate. but it's still difficult to govern. they have a lot of conservative democrats not easily moved on the agenda they want to get through. but i think there is -- i talked to somebody close to the white house last night, who said, look, the problem is that there's too many americans who look and see that washington is not working, that the system is rigged against them. that obama has not made good on the promise to drain the swamp. as long as that's out there, it will be very difficult for democrats. obama has the time to adjust. he can get past the first year, he has a second year there is a reason there's a four-year term. but his party and ultimately him in terms of the mid-term election year that can bear the brunt of it.

    >> i don't think barack obama is in any more trouble than he was a few years ago. he trounces republican challengers, but savannah it's the democratic congress, and especially the one that won in districts that john mccain carried. they won over the past four years, because bush's disastrous second term. they have to be very nervous right now, they are applying pressure on the white house .

    >> there's no question about that. that's why it hasn't been such an easy lift to get the house to pass the senate bill . democrats are very, very worried. and i'll tell you what wakes them up in the middle of the night . barack obama going to massachusetts in the last-minute effort to save martha coakley had zero effect . it happened too late to change the course of the election and it was martha coakley who ran the bad election, but that's scary for democrats if they think he can't sell the message.

    >> savannah, if i'm in north carolina or kentucky or virginia, and i've got -- i've got the white house telling me, hey, you got to trust us here and i'm a democrat, you couldn't win a seat in massachusetts , and you're telling me in north carolina to trust you? i mean, i've seen how this has happened before . that's now newt lost support, david gregory , over time . when moderates in the northeast started losing, other moderates told newt, you're on your own. we're not following crazy guys like scarborough, even if he does wear a great sweater, with a kid on his lap.

    >> i was referring to wilfred grimley. remember the old commercials?

    >> too late. too late. go ahead.

    >> i think that's the reality right now. you have evan bayh , others talking about the way his constituents view what's happening in washington , high-def sits, a lot of spending, taxes and all the rest is not what's going to help him in his state. and that -- that's not going to change, which is why the question as to what extent they recalibrate by moving more to the center. the flipside, they will go after more in a populist direction on the bank this is delivering for the middle class in their judgment. you have to stand up and fight the people responsible for the recession.

    >> david , other than wilfred brimly, who is on the show?

    >> we have valerie jarrett and mitch mcconnell , leader of the republicans in the senate.

    >> savannah, what do you have on your show?

    >> we'll talk to congressman barney frank about the wall street business and ben ginsberg about the campaign finance ruling, it's huge.

    >> if it's 9:00, it's "the daily rundown," and if it's sunday, it's "meet the press." number one again. despite the fact that they have a guy hosting it that does some really weird and disturbing things. come on, it's just a sweater. and are y you are turning me into merv the perv. that's the genius about david gregory . he says whatever comes to mind. thanks a lot, david . my dad does that too. it's that thing that stops what's

By
updated 1/22/2010 11:40:10 AM ET 2010-01-22T16:40:10
analysis

Trimming back the 2,000-page, trillion-dollar Democratic health care bills to the parts that average folks understand and like may not be as simple as it sounds.

A complete ban on insurance companies denying coverage to people with medical problems would be out of the question. Forget about guaranteed health insurance for all Americans — it costs too much. Still, Congress might be able to craft legislation that takes some rough edges off today's coverage problems and makes progress in controlling costs.

That's if Democrats and Republicans can call a truce.

Republicans, who for months have been urging "commonsense" alternatives to the Democrats' sweeping overhaul plan, may still be unwilling to help pass anything that lets President Barack Obama claim an election-year victory. They'll have 41 votes in the Senate to block it once Massachusetts' Scott Brown is seated.

Yet the nation's health care system is unlikely to heal itself. The number of uninsured will rise above 50 million unless government steps in, while ballooning costs could leave the baby boom generation with a bare-bones Medicare.

"The problems that exist in our health care system are real problems," said Sen. Jeff Bingaman, D-N.M., a moderate who has worked to find compromise with Republicans. "It would be unfortunate if we were to just set aside significant health care reforms."

Image: Obama financial reform
Kevin Lamarque  /  Reuters
President Barack Obama speaks about financial reform after his meeting with Presidential Economic Recovery Advisory Board at the White House Thursday.
Obama has suggested shifting the focus to popular proposals like banning denial of coverage to those with medical problems. That particular fix is unlikely because it would encourage people to put off getting insurance until they're sick, driving up premiums for everybody else.

"In health care, everything fits together," said Sen. Jay Rockefeller, D-W.Va. "It's very hard to say we can cut this out and do that." Banning pre-existing condition denials would have to go hand-in-hand with coverage for all.

Still, some limitations on health insurance companies are feasible, said Mark McClellan, who served as Medicare director for President George W. Bush.

"There is a starting point," McClellan said. "There is a way to do something meaningful without going to requirements for coverage and trillion-dollar subsidies."

On McClellan's short list would be a ban on denial of coverage to children with medical problems, forbidding insurers from canceling the policies of people who get sick, and limiting in some way what the companies may spend on overhead and profits instead of direct medical care.

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Other possible insurance fixes include eliminating lifetime dollar limits on coverage and allowing children to stay on their parents' coverage into their late 20s.

Such changes could be combined with federal funding for high-risk insurance pools to provide affordable coverage for people in poor health shut out of the private market. Obama supports risk pools, as does Sen. John McCain, the 2008 GOP presidential candidate.

Another bipartisan idea is tax credits to help small businesses get and keep coverage. A modest expansion of Medicaid to help low-income working people isn't out of the question. Both ideas are already in the legislation.

Notably, individual components of the Democratic megabills are far more popular than the whole, according to a poll released Friday by the nonpartisan Kaiser Family Foundation. Seventy-three percent of Americans support small business tax credits, and 62 percent back a Medicaid expansion. Allowing dependent children to stay on their parents' coverage until age 25 got 60 percent support.

Such steps could help many who now lack coverage, but that would leave holes in the safety net.

On cost-control, incremental improvements also are possible.

There is broad agreement that the way Medicare currently pays hospitals and doctors rewards high-volume, low-quality care. Shifting Medicare payments to make providers more accountable for whether the patient ultimately gets better could have a positive impact throughout the health care system. The Democratic bills would launch a series of experiments aimed at getting good quality care at lower cost, and those could be incorporated into a scaled-back bill.

Alternatives to medical malpractice litigation also could yield savings. The Congressional Budget Office, reversing a previous analysis, says curbs on jury awards in malpractice cases could save the government $54 billion over 10 years by reducing defensive medicine.

Timeline: Health care highs and lowsIt's too early to tell whether Democrats will embrace the smaller-is-better route, much less get it through Congress in the current political climate.

"The well has been poisoned," said Robert Laszewski, a health industry consultant. "The Republican base is not going to let any Republican senator take Democrats off the meat hook they are on now."

Still, for Democrats, there is a hopeful precedent. After the Clinton-era health overhaul imploded in 1994, Democratic and Republican lawmakers coalesced around the idea of a new health insurance program for the children of low-income working parents. That program, still thriving, now covers about 6 million kids.

Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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