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'Meet the Press' transcript for July 19, 2009

MR. DAVID GREGORY: This Sunday: It's do or die for the president's

massive healthcare reform.


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


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.


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


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


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?


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.


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...


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: 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.


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


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


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


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...


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


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


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.


SEC'Y SEBELIUS: But that's a personal responsibility that all of us can


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.


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.


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.


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


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



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.


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


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


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


MR. GREGORY: We will leave it there. Secretary Sebelius...


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



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



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.


MR. GREGORY: But it seems to be a matter of debate. You just mentioned

access. You've got 47 million people who are uninsured.


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.


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


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.


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.


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.


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



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


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


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


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.


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


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. 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. 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


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. 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


MR. GREGORY: Right. Because it's not just Republicans.


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...


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


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. 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. 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. 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?


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


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. 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. WOLFFE: 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...


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...


MS. NORRIS: ...and not in a good way, during the campaign.


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.


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


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