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'Meet the Press' transcript for July 19, 2009
Kathleen Sebelius, Mitch McConnell, Paul Gigot, John Harwood, Michele Norris, Richard Wolffe
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 Netcast President Obama has asked Congress for a health care reform bill by their August recess and now the debate over how best to reform the system reaches a critical point. We'll talk to the President's Secretary of Health & Human Services, Kathleen Sebelius, about the administration's health care reform priorities. Then, the other side of the debate, with the Republican Leader in the Senate, Sen. Mitch McConnell (R-KY). Also, a political roundtable. |
Exclusively on msnbc.com |
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. 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 sick or 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.
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