MR. GREGORY:
Let me ask you a couple of questions about
health care
. The difficulty of deadlines being missed and more public opposition to
health care
leads to the question of whether or not the president is losing the economic argument, that is the argument that
health care
is essential as an economic fix.
DR. SUMMERS:
It is essential as an economic fix. It's essential because of how much of the
federal budget
health care
represents. It's essential because it's so important for the competitiveness of American businesses. You know, for some of the automobile companies, the
health insurance
companies are actually their largest supplier. And it's essential to slow the growth of health costs if American families are going to see rising wages that rise ahead of inflation. So it is essential.
MR. GREGORY:
But is the president losing that argument?
DR. SUMMERS:
What's, what, what about, what about the, what about the argument -- there has been, there have now been healthcare bills voted out of four
congressional committees
. That is four more
congressional committees
than have voted, that have voted comprehensive healthcare legislation in the last, in the last generation. Yes, it's going to take time to work out, to work out the argument. Yes, there are continuing controversies, as there should be. But let's not forget that we are closer to comprehensive
healthcare reform
than this country has ever been. Let's not forget how we're doing it. We passed tax cuts at the beginning of this decade. We passed a
prescription drug
benefit at the beginning of this decade. Nobody even thought about the question of how they were going to be paid for. Nobody set an aspiration of doing it in a balanced-budget way. Yes, we're having a lot of arguments about how best to do it in a balanced-budget way, and there's tension in those arguments. But how much better it is to be doing these things this way, the way this president is doing it, by insisting on the pay for, by insisting that it be done in a balanced-budget framework...
MR. GREGORY:
Well, let's talk about that point.
DR. SUMMERS:
...even recognizing that's going to lead to some arguments.
MR. GREGORY:
That's a very important point, and yet the
CBO
, the
Congressional Budget Office
, has looked at this, a nonpartisan actor in this debate, and has said there is a shortfall in paying for it even over the first decade, and that shortfall grows in subsequent decades. As you look at these healthcare plans, do there have to be fundamental changes if you're going to avoid adding to the deficit down the line?
DR. SUMMERS:
CBO
said that about one of the bills that's passed, one of the committees. This is why the discussions are continuing. No bill is going to move forward that is not over the first 10 years scored by the
CBO
as budget neutral. But the president's, in addition to insisting on budget neutrality, which we didn't use to do, the president's doing another important thing. It's what we've called a belt and suspenders approach. There's some things -- how we pay
drug companies
, for example -- where you can do the accounting very accurately and you can see what happens to the deficit. There are other things -- encouraging prevent, encouraging
preventive care
, taking the whole reimbursement system out of politics -- where it's much more difficult to do the exact calculation. And so the
CBO
doesn't give us any credit for them even though most people would say that, over time, they're likely to have some benefit. And so we're doing both sets of things. And so I think we've got a lot of basis for being optimistic that, whatever the
CBO
says, it's going to end up better. But we're being very conservative. That's why it's belt and suspenders. We're not taking any account of that second set of changes, the
preventive care
and all of that.
This is the most fiscally responsible approach to introducing a major
structural change
in the economy that's ever been pursued. If you look at what happened with
Medicare
, if you look at what happened with
prescription drugs
, if you look at what happened when
food stamps
was introduced, there has never been this degree of careful scrutiny of long-run, long, long-run cost impacts. And it's right because the center of this has to be containing healthcare costs, otherwise it's not going to work for most families.
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