December 25, 2009

As Steve Benen noted this is a better answer than the "I didn't campaign on the public option" nonsense which I thought was silly and insulting. People who've been following the process understand the difference between what you'd like to get passed and what's achievable with this Congress. President Obama said he got 95% of the reform he wanted in the health care bill. Whether you can call this 'reform' or not and whether he actually got what he wanted as opposed to what he campaigned on is something all of us will be debating for some time to come. There are some good things in the bill but I personally don't think they outweigh the bad without some meaningful regulation on the insurance companies.

This type of clarity in the beginning of the debate might have been helpful since we could have been pushing harder for meaningful regulations to keep prices down instead of a public option, but who knows. Maybe the public option was nothing but a shiny object so Joe Lieberman could have his ego stroked and feel like he got his evens with the progressive blogosphere and keep him focused on that instead of him attacking things the administration did actually care about keeping in the bill. Lieberman gets to give the progressive community a kick in the teeth to make him feel better without hurting what they actually cared about having passed in the legislation. It's that or Lieberman gladly played boogie-man to give them exactly what they wanted, or maybe a little of both.

I don’t know of anyone who is satisfied with what’s in this bill so far and no one knows what we’re going to end up with once it comes out of the conference committee. I do know we’re going to keep fighting to fix whatever mess gets heaped upon us and that John is talking to House members to keep the pressure on to try to improve whatever comes out of the committee. Next moves will come after the holidays.

You can watch the entire interview on PBS's site here.

On a personal note, I hope everyone who is celebrating had a wonderful holiday out there. We did ours a bit early because of conflicts with my brothers seeing their families and people going out of town. Everyone dealing with this terrible weather be safe out there and drive carefully.

Transcript below the fold.

JIM LEHRER: So you are completely satisfied with the health-reform bill that the Senate's about to pass?

PRESIDENT OBAMA: You know, I am never completely satisfied. But I am very satisfied. Look, when I made that speech in the joint session of Congress, I set out some criteria for what in my mind would qualify as reform, based on the conversations that I had with families all across the country and the letters that I was receiving about people really going through a tough time in the health-care system.

I said that we wanted to make sure that people who didn't have health insurance could get health insurance. And this bill covers 30 million people who don't have it.

I said that for people who have health insurance, we've got to end insurance-company abuses, where they ban you from getting health insurance because of preexisting conditions, or they've got fine print - print that sets up lifetime limits on what you can spend, so if you really get sick, suddenly you may lose your house, even though you think you've got health insurance.

We've got the strongest health-insurance reforms that we've ever seen in this bill. I mean, all that - that whole argument about patients' bill of rights back in the 1990s: this is the patients' bill of rights on steroids.

I said it had to be deficit-neutral. It doesn't just meet that criteria; it actually reduces the deficit. I said that we had to make sure that we were bending the cost curve, meaning that we were starting to get a better bang for our buck so that doctors, hospitals, nurses, providers all were focused on what provides quality care, and not just more expensive care. And we have all of those game-changers inside the bill.

So when you look at the criteria that I've set forth, this is a good deal. Now, are there provisions here, provisions there, that I would love to have in the bill? Of course. But overall, I think that I've seen 95 percent of what will work for the American people, for small businesses and for the government budget that I was seeking from the beginning.

JIM LEHRER: Ninety-five percent of what you wanted?


JIM LEHRER: Now, do you feel the same way about the House version that passed a few weeks ago?

PRESIDENT OBAMA: You know, what's interesting is, the House version and the Senate version are almost identical. There are some differences in terms of how they pay for particular provisions. But the same principles about setting up an exchange where small businesses and individuals can buy in, pool their purchasing power to get a better deal from insurance companies, that's in both bills. The insurance reforms are both in the House and the Senate versions.

One of the things that I think is important to remember is that, even though the exchange - the pooling that I'm talking about doesn't start for several years, a lot of the insurance reforms start right away. Children, for example, won't be able to be barred from getting health insurance, even if they have a preexisting condition, as soon as I sign that bill and we get that reform in place.

So there are a lot of provisions that are both in the Senate and the House bill. I actually think that reconciling them is not going to be as difficult as some people may anticipate.

JIM LEHRER: Are you going to be involved in the reconciliation?


JIM LEHRER: I mean, on a hands-on way?


JIM LEHRER: Are you going to actually participate with -

PRESIDENT OBAMA: We are - we are - we hope to have a whole bunch of folks over here in the West Wing, and I'll be rolling up my sleeves and spending some time before the full Congress even gets into session, because the American people need it now. I mean, something that's gotten lost, Jim, during the course of this debate - because this is how Washington works - it ends up being, well, did the president win on that one or did he lose on that one? What's Joe Lieberman doing today, and what's Mitch McConnell doing tomorrow?

Right now there are families who don't have health insurance and, as a consequence of somebody getting sick in their family, have been bankrupt. Right now there are small businesses who've been doing the right thing by their employees and just got a notice from their insurance companies that their premiums went up 25, 30, 40 percent; and that business owner's having to make a decision, do I start dropping coverage for my employees or do I have to lay off one employee to keep coverage for everybody else?

Those kinds of decisions are happening right now. And so, you know, I intend to work as hard as I have to work, especially after coming this far over the course of the year, to make sure that we finally close the deal.

JIM LEHRER: But you're not - you're not going to sit down at that table with the conferees with a list, spoken or unspoken, of your own kinds of killer provisions that you can't - you got to get them out of there, or a favorite provision that you want in there? I mean -

PRESIDENT OBAMA: Look. Look, I mean, the -

JIM LEHRER: - any of your own preferences?

PRESIDENT OBAMA: Obviously, I've got some very smart people who are here working day to day on these issues. I am, though, consulting very closely with health-care economists, for example, to make sure that - for example, the provisions that will change how doctors, hospitals, other providers provide care so that it's more patient-centered and it's not focused on how many tests can we do, but rather what's going to produce the best-quality outcomes; how can we reduce, for example, medical errors in hospitals, which cost us hundreds of billions of dollars and thousands of lives every single year, and we know what will prevent them. Simple checklists of things that hospitals can do.

You know, those are the kinds of things that I have enough interest in that I'm going to say to the conferees, you guys have to make sure that that's included, because part of the deal here is not just providing more coverage or more subsidies but we keep on spending twice as much as every other advanced country and we have worse outcomes. Part of our goal is to spend our money more wisely, because if we don't do that, then it doesn't matter how many subsidies we have in there, how many taxes we impose. Sooner or later we start running out of money; it gobbles more and more of our overall federal budget and families' budgets.

JIM LEHRER: And let's say, for instance, the public-option plan: It's in the House version; it's not in the Senate version.


JIM LEHRER: All right. What's going to be your position when you sit down and talk about this?

PRESIDENT OBAMA: You know, look, I've been in favor of the public option. I think the more choice, the more competition we have, the better.

On the other hand, I think that the exchange itself, the system that we're setting up that forces insurance companies to essentially bid for three million or four million or five million people's business, that in and of itself is going to have a disciplining effect.

Would I like one of those options to be the public option? Yes. Do I think that it makes sense, as some have argued, that, without the public option, we dump all these other extraordinary reforms and we say to the 30 million people who don't have coverage, "You know, sorry. We didn't get exactly what we wanted?" I don't think that makes sense.

JIM LEHRER: So it is not - that's not a deal-breaker for you in any - any way, either way.

PRESIDENT OBAMA: I think - I think, right now, that the Senate and the House bills - if you look at their overlap, the 95 percent that they agree on - if that bill was presented to me -

JIM LEHRER: You'd sign it?

PRESIDENT OBAMA: - I would sign it.

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