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CNN Live Event/Special

Healthcare Summit

Aired February 25, 2010 - 09:50   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

KYRA PHILLIPS, CNN ANCHOR: And in light of that discussion we just had, Wolf Blitzer, you're getting ready to handle this special coverage for us.

I mean, whether it's a reform with regard to insurance company or a reform in policies to help feed our children, today is a very important day.

WOLF BLITZER, CNN ANCHOR: Thanks very much, Kyra. Even in a time slot known for melodramatic soap operas you've probably never seen anything quite like what could be a political soap opera set to unfold on daytime TV. We're only minutes away from a potentially climactic moment in the health care debate, the White House health care summit.

Right now you're looking at live pictures inside the Blair House; that's across the street from the White House, where this event will take place.

Here's the cast. The President of the United States and his Democratic allies up on Capitol Hill and Republicans led by the senate minority leader Mitch McConnell and the house minority leader John Boehner.

The Democrats' goal, convince Americans, many of whom want health care reform, that the Democrats' plan works and is good. The Republicans' goal, make sure any plan includes their ideas.

This historic back and forth on live TV will happen in this event that's going to continue for at least -- at least six hours. Who knows how long it will go. It's happening over at Blair House. As you know, that's the presidential guest quarters on Pennsylvania Avenue right across from the north lawn of the White House.

Both sides say they want to work together, but will they really stand on common ground?

CNN is covering this summit from multiple angles. All of our correspondents, our analysts are standing by.

But I want to bring in right now our White House correspondent, Ed Henry. Ed, you're there on the scene. You're getting some new information on the timeline.

ED HENRY, CNN SENIOR WHITE HOUSE CORRESPONDENT: That's right, Wolf. We're hearing some new information that now the new target is to get this done by the end of March, a final health reform package.

The reason is that we're picking up from top Democratic sources that the Congressional leadership, Harry Reid and Speaker Pelosi have been warning the White House privately in recent days that they're going to be going on a long recess at the end of March into mid-April to celebrate Passover and Easter. And they're basically telling the White House if they can't get this done by that recess, they're going to have to move on when they come back in mid-April to the economy, to jobs, to unfinished spending bills, all these other things, the part of their agenda that have been undone.

And so this adds new urgency to this summit because basically when this summit wraps up later today, the president only has one month until the end of March to really get this done. As you know, there have been many other deadlines last year that were missed. This is finally make-or-break time because midterm elections are coming up. Democrats warning the president, it's now or never -- Wolf.

BLITZER: Ed Henry, stand by. Dana Bash is up on Capitol Hill. The Democrats have an agenda, the Republicans have an agenda. Dana, what should we be looking for?

DANA BASH, CNN CONGRESSIONAL CORRESPONDENT: Well, I think we should be looking for, obviously, any kind of sign of agreement, but I think the most interesting thing to me based on what Ed was just reporting is Democrats.

I've been told, Wolf, by Democratic sources that a big reason why they're doing this bipartisan summit with Republicans was to actually unify the Democrats because they knew that they have this deadline. They know that they really don't have much time. And they also know that despite what they're doing with this summit they are quietly making plans to work around Republicans.

Republicans know that so it will be interesting to see how they deal with the fact that everybody is sitting there and they know that this is about political points maybe more than actually pushing real legislation.

BLITZER: Stand by, Dana Bash. Candy Crowley is here together with the best political team on television. We're going to assess what's going on.

Candy, a lot of people think this is just political theater. How shocked should we be though at the end of six or seven hours they actually emerge and say, you know what, we've got some sort of momentum going. Maybe we can work out a deal.

CANDY CROWLEY, CNN HOST, "STATE OF THE UNION": Well, they'll probably come out and say we have got momentum going. We'll see. I would be stunned if they came out and said, well, we have the makings of a deal here. I don't think that's going to happen.

But I think this is important not just because it's theater and kabuki and all that kind of stuff but because the president has got to get the American people on his side. He has to be the one that's seen as trying to be bipartisan. And the Republicans have to make their points without looking like the party of no. So there's a lot going on here in terms of dynamics.

BLITZER: But, John, the Democrats Harry Reid in the Senate, Nancy Pelosi in the House, they're already assuming this is going to fail, I think, and they have got some plan B ready to go.

JOHN KING, CNN CHIEF NATIONAL CORRESPONDENT: And that's what makes this so fascinating because this is essentially two campaign rallies in a building usually used for visiting diplomats across the street from the White House. The Democrats and the president have their case to make.

The president wants to be able to say, "Well, I tried bipartisanship so if you don't like the fact, we're going to try to ram this through with just Democratic votes. We tried, we had this big summit."

The Republicans believe they have the momentum right now. They know the American people want health care reform. We talked about a Democratic agenda and the Republican agenda. How about the American people's agenda? They want health care reform. They want to deal with insurance premiums. They want to deal with pre-existing conditions.

What the Republicans have succeeded so far in this debate is saying the president is too big, costs too much and puts too much money, too much power in Washington, D.C. And they have also had the subplot saying we should be talking about jobs, not health care right now. So the Republicans have the political upper hand right now but the president is a persuasive guy.

BLITZER: Here's Harry Reid, the Democratic leader in the Senate, Nancy Pelosi the Speaker. You just saw a little while ago, Boehner and McConnell, the Republican leaders.

I noticed, David Gergen that they already had that big stack of thousands of pages of the Democratic legislation that passed the Senate. A different version passed the House, but I guess the Republicans brought along some props.

DAVID GERGEN, CNN SENIOR POLITICAL ANALYST: Oh, they will bring along props. They have got talking points. They have got little things that they're going to roll out. This is going to be very interesting. It may descend into wonkery (ph). I guess we have to avoid that.

I'm struck Wolf that this is also occurring in a historic place for bipartisanship. After World War II when Harry Truman proposed the Marshall Plan and he had a Republican Congress, they hammered out the Marshall Plan at Blair House with Republicans there on a regular basis. So it's nice about that.

I know you're too modest to say this but as I recall a young Wolf Blitzer asked a question at the Blair House when the Egyptian President Anwar Sadat came in 1977. You asked him, "Why don't you reach out to Israel."

And a few months later he did and said Wolf Blitzer made me do it.

BLITZER: There you see the president of the United States walking from the West Wing of the White House with Joe Biden. You see them there. It's just a very, very quick walk across the street, Pennsylvania Avenue.

Since the Oklahoma City bombing as all of our viewers -- or at least most of them probably remember has been shut to vehicular traffic unless it's an emergency vehicle. But it's an easy walk across the street.

Gloria, you've seen this walk on many occasions. The president will go in. He's got Biden, Sebelius, secretary of health and human services. He's got his whole team there basically ready to go but there are a lot of Republicans and a lot of Democrats as well.

GLORIA BORGER, CNN POLITICAL ANALYST: You know, what was interesting Wolf, they were even debating the shape of the table and whether the president should be standing or whether he would be sitting because if he were standing, he would get a little bit of a benefit over the Republicans.

Remember he met with the Republicans not too long ago in Baltimore and they felt that he was lecturing them. So they didn't want that to happen again.

But what's also really interesting here, to follow up on the point that Dana Bash made a moment ago is that it not only does the president have to really talk to the public but he's got to try and unite Nancy Pelosi and Harry Reid and their caucuses. Remember there were 39 Democrats in the House who voted against the House version of health care reform, and the president has to convince them that this new version is something they can support. And if he does well today, that may help him do that.

BLITZER: As you know, Joe, the Democrats and the president, they could have a deal tomorrow if the House would simply pass the Senate version of health care reform and then maybe make some revisions in separate legislation down the road, but that doesn't seem to be possible right now.

JOE JOHNS, CNN CORRESPONDENT: No, and it sounds like the House actually may turn out to be a bigger problem than the Senate, which is just a bit unusual. Look, the thing about this that's really interesting to me is this notion of the president trying to at least put an air of transparency and openness around the health care debate.

There is so much talk about the Democratic leaders going behind closed doors and hashing out the bills. So now we see the president sort of trying to at least put out the notion that he is following up on a campaign promise that he made to have the negotiations on C-SPAN and on CNN as well, I should say. But the truth of the matter is a lot of the important hashing out of these bills has already been done behind closed doors and now they're just working around the margins.

BLITZER: We'll see if they can come up with some of those margins. Dr. Sanjay Gupta, our chief medical correspondent, has a unique perspective on this health care debate. What are you going to be looking for, Sanjay, over the next six, seven hours?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, for some time now you look at all the various proposals that have been put forward. And it's gone more from just being health reform to more health insurance reform. You know, a lot of people - the public option no longer being discussed as much, instead a lot of regulations specifically on the insurance industry.

So there does seem to be more agreement on some things. What I'm looking for is what are the continued deal breakers? What are the things that both sides will say we absolutely cannot tolerate as far as, you know, health reform moving forward. Also, you know, I thought there was an interesting analogy this morning reading through some of the newspapers, this idea that they keep saying the White House, we're on the 99 yard line.

You know, if you use the analogy of a football game here. The question now really are they going to go for the touchdown or might they simply go for a field goal. I think what they're alluding to is this idea that there is a more modified plan, a scaled-back plan that might be, you know, what the White House ultimately puts forward. We may start to see some of the groundwork laid for that today as well, Wolf.

BLITZER: Yes. But those of us who are football fans as Sanjay knows that a team can go 99 yards, get up to the one yard line and fail on fourth and one, fourth and goal to get a touchdown. So that's obviously not unheard of either.

Let me go through some of the agenda, what we're about to see in the coming minutes. We're told the president will open up this historic session with a statement that will be followed by separate statements from the Republican and Democratic congressional leaders. There you see John McCain and Lamar Alexander. They have come - the representatives from the House, the senators and the Senate, they have been selected by the leadership to attend for their presumably unique perspective, their important roles in this health care process.

John King, if you take a look at those who have been invited to this session, Eric Cantor, the number two Republican, you see him right there, the minority whip. It's a pretty - I would say on the House side, on the Democratic side, it's sort of stacked.

KING: It's - well, this is a very liberal conservative contrast in this room especially when you look at the House delegations, without a doubt. Nancy Pelosi, the speaker, has brought her chief lieutenants on the health care issue and on other issues, with the exception of Jim Cooper, a congressman from Tennessee, who tends to be a more centrist Democrat. It is a predominantly liberal group.

The Democrats from the Senate are slightly more centrist, they're left of center but they're more centric, which is part of the problem we were just talking about. The Democrats can't referee their own differences, let alone the significant divide with the Republicans.

One other interesting footnote, three medical doctors among the Republicans in the room and they are there because they know they're going to get into the policy in this and those doctors are in the room to essentially if they need to raise their hand and say, Mr. President, or Madam Speaker, that may be how we talk about it in Washington but that's not going to work out in the real world.

BLITZER: Let me bring in John Avalon. He is a columnist for the "Daily Beast." He has studied those independents out there and that's the key goal right now, to win over some of those independents, John.

JOHN AVALON, "THE DAILY BEAST": That's exactly right. You know, and I think there's both the opportunity and -

BLITZER: Hold on, John, hold on one second, John. I just want to interrupt for a second because the president is now walking into this room. He's going to greet the Democrats, greet the Republicans. They're going to go through a little informal greetings over here. Maybe we can hear and listen in if the microphones are working.

That's Tom Coburn, the Republican senator from Oklahoma who himself is a physician, one of the physicians in the room that John King just mentioned. As I said, the president, once he sits down, will open up with a statement. We'll listen very, very carefully for the nuances. How open will he be? I noticed he gave Tom Coburn that nice little hug, even though they obviously disagree strongly on this health care legislation.

That's Jay Rockefeller. Let's listen a little bit.

UNIDENTIFIED MALE: Mr. President, good to see you.

UNIDENTIFIED MALE: Hey, Mr. President.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Good morning. Good to see you.

UNIDENTIFIED MALE: Good to see you again.

UNIDENTIFIED MALE: How are you?

UNIDENTIFIED MALE: Mr. President.

UNIDENTIFIED MALE: Nice to see you. I'm doing great. Good to see you.

BLITZER: Henry Waxman is the guy in the middle, that's Democratic congressman from California who plays a really important role in health care reform legislation. Charlie Rangel, you see his back there. The president is meeting some of the Democrats right now.

It's sort of White House turf, Blair House, but it's not exactly the White House and I think that's one of the reasons why they selected Blair House. As the president sits down, gets his notes, let's listen in to the president.

OBAMA: Good morning, everybody. Welcome. Thank you so much for participating today. I am very grateful to all of you because I know how busy you are.

What I want to do is just make a few brief remarks on the front end and then we're going to allow leadership from both the House and the Senate to make some opening remarks and then we will dive in.

Last year obviously was one of the toughest years we've had on record, and all of us in one way or another were devoted to focusing on breaking the back of the recession, restoring economic growth, putting people back to work.

We've still got a long way to go, and so I know both the House and the Senate are interested in how do we propel economic growth forward, how do we create more jobs.

I was very pleased to see a glimpse of bipartisanship in the Senate recently in passing a jobs bill, and I hope that continues, and I know there are going to be some additional pieces of legislation moving forward around, for example, making sure that small businesses can get financing.

And those are the kinds of things that I think all parties and both chambers should be able to agree to. So I'm very much looking forward to working with you on all those issues.

I have said repeatedly, I said at the State of the Union, I said last night when I was meeting with the Business Roundtable that in addition to dealing with the immediate challenges we face in the recovery, it's absolutely critical that we also look at some fundamental structural problems in our economy that are hurting families, hurting businesses, and having an impact on the exploding deficits and debts that the federal government, but also state governments are carrying.

And it's for that reason that last year, around this time actually, I hosted in the White House a health care summit and indicated to Congress that it was absolutely critical for us to begin now moving on what is one of the biggest drags on our economy and represents one of the biggest hardships that families face.

Some of you know that I get 10 letters out of the 40,000 that I receive every day for me to take upstairs to the residence and read every single night. And these are letters from all across the country, constituents from every walk of life. And I can tell you that at least two, sometimes five of the 10 letters relates to the challenges that people are experiencing in health care every single day.

I'll get letters from parents who -- whose children have preexisting conditions and maybe those children were able to get health insurance when they were young, but now they're grown up, they're about to move out, and they can't get insurance no matter what job they find. I hear from small businesses who have just opened up their new rates from their insurance company and it turns out that the rates have gone up 20, 30, in some cases 35 percent.

I hear from families who have hit lifetime limits, and because somebody in their family is very ill, at a certain point they have to start to dig out of pocket, and they are having to mortgage their house, and in some cases have gone bankrupt because of health care.

So this is an issue that is affecting everybody. It's affecting not only those without insurance, but it's affecting those with insurance. And when you talk to every single expert and you just talk to ordinary people and you talk to businesses, everybody understands that the problem is not getting better, it's getting worse.

Right now, it's projected that premiums for families with health insurance -- not people without health insurance, but with health insurance -- will almost certainly double over the next decade, just as they doubled over the past decade. In the individual markets, it's even worse. Businesses are having to make decisions about just dropping coverage altogether for their employees. If they're not doing that, then money that they are spending on health care is money that otherwise could have gone to job creation.

And I don't need to tell people here about the effects on the federal budget. You know, we've got some people who've been working a very long time on figuring out how can we control the huge expansion of entitlements. Almost all of the long-term deficit and debt that we face relates to the exploding cost of Medicare and Medicaid, almost all of it. And that is -- that is the single biggest driver of our federal deficit, and if we don't get control on that, we can't get control over our federal budget.

Now, I'm -- I'm telling all of you things you already know. Maybe more personally I should just mention the fact that I now have about as good health care as anybody could have. I've got a doctor right downstairs.

And all of us, when I was in the Senate, and all of you as House and Senate members have good health care. But remember maybe when you were younger, when you were first starting off, I can certainly remember Malia coming into the kitchen one day and saying, "I can't breathe, Daddy," and us having to rush her to the emergency room because she had asthma. Or Sasha when she was a baby getting meningitis and having to get a spinal tap and being on antibiotics for three days, and us not knowing whether or not she was going to emerge OK.

In each of those instances, I remember thinking while sitting in the emergency room, what would have happened if I didn't have reliable health care? My mother, who was self-employed, didn't have reliable health care, and she died of ovarian cancer. And there's probably nothing that modern medicine could have done about that.

It was caught late and that's a hard cancer to diagnose, but I do remember the last six months of her life, insurance companies threatening that they would not reimburse her for her costs and her having to be on the phone in the hospital room arguing with insurance companies when what she should have been doing is spending time with her family. I do remember that.

Now, everybody here has those same stories somewhere in their lives. Everybody here understands the desperation that people feel when they're sick. And I think everybody here is profoundly sympathetic and wants to make sure that we have a system that works for all Americans.

You know, I was looking through some of the past statements that people have made, and I think this concern is bipartisan. You know, John McCain's talked about how rising health care costs are devastating the middle class families. Chuck, you know, you've been working on this a long time. You've discussed the unsustainable growth in Medicare and Medicaid in our budget.

Mike Enzi, who's worked on this and partnered with Ted Kennedy on a range of health care issues as the chairman of the committee, you know, you said that small businesses in your home state are finding it nearly impossible to afford health care coverage for their employees. And you said the current system is in critical condition. And Mitch, you know, you've said that the need for reform is not in question. Obviously, there are comparable statements on the Democratic side as well.

So here's the bottom line. We all know this is urgent. And unfortunately over the course of the year, despite all the hearings that took place and all the negotiations that took place, and people on both sides of the aisle worked long and hard on this issue, and you know, this became a very ideological battle. It became a very partisan battle and politics, I think, ended up trumping practical common sense.

I said in the State of the Union, and I'll repeat, I didn't take this on because I thought it was good politics. This is such a complicated issue that it's inevitably going to be contentious. But what I'm hoping to accomplish today is for everybody to focus not just on where we differ, but focus on where we agree, because there actually is some significant agreement on a host of issues.

Now, I've looked very carefully at John Boehner's plan that he put forward. I've looked at Tom Coburn and Senator Burr's plan that's been put out there. Paul Ryan has discussed some of the issues surrounding Medicare. I've looked at those very carefully. Mike Enzi, in the past, you've put forward legislation around small businesses that are very important.

And so when I look at the ideas that are out there, there is overlap. It's not perfect overlap. It's not 100 percent overlap, but there's some overlap. Now, what I did, what the White House did several days ago was we posted what we think is the best blend of the House and the Senate legislation that's already passed. The basic concept is that we would set up an exchange, meaning a place where individuals and small businesses could go and get choice and competition for private health care plans the same way that members of Congress get choice and competition for their health care plans.

For people who couldn't afford it, we would provide them some subsidies. But because people would have some pooling power, the costs overall would be lower because they'd be in a stronger position to negotiate.

We think it is a plan that works with the existing system, the employer-based system, the private health care system, but allows a lot of people who currently don't have health care to get health care. More importantly for the vast majority of people who do have some health care, it allows them to get a better deal.

We also have some insurance reforms in there that, for example, prohibit people who have preexisting conditions from being banned from getting coverage. We also talk about how we can help to make the Medicare system more effective and provide better quality care. In each of these cases, there are corresponding ideas on the Republican side that we should be able to bridge.

So I promised not to make a long speech. Let me just close by saying this. My hope in the several hours that we're going to be here today that in each section that we're going to discuss -- how do we lower costs for families and small businesses; how do we make sure that the insurance market works for people; how do we make sure that we are dealing with the long-term deficits; how do make sure that people who don't have coverage can get coverage -- in each of these areas, what I'm going to do is I'm going to start off by saying, "Here are some things we agree on."

And then let's talk about some areas where we disagree and see if we can bridge those gaps. I don't know that those gaps can be bridged, and it may be that at the end of the day, we come out here and everybody says, "Well, you know, we have some honest disagreements. People are sincere in wanting to help, but they've got different ideas about how to do it and we can't bridge the gap between Democrats and Republicans on this."

But I'd like to make sure that this discussion is actually a discussion and not just us trading talking points. I hope that this isn't political theater, where we're just playing to the cameras and criticizing each other, but instead are actually trying to solve the problem.

That's what the American people are looking for. As controversial as the efforts to reform health care have been thus far, when you ask people should we move forward and try to reform the system, people still say yes. They still want to see change.

And it strikes me that if we've got an open mind, if we're listening to each other, if we're not engaging sort of the tit for tat and trying to score political points during the next several hours, that we might be able to make some progress.

And if not, at least we will have better clarified for the American people what the debate is about. So with that, I just want to say again how much I appreciate everybody for participating. And I am going to now turn it over to Senator McConnell so that he can make some opening remarks, and we'll just go back and forth between the Democratic leaders and the Senate -- and the Republican leaders, House and Senate, and then we'll just open it up and we'll start diving in. All right?

SEN. MITCH MCCONNELL, R-KY., SENATE MINORITY LEADER: Thank you very much, Mr. President.

John Boehner and I have selected Lamar Alexander of Tennessee to make our opening framing statement. And let me turn to him.

SEN. LAMAR ALEXANDER, R-TENN., CHAIRMAN, SENATE REPUBLICAN CONFERENCE: Thanks, Mitch and John.

Mr. President, thank you very much for the invitation. Appreciate being here. Several of us were part of the summits that you had a year ago. And so I've been asked to try to express what Republicans believe about where we've gotten since -- since then.

As a former governor, I also want to try to represent governors' views. They have a big stake in it. I know you met with some governors just the last few days.

We believe that we -- our views represent the views of a great number of the American people who have tried to say in every way they know how -- through town meetings, through surveys, through elections in Virginia and New Jersey and Massachusetts -- that they oppose the health care bill that passed the Senate on Christmas Eve.

And, more importantly, we want to talk about we believe we have a better idea. And that's to take many of the examples that you just mentioned about health care costs, make that our goal, reducing health care costs, and start over, and let's go step by step toward that goal.

And we'd like to briefly mention -- I'll briefly mention, others will talk more about it as we go along -- what those ideas are, what some of them are, what some of the suggestions we have are.

I'd like to begin with a story. When I was elected governor, some of the media went up to the Democratic leaders of the legislature and said, "What are you going to do with this new young Republican governor?" a few years ago. And they said, "I'm going to help him, because if he succeeds, our state succeeds." And they did that. That's the way we worked for eight years. And -- but often they had to persuade me to change my direction to get our state where it needed to go.

I'd like to say the same thing to you. I mean, we want you to succeed, because if you succeed, our country succeeds. But we would like, respectfully, to change the direction you're going on health care costs, and that's what I want to mention here in the next -- next few minutes.

I was trying to think about if there were any kind of event that this could be compared with, and I was thinking of the Detroit Auto Show, that you had invited us out to watch you unveil the latest model that you and your engineers had created and asked us to help sell it to the American people, and we go and you do that and we look at it and we say, "That's the same model we saw last year," and we didn't like it and neither did they because we don't think it gets us where we need to go and we can't afford it.

So as they also say in Detroit, again, we think we have a better idea.

Your stories are a lot like the stories I hear. When I went home for Christmas after we had that 25 days of consecutive debate and voted on Christmas Eve on health care, a friend of mine from Tullahoma, Tennessee, said, "I hope you'll kill that health care bill."

And then, before the words were out of his mouth, he said, "But we've got to do something about health care costs. My wife has breast cancer. She got it 11 years ago. Our insurance is $2,000 a month. We couldn't afford it if our employer weren't helping us do that. So we've got to do something."

And that's about -- that's where we are. But we think to do that we have to start by taking the current bill and putting it on the shelf and starting from a clean sheet of paper.

Now, you've presented ideas, there's 11-page memo on the -- I think it's important for people to understand there's not a presidential bill. There's -- there are good suggestions and ideas on the Web. We've made our ideas. But it's said it's a lot like the Senate bill. It has more taxes, more subsidies, more spending.

So what that means is that when it's written, it'll be 2,700 pages, more or less, which means it'll probably have a lot of surprises in it. It means it'll cut Medicare by about half a trillion dollars and spend most of that on new programs, not on Medicare and making it stronger, even though it's going broke in 2015.

It means there'll be about a half trillion dollars of new taxes in it. It means that for millions of Americans premiums will go up, because those -- when people pay those new taxes, premiums will go up, and they will also go up because of the government mandates.

It means that from a governor's point of view, there are going to be what our Democratic governor calls the mother of all unfunded mandates. Nothing used to make me madder as a governor than when Washington politicians would get together and pass a big bill, take credit for it, and then send me the bill to pay, and that's exactly what -- what this does with the expansion of Medicare.

And in addition, it dumps 15 to 18 million low-income Americans into a Medicaid program that none of us want to be a part of because 50 percent of doctors won't see new patients. So it's like giving someone a ticket to a bus line where the buses only run half the time.

When fully implemented, the bill would spend about $2.5 trillion a year, and it still has the sweetheart deals in it. One's out, some are still in. I mean, what's fair about taxpayers in Louisiana paying less than taxpayers in Tennessee? And what's fair about protecting seniors in Florida and not protecting seniors in California and Illinois and Wyoming?

So our view, with all respect, is that this is a car that can't be recalled and fixed and that we ought to start over. But we'd like to start over.

When I go down on the floor, and I've been there a lot on this issue, some of my Democratic friends will say, "Well, Lamar, where's the Republican comprehensive bill?" And I say back, "Well, if you're waiting for Mitch McConnell to roll in a wheelbarrow in here with a 2,700-page Republican comprehensive bill, it's not going to happen," because we've come to the conclusion that we don't do comprehensive well.

We've watched the comprehensive economy-wide cap in trade. We've watched the comprehensive immigration bill. We had the best senators we've got working on that in a bipartisan way. We've watched the comprehensive health care bill. And they fall of their own weight.

Our country is too big, too complicated, too decentralized for Washington, a few of us here, just to write a few rules about remaking 17 percent of the economy all at once. That sort of thinking works in a classroom, but it doesn't work very well in our big, complicated country. And it doesn't work for most of us. I mean, if you look around the table, I'm sure it's true on the Democratic side as it is on the Republican, we've got shoe store owners and small-business people and a former county judge and we got three doctors. We've got people who are used to solving problems step by step.

And that's why we said 173 times on the Senate floor in the last six months of last year, we mentioned our step-by-step plan for reducing health care costs. And I'd like to just mention those in a sentence or two.

You mentioned Mike Enzi's work on the small-business health care plan. That's a good start. It came up in the Senate. He will explain why it covers more people, costs less, and helps small businesses offer insurance.

Two, helping Americans buy insurance across state lines. You've mentioned that yourself. Most of the governors I've talked to think that'd be a good way to increase competition.

Number three, put an end to junk lawsuits against doctors. In our state half the counties, pregnant women have to drive to the big city to have prenatal health care or to have their baby because the medical malpractice suits have driven up the insurance policies so high that doctors leave the rural counties.

Give states incentives to lower costs, number four.

Number five, expanding health savings accounts.

Number six, House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer. Because she has a preexisting condition, it makes it more difficult to buy insurance.

So there's six ideas. They're just six steps, maybe the first six, but combined with six others and six more and six others, they get us in the right direction.

Now, some say we need to rein in the insurance companies -- maybe we do -- but I think it's important to note that if we took all the profits of the insurance companies, the health insurance companies entirely away, every single penny of it, we could pay for two days of the health insurance of Americans, that would leave 363 days with costs that are too high.

So that's why we continue to insist that as much as we want to expand access and to do other things in health care, that we shouldn't expand a system that's this expensive, that the best way to reduce cost -- to increase access is to reduce cost.

Now, in conclusion, I have a suggestion and a request for how to make this a bipartisan and truly productive session. And I hope that those who are here will agree I've got a pretty record of working across party lines and of supporting the president when I believe he's right, even though other members of my party might not on -- on that occasion.

And my request is this -- is -- is before we go further today that the Democratic congressional leaders and you, Mr. President, renounce this idea of going back to the Congress and jamming through on a bipartisan -- I mean on a partisan vote through a little used process we call reconciliation your version of the bill.

You can say that this process has been used before, and that would be right. But it's never been used for anything like this. It's not appropriate to use to write the rules for 17 percent of the economy. Senator Byrd, who is the constitutional historian of the Senate, has said that it would be an outrage to run the health care bill through the Senate like a freight train with this process.

So this is the only place, the Senate, where the rights to the minority are protected. And sometimes, as Senator Byrd has said, the minority can be right. I remember reading Alexis de Tocqueville's books, which most of us have read. And he said in his American democracy that the greatest threat to the American democracy would be the tyranny of the majority.

When Republicans were trying to change the rules a few years ago-- you and I were both there. Senator McCain was very involved in that, about getting majority vote for judges. Then-Senator Obama said the following, "What we worry about is essentially having two chambers, the House and the Senate, who are simply majoritarian. Absolute power on either side. That's just not what the founders intended." Which is another way of saying that the founders intended the Senate to be a place where the majority didn't rule on big issues.

And Senator Byrd in his book -- or Senator Reid in his book, writing about the gang of 14, said that the end of the filibusterrequiring 60 votes to pass a bill would be the end of the United States Senate.

And I think that's why Lyndon Johnson in the '60s passed the civil rights bills in Everett Dirksen's office, the Republican leader's, because he understood that having a bipartisan bill not only would pass it, but it would help the country accept it.

Senator Pat Moynihan has said, before he died, that he couldn't remember a big piece of social legislation that passed that wasn't bipartisan.

And after World War II in this very house, and in the room back over here, President Truman and General Marshall would meet once a week with Senator Arthur Vandenberg, the Republican chairman of the Senate Foreign Relations Committee, and write the Marshall Plan.

And General Marshall said that sometimes Van was my right hand and sometimes he was his right hand. And we know how to do it.

I mean, John Boehner and George Miller did that on No Child Left Behind. Mike Enzi and Ted Kennedy wrote 35 bills together. You mentioned that in your opening remarks. You and I and many other senators worked together on the America Competes Act.

We know how to do that. We can do that on health care as well.

But to do that, we'll have to renounce jamming it through in a partisan way. And if we don't, then the rest of what we do today will-- will not be relevant.

I mean, the only thing bipartisan will be the opposition to the bill, and we'll be saying to the American people who have tried to tell us in every way they know how -- town halls and elections and surveys -- that they don't want this bill, that they would like for us to start over.

So if we can do that -- start over -- we can write a health care bill. It means putting aside jamming it through. It means working together the way General Marshall and Senator Vandenberg did.

It means reducing health care costs and making that our goal for now, and not focusing on the other goals. And it means going step bystep together to re-earn the trust of the American people.

We'd like to do that. And we appreciate the opportunity that you've given us today to say what our ideas are and to move forward. Thank you very much.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: Well, thank you, Lamar.

Both I and Lamar went a little bit over our original allocated time. I'm not one to be a hypocrite. I wanted to give you some slack.

We're going to have Nancy and Harry.

I think -- my understanding is you guys want to split time?

REP. NANCY PELOSI (D-CA), SPEAKER OF THE HOUSE: We will.

(OFF-MIKE)

OBAMA: We'll split it up. So we'll let them make some quick remarks.

What I will then do is just address -- John, are you going to make the presentation yourself?

OK. What I will then do is just address a couple of points that were raised by you, Lamar, in terms of process. And then we will start diving in and getting to work. All right?

Nancy?

PELOSI: Yes, Mr. President. Thank you very much for bringing us here today. I will try to stick to the time because we have many people to hear from.

Thank you, Mr. President, again. It was almost a year ago, March5th of last year, when you brought us together in a bipartisan way to set us on a path to lower costs, improve quality, expand access to quality health care for all Americans.

In the course of that time in our committees in the House and the Senate, we've had lively discussions. Here we are today.

You began your remarks, Mr. President by saying there was a glimmer of bipartisanship in the Senate with the passage of the jobs bill. I want you to know there was a blaze of bipartisanship in the House yesterday with, what, 406-19, we passed under the leadership of Congresswoman Louise Slaughter, Tom Perriello, Betsy Markey and others the listing repealing the exemption that insurance companies have on health insurance and the anti-trust laws for health insurance -- 406- 19, a strong message that, yes, the insurance companies need to be reined in.

So, put us down on that side of the ledger.

The -- that day, March 5th, we all remember the bipartisan spirit, the hope that was in the -- in the room, and also when Senator Kennedy came into the room and declared himself a foot soldier in the fight for health care for all Americans.

And then later he wrote to you and said, "This is not just about the details of policy. It is about the character of our country."

The character of our country has formed the backbone of our country, our working middle-class families in America. As we sit around this table, I think we should be mindful of what they do when they sit around their kitchen table. What we do here must be relevant to their lives.

And for them, they don't have time for us to start over. Many of them are at the end of the line with their insurance, with their caps, with this and that.

You talked about stories. Senator Alexander did, too. I can tell you many stories, as I travel the country, where I've seen grown men cry. One man in Michigan, Mr. Dengel (ph), told me that his wife had been sick for a long time. He was at the end of the line in terms of his finances. He might have to lose his home. And she was bedridden. He was afraid of what was going to happen. And he was too proud to tell his children that he needed help, because they were raising their own families.

He said, "When is something going to happen on health care in America? I can't hold out much longer."

I have a letter from a -- Michigan seems to be where I get some mail on this subject, since I've traveled there recently -- by a woman who said that their family they're going to have to pay their deductible, they have to subtract it from their food budget. And that's just one of the concerns she mentioned.

Can't mention health care in Michigan without acknowledging Chairman Dingell -- his institutional memory of how difficult it was to pass Medicare, how he has worked over the decades to improve it, how committed he is to preserving it, and how important a part of preserving Medicare is to this -- passing this health care bill.

Later he will inspire us with that, but he, Mr. President, as you know, as a young congressman gavelled Medicare into law in the House of Representatives.

The -- you have talked about how the present system is unsustainable for families, for businesses -- large, modern and large, small, any size -- and how it's unsustainable, as you said on March5th of last year.

And health care reform is entitlement reform. Our budget cannot take this upward spiral of cost. We have a moral obligation to reduce the deficit and not heap mountains of debt onto the next generation.

So I want to talk for a moment about what it means to the economy. Imagine an economy where people could change jobs, start businesses, become self-employed, whether to pursue their artistic aspirations or be entrepreneurial and start new businesses, if they were not job-locked because they have a child who's bipolar or a family member who's diabetic with a pre-existing condition, and all of the other constraints that having health care or not having healthcare places on an entrepreneurial spirit.

Think of an economy with that dynamism, of people following their pursuits, taking risks. We want them to take risks, and yet we lock them down and we have an anvil around our businesses because of these increasing costs of health care. So this bill is not only about the health security of America; it's about jobs. In its life it will create 4 million jobs, 400,000jobs almost immediately, jobs of, again, in the health care industry but in the entrepreneurial world as well.

You, Mr. President -- under your leadership, we passed the American Reinvestment and Recovery Act (sic) last January and got a running start on some of the technology on scientific advancements in this by the investments in biomedical research, health I.T., health information technology; a running start by your signing the SCHIP, the children's health bill, insuring 11 million children.

We had a running start on expanding access, and not only that, but doing it in a way that is of the future. This is not just about health care for America; it's about a healthier America. This legislation is about innovation. It's about prevention. It's about wellness.

But most people haven't heard about that. And those people sitting at that kitchen table -- they don't want to hear about process. They want to hear about results. They want to know what this means to them. And what it means is a health initiative that is about affordability for the middle class, lowering costs, improving access for them; accessibility -- affordability and accessibility are closely aligned -- and accountability for the insurance companies.

So it is a very important initiative that we have to take. And I want to say, because Medicare was mentioned, unless we pass this legislation, we cannot keep our promises on Medicare. We simply must make the cuts and waste, fraud and abuse in Medicare so that the benefits and the premiums are untouched. We owe it to our seniors. We owe it to our country.

That day, March 5th, Senator Kennedy said health care is a right, not a privilege. Let us move in a way -- who can say "ram"? We've started this six weeks after your inauguration, just six weeks after your inauguration, on March 5th, with you extending a hand of bipartisanship. And many of the provisions that are in our bill are initiatives put forth by the Republicans.

Others of our colleagues will talk about this. But I just hope that, as we sit around this table, we understand the urgency that the American people have about this issue, how it affects not only their health but their economic security.

And I thank you, Mr. President, for your leadership in getting us to this place.

REID: Mr. President, my friends in the House and in the Senate, I want to spend a few minutes talking about Nevada, about our country, and not what's going on here in Washington.

I want to start by talking about a young man by the name of Jesus Gutierrez. He works hard. He has a restaurant in Reno, Nevada. He had everything that he wanted except a baby. He had health insurance. He had employees that liked him. But he was fortunate. They were going to have a baby. It was going to be a little girl.

And the baby was born. And in just a few minutes after the birth of that baby, he was told that the baby had a cleft palate. "But that's OK," he was told, "We can take care of that," and they did.

They did some surgery on the baby, and he was happy, that is, Jesus was happy until he got his mail four months later, opened the envelope and the insurance company said, "We didn't realize that your baby had a pre-existing disability. We're not covering the $90,000 in hospital and doctor bills you've already run up."

So he's trying to pay that off. The baby needs a couple more surgeries.

This shouldn't happen to anyone in America. He had health insurance. He paid his premiums.

I say to my friend Lamar, who I have great respect and admiration for, you're entitled to your opinions but not your own facts. Your opinion is something that is yours, and you're entitled to that, but not your own set of facts.

Senator Moynihan said that many years ago. And that's what we have to do here today. Let's make sure that we talk about facts.

Last Monday, a week ago Monday, all over America, the results were run from a poll done by the Kaiser Foundation. It was interesting what that poll said. Fifty-eight percent of Americans would be disappointed or angry if we did not do health care reform this year -- 58 percent.

Across America, more than 60 percent of Republicans, Democrats and independents want us to reform the way health care works. Is it any wonder?

They want it so that businesses can afford health care. They want to give consumers more choices and insurance companies more competition.

And the doughnut hole -- what is the doughnut hole? Well, a senior citizen will tell you what the doughnut hole is. Under the Medicare law that is in existence, you can be sick and you can get your medication paid for, for a while. After you spend $2,000,approximately, in medication, you are finished until you spend $3,500more out of your own pocket.

And what happens during that hole that we've called the doughnut hole?

Seniors in America are splitting pills in half, not getting their prescriptions filled, taking them every other day.

Again, Lamar, you're entitled to your opinion but not your own facts. No one has said -- I read what the president has online. No one has talked about reconciliation, but that's what you folks have talked about ever since that came out, as if it's something that has never been done before.

Now, we as leaders here, the speaker and I, have not talked about doing reconciliation as the only way out of all this. Of course it's not the only way out. But remember, since 1981, reconciliation has been used 21 times. Most of it's been used by Republicans for major things, like much of the Contract for America, Medicare reform, the tax cuts for rich people in America. So reconciliation isn't something that's never been done before.

It's as if there's a different mindset, a different set of facts than the reality. Remember, Chairman Dodd, in the HELP Committee, held weeks of markups, and in the bill that he reported out of that committee, there's more than 150 Republican amendments that are part of that legislation. The same happened with Chairman Baucus in the Finance Committee. And those were put together. That's what we brought to the floor.

So the bill on the floor that my friend Lamar is lamenting here has significant input from the Republicans.

So let's look at the facts a little bit more. Because they can be stubborn, you know.

Harvard just completed a study that shows 45,000 Americans die every year because they don't have health insurance, almost 1,000 a week in America.

In 2008, about 750,000 bankruptcies were filed. About 70 percent of those bankruptcies were filed because of health care costs. Eighty percent of the people that filed for bankruptcy because of health care costs had health insurance. America is the only country in the world where, if you get sick or hurt, you're going to have to file bankruptcy -- 750,000 bankruptcies in 2008.

These facts show that the story that I told about Jesus is not just a story of some young businessman in Reno, Nevada, running a restaurant, that gets jerked around by an insurance company. It happens all over.

Health reform shouldn't be about political parties fighting each other.

SEN. HARRY REID (D-NV), MAJORITY LEADER: It should be about people fighting for their lives and fighting for a better quality of life; people like (inaudible) and that little girl.

This debate shouldn't be about whether an idea came from Democrats or Republicans or one side of the aisle or the other side of the aisle, but whether the idea will improve the health care delivery system in our country.

I know, it's obvious, we've heard it, my Republican friends oppose our legislation and that is your right. But also it becomes your responsibility to propose ideas for making it better. So if you have a better plan for making health insurance more affordable, let's hear it. If you have a better plan for making health insurance companies more accountable, let's face it, let's work on it.

If you have a better plan for doing this while cutting the deficit, as our bill did -- during the first 10 years, our bill cuts the deficit by $132 billion; the second 10 years up to $1.3 trillion. Those aren't my numbers. They come from the Congressional Budget Office.

So we're ready to listen. I so appreciate the president getting us together. And I want the American people to know that we need to work together, and I want to do everything I can as a senator to work with my colleagues on both sides of the aisle to get this done. We need to do health care reform.

I've spoken with Madam Speaker on many occasions, numerous times about health care. We spent most of the last year talking about health care. I so admire her tenacity, her legislative brilliance, and I will do everything I can, Mr. President, to get this health care reform over the goal line.

OBAMA: Well, thank you very much, Harry.

Everybody went a little over time, which is not surprising with a room full of elected officials. I wanted to give people a little bit of wide berth starting off, but we're going to need to be more disciplined moving forward if we're going to be able to cover every item, and I'll try to set the example here.

I just want to address very quickly, Lamar, the issue of process that you raised at the beginning, and then we'll move on and start talking about the specifics. As I listened to your description of the House-Senate bill, as well as the proposal that I put on our Web site, obviously there were some disagreements about how you would characterize the legislation.

On the other hand, when I listened to some of the steps that you thought Republicans would be open to, I thought, well, a bunch of these things are things that we'd like to do, and in fact are in the legislative proposals.

So part of the goal here, I think, is to figure out what are the areas that we do agree on; what are the areas where we don't agree; and at the end of that process, then make an honest assessment as to whether we can bridge these differences. I don't know yet whether we can. My hope is that we can, and I'm going to be very eager to hear and explore how we might be able to do so.

So rather than start at the outset talking about legislative process and what's going to happen in the Senate and the House and this and that, what I suggest is let's talk about the substance, how we might help the American people deal with costs, coverage, insurance and these other issues. And we might surprise ourselves and find out that we agree more than we disagree. And that would then help to dictate how we move forward.

It may turn out on the other hand there's just too big of a gulf, and then we'll have to figure out how we proceed from there. So that would be my proposal.

And what I'd like to do, then, is to start first with something I heard everybody agree on, every single speaker, and that was the issue of cost. It is absolutely true that if all we're doing is adding more people to a broken system, then costs will continue to skyrocket, and eventually somebody's going to be bankrupt, whether it's the federal government, state governments, businesses, or individual families. So we have to deal with costs. I haven't heard anybody disagree with that.

Now, I've already indicated some -- some statistics, but I just want to reemphasize these. More than a quarter of small businesses have reported a premium increase of 20 percent or more just last year-- 20 percent. As a consequence, a lot of small businesses dropped coverage altogether. Fewer than half of businesses with fewer than 10workers now offer coverage.

By one estimate, without health care reform, by the end of the decade premiums for businesses would more than double in most states. And the total cost per employee is expected to rise to more than$28,000. So you can imagine what that does to hiring, what that means for incomes, and you can imagine how many families are going to be unable to afford insurance.

As I mentioned earlier, I hear stories from people all the time about how these costs have very concrete impacts on their lives. I spoke to a family, the Links (ph) from Nashville, Tennessee. They've always tried to do right by their workers, with their family-run company, but they had to do the unthinkable and lay-off employees because their health care costs were too high. I've talked to other business people who say, "We were going to hire, but we decided not to when we got our monthly premiums."

And so one of the goals that I set out very early-on in this process was how do we control costs. Now, what we have done, as I mentioned earlier, was to try to take an idea that is not just a Democratic idea, but actually is a Republican idea, which is to set up exchanges. These are pools where people can come in and get the same purchasing power as members of Congress do as part of the federal employees' health care plan, as people who are lucky enough to work with big businesses can do because there are a lot of employees in those big businesses.

What we've said is that if you join one of these exchanges, you will have choice and you will have competition. You will have a menu of private insurance options that you'll be able to purchase, but because you're not purchasing it on your own, you're purchasing it as part of a big group, you're going to be able to get lower costs.

WOLF BLITZER, CNN ANCHOR: All right, we're going to take a quick break. We'll continue our coverage in a couple of minutes. Stand by, this conference is only just beginning.

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