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Health Care Summit Examined


And for more on today's proceedings, I'm joined by NPR health policy correspondent Julie Rovner, who spent the day watching the summit. Hi, Julie.


SIEGEL: President Obama promised on the campaign trail that all the negotiations on the health care bill would be televised on C-SPAN. I watched some of it on C-SPAN. It didn't look like people negotiating a bill.

ROVNER: No, this is not what negotiations look like. This is what it looks like when you bring television cameras into a meeting of 40 members of Congress and the president and vice president. And try as the president did, everyone retreats to their talking points. This was 40 members of Congress with their talking points. A real negotiation, believe it or not, is a lot drier then even this meeting was, although probably a lot more substantive, and I have sat through my share of real negotiations on big bills.

SIEGEL: Now the stated goal of this meeting was to find some bipartisan consensus on the health bill. Any sign of that, that you saw?

ROVNER: Well, not really. You know, there are so many of the individual pieces where there is agreement between Democrats and Republicans, things like banning preexisting condition exclusions in health insurance, cracking down on fraud and abuse, having high risk pools for people with preexisting conditions enabling them to buy health insurance, even doing something about medical malpractice lawsuits. But I think there's something that we really did see clearly today and why - on why there's been so little bipartisan consensus, as we heard in Mara's story.

There is that fundamental philosophical disagreement about the role of government in the health care system. Democrats think that if what's broken is to be fixed, it will take a lot more government involvement. Republicans think there should be less government involvement. So even if Democrats were to add most of the Republicans' ideas that they agree on to the bill, the bill still has so much of a government influence that not many of those Republicans would be willing to vote for it.

SIEGEL: Now there were an awful lot of facts thrown around in that room in the statements by all the people there. Was one side any better with the truth than the other, do you think?

ROVNER: Well, it was awfully hard to keep score. It's interesting. Both sides were doing a lot of fact-checking and they were dozens of emails flying back and forth from the various fact-checkers. But, you know, mostly what was going on is that both sides were making selective use of facts that were sort of correct. Here's a good example: Very early on in the day, President Obama and Senator Lamar Alexander of Tennessee got into an argument about whether the Democrats' bill would raise or lower insurance premiums. Now Republicans say the bill would raise them, Democrats say the bill would lower them and both point to the Congressional Budget Office estimate to make their case.

SIEGEL: And who would you say is right?

ROVNER: Well, they both are, sort of. It turns out that for most people premiums would go down slightly because those people have group health insurance. For individuals, who are a small minority of how people get insurance, premiums would go up but that's because they would get better coverage, meaning they get more things covered. And for most of those individuals, they wouldn't pay more because the bill would give them help to pay those premiums. For the few people who wouldn't get help, the better coverage would probably mean they would pay less overall in total out-of-pocket cost for their medical bills because that better coverage would mean that they would actually...

SIEGEL: Cover more procedures and lower deductibles, yeah.

ROVNER: It would cover - that's right. Exactly. But so...

SIEGEL: So answer is, it's complicated.

ROVNER: Exactly.

SIEGEL: All the questions are complicated.

ROVNER: Well, right. Like the rest of health care, as president likes to say, is complicated.

SIEGEL: And where does this complicated matter go next?

ROVNER: Well, given that they didn't come out with a big bipartisan agreement, not that anyone expected they would, I suspect Democrats will now have to regroup and figure out how to pass a bill without Republican support. That's not a big surprise. They've been preparing for that pretty much for the last several weeks. It probably means using the budget reconciliation process, as Mara also gave reference to. It probably also means that the House is almost certainly going have to pass the Senate bill first. That's not talked about very much, but that's probably going to be a precursor to being able to use that process. That won't be easy either. It's going to be difficult to get those votes. And I think that that's going to have to begin as soon as tomorrow.

SIEGEL: NPR health policy correspondent Julie Rovner. Thank you, Julie.

ROVNER: You're very welcome. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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