Our previous coverage of President Obama’s July 20, 2009 blogger conference call on health care reform:

The healthcare battle looms large

President Obama: health care reform – blogger conference call

President Obama: health care reform – blogger conference call – Q and A

Axelrod and DeParle: health care reform – blogger conference call – Q and A

After President Obama left the conference call his senior aides David Axelrod and Nancy-Ann Deparle continued to take questions from bloggers in on the call. This is the final portion of the transcript:

….Question: …You and the President both mentioned Senator DeMint’s comment about Waterloo. I’m actually watching the House Energy and Commerce Committee right now and it’s pretty clear that the Republicans there are doing everything they can to kill the bill. So, my question is, and there’s been a lot of talk, and there’s a lot of talk in Washington, you know, amongst the talking heads about how important bipartisanship is. When does bipartisanship become just, so, less of an issue and good policy becomes the driving force? And we, and we kind of get away from that talk about having to have a bipartisan bill if, if it means that, now that, especially now that we know the Republicans’ main agenda is to kill health care reform.

David Axelrod: Well look, uh, good policy has to ultimately be the driver here. And the, the President said he didn’t want to make the prefect the enemy of the good. But, uh, I don’t think, uh, we want to make, uh, uh, but, but we want a bill that’s good. We want a bill that addresses the fundamental issues that he raised, that I’ve raised, that Nancy-Ann has, uh, has raised. We, uh, so it has to meet certain standards. We, we would love to do that, it would be, uh, easier to do that with, uh, bipartisan support, but that, we’re not driven by the process, we’re driven by the outcome. And, uh, uh, we’re gonna do whatever is necessary to achieve the outcome that will bring real relief to the American people and will stabilize our health care system now and for, for, uh, years to come. And so, uh, you know, there are still, uh, uh, those in the other party who are, uh, perhaps to the consternation of some of their, uh, co.., peers who are, who are sitting in in good faith trying to, uh, work this through. And we want to, uh, uh, and we want to explore that, uh, thoroughly. Not everyone is following the admonition of Bill Kristol who said today that they should resist the, uh, temptation to be constructive or responsible and go for the kill. Uh, there are, there are those who actually want to be constructive and, uh, and responsible. And we’re gonna, we’re gonna explore that fully. But rest assured that ultimately, uh, the goal here is to get, um, some fundamental reform for the American people to get them out from the yoke of this ever increasing burden and to, to rescue, uh, our, our, our, our businesses from that and the government from that. So, um, you know, we’ll do what’s necessary to achieve that goal…

….Question: …Do you think it was a mistake to back off and sort of allow Congress to take the lead on health care reform as long as you did?

David Axelrod: No, Oliver, I, I, it’s a good question. I think the answer is no. I know the answer is no because we’re closer today than we’ve ever been to actually achieving this. You know, people have tried, uh, uh, in the past to achieve comprehensive, uh, health care reform that would, uh, make, uh, quality affordable health care available to, uh, all Americans and bring the kind of reforms we’re talking about. And, uh, uh, and, and they, they haven’t gotten as far. So, you know, we, we have some agreement on, you know, probably seventy percent, uh, of the, uh, of the issues here. And I think partly that’s because we didn’t arrive on Capitol Hill in January with stone tablets and ask people to, uh, uh, you know, uh, pledge fidelity to them. Uh, we’ve allowed the process to work. But now the President, uh, has, uh, you know, we’ve reached another phase of this debate. The President is obviously deeply, uh, involved and, uh, and, and will be, uh, to the end. And I will say that Nancy-Ann and her team have been working closely with members of Congress from the beginning. So it isn’t as, as, as if, uh, we haven’t, uh, uh, been, uh, an integral part of the process, it’s just that we haven’t tried to dictate the outcome from the beginning. I’m quite certain that had we done that we would have not ended up, uh, in a position to accomplish, uh, what I think we’re in a position to accomplish now.

….Question: …Here in Pennsylvania, uh, we’re trying to get a single payer plan bill passed in the state level. We have the governor’s [garbled] he’d sign it. Uh, being from Philadelphia, uh, [garbled] you have a, uh, certain empathy for us in Pennsylvania. Since single payer isn’t on the table on the national level will the White House support our efforts here in Pennsylvania to, uh, do a model on the state level?

Nancy-Ann DeParle: Well, uh, in fact Governor Rendell was just down here last week, uh, meeting with folks, uh, here at the White House. And, um, I, we, he’s a great friend of, of this administration and we work closely with him. You know, I think we have the same goal, which is we want to get people covered, we want to lower costs, we want to increase quality. We want to get out of this, this, uh, system we’re in now where people are, are paying more and getting less every year. So, uh, we want to work with you to move forward in doing that and I think we’re just not about drawing lines in the sand at this point. That is not the focus, as you say, single payer is not the focus of the debate in Washington, but, um, you know, it’s good to hear you’re moving forward in Pennsylvania. We know you have, uh, a problem there with, uh, people being able to afford, uh, coverage. We know you have a problem of, of, frankly, monopolies with insurance companies ’cause I’ve looked at the data about that. So, um, you know, good luck to you and we’d love to work with you.

David Axelrod: And I think it is a reflection, uh, of the, uh, seriousness that I think people all over this country feel, uh, about this problem. It just sim.., it’s simply not, something that we can’t delay and defer for another, uh, another fifteen years, another generation. I, I don’t think the system can tolerate that. Uh, we are on a, you know, an unsustainable path. So, it’s not surprising that states have taken up, uh, the initiate because there hasn’t been, uh, leadership from Washington. Well we’re, we’re, uh, trying to provide that leadership and, and solve a problem that’s been deferred for far too long.

….Question: …I just wanted to first thank you guys for doing this and, uh, second say please do it more….I’m wondering if, uh, the President would veto any health care bill that doesn’t include a public option. Is, is that something that, uh, you’ll be willing to [garbled]?

David Axelrod: Well, first of all, uh, let me, uh, return the thanks for what you guys do every day, uh, to keep the dialog going in this country and to, uh, help involve people and keep ’em, uh, up to date and, uh, to give people a platform, uh, uh, to express themselves on, uh, these issues.

The President feels very, very strongly that a, uh, a public option within the health insurance exchange will help, uh, create competition and, uh, will create, uh, uh, will help keep in, insurance companies honest and that will rebound to the benefit of, uh, consumers. Uh
, we expect that, uh, the bill he signs will include, uh, include, uh, a public, uh, choice. We have not, uh, uh, we’ve not, uh, uh, been wielding, uh, the big, uh, veto pen threat, uh, as yet because, uh, uh, we want to see how this whole thing unfolds. But I think he could have been more, uh, clearer, uh, about his, uh, his feeling that this would be an important part of a reform package. And nothing has changed.

….Question: …Last week, uh, six U.S. senators sent a letter to Harry Reid and Mitch McConnell stating a commitment to health care reform but asking for additional time. Uh, as this process moves forward how can the American people separate those who are making this commitment in god faith from those who are only promoting delay?

David Axelrod: Well, I, I, you know, and there’s no, there’s no doubt that, uh, uh, there are those who, who, who, uh, are, uh, asking, uh, for that in good faith. Uh, but, you know the answer, the respectful answer is that, uh, that this issue has been, uh, talked to death, not just for the last six months, but for, for decades. Uh, and, uh, we’re circling around the same issues that people have always, uh, that people have known for a long time would frame, uh, this debate. And I, I think if, if anyone needs any, just to repeat what I said earlier, if anybody needs any, um, demonstration, uh, of why, uh, uh, it’s important to move with some dispatch is the fact that those who want to stop this for political reasons are counting on a delay in order to, uh, um, muster, uh, greater, uh, lobbying efforts, greater misinformation, uh, campaigns. This is how the special interests have killed health care reform time and again and we’re not going to, uh, you know, we don’t want to walk down that same dark alley. Uh, and so we’re fighting, uh, um, uh, you know we’re fighting very hard to get this done. I’d say one other thing. Um, I suggest that anyone, uh, Republican or Democrat, who is arguing for delay, um, should, uh, check, uh, their mail, as I’m sure they do, as the President does every day, and read the letters from people who, some of whom have insurance, uh, and yet, uh, uh, are, uh, you know, are, are either not, not able to get the care they need or are, are being crushed by the cost of it, or the many who don’t, people who have pre-existing conditions and can’t get coverage. Uh, for example, people who have lost their jobs and are dumped into a private market that is way overpriced that they can’t afford. Uh, those people don’t have time. Those people are waiting for us, uh, to act and I think they have a sense that, uh, delay may be not for a matter of months, but for a matter of years if we don’t act now. So, I think it’s time to seize the moment and, uh, the President is gonna be urging that from now, uh, uh, until we get this done.

Thanks everybody for participating. Look forward to talking to you again.

Nancy-Ann DeParle: Thanks for all you’re doing….

Operator: That does conclude our conference for today…

Our previous coverage of President Obama’s blogger conference call on health care reform:

The healthcare battle looms large

President Obama: health care reform – blogger conference call

President Obama: health care reform – blogger conference call – Q and A

After President Obama left the conference call his senior aides David Axelrod and Nancy-Ann Deparle continued to take questions from bloggers in on the call. Our very own Blue Girl got in a question (below the fold):

….Question: …Our readers are very community oriented and very supportive of the President and they’ll want to know what they can personally do to help insure health care reform happens in the House and Senate.

David Axelrod: You know obviously we’re eager to spread the word. I mean one of the frustrating things about this, uh, uh, enterprise is that, uh, a lot of the coverage focuses on, uh, kind of the trees and not the forest. Uh, you heard the President articulate what his vision is and where he’s driving in terms of, uh, health reform. He, he defined it, uh, well I think, uh, in this conversation and, uh, and I think laid out the parameters that, uh, are important to him. I think for you guys to spread the word on that, uh, would be very, very important. We’re after health, uh, insurance reform, health care reform that will benefit all Americans, uh, folks who have insurance and have seen their premiums, uh, double over the last decade and have seen, uh, uh, health, uh, care, uh, premiums, uh, rise at three times the rate of wages. Uh, and who are increasingly finding it difficult to, uh, maintain [garbled]..I saw today, uh, uh, Mr. Steele say, uh, that, uh, under the Obama plan people would pay more for less. That’s exactly what’s happening every single year. People are paying more money for their health care and they’re getting less, uh, for it as deductibles rise, out of pocket costs, uh, rise. That’s exactly what we’re trying to address. Uh, and, uh, as well as deal with the issue of the uninsured and deal with the issue of the underinsured and people who, um, uh, have pre-existing conditions or loo…or have lost their job or changing jobs. These folks need some security and some stability. And that’s what this, that’s what this effort is about. And, uh, we want to make sure that people understand what it is that we’re fighting for and why it’s so important. And so to the extent that you can enlist people to spread the word, uh, and, uh, to mobilize folks, uh, to speak to their representatives in Congress and, uh, let them know, uh, that now’s the time. Uh, we saw, and I’ll yield the floor to, uh, Nancy-Ann here, but, uh,, we saw, uh, you know, over the weekend, uh, Senator DeMint, uh, say that the, you know, the strategy is to, uh, delay, uh, this process long enough so that they can, uh, kill it, uh, so that, uh, they, they, they said it could be Obama’s Waterloo, we can, uh, we can break him with this. Well the point is that there are millions of Americans who are being broken every single day. Uh, or, or every single year I should say, by, uh, uh, by, uh, climbing costs, uh, of health care. And that’s what we’re concerned about and that’s what we want to address. Do, do you want to add?…

…Nancy-Ann DeParle: No, I think your answer is right on point. And thank you for asking. We, we need your help to, uh, make sure that everyone knows what the President is fighting for here and that it has to happen now. And we, we appreciate everything you’re doing….

….Question: [Blue Girl!] …Uh, actually that’s They gave us a republic dot com. But anyway, uh, my question is about provider shortages. I’m a lab professional. I’ve spent more than twenty years on trauma teams and the fact that I’m still the young one speaks for itself. Uh, yeah, we’re, it, access doesn’t matter if you don’t have a doctor to see.  So is there any op.., any chance that we might, uh, see some training programs that are maybe tied in with Americorps or something? Or something like the military does now with ROTC and medical schools to staff, uh, military hospitals? Uh, [garbled], you know, to get people trained and on the job. The nursing shortage alone is a nightmare.

Nancy-Ann DeParle: Yes and [Blue Girl] thank you for what you’re doing and for your, your serving as a health [crosstalk]…

Question: Oh I’m, I’m retired. [laugh] And I was still the young one when I retired.

Nancy-Ann DeParle: The President spent some time today at Children’s, uh, National Medical Center here in D.C and met with nurses and physician assistants and doctors and, and talked about, uh, the struggles that families are facing in, in getting adequate care. And the emergency room there he, um, he was talking about the fact that they now have eighty-five thousand people, I think, a year, visits a year in their emergency room, up from fifty thousand. So we see the shortage, we see the need for more health professionals. In fact, one of the first things the President did, uh, was to, in the recovery act, uh, uh, add some additional funding, a substantial amount of additional funding that hasn’t been seen in a long time to the National Health Service Corp to train, uh, folks who will become health professionals in under served areas of the country. And we know that’s just the start of what is needed and in the health reform bill the House is, uh, doing right now they do have some authorizations for more funding for training.

I like your idea about trying to figure out a way to, uh, one thing that we’ve talked about is there a way to, to, uh, work with the returning, uh, veterans and those who have medical training, uh, and try to make sure that they can be, uh, plugged in to the, to the system and get jobs doing, uh, the work that they have been trained to do and which we need them doing. So, we’re looking for any and all ideas like that to make sure that we have adequate, uh, numbers of professionals out there. And appreciate your help in getting us new ideas….

….Question: …What’s your biggest concern about the current state of the debate? What’s your biggest fear in, in, in that way? What could we help do?

David Axelrod: [garbled] I, I think, uh, I, I appreciate the question and I, and I, uh, uh, you know I think I began to get at that, uh, a second ago. You know here in Washington, uh, the President always likes to say they sc.., you know they, they, they have a scorekeeper’s mentality. It’s all about who’s up and who’s down and, uh, people view this as a, kind of a, uh, uh, a game. And, uh, they tend to focus on, um, uh, uh, on, ss.., you know, uh, on the trees, as I said, rather than the forest. And I think, um, what we’re what we’re trying to stress is that, you know, the, the other side is using a tactic, uh, uh, of a, or opponents of this, of fear that change is frightening and the devil you know is better than the one you don’t. Well the fact is that, uh, what we have right now is unsustainable and that, you know, we want to communicate that that, uh, the reason it’s essential that we act now is that, uh, we can’t go decade after decade with health premiums doubling, with out of pocket costs, uh, growing, uh, uh, by a third. We can’t go with ten or twelve or fourteen thousand people a day losing their health, uh, uh, coverage. There’s an enormous price to be paid, human price, for inaction, uh, now. And we have a health care system right now that works, uh, well for, uh, uh, insurance companies and drug companies, but not so well for, um, individual Americans who, who are, are just getting crushed by the cost. Not so well for b
usinesses, small in particular, but also large. And we’re on an unsustainable path in terms of cost to the government. Uh, and we have to address these things. So, the thing you can communicate is this sense of urgency, uh, uh, that, uh, that we, that we have [garbled] that the program that we ult.., that the President will sign will address these issues, will give people some, uh, security, will have long overdue insurance, uh, reforms, and will make, uh, make the whole system work better, uh, give more choice in certain, more competition for consumers, more transparency. Uh, will do the things that are necessary to really bring about health care reform….

Our previous coverage of President Obama’s opening remarks: President Obama: health care reform – blogger conference call

….Question…Now we have these, uh, we’ll call them, uh, conservative Democrats joining with some Republicans [garbled] wanting to delay the bill, saying they need more time to, to go over and actually read it. But my question to you is will you ask Congress to forego the August recess and work this bill out? Because while they’re taking a vacation millions of Americans are either losing their health care or about to go bankrupt because of health care issues. So if they are going to whine about not having enough time they should act like real Americans and work during August.

President Obama: Well, here, here’s, here’s what I’ve said. Uh, we cannot delay any longer. Uh, if people keep on saying, “What’s the rush?” We’ve been debating this for fifty years. Uh, we’ve been talking about health care reform throughout the campaign. The day after, uh, I was elected, uh, we started contacting key leaders in Congress about the fact that this was gonna be our number one domestic priority. Uh, all these committees have been meeting. Experts, uh, have been talking. And now’s the time to make tough decisions. And I understand people wanting to put off tough decisions, but, uh, ul…ultimately, uh, we can move a process forward in which all the options have been dec…considered and we go ahead and make smart choices that provide the American people more security, uh, greater options, as well as, uh, bending the cost curve over the long term. And I, I’m confident that we can achieve that on the time line, uh, that I’ve put forward. I, I think it was telling, some of you may have seen, uh, uh, a Republican senator this weekend saying “That we’re just gonna delay and delay because if we can stop Obama,” uh, “on this one this is gonna be his Waterloo.” Uh, “We’ll break him.” Uh, that, that, that was a quote. And I think it indicates the degree to which, uh, a lot of folks may sincerely think that the more time we take, uh, the better off we’re, we’re gonna be, but I also think that there are some who deliberately want to delay this process because they know that the longer the special interests have to run negative ads or lobby members of Congress, uh, the more difficult it becomes, uh, to get this done. And, uh, you know, I think that, uh, the time for talk is, is through. Uh, now’s the time for us to go ahead and act.

Question I agree. Will you then make them give us a bill before the August recess?

President Obama: Uh, we, we are working, uh, as hard as we can and I, I’ve told, uh, uh, Harry Reid and and Nancy Pelosi that, uh, you know, it is critical, uh, that we see serious forward motion, uh, before people leave. All right?…

….Question …Given the time line and the fact that it seems like, uh, bills may not be through both the House and the Senate by the August recess, is there a point at which you would say to the Senate your, uh, sixty votes is, doesn’t seem like it’s gonna happen, use the reconciliation process, uh, lower the threshold so the Republicans cannot delay the process? Is there, I know it’s not optimal, but is there a point at which you would say that to the Senate?

President Obama: Uh, keep in mind that, uh, the way we had structured the reconciliation issue, uh, several months ago. Uh, we, we moved forward on, on the basis of the assumption that we can get a bill through the regular order and the regular process by October. If I think that that is not possible then, uh, we are going to look at all of our options, including reconciliation. Uh, not because that’s my preferred option but because what I, what I think will be unacceptable for the American people is inaction, uh, at a time when, uh, we have been, uh, seeing families bankrupted, businesses, uh, straining under the costs of health care, uh, and in the absence of action, uh, a continuation of a Medicare and Medicaid, uh, trajectory that is unsustainable. Uh, now in, in fairness I do think that, uh, what you’re seeing right now is really serious hard work on the part of, uh, members of the Senate, uh, and those on the Finance Committee. And although, uh, I may not, uh, agree with every single decision that may be made in, in any of the committees I think that folks really are working overtime. Uh, and t..and I appreciate the work that they’ve done and I remain confident that we can pass a bill, uh, in the absence of reconciliation. But I do think that, uh, the bottom line for me is give the American people a, uh, a serious reform package that lowers costs, increases choices, covers Americans, improves quality, changes our delivery system in, in a way that’s rational and, and, uh, makes our health care system, uh, a lot smarter and more efficient than it is right now. And I think that’s achievable and I, I continue to believe there are enough people of good faith, uh, who want to see that happen that we’re gonna get it done, uh, through the regular process….

….Question …Robert Reich, uh, put out an article today talking about the tension between, uh, some of the deals that have been made with, uh, stakeholders…

President Obama: Um hmm.

Question …in the debate, pharmaceutical deals, hospitals and things. And the need to, uh, bring more costs out of the current system. Is there a tension there and, and considering that the debate seems to be moving towards costs, uh, is there a tension with holding up to these deals with, sort of keep these stakeholders at bay and on the same side And also trying to, you know, get as much costs, uh, internally, uh, recycled back into the system?

President Obama: Right.

Question Which, you know, are, obviously at some point the rubber hits the road and it hurts the stakeholder

President Obama: Right. Well look, uh, obviously, uh, I, I can’t expect, uh, the hospital association to sign up for something that they don’t think is gonna be good for hospitals. Uh, and so I think there’s nothing wrong with them saying in the context of serious reform, knowing that reform’s happening and, uh, that we, uh, are gonna have to change how we do business, can we negotiate and find a way of doing it that, uh, works for our membership, uh, but also, uh, moves the reform process forward? Uh, it, you know, it’s conceivable, obviously, that in any of these cir…circumstances we might be able to cram down, in theory, additional savings. Uh, but for us to have the American Medical Association, the nurses association, hospital association, uh, and even pharma, as well as large employers like Wal-Mart, uh, saying this is important to do, uh, I wouldn’t underestimate the degree to which that helps us get, uh, a final package done that, that works. Uh, as I said, one, one of the difficult things, uh, about health care reform is we all know that theoretically there are enormous savings to be had in the existing system. So on paper we should be able to design, uh, a system that, uh, covers everybody and reduces costs compared, uh, what we’re spending right now, with no additional revenue. But capturing those savings, uh, changing delivery systems, uh, changing reimbursement systems, uh, that’s a lot harder to do in practice because you’ve got these legacy systems that are put in, in to place. And so if we can at least get a framework in which reform begins, we get people covered, we set up an exchange, that we have a public option, we have, uh, concrete reductions that can be applied, uh, and that the Congressional Budget Office can point to and say, you know, this is helping to pay for health care reform. Uh, if we can put more money into prevention and wellness and health IT and, uh, [garbled] do systems like comparative, uh, effectiveness, uh, research in order to move the system in a more efficient direction, then it’s co
nceivable that once the first ten years is completed we are seeing a even more efficient system and greater savings, uh, than we had anticipated or were memorialized, uh, in, in some of the agreements that have been made so far….

….Question …I actually have a question that was asked more than once by our readers. Uh, and they wanted to know, will self employed individuals and small businesses be able to enroll in the public option and what will their, uh, benefit for this new health care reform be?

President Obama: Well, that, they are some of the primary beneficiaries of the potential public option. The, they way we want to set it up is they can sign up into the exchange. The exchange would be specifically for folks, uh, or especially for folks like that who may not have any other recourse, they’re not part of a, uh, big self funded employer health care plan, the, they don’t get health care, uh, through, uh, a big pool that drives down their costs. They can then come into the exchange, they can shop for the best possible benefit, uh, in some cases they may be eligible for tax credits or, uh, other subsidies to make it more affordable for them. Uh, and that exchange would allow them to look at not just, uh, a public option but potentially if they preferred it, uh, other options, uh, through, uh, the private insurance market that, uh, they think, uh, serve their family’s needs, uh, the best. So, uh, it is precisely for those folks who have so much difficulty pooling, uh, and getting a decent bargain through the private marketplace, uh, that the exchange can end up being, uh, a very powerful tool, uh, for them to get high quality affordable health care.

….Question …We invite you back to visit Maine in the summer.

President Obama: …You know, Maine is gorgeous all the time, but, uh, I gotta admit that when it’s warm I like it better. I grew up in Hawaii, what can I tell you?

Question Exactly. Um, I’ve been running into the same, the same quote from, uh, from an opinion piece from Investors, Investors Business Daily, uh, where they’re saying that, uh, HR 3200 will make individual private medical insurance illegal. And they actually quote from Section 102 of the bill which is grandfathering, um, existing policies. Is this true, will, will people be able to keep their insurance and will insurers be able to, um, write new policies even though, uh, HR 3200 is passed?

President Obama: You know, I, I have to say that I am not familiar with the provision you’re talking about. I’ll, let me just speak for, uh, the Obama administration. Uh, I have committed myself consistently to a very simple proposition. If you have health insurance and you like it and you have a doctor that you like than you can keep it. Period. And I won’t, uh, sign a bill that somehow would make it tougher for people, uh, to keep their health insurance. Uh, I want to make it more affordable and easier for them to keep their health insurance. And that’s exactly why reform’s so necessary right now because if current trends continue more and more people are gonna lose their health care. At minimum more and more people are gonna be paying more money for their health care. And so, uh, we certainly would not be, uh, signing a bill that, uh, somehow prevented somebody from, uh, from getting, from keeping, uh, insurance that they’ve already got or, uh, allow, uh, private insurers to sign up new folks if, uh, if they’re providing good service.

Okay, I, I’ve got time for one more question….

….Question Thank you Mr. President for, for doing this. We really appreciate it.

President Obama: I enjoy it, thanks.

Question Um, I was reading in Roll Call today that the Senate Finance Committee is still working on Conrad’s co-op proposal and I’m wondering if there’s any kind of co-op plan you can envision that will fulfill what you see as a good public option.

President Obama: Well, you know, I’m still looking at the details of, uh, a co-op approach. Um, I will tell you that, uh, there are some, uh, instances of co-ops being set up and just having a very difficult time getting off the ground, uh, because they don’t have the scale, uh, and the resources to be able to, to compete effectively. Uh, what I’ve asked my health care team to do is to get what, uh, um, uh, what evidence we have that this could provide a, the kind of competition that drives or helps to promote insurance reform, uh, and helps improve quality and drive down costs. Uh, if I can see some evidence that that could work then I’d be happy to consider it. Uh, but I will tell you that, uh, as I’ve been very clear about before, uh, I continue to believe that a robust public option, uh, would be, uh, the best way to go.

Uh, the, the one thing I, I do want to, uh, say, um, uh, to all of you as, as I sign off and, and, uh, David Axelrod and  Nancy-Ann DeParle should, should still be on after I hang up, is that, you know, the House bill and the Senate bills are not gonna be identical. Uh, we know this. Uh, the, the politics are different because the makeup of the Senate and the House are different and they operate under different rules. Uh, [garbled]  I am not interested in making, uh, the best the enemy of the good. And there is gonna be a conference committee in which the House and the Senate bills are reconciled that is gonna be a very tough, lengthy and serious negotiation process. Uh, I think that, you know, I, I’m less interested in making sure that there’s a litmus test of perfection on every bill that comes out of every committee than I am in going ahead and getting a bill off the floor in the House, a bill of the floor in the Senate. Eighty percent, uh, of, uh, those two bills will overlap. There’s gonna be twenty percent that’s gonna be different in terms of how it’s funded, it’s approach to the public plan, it’s approach to, uh, the pay or play provisions. And, you know, I think that, you know, we shouldn’t automatically just assume that if any one of the plans that come out of the committees, uh, don’t, uh, meet our tests that somehow, um, there’s a betrayal or there’s a failure. I think it’s an honest process of trying to reconcile a, a lot of different interests in a very big bill. Uh, the conference then is gonna be the place where these differences get ironed out and that’s where, you know, my bottom line, uh, will remain.

Does this, uh, cover all Americans? Does it drive down costs both in the public sector and the private sector over the long term so that it’s sustainable?  Does it improve quality? Does it emphasize prevention and wellness? Does it have a serious package of insurance reforms that insure that people aren’t losing health care because of pre-existing conditions, or changing jobs, or losing their jobs? Uh, are we giving relief to small businesses? Uh, do we have, uh, serious, uh, options, uh, a, a serious public option in place? You know, tho..those are the kinds of, uh, benchmarks that I’m gonna be using, but I, I’m not anticipating that, you know, uh, either the House or the Senate bills will match up exactly with where, uh, I want them to end up. Uh, that’s part of the democratic process, but, uh, I am gonna be insisting that we get something done. All right?

Thank you everybody. And, uh, I look forward to talking to you again in the future. Bye bye….

Blue Girl and I took part in a conference call for bloggers on health care reform with President Obama and senior members of his staff late this afternoon. The President made a brief opening statement and then took questions from those on the call. The President’s staff continued after he left the call.

The transcript of President Obama’s opening remarks:

Operator:….We have the President of the United States.

President Barack Obama: Hey guys. Uh, it, it is great to talk to you. Thanks, uh, so much for, uh, thanks so much for being on. And I want to just make a couple of quick comments. I want to leave about fifteen minutes for questions to me directly. And then David Axelrod, uh, my senior advisor, as well as Nancy-Ann DeParle who is my chief, uh, uh, member of my health care brain trust, uh, will stay on and she can, uh, answer some additional calls afterwards.

Um, this is a critical time for us who care deeply about changing the health care system and how it’s currently working. We are closer to reform than we’ve ever been. Of course that means that the special interests and some of their representatives in Congress are gonna pull out everything they have to stop it. I want to make sure that all of you and your readers hear from me directly and others on my team about what’s going on. I know that there’s been a lot of focus, uh, from a lot of people on keeping the bill strong and that continues to be a key focus for me as well. But, there’s also a primary point that can’t be lost. The status quo is unacceptable.  Uh, you’ve got forty-six million people without health insurance. You’ve got premiums going up three times faster than wages, out of pocket costs skyrocketing. Uh, so people who would defend doing nothing, uh, I think are defending the indefensible. Uh, so far those who oppose reform have offered no meaningful, uh, alternatives. And one of the things that I know the blogs are best at is debunking myths that can slip through a lot of the traditional media outlets and a lot of the conventional wisdom.

And that’s why you’re gonna to play such an important role in our success, uh, in the weeks and months to come. For example, the idea that the legislation I sign is going to be a source of record deficits is simply not true. It’s a myth that’s been spread by the same people that were responsible for record deficits over the last eight years, a deficit that I inherited. And now we’ve got folks going out there saying that somehow that that should be an excuse for inaction when it comes to health care. Uh, I’ve explained from the v…very beginning that this legislation has to be funded over the course of the next ten years. And I’ve talked about the fact that two thirds of the funding, uh, are gonna come from, uh, ending unwarranted give, giveaways, hundreds of billions of dollars, to insurance companies, and the Medicare and Medicaid system, and other changes that, uh, reallocate tax dollars that are already into the system, uh, and spending those dollars in a more intelligent way.  Uh, so that’s just an example of the, of the kind of, uh, change in the debate that so many of you can drive. And I think that’s absolutely critical.

Uh, I also think it’s important just to keep the pressure on members of Congress, uh, because what happens is there is a, uh, there is a default position of inertia here on, here in Washington. And pushing against that, making sure that people feel that, that the desperation that ordinary families are feeling all across the country every day, uh, when they’re worrying about whether they can pay their premiums or not, or how to, uh, deal with a loss of insurance when they lose their job. Pe.. people have to feel that in a visceral way. And you guys can help, uh, deliver that better than just about everybody.

So, uh, I appreciate you guys being on. Uh, Jesse [Lee – White House Director of Online Programs] why don’t you, uh, tell me who’s gonna be, uh, the first, uh, first caller. The first question….