Health Care's Political Wall

" But doctor -- quickly -- on the phone with us to continue this health care debate. He's executive director of the Deloitte. Center for health solutions -- also frequent it are Saturday show your questions your money actually I think. Due to appear this Saturday as well well how IPO. I'm well Turkey are here I'm great thanks for doing this for so. The big question that we all have is what is it that you want to hear from President Obama tonight."

" Well I -- Who want facts I'm prone to one data and straight talk. Well I enjoyed about our discussion and the past few days has been we are selective and our choice of facts. That support a predisposition towards something we'd like to see. But often we leave out the other part of the data. Makes it a little more. Clear so I'm looking for the data on which we based the permits. We can reform the system both insuring every one and reducing costs. We can't -- occur here well we can change the delivery system here is what that might look like."

" You -- go back here first that your first come I was on the pre you're using our previous discussion. We doctoral -- as an example and I assume you're saying that she left out some facts to say that Americans in. You know general would support some version of government run health care. What what was left out there what would you get a chance to listen to at least a little bit out of what did you think was missing."

" Yeah heard it and what we know from 14000 interviews is that most people in the country want to see health reform. They however are reluctant to think the government can actually solve the problem. So it it has two dimensions that were not satisfied. 38%. Give the US system but. 20% you're given that they are being. We know however that only 27%. Of adults. Say they actually understand our system. So you have a sense among consumers that the system we have is not perfect has a lot of flaws. But we really are very comfortable with the government stepping in solving those prop."

" And one of the things that you noted in your studies is that. From cost cutting and friends that care and getting medical records online and technology we could actually save enough money. To ensure the real realistically 15000016. Million or so that are truly uninsured so we don't need. This potential over all of the system in other words that would add that don't have insurance but would like to have it is your eight yes exactly right that that aren't you have a different -- right."

" There have been -- very clear that there are huge ways. Reduce cost and important population based -- If we pay for outcomes rather than volume if we -- assistant orbit -- to the evidence. If -- standardize. And simplify the administration of the system. They have they have public policies. Reward accountability on the part of providers and individuals. We condemn occur and we can improve the health system's performance. And end what has really become -- a deficit that this discussion of -- reform has been. The fact. Around those objectives that we can't actually achieve those with the right types of incentives right now we need to be picking up the pieces instead of dealing with the."

" Whole all right stop Paul acknowledge the surrender abroad not the discussion a little bit and then invite David Kendall and join a cease senior fell for health policy third way is. Who's with us now from DC David good to see new you know Paul started this off their doctor -- an earlier talked about some of the benefits seesawed. In more government involvement neck and Paul told -- sort or started to have make the case for why the government shouldn't be as involved who can do more without government. Where you see it in a third way we should point out the peoples are generally a democratic organization right but there's more aligned with -- DLC with a democratic leadership council more moderate Democrats is that reverend you. Where do you guys see this a debate going."

" Well what we think it is the key here is to have the right kind of -- Clearly the American public doesn't want to house. The government take over health care and that's not really what's on the table. And at the same time the public doesn't want to have. No actually you know if we don't do anything you know costs are connected to continue to rise people going to lose their health care coverage. And was appointed and not to have stable coverage if you lose your job and America you lose your coverage. And we need to make sure that people have that kind of stability of their cars and health care. -- the third -- offers what you're calling a hybrid plan of both the public and private option you want to just give us a quick synopsis of that. Sure that one of the ways that we think you can resolve this debate over republic versus. Co -- plan is to have a sunset so that after several years. Four years perhaps. The the public but I would just go away in -- congress tree off right I'm -- the simple way to help. Calm fears that this will lead to a government health care system and because it would just only be read reinstated if there was in fact support for."

" Okay let's take that and you can you give us and the other ideas that are that are hybrid plan. David says Paul go back the book quickly on this that's essentially the opposite of a trigger sunset over the plan would go away -- supposed to be. Triggered in the place. To what's your take all."

" Well -- on the trigger because I think you need to let. Private set her -- the solution. Without. Having to what I think the objective from present third -- 24 ourselves insurer rewarded in the -- reduce cost right. Given that as a challenge I think you give the private sector that opportunity. Insurance reform as you remember. -- that says let's keep the insurance companies honest and let's make sure there's -- the insurance market. So what triggered option where there's lack of -- and after a period of time when under the State's oversight. The private sector plans and new entrance plan could generate competitive market committee would be more palatable. The majority of the US population. Then imposing a government pulled them out of the gate."

" Pilots elected David interest a tepid real quick on the trigger idea because that's it's been since they were saying. Sunset you brought up we go away after -- at a time versus trigger would be put in place at the other plant if the private sector is not working out. We think David."

" Well you know the most important thing is that we don't let the public -- debate define this whole debate and I think that's what the president's going to talk about tonight. We can't Europe -- wants in this bill. For middle class America that will give them. Carbon is that they can't lose that they lose their job that the can't lose if they get sick and those of the provisions that I think -- the most important things now. Where we end up with the public plan you know we can debate that here. Till the cows come home but we won't know for sure what's going to happen -- the members of congress are forced to just make a decision and that's what the president really needs that was tonight."

" But did it it -- all the same question how -- we're not hearing and I -- I'm stuck on -- we're not hearing anything about tort reform. We're not hearing enough about being able to bring your plant across state borders I mean these are the things that people need. To make their lives better. Get rid of malpractice suits and you costs will come down dramatically and we're not here and that it seems that. Congress is getting lost."

" The -- Well that's what they -- fortunate tragedies of not having Republicans engaged in this debate as vigorously as it as as I would like this in view -- They often talk about tort reform and that would be a great part of this -- but if the Republicans are to sit on the sidelines we're not going to have the debate is part of it. You know though the fact is that. What we need to do is it out a kind of a slow transformation of our. Court system that. Wouldn't scare people from the fact that they do like to have the right to sue. And so any limits -- matter are very scary just like health care -- scary to a lot of folks and so we need to have a strategy for that that would need to change over time. Paul and I think that he's still possible if we can get if we can get that. You know talked about. In a bipartisan."

" this you know because David does make a decent point about the Republicans any. The same thing happened during Clinton's -- as well. Republicans just sit and they don't like it but didn't really come to the table of anything impressive to counteract it to what the Democrats were offering. Why aren't Republicans out there were talking about these things because they do have had to be mentioned tort reform cross border insurance things like that on occasion."

" You got until both sides of this discussion you'd rather unfortunate rhetoric based on more partisan than it is track so. The fact is that malpractice. Would reduce cost if we reformed the malpractice system. Even the GAO says two to 3% of cost would come out some studies say substantially more. And it's part of a solution and so -- all of us -- letting up all the police. But that the Republicans -- being at the table of the Democrats not wanting that as part of package right we ought to be having also been discussion around. Comparative effectiveness senator baucus and Conrad of the bill well since. July that discusses. Putting comparative effectiveness in places away. But making transparent what we know works and what we know doesn't work so we're not guessing and that data is so profound thing. That we're you blew itself as a lot to do with the quality of -- you get. A lot of what we do is not necessary here. So we can't have that discussion along with malpractice reform that's not a partisan issue that the systemic reform."

" Fair point Paul correctly thanks for all your time banks fought senator for health solutions -- data -- let me just give one more question to you and let you -- on this because to me. You're the second guess that is I brought up this issue. I think it was doctor Loomis said earlier hate and and you mention the president's actually spoken to -- as well. Let's not let the public option debate define what's happening. And health care debate overall understand the point understandably we need to talk about some of the other issues but at the end of the day you know politics is the business you're in. Is that that's the sticking point here isn't it and we have to debate that because of that. Which is on the other issues there's pretty widespread agreement because -- mean and that that's really what's holding us up so we have to get to some sort of -- a resolution our power going to handle that public option there was nothing gets done right brighter -- I have."

" They agree to 100% if it is it is what's this major sticking point right now. But it is very resolve -- Even though may not seem like death threats to people are watching this from. From the sidelines crowd this is that insider game both of them public you know world sort of say out yes sure I'll take on option that the publicly about. But they really don't know what it means so this is really an insider deal that have to be resolved. Very simply members of congress have to make a decision that this is this is the week where the president you will say. Time to put up or shut up -- and."