Transcript: Health Care Debate

Nov. 22, 2009 — -- STEPHANOPOULOS (voice-over): Good morning, and welcome to "This Week."

(UNKNOWN): The motion is agreed to.

STEPHANOPOULOS: Sixty votes, and the debate begins.

(UNKNOWN): Doing nothing is not an option.

(UNKNOWN): These bills don't reform health care. What they do is grow government.

STEPHANOPOULOS: But are there 60 Senate votes to pass reform? Can there be agreement with the House?

SEN. JOHN MCCAIN, R-ARIZ.: Bernie Madoff went to jail for this kind of behavior.

SEN. CHARLES E. SCHUMER, D-N.Y.: I have no doubt we will pass this bill.

STEPHANOPOULOS: And are those controversial new cancer guidelines the future of health care?

(UNKNOWN): This is how rationing began.

WASSERMAN SCHULTZ: This is an independent task force. It's not the government.

STEPHANOPOULOS: Those questions this morning to four key players from the Senate and the House, our "This Week" debate.

Then, as the president tours Asia, Sarah Palin tours the country. That and the rest of the week's politics on our roundtable with George Will, Robert Reich of the American Prospect, Republican strategist Liz Cheney, and best-selling biographer Walter Isaacson of the Aspen Institute.

And, as always, the Sunday funnies.

DAVID LETTERMAN, TALK SHOW HOST: They're having a big Thanksgiving dinner at Sarah Palin's house, and people say, "Well, is she a good cook?" And I said, "Well, sure. She cooked John McCain's goose."

(END VIDEO CLIP)

ANNOUNCER: From the heart of the nation's capital, "This Week" with ABC News chief Washington correspondent George Stephanopoulos, live from the Newseum on Pennsylvania Avenue.

STEPHANOPOULOS: Both sides called it historic, but while Republicans insisted that yesterday's vote to break a filibuster is the decisive vote on health reform, several Democrats said there was nothing final about it, simply a vote to begin the debate.

And let me begin our debate this morning by bringing in our panel. I am joined by Congresswoman Marsha Blackburn of Tennessee, Republican of Tennessee, Senator Tom Coburn, Republican of Oklahoma, Senator Ben Nelson, Democrat of Nebraska, and Congresswoman Debbie Wasserman Schultz, Democrat of Florida.

And, Senator Nelson, let me begin with you on this -- on this overall question. You heard Senator McConnell, several other Republicans yesterday saying this is the vote. And -- and a couple of weeks ago, you -- you seemed to agree. You were talking to our Jon Karl, and you said, if you couldn't live with the bill, then you wouldn't vote to let the debate begin. So that does mean that you can live with this bill?

NELSON: No. What I -- what I meant by that is that, if I thought the -- the vote -- the bill couldn't -- this was before I saw the bill, but I thought the bill couldn't be amended and couldn't be corrected and improved, then I wouldn't move -- vote to move it forward and move the debate. But when I saw the bill, I said, "This can be amended. It can be improved." And the -- the debate should begin, and ought not to stop the opportunity to improve the bill when it...

STEPHANOPOULOS: Just to be clear: If this bill -- if there were a vote to end the debate today, you would not vote to end the debate, to get this...

NELSON: I would have voted no. I would have voted no. I would have voted to end -- not to end debate. I would have voted no on a cloture vote to end debate.

STEPHANOPOULOS: So you wouldn't let it get off the floor?

NELSON: So I would not let it get off the floor. That's what that means at the -- that's the next round.

STEPHANOPOULOS: Senator Coburn, you also promised before the vote yesterday to read all 2,000 pages, yet you didn't do it. Is that a sign to you that just the handwriting is on the wall and you decided to fold?

COBURN: Well, it -- it didn't accomplish a purpose. What we're going to do is read the bill to the American public. I think when you'll be -- what you'll be seeing when we come back is us going through it section by section, explaining what it means. It was a symbolic gesture, but it -- it didn't work with what Senator Reid and Senator McConnell wanted to do. I understand that.

I don't think we lose anything in the debate. But the important thing is for the American people to understand that this bill doesn't fix what's wrong with health care. We're treating symptoms, not the disease, and it's really malpractice what we're doing.

The -- the -- the problem in America today with health care is it costs too much, George. And there's nothing to address that. And one out of every three dollars that Americans spend today doesn't help anybody get well and doesn't keep anybody from getting sick. So why would -- why would we not want to go and fix the problems in health care, not the symptoms that all the politicians play around with, but the real problems?

STEPHANOPOULOS: I want to get to the congresswoman, but, first, let me -- just answer that point. He says he doesn't do anything to control the costs.

NELSON: Well, you know, it doesn't do enough to control the costs; that's for sure. And we do need to address that cost containment. I'm very concerned about that. But I -- I certainly couldn't say it does nothing.

I think the effort on prevention, early detection, wellness, the workforce development for more primary care physicians, those will all be helpful in -- in reducing the costs of health care.

COBURN: And ask -- ask the question, George, why did -- do we have an imbalance in primary care physicians? Why is it there? Does anybody know? It's because we pay them 300 percent lower than we pay the sub-specialists. And so we don't do anything in that -- we're going to help pay for some of their education, but we paid -- we do nothing to change that balance. One in fifty doctors graduating last year decided to go into primary care. That's a disaster that has been caused by Medicare setting the prices.

STEPHANOPOULOS: So not enough for primary care, although, as you point out, there are more incentives for primary care education in this. But I want to bring the question to you, Congresswoman, is the -- the differences between the House and the Senate bills, some fairly significant differences over how to pay for the bill, over how abortion services are covered, on size, $1 trillion or so for the House bill, below $900 billion on the Senate bill, and, of course, on this public option.

So when you look at what the Senate is considering now, is that something you and the majority of Democrats in the House can go for?

WASSERMAN SCHULTZ: Well, what's important to focus on, George, is that there's far more that we have in common between the two bills than our differences. And while some of the differences are significant, all Democrats, whether it's a Senate Democrat or a House Democrat, are committed to health care reform and making sure that we can cover the people in America who are uninsured -- about 31 million or 36 million individuals are covered by both of these bills -- make sure we can provide security and stability to those who don't have health insurance, and that's really been -- that's been really underexamined.