away. ♪ ♪ tarnish with a battle in the house. It's a rat's nest in there. They rejected the amendment ten months ago, they'll lose. I like our chances now. 007 over here into a... See More
away. ♪ ♪ tarnish with a battle in the house. It's a rat's nest in there. They rejected the amendment ten months ago, they'll lose. I like our chances now. 007 over here into a country that wants cia blood on their breakfast cereal. And you're going to walk the brady bunch out of the most-watched city in the world. That's right. We did suicide missions in the army that had better odds than this. 100% he's there. Okay, fine, 95%. Because I know certainty freaks you guys out. But it's 100. Lot of politics up for best picture this year. We'll talk about that in a little bit. Here with our second roundtable. Joined by george will again. Abc news contributor donna brazile. Steven brill. Author of a new "time" cover story. "Why medical bills are killing us" is the title. Steven rattner. And kimberley strassel. I want to start talking about this sequester, it is hitting on friday. The public doesn't seem to mind all that much. A pew poll out this week, about 49% of the public say they want to delay the cuts. But 40% say let them go in effect. Most of the blame seems to be heading towards the gop. 49% say they should bare the blame for this. Only 30% for president obama. Kim, you argued in the wall street journal this week, republicans are in a strong political position, you say that the sequester isn't some gop fallback position, it's a proactive strategy. Their way of changing the washington spending debate. They aren't bluffing. This is where they wanted the debate to be, on government spending. You go back two months ago, the focus was on the lack of unity in the party. Now, they have brought this back to the issue they think matters, which is size of government, whether or not we're spending too much, what the drag of federal spending is on the private economy, and increasingly, they're bringing it back to this one central question, which is the only question in this debate, which is to the white house, are you honestly saying that you can't cut $85 billion out of a $3.8 trillion budget? It was meant to force a compromise. A balanced way of spending cuts as well as revenues. It wasn't intended to shut down a government or to have one side win an argument when both sides agreed that we need to have a more robust economic growth and a plan to solve this problem, not just in the short term but in the long term as well. 85 billion number itself is the wrong number. That's budget authority. The cbo, congressional budget office, said actual spending cut would be $44 billion in this fiscal year. That's less ngress shoveled out the door to he the victims of superstorm sandy. But, george, it's on top of a $1.5 trillion. Well, we're being told by the president that these are severe, brutal, meat-cleaver, those are all his words. Approaches. 2.4 spending. One-half percent gdp. The domestic agencies that would receive on average a 5% cut, received from mr. Obama in the last five years, 17% increases. So, the president's position has to be, the logic of it is, right now the government is the minimal government that spends between us misery and chaos. That's not the president's position. Let's start with facts. It's not a 2%. These cuts are focused heavily on what we call domestic discretionary spending. Education and traffic. Things that matter. These are 5% cut. As george said, on top $1.7 trillion of cuts voted in the last two years, all on these same programs. I don't think the president is opposed to talking about spending. I'm certainly not opposed about talking it. Let's put everything on the table, including entitlements and including revenues. Revenues were increased a small amount relatively to amount of spending cuts. It needs to be a balanced approach. But it doesn't have to be that way. This is up to the white house. It's not up to the white house. You can fix it tomorrow. Just move the $85 billion. Are you saying that subsidies to companies, slush funds, duplicated programs? There are plenty of ways to move that money into something that makes sense. Absolutely. The president has proposal to where to move it to. Republicans aren't interested. Tax hikes. Not just tax hikes. He has spending cuts in it. He's prepared to do that. The republicans would rather say, sequester is the president's idea. We're not going to allow anything to happen to it. Because we want it to go into effect so everybody will see that it's the president's idea. What I don't understand about this is, everybody says it's a terrible idea. An awful idea. Yet, everybody voted for it. And the white house keeps repeating that they want a balanced approach. The president has all of these cuts in mind, including cuts to entitlements. But I haven't seen anything specific that he's proposed. At least two specific entitlement cuts on the table. The consumer price index on social security. Proposed limiting that. Raising the age for medicare eligibility. The president has come up with three different plans. At various times post the sequester to try to force the republicans to come back to the table to bring revenues into the table. When did he put out a statement, let's raise the medicare age to "x"? I haven't heard that. Couple of things. The president has talked about raising the medicare age. To what? To 67. In fairness, he backed off that a little bit. The fact is, the president has a plan. This is his plan. 1.4 trillion cuts. Balanced between revenues and spending. He's ready to have a dialogue. The republicans, you're saying that you like the sequester. It's fine. That's your position. Let's let it happen. I want to go back to what you said, mr. Rattner, $85 million out of $1.6 trillion economy. At the end of the world war ii, cut federal spending 40% in one year. And what resulted was what we called was a postwar boom. I didn't say it was going to knock the economy sideways. I said it was going to have an effect on the economy. It might sound like a lot. Fragile economy. But there are specific programs that are going to be affected. What every unemployed person gets will be reduced. There are going to be fewer agriculture inspectors to stand in food processing plants. Which means, those plants can't process foods. One of the things that i think the democrats are counting on, some time in april and may, when this all starts to kick in, the republicans are going to break again. They're not going to, because they have put this central to their strategy, they chose to do this. They want to have this debate. Again, it's not a fallback. I think there a are a couple of dangers here for the white house. They are warning of doom and gloom. How bad is it actually going to be when it happens? That's a big question. That hasn't been answered. Lot of people aren't paying attention. How many americans -- this isn't a government shutdown. People are still going to get their passports, visit national parks. How many americans are paying attention? And how many are going to decide this is the armageddon of. President -- it's the government slowdown. A shutdown might occur in march 27th, WHEN THE CONTINUED Resolution runs out. But this will have a real impact on the regional economies all across the country, whether it's the threat of furloughs to federal employees. George, we have to brace for it in the washington region. But the truth is that, it's going to have an impact on children in head starts. Schoolteachers, first responders, firefighters. People who live in subsidized housing will see their checks drop. And, george, the economy doing fairly well right now, was on track for about 3% growth. If you add the effect of the sequester, if it holds, and the tax increase at the beginning of the year, economists say that took over 1% off the economic growth. Some economists. Other economists deny that you can have a discernible effect with $34 billion. Also, maybe it could have a positive effect. Markets are worried about the size of the deficit. The size of the debt. They actually want some proof that washington is making the start of fixing this program. You do this, you let this go into effect, hopefully, you do this, you send a signal to the markets that washington is making a start. What the american people want is a balanced approach, between spending and taxes. As we said earlier, we cut made the cuts. Our spending on r and d and infrastructure has gone down by half over the last 30 years. The american public wants health care they can afford and healthare that works for them. That gets to the subject of stephen brill's cover story. Let's put up the cover right there, bitter pill, why medical bills are killing us. Some shocking details here, steve, you talked about sky-high medical bills. People paying $150 for an aspirin. 300 for an x-ray. That's just the beginning and right. That bares on the conversation we're having, because a chunk of that money is paid by medicare. Medicare is like I pointed out in the article is very efficient at most things. It buys health care really efficiently, which is a great irony, because it's supposed to be the big government of bureaucracy. Where it's not efficient, congress, because of lobbyists have handcuffed medicare. Medicare can't negotiate what it pays for any kind of drugs. It can't negotiate what it pays for wheelchairs or diabetes testing equipment. If congress took those handcuffs off of medicare you could get about half of the spending cuts that we're sitting around here talking about. Is that true? You could get a fair amount. Look, if medicare could get the same prices for prescription drugs that medicaid gets, it would save -- steven, I think your article was great. But I don't want people to be confused. I don't believe that we can cut our way, change the pricing and still save medicare. The average person who's at medicare retirement age has paid in some $122,000 into the system. They'll get back $387,000 in benefits. We have to fundamental medicare reforms. In the larger health care system, this is something that everyone at this table will think I should go to mental hospital after I say this -- the government and all of us would actually save money if you lowered -- I said lowered the age for medicare. If the medicare age were 60 instead of 65, the economy and the taxpayers would actually save money and, george, please don't look at me like that. You're potentially right. And part of the argument -- you're taking people out of the medicare system. Right, and what you would be doing, you would be putting the most efficient player, which is medicare, medicare spends 80 to 90 cents to process a claim and the health insurance companies spend $25 to process a claim. Health insurance companies pay two, three, four times what medicare pays through various services. If you lowered the age, you would put more people into the bucket of much more efficient health care. And the worst part about it is, the reforms thathave now, with the president's plan, are actually going to raise the costs because all of the people who are 60, 62, 63, who can't afford the premiums that they're going to have now, are going to be subsidized by the taxpayers. That becomes an argument for a single-payer system. Here's an argument against that. 12 cents is the most important number. 12 cents is the portion of every health care dollar paid by the person receiving the health care. Someone else is paying the rest. It was 47 cents 50 years ago when jack kennedy was president. Now, let me ask the five of you a question, you go to doctor and they say I want to give you a following test? How many of you say, how much does that cost? Don't bother. The doctor can't tell you. George, you're completely wrong. We have tried that experiment with 30 million to 50 million americans who don't have health insurance and have to pay 100% right now. And they have no choice. They are powerless consumers. If you go to an emergency room and a doctor says, you need a c.A.T. Scan, you're not saying, I wonder if this is the most efficient emergency room. I wonder if I really need that c.A.T. Scan. No, we haven't. We only have a small group of americans who are doing that. We have a much larger group of americans who are getting their health care through their companies and it's largely paid for them and they have no skin in the game. The most important part of your piece you mentioned that this is a seller's market. There's no transparency in this market. There's no competition. We spend hours deciding which toaster we're going to buy. We put no such thought or work into where we're going to get our health care. You have had companies like safeway who worked with their employees to introduce the transparency. And you have seen a big reduction in health care costs. There's a difference between buying a toaster and buying a c.A.T. Scan. I agree with george, that right now, most americans don't see price in health care. You see price in toasters, cars and homes. In health care, you don't see price. Therefore, I have to agree, when people go on medicare, they don't see price. They tend to consume more than they otherwise would. 26 prkt of all medicare spending is the last year of life. These are really tough moral questions for the country. We'll have to deal with them. What you're getting to, though, is the fundamental question, are you going to let consumers make decisions about end of life decisions? That's a great point. If consumers you have in mind have the money because they're not going to have the insurance. That's not the world we live in. They're making decisions now, those consumers who don't have insurance, because they don't have the money, they can't write the checks. They're being sued for their bills. You know, this world you describe -- they're in a different position. They're 65. People on either private insurance or medicare, probably consume more medical service than they need because they don't see price. The uninsured is not the germane cohort. The germane cohort is those with high deductible insurance. No one expects your automobile insurance to cover your windshield wipers or your oil chs. People who buy high-deductible insurance, now we have enough of them that we have real data. Two things, they use the health care system less and there's no discernible health cost to it. I want to get to one more issue before we take a brk. The rest of the agenda has been bogged down in these budget fights, especially gun control LAST NIGHT, wayne LaPierre of the nra coming out hard against universal background checks. Background checks. It all sounds so reasonable. But don't you be fooled. It's aimed at registering your guns. And when another tragic opportunity presents itself, that registry will be used to confiscate your guns. Donna brazile, it seems as this whole effort has slowed down. No, it hasn't. It has gone on. Joe biden is the public face of it. He's out there meeting, he was in newtown last week, he's traveling all across the country meeting with law enforcement officials. Patrick leahy will be putting together some proposals to try to advance this at the end of the month. Gun safety laws are still topic "a" across the country from tucson to colorado. Maryland. State lawmakers are taking the initiative. I THINK MR. wayne LaPierre is on the wrong side of history. It has slowed down. But the reason it has showed down is because the president's own party is divided on this issue. When you look in the senate, there's a lot of disagreements. Among democrats themselves. The ban on semiautomatic, known as the assault rifle ban, so, there's going to be a lot of fights. But it's going to be between democrats. That has put them in an unusual spot. Only the six democrats running for re-election. The democrats respect the second amendment rights. It's about military-style rifles. Should we get them off the streets? Many americans agree. Get them off the street precisely. The president went to chicago this week. Chicago has more than gun homicides than new york, new york has three times the population, what's the difference? The difference is different police measures. New york, with a lot of controversy, has had stop and frisk. Has had a measurable effect on violence. It's at the local level and it works. It did appear that there was going to be a consensus on background checks, that seems to be fraying? Yes. YOU SEE wayne LaPierre and you wonder about it. The problem here is, what history would tell us, time is not your friend on this. Going back to 1968, when lyndon johnson was trying to pass gun control legislation, since jfk was assassinated, it seemed like a no-brainer, it was going to get passed, slowly, I got in the mud. We're going to take a quick
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