'This Week' Transcript: Health and Human Services Secretary Kathleen Sebelius and Senate Minority Leader Mitch McConnell

OBAMA: (inaudible) presidential politics. (inaudible) 50 plus one, but you can't get it. (inaudible). We're not going to pass universal health care with a 50-plus-one strategy.


DOWD: Is it -- didn't the president, then candidate Obama, warn against just what the administration is doing and just what Democrats in the House and Senate are doing? He warned against exactly what's happening today.

SEBELIUS: Well, actually, I think part of the pace of this debate was a real attempt to have a bipartisan approach. The House bill had Republican support. In the Senate bill, there were months spent with six senators, three Republicans and three Democrats, in a room, negotiating, adding ideas to the bill, trying to figure out a strategy to move forward in a bipartisan fashion.

As you know, the Senate bill didn't pass 50 plus one, it passed with 60 votes, a supermajority, and I think the president would love to have Republican votes. What he has is lots of Republican ideas -- selling insurance across state lines, making sure that we crack down very aggressively on fraud and abuse, you know, moving forward.

But there is a fundamental difference. The Republicans feel strongly that insurance companies should have less regulation than they do now, less consumer protection, less oversight. The president feels strongly that we need to change the rules of the road, that we can no longer have a private health system where insurance companies get to pick and choose, where they can lock people out and price people out. And that's really one of the fundamental divides. And even though there are lots of Republican ideas in the bill, I'm not sure -- you know, we are hopeful that there will be Republican votes, but I'm not sure there will be.

DOWD: Well, I think one of the big Republican concerns and a concern of a lot of other people, including Warren Buffett, who mentioned it this week, is that what is going to happen with costs? Is anything getting really done with costs? I think everybody agrees that coverage will be expanded to 30 million people or so, but cost is the real factor. And what three things in the bill will lower health care costs in the next three years? In the next three years, by 2012, what three things in the bill that the president is pushing will lower costs?

SEBELIUS: Well, there are huge delivery changes in the bill. So looking at where we're spending money right now, that not only it's not adding to health quality, but drives costs. Patient readmission, the changes will be beginning, so we begin to pay hospitals based on who does good follow-up care and who doesn't. Good for patients, good for costs. (inaudible) care, working in a more coordinated fashion with providers and hospitals. The kind of medical help that people actually really like as patients that also really pays huge dividends, so you coordinate care. The introduction of health information technology, which really drives a lower error rate for docs, but also dramatic administrative simplification. Taking of that 30 cents of every dollar that does not pay for health care and taking it out of the system.

Certainly the issue of taxing insurance plans, the highest priced insurance plans, beginning to change those patterns. Economists all say has a huge cost driver. The Medicare commission is a huge cost driver.

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