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

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.

DOWD: One of the things, the other thing that I think Republicans have raised is a concern about the expansion of the deficit by this bill, and Representative Paul Ryan, who was at that summit--


DOWD: -- spoke about that, and talked about the sort of budget shenanigans in his view that are being done to make it look better than it is. And so, let's watch that tape.


RYAN: The bill has 10 years of tax increases, about half a trillion dollars, but ten years of Medicare cuts, about half a trillion dollars, to pay for six years of spending. Now, what's the true ten-year cost of this bill? In ten yeas, that's $2.3 trillion.


DOWD: Is he right about that, that you're basically saying we're going to have ten years of revenues, (inaudible) six years of cost, and that makes the bill look better than it is?

SEBELIUS: Actually, he's absolutely wrong about it. The neutral, nonpartisan Congressional Budget Office says just the opposite, that there is about $150 billion, $130 billion in savings the first ten years. But then almost $1 trillion in deficit reduction. In fact, most of the savings don't even kick in until after 2014, after the bill has expanded. They go out the full two decades. They look at all the spending, all the savings.

And I would say, Matt, that the Congressional Budget Office is very conservative in the savings. They really don't say prevention and wellness efforts save any money, and we think that saves a dramatic amount.

DOWD: But doesn't the Congressional Budget Office only make those assumptions and that analysis based on what they get? And so if the legislative leadership tells them to analyze this according to ten years of revenue and six years of expenses, they put out a bill that says it makes it -- it saves on the deficit?

SEBELIUS: What we're both talking about and what Representative Ryan referred to is the first decade, where some of the implementation strategies are measured as people have demanded, you know, look at the costs first before you add new people. That's exactly the way the bill is structured, but then they look at the second ten years.

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