GRASSLEY: There's a lot of financial committee work underway
this week and next week. Yesterday, the committee held our third and
final roundtable. It was about financing health care. Today,
Republicans and Democrats members will meet separately in their
respective caucuses on reform. And tomorrow morning, we'll have what
we call a walkthrough on the options for expanding coverage.
I hope that it's possible to put together a bipartisan
legislation that will drive down health care costs which continue to
rise, as we all know, at an unsustainable rate and to make health care
coverage more affordable and accessible. I want an individual and
small groups insurance market that works for consumers. We need to
prohibit insurers from denying coverage to people with preexisting
medical conditions and charging higher premiums to people who are
sick.
Yesterday, the Medicare trustees issued an annual report on
fiscal health of the Medicare program. Very loud and clear message
that Congress needs to act. Kicking the can down the road is not an
option anymore because we're at the end of the road. It will take
time to implement policy changes, and if Congress waits too long, the
savings from those changes won't materialize until the program is
insolvent. At that point, the only options would be cutting provide
payments, reducing benefits, or raising payroll taxes.
Medicare's fiscal problems underscore how it doesn't make sense
to create a government-run health insurance plan which is very much a
controversial part of our health care reform debate. We can't afford
the public plan that we already have, and if we create a government-
run health care plan that's unaffordable and unsustainable, it isn't
going to be any good for anyone.
The way I see it, this reality is on top of the fact that a
government-run plan would push other insurance coverage options out of
existence, and people wouldn't be able to keep the health care plan
option that they have. And that's something that the president
promised to do, and it's a promise that I want to help the president
keep.
And if you wonder whether or not the federal government is
competent to run a government-run health insurance plan in competition
with the private sector, just remember that the Senate was incapable
of running its own restaurant and turned it over to private enterprise
here about six months ago.
I'm ready for questions on any subject.
Kerry?
QUESTION: Thank you, Senator.
Will you talk to us about your White House visit last week,
please?
GRASSLEY: Yes. I can tell you a lot about it. I won't quote
any other person present. There was four of us there. No staff. The
president, the vice president, Senator Baucus, and me. We went more
of our time talking about health care reform, more about process than
substance.
The president made very clear to me that he wants a bipartisan
proposal -- I mean, a bipartisan product. And I think he best
indicated that by saying that he did rather that a bipartisan one and
get part of what he wants than getting all that he wants -- all of
what he wants with a partisan vote.
And there was just good change, good atmosphere. The president
is very disarming. You feel very much at home. You know, so anything
else you want to know, ask me.
QUESTION: OK. Do you feel that he is genuine that way as
opposed to that's just his public persona?
GRASSLEY: I thought he was very genuine. I think -- you know,
let me put it this way. As a senator and not as a president, if he
were talking to you, you'd be the most important person around. He's
not one of these people that talks to you and looks around to see
who's more important to talk to.
Tom Beaumont?
Mike Glover?
QUESTION: No, Senator, I'm right here.
GRASSLEY: Oh, go ahead, Tom.
QUESTION: With tomorrow -- with the proceedings tomorrow, do you
expect to know coming out of that whether a public option will, in
fact, be a part of the Finance Committee bill?
GRASSLEY: No, we won't, but we will have a good idea of how
controversial it is and how strong people feel about it on both sides.
And that's some indication of what you want. But would there be
enough come out of the public hearing that would say it's in or out?
No, because I think right now there's a lot of people, including me --
I'd prefer it not to be in -- then there's a lot of people that say,
well, it's got to be in or no bill.
And then there's a dozen ways to look at possible compromises.
And I think before I would write off completely, I would want to look
at what those possible compromises are.
QUESTION: And what will you urge members in your caucus today
when you talk about it?
GRASSLEY: Well, for me, it's got to be more -- it's got to be as
much of a listening session. And I'm not sure that I would try to
dictate, but I would -- I think that the extent to which Republicans
show some unity on a government-run health insurance plan, it -- it's
a better opportunity to keep it out completely.
Now, if Republicans are mixed on it -- and I don't think we are
-- then -- then that's -- you know, that's a different story. I think
the Democrats are going to be fairly united that they'd like something
in, but that doesn't -- either extreme position does not keep the
possibility of negotiating.
And I suppose we will be trying to discuss with my colleagues on
the Republican side what -- how do you look at this possible
compromise or that possible compromise.
Mike Glover?
Let's see. Mary Rae Bragg?
QUESTION: Senator, in this discussion about health care, what
can you say to Americans who have come -- because -- much because of
this -- the financial crisis that we've gotten into -- to Americans
who have come not to trust big business, and they don't want to trust
their health care -- continue to trust their health care to big
business?
GRASSLEY: Well, I don't think it's the fact that it's big
business is the problem. I don't know whether it's lack of trust. I
believe that there's people that have problems with these pre-existing
conditions and these high costs that go with -- with -- the high costs
that go with people that have -- have been sorted out because of their
special health problems and the uncertainty of having health
insurance, the uncertainty of cost.
And I think we're trying to address that. And -- and -- and in
fact, you know, the very question you're asking me, the insurance
companies are very cognizant of this as well. And so they're coming
to us in open hearing, in fact, a little bit what they did at the
White House on Tuesday about saving money, understanding all of this.
And they're seeking government regulation to a greater extent.
They're willing to do away with their precondition policies.
They're willing to have more, what we call, rating -- "community
rating" is the word I should have used. Maybe not pure community
rating, but modified community rating where maybe there's some rating
based on age because, quite frankly, people that are older have more
health problems than people that are younger.
And we want to make sure that we don't create a health care
system where young people have revolt against buying health insurance
because they see themselves paying to maintain older people just like
they do with Social Security when they don't think there's going to be
any Social Security left for them.
So between -- between what the insurance companies realize that
the public is demanding of them plus -- including the possibility of
getting the concept of the individual responsibility out there that
you ought to have health insurance just like you have to have car
insurance and community rating, if we impose that, you know, it's --
it's going to make -- it's going to take a lot of the uncertainty out
of health insurance, and it's going to reduce cost when you have 47
million people that aren't covered today that would be covered and
things of that nature.
So that's where we're headed.
That's Mary Rae.
Tim Rohwer?
Christinia?
QUESTION: I'm good today, thank you.
GRASSLEY: OK. Tim Rohwer, you're usually there. I guess he's
not.
I think I've gone through the list. Anybody else to jump in?
QUESTION: Senator, there was some news -- on the news this
morning, they were talking about Social Security and Medicare running
out of money, perhaps, sooner than had been anticipated. Can you
comment on that? Is that true? Or do you have any concerns about
that? Or how do we deal with that?
GRASSLEY: Well, it's a -- it's a problem regardless of the most
recent report. The only thing is it's a more imminent problem because
of the most recent report. And the reason it's more of an imminent
problem is because of the recession and unemployment and less people
paying payroll taxes.
And so it just brings to mind that the sooner we work on it, the
better. And we ought to get on it right away because every day you --
you -- every day you waste, it takes more -- it's just a more
difficult problem to solve.
QUESTION: Do you believe the Obama administration will work with
you on that in the Finance Committee in dealing with those issues?
GRASSLEY: Yes. To some extent, when we talk about health care
reform, which includes the 45 percent of health care that's government
programs and the 55 percent that's private insurance or private pay,
we are doing some things that affect Medicare but not directly but
indirectly. Like, for instance when we get to a point where we're
consummating through what we call coordinated care for the five
diseases -- five or six diseases and maladies that are responsibility
for 80 percent of the cost of medicine, you know, that's a problem for
Medicare as well as it is for private insurance.
We're going to be helping that. You know, one-fifth to one-third
of the people coming out of the hospital are readmitted within a
month. We've got plenty of demonstration projects around the country
where they concentrate on making sure that it's done right the first
time and taking care of people after they get out of the hospital so
you don't get readmitted.
And you improve the quality of health care, and you actually save
dollars. Well, that's going to help us with Medicare as well as all
of health care costs.
Anybody else? OK. Thank you all very much.