GRASSLEY: Obviously, we're continuing work in the Finance Committee to try to get together a bipartisan bill. We're focused on making coverage accessible and more affordable to every American and driving down the cost of health care.
Last week, there was a kind of a bombshell by the director of the Congressional Budget Office, CBO, when they said that neither bill that's passed so far out of the Senate committee or the House committees actually controls costs. So both leave big holes in the federal deficit.
Maybe even more importantly than the federal deficit, overall health care inflation is not bent downward, instead upwards, with the proposals that are out there, whereas in the Senate Finance Committee, one of our proposals -- total package we're working on -- is to make long range that the inflation of health care is closer to the inflation rate of the entire country inflation rate, CPI, as opposed to being two or three times that.
I'm ready for questions on any subject.
You're going -- you're going to call the names?
STAFF: Yes, sir.
GRASSLEY: Go ahead.
STAFF: Tom Beaumont?
BEAUMONT: Senator, I saw a report yesterday that said that the negotiators had come to an agreement on two key areas. Can you talk about that?
GRASSLEY: No, because actually there's no agreement until the whole package is put together. I think it's fair to say that, in some areas, there's been narrowing of differences. And some of those have been in the area of revenue and cost savings, and some of them have been in the area of policy.
But I think it's better at this point that there's not seen as -- as your question would imply -- that there is a clear-cut deal in this area or that area, because anything can be changed at the last moment because there's no agreement until you've got a final package.
BEAUMONT: Then, I saw another report that mentioned the option of taxing insurers for high-end policies. Can you comment on whether there's momentum or -- or consensus on that?
GRASSLEY: That is a new item on the table getting some consideration, trying to get scores now from the Joint Committee on Taxation and trying to find if it would, from Congressional Budget Office, if it would have the same impact as capping the exclusion would.
And -- and if it does, I think it's going to get a positive look-see. But if we don't get positive feedback on -- on the curbing of high-end use -- and this would probably be above $25,000 -- high-end use, then we probably won't be looking at it.
But if we -- if it has -- if it has a discipline effect of capping the exclusion, I think it'll get a very serious look.
BEAUMONT: Thank you.
GRASSLEY: You bet.
STAFF: Kerry Cathcart?
CATHCART: Thank you.
Senator, now that you've had a chance to meet her in person and also participate in the Judiciary Committee hearings with Judge Sotomayor, have you made any decision yet how you're going to vote on her nomination?
GRASSLEY: No, I haven't gone through the record yet and probably, even if I had, I probably wouldn't announce until maybe the day before we vote in committee. And I think that'll be next Tuesday when we're going to vote on Sotomayor.
CATHCART: OK, thank you.
GRASSLEY: OK, next?
STAFF: James Lynch?
QUESTION: Senator, I'm wondering if this whole health care debate is putting you crosswise with your Republican and conservative base. I see the Iowa Republican Party say that Obama's plan is an experiment Iowans can't afford. The American Futures Fund says you're the best hope for taking down health care and urges you to walk away from the table.
GRASSLEY: Who -- who are you quoting on the latter one?
QUESTION: The American Futures Fund. And, first, I guess, do you have any interest in taking down health care reform? And -- and you concerned about sort of going off the direction from your party?
GRASSLEY: Well, when -- I think when it comes to politics, the best answer is a consistent answer in a lot of areas, not just in health care, but the best policy is the best politics.
OK, next?
STAFF: Ken Thomas, A.P.
Jim Boyd, WHO?
BOYD: I'm good today. Thank you.
STAFF: Tim Rohwer, Council Bluffs Nonpareil?
ROHWER: Yes, Senator. Excuse me. Representative Steve King has expressed concern that -- that this health care reform bill, at least the one being, you know, in the House, would end up providing health insurance for up to 5.6 million illegal immigrants over the next 10 years. And he got this information from the Congressional Budget Office. Is this a concern that you may have?
GRASSLEY: Oh, sure. And we're not going to negotiate health care insurance for illegal aliens in the committee I'm serving on. And maybe I ought to get back to the previous person that asked me about when I said the best policy is the best politics.
And I'm partly answering your question, too, there, at the Council Bluffs Nonpareil, that I think when you -- first of all, the issue was President Obama's plan. Well, he doesn't have a plan. The plans that are being developed up here are probably even worse than what he would have submitted to Congress if he had submitted plans, because based upon his campaign promise, he wasn't going to have a national health insurance program like single-payer, like they have in Canada, and he was not -- he was going to try to it incremental, as opposed to what's going up here on the House of Representatives and Senator Kennedy's committee, which both are entirely different than the approaches that we're taking in the Finance Committee.
So I think that -- that anybody that speaks about an Obama plan probably doesn't realize that the president has submitted anything. He's given some broad guidelines of what ought to be done, but you find -- for instance, you find both Senator Kennedy's bill and what's developing in the House of Representatives now being completely contrary to the letter that the president sent up here on June the 2nd when he said that he wanted to bend the inflation curve of medical care downward.
And the director of the Congressional Budget Office -- the director of the Congressional Budget Office said last week that both of these bills that are out there already do just the opposite: increase the cost of health care.
And then you get back to the other issue about what maybe some Republicans are saying. I would think that, with the development of -- of what the Democrats want to do, of a government-run health insurance plan, and what they want to do in raising taxes phenomenally, as they're doing, and outside of health care raising taxes, so you increase the cost, rather than getting more for your money within the 16 percent of the dollars in our economy that's spent on health care, I would think they'd appreciate having a Republican at the -- at the table. In fact, there's more than one Republican at the table.
And then the other thing I would suggest is that -- that there -- there have been some Republicans that haven't been looking at the polls that, if we don't do something on health care reform, the voters are more apt to blame Republicans than Democrats.
And I cite a poll from last week: 30 percent might blame the health industry; 22 percent blame Republicans in Congress; 11 percent blame Democrats in the Congress; and only 4 percent blaming President Obama.
So it seems to me that we have a responsibility to the Republican Party not to be seen as destroying or at least not talking about things that are -- that people believe are wrong with the present health care system.
Even though 82 percent of the people are satisfied with the insurance they have, that same 82 percent are saying overwhelmingly that there are things just not right about that we -- we waste so much money in health care.
Let's go on to the next person.
STAFF: Christinia Crippes, Burlington Hawkeye?
CRIPPES: Hi, Senator. Thank you for taking my call.
GRASSLEY: How are things down there in Burlington?
CRIPPES: Oh, we're doing just great. Thank you.
GRASSLEY: OK.
CRIPPES: I was just wondering how likely you see the possibility that health care legislation is going to get delayed past this August recess and, if it does, who that's bad for?
GRASSLEY: OK, well, it's not bad for anybody, because if people want us to do health care reform, they don't want to rush it through. They want it to be a very thoughtful process.
And -- and, remember, you talk about health care reform, but as I just indicated, you're talking also about restructuring 16 percent of the economy. That ought to be done in a thoughtful way. We ought to know exactly what we're doing. And it ought to be done on a -- I hope on a bipartisan basis that, when you're doing something that gigantic, that there's a broad consensus that what you're doing is the right thing to do.
And that's just not a Republican approach or a Democrat approach. It ought to be from 80 people in the center of the Senate, I would think.
CRIPPES: Thank you.
GRASSLEY: OK, anybody else?
STAFF: Jens Krogstad, Waterloo Courier?
KROGSTAD: Yes, hi, Senator.
GRASSLEY: Yes, hi. How's things in Waterloo?
KROGSTAD: They're doing great, thank you.
GRASSLEY: Yes.
KROGSTAD: I was wondering, is there much talk in the Finance Committee about significantly reforming the Medicare and Medicaid reimbursement to pay for quality, rather than quantity?
GRASSLEY: Yes. In fact, it's at the heart of -- you've heard me on this telephone conference with you say twice about bending down the inflation curve in health care. And reimbursement based on quality, as opposed to quantity, is essential to doing that.
In other words, for 40 years, we've had these perverse incentives, where it's kind of like a doctor says to you, "I want to see you every day and twice on Sunday," because, every time he sees you, he gets paid for it. Well, you know -- and in Iowa, this isn't much of a problem, because we've got high-quality health care. We're fourth or fifth in the nation.
But if you would take the country as a whole and they would practice medicine like we do in Iowa, we'd save one-third of Medicare, mostly because people are healthier, don't run to the doctor at the drop of a hat, a doctor does it right the first time. You know, hospitals tend to do it right the first time more often than other places in the country.
So we want to move this for pay based on performance or quality, like you said. And that ought to help Iowa's proportionate standing in other states on reimbursement for Medicare, as well.
KROGSTAD: OK. I asked that because a lot of these model -- so-called model health systems, like Mayo, are -- like they just took out a full-page ad in the Washington Post today. And they're saying there isn't enough being done on this, they think.
GRASSLEY: Well, that's true. But they were quoting just from the House bill, you know.
KROGSTAD: OK. OK.
GRASSLEY: And -- and, also, because the House bill is being driven -- I mean, if it's carried out, you're still going to have private insurance, but not for very long. You know, within -- you know, when you have 120 million people opt out to go into a government program, they're presently covered by health insurance, you know what that's going to do for the premiums for everybody else. It's going to drive it way up.
And consequently -- drive it way up so, consequently, you know, then every -- more people opt out. And pretty soon, you've got a Canadian-runs (ph) program where, you know, you can't get an MRI for three months. So if you've got a headache for one month, you don't want to wait another two months to see if you've got a brain tumor.
If you've got enough money, you come to the United States. If we adopt a system like that, we surely aren't going to go to Mexico for our health care.
KROGSTAD: Yes. OK. Thank you, Senator.
GRASSLEY: OK, anybody else?
BEAUMONT: Senator, Tom Beaumont again. I know you've said that it's better to do it right than quickly. But do you agree with the -- the president's purpose in pushing the bill before the recess in that, you know, he seems to suggest that the longer it takes, the more time it gives opponents to gin up resistance?
GRASSLEY: Well, on the other hand, what's democracy all about? What's representative government all about? It's those of us who are representatives of the people communicating with the grassroots to get feedback. And if we're putting up a policy that can't withstand the test of public opinion, we shouldn't be doing it in the first place.
OK, anybody else?
QUESTION: Senator, it's James Lynch. I just wanted to ask you, the poll you cited on who the public is going to blame, what's the source on that?
GRASSLEY: Can we get James Leach -- you remember last week some Republicans quoted a poll saying that -- that public support for health care was going down. And then they didn't quote the part about, well, who's going to get blamed? You know, it was about 30 percent industry, 22 percent Republican congressmen, 11 percent, and then 4 percent Obama. Can you get that for James?
Jill will get that for you.
QUESTION: Great, thank you.
GRASSLEY: Because I don't -- I don't know the source of it. I'm -- I'm -- well, I had to have a source. I actually read it.
QUESTION: OK.
GRASSLEY: We'll -- we'll get it for you.
QUESTION: Thank you.
GRASSLEY: OK, anybody else?
OK, thank you. Goodbye, everybody.