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Nancy Pelosi on Health-Care Reform


Earlier today, in an interview with three reporters, Speaker Nancy Pelosi said health-care reform would pass the House and that it would include a public plan. She also said the Blue Dogs were basically resigned to this prospect, and that the Republicans "will do everything they can to stop it, not only because they disagree philosophically, but because they know politically that this is so very powerful" politically. The discussion was a bit disjointed for a straight transcript, but selected excerpts follow.

On the need for a public plan.

We have been very clear about the fundamentals. We do not see real, systemic change in the health-care system if there is not a robust public option. We see that as the way to quality, affordability, accessibility, and universality in health care. If someone has another way, show us, but until that time comes, this is the way we see it.

On the co-op compromise.

I think it might be something additional. I don't see it as an alternative to the public option.

On the Blue Dogs.

Some of the concerns the Blues have raised are concerns others have raised as well. The public option is going to happen. They recognize that. They may want to put it on their list of concerns about how it will work. But part of what this is is removing misconceptions. One of the misconceptions was that the public option would be funded by the federal government, wouldn't have to pay back its start-up costs. And that has never been the case. To be a competitor, it will have to be able to compete, be fiscally sound, and be responsible for its administrative costs. It will have advantages, but it has to compete.

On the Congressional Budget Office.

We do have to be fiscally responsible. We will live by the rules of the CBO. But it's also true that the CBO doesn't count things that we know will save money, like prevention, wellness and end-of-life issues. You don't need to be a congressional accountant to know those will save money. We are very confident that this bill will have savings, and many of them will not be counted by the CBO. But they will save money. Outside groups can document them. We will live by the rules so we are fiscally sound and all the rest. But that doesn't mean we won't have other provisions that save money, but won't be scored.

On the Republicans.

We have to assume that the Republicans share our value that all Americans should have health-care coverage. But the Republicans know that passing real health-care reform that is meaningful to the American people is politically powerful. And they must stop it. It's the most noticeable initiative Congress can take to improve the lives of the American people, and they must stop it.

Can they stop it?

They can't stop it. It's going to pass. It's like, can you stop the night from coming after day? But they will do everything they can to stop it, not only because they disagree philosophically, but because they know politically that this is so very powerful. They know this is the most noticeable initiative Congress can take to improve the lives of the American people, and they must stop it. I would imagine there were some Republicans who felt some discomfort at [Jim DeMint's comments that this could defeating health-care reform could "break" Obama], because he blew their cover.

Do you need Republicans on the bill for Democrats to vote for this in significant numbers?


On legislative strategy.

I call Washington "the city of the perishable." You get the votes and you take the vote because you never know what can happen.

On 1994.

That was like a 100 years ago. Everyone here is focused on tomorrow. This is a funny place. You pass a bill and it's the biggest thing in the world and then it's like, "What's next?"

On deals with the industry.

We know we can squeeze more from the system. The minute the drug companies settled for $80 billion, we knew it was $160 billion. Right? If they're giving away 80? But in any event, they're supporting the bill and everybody likes that. But there could be more money. But when you want to squeeze more, you have to be careful about what you're squeezing. You have to make sure it's waste, fraud, and abuse. We don't have the capability of squeezing from the private sector. All we can squeeze is out of the public sector. And the president made the agreements he made. And maybe we'll be limited by that. But maybe not!

On the MedPAC/IMAC ideas.

MedPAC has been an idea out there for awhile. There have been some concerns about it among many of us because it's a big transfer of authority to the executive branch. I myself could have argued the issue both ways. Do I want my members figuring out how much oxygen people need or do we want to pass it on? But how we pass it on was important. Does Congress participate in appointing membership? Do we establish criteria to make sure we bend the curve in a way that protects people?

Steny [Hoyer] and Mr. Waxman and Mr. Dingell and, I think, Mr. Rangel were among those who did not fondly receive this proposal at first. It became more of an issue when we were seeing what CBO was going to score. When we found out they could score that, we thought okay, with the proper criteria, this is something we could probably live with.

They mention the Defense Base Closure and Reauthorization Commission. But leadership has appointments to BRAC. We want to see representation, not some ex officio group we have no say over.

On the Senate's timetable.

I'd be more concerned if this were next Wednesday and they didn't have anything. But they have another week. They're here a week longer than we are.

Her hardest vote this year

Health care is not the hardest vote I've had this year. Not by far. That was the [war] supplemental. That was the worst. Energy was a heavy lift. But you're talking substance. You're discussing issues with people. But we had never thought we'd have to do another supplemental. Not that we would have to vote for. But then the president brought home the IMF and Republicans all took a hike. Then we were stuck with it. Oh brother! That was the hardest. Budget, stimulus, those were all heavy lifts. None of it is easy. But you get ready for things like energy, health, education, and budget. But the supplemental? That's where we have to do a heavy lift? We all said we were never ever voting for this again. But in any event, I think the administration knows that that was it.

Do you need more time?

You don't need more time. The time is now. People have been waiting so long for this. I had a friend who was getting married, I said "You're getting married, I didn't know about all this!" She said, "I need health benefits."

Photo credit: Nelson Ching -- Bloomberg News Photo .

By Ezra Klein  |  July 22, 2009; 5:34 PM ET
Categories:  Health Reform , Interviews  
Save & Share:  Send E-mail   Facebook   Twitter   Digg   Yahoo Buzz   StumbleUpon   Technorati   Google Buzz   Previous: Filibustering Is Not the Same as Voting "No."
Next: Tab Dump


"people have been waiting so long for this" Where's the evidence of that? It's just an assertion. Some people have wanted it, others are indifferent, others opposed. More interesting than this interview is Obama's meeting today with Doug Elmendorf. It took guts for Elmendorf to do what he did, and I wondered how long he would be left, well, standing. THe intimidation begins. It doesn't matter what Obama said. The summons speaks volumes.

Posted by: truck1 | July 22, 2009 6:26 PM | Report abuse

Some people are indifferent to health care reform? People might be scared about the costs but I don't know anyone who likes paying what they pay and I'm talking about people who have coverage. Seriously we can fight about the details but get serious about people being indifferent.

Posted by: rldestef | July 22, 2009 6:54 PM | Report abuse

-- It's like, can you stop the night from coming after day? --

I wish that had been reversed for the sake of the imagery.

Posted by: eRobin1 | July 22, 2009 6:55 PM | Report abuse

"people have been waiting so long for this..."where's the evidence of that?"

where is the evidence of that?
yesterday, there was a replay of a lecture on this blog, about octopi, and their abiity to scuttle and hide under the rocks.
but we are not a community of octopi.
go to the nearest place where there is more than one person, and there will be evidence that people have been waiting a long time for this.

and, imagine, wolf blitzer right now, is discussing whether president obama is "over-exposed."
we finally have a president who is willing to get in the front of be available, engaged, perfectly informed, conversational, passionate and involved...and the best spin that can be put on it, is that he might be "over-exposed."
why not celebrate that we have a president who is determined to create reform in a climate in which it is almost impossible to please the right and the left?
whatever he does, there is blistering criticism.
nothing ever seems good enough.
as a friend told me, " it is always easier to be against something than for something."
easier to complain than to struggle and accept compromise in an imperfect world.
i am surely grateful that he is our president.
may he be blessed with patience, resolve, courage and good humor.

Posted by: jkaren | July 22, 2009 7:21 PM | Report abuse

yes..I too had to wonder what part of town truck1 lives in that he doesn't know that almost everyone is concerned about health care - so great a majority of people that we know by living in our culture, in our neighborhoods, on our street, in our workplace.

Ezra's solitary tab dump link above this story is great - if you appreciate Obama you'll enjoy his political acumen (as well as his humanity, and his presidential ambitions) revealed in his interview with Fred Hiatt.

Posted by: wapomadness | July 22, 2009 7:47 PM | Report abuse

Lies, manipulation, intimidation and coercion! That's Obama's and Pelosi's strategy to shove socialized health care down our throats.

EVERYTHING Obama has done so far has harmed us. He has multiplied our deficit, increased unemployment, increased poverty, and decreased our wellbeing and safety. He sides and defends terrorists and U.S. enemies (Hamas, Castro, Chavez, Zelaya) and harms us and our friends (Israelis, Hondurans).

How can anyone believe that his plans to socialize our health care system are good for us? Socialized health care is just another step to impose socialism/Marxism on us, and the corruption, poverty, enslavement, destruction and despair that Marxism entails.

Posted by: AntonioSosa | July 22, 2009 7:47 PM | Report abuse

The House version of the Health Care Bill (pages 425-430) is going to require mandatory end-of-life (death) counseling for all those over 65, at least every five years and more often if the person is sick or in a nursing home. That may be one way Obama is planning to “save” money – coercing 65-year olds to die before they cost any money!

Posted by: AntonioSosa | July 22, 2009 7:50 PM | Report abuse

Those who want socialized medicine and a socialist/communist country, please move to Cuba or North Korea! You have no right to transform the U.S. into a failed socialist country like Cuba just because you are "dumbed down," as per Pravda:

Posted by: AntonioSosa | July 22, 2009 7:54 PM | Report abuse

How can anyone believe that paying for additional bureaucracy is going to save us money and improve our health care system?

Adding billions of dollars to our deficit so Obama can pay thousands of additional ACORN-type government workers -- to decide who lives or dies -- is an ABOMINATION. Obamacare will only increase our deficit, further steal from our children and grandchildren, and further deteriorate health care.

To fix our health care problems, we need to go in the OPPOSITE direction in which Obama is taking us. A socialized health care system would be another step to destroy our country, our future and the future of our children and grandchildren!

Posted by: AntonioSosa | July 22, 2009 7:57 PM | Report abuse

What does Pelosi mean by saving money with "end of life" issues? She seems to be implying significantly reducing or ending health care for those people, except the rich and celebrities of course, deemed by some doctors not to have much longer to live.

If so, this would be reminiscent of the ancient Spartans who left weak babies out to die. I hope I am misinterpreting what she meant.

Posted by: Aprogressiveindependent | July 22, 2009 8:58 PM | Report abuse

No you are not misinterpreting. What you are leaving out is the exemptions for people with connections, politicians and celebrities. The shameful excess of Ted Kennedy's treatment for brain cancer, while similarly afflicted children struggle, will be the scene nationwide. Do you think for one minute, under the new dispensation, he will be asked to not call to his bedside every expert from around the country, as he did the day after his diagnosis? Will your child be able to avail himself of similar care?

Posted by: truck1 | July 22, 2009 9:04 PM | Report abuse


The healthcare reform bill released by the House Of Representatives is an excellent bill as I understand it. It's a bill with a strong, robust, government-run public option, and an intelligent, reasonable initial funding plan to cover almost all of the American people. It is carefully written, and thoughtfully constructed, informed, prudent and wise. This bill will save trillions of dollars, and millions of your lives. It is also now supported by the AMA.

This is the type of bill that all Americans can feel good about. And this is the type of bill that has the potential to dramatically improve the quality of healthcare for all Americans. Rich, middle class and poor a like. Democrats, Republicans, Independents, and all other party affiliations. This bill has the potential to dramatically improve the quality of life of every American.

The house healthcare bill should be viewed as the minimum GOLD STANDARD by which all other proposed healthcare legislation should be judged. All supporters of true high quality healthcare reform should now place all your support behind this healthcare reform bill released by the United States House Of Representatives, as the minimum Gold standard for healthcare reform in America.

You should all now support this bill with all your might, and all of your unrelenting tenacity. This healthcare bill is a VERY, VERY GOOD! bill for all of the American people. Fight tooth, and nail for every bit of this bill if you have too. Be aggressive, creative, and relentless for this bill.

From this time forward, go BIGGER and DEEPER with the American people every day until passage of healthcare reform with a robust, government-run public option.

FIGHT!! like your life and the lives of your loved ones depends on it. BECAUSE IT DOES!


Senator Bernie Sanders on healthcare (

God Bless You

Jack Smith — Working Class

Posted by: JackSmith1 | July 22, 2009 10:24 PM | Report abuse

The wicked witch from the west. Who wants to bet she can't add or read?

Posted by: fallsmeadjc | July 22, 2009 10:30 PM | Report abuse

No, you are not missinterpreting, Aprogressiveindependent. That is exactly what Obama and his accomplices have in mind -- mandating counseling to 65-year olds so they let themselves die before they cost any money! The Health Care Bill (pages 425-430) is going to require mandatory end-of-life (death) counseling for all those over 65, at least every five years and more often if the person is sick or in a nursing home. That may be one way Obama is planning to “save” money!

Posted by: AntonioSosa | July 23, 2009 12:55 AM | Report abuse

Pages 425-430 is about making sure that the elderly who get sick plan ahead on end of life issues so that there isn't ambiguity as to who has power of attorney and what their wishes are for their care if they are incapacitated. It does save healthcare costs if the seniors define what their wishes are rather than tie up courts in and hospitals on the ambiguities of their wishes. That's all it is about.

Have you written you will? Or are you the kind of capitalist who wants to be a vegetable in a hospital bed for the rest of your life because you didn't write a will or give power of attorney to a loved one?

Posted by: CitizenJay | July 23, 2009 11:39 AM | Report abuse

management has a science and art component..setting deadlines is part of the science and is a necessity when making radical changes..the art is knowing when the deadline can move and still achieve the same results..let's see how much of an artist President Obama is..

Posted by: notmd | July 23, 2009 2:58 PM | Report abuse

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