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President's question time

Remember the old joke, "I was at a fight and a hockey game broke out?" Well, earlier this afternoon, I was at a photo opportunity and a policy debate broke out.

Obama's Q&A session with the House Republicans was transfixing. What should have been a banal exchange of talking points was actually a riveting reminder of how rarely you hear actual debate -- which is separate from disagreement -- between political players.

This was a surprise. The session was clearly proposed so that Obama could appear to be taking real steps to reach out to Republicans. That implied warm feelings and a studied unwillingness to cause offense. But that was not the event we just saw. Instead, Obama stood at a podium for an hour and hammered his assailants. That makes it sound partisan and disrespectful. But it wasn't. It was partisan, but respectful.

There's a value in proving that you understand the other side's ideas deeply enough to disagree with them. And that was the message of Obama's session. Not that the Republicans were right. But that he'd looked hard enough at their ideas to realize they were wrong. I'm willing to work on tort reform, Obama said, but it's not a credible way to rein in health-care spending. The GOP budget might save a lot of money in theory, he admitted, but it does that by voucher-izing Medicare and holding its spending constant even as health cost increase -- which means seniors will go without a lot of necessary care. And it's hard to take that proposal seriously coming from the party that spent the past few months saying slight decreases in Medicare Advantage reimbursement represented an unforgivable threat to seniors.

Yesterday, I interviewed David Axelrod and was struck by his inability to explain how the White House would highlight the the difference between disagreement and obstruction. Today's session, if it becomes a regular event rather than a one-off, provided part of the answer. He'll debate them directly. But that may be tough to do. Republicans are already spreading the word that they made a mistake allowing cameras into the event. Apparently, transparency sounds better in press releases than it does in practice.

But if this is to be the last of these we see for a while, make sure to take the time and watch it, or read the transcript. It's some of the best political television I've seen in memory.

By Ezra Klein  |  January 29, 2010; 2:42 PM ET
 
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Comments

A policy debate? Remember that time Al Gore and Ross Perot debated NAFTA on Larry King? It turned public opinion behind NAFTA. Might a similar debate get healthcare back on track? And can these forums be scheduled around all of the major issues? A financial reform debate. A "what's the best way to spur job growth" debate.

The White House seems confident in their ideas, and I'd love to have them a real prime time debate on Larry King again, rather than the fake debates that occur on Meet the Press every week.

Posted by: Quant | January 29, 2010 3:04 PM | Report abuse

Can you post a link to the video coverage? Was this on C-Span?

Posted by: cminmd1 | January 29, 2010 3:06 PM | Report abuse

"I'm willing to work on tort reform, Obama said, but it's not a credible way to rein in health-care spending."

**********************
Apparently the President only feels that the CBO is "credible" when it supports his worldview.

$54B here, $54B there, and pretty soon you're talking real money.

http://www.cbo.gov/ftpdocs/108xx/doc10802/12-10-Medical_Malpractice.pdf

Posted by: Policywonk14 | January 29, 2010 3:10 PM | Report abuse

Thanks!

Posted by: cminmd1 | January 29, 2010 3:12 PM | Report abuse

I think this is eminently plausible, and a good way for Obama to use the bully pulpit to maximum effect.

"I'm going on Larry King next Thursday to talk about my healthcare/bank/jobs (pick one) plan. I'd like the republicans to send someone, anyone, to debate me. We won't have a one minute time limit like the presidential debates. This will be a serious policy debate."

Bingo, big ratings, and a platform to educate the public on exactly what the reform package is.

Posted by: Quant | January 29, 2010 3:13 PM | Report abuse

I think that CBO report absolutely supports Obama's worldview. That's 54 billion over 10 years. Healthcare spending will be north of 40 trillion dollars during that same timespan. While there are merits to tort reform, it is a pimple on the side of our healthcare system.

Posted by: jimotto | January 29, 2010 3:19 PM | Report abuse

One thing I would have liked to have seen. The fundamental reason the Republicans are being obstructionist is not because they don't have ideas (they do, and some of them are good), is because they refuse to -vote- for any bill that isn't entirely theirs, no matter how many Republican ideas are in it. Obama never challenged them on this:

First, what would have to be in the bill for you to support it? Will you commit to specifics. If there is not a list of policies that you would exchange for your vote, then you must stop complaining about not being heard, because you are not serious about compromise.

Second, could that list of policies possibly appeal to at least a moderate number of Democrats? If not, then how do you expect it to pass? The Democrats have the exact same pressures on them by their base. You can certainly go down fighting that the Democrats' policies will ruin America, but you cannot complain that they are the ones being obstructionist.

Posted by: CharlottesvilleVA | January 29, 2010 3:29 PM | Report abuse

$ in billions
Fed Gov. S/L Total
Healthcare
784.2 -285.8 -500.6 999.1
medical services to seniors
430.8 430.8
medical services -23.4 207.4 184.0
Public Health 3.9 3.9
Research and Development 33.7 33.7
Welfare Vendors
315.8 -262.4 293.2 346.7

http://www.usgovernmentspending.com/year2009_0.html#usgs302

Yes, 54 B is something- it could pay for Public Health and R&D with 16 B to go toward the nearly trillion dollars in other health related spending.

Posted by: cminmd1 | January 29, 2010 3:31 PM | Report abuse

It was awesome. Absolutely riveting. This is where brains (and cool) gets you over brawn. And that is why such an event will never happen again. I wasn't there, but I sensed from listening that even this room full of Republicans was struck back in admiration (as evidenced by the number who came up to get autographs after). And that is why they are afraid of him. That is why they have to paint him as a "Bolshevik radical." Best TV I've seen in years.

(For those who missed, it's available on C-Span and will repeated there at 8pm eastern)

Posted by: JJenkins2 | January 29, 2010 3:42 PM | Report abuse

Watching this, you get the sense why Obama is a politician with a national constituency, as opposed to the GOP politicians, who have a sort of regional appeal to uneducated rubes and various scoundrels who put their personal interests ahead of their country.

Posted by: antontuffnell | January 29, 2010 3:47 PM | Report abuse

cminmd1: did you miss the part about 54 billion over 10 years? That's a bit over 5 billion dollars a year.

You are comparing 1 year costs with 10 year savings. Health care spending is 40 trillion over 10 years. back of the envelope says that tort reform is .1% of the health care expenditure over a 10 year period. Not credible as a cost reduction strategy.

And yes 5.4 billion would cover public health care, but that just shows how small public health care is compared to other expenditures which is an embarrassment to the US given the number of poor people that desperately need health care.

Posted by: srw3 | January 29, 2010 3:57 PM | Report abuse

The TV clip stopped early on so I read the transcript. It was good. Probebly way too good for Obama, especially when he said things like "how can we trim Medicare costs, which everyone acknowledges are a huge problem, if cutting subsidies for Medicare Advantage is characterized as 'taking benefits away from Seniors.' You box yourself in by exaggerating to your constituents."

I like the idea of him appearing on a varioety of shows for an hour or half hour to debate whoever they send. But I doubt they'd do it.

Posted by: Mimikatz | January 29, 2010 3:58 PM | Report abuse

That was awesome.

The only depressing point is that the only thing Republicans recognized as a mistake is that they let cameras in... not that they were schooled backwards and forwards for being jerks and being WRONG, but that they let people see it.

Sigh. Typical.

Posted by: roquelaure_79 | January 29, 2010 4:11 PM | Report abuse

The reality is that Barack Obama works very hard at his job and pays attention to it. Unlike Bush, who was a fantastic political operative, Obama really is a chief executive. He investigates the opposition's ideas because if they do not suck, he will totally steal them. And he does his work well enough to explain why, if he rejects the ideas, it's because they suck.

Bush couldn't do that because he was basically a political guy, not an executive. Most people in government can't do that because they're just not as good at their jobs.

Obama is a really, really good President. He's very good at his job.

His problem is a structurally dysfunctional legislature and press, which keeps him from the real-world problems he really needs to solve. Today was a good opportunity for him, because neither the media nor the political process were able to get in the way. And he was able to say "no, you're wrong when you use that number. And you know you're wrong. And you need to stop doing that or we're never going to get anywhere."

Posted by: theorajones1 | January 29, 2010 4:20 PM | Report abuse

Definition of credible: 1. Capable of being believed; plausible. 2. Worthy of confidence; reliable. (Per the Free Online Dictionary)

Note the words that the President didn't use: "effective," "complete," "the best," etc. He also didn't say that the $54B was de minimus, too small, "a pimple on the side of our healthcare system," or spread over too many years, or anything like that. He used the word "credible" -- i.e., he doesn't believe the CBO's estimate. And the President, like most lawyers, uses the precise word to convey the exact shade of meaning he intends.

That's a far cry from how jimotto and srw3 would have it.

And do you think we should simply ignore small fixes to healthcare cost? By your reasoning, then we should jettison all the Medicare pilot programs aimed at controlling Medicare costs. But you're not suggesting that, are you? What's a "pimple" to one person may be another's "beauty mark."

Posted by: Policywonk14 | January 29, 2010 4:21 PM | Report abuse

I missed a lot of it, but caught the last few questions.
The GOPers had their points, but so did the president.

But I seriously doubt that the GOPers will ever want to do that again. If they do, they will want to bring more facts with them.

Posted by: gratis11 | January 29, 2010 4:24 PM | Report abuse

No, Obama should not go on Larry King.

This was good because it was UNMODERATED.

The problem with moderators is that they bring their own political agendas. They bring their own professional agendas. They bring their own worldviews (like, um, a family making an "average" salary of over $250,000 annually...). They bring their own list of what issues they think are important (do you think Hillary Clinton is likeable?).

But moderators don't matter. Nobody elected them to anything.

This was great because there were NO moderators. And none were necessary. Because Obama answered the questions without a moderator holding his hand. And Republicans were civilized.

So, no Larry King. No more media "moderators". They stink at their jobs. Time to go away.

Posted by: theorajones1 | January 29, 2010 4:25 PM | Report abuse

I missed a lot of it, but caught the last few questions.
The GOPers had their points, but so did the president.

But I seriously doubt that the GOPers will ever want to do that again. If they do, they will want to bring more facts with them.

Posted by: gratis11 | January 29, 2010 4:25 PM | Report abuse

I haven't seen it. But if this was as good as it sounds, he should do it with Dems too. A possible way to bridge the divide btwn the Executive and Legislative branches while resurrecting the Pres' stature as head of the Democratic Party (the dual role definitely seeming to have a schizophrenic effect on anyone who sees the two branches as being coequal, including me).

CSpan video of the event here: http://www.c-span.org/Watch/Media/2010/01/29/HP/R/28993/President+Speaks+at+GOP+Retreat.aspx

Posted by: slag | January 29, 2010 4:44 PM | Report abuse

theora-

that's why i made mention of the Larry King NAFTA show- iit was very lightly moderated- essentially Gore and Perot just talking to each other. That's the venue you need.

Posted by: Quant | January 29, 2010 4:49 PM | Report abuse

"And do you think we should simply ignore small fixes to healthcare cost? By your reasoning, then we should jettison all the Medicare pilot programs aimed at controlling Medicare costs. But you're not suggesting that, are you? What's a "pimple" to one person may be another's "beauty mark.""

-----------------------

You're right of course. Perhaps the GOP could add an initiative to try to reduce the cost of gauze and adhesive bandages. Together with "tort reform" you could call it a reform package.

Posted by: antontuffnell | January 29, 2010 4:57 PM | Report abuse

I can think of few things that would be healthier for our current political environment than to have these televised sessions between the President and Congress become a regular part of our political culture. With most of our mainstream media willing to simply parrot partisan talking points and put blowhards on television who are free to say whatever they want about their political opponents with no risk of disputation, a televised forum like this forces the actual political actors who decide our national fate to defend themselves and their ideas in front of the public in a largely unmediated fashion. Today's meeting between the President and the Republican minority in the House was truly a breath of fresh air wafting over our country's stagnant political discourse.

Posted by: lorax382 | January 29, 2010 5:06 PM | Report abuse

Definite highlight: Pointing out that the vast majority of the estimated deficit to be incurred in the coming years will be the result of policies put in place by Republicans.

There definitely needs to be more of this...

Posted by: megankeenan | January 29, 2010 5:06 PM | Report abuse

cminmd1: did you miss the part about 54 billion over 10 years? That's a bit over 5 billion dollars a year.

You are comparing 1 year costs with 10 year savings. Health care spending is 40 trillion over 10 years. back of the envelope says that tort reform is .1% of the health care expenditure over a 10 year period. Not credible as a cost reduction strategy.

And yes 5.4 billion would cover public health care, but that just shows how small public health care is compared to other expenditures which is an embarrassment to the US given the number of poor people that desperately need health care.

Posted by: srw3 | January 29, 2010 3:57 PM | Report abuse


srw3,

you're absolutely right. Its ludicrous to take one or even multiple year figures and equate them over 10 years. Its kind of like if you charged taxes to pay for a bill for 10 years but only gave you the "benefits" of the bill for 4 years.

Talk about dishonest.

Posted by: visionbrkr | January 29, 2010 5:16 PM | Report abuse

The TV clip stopped early on so I read the transcript. It was good. Probebly way too good for Obama, especially when he said things like "how can we trim Medicare costs, which everyone acknowledges are a huge problem

Posted by: Mimikatz | January 29, 2010 3:58 PM | Report abuse

You know how you do it Mimi? You actually take Medicare fraud seriously. You know that $60 BILLION+ per year. That's no pimple.

From Politico:

MEDICARE FRAUD REMAINS CONSTANT, reports USA Today’s Brad Heath: “Two years after the federal government started its latest push to crack down on Medicare fraud, the number of people charged with ripping off health care insurers has barely changed, Justice Department records show. That effort comes at a critical time, because the White House and lawmakers are hoping to use savings from anti-fraud measures in the government-run health plan to help pay for health care legislation. Fraud costs Medicare an estimated $60 billion a year, Attorney General Eric Holder said Thursday. … The Obama administration gathered experts at a Medicare fraud summit Thursday to find new ways to stanch the losses. Most anti-fraud measures focus on prevention and civil tools that can recover improper payments; typically only the most blatant schemes lead to charges.”

Posted by: visionbrkr | January 29, 2010 5:35 PM | Report abuse

Write the Pres and your reps. Ask for televised "Town Hall Meetings" with Pres and Dems and with Pres and Repubs.

This would be a great Public Education tool ... and perhaps a small step towards restoring our confidence in our institutions of governance.

Posted by: onewing1 | January 29, 2010 5:37 PM | Report abuse

This badly needs to be an institution!

Posted by: adamiani | January 29, 2010 6:14 PM | Report abuse

I would be really happy if everyone who throws numbers in the room would have read what bot bills really cost and achieve. It's no wonder the GOP bill would be much cheaper because it would only cover 3-5 million more uninsured people. But you have to understand that if you want to cover 30 million people and want to get rid of beeing denied coverage because of preexisting conditions it costs a little more at the beginning.
I can't understand why one shouldn't look at the numbers over a period of 10 years. That's what every company does when it's planning a huge investment.
A national exchange would surely lower costs by increasing competition, but you have to be aware that there are states that allow insurance companies to sell junk policies. Nothing against that, but you have to make sure that people are not tricked into buying something that doesn't really cover them.
Tort reform would be a great thing and would surely lower costs. So every little thing would make a difference. Just because you "only" save a couple of billions it isn't worth the effort.

Today was a great day for democracy. That's how it should be. Not just talking points but pointed discussion about issues. You can't reduce such complex matters two 10 second sound bites. We should have more of that. And please no pundits or talkingheads. They only filter the truth.

Posted by: kmsoftly | January 29, 2010 7:10 PM | Report abuse

I shouldn't try to write with ten fingers. So please ignore the spelling-

Posted by: kmsoftly | January 29, 2010 7:14 PM | Report abuse

It's about effing time!

Posted by: pj_camp | January 29, 2010 9:31 PM | Report abuse

"Apparently, transparency sounds better in press releases than it does in practice."

You should really move past silly playground sniping. You come off as an a robotic shill for the Democrats. All I can say is that at least the Republicans had the balls to televise it, which is more than Obama can say considering his broken campaign promise to show all health care debates and dealings on CSPAN.

Posted by: bobopapal | January 29, 2010 11:16 PM | Report abuse

Well written, Mr. Klein.

Posted by: free-donny | January 29, 2010 11:50 PM | Report abuse

Now that they've had their collective butt handed to them by Obama, the Repubs are sorry they let the cameras roll? Gee! It appears that obstructionism does not like the light of day.

Posted by: Gatsby10 | January 30, 2010 10:18 AM | Report abuse

"And do you think we should simply ignore small fixes to healthcare cost? By your reasoning, then we should jettison all the Medicare pilot programs aimed at controlling Medicare costs. But you're not suggesting that, are you? What's a "pimple" to one person may be another's "beauty mark.""

-----------------------

You're right of course. Perhaps the GOP could add an initiative to try to reduce the cost of gauze and adhesive bandages. Together with "tort reform" you could call it a reform package.

Posted by: antontuffnell | January 29, 2010 4:57 PM |

************************

Then I guess you'd be surprised to learn that I'm not a registered Republican, nor have I ever voted Republican.

As the President said, it would be a good idea for all to stop demonizing people with whom they don't agree, and work towards solutions.


(aka PolicyWonk14)

Posted by: Policywonky | January 30, 2010 11:08 AM | Report abuse

You know how you do it Mimi? You actually take Medicare fraud seriously. You know that $60 BILLION+ per year. That's no pimple.

Posted by: visionbrkr | January 29, 2010 5:35 PM
**********************************

Excellent point.

I don't think they need a summit to tell them what needs to be done, though. Rather than simply giving lip service to fighting Medicare fraud, the Administration needs to direct and implement an initiative and appropriately fund it. From what I've heard from DOJ, the problem is lack of Administration emphasis on Medicare fraud fighting, and lack of funding, particularly for specialized anti-fraud units of the Medicare fiscal intermediaries, where fraud can best be detected and a case be built. Perhaps they could have a focused initiative in south Florida, where many of the crooks set up shop. Put your money where your mouths are, Mr. President and Sec'y Sebelius, and see what happens.

The same could be said for Medicaid anti-fraud efforts.

Posted by: Policywonky | January 30, 2010 11:17 AM | Report abuse

" Not that the Republicans were right. But that he'd looked hard enough at their ideas to realize they were wrong." I was struck by that quote. Your attitude Ezra is a common attitude held by Democrats and is one of the reasons why no Republican is willing to sign on to Obama's and the Democrats health care "reform" Because it's the Democratic big government healthcare reform. Why would any Republican ever be willing to support this bill? If your a member of the Republican pary the expectation is that you have a certain worldview and massive governmental intrusion into 1/6 to the economy is not part of it. That's the problme you've always had Ezra, you think just because you're a big government liberal that your worldview is right and everyone else's is wrong.

Posted by: RobT1 | January 30, 2010 1:53 PM | Report abuse

Policywonk,

the problem is that the answer to fighting a large majority of medicare fraud is absurdly simple. CONTRACT WITH PROVIDERS. Right now providers just submit to medicare for reimbursement and as long as all the correct coding is on a bill then BY LAW its paid within 15 days which isn't enough time to correctly ajudicate a claim. Perpitrators of fraud KNOW THIS and target Medicare and Medicaid for tens of billions of fraud per year.

The problem with the solution is that Medicare would have to spend money to contract with providers (something insurers do) and Medicare would lose the ability to LIE and say they do for 3% what insurers do for 10-15%. The other difference is that Medicare doesn't have to and doesn't advertise. They're a captive market (something liberals conveniently forget too).


This usually ends the comments to as they have no answer to this truth.

Posted by: visionbrkr | January 30, 2010 5:22 PM | Report abuse

PRESIDENT BARACK OBAMA: You NOW have an opportunity to end the Recession by encouraging the Banks to make Prudent CRE Loans. The Banks are now unfettered to make Safe Loans. In Large American Cities there are thousands of Major Projects with Entitlements. CRE PRODUCES THE GREATEST NUMBER OF JOBS than any other segment of the Economy. Glass mfg, Steel Industry, truckers, architects, brokers, agents, construction workers, electricians, plumbers, office furniture manufacturers....WE COULD HAVE 6% UNEMPLOYMENT WITHIN 4 MONTHS....THERE ARE 140 SHOVEL READY, ENTITLED, PROJECTS OF 70 OR MORE UNITS READY TO GO IN LOS ANGELES alone!! People will be WORKING FOR 2 YEARS BEFORE THE BUILDINGS ARE COMPLETE; and by then, the Recession will be over and Tenants will Flood the Market to Purchase Modern “green” units. This same scenario is found in Boston, Philadelphia, Houston, Ft. Worth, Detroit, Cleveland, St. Louis, Kansas City, Tampa, Providence, Hartford, St. Paul—all across America.

Posted by: MSFT-PELOSI | January 30, 2010 6:49 PM | Report abuse

Well, here's one Republican who wishes they would do this more often. I didn't see the video, but I read the transcript. Presumably you felt that Obama did so well (he did fine) because (a) he got all the talking time and the last word, and (b) you agree with whatever he says. No problem - let's do it often.

Posted by: MikeR4 | January 31, 2010 2:54 PM | Report abuse

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