Obama Debates Republicans on Health

WASHINGTON (CN) - In a partisan debate over health care on Thursday, Arizona's Republican Sen. John McCain said the health bills were crafted from "unsavory deal-making" with special interest groups, to which President Obama replied, "We're not campaigning anymore. The election's over."

McCain had criticized the Senate health bill for allowing 800,000 Florida seniors to keep their Medicare Advantage plans intact when most others would have theirs chipped away.

"I think you make a legitimate point," Obama said.

McCain paused, a look of surprise on his face. "Well," he said, "thank you very much." Obama flashed a smile.

The 7-hour meeting at the Blair House stayed mostly civil, with Obama acting as moderator, but neither party seemed swayed by the other's argument.

Republicans and Democrats, sitting in a large rectangle, appeared to agree that out-of-pocket expenses should be capped, that barring insurance for people with pre-existing conditions should be outlawed, and that small businesses and individuals should be allowed to pool into large groups to exert more influence over insurance prices.

But Republicans criticized a 2,400-page health bill as "big government," saying it would bankrupt the nation by expanding entitlements and that Washington should not dictate regulations. They insisted that the changes would drive premiums up, and demanded that Democrats scrap the bill and proceed with reform in a piecemeal fashion.

"This is a car that can't be recalled and fixed" Tennessee Republican Lamar Alexander said.

They proposed limiting doctors' liability and cutting waste.

Obama maintained that he is open to Republican ideas that work, and said many have been incorporated into the bills, such as allowing small businesses and individuals to pool together. But he said Republicans also must compromise.

Democrats responded to Republicans by pointing to Congressional Budget Office estimates showing premiums would go down under the bill, and that the deficit would be reduced. They characterized the Republican plan as inadequate.

Democrats balked at the idea of scrapping the bill. "(Americans) don't have time for us to start over," said House Speaker Nancy Pelosi, a California Democrat.

Obama, who appeared comfortable throughout the meeting, said health reforms are connected and must be offered as a package. Stopping pre-existing condition exclusions would require a mandate that everyone buy coverage, he said. Otherwise, patients would wait until they get sick to buy insurance.

Democrats downplayed the differences between the two parties, saying they mostly agree. Republicans maintained that the two parties have drastically different philosophies - that they want a free-market solution as opposed to a government solution.

Wisconsin Republican Rep. Paul Ryan said he wants to leave legislation to the states. "Do we distrust our governors, do we distrust all of our state legislatures?" he asked. "This is a difference in philosophy."

New York Democratic Rep. Louise Slaughter suggested that the free market and states have failed. She said that one of her constituents didn't have dental insurance, so she took her sister's dentures after she died. "She wore her dead sister's teeth," Slaughter said. "Did you ever believe that in America, that's where we would be?"

The bills would raise more than $500 billion in taxes and chip away at Medicare Advantage to incorporate an extra 30 million people into Medicaid, cut premium prices by 14 to 20 percent for the average family and pay down $120 billion of the debt over a 10-year period, according to Congressional Budget analyses.

Medicare Advantage is a system in which the government pays insurance companies to run some Medicare plans; Obama said he considers it wasteful.

The bills also outline a set of minimum criteria for insurance policies, such as coverage of mammograms.

Republicans objected to the minimum requirements for insurance plans, saying it would make them more expensive. They said plans should be left to the choice of patients.

Obama compared that argument to firing meat inspectors to bring food prices down. "We make some decisions to protect consumers in every aspect of our lives, and we have bipartisan support for doing it," he said.

Illinois Democratic Sen. Richard Durbin took aim at another Republican proposal. He acknowledged that cutting doctors' liability might save $50 billion over the course of 10 years, but said that is almost nothing compared to the $2.5 trillion Americans pay in health costs each year.

He noted that California - where rates are among the nation's fastest-growing - already has the system that Republicans are promoting.

Democrats have left open the option of running the health bills through a process called reconciliation, requiring only a simple majority in the Senate to pass, as opposed to the 60 votes required to break a filibuster. The process is typically saved for budget issues.

"They don't want to hear about process," Pelosi said in responding to Republican objections to the procedure. "They want results."

Obama seemed to doubt whether the health reform bills could pass without reconciliation. "Politically speaking, there may not be any reason for Republicans to do anything," he said.

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