JIM LEHRER: The president and the Republicans staked out their health care ground today in a nationally televised summit.
JUDY WOODRUFF: There was an air of suspense as the day and the long-awaited event got under way.
U.S. PRESIDENT BARACK OBAMA: Looking forward to listening.
JUDY WOODRUFF: President Obama was upbeat this morning as he walked from the White House across the street to Blair House. Once inside, he and other top administration officials joined almost 40 Democratic and Republican members of Congress in a bid to revive health care reform.
BARACK OBAMA: We all know this is urgent. And unfortunately over the course of the year, despite all the hearings that took place and all the negotiations that took place, and people on both sides of the aisle worked long and hard on this issue, and you know, this became a very ideological battle. It became a very partisan battle and politics, I think, ended up trumping practical common sense.
But what I'm hoping to accomplish today is for everybody to focus not just on where we differ, but focus on where we agree, because there actually is some significant agreement on a host of issues.
JUDY WOODRUFF: Mr. Obama laid out his own plan on Monday, much like the bill the Senate Democrats had produced, making health insurance mandatory for most Americans, but with subsidies for those who need it; covering 31 million now-uninsured Americans, and creating a federal body with the power to block premium hikes.
The president noted today that Republicans have ideas on many of the same points. And he made a plea.
BARACK OBAMA: In each of these areas, what I'm going to do is I'm going to start off by saying, "Here are some things we agree on."
And then let's talk about some areas where we disagree and see if we can bridge those gaps. I don't know that those gaps can be bridged, and it may be that at the end of the day, we come out here and everybody says, "Well, you know, we have some honest disagreements."
But I would like to make sure that this discussion is actually a discussion and not just us trading talking points. I hope that this isn't political theater, where we're just playing to the cameras and criticizing each other, but instead are actually trying to solve the problem.
JUDY WOODRUFF: Tennessee Senator Lamar Alexander was asked by the GOP leadership to lead off for his party.
He explained why Republicans oppose the Obama plan.
SEN. LAMAR ALEXANDER, R-Tenn.: We believe we have a better idea. And that's to take many of the examples that you just mentioned about health care costs, make that our goal, reducing health care costs, and start over, and let's go step by step toward that goal.
We have to start by taking the current bill and putting it on the shelf and starting from a clean sheet of paper.
Now, you've presented ideas. There's 11-page memo on the -- I think it's important for people to understand there's not a presidential bill. There's -- there are good suggestions and ideas on the Web. We've made our ideas. But it's said it's a lot like the Senate bill. It has more taxes, more subsidies, more spending.
It means that for millions of Americans premiums will go up, because those -- when people pay those new taxes, premiums will go up, and they will also go up because of the government mandates.
Our country is too big, too complicated, too decentralized for Washington, a few of us here, just to write a few rules about remaking 17 percent of the economy all at once. That sort of thinking works in a classroom, but it doesn't work very well in our big, complicated country.
And it doesn't work for most of us.
JUDY WOODRUFF: Alexander outlined a limited Republican plan for health care reform that would allow Americans to buy insurance across state lines, limit lawsuits against physicians, expand health savings accounts and help people with preexisting conditions get health insurance.
And he challenged Democrats to drop the idea of pushing reform through with a simple 51-vote majority, a procedure called reconciliation.
SEN. LAMAR ALEXANDER: And my request is this -- is -- is before we go further today that the Democratic congressional leaders and you, Mr. President, renounce this idea of going back to the Congress and jamming through on a bipartisan -- I mean on a partisan vote through a little used process we call reconciliation your version of the bill.
You can say that this process has been used before, and that would be right. But it's never been used for anything like this. It's not appropriate to use to write the rules for 17 percent of the economy.
JUDY WOODRUFF: Senate Majority Leader Harry Reid responded.
SEN. HARRY REID, D-Nev., majority leader: We as leaders here, the speaker and I, have not talked about doing reconciliation as the only way out of all this. Of course it's not the only way out. But remember, since 1981, reconciliation has been used 21 times.
Most of it's been used by Republicans for major things, like much of the Contract for America, Medicare reform, the tax cuts for rich people in America. So reconciliation isn't something that's never been done before.
JUDY WOODRUFF: President Obama clashed with Senator Alexander over one of his main assertions.
BARACK OBAMA: Lamar, when you mentioned earlier that you said premiums go up, that's just not the case, according to the Congressional Budget Office.
SEN. LAMAR ALEXANDER: If you're going to contradict me, I ought to have a chance to -- to...
ALEXANDER: The Congressional Budget Office report says that premiums will rise in the individual market as a result of the Senate bill.
BARACK OBAMA: No, no, no, no. Let me -- and this is an example of where we've got to get our facts straight.
JUDY WOODRUFF: Sparks flew when Arizona Senator John McCain criticized the Democrats' process for arriving at their overhaul plan.
SEN. JOHN MCCAIN, R-Ariz.: Now, both of us during the campaign promised change in Washington. In fact, eight times you said that negotiations on health care reform would be conducted with the C-SPAN cameras. I'm glad more, than a year later, that they are here.
Unfortunately, this product was not produced in that fashion. It was produced behind closed doors.
BARACK OBAMA: Let me just make this point, John, because we're not campaigning anymore. The election's over.
SEN. JOHN MCCAIN: Well, I -- I'm reminded of that every day.
BARACK OBAMA: Well, I -- yes.
JUDY WOODRUFF: With giant stacks of more than 2,000 pages of the Democrats' bills piled in front of them on the tables, Republicans repeatedly zeroed in on differences, rather than any agreement.
REP. ERIC CANTOR, R-Va., House minority whip: There is a reason why we all voted no. And it does have to do with the philosophical difference that you point out.
SEN. JON KYL, R-Ariz., minority whip: It's just a fundamental disagreement between us. Does Washington know best about the coverage people should have? Or should people have that choice themselves?
JUDY WOODRUFF: As they waited for their colleagues to return from a lunch break, Senate leaders engaged in animated talk in the Garden Room of the Blair House.
Once the summit got back under way, the chair of the Senate's Health Committee, Iowa's Tom Harkin, dismissed Republican calls to take a step-by-step approach to health care reform.
SEN. TOM HARKIN, D-Iowa: We're sinking. We're drowning, in this country, on health care. An incremental approach is like a swimmer who's 50 feet offshore drowning, and you throw him a 10-foot rope. And you say, well, it didn't reach him, but we'll get it back in, and we'll throw him a 20-foot rope next time. Then we'll throw him a 30-foot and a 40 -- by that time, the swimmer's drowned.
JUDY WOODRUFF: Also on the agenda was how reform would impact the country's growing budget deficit. Vice President Biden said the key was lowering the cost of entitlements, including the Medicare plans sold through private insurers, known as Medicare Advantage.
U.S. VICE PRESIDENT JOSEPH BIDEN: What was the rationale for Medicare Advantage? The rationale for Medicare Advantage a decade ago was that private insurers could provide insurance, better insurance, cheaper than the government can do it. They can do it better.
And we said, the reason why we're going to pay them more than what they're going to give at the front end is to incentivize them to get in the business of doing it. And so, we paid them $1.15 for every dollar's worth, what we could have bought for a $1. We did it -- and it was a rational thing to try -- we did that because we wanted them to get engaged in the business we thought government didn't do as well as the private sector did.
Well, here we are, we're overpaying insurance companies about 15 cents on the buck that -- what we could buy for $1, and we call for eliminating that.
And so the other point I would make, Mr. President, is that we're in a situation here where at the end of the day nobody in this room -- I don't think anybody in this room is going to say, "You know something, we are really going to be reforming the health care system without affecting the effect on the long-term deficit."
JUDY WOODRUFF: The top Republican on the House Budget Committee, Wisconsin's Paul Ryan, said the Democratic bill doesn't accomplish that goal.
REP. PAUL RYAN, R-Wis.: This bill does not control costs. This bill does not reduce deficits. Instead, this bill adds a new health care entitlement at a time when we have no idea how to pay for the entitlements we already have.
Now, let me go through why I say that. The majority leader said the bill scores as reducing the deficit $131 billion over the next 10 years. First, a little bit about CBO. I work with them every single day -- very good people, great professionals. They do their jobs well. But their job is to score what is placed in front of them.
And what has been placed in front of them is a bill that is full of gimmicks and smoke and mirrors. Now, what do I mean when I say that?
Well, first off, the bill has 10 years of tax increases, about half a trillion dollars, with 10 years of Medicare cuts, about half-a-trillion dollars, to pay for six years of spending.
JUDY WOODRUFF: Ryan's assertion was challenged by Democrats. About half of the Democratic bill would be paid for by cuts to Medicare Advantage. The president pointed to weaknesses he sees in the program.
BARACK OBAMA: The Medicare Advantage program, which is what we are proposing to reform, is actually not a good deal for taxpayers or for seniors, and certainly not a good deal for the 80 percent of seniors who aren't in Medicare Advantage, because, by the way, they're paying an extra premium of about 90 bucks a year to subsidize the 20 percent who are in Medicare Advantage.
SEN. MITCH MCCONNELL, R-Ky., Minority Leader: Mr. President, John McCain also would like to address that issue.
BARACK OBAMA: I'm sorry. So, if somebody else wants to address it -- you know, I...
SEN. JOHN MCCAIN: I would just make one comment. Why in the world, then, would we carve out 800,000 people in Florida that would not be -- have their Medicare Advantage cut? Now, I proposed an amendment on the floor to say everybody would be treated the same.
Now, Mr. President, why should we carve out 800,000 people because they live in Florida to keep the Medicare Advantage program, and then want to do away with it?
BARACK OBAMA: I think you make a legitimate point.
SEN. JOHN MCCAIN: Well, maybe...
BARACK OBAMA: I think you do.
SEN. JOHN MCCAIN: Thank you. Thank you very much.
BARACK OBAMA: Yes.
JUDY WOODRUFF: But that point of agreement with short-lived, with House Republican Leader John Boehner returning to his party's most frequent claim.
REP. JOHN BOEHNER, R-Ohio, House Minority Leader: This right here is a dangerous experiment. We may have problems in our health care system, but we do have the best health care system in the world by far.
And -- and having a government takeover of health care -- and I believe that's what this is, is a dangerous experiment with the best health care system in the world that I don't think that we should do.
So why did I bring this bill today? I will tell you why I brought it. We have $500 billion in new taxes here over the next 10 years. At a time when our economy is struggling, the last thing we need to do is to be raising taxes on the American people.
Secondly, we've got $500 billion worth of Medicare cuts here. I agree with Kent Conrad, we need to deal with the problem of Medicare.
But if we're going to deal with the problem with Medicare and find savings in Medicare, why don't we use it to extend the life of the Medicare program as opposed to spending that $500 billion creating a new entitlement program?
BARACK OBAMA: John, you know, the challenge I have here -- and this has happened periodically -- is we're having -- every so often, we have a pretty good conversation trying to get on some specifics, and then we go back to, you know, the standard talking points that Democrats and Republicans have had for the last year.
JUDY WOODRUFF: After hours of trying to get participants to focus on where they agree, the president tackled some prime differences, including who gets coverage.
BARACK OBAMA: Can America, the wealthiest nation on Earth, do what every other advanced nation does, which is make sure that every person here can get adequate health care coverage whether they're young or old, whether they are rich or poor?
SEN. JOHN BARRASSO, R-Wyo.,: I do believe we have the best health care system in the world. That's why the premier of one of the Canadian provinces came here just last week to have his heart operated on. He said it's my heart; it's my life; I want to go where it's the best, and he came to the United States.
It's where a member of parliament, a Canadian member of parliament with cancer came to the United States for her care. They all have coverage there, but what they want is care. So coverage does not equal care.
JUDY WOODRUFF: In the end, before the session finally concluded, the president said he is unsure whether he can bridge the gap with Republicans.