What Might Make It Into The Health Care Bill? Wednesday night, President Obama delivers his health care speech to Congress. Tell us what you want to see included in the health care bill, and tacticians from the left and right will let you know if they think you'll get your wish.
NPR logo

What Might Make It Into The Health Care Bill?

  • Download
  • <iframe src="https://www.npr.org/player/embed/112679729/112679724" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript
What Might Make It Into The Health Care Bill?

What Might Make It Into The Health Care Bill?

What Might Make It Into The Health Care Bill?

  • Download
  • <iframe src="https://www.npr.org/player/embed/112679729/112679724" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

Wednesday night, President Obama delivers his health care speech to Congress. Tell us what you want to see included in the health care bill, and tacticians from the left and right will let you know if they think you'll get your wish.

Ken Rudin, political editor for NPR
Anna Greenberg, senior vice president and principal, Greenberg Quinlan Rosner
Matthew Continetti, associate editor, The Weekly Standard


This is TALK OF THE NATION. I'm Neal Conan in Washington.

Congress returns, the president speaks, Joe Kennedy declines. It's Wednesday and time for a whiplash edition of the Political Junkie.

Former President RONALD REAGAN: There you go again.

Former Vice President WALTER MONDALE: When I hear your new ideas, I'm reminded of that ad. Where's the beef?

Former Senator BARRY GOLDWATER: Extremism in the defense of liberty is no vice.

President RICHARD NIXON: You don't have Nixon to kick around anymore.

Secretary of State HILLARY CLINTON: Lipstick.

President GEORGE W. BUSH: But I'm the decider.

(Soundbite of scream)

CONAN: Every Wednesday, NPR political editor Ken Rudin joins us for a roundup of all things political and what a week. President Obama makes a high-stakes address to Congress tonight to try to reclaim the health care debate. We'll focus on the politics of health care in a bit.

It's open season for the late Ted Kennedy's seat in Massachusetts after nephew Joe Kennedy says he will not run. The press tells kids: Be true to your schoolwork. New York City Democrats get set to nominate a long-shot candidate for mayor, and four - count them, four - disgraced lawmakers try to reshape their images.

Later this hour, Bill Keller of the New York Times on the dramatic rescue of a correspondent in Afghanistan that cost the lives of his translator, a British commando and at least one Afghan civilian. But first, political junkie Ken Rudin joins us here in Studio 3A. Hey, Ken.

RUDIN: Hi, Neal.

CONAN: As always, we'll start with a trivia question. Well, since we're going to be talking about Massachusetts, and we will be talking a lot about Massachusetts, the state Attorney General Martha Coakley announced her candidacy for the Senate earlier this week to succeed the late Edward Kennedy.

Massachusetts is one of many states that has never elected a female senator, but there are five states that have never elected a woman to the House or Senate. Name all five.

CONAN: If you think you know all five - you've got to get them all.

RUDIN: I know.

CONAN: All five.

RUDIN: Oh, you mean somebody else.

CONAN: Somebody else, yeah. If you think of all five states that have never elected a woman to the house of Representatives or to the United States Senate, give us call, 800-989-8255. The first person to name all five correctly will win a fabulous no-prize T-shirt.

And in the meantime, there's an awful lot riding on President Obama's speech tonight, but in a few minutes, Anna Greenberg and Matt Continetti will join us to talk about the politics of health care.

So let's start with Ken. With that open Senate seat in Massachusetts, and before we get to the special election in January or the real election of the Democratic primary in December, Massachusetts has got to decide whether there's going to be an interim senator.

RUDIN: Right, and they start today with a public hearing. It began about an hour ago at the state house. Obviously, they want to change the law. The way the law stands right now is that there will be a special election within 145 and 160 days after a vacant seat for the Senate, and of course, Ted Kennedy died on August 25.

So there is, as you say, there'll be a primary on December 8th and a special election on January 19th, but they want to change the law. They want to give Governor Deval Patrick, a Democrat, the opportunity to appoint an interim senator to serve until that special election.

One of the reasons the Democrats so desperately want that opportunity for an appointment is because right now, theoretically, if you count all the independents and things like that, the Democrats only have 59 votes in the Senate, minus Ted Kennedy, of course, and they need a 60th just in case that vote is needed, and it may very well be needed.

CONAN: And you need 60 votes to avoid cloture, which is a word we're all going to learn anyway. But in the meantime, who is coming out of the woodwork to run for that Senate seat. Is Curt Schilling the favorite?

RUDIN: Well, he and his bloody sock, and of course, as a Yankee fan, we don't like to talk about Curt Schilling, but he - Curt Schilling, of course, is a registered independent who usually votes for Republicans. He supported President Bush over John Kerry in Massachusetts in 2004. He backed John McCain in 2008. There's some - he probably won't run, and the focus will probably be on the large and increasingly large Democratic field now that Joe Kennedy said he is not going to run.

CONAN: And who's in that, besides Martha Coakley, who we mentioned.

RUDIN: Martha Coakley announced. Stephen Pierce - I'm sorry, Stephen Lynch is a congressman, kind of a blue-collar/moderate conservative from South Boston. He's already taken out nominating papers. Michael Capuano is another member of Congress who's also taken out nominating papers. They're talking about Ed Markey, a member of Congress; Marty Meehan, the former member of Congress. Again, many people were waiting for either Reggie - I'm sorry, Vicki Reggie Kennedy, the senator's widow, who of course has said over and over again she has no interest, or Joe Kennedy, who announced last week that he will not run.

CONAN: And of course, Senator Kennedy, the late Senator Kennedy, was the chairman of the Senate Committee on Health. His staff played an important part in the health care debate that's still going on, of course, in Congress. And much more about that later, but nevertheless, his departure means, well, some musical chairs with Senate committees.

RUDIN: Right, exactly, and the person all attention seemed to be focused on was Chris Dodd, the Democrat from Connecticut. He is chairman of the banking committee, and he's working - he's very involved in consumer legislation. He's also in for a tough re-election battle next year, and the feeling is whether he should take the Health, Education, Labor and Pensions Committee chairmanship that Kennedy headed or stay at banking.

It looks like at this hour, he's probably going to announce that he'll stay with banking, and I think he's basically been running a very populous effort because he's in a tough re-election next year. He may talk about consumer fraud and things like that, less headaches, I think, than health care.

So it looks like that new - that HELP Committee will now be headed by Tom Harkin of Iowa, who will give up agriculture, and then agriculture may go to Blanche Lincoln of Arkansas, who is also in a tough battle next year.

I'm leaving little crumbs, so if you follow my steps, you can follow where I'm coming from.

(Soundbite of laughter)

CONAN: Okay. In any case, there will be more on this on the Political Junkie blog, which Ken Rudin, well, writes almost every day.

RUDIN: I read it almost every day, too.

CONAN: And that's at npr.org. In the meantime, let's see if we can get some people with answers to our trivia question, and that is the five states in the union that have never elected a woman to the House of Representatives or to the United States Senate, and let's see if we can get some callers on the line. Let's go to Mike in St. Louis.

MIKE (Caller): Hi.


MIKE: So I'm saying Utah, Nevada, Montana and North and South Dakota.

RUDIN: Well, I can say you're wrong on several things because South Dakota right now has a female member of Congress, Ms. Sandlin Herseth - Stephanie Sandlin Herseth is a member of Congress right now.

CONAN: And even I remember Jeannette Rankin.

RUDIN: And Jeannette Rankin, of course, Montana, and she was a Butte - yeah, I'm sorry.

(Soundbite of laughter)

RUDIN: And the other states, also Nevada also had one, Barbara Vucanovich, and there's Shelly Berkley, who's a member of Congress from Nevada right now. So most of those are wrong.

MIKE: All right.

CONAN: But nice try, Mike. Thank you very much for that. Let's see if we can go next to Anne(ph), Anne with us from Lutsen - is that right? - in Minnesota.

ANNE (Caller): No, Lutsen.

CONAN: Lutsen. Okay, I apologize.

ANNE: Iowa, Delaware, Mississippi, Vermont and Puerto Rico?

RUDIN: Well, you did very, very well except Puerto Rico is not a state. So we need a fifth state there.

CONAN: But other than that, you were pretty good.

RUDIN: You did very well, except we need one more state.

CONAN: Nice try. Bye. Let's go next to - this is Kevin, Kevin calling from Savannah in Georgia.

KEVIN (Caller): Yeah, Utah, Idaho, Iowa, Alaska and Hawaii?

RUDIN: Well, Alaska, of course, is wrong because we have a senator right now, Lisa Murkowski. Idaho is wrong. We had Helen Chenoweth there for a long time; and Hawaii, of course, we had Pat Saiki, who was a member of Congress for several years before she ran for governor. So that's wrong, but Anne from Minnesota was the closest. We just need a fifth state.

CONAN: Kevin, thanks very much. Let's see if we can go next to - this is Travis, Travis with us from San Jose.

TRAVIS (Caller): Yes, I said Alabama, Mississippi, South Carolina, Nebraska and Virginia.

RUDIN: No, we had Leslie Byrne in Virginia. We had Liz Patterson in South Carolina, and I think - did you say Nebraska? Because we had Virginia Smith in Nebraska. So those are three that are wrong, as well.

CONAN: Okay, thanks, Travis.

TRAVIS: Thank you.

CONAN: Let's see if we can go next to…

RUDIN: How do I know this stuff?

CONAN: I don't know. Tom(ph), Tom calling from Ann Arbor.

TOM (Caller): Well, I think there are only four, Ken: Delaware, Iowa, Mississippi and Vermont.

RUDIN: That's correct. You have four states, but there is a fifth state that has never elected a woman to the House or Senate. We need that fifth state.

CONAN: And I think the key word…

RUDIN: No, no, no, don't give it away.

TOM: Oh, you only elected, as opposed to serving.

RUDIN: That's correct.

CONAN: Ew. One more, Tom.

TOM: Well, I'm not sure.

CONAN: That's not a state, like Puerto Rico.

TOM: Louisiana.

CONAN: Nice try, but Mary Landrieu.

RUDIN: Mary Landrieu.

CONAN: Let's see if we can go next to - this is Steve, Steve calling us from Anchorage.

STEVE (Caller): Well, I think that gives it away. It's Alaska.

RUDIN: No, no because Lisa Murkowski was elected. She was appointed but subsequently elected.

STEVE: Ah, that's right. That's right.

CONAN: Nice try.

STEVE: Let me see. How about…

CONAN: I'm not sure this is kosher.

RUDIN: No, no.

CONAN: That's it. All right, nice try.

RUDIN: Gabrielle Giffords is a congresswoman from Arizona right now.

CONAN: Ben is calling from Flagstaff.

BEN (Caller): Hi, huge fan of the show, guys.

CONAN: Thanks.

BEN: Let's see if I can decipher this: Delaware, Iowa, Vermont, Mississippi and Missouri.

RUDIN: No, we have Claire McCaskill who's a senator right now from Missouri.

CONAN: And we have - this as another one that's close, email from John(ph) in Tucson: Delaware, Iowa, Mississippi, Vermont and Massachusetts.

RUDIN: Well, we said - no, Massachusetts because we had Margaret Heckler, who actually lost to Barney Frank in 1982. So we did have a female member of the House but never the Senate. But we need somebody who was never elected in the House or Senate, the fifth state.

CONAN: Let's go next to - we'll go to Henry, Henry with us from Margate in Florida.

HENRY (Caller): Yes, it's Wyoming.

RUDIN: It's not Wyoming because we had not only - we had Barbara Cubin, who was a member of Congress, but I think her successor was also a woman in Wyoming.

HENRY: Okay, thank you.

CONAN: All right, nice try. Can Jeff(ph) get it? Jeff is calling from Philadelphia.

RUDIN: Please, Jeff.

JEFF (Caller): All right, I'm just going solely out on a limb here: Delaware, Iowa, Mississippi, Vermont and Texas.

CONAN: Oh, come on.

RUDIN: No, we have Kay Bailey Hutchinson who's a senator right now.

JEFF: All right. All right, thanks anyway, guys.

CONAN: And well, we'll give somebody else a chance to call in with this, but we've got some more news to get to, and that includes - there are, we mentioned, four disgraced former politicians who are, well, some of them still current politicians, trying to repair their reputations, Ken, including Governor Sanford in South Carolina.

RUDIN: Well, Mark Sanford, of course, the latest news is that the speaker of the House, Bobby Harrell, yesterday said that Mark Sanford should resign. Now, Bobby Harrell is one of the key Republicans who had not had an opinion, had a public opinion, on what the governor should do - but the governor insists in saying that, look, it's premature. He's not leaving.

CONAN: Rod Blagojevich has a book out.

RUDIN: He does. It's called "The Governor," which is very clever, and he says that the snippets we've heard of these wiretaps, these government wiretaps, did not tell the whole story. And he says that at his trial - is a perjury trial, which - at his perjury trial, he will call President Obama to testify on his behalf.

CONAN: Jimbo Traficant called the citizens of Youngstown, Ohio, to his behalf.

RUDIN: Yes, he was released from prison last week after seven years of prison, and he's talking about perhaps running for the Senate. That's a possibility there. There are some people, there, of course, in Traficant - in Youngstown - also known as Traficant - who loved him, but there were a lot of people who are ashamed of the - basically, Youngstown for the longest time was an ethics cesspool, and Traficant was part of that, and they do not want a return of Jim Traficant.

CONAN: And finally, people thought Mark Foley could not sink any lower, but now he's gotten into radio.

RUDIN: Well, not only has he gotten into radio, but the name of this new rodeo - radio show is called "Inside the Mind of Mark Foley." Anybody who knows what happened to Mark Foley, his drastic fall from grace, would not like to know what's inside the mind of Mark Foley.

CONAN: And we have a winner.

RUDIN: Oh no!

CONAN: We have - Tran(ph) is sent by email, and he has successfully named the fifth elusive state of North Dakota. Ken, explain.

RUDIN: Because Quentin Burdick, when he died, his wife, his widow, Jocelyn, was appointed to the seat but never was elected. North Dakota is the fifth state.

CONAN: And Tran will get a Political Junkie T-shirt because we've got his email address. Ken, stay with us. We're going to be talking about the politics of health care. Stay with us. It's TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington. It may not be quite make or break, but President Obama faces a tough challenge tonight when he delivers his health care speech to a joint session of Congress in primetime. He's got to explain what the health care overhaul will mean to Americans and convince them they need it. The latest polling shows 51 percent of Americans now believe that they disapprove of President Obama's handling of the health care issue.

He's also got to appeal to Republicans in Congress, most of whom say they won't support an overhaul with a public option and may not support it anyway. He's got to bring together the various factions within his own party, too, and that may be even more difficult.

He began his push to reclaim the health care debate two days ago when he addressed the AFL-CIO at a rally in Cincinnati.

President BARACK OBAMA: I see reform where Americans and small businesses that are shut out of health insurance today, will be able to purchase coverage at a price they can afford,; where they'll be able to shop and compare in a new health-insurance exchange; a marketplace where competition and choice will continue to hold down costs and help deliver them a better deal. And I continue to believe that a public option within that basket of insurance choices will help improve quality and bring costs.

(Soundbite of applause)

CONAN: And the president would be thrilled to get such cheers tonight before a joint session of Congress, not likely. NPR political editor Ken Rudin is still with us, our always healthy political junkie.

For the rest of this segment, we'll focus on the politics of health care. We want to hear from you. What do you want to see included in this health care bill, and we'll ask our next two guests if they think that'll fly in Congress.

800-989-8255. Email talk@npr.org. You can also join the conversation on our Web site. That's at npr.org. Click on TALK OF THE NATION.

With us here in Studio 3A is Anna Greenberg, a Democratic pollster, senior vice president of Greenberg Quinlan Rosner, and always good to have you on the program.

Ms. ANNA GREENBERG (Democratic Pollster; Senior Vice President, Principal, Greenberg Quinlan Rosner): Thanks for having me.

CONAN: And Matt Continetti, associate editor of The Weekly Standard, is also with us here in Studio 3A. Nice to have you back with us, Matt.

Mr. MATTHEW CONTINETTI (Associate Editor, The Weekly Standard): Thank you, Neal.

CONAN: And as we heard in the clip of President Obama, Anna, he still says he believes the public option is an important part of any health care overhaul. He is not saying, though, it has got to be in there or else.

Ms. GREENBERG: And that's deliberate. I think he is keeping all of his options open. Notice he also talked about an exchange, which is something that Senator Baucus has been talking about in his plan.

One thing I would not that's really interesting to me with all this controversy over the public option, in the latest Gallop poll, came out about a week ago, 55 percent of people support the public option, and actually, all of the public polling all along have support - have shown majority support for the public option. So in some ways, it's more controversial in Congress than it is among regular voters.

CONAN: And is anybody in the Republican Party, Matt Continetti, prepared to vote for it?

Mr. CONTINETTI: Oh, I don't think so because Republicans view it as a government takeover of health care, a Trojan horse for a single-payer system down the line. It seems to me like there are really two conversations going on about health care. There's the conversation the president is having with the Congress, which gets to the nuts and bolts of the legislation, and how are we going to tweak this policy, and how are we going to fix this social malady; and then there's the Republican conversation, which has been going on in town halls throughout the country over the past summer, which is all about larger questions involving freedom and decision-making and the role that the state should play in various parts of our economy. And these two conversations are very different.

CONAN: And to be fair, they're also talking about Waterloo.

Mr. CONTINETTI: Yeah, well, that's absolutely. And also how this is kind of a dividing line. You know, Obama wins this battle, and Republicans won't be able to stop them with much else.

CONAN: And Anna Greenberg, to be fair, there's also a debate within the Democratic Party. They're also talking to the president, and part of it has to do with whether the public plan is going to survive, and well, an important Democrat in the House of Representatives, that's Steny Hoyer of Maryland, said yesterday, well, he likes the public option, but:

Representative STENY HOYER (Democrat, Maryland): I'm not one of those that says if you don't have a public option, it's not a good bill. I think it's a very good bill. I think the public option makes it much better.

CONAN: And Nancy Pelosi doesn't necessarily agree with him.

Ms. GREENBERG: Well, I think you are going to see something that passes the House that has a public option, but you're already seeing signs, even from the progressive side of the House, of some softening on the public option. I don't think that's going to be the make or break on whether or not something passes Congress.

CONAN: And Ken?

RUDIN: Yeah, well, I was going to say, Max Baucus today, who will probably announce his plan within the week and probably submit it to the Senate Finance Committee a week after that, said today that look, public option is not going to pass the Senate. So Nancy Pelosi can very well say yes, it has to pass the House, and it probably will, but of course, when the Senate passes theirs without the public option, then comes that crucial conference committee.

CONAN: And Matt Continetti, one of the key figures here is Olympia Snowe of Maine, the Republican, one of the members of so-called Gang of Six on Max Baucus' Finance Committee, and she's noises about something called a trigger. In other words, there would be no public plan unless the insurance companies do not compete successfully. Then, five years from now, it would automatically kick in.

Mr. CONTINETTI: That's right, and you know, that may be enough. This trigger may be enough to secure Snowe's vote for any reform legislation. They need that 60th vote in the Senate, of course, that is if they don't go for a reconciliation, if they don't try to pass…

CONAN: A reconciliation is that parliamentary maneuver whereby they can get this passed with 51 votes.

Mr. CONTINETTI: That's right, but I think the larger issue here is public opinion. As you noted in your introduction, at the moment, more Americans disapprove of Obama's handling of this issue than approve of it, and what we're going to see tonight is his attempt to kind of re-take the argument.


RUDIN: Matt, following up on that point, who won August? I mean, we're always talking about who won a month at a time, and of course, a lot of people said well, you know, you heard a lot of crazy-sounding people with misinformation screaming and yelling at town hall meetings, but at the same time, you saw Barack Obama - President Obama's numbers significantly go down, his job-approval numbers. Who won August?

Mr. CONTINETTI: Well, I think you can make the case that this grassroots, or the AstroTurf, whatever you want to call it, this movement, this tea-party movement, this anti-Obama, anti-spending, anti-government movement that you see at these town halls, they effectively shifted this debate that we're having to the right over the course of the summer. And in so doing, I think they've come across with the stronger hand.

That's not necessarily the Republican Party. I think a lot of the people at these town hall meetings are not partisan Republicans.

Ms. GREENBERG: I have to disagree, and I would look at two pieces of evidence. I would argue, Ken, that it was a draw. Two pieces of evidence. First, if you just look at people's self-report about how these town hall meetings affected them, about 60 percent in the Gallop Poll said they had no impact whatsoever on them. About 20 said favorable; 20 percent said made them more - you know, less favorable.

But if you look at public opinion over August, and I'm not talking about measuring June to July to August, I'm talking about the month of August, everything was stable but particularly on health care. And remember, we didn't just have town meetings. We had a lot of paid advertising in competitive districts and in competitive states.

So I'd argue that we're coming into this debate in August largely where we left it when Congress when out of session. I don't think it had much impact one way or the other.

I do want to say one more thing. You know, it is absolutely the case that you have a bare majority, not a big majority, disapproving of Obama's handling of health care reform, but if you look at the individual items in health care reform, there's overwhelming support for it. This battle is far from over.

CONAN: And Anna, as the pollster, I wanted to ask you. The black caucus and the Latino caucus, staunch members of the progressive coalition, say they will not vote for this unless it has the public option in it. How does this break down in terms, demographically in terms of polling? Is the president holding his support among African-Americans and Latinos? Is he losing support amongst whites?

Ms. GREENBERG: He's - well, I mean, overall, he's holding his support among Democrats, and to some degree, that includes a lot of African-Americans and Hispanics, but Democrats have been very stable. Where you've seen some decline in supporters have been among independent voters.

CONAN: Let's see if we can get a caller in on the conversation, and let's start with Sam(ph), Sam with us from Charlotte.

SAM (Caller): Hi, Neal, thanks for taking my call. My biggest concern right now with health care is to get a level playing field. When I was in corporate America, I left, and you know, of course, the company was paying my insurance. Then I left, went on COBRA. I was paying $450 a month for $1,500 deductible.

Then when I had to buy it on my own, all of a sudden, same person, I had to jump up to $1,200 a month for a $5,000 deductible, and the same thing happened. I went into public sector paying - the school was paying my insurance, and then come out, and now my COBRA payment is $350 a month. If I had to buy it on my own, it is outrageous. I'm the same person either way.

CONAN: Yeah, it depends on which group you're counted in, and that's the idea of setting up some of these exchanges. Matt Continetti, do you think that anything that will get approved by Congress would cover people like Sam?

Mr. CONTINETTI: Well, the Democrats certainly want to, and the intention of all these laws is to lower the prices, control the prices in the individual insurance market. The problem is, though, from what I see, the means of doing that, let's take guaranteed issue, which is that insurance have to give insurance plans to everyone. They can't deny people on the basis of pre-existing conditions, and then something called community rating, which is you cap the premiums based on everybody in the community, including young people and so forth.

New York state, for example, has both of those things, and they have extremely high, I believe the most expensive individual insurance premiums in the nation. So that's the kind of internal tension that I think is defeating a lot of the Democrats' arguments.

CONAN: And Anna, concern about costs is behind a lot of this.

Ms. GREENBERG: Well, sure, I mean, a couple things. They're talking about tax credits or subsidies so people can afford these premiums. So it's not that, you know, you're going to have high premiums or high individual costs, and then no one's going to buy them. The idea is to make them affordable or to give people the means to get them, and the other piece is not just about cost. It's about standardization so that you are sort of in this sort of situation where you leave jobs, and all of a sudden, you know, what you can get access to is different than what you could get before. I mean - so the whole - it's more comprehensive than that.

Cost is a huge issue, and I actually think one of the challenges that we face as Democrats is not truly explain to people how it's going to bring down their cost. I believe it will, but I think that we have not done a good job explaining that to people.

CONAN: Anna Greenberg is with us, also Matt Continetti and, of course, political junkie Ken Rudin. And we thank Sam for his phone call. Let's go next to Mike, Mike with us from La Grande in Oregon.

MIKE (Caller): Well, good morning. Glad to talk to you.

CONAN: Good afternoon where we are, but we're willing to extend to you the benefit of the doubt out there.

(Soundbite of laughter)

MIKE: Look, what I'd like to do is very quickly bring this personal anecdote. I worked 11 years in the same business. I started out with a $500 deductible. It's now up to $2,000. I left the business in the middle of '04, went to work for a friend of mine, from a $50,000-a-year job to minimum wage-plus, no medical care whatsoever, none. If you - and this is what I don't hear people talking about - it's a totally naked feeling to have no medical care and not have enough money saved to cover yourself in case something happened. So, there must be, in my opinion, there has to be, number one, portability.

If you leave your job, get fired from your job, get laid off, get sick, you have to have medical care that moves either from your job that you had with the same coverage or something that will pick it up with at least equal coverage for the person. A person - because your work, it should not depend whether you live or die or get sick or well. That's my opinion. I want a public option to keep the insurance companies honest. But it's got to be something portable, Neal.

CONAN: Anna Greenberg, I think portability is in every bill that I've seen.

Ms. GREENBERG: That's right. I mean, a key argument that President Obama has been making and has to continue to make is about - this is about security. One of the ways - this is going to impact people directly in the immediate term -because it's hard to bring down cost in the very immediate term - is that you have the security of knowing if you lost your job or you quit your job or you want to do something else, that you're not going to lose your health insurance. That's the most direct impact of this reform.

CONAN: And portability, Matt Continetti, I think is something that Republicans support as well.

Mr. CONTINETTI: Well, that's right. And, of course, they just have a different avenue towards the issue. They want to make portability by having the individual on their insurance program rather than getting it through their employer. There are a whole hosts of ideas. I hope to see Obama really reach out across the aisle with medical malpractice. That's the key place I think where you could get bipartisan support.

CONAN: In other words, if he was willing to compromise on tort reform.

Mr. CONTINETTI: Tort reform, capping, lawsuits and (unintelligible)…

CONAN: Then Republicans would be willing to compromise on what?

Mr. CONTINETTI: Well, on something.

(Soundbite of laughter)

Ms. GREENBERG: Exactly.

Mr. CONTINETTI: Maybe not the public option, but maybe something else.

CONAN: All right.

MIKE: Neal, am I still on the line?

CONAN: Yes. But you have to make it quick. We need to get somebody else.

MIKE: I will make it very quick. I think the tort reform is a red herring here. I think it's just an excuse to shoot this down. I don't think it's important as people like me who work for a living need to be able to carry our insurance somewhere else, have the government provide it if we can't provide it and keep the cost down. And I'll ring off on that one.

CONAN: All right. A very small soap box for you there, Mike.

You're listening to the Political Junkie on TALK OF THE NATION from NPR News.

And here's an email from Deb(ph). You are misinterpreting the poll you mentioned. Just because voters disapprove of the way President Obama is handling health care reform does not mean voters disapprove of health care reform. And I think Anna did point that. And also, we're talking about the politics of health care reform which has to do with that more than a little bit.

This email from Emily: It should be illegal to discriminate against people with preexisting conditions trying to buy private insurance, the same as it is illegal to discriminate in group plans.

And, again, Matt Continetti, I don't think that's controversial.

Mr. CONTINETTI: No, not at all. And, you know, I think if Obama had taken this issue from a different direction, maybe just focus on a few insurance reforms like, say, the preexisting - eliminating their ability to deny you on the basis of preexisting conditions or, say, getting rid of recession where sometimes these insurance companies drop people from the plans once they develop a condition. You know, I've heard from Representative Michael Burgess(ph), conservative Republican physician from Texas. And he'll say, listen, you used to have overwhelming votes for those two things.

CONAN: But, Anna, he says this is the time for comprehensive health care reform. Reforms like that - less than half a loaf, I think he would say…


CONAN: …aren't going to get to the real issues?

Ms. GREENBERG: Well, I mean, those are real issues. And if just those two things happen, that would be important reform. But you have issues of people who are uninsured which is 41 million people. You also have the long-term economic cost of our health care system, which is going to be a - it is a problem now, will be even bigger problem for a country economically.

CONAN: Let's go to Steve(ph) in Flagstaff.

STEVE (Caller): Hi. Thanks for taking my call. I'm thinking what - if the Democrats would kind of drop the public plan thing and just offer everybody Medicare and…

CONAN: Oh, re-label it in another words?

STEVE: Re-label it, call it Medicare for everybody. Everybody is familiar with Medicare. Everybody knows somebody that's on Medicare. And then, just, you know, have them pay their own tax and everybody pays in.

CONAN: Well, Ken, probably a little late in the game to talk about relabeling things, don't you think?

RUDIN: Right. I mean, I don't mean to be semantic but you're exactly right.

(Soundbite of laughter)

RUDIN: You don't want to do that. But what I'm curious about, if I can, from day one, it seemed like Barack Obama did not want to repeat the mistake of the Clintons. That Clintons, it was my way or the high way - they did their way, whereas Barack Obama let Congress do it. I'm talking to both of you. Do you think that he made a mistake in giving Congress the first step?

Ms. GREENBERG: I don't think he made a mistake. I think it actually made a lot of sense. I think, where - and frankly, he said this himself I believe yesterday or the day before. I think where he could have been stronger was to articulate clearly at least some core principles that had to be in a reform package which both he can sort of promulgate, but that others could also rally around.

Instead, you know, in his attempt to keep sort of all options on the table and not shut down any particular avenue for reform, it was a little confusing about what he was for. And so I think that that's - the speech tonight is actually think, he attempted to do exactly what I'm talking about. And, again, he sort of said it himself, I haven't been clear enough about what it is I'm for.

Mr. CONTINETTI: I think the Obama White House was so focused on not repeating the Clinton White House's tactical mistakes that they may have overlooked the larger strategic issue. And that is a lot of Americans who already have health insurance are very leery about kind of, you know, fiddling around with these institutional arrangements. And so, as soon as you start talking about so complex a topic as health care and also one that's so personal, right? And this is why Sarah Palin was able to affect this debate in such a, you know, visceral way in the summer. As soon as you start talking about that, you get people leery and it becomes a real political - a trial for you, I think.

Ms. GREENBERG: I just don't understand how you're going to get reform without messing around with these institutions. I don't think that that is a mistake on his part. I think that's the reality of this process.

CONAN: Well, do people really believe that doing nothing is not an option?

Mr. CONTINETTI: Well, no. If you…

Ms. GREENBERG: We still have very large majority of people saying we either have to have fundamental overhaul or major change in the system.

CONAN: Well, I'm talking about the (unintelligible).

Mr. CONTINETTI: Look at the George W. Bush experience, where he wanted fundamental reform of social security. If you talk - if you look back on that process now, I think a lot of Republicans would tell you, no, the mistake was you should go for incremental reforms.

And, of course, we spend all this time hearing that Obama was a gradualist. He's not so gradual on health care.

CONAN: Well, we'll see what he has to say tonight - live coverage on all of these NPR stations, I'm pretty sure.

Our thanks to Matt Continetti of the Weekly Standard, our thanks to Anna Greenberg of Greenberg Quinlan Rosner, a Democratic pollster, and, as always, our thanks to Political Junkie Ken Rudin who joined us all here in studio 3A.

Coming up, the dramatic and costly rescue this morning of a New York Times reporter held captive in Afghanistan. Executive Editor Bill Keller will join us. Stay with us.

I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

Copyright © 2009 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.