Emanuel: Changes To Health System Take Time In an interview with NPR, White House Chief of Staff Rahm Emanuel acknowledges it is unlikely that Congress will meet an August deadline to finalize health care legislation. But, he says, he expects to have a bill by the end of the year "that controls costs, expands coverage and provides choice."
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Emanuel: Changes To Health System Take Time

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Emanuel: Changes To Health System Take Time

Emanuel: Changes To Health System Take Time

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Now while the president traveled, his chief of staffs spent hours in meetings at the Capitol. Senate leaders say they will not vote on a health care plan before their summer recess as the president had asked. Like yesterday, Rahm Emanuel returned to his corner office in the White House and said that congressional committees at least should finish their work.

Mr. RAHM EMANUEL (White House Chief of Staff): Okay, you're basically three-fifths of the way there in the sense of committee work in getting this done.

INSKEEP: It sounds like the House is not likely to pass legislation, either -the full House - before the recess.

Mr. EMANUEL: Well, I can tell you what I know, which is, the speaker, today, announced to the caucus that their intention is to go next week. And she is working towards that goal.

INSKEEP: Now this former Congressman has to make sure the bill doesn't lose momentum in August as lawmakers return to their districts.

What danger is there that you go away for the summer, or Congress does, and you have a small number of vulnerable Democrats in relatively conservative districts who hear the concerns of their constituents or of lobbying groups and they come back in September…


INSKEEP: …and they're not going to be voting with you anymore?

Mr. EMANUEL: Well, first of all there's - there's always a lot of danger but let me say one thing - you said two different things.

INSKEEP: Mm-hmm.

Mr. EMANUEL: And I want to draw a distinction. Having been a Congressman, representing the Northwest side of Chicago and suburban area, what I heard from people, they couldn't afford health care. They had a daughter or a son who had a pre-existing condition and therefore were dropped. Or when they left jobs they couldn't get covered under that insurance policy. So hearing from constituents will not be the same as hearing from the special interests, which is what you also said. So, let me address what the second thing you said…

INSKEEP: Mm-hmm.

Mr. EMANUEL: Because the public wants health care reform that fundamentally doesn't put the insurance companies in control of the process, which is where they are. That, by any constituent level, will tell you people are not happy with the present system.

INSKEEP: Well, there's two different things there as well because surveys would suggest the public is with you in describing the problem. Surveys would suggest the public is a little bit less with you as far as the specific solution. They're concerned about the direction this bill is going…


INSKEEP: …might some lawmakers come back from this recess and they've been pushed out of where they can't really support you anymore.

Mr. EMANUEL: And somebody come back even stronger committed to getting it done. I don't think it defaults to the one option.

INSKEEP: How difficult is it to make sure that all the different interests, corporations, groups of lawmakers, individuals who are with you now or maybe with you now stay onboard as you tweak this bill. Any little change might cause somebody to lose money or lose interest in your bill.

Mr. EMANUEL: No. The doctors in the past were against Medicare. Now they're the biggest advocates. When I worked for President Clinton and we were trying to create the children's health insurance program, private insurers were against it. Now they're for it. So, one of the things that I think important is keeping the advocates who've been in the past the biggest stumbling blocks to reform on the side of getting reform done - not at all costs, but helping them push this along. That has been a key part to this. We are down to the final details. Those details matter. But we will, I think, are making progress.

INSKEEP: Well, let me ask you about one of those details. There are a number, as you know very well, moderate or conservative Blue Dog Democrats who are concerned about the cost of this, looking for cost savings. Just in the last few days, House leaders came up with some savings that looked like they might come out of the pockets of doctors and hospitals. And suddenly doctors and hospitals who had been supporting you have put out statements saying we're not sure we can support this bill anymore.

Mr. EMANUEL: Well, I met with members of the AMA.

INSKEEP: American Medical Association.

Mr. EMANUEL: Who are - American Medical - who are still supportive - the lead organization for doctors. But if you want to control costs, one of the things that the president talked about is to have a group of health experts insure that in fact the changes that are necessarily so the system is more efficient, more cost effective, are done.

INSKEEP: Is it going to cost you votes in order to gain the votes that you got from these conservative Democrats? That's what I'm wondering in the end.

Mr. EMANUEL: Well, I don't want to fast forward the movie. You're just going to have to watch the movie all the way through. But the key thing that you got to understand of this in my view is we now are debating how to control costs. This has not happened before. You're not just running it up on the credit card, which is how they did the prescription drug bill. They charged it, which was a $900 billion charge, and nobody it'll be paid for.

INSKEEP: How long can you hold together the supporters you have while you work to get the last few supporters you need?

Mr. EMANUEL: I think people are - I've seen legislation, Steve, you know, this is just my guess - you know, it's a guess. I've seen places where people are trying to find a way to be a no and I've seen places where people are truly, earnestly trying to find a yes, and I think we're in the process of people trying to find out how to get to a yes.

INSKEEP: Meaning you think you have time?

Mr. EMANUEL: No, I mean that I think we're going to get to a yes, and we're working on it, and I think we'll have a bill by the end of the year for the president to sign on health care reform that controls cost, expands coverage, and provides choice.

INSKEEP: I'd like to ask about the Republican's fear. One Republican, Senator Jim DeMint…

Mr. EMANUEL: Yeah.

INSKEEP: …said a few days ago that this could be President Obama's Waterloo. If he's defeated on health care, this could break him. I'd like to turn that question around and ask you if you think that this battle could be Republicans' Waterloo in your view?

Mr. EMANUEL: Well, I - you know, let me reject the premise because I really want to stress this and I don't - I mean, I'm okay with politics, as you well know - on that, you know, Senator Inhofe, I don't have the exact quote, but basically the thrust of the quote was the political importance of defeating this, because of what it would do to President Obama, they're seeing it in political terms and they've decided that if they can beat the president on health care reform, they've scored a big political victory. But what they've also guaranteed in policy terms is that you have the status quo. I actually appreciate what Senator DeMint said and Senator Inhofe. I'm different than everybody. I'm not going to criticize them. I compliment them. They're honest. Now…

INSKEEP: Are you telling Democrats there's actually some truth to that? If you guys don't stick with us on this, it could be a disaster?

Mr. EMANUEL: No, no. You asked me about what they said.


Mr. EMANUEL: No, no. But they're being honest about (unintelligible) the stakes.

INSKEEP: But looking at…

Mr. EMANUEL: And what I find interesting is that I haven't heard a lot of people in their party criticize them.

INSKEEP: Are you enjoying this fight?

Mr. EMANUEL: I'm enjoying this interview. No, am I enjoying this? You know, here's the deal. My dad's a doctor. My mother was a nurse. You know, and I've never in my life either as a son of a doctor and a nurse or somebody who's been in public life, never really had to be scared about their health care. Not having insurance, I don't have that fear. And I think that this is a fight worth having.

INSKEEP: Rahm Emanuel, thanks very much.

Mr. EMANUEL: Thank you.

(Soundbite of music)

INSKEEP: Rahm Emanuel is President Obama's chief of staff.

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