senate majority leader bill crist, both doctors. they have very different prescriptions for the health care system. all that and more next on "larry king live." two extraordinarily gifted americans join us to discuss the health care question, elizabeth edwards senior fellow at the center for american progress primarily focusing on health care issues the wife of the former democratic presidential candidate john edwards and the best selling author of "resilience" and in madison, wisconsin, tommy thompson, who was the secretary of health and human services under president george w. bush and is the former republican governor of wisconsin. elizabeth, in an interview last month you said you thought substantive health care reform would be enacted. do you stand by that? >> i still do. i'm incredibly optimistic.

i think the american people are still in favor of health care reform despite the assault they've had of a lot of hyperbole and misstatements and people know in their real lives that they need, they're going to need change. we're going to need change in health care nationally and in their own communities and in their own families. >> tommy, in an interview with dr. val jones the ceo of better health, a blogger medical education network you said in february you can bet your bottom dollar the health care system we know today is going to be changed so considerably i doubt you'd recognize it a year from now. do you stand by that? >> i stand by it because it already has many changes in the stimulus package there was a comparative equivalent, there's $20 billion set aside for electronic medical records. there's a lot of other projects already passed that's going to

transform health care in the future. the truth of the matter is and i think the question you're getting at is what about the barack obama legislation and what the democrats are doing in congress? i think the democrats are going to have a very difficult time passing a comprehensive bill unless they want to bring in the republicans and scale back and have a really comprehensive, bipartisan bill. that's what i'm hoping they will because i believe that elizabeth and i both agree that there's need for comprehensive health care reform in america but the kind of comprehensive health care reform is what really is going to be the most important item. i hope it's a bipartisan one that i think can bend have a great deal of support in the country. >> elizabeth, can that happen without the government being involved in kind of a quasi insurance company of its own? >> can we pass health care reform? we can pass health care reform

without having what is commonly referred to as a public option which means to compete with your private insurers, united health care or cigna or aetna or blue cross/blue shield you would have the federal government also offering you the option of insuring yourself through the government plan. i think it would be a huge mistake to pass any kind of reform without a -- without that public option. for a lot of reasons. one is that one of the things we want to do is make certain we're providing to 46 million americans who are uninsured, to 25 million who are under insured, a way of getting reliable, transparent, and cost effective, accessible -- cost accessible insurance. the way you do that is make certain you'll have that option. so far the private sector has not provided it. we all know that. our insurance premiums are now 15,000.

next year 18,000. might be the average. in ten years, 36,000 dollars a year for our whole family. if we want those to be controlled, we're going to have to have a public option. >> tommy, the republicans have fought that. why? what's wrong with the public option? >> if you want to really ruin health care in america, have the government run it. everything elizabeth said i have difficulties agreeing with because a public plan is really the tantamount to saying health care has failed in america. we're turning it over to the government to run and regulate. the innovations i want for breast cancer in america and elizabeth wants for breast cancer in america will be short circuited. new kinds of innovations and medicines will be put on the back burner. there will be certainly a reduction of reimbursements. the private health insurance companies would more than likely have to be retracted and reduced.

90% of the people like their health insurance. that's going to be changed because when you put the government in and have a public plan in the government you're going to have a shifting and even obama says we're going to allow people to have their same health insurance. you can't because there is going to be a shift. a public plan is tantamount to having a partisan, democratic plan thai think is going to fail. >> elizabeth, why is the current operation, forget the pun, so deficient? >> well, i want to answer that but i would also like to respond. i think that what tommy is saying is, the governor is saying is that -- >> tommy, elizabeth. >> okay. thank you, tommy. that the mistaken kind of language we hear that a public option creates a government run program. another part of what he said, though, if you listen, 90% of

people are happy with their insurance. we have 46 million people who are uninsured who would like to have insurance and maybe 10% who are unhappy with their insurance and maybe looking for something else. those are the people who are going to be moving perhaps to a public option. you aren't going to see some huge shift in the number of people who go to private insurers. if private insurers do a good job of innovation, tommy and i agree about that but they don't do a good job of keeping their administrative costs and the cost of their insurance down. when the health executives are paid $30 billion in a year and we had at least two major ceos, you can be pretty sure the health insurance costs for those policy holders are going to be higher than they need to be. and so if we can keep those administrative costs down, maybe we'll have a good effect for both of them. maybe the government will be required to be a little more innovative and maybe the insurance companies will be forced to keep their costs down.

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>> larry: tommy, in response can you say the insurance companies in america are doing a wonderful job? >> no, of course i can't. some do a wonderful job. some do a poor job. let's face it. if you put the government in here, and which they don't have to have a, make a profit, they're going to be able to under sell any private health

insurance company and -- >> larry: so wouldn't we benefit from that? >> no, we wouldn't. if a company is going to want to keep their own health insurance but knows the government is selling their health insurance cheaper, companies are going to migrate toward that and you'll see a demise of private health insurance industry in the country. if you want the government to control health insurance which democrats want and i think it's a terrible mistake, look at medicare. it's going broke. look at medicaid. breaking most of the states because of the cost. look at social security. everything the government really runs has not really measured up. >> larry: tommy, don't you think the public wants medicare and loves social security? >> oh, sure people do. but the truth of the matter is they're going broke. medicare is going broke this year. we can fix the health insurance industry. i'm not saying the health insurance companies are perfect and should not be changed. we should. we should allow for guaranteed issuance allowing people to come

in. we should be able to cover all of the uninsured in america. do it in a competitive and free enterprise manner. that ales t that's the way to have bipartisanship and fix the health care -- >> larry: why couldn't that work, elizabeth? >> that's what we've been trying and it hasn't worked and the costs have doubled since 2009 -- 2000 to 2009. the costs of our insure hanns has gone up 119%, more than doubled. it's causing people to file bankruptcy. 62% or 61% of the people who file bankruptcy cite medical costs as a substantial part of the reason why they had to file bankruptcy. it is clearly not working. we're on a track right now where we could be paying in ten years for our health care system over all $40 trillion. we're going to have to get ahold of this. and tommy knows this. we can't stay on the same path that we've been on. the very idea that if the

government doesn't have to make a profit therefore they'll be able to under price the insurance companies, there are plenty of nonprofits. health net colorado has done an analysis that said it didn't make any difference whether it was a profit or nonprofit company. that the prices they were offering to consumers was the same. all too high. and so we need somebody to be able to come in and put downward pressure. federal express and u.p.s. do fine in competition with the u.s. government. >> larry: let me get a call in. orlando, florida, hello kncht i'd just like to ask tommy thompson if my premium went from $500 a month five years ago to $2500 a month today, does he feel that's fair? >> i got to know what kind of coverage you got, whether you changed it, who you've got it insured with. i'm not saying it's fair or unfair. i don't know the facts. but i want to tell you something. i want to come back to this private versus public. you know, this is the issue that

really is affecting whether or not we'll have health reform. >> larry: right. >> i want health reform in america. the way to do that is to look at the things that bring us together and reach a bipartisan thing that is going to help transform health care and insurance. let's change the system from a disease system to a wellness system. let's do something about chronic illness and manage diseases. let's do something about the kinds of things like diabetes, like cancers and so on that we can really impact and reduce the costs of health care. 7 75% of the cost goes into chronic illness. we can do that on a bipartisan. let's have an electronic medical record. both parties want that. that's another 10% to 15% we can take out of the costs, hold down health insurance and the premiums and still improve the system. let's do things about cessation of smoking. all of these things can be done on a bipartisan basis and we can fix the health care. we can reduce the costs and we

can make it much more efficient. that's what needs to be done in america. >> larry: we'll take a break and be right back with elizabeth edwards and tommy thompson. don't go away. really has the mat cornered on. let me make it easier for you. let me show you how i can make it easier for you. we have the number one rated online banking website. it has an alert system that can text message you, so you're mobile banking, your bank's telling you what your current balance is. it's telling you if a certain check is cleared. customers that use the internet, use online banking. it all kind of falls in with what you're doing, and it's free. you can pay all your bills online, customers can save tons of time. we have great new image atms. it will give you a receipt which has a copy of the check you deposited. deposit cash, any denomination you don't even have to count the cash, just put it in there. let it do the work for you. and they can have those deposits posted to their account the same business day up until 8 o'clock. you're in control of your finances. now when you talk about convenience, you measure us up to everyone else. well, you'll see we stand ahead of the curve.

>> larry: we're back with elizabeth edwards and tommy thompson. debate over health care reform has gotten fierce. we've seen town halls turn into town brawls, this from an event held by congressman barney frank. watch. >> why do you continue to support a nazi policy as obama has expressly supported this policy. why are you supporting it? >> when you ask me that question i am going to revert to my ethnic heritage and answer your question with a question. on what planet do you spend most of your time? >> larry: elizabeth, is all of this deflecting away from the real debate? >> i think that it is. i mean, you've seen the -- i think that tommy would probably

reject some of the language that you see used to hype up crowds and some of the posters that you see. we don't -- we are not unplugging grandma as senator grassley said. we don't have death panels as senator kyl said. this kind of language of course generates an enormous amount of anger, an enormous amount of fear. tommy and i can have a reasonable discussion about the benefits or, you know, from my perspective, or the disadvantages from his perspective of a public option which seems to be the center of the real controversy here. we agree about almost everything else. but this seems to be the center and we can have a reasonable discussion but not when you use that kind of language. >> larry: tommy, would you agree? >> i think the language has gotten out of control. i think both sides, i think barney frank comes out and says what planet do you live on, if i was an elected official saying that to my constituents they'd be a little upset. >> larry: but if your

constituent just said your president was a nazi -- >> well, i'm saying, the rhetoric is bad but i think an elected official has to temper their remarks too. it's just, you know, both sides. i mean, it happens, you know, that a lot of hyperbole, a lot of accusations are going on but the truth of the matter is it's the american way. americans should have an opportunity to influence legislation. and this legislation, americans feel, is being crammed down their throats. they're upset about it. they're afraid of the spending. they're afraid of the trillion dollars more in deficits. and they feel, and i think rightly so, that the government is spending way too much money and we got to get it under control. i agree with elizabeth and myself, i think elizabeth and i could sit down and have a very constructive dialogue about public versus private and i don't think we'd reach, convince each other but i think we could certainly come out and articulate the issues and i think elizabeth and i could come up and i think democrats and

republicans, i think that's what we should do. we should set aside those poison items and get down to trying to influence a transformation of health care, cover the uninsured. fix the insurance companies. do something about a chronic illnesses. get a tax credit so krindividua poor people that are uninsured can buy health insurance in america and we would fix this problem. >> larry: why don't both parties appoint the two of you to sit down in a conference room, come out and whatever you decide is it. we'll be back with more right after this.

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>> larry: elizabeth edwards, you have breast cancer. tommy thompson, your wife and daughter both had breast cancer. for both of you, how does that affect your thinking in this? elizabeth? >> you know, a lot of people that have breast cancer come up to me and one of the people who came up to me in cleveland in 2007 was a working mother who said she was afraid for her children because she couldn't go to the doctor despite the fact she found a lump in her breast. she was whispering in my ear because she hoped that in america, you still had the power to whisper in the right person's ear and get the kind of changes you needed. it is unconscionable in a country of this wealth of working mother cannot afford to buy the health insurance that will protect her and allow her to be continue to be a good mother to her children. >> larry: one of the keys, tommy, do we have the right to

help? >> i believe we do. and i agree with elizabeth. we should have health insurance for mothers and there are many ways to do it. a tax credit for low-income individuals to purchase health insurance, save so much more money and be the right thing to do. many new companies and innovation instead and sexually transmitted diseases can -- break the barriers. and there's companies like -- the guy asked me going from $500 to $2500, set up policies everybody can be covered and hold down costs. there's so much innovation out there, larry. that is good for breast cancer patients and individuals like my wife and daughter who have had it. like elizabeth still does. that we should be able to put the kind of dollars and research in order to do that. we can fix the system. let's not damage the system by bringing in a public plan that's going to, i think, hurt and prevent really revolutionary transformation of health care in america. >> larry: what do you think will happen, elizabeth?

>> i hope that -- i -- with tommy the whole way until the last thing he said which i think is more of the fearmongering. 14,000 americans lose their health insurance every day. and they lose it because it is too expensive. so unless we create a provider that's going to have -- cost accessible health insurance which is apparently not going to be possible with these private insurers. it is not possible today. right now they have the most motivation of all time to make certain the people are not losing their coverage. yet, they will not provide -- they will not provide a cost-efficient -- we can't do it -- i think it is -- sounds like a great idea. let's do a tax rebate. i mean, a refundable tax credit to people who -- so they can get health insurance. are we going to give families $18,000 a year to pay for their health insurance next year? that's the average cost of insurance. >> we don't have to. >> of course we have to. that's the average cost of insurance. >> you put out -- you put out private -- put private insurance

out on a competitive basis and be down $4,000. refundable tax credit will cover that and you will be able to solve a lot of the problems. get a lot of the uninsured. the problem is -- >> that's not just realistic, tommy. >> it is, elizabeth. it is very realistic. like we did on part d. we put drugs out for competitive bids and stabilized the drug prices. you put out the bids for all the uninsured in every state and have the states hold and allow insurance companies to come in and bid on that, you will drive down the cost and put a refundable credit in for those individuals under 125% of poverty and we can cover everybody in america. that's what you want, that's what i want and we can do it without the government running the health insurance. >> when the republicans were in charge of doing something about health care, it was -- what they did was -- just what you said. prescription drug benefits for seniors, what they decided was the federal government could not negotiate the lowest possible price. protected -- protected the company and to the disadvantage of the american consumers.

again, we are seeing republicans protecting the companies, insurance companies, to the disadvantage of the american consumer. >> republicans want to protect health care in america and democrats want to destroy it. if you want to call it radical rhetoric, elizabeth -- then let's fix the system. let's not destroy it. let's not have the government control health care -- people don't want -- people don't want it. >> larry: let's have both of you come back. you are both terrific. elizabeth, how's your health? >> pretty good. i'm still out here fighting. >> larry: you're stage four though, right? >> yes. the numbers don't look that optimistic but i feel good and i've had recent tests that show me to be in pretty good health all things considered. >> larry: tommy, your family, how are they? >> first off i'd like to say,

elizabeth, we're pulling for you and praying for you. keep fighting. >> thank you. >> you're a great model. you're wrong on public insurance but you're right on fighting for breast cancer. my wife and daughter, thank the good lord, are doing well. >> that's great. >> they're both working and doing great. >> larry: thanks both very much. elizabeth edwards and tommy thompson. ( revving, siren blares )

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>> larry: everyone talks about the weather and no one does anything about it. right now that weather is affecting our signal in vermont because of the weather storms up along the east coast so we'll check in with howard dean in a moment. joining us right away from nashville is former senator bill frist, professor of medicine and business at vanderbilt. former senate majority leader, heart transplant surgeon, and a new book of his coming out in october "a heart to serve, a passion to bring health, hope, and healing" due in october. a key area is public option. sunday kathleen sebelius said it's not essential. today she is fully behind it. let's watch. >> here's the bottom line. absolutely nothing has changed. we continue to support the public option that will help lower costs, give american consumers more choice, and keep private insurers honest. if people have other ideas about

how to accomplish these goals, we'll look at those too. but the public option is a very good way to do this. >> larry: senator frist, do you like the public option or not? >> larry, i don't think it's necessary. if you look at the public option very simply it's a single payor system that is nationalized and i think what it does is crowds out a lot of the innovation, a lot of the creativity, a lot of the change that we know is necessary to keep up with the biological systems that we have to treat through prevention and wellness. >> larry: doesn't it force other insurance companies to reduce costs when the governor is one of their competitors? >> that's what the line is fan you pay the public plan or the national plan, single payor plan, we pay physicians less, we pay hospitals less by definition and the real fear and i think it would happen because we saw it happen actually through a very

similar plan here in tennessee, is that it causes the employer sponsored insurance industry to diminish because all of those people on the more expensive plans get dumped onto the private plan. over a period of time that -- or the public plan. the public plan over a period of time continues to grow and grow and grow. the private insurance diminishes and it's in the private insurance market we see the innovation and choice and then you end up with a single payor national plan that people simply don't have the choice they would otherwise. >> larry: but we also senator, obviously there's something wrong if 48 million people aren't insured if all other major civilized countries have some sort of national health insurance and we don't do you think philosophically we're entitled to health? >> i do. i think that the time has come in a nation that is as rich as ours that everybody is entitled to affordable access of some kind of health insurance policy. you say we have 48 million people uninsured. we have about 20 million people who are hard core uninsured

today. and i think in the 21st century in the united states of america now is the time to bring them into the insurance market and then focus on how to make those insurance markets work. have more competition. more transparency. more choice. because you're right. we have huge health care problems today but the real answer to me is not more public health, not more single payor, not more national health, but more transparency where you can empower consumers to make choices for what is best for them. and then address the uninsured issue, the 20 million hard core. but you don't have to do what president obama has promised people in the past and that is to give all 46 million people a very expensive health care plan like the president has or a united states senator has. >> larry: you are not as some on the left are charging saying that the republicans just don't want health care reform? >> no. listen. i was majority leader of the united states senate and under our leadership, under republican leadership and working with president bush we passed about a $600 billion health care plan

that gave affordable access to prescription drugs to 40 million seniors under medicare who didn't have it. so, no. i am hard charging for reform but i want to do it in a smarter way with smarter purchasing, more choice instead of centralized bureaucratic control from the top. come back to the doctor. come back to the doctor. come back to the patient. moist,

>> larry: moments ago, senator, congressman barney frank of massachusetts wrapped up a town

hall meeting on health care in dartmouth, massachusetts. watch this exchange. >> why do you continue to support a nazi policy as obama has expressly supported this policy? why are you supporting it? >> let me -- all right. i will -- when you ask me that question i am going to revert to my ethnic heritage and answer your question with a question. on what planet do you spend most of your time? you want me to answer the question? >> yes. >> yes. you stand there with a picture of the president defaced to look like hitler and compare the effort to increase health care to the nazis. my answer to you is as i said before, it is a tribute to the first amendment that this kind of vile, contemptible nonsense is so freely propagated.

ma'am, trying to have a conversation with you would be like trying to argue with a dining room table. i have no interest in doing it. >> larry: we are now connected with governor dean. you can see a lot of this occurring across the country and comparing the president to hitler and conceptions like that. how did it get to this, howard? >> look, i think this is very complicated and do you really want to talk about this or talk about health care? >> larry: but health care has come under this kind of concept. >> this is nothing to do with health care, larry. this is a group of very angry, frustrated people, well organized, and this kind of anger politics has been going on for 30 years. look. we've had a huge shift in this country as a result of the past election. for the first time more than -- more people under the age of 35 voted than over the age of 65. there are a lot of people who are kind of feeling adrift. they're in a big recession which they didn't cause and they're very angry about that. this is a much bigger deal than health care all this kind of

mass anger. it doesn't have a lot to do with health care. >> larry: have you been listening? we couldn't make a connection because of the weather. >> i could hear everything. >> larry: what are your comments on what was said? >> well, first of all, i always enjoyed bill because he doesn't exaggerate and give the party line so much as some of the other folks i get on the show, so, bill it's great to be on with you again. i think it's true the public option is a form of nationalized government run health care. that's what medicare is. we have 50 million people in the medicare system, a veterans affairs system which is very good so we already have nationalized care. there's already another group of people of which senator frist was one, congress has a socialized health care. you get sick, go downstairs to the doctor, go to walter reed hospital. it's all government run. the question is, who's going to choose? my question is why can't we, given the successes of this national health care system, why can't we let more americans make their own choices? the truth is, not very many

people will actually choose a public option. senator frist talked about the medicare part d which has been very successful. only 6% choose the public option there. but to have the public option, if you can't get into an insurance company, if they cut you off as unfortunately so many of them do, if you get sick, if you move, if you lose your job the public option is always there. a wonderful thing about medicare is they don't charge you any differently whether you're healthy or sick. that's the way the health insurance system should run. >> larry: hold on. let me let senator frist respond. we'll be back right away. >> okay.

>> larry: senator frist, is governor dean right? have a lot of these federal programs worked? >> larry, he said medicare. overall it's worked pretty well. it's a great program and as a physician obviously i had thousands of patients who were in it. he didn't mention the health service though which is one of the most miserable, under

supported, inadequately managed programs and it's a federal health program. or medicaid which has about 35 million people and it's a federal program. it is a federal government program that is a federal state program and he didn't mention that where physicians are getting paid 20% less but are in the private sector. in a state like tennessee people flee from medicaid. only about 40% of the physicians in tennessee have stayed in the program because they are under paid. >> i don't mean to interrupt but in fairness every child, essentially every child in vermont has health insurance because of medicaid so that changes from state to state. >> it's very good and i don't think you would want medicaid to be the program throughout the country today. >> what we did is raised reimbursement rates. you're right about that. in order to make it work. >> that's what happened in tennessee in 1994. we put a universal coverage program in called ten care. you're familiar with it. >> yes. >> we extended coverage. it worked great for about three years. but after about four or five

years, the costs went exactly what you said. you had to start escalating it and it ended up eight years later costing three times both per capita and at the state level it just about drove the state bankrupt. an experiment that didn't work in tennessee, 140,000 people were taken off the rolls a year ago by a democratic governor because it failed. america doesn't want to have an experiment that failed in tennessee to be taken nationally. that's what -- >> we're not talking about that, bill. >> but it's a government program. >> larry: let him speak, governor. >> we've had it for 45 years. >> i'm just saying, you clearly believe the federal government is the answer and you use medicare which is a good program. >> i'm saying you don't mention the indian health service, you don't mention medicaid. >> let him respond. >> i don't think the federal government is necessarily the answer. i think the american people are the answer. i think if you put two choices out there the public and private sector and let the american people choose they'll reform

health care as they see fit. if the public sector program is no good they won't use it just as they haven't used it very much in part d in medicare. if it's great the insurance companies are going to have to start behaving themselves and not culting people off and doing all these terrible things they do to people. let the american people choose. i think the american people deserve to have this choice. >> larry: gentlemen, i'm sorry we're limited in time. we'll do a lot more with both of you. quick question for each. are we going to get a program passed, howard? >> yes. a public option will be included in the final program. it'll be up to the american people to choose whether they want it and the president will sign it in december. >> larry: senator, are we going to get a plan? >> we will have a plan passed in november about $800 billion to insure about 20 million more people. it won't cover everybody. it'll have a public plan, not howard's type, as a backup plan as a fallback option. probably a cooperative type plan. >> larry: one quick question, senator, before we leave. we understand from our crack staff that you took advantage of the cash for clunkers program.

we understand you traded a 1991 chevy suburban for a 2009 prius. >> and in tennessee the prius is for a republican, you don't see a lot of republicans driving a prius but i am going to get 50 miles to the gallon. my 18-year-old suburban is going to have that junk put in it which is going to kill it so i'm very sad but the taxpayer gave me $6,000 to do it so i'm out there driving my prius. >> larry: thank you both. >> imfweet 'm about to do the s i'm getting a ford escape because i like to buy american. >> you got me there. >> larry: howard dean and bill frist going at it. thank you very much. three more doctors coming. congressman ron paul, a doctor. dr. paul song and dr. sanjay gupta write their prescriptions for health care next. up just to get out of bed. then...well... i have to keep winding myself up to deal with the sadness, the loss of interest, the trouble concentrating, the lack of energy. if depression is taking so much out of you,

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>> larry: three more doctors join us. congressman ron paul republican of texas, medical doctor. he was a flight surgeon in the u.s. air force and an ob/gyn in private practice. here in l.a. dr. paul song, radiation oncologist. he supports the president's health care initiative. believes there must be a public option. and in atlanta, our own dr. sanjay gupta, cnn chief medical correspondent, and a practicing neurosurgeon. how will this debate about public access and the like affect you? will public option affect you, sanjay? >> probably not. in fact, the president has said people who have access to private insurance and whose premiums are not a certain percentage above their income won't be eligible for the public option so a lot of people it won't affect. that's really important because there was all this talk about people flooding the public option, not everyone is going to qualify myself included.

you as well, larry. >> larry: dr. song, you favor it do you not? >> yes. i think the big reason is milton freeman who is an economist a lot of conservatives like to quote in 2001 had an essay that basically said the third payor system we have right now was the most cost ineffective system available. but since that time the insurance companies continue to grow. they -- their overall profits have increased by over 400% and the premiums have raised by greater than 87% during that time. i think the big concern is that if we don't have a public option, all you're doing is putting more money into the system that will basically go to the insurance companies without any regulation for patients. >> larry: congressman paul, if you agree something's wrong and you don't like public option, what do you like? >> i like to see a little bit more freedom. most of the time people do say there's problems. nobody's denying that. but, you know, the problem is

that we've had managed care, government manipulation of medical care for 40 years now. so we can hardly say it's the private sector that caused the trouble. i would like to see renewal of a spirit of freedom in this country where we can trust the market but not trust the government because the government doesn't deliver. they've had medicare. it's broke. they have veterans care. it's a lousy system. nobody likes that. people aren't getting taken care of. what do we do? we have rejected the notion of save the church hospital. we wiped them out of business. we have schreinhrin shriner hosf them, who give free care to children and they are having trouble because of inflation and the costs so i think our biggest failure in this debate is we have not analyzed where the problems came from rather than saying go on with more government. >> larry: before we go back to dr. gupta, do you want to respond? >> yes. i have a lot of respect for dr.

paul but one thing i think he is saying is incorrect. the idea that the va system and medicare are failures or not popular are absolutely saying about failures not being popular are false. the rand corporation, a conservative thinktank, recently published a study that showed excellent satisfaction with the va system and the kaiser family foundation showed medicare is run more efficiently with much more dollars going for actual patient car than the private sector. and the other thing i want to touch on is this idea of freedom. we have less freedom when you are told by an insurance company where to go, where to get your treatment, where -- what hospital you need to get seen at. some patients need to drive extra distances because their insurance companies won't let them two to the hospital that's in their own neighborhood. if you have some type of single payer system, patients would be free to go wherever they wanted. and i would also add, if you're really concerned about freedom, then if you're an employee who's stuck in a job that you don't like but you're there strictly because of the health benefits,

if you had some sort of universal system, you could go to take a job anywhere you wanted. >> larry: dr. paul, before we get to sanjay, what do you think of the co-op idea? >> if it's private, it's okay. but a government-mandated co-op won't work. the doctor misinterpreted what i said, because he didn't accept the fact that we've had managed government care. so if he says it's not doing well, then you have to blame managed care, the tax code, tort law, how well people can sell insurance across the borders, inflationary problems. and i did not say medicare didn't work. i said it was broke. you got to admit that. here we are putting another program on the government system. the government, we have $2 trillion worth of debt this year and you think we're going to add this new program and the country's bankrupt. it's not practical at all. >> sanjay, sanjay, where are you in this? >> no one's good at controlling costs here. that's one irrefutable fact.

whether it's the private sector or public sefter. you can't hold up any of these sectors and say, look, this is a good example of how to do this right. it's not the united states. it's around the world that health care costs outpaced inflation than just about every country in the world. this is something we're dealing with as a global society, larry. whether it's people are using technology more, using more prescription drugs, whether it's chronic disease. we spent almost $150 billion on obesity-related diseases in this country alone. health care is expensive. i think that's really at the heart of a lot of this. how exactly you pay for it, who's going to pay for it exactly? i think that's where this debate's really centered. thththh

>> larry: sanjay, can you briefly explain the co-op idea? >> a co-op is not government run, although it may have some government seed money. it is a nonprofit organization that, you know, typically is made up of people who are often members insured, meaning people they want to get health care insurance from a co-op but they're also members of the board of co-op, so they can help determine premiums. they can help determine what sort of services are covered. the way a co-op is successful typically is it's based on scale. if you have hundreds of thousands of people involved in a co-op actually buying into it, you can negotiate prices well and be competitive with the private insurance industry. a house mom in tennessee watching and she's uninsured and wants to get herself and kids insured, she might join a co-op, and it could be cheaper if they

have lots of people involved. but if they don't, it's very hard to compete. >> larry: does that appeal to you? >> i think the problem with that and my study of this, unless you have at least 500,000 people that will form and network, that it's going to be hard to do. particularly in rural areas. what you're seeing more and more in the past seven years is monopoly that's have been formed by insurance companies that make it real hard for any type of negotiating power, and premiums have gone up. so if you can't get 500,000 people together to really put together a good economy of scale, i'm not sure how this is going to work in large parts of our society. >> larry: congressman paul, you're there in the house. where do you think this is going? what do you think we're going to get? >> oh, a little incrementalism. don't think obama's going to get what he wants but we'll have more government and the costs will continue to go up and the medical -- quality of medical care will go down. they put $50 billion in the bill just for surveillance of every single medical transaction, and they have the legislation to control that in washington. so there will be no medical

transaction that isn't controlled electronically and known by the government for so-called monitoring. so it's going to cost $50 billion to try to find out where the waste and fraud is. but this is wasteful and fraudulent. >> larry: sanjay, you look puzzled. >> i guess i was a little confused as to what specifically congressman paul was talking about there. i'm not sure if he's talking about the health i.t. or what, or if he's saying that's a bad idea. my understanding was that was to try and streamline a lot of the unbelievable paperwork. have you primary care doctors who are seeing over 5,000 patients in their clinic. each one of those patients comes with insurance forms and all sorts of other forms to try to streamline that in some way has been one sort of tactic to try to increase the number of primary care doctors. i was just a little confused by what you were talking about. >> okay. let me tell you, the stimulus package gave the authority to the executive branch to set up a computer system to record every medical transaction in the country. now they put $50 billion of seed

money in there for somebody to monitor everything a hospital does, everything a lab does, everything a doctor does, everything a pharmacy does. now, that is not going to be efficient. that is going to cost a lot of money, very confusing and it's going to distort the whole concept. but when the government's in charge, and they want this one payer system, this is socialized medicine. it doesn't work. it fails all the time. some people may get care for a while, but eventually everybody's going to get equal care but equality's going to go down. that's what it's all about. >> larry: but we don't have the best care now, do we, dr. song? >> no, i would argue that no one agrees -- we can all agree that the current system is absolutely broken. and as far as the track record of how government programs work, i think medicare has been in business for 45 years. my own father, who was diagnosed can cancer -- >> but they're broke! >> -- is able to get access to care in a much more timely fashion than my own patients who are coming to me who have

private insurance. >> larry: i will tell what you, guys, we are going to have you all back maybe tomorrow, because this needs a lot more attention than it's getting. and it's getting a lot. good evening, everyone. i'm don lemon. breaking news downgraded but still dangerous. hae hurricane bill is a category 1 storm but it is still a threat to the atlantic seaboard. high winds and huge waves are crashing into east coast beaches tonight. dangerous rich currents closed beaches in some areas tonight and kept lifeguards extremely busy in others. they've had to rescue dozens of people. straight to our jacqui jeras we very latest. jacqui? >> the waves have been incredible today, don. let me get you this right away from our i-reporter. this is from richard and this was taken on the beach in rhode island. the waves were crashing. we had reports anywhere from eight and ten-footers crasng