>> i was going to ask whether you saw a possibility for some republican to, in my mind anyway, get wise and decide that, decide that they want to be the person who is credited with actually passing real health care reform. or whether the pressures are -- >> the pressures are tough, and i think if it happens, it's going to be more than one. >> right. >> you basically -- i shouldn't say you know, who knows how they're going to vote for sure, but it appear that is the main senators, olympia snowe and susan collins are probably going to be -- snowe a little more likely than collins, but are probably going to agree to what most democrats agree to. ..

democratic president has been trying for this for 60 years or more, now has happened and we will come back to fight another day to get the rest of what we want and that gets into the argument about whether you think enduring and successful show -- social changes achieved by a bipartisan efforts or ramming through something you believe in. their arguments and example on both sides. i donau how this one is going to play out. condoleezza rice of the interesting dynamics to watch during the summer. >> what happened to barack obama's plan on bipartisanship? you don't see a lot of that.

>> he is actually gotten the benefit of it. it was mostly about atmospheric, the idea that we are going to tone down the rhetoric and work together. one of the interesting things about the campaign was there were not many substantive differences between the democrats when they were running, and getting to the general election, it was hard to find an issue, setting aside guantanamo and torture, that is the biggest fighting line between the parties where the parties agreed. these were deep ideological differences, on the economy, health care, across the board, and you are seeing that play out. you can have as many coffees and super bowl parties and movie nights at the white house with republicans as you want, but they will not vote for an

$800 billion stimulus plan. the obama team knows that. what they get is credit for trying for being civil. when you are talking about the republican party, which is increasingly a southern, regional conservative party. >> be a thing like democrats, for wrigley, for the past few decades. joining the circular firing squad. >> they need to go through what the republican party went through after goldwater and what the democratic party went through in the 80s, they needed period of reform and renewal. >> who is the leader of the republican party? [laughter] >> there isn't one. i was meeting with john bain, he was very open.

a poll came out, people identify the first one, none of the above is well over 50%. that is the same as democrats in 2001. bonds of leaders are the people who are getting the most air time. newt gingrich and dick cheney and rush limbaugh. and what somebody like john boehner will say they are not on the ballot, they are filling a vacuum. we had a presidential candidate last night who was clearly the last stage of his national career, however long he remains in the senate. the leaders in the house and senate are fairly skilled players, but they're never going to be national spokesman. you have to look around outside

washington to see who is going to grab the mantle. there is no obvious candidate. governor bobby jindal tried to respond to the president, and sarah palin -- [laughter] >> she had a moment in november of last year, she was the second most well-known, most popular politician in the country and has done nothing with it for 7 months. david letterman -- every -- the you hear about sarah palin is about her daughter's or a fight with david letterman or she is on some websites attacking someone else. she is not going to rise to international leadership that

way. some governors -- >> it is okay to have a sigh of relief. [laughter] not that i have any political prejudice. >> if the republican primaries were held 6 months from now, my guess is mitt romney would win. >> then you have the genius of barack obama in appointing the governor of utah to be ambassador to china and thus removing one of his, perhaps, main rivals. >> someone from the west who was calling for a different kind of republican party. john mccue, secretary of the army, jim leach, republican congressman from iowa, national endowment for the -- congressman from illinois, secretary of

transportation, this is from the same thing i am thinking of. our friend rahm emanuel -- >> mid ronny running the campaign around the country, the same candidates to learn, this was his pride and joy, finding the right person to unseat the wrong person. [talking over each other] >> exactly. sacrificing pieces left and right. let's say you were in a ballroom with out any windows talking to a group of people of particular interest in one part of health care reform. what is the best way to communicate with washington these days? how would you advise getting through to people, there's so much information, so many groups trying to get their point across. what is the most effective way.

>> i can't tell you anything you don't already know. especially with individual mets, efforts of congress, the public at large, a story is more than a statistic. that is almost always what breaks through. and you have had great success with your issues in reminding people that this is something everyone is touched by. that is an important way to make the case. in this environment, the other thing i would add, you can make the argument that this is cost-effective, that is also important. >> it is remarkable. if you hear what george said and what the analysts said this morning, it is almost exactly the same thing, which means you

are either all really bright or -- [talking over each other] >> you are all on psychotropic medication. let's wrap up our conversation with a personal perspective. this is the basic place to work where it is friday, lee 2 more working days until monday. >> for me i work on sundays. >> in the white house, we had our share of ups and downs over various issues. can you pick the day that was your best day in the white house? >> i can't do one, i can do three or four. there's nothing like the first day. my second day socked. [laughter] the first day, having the

inaugural and walking into a place i never walked into before in my life and suddenly i was working there, walked up pennsylvania avenue and walked into this office. i was going to put my hand on the wall, i just can't believe this. i was giving one of the all-time worst press conferences in white house history, the degree of difficulty was pretty high. that is one. the second two which are similar to, now it seems so long ago, but in 1993, september 1993, we got birdie israelis and palestinians were prepared to make peace. it had be ratified on the white house lawn. rahm emanuel and i had a huge

team organizing this ceremony. getting yasser arafat to shake hands, similar to me, i was at the center of 2 other things in 1995, was trying, after the disastrous election in 1994, trying to come up with a policy that would preserve affirmative action, worked on acute policy review, the president ended up giving, a precursor to a president obama's race speech, national archives in july and in that was incredibly gratifying. finally, it was the last day of 1995, 1994/1995 were difficult years, our white house was a

very kayak -- very chaotic place. very schizophrenic. we were pursuing 2 different political projects at exactly the same time. what it culminated in was discovering the shutdown in 1995, and clinton sympathized the 2 camps he created in the white house. the fact that i was fighting on pretty much prevailed and it was clear in those final days of 1995 that by standing up the way we did, forcing the republicans to shutdown the government, at both preserve a lot of programs that lot of us cared about for a long time and in -- it ensured clinton's reelection in 1996. i remember walking into the oval office on the last day of that year, clinton was eager please

or angry with me on alternate days that entire year but on that day he gave me credit. that felt good too. >> i want to ask about the worst. that would go on for 3 hours. we are too many years since then, a lot of things have changed for us, family, children, different jobs. but we have faced different kinds of stress. i was wondering, when you recall those days with the president, particularly the bad days, when you think about it now, what is worse? receiving a temper tantrum from the president or one from your daughter? [laughter] >> we are going to leave this program and take you live to chicago, president obama.

[applause] >> thank you so much. thank you. thank you so much. please be seated. you are very kind. thank you. let me begin by thanking nancy for the wonderful introduction. i want to thank dr. joseph heymann, the chair of the board of trustees as well as dr. jeremy lazarists, speaker of the house of delegates, thanks to all of you for bringing me home, even if just for a day. from the moment i took office as

president, the central challenge has been to lift ourselves out the worst recession since world war ii. we have kept extraordinary steps to repair the immediate damage to our economy, and to build a new foundation for lasting and sustained growth. we are here to create new jobs, not freeze our credit markets, stemming the loss of homes and the decline of home values. all of this is important. even as we have made progress, we know that the road to prosperity remains long and difficult. and we also know that one essential step on our journey is to control the spiraling cost of health care in america. in order to do that we need the help of the a am a.

[applause] today, we are spending over $2 trillion a year on health care. almost 50% more on person than the next most costly nation. and yet, i think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower and we aren't any healthier. in fact, citizens in some countries that spend substantially less than we do are actually living longer than we do. make no mistake, the cost of our health care is a threat to our economy. it is an escalating burden on our families and businesses. it is a ticking time bomb for the federal budget and it is not

sustainable for the united states of america. it is unsustainable for americans like a young mother that i that in wisconsin last week who has learned that the breast cancer she thought she had been had spread to her bones, but who is now being forced to spend time worrying about how to cover the $50,000 in medical debts she has already accumulated, worried about future debts that she is going to accumulate, when all she wants to do is spend time with her 2 children and focus on getting well. these are not the worries that a woman like laura should have to face in a nation as wealthy as ours. [applause] stories like laura's are being told by women and men all across this country, by families who have seen out of pocket costs

soar and premiums double over the last decade at a rate 3 times faster than wages. this is forcing americans of all ages to go without checkups or prescriptions that they need. that you know they need. it is creating a situation where a single illness can wipe out a lifetime of savings. our costly health care system is unsustainable for doctors like michael caen in new hampshire, who as he puts it, spend 20% each day supervising a staff, explaining insurance problems to patients, completing authorization forms, writing appeal letters, a routine that he calls disruptive and distracting, giving him less time to do what he became a dr. to do, actually care for his

patients. [applause] small business owners like chris and becky linked are struggling. they always wanted to do right by their workers at their family run marketing firm, but they have recently had to do the unthinkable and lay off a number of employees, layoffs that could have been deferred, they say, if health care costs were not so high. across the country, 1/third of benefits have been reduced, and 1/third have reduced coverage since the early 1990s. our largest companies are suffering as well. a big part of what led general motors and chrysler into trouble in recent decades were the huge costs they racked up providing health care for their workers. costs that made them less profitable and less competitive with automakers around the world. we do not fix our health care system, america may go the way

of gm, paying more, getting less and going broke. when it comes to the cost of our health care, the status quo is unsustainable. [applause] reform is not a luxury, it is a necessity. when i hear people say why have you taken this on? you have all these other problems, i keep reminding people i would love to be able to defer these issues, but weekend. i know there has been much discussion about what reform would cost, and rightly so. this is a test of whether we, democrats and republicans alike, are serious about holding the line on new spending and restoring fiscal discipline. but let there be no doubt, the cost of inaction is greater. if we fail to act -- [applause]

-- if we fail to act, you know this because you see it in your individual practices. if we fail to act, premiums will climb higher, benefits will erode further, the roles of the uninsured will swell to include millions more americans, all of which will affect your practice. if we fail to act, one out of every $5 we air will be spent -- in 30 years will be one out of every 3, a trend that will mean lost jobs, lower take-home pay, shattered businesses and a lower standard of living for all americans. if we fail to act, federal spending and medicaid and medicare will grow over the coming decades by an amount almost equal to the amount our government currently spends on our nation's defense. it will, in fact, eventually grow larger than what our government spends on anything

else today. it is a scenario that will swamp our federal and state budgets and impose a vicious choice of either unprecedented tax hikes or overwhelming deficits or drastic cuts in our federal and state budgets. to say it as plainly as i can, healthcare is the single most important thing we can do for america's long-term fiscal health. that is a fact. that is a fact. it is a fact. the truth is, most people know it is a fact. and yet as clear as it is that our system that the needs reform, reform is not inevitable. there is a sense out there among some, and perhaps some members

who are gathered here today, that as bad as our current system maybe, and it is pretty bad, the devil we know is better than the devil we don't. there is a fear of change, a worry that we may lose what works about our health care system while trying to fix what doesn't. i am here to tell you i understand that fear and i understand the cynicism. there are scars left from past efforts at reform. presidents have called for health care reform for nearly a century. teddy roosevelt called for it, harry truman called for it, richard nixon called for it, jimmy carter called for it, bill clinton called for it. but while significant individual reforms have been made such as medicare, medicaid and the children's health insurance program, efforts at comprehensive reform that covers everyone and bring down costs,

have largely failed. and part of the reason is because different groups involved, doctors, insurance companies, businesses, workers, and others, simply couldn't agree on the need for reform, or what shape it would take. if we are honest, another part of the reason has been fierce opposition field by some interest groups and lobbyists, opposition that has used fear tactics to paint any effort to achieve reform as an attempt to socialized medicine. despite this long history of failure, i am standing here because i think we're in a different time. once thing that different, the senate passed a bill that will protect children from the dangers of smoking, a reform the ama has long championed.

[applause] disorganization went nowhere. when it was proposed decade ago -- i will sign this into law. a [applause] what makes this moment different is that this time, for the first time, stakeholders are lining not against, but in favor of reform. they are coming out, coming together out of recognition that while reform will take everyone in our health care community to do their part, everyone will have to pitch in, ultimately, everybody will benefit. and want to commend the a m a for offering to do your part to curb costs and keep reform. just a week ago you joined of hospitals, labor unions,

insurers, medical device manufacturers and drug companies to do something that would have been unthinkable just a few years ago, you promised to work together to cut national health-care spending by $2 trillion over the next decade relative to what it would have otherwise been. that will bring down costs, that bring down premiums, that is exactly the kind of cooperation we needed we appreciate that very much, thank you. the question is, how do we finish the job. how we permanently bring down costs and make quality, affordable health care available to every single american? that is what i have come to talk about today. we know the load is right for health-care reform, we know that this is a historic opportunity, we have never seen before, and may not see again. but we also know that there are those who will try to scuttle this opportunity no matter what, who will use the same scare

tactics and fear mongering that has worked in the past. who will give warnings about socialized medicine and government takeovers, long lines and ration of care, decisions made by bureaucrats and not doctors, we have heard this all before. because these fears tactics have worked, things have kept getting worse. let's begin by saying this, to you and to the american people. i know that there are millions of americans who are content with their health care coverage. they like their plan, and most importantly, they value their relationship with their dr.. they trust you. that means that no matter how we reform health care, we will keep this promise. to the american people. if you like your doctor, you will be able to keep your dr. period. [applause]

if you like your health care plan, you will be able to keep your health care plan, [applause] no one will take it away. no matter what. my view is that health care reform should be guided by a simple principle, fix what is broken, build on what works. that is what we intend to do. if we do that we can build a health-care system that allows you to be physicians instead of administrators and accountants, a system that gives americans -- [applause] a system that gives americans the best care at the lowest cost, a system that uses up the pressure on businesses and unleashes the promise of our economy, creating hundreds of thousands of jobs, making take-home wages thousands of dollars higher, growing our

economy by tens of billions of dollars more every year. that is how we will stop spending tax dollars to prop up an unsustainable system and start investing those dollars on innovation and advances that will make our health care system and our economy strong. that is what we can do with this opportunity and that is we must do with this moment. the good news is that in some instances, there is already widespread agreement on the steps necessary to make our health care system work better. first, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping. we have already begun to do this with an investment we made as part of our recovery act. it simply doesn't make sense that patients in the twenty-first center still filling out forms with pens on papers. that have to