questions, gordon brown discusses public spending, northern ireland, and proposed changes. nick play criticizes the government's regulatory role in the financial crisis. this is the last session for speaker michael martin, who resigned today in the wake of mp expenses. that is tonight at 9:00 p.m. eastern on c-span. .

>> it has not been scored because the legislative language is not complete. let me give you an example. i am quite sure, there will be a subsidy for small business. that could run billions of dollars. i doubt if the bill itself will go over a billion dollars a year.

$100 billion a year. >> you have a generous subsidy program for [inaudible] >> we have a range. this is a plan that defines how we are going to get affordable, quality medical care to every american. the numbers i can tell you we have had is an outline, and there is a lot of change, it provides a 95% of americans coverage, up to 97%, which is what i am hoping for. i am not being coy, is just that all these things interact. until we agree on the final legislative language, we cannot get a final price. if you want to say 100 billion, then i say a hundred. i'm not going to fight with you. but we do not know yet. after we get hearings next week,

we will know the ability to dial up or dial down. if we to save money, can we cut the small-business exemption? maybe, i do not know politically whether we can. can we raise the amount we pay for children's health care? all those things interact and the truth is we are in this framework and we are one week away from finalizing it. >> people talk about the amount of cost. with that money, you are buying something. on the senate side, they have been struggling with some of the numbers have gotten to achieving the same basic goals you have laid out covering nearly and every one and a dress in long term cost issues and change incentives to change quality. they have been struggling to find a way to do that and keep the price tag below one trillion dollars. my question is do you think

roughly a trillion dollars over 10 years is enough money to achieve those objectives? >> i have no idea what the senate is doing. you have different plans. i know the three committees in the house are in total agreement. we have different jurisdictions in each committee, so energy and commerce will do medicaid which i don't know a lot about their provisions. ways and means will medicare. labor will take care of labor issues. when we finally come together, there will be three bills that will be different only in a jurisdictional areas. then we will meet and i think without much trouble at all, be able to meld those bills into one. i think by the fourth of july recess, you will see a complete bill with costs, with cost

estimates, and that will go -- after the recess we will start to mark up that bill. that is a tough schedule. this is the first weekend the staff will be able to get to bed before 2:00 or 3:00 in the morning. listening to all people -- we have had hearings and input from providers, input from beneficiary groups, every group in town has been giving us their interests. we try to come where we can, accommodate reasonable interests toward getting this bill. north of 95% of every american with an affordable, quality health care program. >> have you had input from republicans? will this be a bipartisan bill? they say it is not. >> yes.

we had a meeting scheduled where we had and 80-vote thing last week. it kept us from meeting, but i met several times with dave camp and we discussed -- we discussed relative problems and we hope next week to meet with them as a group. they have a short outline of their bill as you know. they seem to be getting all the informations from us. they are receiving our 300 or 700 pages. the staffs are working hand in glove. there are differences, obviously, but we are keeping them informed and they are keeping us informed. >> a lot of debate on the cinder path -- the single payer option. will that be part of the bill? >> it's an essential part of the bill. without it, it's impossible to have competition and insure the american people that they have a choice of plans.

nobody trusts the private insurance companies. all they do is figure out how to not give you coverage. private insurance companies spend all kinds -- this guy that just had testimony -- they will support recision. do you know what that is? after you get sick, we will cancel your health insurance. she manna refused to do away with precision -- human refused to do away with recision. if for some reason you do not have insurance through the benefit of c-span that treats -- that serves the public so well, you will have the choice to go pick a plan. a private plan if you like or the public plan. i am sure there will be several plans. >> i would like to follow up on a public plan questions below it. this gets talked about a lot.

the public is lined up against it. the have been vocal about how they [unintelligible] but there is opposition to something resembling what is in the draft bill that you and your colleagues put out friday on the democratic side. are you confident at the end of this process that your bill will attract a majority or nearly all house democrats in spite of the concerns expressed by some of the more conservative members of the party about the public plan? >> there are concerns expressed by the more liberal groups of the party may like to have single payer. there are concerns by the christian scientists who want to do other things. but at the end of the day, if you choose to have competition and choose to have a plan that is dependable and affordable, you cannot do it without having

a public plan there. that creates the competition in a private plan. so there would be a public plan in the bill. will people vote for it? i do not know. who wants to go home in next year's primary and say i vote against plan that provides 30,000 people in my district, and our non-white, most of whom are poor, most of whom are working, if most of whom do not have a way now to get insurance -- i voted against a way to get them into the doctor's office. i don't think that's a vote many people want to make. >> isn't it easier to take if the bill cost a trillion dollars or more and is paid for with tax increases. >> is premature to suggest how the bill will be paid for. let's say it's paid for by cuts

in provider pay. >> can you find a trillion dollars in provider pay? >> that is what we hope to find out. the process we are following is we hope to say let's put a bill out there, which is the first debt and see if it can provide benefits the president has suggested he wants that democrats in the house want. once that is in legislative language, we will have to get the process. it will cost more, if it is a bill i want, it will cost more than we will be able to do. then we will have to figure out, we don't know yet, how we do various pieces and many of them are interrelated. how much do you subsidize? how fast you bring the subsidies then? all these things relate to the cost and our thought was that first we would put the benefits down there and secondly we would get across and adjust as we

must. >> regardless of how you pay for it, democratic leaders have said there would be -- that it would be budget neutral. is that still the way you are headed? >> yes. there is an issue of dr./physician reimbursement that we have to take off the table. then we go to pay-go from there. there's about two hundred $85 billion at the republican's lead buildup. -- there is about $205 billion the republicans let build up. assuming that is off, we are pay go from there. >> that's not -- [unintelligible] >> that means it's not going to be paid for? >> there is no way it would be paid for. it's one of those things that has been postponed and put off every year by the republicans as they went ahead and gave

physicians it an increase without paying for it. it is a bookkeeping entry, let's say the credit cards are going bankrupt -- >> [inaudible] >> if it is done administratively. that's above my pay grade. i'm not sure either, but i would take it. >> we have talked about coverage for the uninsured. i wonder if you elaborate on something president has talked about, which is if how a bill like yours the two are working on, how will it be beneficial for middle-class people who already have health insurance? >> if they like health insurance have, let's say that's 160

million people getting it through their place of employment now, they will keep it. americans don't like to change. if i said all of you in your listening audience, january 1, 2010, your health insurance and and pete stark is bringing you a new plan. there would be a million people ready to mail my height to the capital before. they like what they have. i like medicare. people like lacrosse. -- people like blue cross. if you like what you have, you can keep it. for those people who are afraid they will get laid-off, or the chrysler employees, when they go bankrupt and wipe out their plan, they are the ones who will benefit in the sense that they can now go and get a plan, not an individual plan that may have exemptions or pre-existing conditions or price them out of the market if there is a history

of high blood pressure, that will be gone. they will be go when to get a group rate basically of a plan that will provide in benefits they cannot lose. >> if people like what they have and they will keep it, this -- will this bill to -- will this bill do anything to make the coverage better or less expensive? >> we hope so. that is through the public plan. if the rates are set, we will force the competition. secondly, there will be changes in the insurance laws that will not allow them to medically underwrite. there will be universal pricing. basically there will be protections built then against the private insurance companies ripping people off. private market will become more

fair and consumer friendly. hopefully, with the public plan establishing rates, we will push people to better rates. >> if you like what you have and have an employer-based plan and nothing changes, will you be taxed on that under your plan? >> no. >> where is the money coming from? >> where is what money coming from? >> to pay for this. >> when we get the estimates from the cbo, a good bit of that will come from the reduction in payments. a good bit of it will come through the pay or play issues. the employers who choose not to participate will pay. you will pay, i will pay, everybody who doesn't have a plan will pay something.

even bill lowest income people will pay a little bit of something toward -- even the lowest income people will pay a little bit of something toward the exchange plan for which they can choose any plan in the exchange. >> but you are saying no tax on your current insurance plan? middle-class families will not be taxed as a source of income? >> i'm not sure that middle- class families -- it depends on where you call a tax. if they choose not, they will pay something under the mandate. you call it a tax, i call it a fee. everybody will pay something. employers, employees, providers, we are all in it. >> you are talking about hundreds of billions of dollars worth of coverage of payments to providers.

it includes a public option that would compete with private insurance. you have a pay for play requirement for businesses. it looks like you will wind up with a bill opposed by doctors, hospitals, the insurance industry, and businesses. how you get past in the face of that kind of opposition? >> before you make that as a statement, and that is a statement with which i would not agree, come to the hearings. we will have the next week. here the hospitals, the for- profit hospitals, see what they will say. see with the aarp will say. see what the ama will say. for the ama it is a big improvement in the payment for physicians. it's a marvelous new way to reimburse physicians, even though i did not write it. there are benefits.

plus, there are 40 million-50 million people who are uncompensated, who charity has to take care of, will be putting money into the system because they don't have insurance. -- because they have insurance. i think every provider, even though the per procedure rate may drop, the volume rate and their total revenue increases over the time of the bill. >> i don't want to get stuck on one thing. there are a lot of moving pieces to figure out in terms of the cost. but among the things on the table, are there various kinds of tax increases if so you're looking at? >> no. there is i think and 8% gross

payroll charge to employers. in that bracket. it may be six, and maybe eight. i don't know where the final number comes. there are no other numbers. in terms of what we do, i think everything is on the table. if you are talking about outside the bill, will ways and means committee have to come in? you can find there as many ideas for taxes as members of the ways and means committee. that is completely undecided. people talk about a variety of issues, but i would say there is no consensus. nobody likes to raise taxes. i would be misleading you if i said there's going to be a back door. i am quite sure there will be an

increase for people making more than two hundred $50,000 a year. -- for people making more than two hundred $50,000 a year. -- people making $two and 50,000 per year. >> is a your goal and the think it's attainable to finance the bill at the end of the process without additional taxes? >> i do not know. when you say taxes, we're going off into the issue of income-tax is. when you say within the system, the call pay or play tax or a fee? we think we can do it within the context of the bill.

are we going to have to add 10 cents to the cans of soda pop? people have raised that. my kids would scream. i don't drink enough soda pop that would make a difference, but it makes a lot of money. what i object? but i don't know. 10 cents a can for soda pop, that would make kids a little less punchy and raise a lot of money. all of those things are possible, none of them have been established. that is the second step. the first thing we have to do is decide in this draft bill what will be there. after the hearings, we will hear from providers, the beneficiaries, we will hear a lot of complaints and hopefully a lot of support. then we come back to work, put the bill together and try to

finalize the language, but the final cost and then we will have to revise it again. it is not a simple process. >> you have talked about why providers and doctors might support this bill. why would other businesses support this bill? people home. american workers? >> because a lot of businesses do the right thing. they might have happened healthy employees. a couple of years ago, when everyone was complaining that wal-mart was dumping employees on medicaid, what are they doing now? why? public opinion said let's do it and their employees are happier. even at a time when they have for applicants for every job, it's not exactly a buyer's market. so there are many businesses that want to do the right thing.

i believe that. >> do you think those businesses are represented by lobbyists from washington? >> in d i do. -- indeed i do. there are some of some. who will say what a minute, i can't afford this. i will ask my employees to go when. the boss can take the cadillac plan and kick the other employees out. -- the boss cannot take the cadillac plan and to the other employees out. small businesses like to do this for their employees. the can afford it and hopefully and this plan will be able to. >> you said your own experience with your own illness the sheer luck she see the health industry up close and personal. what did you learn? >> i learned that john hopkins hospital is one of the preeminent medical delivery systems and the country. i had a bout with ammonia that

kept me in the hospital couple of weeks. -- a bout with pneumonia and hospital for a couple weeks. probably cost lacrosse of part of $100,000 and i think them very much. -- it probably cost of lacrosse $100,000 and i thank him very much. had i not had my federal employees plan, i would have been treated quite a bit different. what i am hoping is that we can have centers of excellence like that around the country and you want to be a members -- a member of congress for the federal employees benefit plan which you and the other taxpayers pay for me. i pledged -- i pay a quarter of it. it is a real relief when somebody gets whacked with the bill of over $100,000.20 weeks before they were inaugurating president obama and feeling good and then you start to

coffin had pneumonia and go to the hospital. i have never had pneumonia before. -- you start to cough and had pneumonia. the food was lousy, but the care was fantastic. it was team care. they still don't know what it was. but they are sure i am better and it is evident that the x- rays, the drugs, they look inside your lungs -- it's a complicated and complex time. i'm very thankful they have a good professionals ahead. >> do you worry the regulation that will be part of this bill will stifle the excellence you just referred to? >> absolutely not. it would increase it. the way we would reimburse physicians, we created new concept called but

accountability where we encourage physician groups to come together and be more efficient in delivering care through multidisciplinary physicians and including hospitals. the physicians get to share, the group is to share in the savings and that will be deducted from other reimbursements. we think that is a new step in the reimbursement of physicians that the ama has so far endorsed. >> congressman pete stark, members of the ways and means committee. thank you for joining us. >> go in good health. >> we continue the conversation with a health care reporter for "hill" and a reporter from "cq politics."

>> i would bet over on a trillion dollars on 10 years on this bill despite what the congressman said. they have a large program of subsidies for people to buy insurance. they have a big expansion of medicaid and a lot of improvements to medicare. it is an expensive bill and i think will be over a trillion dollars. they're still struggling with ways to pay for. >> if i could continue that. . that does is substantiated by what's already happening on and send it to -- on the senate side. if the legislation is not the same. they have been communicating with the congressional budget office to figure out how much is going to cost to cover everybody. there are other expenses, but it's safe to say most of the money is going toward expanding coverage to the 40 something million people who cannot have insurance. those scores are coming back more than a trillion dollars. on the cost side, i can't imagine house bill costing less than that.

they may write deeper cuts to medicare and medicaid providers in other areas that would bring down the price tag, but the new spending for the new program is going to do more than a trillion dollars. >> with all that has been happening in the past couple of weeks, has the momentum changed or shifted in any way in terms of health care legislation? >> we cycle earlier this week that said while people still like obama a lot personally, they are starting to get suspicious of his policies. when we get into these questions about how much this bill is going to cost and what people will have to pay for it, that is when you start affecting support. >> i think that's true. the president has tried to emphasize is rhetorically and you could argue in the structure of the plan he campaigned on, which is what the democrats in the house have based their bill on and likewise in the senate, trying to emphasize to middle-

class voters, people have health insurance already that this will be good for you as well. the congressman when into it a little bit earlier on the program, but -- went into it a little bit earlier on the program. during the clinton years, one of the mistakes they made was a focused on the uninsured and not the ensured who want their coverage to be better and premiums to be lower and are out of pocket expenses to be lower. if you cannot persuade his people that this will be good for them, they're going to be against it, especially through one means or another, they're being asked to help to pay to provide coverage to the people. altruism is not a good political strategy. if middle-class voters are being asked to pay a tax on health benefits they get from their employers or attacks on a can of soda or any of these things, and they perceive the money is only going