captions paid for by nbc-universal television this sunday, going for broke on health care reform. after the divisive debate of the summer, the president will detail his plan before a joint session of congress this week. and try to regain control of the debate. while liberals in his party

demand a public option, centurists and republicans oppose it. is there room for compromise? we'll ask the man behind the president's message and new strategy senior adviser david axelrod. then the hard choices and political realities as the president pursues his agenda this fall. health care and the economy, afghanistan and terrorism eight years after the 9/11 attacks. with us, former mayor of new york city and 2008 republican presidential candidate, rudy giuliani. the chairman of the democratic leadership council, former congressman harold ford, new york times columnist, tom friedman and special correspondent for nbc news, tom brokaw. but first, the president's senior adviser, david axelrod is joining us live. welcome back to "meet the press." >> thank you, david. good to be here. >> so here is the state, the landscape the president now faces on health care. a poll this week shows the majority of americans oppose, 51%. republican leaders in the past

few days have been saying if the president is going to speak before congress it is time to hit the reset button and start over. will he? >> well, look, first of all, understand that when people hear the details of where the president wants to go, bringing stability to people who have insurance today and security for them and helping those who don't have insurance get insurance, they support this plan. so the president has an opportunity on wednesday to speak to the nation and the congress on this. i think that he'll in gender great support for where he wants to go. we have been through a long debate, all the ideas are on the table, it is time to bring the strands together and get the job done for the american people here. >> is this his plan that he'll present on wednesday? >> well, i think there are elements -- look, all the ideas are on the table, david. the president set fort principles at the beginning of the discussion at the beginning of the year and now all the ideas are on the table and the president will say we agree on 80% of this, let's do the final 20%. let's get the job done. here's how i think we should do

it. >> if americans are confused, if they think this health care plan is negative, if they are scared by it, some think it is socialism, what's the one thing americans will come away with on wednesday? what will they know about this plan? >> well, i think they will come away with a clear sense of what it is and what it is not. what it is is a plan that will again give more security and stability to people who have insurance today and it will make it easier for those who don't to get -- you said in your open, the president is going for broke. the idea is to keep the american people from going broke as a result of soaring health care costs that have doubled in the last ten years, risen three times the rate of wages. we want to bring security to people who have insurance to so that they are not thrown off insurance if they are sick, if they change or lose their job, they will still have coverage. so people with pre-existing conditions can get insurance. that's what the american people need to know. >> let's talk about ideas on the table. the big one is the so-called public option, a government plan

that would be along side private insurance plans to create competition and drive down costs. this is what the president said back in july about the public option. >> that's why any plan i sign must include an insurance exchange, a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest. and choose what's best for your family. >> does the president stand by that statement? >> you know, he certainly believes that a public option within this exchange would be important. let's -- let's -- >> he said it must be included, david. it must be included. >> he said there must be an exchange where people can get insurance at a competitive price. he believes in competition and choice. the public option is an important tool to help provoke that way. there is in competition. he still believes that. here's the problem, david. if you don't have insurance

today, if you don't have insurance through your employer and you need to get a policy, it costs you three times as much on the average as it would if you had employer coverage. people simply can't afford it. one of the ways -- we want to create a pool in which people who don't have insurance in small businesses can go and get insurance at a competitive price. and a public option would be a valuable tool within that group, that package of plans that would be offered, private and public. >> i just want to be clear here because in his statement he was unequivocal. he said it must be included. a public plan must be included. is he signaling he would be compromiing on that with some level of competition? >> first of all, you have to take the whole statement. he believes the health insurance exchange where people can go, small businesses, people who don't have insurance and get insurance at an affordable price is still essential to any health

reform and he believes a public option would be an important part of that package. he hasn't changed his view. >> this is what the house speaker says, nancy pelosi, she says the following, any real change requires the inclusion of a strong public option to promote competition and bring down costs. if a vigorous public option is not included it would be a major owe victory for the health insurance industry. a bill without a strong public option will not pass the house eliminating the public option would be a major victory for the insurance companies. we have rationed care, increased premiums and denied coverage. does the president agree with the house speaker? >> well, you certainly agree we need competition and choice. we have to have insurance protections for folks who have insurance so they can't do the kinds of things they have done in the past arbitrarily throwing people off their insurance if they have a pre-existing

condition or if they get seriously ill. he agrees with all of that. the idea here is to bring more security and stability to people who have insurance and to help those who don't have insurance get it at a price they can afford. the public option within that exchange is certainly a valuable tool. >> the reality is as a political matter, you cannot get republicans to sign on nor can you get moderate democrats, maybe ten or 12 of them to sign on if the president fights for a public option. true or false? >> look, why don't we let the president speak and make his case and then we can have this discussion. i believe there's an enormous consensus around a broad number of issues to make a great gimps for people who have insurance and people who need insurance and we have to build on that. i think the president will be able to do that on wednesday night and we'll go from there. >> what about the idea of a trigger, which is to say you can introduce a government plan into state if the private insurance market doesn't succeed a driving down prices? does the president think that's an idea worth considering? >> well, i'll let the president address the specifics on wednesday, david, but, again, the goal here is to create competition and choice. there are markets where there are insurance companies that have 90% of the business, states

in this country, so it is very difficult to discipline the insurance companies on price and on the quality of care. competition would do that and give the consumers a better break. he's for promoting competition and choice. >> so a trigger is still possible? >> well, again, i'll let him address this. he believes the public option is a good tool. now, it shouldn't define the whole health care debate, however, the insurance guarantees they are in there for the 160 million who have employer-based coverage are absolutely essential, so that they have the ability to hang on to their insurance if they get seriously ill and not get thrown off. if they have someone in the family with a pre-existing condition, they can get them covered and so on. there's a cap on out-of-pocket expenses, so if you get sick you don't go broke. this is what the health reform will bring to people who don't have insurance today to hold on to the policy that is they have. >> we'll look at the president's political standing over the

course of the summer as the debate raged on. among independent voters, those who delivered the presidency to mr. obama, the numbers have flipped now. since july, his approval rating overall among independent voters down to 43%. did the administration lose control of the health care debate? >> well, look, if this is a difficult issue, david, we have been trying to solve this for decades and the problem has gotten worse as washington ditherred. the reason it is difficult is because it inpyres great passions. we knew that. the president of the united states is not sitting there reading his poll numbers. the numbers he is reading are the 12 million people who have been excluded from insurance in the last few years because of a pre-existing condition. he's reading letters from people who have lost their insurance simply because they became seriously ill. he's worried about the continued doubling every ten years of health care costs and what that means for families and businesses and the government itself. those are the numbers that he cares about. that's what he's focused on and

he believes that if you do the right thing, you solve problems, that the rest will take care of itself. so, you know, we are going to forge forward, get this done. it will be an advancement for the american people and ultimately that will take great dividends politically, but that's not the motivation. solving the problem is what we have to focus on. >> bottom line, what is achievable on health care this year? >> i think we are going to have major reform this year. reform, again, that brings stability of people who have insurance so they are not abused within the insurance system and give the option to -- give the ability to people who don't have insurance to get insurance at a price they can afford. and it brings the overall rate of health care spending down to so that we are not on the unsustainable decline. i believe those things will happen this year. there's a will to do it, the american people want us to do it and we are going to get it done. >> let me ask you about the education speech the president plans to give on tuesday. it created a firestorm of controversy around the country.

he wanted to address students coming back to school, welcome them back, talk about studying, staying in school, personal responsibility, but now school districts are saying, hold on. we want to look at this thing. we may not show it in our classrooms. we don't like the lesson plans that go along with it. it may not go off anywhere near how it was intended. how did you lose control of this? >> well, first of all, we'll be releasing the president's remarks in advance, so everybody can have a chance to evaluate it. he'll say the same thing he's been saying to young people throughout his public life, which is they have control over their own destiny, they have to work hard, they have to study, they have to -- they are the ones that can make something of their own lives. all we can do is give them an opportunity. it is an important message. it is a message about personal responsibility and i would think it would be welcomed across the country, but that's up to -- people will make their own decision about it. >> what happened here? are you surprised at this reaction?

>> well, you know what, i mean, i was -- i was a little bewildered by it because i think it is an important and wholesome message. there's nothing political about it and it's a shame some people have tried to poll it will size it. but when the president speaks, i think people will make their judgment. i think it is important for a president to stand up for that principle of individual responsibility, and i think if your young people -- if he can help one young person, we have nearly a 30% dropout rate this country, if he can persuade one child to stay in school, to keep at it, to make something of their lives, then the whole exercise would be worth it. >> van jones, an adviser to the white house on environmental policy, he resigned overnight because of inflammatory comments he's made over time, including a petition he signed that blamed the government for the 9/11 attacks. was this an issue that got to the president? did he personally order he be

fired? >> absolutely not. this was van jones' own decision. he is internationally known as an advocate for green jobs. and that's the basis for which he was hired. he said in his statement he didn't want his comments to become a distraction from the issue, which is so important for the future of the economy and the communities around the country. and i commend him for making that decision. >> was he the victim of a smear campaign, as he alleged? >> well, look, the political environment is rough. so, you know, these things get magnified, but the bottom line is that he showed his commitment to the cause of creating green jobs in this country by removing himself as a issue. i think that took a great deal of commitment on his part. >> but what the president offended by what he said?

>> i haven't spoken to the president about this. as you know, this thing has bubbled up in the last few days. frankly, my conversation with the president has mostly been about health care, which is where our focus should be right now. >> do you find what he said objectionable? >> well, i haven't read all his comments either, david. i'm focused on how we get health security for all americans, how we get this economy moving in the right direction. we have pulled back from the abyss of a potential collapse and now we have to build for the future and get people back to work. i think those are the things we should be focused on and that's what i'm focused on. >> david, i want to end on a question about the other huge challenge for this administration and this president, afghanistan. this is the washington post from tuesday. this is serious and the crystal is expected to seek more resources, but the white house is weary. will the president will

reluctant to commit more u.s. forces to the war in afghanistan? >> well, look, we have been in afghanistan since 2001 when we were attacked by al qaeda who were posted there. that's why we went. we drifted for a period of years where we had no strategy. the president ordered a strategic review in the winter and we are executing that, but it called for a review, another review after the election. that's where we are. he is going to get general mccrystal's reports and recommendations as well as those from others and make the decision. the main thing is to keep focus on what our mission was there, which was to disable and destroy al qaeda so they don't threaten us any longer. that's the prism through which he'll make his judgments. >> should there be a deadline for troop withdrawal just as senator obama called on the bush administration to get troops out of iraq? is it reasonable to set that deadline to troops in afghanistan? >> well, look, we have a different situation in

afghanistan. afghanistan is actually the place that afghanistan, pakistan, where the folks who attacked us on 9/11 are holed up and plotting against us still. that's a problem that still exists, a threat that still exists, we have to deal with it. so it is a wholly different situation. >> so no deadline? no deadline is appropriate? >> the president will evaluate all the information that's coming to him now. we have a series of benchmarks and review points set up. he'll make the hard judgments that need to be made. >> we'll leave it there. david axelrod, thank you very much. >> okay, david, thanks for having me. straight to the round table here in washington. joining us, harold ford jr. of the chair of the democratic leadership council, rudy giuliani, former mayor of new york city, tom brokaw of nbc news. and tom friedman of "the new york times." let's start with health care. david axelrod spoke about security.

is this a big theme for wednesday night? >> i would think it is. the president needs to clarify what he really does want out of health care in the next year. i'm pretty dialed into this issue and i'm with a lot of american people who have been watching all this. 50% of them say they don't understand what this debate is all about. my guess is that the number is probably closer to 80%. a lot of moderate democrats on the president's side of all this have some real reservations about where they can get to realistically. one of them, kent conrad of north dakota, a principal player in the gang of six is terribly worried about the cost of the public option. it is more than $1 trillion. david axelrod didn't raise that at a time when the country is trying to kick start the economy and people across america are being told to save more money and cut back on their expectations. then they look at the price tag, which goes with t.a.r.p. and stimulus and the bailout of automobiles and it gives them pause about what's achievable. there's no question the american health care system does need to be reformed at several different levels. i think the white house

overstepped at the beginning in not having a clear, simple plan about what we want to achieve and when we want to achieve it. >> harold ford, the question of cost, tom raises a huge issue. the democrats i talked to said, look, you are not forgetting about republicans. you are not going to get moderate republicans unless the price comes down. one of the ways to do that, get off the idea of universal health care. cover fewer people. do you think that's what's going to happen? >> he may have to. brokaw has it about right. he hals to say to the majority of americans who have the health insurance, how will this affect your own choices? will you be able to see the doctor you have seen in the past? many americans with health insurance policy are worried about just that. two, i don't think the president can win over a majority of democrats with a trillion-dollar price tag. hate to say it, we have to make choices here. some of my liberal friends in the congress, my former

colleagues probably are beginning to be disappointed with what the president says in the next night or so. and some of my republican friends who want to reject the president may end up supporting the president because he brings the price tag down, he encourages insurance reform, he insures that children will be covered, and hi says that once the economy gets back on track we'll have a longer conversation about this. i was pleased to hear one thing, choice and competition. the american people understand those terms and they resonate. if he's able to secure your doctor choices today, choice in competition and bring the price tag down, he might not only win a majority of democrats and bring some republicans along as well. >> major giuliani, you heard him say major reform is still achievable this year. can he do it with republicans? >> not if he has the public option. i think he gave up the public option. i was trying to listen carefully to what he was saying, but it sounds like the public option is gone. >> the willing to compromise is what i heard. >> the biggest mistake the

president hasn't done is to put a realistic cost proposal on the table. an april. the realistic thing is that every costs three times as much. a trillion dollars is a low-ball estimate of what this is going to cost. he took off the table medical malpractice reform. big mistake. big mistake if you have a bipartisan solution of this. you take off the table one of the biggest layers in which you can save money and create equity in the system. he took off the table interstate purchase of insurance. that's real competition. now you have 50 states that are competing with each other, you can really bring the cost down. >> is that to cover fewer people? >> if he had done what i was talking about, medical malpractice, interstate, real significant tax reform, maybe he could have achieved universal coverage, but i think he achieved it through subsidies or tax breaks, not through a big government agency trying to run health care for america. >> tom friedman, back in 1993, when you were a mere beat

reporter covering the white house. and 16 years ago -- >> what president was that? . it was president clinton. >> it was president clinton giving a speech on health care. the clinton administration's toughest plan in selling the overall to the american people will be boiling down into a single e vok tif logan white house officials said if they had to distill their message to baumper sticker it would be one word in capital letters, security. first and foremost will be the theme of security, said a president adviser, george stephanopoulos. no matter what happens to you, if you lose your job, if your wife loses her job or the company goes under, your health care will be nationally guaranteed. sounds like we're in the same place. >> that's quite interesting, david. i'm a believer that to name something is to own it. if you can name the issue, you can own the issue. one of the things that has happened -- tom's point, the republicans named this issue.

they named it pulling the plug on grandma. what you saw with axelrod was trying to retake the naming of this issue. security, stability, affordability. that's clearly where they are going to go. but i also want to say one other thing because the president has gotten a lot of criticism for -- and fair enough, rightly so for not being clear about what he wants. but what about the opposition? there's only one thing that works. that's one part of democracy, when you don't have two parties that are really truly honestly trying to solve a problem. when you have one party democracy, in this case, the democrats, if you have to solve this whole problem among democrats, you are going to get the kind of mess, in my view, that you got in the energy climate bill. give president obama 25 centerist republicans in the house that are ready to work the problem. give him ten centerist republicans in the house really to work the problem.

you will see an outcome that serves the american people very quickly. >> why aren't they there? >> he said, yes, let's have a bipartisan solution, but if you take medical malpractice reform off the table, that is a major republican objective, that's gone immediately. you take intrastate purchase of insurance off the table, that's gone immediately. it becomes impossible for most republicans to figure out how you are going to save the money other than pulling the plug on grandma. remember what the president said was this is going to be deficit neutral. some raise in taxes, but basically deficit neutral. how do you reduce a trillion dollars or $750 million, billion in costs without taking services away from people who get services and the people who get the services are senior citizens. the president created the dilemma, he wasn't just not specific about it, the assumptions he made led to the conclusion you have to cut massive numbers of people off. >> what is interesting to me is that the republicans have raised the public option as some kind of monster. half the health care of america is already delivered by the government.

medicare, medicaid, veterans health care. the federal employees health program is government-run. >> that's part of the problem. part of the problem is half of it is already in the hands of one massive monopoly. you make that monopoly greater and destroy private insurance. same as the anti-trust law. if one company becomes so large and wipes out all the competitors, if that company is the government, which right now threatens to wipe out all his competitors, you ask 40 million people to get private insurance. >> people under the government plans are generally government employees, number one. number two, the cost of private insurance, i would go with you, mr. mayor. i think an overwhelming number of americans knows in the veterans program want some improvement, but -- private health insurance is going double the rate of public insurance policy has gone up, number one. number two, the president from the outset, we can be critical of the way he went about doing health care, but you cannot condemn him for reaching out to the republicans.

what did grassley do? he went home and labelled the bill. we had the senator from south carolina. we stop obama here. we stop everything he stands for. mr. mayor, it is unfair. i appreciate your talk about fiscal responsibility now, but you didn't say a word about the tax cuts, the $1 trillion tax cuts and how to pay for it. i didn't say a word about the trillion dollars medicare drug hill and how to pay for it. nothing about the trillion dollars for the war. at least the president said i'm going to pay for it. for you to be critical -- be consistent. >> the reality is you can't tell me you are going to do a bipartisan proposal and take off two of the major things i want to see compromised. >> but that is saying to republicans to get the code word, that's saying to republicans to forget the way you look at it. we are going to do it my way. let's compromise. >> we'll get a break in here. much more on the political fallout of this and other topics when we come back with the round table. we'll also talk about afghanistan and the war on

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