from nbc news in washington, this is "meet the press with david gregory." this sunday -- the august heat over health care. >> one day god's going to stand before you and he's going to judge you and the rest of your damn cronies up on the hill. >> the president tries to regain control of the debate. >> i need you to keep knocking on doors, talking to your neighbo neighbors, spread the facts, fight against the fear. >> this morning, a special hour-long discussion, making sense of health care. what are the issues at the center of the debate? how would reform affect your health care? separating fact from fiction in a fight. and what does it mean politically for president obama?

with us -- former house majority leader republican dick armey, now the head of freedomwork, a major organizer of protesters of town hall meetings. republican senator tom coburn of oklahoma, a member on health, educati education, labor, and pension. former senate majority leader democrat tom daschle, informal advisor to the white house, and author of "critical -- what we can do about the health care crisis". and rachael maddow, host of msnbc's "the rachael maddow show." plus, additional per specificives from around the country. bruce johnson, executive vice president of the chamber of commerce, and democratic governor bill ritter of colorado. but first, making sense of health care reform for the entire hour. welcome to our panel here.

you know, the president wrote on the op-ed page is that this is a great debate for america right now. we want a civil and informative debate which is what i think we'll have this morning. i want to talk in a few minutes about three major areas of the health care debate. i want to talk about the anger, emotion, fear that's out there. let me begin with you -- all of the town halls have to alter or derail the chance of reform this year? >> it's a good thing. it's drawn greater focus on the issue. president obama out there in places all over the country talking and setting the record straight. these are emotional issues. this is the noise of democracy. you ask 300 people what they should do about health care, you get a lot of good ideas. some are emotional. the bottom line is this helps a lot. >> doesn't hurt -- you really believe it doesn't hurt? >> obviously, the misinformation

hurts. obviously, if you provoke fear, that hurts. but the opportunity that we have to set the record straight, to keep the focus on the issues, to recognize there are millions of people are out there who don't have health care, to recognize there are so many people out there left -- 12 million people have been discriminated against because they have an illness. huge cost problems, huge problems. this is the opportunity to lay the record straight, put the focus where it belongs and get this job done for the first time in 70 years. >> the tone of the debate -- there are death threats to members of congress, nazi references to the members of congress and the president. the president being called a nazi. the reform effort being called nazi like. congress being called the same. and this image outside of portsmith, new hampshire, a town hall event. this man with a gun strapped to

his leg with this sign -- time to water the tree of liberty, a reference to the thomas jefferson quote, the tree of liberty must be watered from time to time with the blood of patriots. that's been the motto for violence. timmy mcveigh, the oklahoma city bomber had that quote on his shirt the day the murrah building was bombed and 168 people were killed. when this element comes out in larger numbers because of this debate, what troubles you about that? >> i'm troubled any time when we stop having confidence in our government. but we've earned it. this debate isn't about health care. health care is the symptom. the debate is an uncontrolled federal government that's going to run up 50% of everything we're spedding this year. we're borrowing from the next generation. >> i want to stop you there. i'm talking about the tone. i'm talking about violence against the government. >> but the tone is based on fear or loss control of their own government. what is the genesis behind

people going to such extreme statements? what is it? we have lost the confidence, to a certain degree. much worse than when tom was the leader of the senate. we have -- we have raised the question of whether or not we're legitimately thinking about the american people and the long-term best interests. that's the question. the volume of all of the senators didn't go up based on health care. the mail volume went up when we started spending away our future indiscriminately -- that's not republican or democrat -- that's been a problem for years. but it's exacerbated now we're in this financial situation. >> freedomworks organization, getting a lot of people out for the protest. do you bear some responsibility for the tone of the debate? >> not whatsoever. not when you see the kind of extreme thing you just saw.

you know, i had my differences with president bush, george w. bush, no doubt about it. they were aware of that. move-on.org ran the ads that compared president bush with adolf hitler, i thought it was despicable they did it. >> move-on.org did -- >> you're going to get the chance to talk. i looked at move-on.org. it was a horrible thing. it was horrible to see this. but i haven't had town hall meetings since 1984. there are always a lot of colorful people who show up at town hall meetings, a lot of people with a lot of statements. when freedomworks encourages people to go to town hall meetings, we encourage them to go and make their points clearly, assertively, and with good manners. i don't know who these folks are. >> you say good manners. the house leader nancy pelosi

wrote an op-ed when she said drowning out opposing views is un-american. drowning out the fact is how we failed at this effort for many decades. un-american, rachael? >> i think any time you're trying to stop discussion, i think that's un-american. i take issue with the idea that the government has done anything to earn the violence threats we've seen. >> it's indicative of the loss of confidence. people are afraid and they do things they normally wouldn't do. we have undermined by our actions, whether it be ear marking and corruption and disconnection between integrity and character and what we do and what the people expect. and these are just symptoms of a lack of confidence for what we do. >> whether or not the government has acted in a way that you feel is defensible, i don't think that the government has done anything to earn, in your words,

the threat of the blood of tie rarnts. that's what the man did with the gun strapped to his leg in new hampshire. i also don't think there is an equivalent between what move-on.org has done and the comparisons to the president and hitler we've seen so often in this debate. some of the major organizations are organized in this event. americans for prosperity, a group that as some similarities to freedomworks but is a different group. they've had speakers around the country, not only comparing health care reform to hitler but poll pot and stalin saying put the fear in your leaders in congress. i don't think the government has done that. >> i don't know what they've done -- put the fire in their bunker, i don't want it on my bunker. the fact of the matter is, we've had nancy pelosi stand up and be barbaric, raucous and vocal group saying i love disrupters.

the speaker of the house saying "i love disrupters." there's been provocation by officially elected people. and that's not a happy thing. move-on.org has been a very aggressive administration. what we should have is people show up, answer the very difficult questions and for people to be well mannered. i'd like to go on to something before -- >> you have to admit the notion that people are being well mannered is not happening. >> i'm appalled by what i see too by some people. >> so the nazi imagery and all that -- you repudiate it? >> that's no place in the debate? >> i repudiated it when move-on.org did it to george bush. did anyone here repudiate it? we said it's all right. but it's not. >> your organization is a member

of the coalition called the tea party patriots health carefree dom coalition partner. that's what americans for prosperity is. if you go to their website, the front page of the website, the top item is a video showing the violence at the town hall in tam tampa, florida, essentially promoting that that that was a good thing that happened. it showed what the health carefree dom coalition wants to have done in the health care debate. freedomworks is part of that coalition. you can say you denounce it, but the organization you head is part of it. >> listen, this -- one of the fascinating things, by the way, about that tea party movement is it is an enormously impressive grassroots uprising across the country, loosely affiliated people. and it's probably 100, 200 different websites by different people. somebody in oregon has one, somebody in illinois. we had a situation with somebody in connecticut that we did not

know and who did not know us put out something that was mischaracterized and attributed to us by somebody who obviously didn't have enough diligence in their ability to do their research to get their facts straight. these things happen. people get blamed for what other people do. that espouses further aggravation. especially when you talk about elected officials. people having privilege of a news shows under the license granted by the federal government. they should at least have the adult discipline to get the facts correct. >> are you a member of the tea party coalition -- >> i'm a member of freedomworks who works for many people who fight for and argue on what have of individual inaccuraci inaccuracies, myths in the debate. what dominated this week is the idea of death panels being part of the government reform effort. that the government would countenance euthanasia against

older americans close to death. chuck grassley from iowa who was negotiating health care reform on the senate finance committee said this during an event on wednesday -- a house bill there's counseling for in delight. and from that standpoint, you have every right to fear. you -- you shouldn't have constantly at the end of life, you ought to have counseling 20 years before you're going to die. we should not have a government program that determines you're going to pull the plug on grandma. >> pull the plug on grandma. that's not part of this debate? it's not in the bill, senator? >> david, it's hyp ee's hypobol mongering, it's the anxiety and fear that people have tide. -- today. it's amazing to me that a good idea that many of us would agree with that there ought to be some consultation, some opportunity to talk about those things

outside of the moment when you're at your most emoti emoti vulnerable state in your life. johnny isaacson, a member of the health committee, actually offered it as a mandatory requirement, that there be a mandatory counseling. it turns out, it was -- they persuaded him to offer it as a voluntary measure. but that voluntary counseling that is something we ought to be encouraging, not discouraging. >> the prescription drug bill that the republican congress passed in 2003 had a similar provision, did it not? >> i don't know. i wasn't in congress in 2003 so i'm not familiar with that. but i was add mately opposed to the prescription drug bill because it added $10 trillion to our grand kids' debt. look, the idea that we ought to talk about our future help and our family and what we want -- it's a good idea. it's legitimate. what is not legitimate is having

government weigh in on it. it's intensely personally. your health care, your plans, your family. there is no role for government in that. and where we've seen a role -- and this happens all the time which goes to one of the things that never gets talked about in health care, is we have the statements, livings will, we have the people who have made those very types of decisions. and then, because they've made them, but because of the malpractice situation and liability, they're ignored. and we still intubate and put people on ventilators that never wanted it because a family member threatens through a situation even though you have that end of life counseling there. so the -- we need to get down to the basics of what's really wrong with health care and there's a lot. it's not the people who are complaining about it. it's not the people who are debating it. the fact is everybody wants to see some change. republicans want to see change. we just want to get there in a different way. in the fact is, we had a way too

expensive health care system -- it is one of the best in the world. and we ought to think about changing it. >> you want a reasonable debate. >> absolutely. >> you said, however, this is a headline from the washington times, july 16 -- coburn -- dem health plan will kill america. that's reasonable? >> it is reasonable. i practice medicine almost on a daily basis. i see patients. how many involved in this debate are in the health care system? very few. the fact is if you create a comparative effectiveness board, which there's no question 70% of the people it will help. and it will help to control some costs. but 30% of the people, it's going to hurt because we're not -- we're not going to use -- >> you can't -- you can't make that assertion. >> we can. >> look at the system -- >> recommendation. mayo clinic? 30% of the people at mayo clinic are disadvantaged because they

have comparative -- >> they do not. >> they don't have it -- >> yes, they do. >> the best institutions in the country, david, use comparative effectiveness and everybody benefits. and jim's point about the fact that we can't have government involved with some kind of consultation, government runs the medicare program. the medicare program covers virtually every senior in the country today. if you're not going to have the government do it through medicare, who is going to do it? you can't say go find a way to do it. we know the status quo wiis a disaster. jim is arguing with -- >> you mean tom. >> you mean tom -- >> jim's my brother. i want to bring in governor bill ritter, the governor, of course, of colorado. he was with the president doing a town hall last evening in grand junction, colorado. governor, i want to ask you about the president's effectiveness right now and whether he's winning this argument. that's certainly been a

motivation for him being around the country doing his own town halls. this is the gallup poll on the president's handling of the health care crisis. approval of 43%. disapproval of 49%. those are the similar numbers that president clinton had back in 1993, 1994. what do you think he's doing wrong? >> i don't think you can blame the president for this. a good part of this has to do with how you open the show. david, it's partisan wrangling. maybe that's too nice of a word for what's been happening at the town hall meetings. capturing the attention. looking where the counseling is. where the swords are crossed. they're not getting all of the information about this. my time as the president and my time at the town hall meeting leads me to believe people who hear me wondering about it. hearing me speak about what it doesn't entail, they're impressed by how -- by his vision and how we go forward with respect to health care

reform. it was a very good town hall meeting. he took questions from people who i would say disagreed with him coming in to it. maybe he disagreed with them as they all left. but i would also say for those folks who are sort of on the bubble that we have to respect that we need to do this and he has a vision for doing it. >> governor ritter, what do you hear most? rocky mountain west, a key vote for the country. the president won their vote in the election last year. it's a real concern with the role of government, the mounting debt that could be associated with the health care plan? what are you hearing? >> that's the right point of it. i think what i hear is the health care system is broken. while there is this concern about a mounting deficit, there's also a real concern that the fact that the system is broken. people view it as unsustainable. people don't view their health plan as something that's really secure for them. they could lose it tomorrow. if the employer takes it away or

they lose their job, they want it fixed. so they want it fixed, but they're also concerned about federal spending, the deficit. and they want to know can you reform health care and at the same time do what's necessary to control federal spending or to bring down the deficit. the president actually addressed this yesterday in the town hall meeting in a very effective way. >> governor ritter, always good to talk to you. rachael maddow, does the president fear some responsibility it will undermine his credibility when he claims -- if you like your insurance, you can keep your insurance. a lot of people have said, not really. employers could drop people from insurance if they wanted to move people to a public plan if that existed. it may be an aspiration, but they can't guarantee it. >> what he has suggested would guarantee it. i think what's happening, where the president has more responsibility is to give the congress more direction. i find it strange that the american people have decided there will be a lot more democrats in congress.

democrats have a huge 60-seat majority in the senate. they have majorities on every other committee today. max baucus a member of the finance committee has a key role, they won't have the whole committee do it. three democrats and three republicans making the decision. one of the republicans is going around country and giving out glen beck's book and saying the plan will pull the plug on grandma -- senator grassley. for them to give up the majority deciding the way it's going to pass, i think there's a reason the democrats have a 60% majority. >> the political tactics involved here. he wrote the president and the team are receiving lots of advice from allies frustrated that the white house has not been more aggressive in firing back at reform critics and in attacking a strategy they believe is designed to bring down obama's presidency. do you think that's what

conservatives have in their gun sites right now? >> absolutely not. this is the huge -- the largest government takeover in the history of the country, 1/6 of the entire economy -- and it's the most intimate. real people on the streets today, are saying am i going to in fact end up with a decision regarding how my liver infection is going to be treated by somebody in a bureaucracy with a degree in sociology. if you read the bill, which is a frightening -- i was reading it again yesterday. it's unnerving to read the bill because of the growth of bureaucracy. and the idea that -- i'll give you an example. i got in contact the other day. a fellow got in touch with me. he's been on social security disability for about seven years. and all of a sudden, out of the blue, he isn't -- he receives a letter saying we're taking you off of disability. you need to send us $21,000.

he doesn't have $21,000. he can't figure out who made the decision. he calls the congressman. the congressman says, i don't know what i can do about that. he tries to call the senator, he can't get a call through. he calls me, for crying out loud. this guy doesn't live in texas. >> that argument suggests that dick obviously enjoys the status quo. the status quo eliminates 50 million of people from insurance today, 12 million because they're discriminated against with disabilities. 18,000 people last year died because they didn't have insurance. that's the status quo. rather than have government do it, dick would rather have the insurance companies do it. that's who's doing it now. jon stewart and others call it the american lottery. you send in your forms and hope you get something back from the insurance companies. that, to me, is why the american people want to see change. they want to see change because of the costs, they want to see change because they understand that employment is going down in this country. they want to see change because so many people are not covered. >> let's see -- >> there's no indicator anywhere

in this country that the quality of medicine has declined. >> there's -- >> that's not true. >> that's absolutely true. >> where we rank in life expectancy -- >> life expectancy is not an indicator when you have a society that's built -- >> it's not an indicator? >> let me finish, tom. we talk about neonatal mortality. where's the neonatal mortality? it's not in the private insurance plans -- it's in medicaid. the government-run program is failing us in terms of neonatal mortality yet we use as an indicator neonatal mortality say we need more government rather than less. let me finish. let me finish. the very fact that the president would suggest that doctors take tonsils out to make money rather than because it's an indicated procedure is ludicrous. most people who get a referral to an ent have only had one

opinion that they're worried. >> quick comment -- >> out of 19 industrialized countries, we rank 19th overall, world health organization listed us 37, just below costa rica and above slovenia. you can rationalize all you want. the fact is the quality in this country -- islands of excellence but a sea of mediocrity. >> let me get in here. we're going to come back and talk about the three most contentious areas. we'll get through all of them to debate it. come back, more of the discussion after a brief break. soon there will be 1 trillion connected devices... in the world. can you hear them? food is talking to store shelves. cargo containers are talking to supply chains. power lines are talking to the grid. now that's smart. systems that allow carrots to tell truck drivers how fresh they are. roads alert cars about traffic patterns. cars alert mechanics before they break down. when things communicate... systems connect. when systems connect... the world gets smarter.

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we are back to continue our discussion on health care take armey, rachael maddow, tom daschle and tom coburn. the three most contentious issues in the debate. we're going to get to it all. there's a lot more to discuss even than just this. the last one is funding. how will the performance be expensive, $50 million without insurance. a price tag of $1 trillion to be able to do that.

the chairman of the house ways and means committee. congressman, welcome. i want to take you to montana. this is a town hall debate that the president had. listen to randy rathy, what he had to say. >> max baucus, our senator, has been locked up in a dark room there for months now trying to come up with some money to pay for these programs and we keep getting the bull. that's all we get is bull. you can't tell us how you're going to pay for this. you're saving here, you're saving over there. going to take a little money there, take a little money there. you have no money. the only way to get that money is to raise our taxes. you said you wouldn't. max baucus says he doesn't want to put a bill out that will. but that's the only way you can do that. >> congressman, isn't he right? >> i can't believe that -- that our democracy is so fragile that people have no answer to a very serious problem would just try to create animosity and hatred

rather than try to sit down and first find out what is the problem, how costly is it and what does it take in order to stop it. there's no question that almost everyone listening to this show have known some horrible story where someone has lost their home, their job, their -- the -- as a result of not being able to -- being able to cope with the costs of health care. it's getting worse. more and more people are losing health insurance and the people who have it don't have it. we're going to have to pay for it. but it's going to be less in doing something right now than if we just let these things turn over -- >> how are you going to pay for it? you're for a surtax. is that going to work in the senate, congressman? >> first of all, when we start talking about how to pay for it, you have to stop the hemorrhage. we can do that. much of the thing that we're doing out there is the cause of the problem we're in can be

taken care of by having the right procedures given to the right people and making certain that we cut down health care. and when the people of the industry can tell you that they can save tens of trillions of dollars by working with the president, then you know that we can resolve most of this by stopping what we're doing wrong. yes, it does take some money. >> i want to focus on that. it does take some money. >> let's talk -- >> my question to you -- can the surtax survive in the senate? you want to raise $544 billion of this price tag with surtax on the wealthy. can that prevail in the senate? >> i don't know what can prevail in the senate. all i know is this -- people are trying to use hatred as a substitute and discussion. we should be talking about how much does it cost. is it costing too much. what is the senate going to do? what is the house going to do? when people are paid to work up

on town hall meetings, it's clear they're not looking for a solution. they're looking for a political out out of this serious question. >> congressman -- >> so we should be talking with the senate. we should be talking to them now. they don't even have a bill. >> congressman, if you look at the longer-term picture here, beyond 2019, the ten-year window for this plan, the congressional budget office said the office will go up at suchl a rate that tax increases and savings cannot keep pace and the deficit will rise. can the president keep his promise to not race taxes on those making $250,000 or less? >> yes, he can. and he will. the problem that we have is what do you score? what does the congressional budget office count as being a savings? people, what happened in the last few years of someone's life, is it the overcharging that pharmaceuticals and doctors have? is it the number of people that go in and out of hospitals that we don't reward those who do the

right thing? these are questions that we should be talking about. but what is happening now is they're building up of hatred. and i'm so surprised that our churches and our synagogues and our mosques are not coming here and saying that what the right thing done by poor folks who can afford health care, working people who don't have health care and should have it and people who do have health plans that really are hemorrhaging in increases and kos. this is not a republican or democratic issue. this is a american humane issue. we're not dealing with it with these types of town hall meetings. >> congressman rangel, always good to have you. senator daschle, the savings the president talked about, there can be tax hikes on the rich. we talked about 2/3 of the program being paid for by other kinds of savings in health care. is that realistic or theoretical savings options? >> keep in mind, in the next ten years, the country will spend $35 trillion on health care.

that's the projection today. that $35 trillion dwarfs the $1 trillion of up front costs we have to construct in order to put this new infrastructure in place, including for the first time covering 50 million new americans insured. i don't think there's any question that we can find within $25 trillion the savings necessary to come up with part of the cost of the infrastructure. i think the president's plan is about right. the balance between revenue on one side and cutting costs on the other. >> i think the policy about what we do makes a big difference on how much we have to spend and how much savings we get. one of the reasons the liberals and democrats are not in favor of the strong option that the costs are lower. we weigh so many billions of dollars on the administrative costs of having the system we have now. you compare the industrialized country that doesn't have the

reliance on thousands of insurance companies, we're wasting a lot of money moving paper around. how professionals how frustrated they are on the paperwork. >> are taxes going to go up? >> of course taxes are going to go up. one of the things about how to pay for it that i think is really causing a lot of distress and anxiety among seniors, i want to observe a couple in the last couple of weeks, seniors today are captured by medicare. they have no choice. they can't get out of it if they want to without being punished by the government. and it's got $46 trillion worth of unfunded liability. they're seeing the baby-boomers coming in. they're scared to death for themselves right now and this bill says they're going to cut medicare by $500 billion. and the senior goes to the town hall meeting and he's frightened by this. and he says, leave your hands off my medicare.

he's mocked by people in the news and he's made a joke by the president of the united states, it's no wonder these folks are frustrated and angry. they're scared to death of what the government is going to do. >> do you really think there's a major uprising of seniors wanting to get out of medicare. you're suing for your right personally to get out of medicare. is that the problem that seniors hate medicare and they want out? >> i didn't say that. i was talking to my minister the other day. my minister said, dick, i'm so fortunate i'm in medicare. i said, bless you, my friend, that you get to be in it if you choose to be so. but give a government program and you let me choose to be in and choose to be out, that's generosity. if you force me in irrespective of my desires, that's tyranny. medicare's $46 million in the red with no idea how we're going to pay for it, why do we not let people who don't want to be in out? >> that's a -- this is a really

important point. >> this defies logic. >> the anti-health care reform lobby thinks health care is tyranny. you said in 1995 that medicare is a program i would have no part of in a free world. you said in 2002, we're going to have to bite the bullet on social security and phase it out. >> it's exactly what i'm talking about. >> medicare -- >> this is your -- >> too the medicare law that was written -- >> important to understand. >> the medicare law that was written by the chairman of the ways and means committee and the chief lobbyists of the blue cross/blue shield voted on in amendment as an amendment to social security first imposes severe sanctions on physicians and medical providers that don't comply with the requirement. and it says to seniors, at the age of 65, you can no longer buy the insurance that you bought prior to '65. and now by virtue of an internal memo, not a regulation, not a

law, they tell seniors today, if you don't sign up for medicare, you lose your social security. you tell me what -- what that has to do with anybody's notion of liberty and freedom? >> okay -- >> even if -- >> i want to move on -- congressman! >> one final point. >> even in canada just last month the supreme court of canada said -- ruled that the canadian government cannot deny the canadika nad yacanadian cit to buy private insurance. >> another area of contention, as if that's not contentious enough -- is the issue of public option. this is the idea. we're still talking about overall costs. public option in a moment. the overall sense of cost. senator daschle, is it appropriate for the president to be singling out the insurance companies when he's not also talking about hospitals -- hospitals that are losing money over medicare and medicaid are

then charging people with health care insurance more for the costs of the procedures, the costs being passed on to the consumers. shouldn't we be talking to hospitals as well as the insurance companies? >> you listen to the town hall meetings, every one of the different stake holders come in to the debate. they should. there are big concerns with regard to quality across the board. but when you talk about insurance, you talk about too many people today who are the victims of our current system, who, above and beyond anything else want to have the confidence in knowing they can buy insurance. they want to know they're not going to be prohibited because they have a pre-existing condition. they want to know they can afford the premiums. they want to know they're not one illness away from bankruptcy. they want to know we have more stability and more ability to deal with the problems we're facing in the health care system through and in part of the health care system we create. that's what the president is advocating. >> what about the specific point about hospitals versus the insurance companies? >> obviously, he's talking about

hospitals, he's talking about the need for comparative effectiveness. he's talking about the need for major change in the way we deliver health care. chronic care management and recognizing the importance of prevention. many of the things that the hospitals are going to have to be a part of as well. it's imperative if you look at the entire context of the deb e debate. he's going to single out insurance companies, doctors, drug companies. he's done all of that. but i think everybody, at least so far, is of a mind that we've got to fix this system because of status quo is unacceptable. >> isn't it a big area of personal responsibility. you talk about health care costs. there's no consumer sentiment involved here. it's not like buying a car when you know how much it costs and what it means to the bottom line. three-quarters of americans get benefits from their employers. most people don't pay the bills for their health care. they don't know what it costs. this is an average health care

premiums. $12,000 worth of premiums. your employer pays $9300 of that. the individual worker pays $3300 of it. people don't know what the costs are. >> there's a disconnect, david. there's no question. therefore, we don't have a transparent market for price and quality, which i think everybody would like to see. we would like to see it reconnected so we have some personal responsibility. the proposals before us really aren't reformed, though. they're not the same. rachael mentioned how efficient medicare is, it's not. the fraud rate is 25%. if you add the overhead to fraud rate, they're seven points above what the average 10-k report for the profit for private insurance. they have a different motivation. the point is, any bill that comes through that increases costs is a failure. because we spend too much today. we ought to be getting more efficiency, in other words,

reconnect that economic. we have one, i think tom and i think agree with it, we have way too much to go to prevent somebody from getting sick and help somebody from getting well. how do you redirect that? you can redirect it with a government and redirect it by reconnecting as you suggest the economic consideration of an individual. we have a bill -- several senators, that say $70 billion the first ten years and well close to $1 trillion plus $960 million for the state in terms of doing just now. in other words, we take medicaid and put it in to private care where we're really competing. >> in our remaining time here, i want everybody to be heard on this. i want to get to the final area that's so contentious. the idea of a public plan. the public plan, government plan to be sponsoring the consumer choices alongside a private plan. senator daschle, the open to reform without a public plan.

kathleen se beil yus saying he would be open to a cooperative rather than a public plan. >> if you want to control costs most effectively. if you want to make sure there's adequate competition, keep the insurance companies accountable. if you want to do everything possible to give the american people as much choice as possible, if you want to do all of that in the public plan -- >> would the president live without it? >> i can't speak for the president. all i know is he wants to get the bill done. he wants to go as far as he can because he's advocated at every single stop. but whether or not he's there at the end of the day is something only congress -- >> public option competition or an unfair fight. >> it's an unfair fight. you read the bill. they built in taxes, regulations, administration, fines, penalties. that discouraged the private option. but we have 1300 private insurance companies in america. if you want the competition in

the purchase of insurance, listen to the congressman shaddock of arizona. why can't i live in texas and buy my insurance in arizona. if you live in michigan, you can't buy a car made in alabama. it would be silly. what you have now -- but the fact of the matter is, let us have fair competition like freedom to choose among the 1300 already existing private companies. the government is what prevents that from happening. >> i don't know what state in the country has secretly more awesome health care than every other state in the country. i feel like every state in the country is in the same pickle when it comes to out-of-control costs, dissatisfied coverage and a huge number of uninsured people. it's not going to be made better by buying across state lines. i think private insurance companies would be really, really, really excited if what came out of this debate was a

requirement that americans buy more pvate insurance, that they were dissatisfied with that allows them to be dropped for pre-existing conditions and all the other things they do. there needs to be serious reforms of private insurance and the only way to get that is to have a public option that people can choose if private insurance continues not to serve our needs as a country. >> the executive vice president of the chamber of congress. they have a perspective on this. your organization and chamber has been buying out of the public option. the cbo, the congressional budget office did a study that in fact the number of those in private health care plans would go up if it's a public option. and people would choose a puck lick option, which is far fewer than opponents say would be the case. >> we do oppose the public option in part because of what you touched on earlier. we have a long history of medicare and medicaid underreimbursing doctors and hospitals, 70% of what private payers do. those unreimbursements are

shifted back to the premium payers, the companies in america providing the coverage to a vast majority of americans, over 160 million of them. with respect to the need for insurance reform and health care reform, the business community is one of the strongest proponents. and we have been for several years. we ran, in fact, ads last year calling for reform. and more choices and bending the cost curve on health care. but, when you under re-imburse, it's cost shifted and you have doctors practicing defensive medicine out of fear of liability, we're correcting the system. the public plan is an uneven playing field. destabilize private insurance and independent researchers and health care analytically as well as cbo have expressed concerns that many employees can migrate away from employer-sponsored cover because of the cost

initially with federal government backstopping. >> thank you very much. senator daschle? >> the basic question, are we building the new system for the american people? that's the key question. how will they be better served? public option for medicare part d today. 60% of the people participate. there's a very small percentage of people who for all kinds of reasons have chosen the public plan when it comes to drugs. the argument is interesting -- this is going to be so popular that people are going to leave the private sector and go to the public sector. that's what choice is all about. but we've got to make sure we level the playing field, make sure that the competition is fair. but you have a choice -- you're going to have a competition or you have a regulatory framework in which the insurance industry is going to have to work. >> big difference on what he said on medicare part d. you allowed nationwide competition of insurance. >> that's what we're doing. >> no, you're not.

regionalizing it. look at the house bill, look at the senate bill. you regionalize it. make it the state base. the difference is new jersey is a mandate. what we need -- we need more competition among the insurance industry. but the way to get it is to open it up. >> let me ask you about a point of news here today. if the president is willing to accept the form without a public plan, without a public option. if he can live with strong, you know, cooperatives that allowed some choice for consumers, can that attract more bipartisan support? will republicans sign off? >> i think there's potential for that. i think the other thing we need to remember is inside the house bill and inside the senate bill is 87 new government programs requiring well over 150,000 new federal employees. we can't accept that. because that is government management of health care and not individual management. i want to make one other point.

on comparative effectiveness. the problem with comparative effectiveness is it provides the loyalty of the physician away from the patient. it takes what is important to you as my patient and all of a sudden, i'm looking over here because somebody here is telling me what i can do rather than what i know needs to be done in -- >> this is just a consumer report on best practices. that's what we're talking about with regard to health care. consumer reports. >> why would they block a prohibition -- >> going to have to respond. almost out of time. >> the bipartisanship, bob dole, howard baker, and i put together a plan that did exactly what i'm talking about. they were very, very supportive of it. i think there's a very good opportunity for us to do bipartisan product in congress. >> you said it was 50-50 whether you get reform. >> that's correct. >> 50-50. let me ask you this question -- what will progressives, liberal, the president's base, accept as

reform. do the independent voters he's escorting in colorado and montana need to be placated in a big part of his base or not? >> i don't think liberals monolith cali feel one thing about it. most would prefer a single payer system. a reform effort which doesn't include a public option is he will have spent a ton of political capital riled up in an angry right wing base that's been told this is a plot to kill grandma and he will achieve something that doesn't save us much money and won't do much for the american people. it's not a good thing to spend a lot of capital on. >> tactically -- i you philosophically, tactically. you said it was crucial for republicans taking over the house. does the president achieve something this time? >> i don't think he does. and i think the fact that he's now signaling his willingness to back off on the public auction and put him to surrogate, which is the government-sponsored cooperatives which is what we

will be following them pretty mad or fannie madd is ghc's finance ministry is horrible. but this is -- when we argued for years that we should have private or cooperatives or associations could put together, these -- >> okay. >> -- all the liberals were against that. now we have government sponsor cooperatives. but don't make a mistake about that government-sponsored cooperative. >> i'm going to let that be the last word. thank you, all. there's more on this to come. the challenge the president has is making this the big issue of the day. we'll be back. take two with maddow. asking her some questions that the viewers submitted e-mail and twitter. take two extra this afternoon on the website. take two extra this afternoon on the websitcould someone toss me

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and finally here in the heat of august and in the heat of the moment for the health care debate, the country marked the loss and celebrated the life of an inspirational woman, eunice kennedy shriver. she died this week at the age of 88. shriver was well known to many because she was a kennedy, a strong sister to some very famous kennedy men. john, bobby, and teddy. she will be remembered, however, because of what she did for others. shriver founded the special olympics in 1968. she was devoted to helping those like her sister, rosemary, who had intellectual difficulties, what used to be called mental

retardati retardation. here she was speaking to special olympians. >> the world said the people with mental problems should not be seen in public. tonight we're in the largest sporting event in the world is watching. >> her daughter, maria this week at her mother's funeral. >> she was the real deal -- a woman who did everything women aspire to. she had a great husband, she had a great family, a deep, deep faith in god. and she combined that with being a fearless warrior for the voiceless. >> tim russert once asked senator ted kennedy here whether his sister, eunice, would be a good president. >> that's what my brother jack always said. he said that she was the best on it. i -- jack was always right. >> but she never ran for office. instead, she did what her strong faith in god called her to do -- she worked to make things better for others. >> her son robert said it well in the 2004 interview, quote, my

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