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from our studios in new york city, this is charlie rose. >> rose: welcome to the broadcast. we are live this evening from washington and new york for coverage of president obama's speech to the nation on health care. the president addressed a joint session of congress earlier this evening at a crucial moment for his top domestic priority. after weeks of declining public support for democratic reform plans, the president outlined his own proposal and called on congress to act. >> there are those on the left who believe that the only way to fix the system is through a single payer system like canadas where we would severely restrict the private insurance market and have the government provide coverage for everybody. on the right, there are those who argue that we should end employer-based systems and leave individuals to buy health insurance on their own.

i've said... i have to say that there are arguments to be made for beth these approaches. but either one would represent a radical shift that would disrupt the health care most people currently have. i understand how difficult this health care debate has been. i know that many in this country are deeply skeptical that government is looking out for them. i understand that the politically safe move could be to kick the road, to defer reform one more year or one more election or one more term. but that is not what this moment calls for. that's not what we came here to do. we did not come to fear the future. we came here to shape it. >> rose: the speech is perhaps the most important moment thus far in the presidency. joining me now, anthony weiner, democratic congresswoman from new york. a democrat of pennsylvania p.a. and a member of the centrist blue dog coalition.

also congressman thaddeus mccotter of michigan, the fourth ranking member of the house republican leadership. later in the program we'll be joined by a group familiar with the issue of health care and this program, joseph califano, former secretary of health, education and welfare during the carter administration, david brooks of the "new york times," al hunt of bloomberg news, and rich lowry of the national review. i am pleased to have all of them on this live broadcast tonight from washington and new york. i begin with people who were there in the hall listening to this speech and ask this basic question: what did the speech change? >> i hope what it changed was actually informing the people of this country really what this bill, what this legislation as we go forward entails. as i did my town halls, 19 of them throughout northwestern pennsylvania, i found that there was just a lot of confusion and a lot of people who were very frighten sod i think the

president kind of laid out what this plan is and i hope that he took a lot of the misrepresentations and a lot of the fears of the people have had. >> rose: do you think he touched the bases that he had to do? >> oh, i do. believe he certainly took on all the misrepresentations right away. almost scolding those who really have been out there spreading these really lies and misrepresentations. >> rose: you're for public option but you are a blue dog democrat, as they say, which is a group of democrats who very r very strong on fiscal restraint and economic issues. >> yes. you know, i actually... when i left for the august break i was leaning towards the public option but really wasn't sure. and honestly as i got to understand the legislation even better over that period of time and talk to my constituents, i really believed the public option is the fiscal responsible thing to do. >> rose: all right. because it creates competition? and therefore... >> exactly. >> rose: insurance companies will have to meet a competition

from a public option? >> we cannot continue. i thought the president saying that health care is the deficit issue, you know, when we look at the deficit... if we don't reign rein in our health care costs, we won't rein in our deficit. and so i think the public option needs to be a component. >> rose: anthony, where are we today? >> i think the president did a great job of laying out why the status quo is unsustainable. one of the first questions i got in my town hall meetings is from people who had health care they thought they liked and was fine and was wondering why we're doing anything that impacted them. i think he made a good argument that it's a national imperative that we act. i was one of the people that got a little finger in the eye when he said he didn't support single player plans that i support. i think frankly we know for example the that hundreds of billions of dollars are taken ouof the health care system and put into profits and overheads by insurance companies that want to bring in as much as they can and pay out as little as they can. he made a good argument for why you need at the very least a public option. if you take a public option out,

take it off the table or out of the plan, then there is nothing in the bill that contains costs effectively. and that, i think, is a very important thing to keep in mind. he made a pretty good argument that you can't public option at this point. and that's good. but to some degree the speak was a rorschach test for members of congress who wanted to see in it whatever they thought was the most important thing but if all americans tuned in even for a moment and said, you know what, this doesn't seem like the worst thing in the world, in fact we have to do it if we want to accomplish the objectives of getting our economy going, it's ultimately going to be a very good thing. >> rose: some are arguing that he was prepared to... well, he laid out the case for public option he also basically said it was not essential. >> well, he's been... in fairness, he's been all over the map on the public option. he said at one point it was just a sliver of the plan. in fact, to someone who is on the committee that helped write h.r. 3200, i can tell you if you don't have competition, there's nothing in the plan that makes insurance companies any more

likely to lower their costs. it's just not there. the only thing that incents them to do it is they're going to have to keep up with the lower cost government option. so it's a real problem. and it's not just me saying this. the c.b.o. also said the same thing, that we have tied the hands of the public option so tightly behind their own backs that you're not getting the savings you really need to. you need some form of competition. we've seen now 44 years that we've had medicare, operating, giving good coverage to people but having obviously financing problems b. the insurance companies far outspending them in terms of health care and inflation that we have. >> rose: what do you say to those who argue that the president has basically said that what's coming out of the finance committee is his proposal? >> well, if that's the case he didn't say that. there are those of us who believe in a vigorous public option that that might be the end game here. but i don't know. you know, to some degree, the month of august we have been kind of flailing around each in our individual districts trying to explain our positions individually. no one can do what the president

did tonight, which is saying from that bullyest of bully pulpits that these are the things we need to do and here's why. in all fairness, there's no president's bill right now. he kept referring to his plan, including some language about tort reform, there's no bill for any of us to look at. sooner or later pen has to hit paper and we have to see what the obama plan looks like. >> rose: before i turn to a republican, it is also argued that this president has to have reform because if he doesn't, if there's not a bill that gets through congress and you go to the elections in 2010, democrats will be in trouble. >> i came to washington partly to do health care reform. and when the president talked about we've been kicking this can down the road for a very long time, i agree. and i've talked about that a lot during my town hall meetings. that we have been kicking this, along with many other issues, down the road. we can no longer do that. i believe less about the elections but really for the future of our country.

i'm a new member of congress. i came down here to do the people's work and people asked us, small businesses asked us, individuals asked us, providers asked us to do something about this health care system. we have got to move forward on this. >> rose: congressman thaddeus mccotter of michigan, the republican with us, tell me how you think the played with republican members? >> well, charlie, i think we felt like guests at a thanksgiving diner where the family was fighting. as you know, we are a distinct minority in the house, we're a distinct minority in the senate, and yet to be portrayed as the reason the bill wasn't passed before our august recess as the president originally asked is a little bit disingenuous. the fact remains the democrat party has to determine whether they want the public option or not, whether they believe the 0th century model of government, centralization and bureaucracy placed on a 21st censure consumer empowered economy is the only way to fix this and they don't really need our input on this, although we're happy to help if they make that

determination. so from our point of view it was really directed largely at blue dogs who, unlike my colleague on the show, have not made the determination that the public option is the only try go. >> rose: so it didn't change any republican minds and you're suggesting this is not even about what republicans will do because that's not what's going to happen? >> well, we don't know what's going to happen. i think that's one of the things that did not happen tonight. while the president came down in favor of the public option, it was more as if this was his perm proclivity to support that as opposed to a ledgety necessity. i think in many ways it was equivalent to having the entire congress there and the nation watching where he kind of voted "present" on this. and so the democratic party is going to still continue their debate as to whether they go in this direction or not. republicans are going to continue to wait and say well, if you make your mind up that you don't think the public option is essential, come talk to us. and i think that's pretty much where we are. >> rose: the president also was a teacher tonight. he was basically saying there's a lot of misunderstanding. do you think he regained control

of the debate so that there is a broader understanding now among those people who focused on this debate, eliminating some of the confusion? >> i believe he made the first stone get to that point. but i think there's still more work to be done in terms of really educating the people about what we are trying to do in this legislation. you know, when i was at my town halls i would have a good hour and a half, two hours with people and there was still things i wasn't able to get to. so i do think that it was the first step, but we have to go further and i think administration has certainly a huge role in this. >> rose: the president is back in control of the debate? >> i think so for a couple of days. and then it's back to law making and that's sometimes people making compromises. look, i do think the president still needs to sharpen his decisions on a couple of these issues that are still bouncing around in congress. the public option is just one of them. he made a had tip.... >> rose: what more can he say about the public option? he's in favor of it, on technological t only hand it is only part of the bill.

that's what he said tonight. >> in case, any other part that contains costs he better tell us what it is because it's not in the present bill. >> rose: there are those who will argue-- as you well know-- that we're going to have is a public option in the house and senate in the senate, the senate will take the senate finance bill essentially and this will be decided in conference. and democrats can't afford to lose. >> well, perhaps that's right. i mean, you know, the senate has been referred to as the cooling saucer of democracy. recently it's been the icebox. it's the meat locker of democracy. those of us in the house have been continually moving forward trying to get the ball moved downfield. putting aside the bank shot of legislation here that's going to have to... it is absolutely essential that we solve this problem. for eight years we had a house and a senate and a white house that was controlled by the republicans, they did absolutely nothing while this problem got worse. we're changing that today. you know, democrats are committed to fixing this problem. and that mccotter is right. we have some intramural concerns but one thing is clear, we're not going to get a lot of

republican votes on just about anything we try to do. >> rose: the economic issue the president after going through what he thought was important to say and where the consensus was, congressman mccotter, he basically ended by talking about first the cost element and then finally about the letter... the eloquent letter from senator kennedy. on the fiscal issue and the deficit neutrality, will that sell? do you have to buy into that? >> well, i think a lot of people were very concerned that supported the president's plan when he said he wouldn't sign the bill unless it was definite neutral because in effect that would kill the bill. the way he's designed this strains credulity. for example, there's two things in the speech when we talked about does this control the debate, what is the fiscal impact. first, he didn't answer the trillion-dollar question about the public option. secondly he talks about $600 billion in cuts in medicare that can be done without helping seniors. well, we should have done that the minute we walked in the

door. and the other part of it that i find interesting especially from a district obviously coming outside detroit where we have a lot of employer-provided plans, is the president said there's nothing in the bill that forces employers to put people into a public option. well my concern and many americans' concern is there's also nothing that in the current bill that prevents an employer from dropping you into the public option for the very reason the president laid out. it's very costly for employers to provide them. >> well, look, the fact is it's always puzzling to listen to my friends fiercely defend cuts in medicare and then go off and beat the drum about how they're against single payer government-run health care. there's a certain schizophrenia in the republican party and maybe what we've finally seen here is that people understand medicare a little better and understand how successful it's been in fact, between now and the year 2013, which is year one in this bill, employers are going to be able to drop people or not drop people just the same way that they could any other time. but i think that fundamentally thad mccoter is right about one

thing. we do need to finish legislating some of these things. one thing we're not going to do is continue to have the status quo in place. and a lot of people that were disrupting the debate over the month of august, that's what they wanted. they wanted the status quo to hold. we're not going to do that. the insurance companies have fierce, fierce defenders, many on the republican side of the aisle and we're breaking through that and it's awful hard but we're going to do it. >> charlie, if i can. >> rose: go ahead. >> the biggest most powerful entity on the face of the human planet is the united states federal government. and what we're talking about doing is expanding its and powers. so when anthony talks about not getting republican support or our schizophrenia first, for the president to get up and stay entire health care system is at the breaking point, when you point to the successes and unfunded liabilities that aren't having anything addressed right now outside of being used to maybe find costs for an even larger health care program, that's schizophrenic, that's actually dysfunctional. our concern has been if you start from the premise that you're going to have larger

control of the marketplace, of people's decision, we won't support that. if you want to break up and have more competition, empower patients and consumers, we're there for you. but, again, you're going to have to set that will debate internally. >> rose: is that where it is? >> you know, i think as we go forward, businesses, as anthony mentioned, they can... they will drop people today. they will drop people next year. we cannot have the status quo. we've got to move forward. and the republicans haven't brought us the ideas. bring us some new ideas. bring us other ways to control the costs. i believe the public option is the way to control costs and i don't see any other way that we can at this point just come forward with new ideas. >> let me push back on the notion of government-controlled health care. all we're talking about now is who's going to take our money and give it to doctors. right now under medicare, medicare, the federal government does it with 4% overhead. under private insurance, up to 30% of it is profits and administration who gives the money to doctors. insurance companies aren't doing a single checkup. they aren't doing a single operation. the doctors are doing that and

under medicare and every government plan we have, people are empowered to choose their doctor as they see fit. the idea simply is what role are the insurance companies playing in all this? are they playing a constructive role? are they apportioning risk? no, because they're not covering anyone over 65 and dropping anyone who gets sick. so the question is what are they doing and should they at very, very least face a little bit of competition? if you want to advocate on behalf of insurance companies, that's someone else's job. buy stock in their company or dial the 800-number. we should be advocating for taxpayers. and if wal-mart can negotiate for low prices for its customers why shouldn't we do the same thing for our customers, meaning taxpayers. that's what this argument is about. on the side of protecting the insurance company should not be with where the democratic party is and that's not where we are. unfortunately it is where a lot of people in congress on the republican side of the aisle are. >> rose: i have to leave it there. thank you very much. thank you very much. thank you, congressman, good to have all of you here. i go to new york, now, joe califano. joe, you have been involved in this issue for a long, long time. you listened to the president

tonight, you've just listened to reaction from three members of congress. how do you see it? >> well, i mean, as far as the president tonight, i mean, i think he made a very eloquent speech. i think the rubber will hit the road when they go to conference with the house and the senate. but i think the reality... all this conversation about controlling costs is only one way to control costs and that's to keep people out of the sick care system. the only things in temples of sick care that will help control costs are if we have a situation in which we deal with some of the things that create them: the fee for service system for doctors. the way hospitals are reimbursed essentially on a cost-plus basis. the failure to have any health promotion and disease prevention. you know, why don't the democrats tax alcohol? why don't they tax tobacco? substance abuse, charlie, alcohol and tobacco account... and the diseases they spawn

account for 30% of the health care costs in this country. 35% of medicare's cost. i think that i wish the president talked about a lot more. but i don't see a public option or a non-public option, either of those things, really having much of an impact on health care costs. the things that produce health care costs are doctors, hospitals, medical equipment manufacturers, pharmaceuticals. the insurance companies, sure, maybe they're making too much money, i don't know. but their level of profit is not the issue here. the issue is the way the system is now organized, nothing in n this bill changes that. >> rose: rich how willery, what did you think of the president? >> it was a very able performance. giving barack obama a teleprompter is like giving a yo-yo ma a cello. it's a can't-miss sort of thing. but underneath the rhetoric about being open to republican ideas and this door being open

all the time was a very tough and partisan speech. it was a speech that basically brushed aside all the concerns we saw in those town hall meetings expressed in august and took the attitude that the opposition to these plans is basically ill intentioned or ignorant or both. and, you know, look, i think it will probably help him in the near term, but he still has two really big problems in selling this thing, charlie. one is just the concern that's been stoked in the public about the level of debt and deficits. he tried to address that by saying he won't sign a bill that increases deficit by a dime in the near term or the long-term. i'm not sure that's a commitment he's going to be able to keep. also, people are concerned about health care, they don't like, necessarily, the status quo. but it's not a crisis. it's not at the top of people's minds right now. that's the economy and that's the jobs. jobs. so those are two big drags on his salesmanship over time in

this plan. >> rose: a little bit of housekeeping here. congressman mccotter, can you stay with us? i don't know whether i had contact with him or not but i could see a picture. the speech opportunity, what has it changed and did the president help himself? >> yeah, charlie, he did. i thought he thread it had needle. he had to appeal to a number of different groups tonight and i think he did that. you know, usually a presidential address like this is setting the terms of the debate. this, after a summer of discontent in which he let the other side set the predicate he got back in the ball game. >> rose: does that mean he should have made the speech before the summer? >> one can argue that. you can say bill clinton did and it didn't work. if he wins he should have made the speech when he made it, if he loses, he should have made it earlier. what he did is he tossed out enough red meat, he got the base excited, he invoked the memory of the great liberal lion edward kennedy. at the same time i think he went

further than rich lowrie suggests, he made concessions and important issues at risk for the at risk pools, medical malpractice. and the initial reaction add to be very enencouraging. ben nelson, the key democrat in the senate called it a game changer. the maim may said.... >> rose: why is it a game changer? >> to ben nelson's view he's moderate enough so he can support things like this, i suspect. olympia snowe, who is the most coveted woman in america today politically said that... she said more good things than bad things about it-- politically that is, charlie. so i think from the president's point of view it was a good night. but there's still a long way to go. >> rose: david? >> i thought it was the best speech of his presidency just as a speech. i thought the teddy kennedy part was extremely strong, the little philosophical part at the end was quite strong and the explanation was strong. and for what it achieved, politically it gave the liberals red meat stylistically, substanively i agree with al, it

gave the center a lot of meat. whether you want to think about the public option, it's dead. the white house... the people inside the white house are completely committed on this. they'd like it in principle but they know they won't get it so they walked away. on top of that, the cost is now down to.... >> rose: and by doing that there's no threat of losing the house? or there is a threat. >> their view, which is completely correct as far as i can see, is that the left lever l never walk away from this bill just because it doesn't have a public option because it does so much else for them. >> rose: al, you agree with that? >> i do. i think it will be harder to get there, there will be messy, there will be threats, the maxine waters, congresswoman from california and others will yell and scream but in the end i think david is right and i think what they were doing tonight was again, laying the ground work for some kind of... whether it's a trigger, a co-op, some kind of backup to at least give them some excuse to say all right, we don't like it but we won't let the perfect be the enemy. but a robust public option is absolutely dead. >> and it's not central in my case. i think the president is absolutely right on that. it was not a big cost saver, it

was not going to change insurance markets. >> rose: was it necessary to increase competition? >> well, the c.b.o. doesn't really think so. they estimate the cost savings as reasonably minimal. then he gave the center some other things. he mentioned medical malpractice. there's a john kerry option to help increase taxes on.... >> rose: that's going back to where bush was, is it not? >> but it's an idea a lot of republicans have supported through the back door. there's this fiscal trigger which rich mentioned. the iron-clad promise to not do a plan that increases the deficit now or ever. now, that is an incredible promise. i don't think he can come close to that. but that promise made so vehemently at least will probably appeal to some blue dogs. >> rose: joe califano, public option is dead? >> oh, i think the public option is dead. i would like to make a point. i think the bottom line is i do think the president got across that there's a basic element of

social justice here that's important whether you're a republican or democrat, which is to provide health care to everybody. on the cost issue, charlie, you know, can i just go back to when we passed medicare and medicaid? there were no... and the costs that have so exploded. why? there were no pet scans, there were no c.a.t. scans, there were no... there was no expensive chemotherapy, there were no organ transplants. nobody expected the expression of life expectancy that came after we passed it. now, for the congress to try and say they can project ten years out what the cost of health care is going to be is patently absurd. we have no idea. we're in the midst of a genetic revolution, of a neurological revolution, we don't know where stem cell research is going to take us. we have domino transplants. we have artificial organs. there are tremendous costs coming. that doesn't mean they shouldn't pass the bill. i think we just ought to be

realistic, and this is going to be a commitment in terms of social justice. it is going to be expensive. the only way to avoid the expense, as i said before, is to provide tremendous prevention programs and keep people out of the sick care system. >> rose: congressman mccotter, can you do it with prevention programs and keeping people out of the system? >> well, i think you have to incentivize people to take preventative measures for their health care and be responsible for it. i think you can dog that by allowing insurance companies and people to contract for health care insurance that recognizes that rewards them for doing so. but i think one of the concerns people have is you're still talking about in the overarching goals of reducing the supply of health care to reduce the cost. that is really what we're looking at. and the problem is with the demographic trends that mr. califano pointed out, with the people living longer, the baby boomers, the largest generation in american history living on, what you're going to see is a continued rise in demand. and if the government tries to control costs through addressing

the supply issue, you're going to see costs go up. that's why the projections that we've seen for other health care that are the government has provided through medicare and medicaid, those expenses are in unfunded trillions over the coming years. >> rose: did the president's argument today about this is the right time, the urgency argument this is what we need to do, that this is an issue of humanity and all the things that he eloquently said make a difference to you or to other republicans? >> well, i think the key is everyone agrees that what we want to do is have health care reform that is effective for the american people, that in a very chaotic time does not add and compound and exacerbate the problems they currently have. but the question is does the system actually provide the goal that is proffered or does it actually make things worse? the road to hell is paved with good intentions. my argument is what we have to do is get this right. if we rush to a judgment for artificial deadlines, be it now

or had it been before the august recess when the bill was first demanded, you increase the risk that the dictum will come true. no matter how bad a problem is, congress can always make it worse. we want to avoid that. >> charlie can i just.... >> rose: yes, please. >> i think one very important thing that happened tonight is we got some passion from barack obama. this was not a cool speech, a teacher... professor in a college. we got passion. and you need passion. when lyndon john season said with the we'll fight for medicare until i have no breath left in my body" we got some of that from from barack tonight that's the only way we're going to get legislation to provide coverage for all the uninsured in this country. he's the only guy that can do it. >> rose: what would lyndon johnson do that barack obama should do? >> oh, charlie. i mean, you know, first of all.... >> rose: (laughs) >> (laughs) >> you can't say that on the air

joe! >> i can give you one simple example. one simple example. after the bill came out of the house lyndon johnson had harry byrd... harry byrd was the most conservative finance committee chairman over the who t white house. >> from virginia. >> couldn't get the senate to move on the bill. and then he said to harry "i'll walk you out to your car." and he walks him out and he's got the press right in front of him and he turned to harry byrd, he said "it's a wonderful thing that wilbur mills reported this bill out of the house committee today and you've got so many thousand unemployed... uninsured in your state, can't you at least have a hearing?" and the press battered him and he finally said "yes, we'll have a hearing." and lyndon johnson said "good." you have to do things like that. bluntly put, you need balls to get something like this through. (laughter) and i think obama will... where

he's got to demonstrate that is certainly when he gets to conference. >> are we on hbo, charlie? (laughter) >> i was hesitating to say lyndon would have done some nut cracking, but joe took care of that for me. (laughter) >> rose: beyond that, david, what else does the president have to do? where does the president go from this speech in the president? >> well, he's actually got get to get legislation. congressman weiner pointed out, he kept talking about "my plan, my plan." there is no plan. but i think it's pretty clear.... >> rose: you don't buy the argument that essentially his plan is the plan coming out of the senate finance... >> i think he's shifted over essentially to the senate plan. so he's got to do that. he's got to settle the public option once and for all, which i think.... >> rose: what else does he need to do on settling it? >> well, i mean he's got to... he sort of says... he says "i'd like it, i understand it's going to go" but he didn't explain how it's going to go, what people are going to get in favor of it.

the final thing i think he has to do... listen, august happened. the summer happened, this bill, at least until the speech, was still unpopular and i thought he went some way to easing some of that anxiety, especially the last section of the speech, because it was not a liberal address. it was the left has some ideas, the right has some ideas, i'm going to head straight down the middle. that's sort of quintessential barack obama. and i thought he recaptured some of his essential sell >> the speech. but he still has to reassure people that government isn't taking over. and the weakest part of the speech by far is the cost section. the idea that you're going to cut medicare and medicaid $600 billion without any effect, that's ridiculous. >> rose: and you can't find savings... >> and people know that waste fraud and abuse, you can't say that with a straight face. so he's got to explain that and then he's got to explain essentially now it's not going to.... >> rose: is there a universal belief in washington and around the country that medicare works and works well? is that a consensus? >> well, it's a popular program, but it's also a program that's unsustainable, like the rest of

the health care system. and the costs are exploding. the speech went well. as i said, i thought it was a great speech. there's a guy in washington named doug el man dorf who heads the congressional budget office. he could utter a sentence at a hearing in a few weeks and it could undermine it all. he could it err sentence where he says "this does not reduce costs, this increases the deficits. then baby barack obama's own promise he's got to not sign the bill. so he's actually got to substantively bend the cost curve. >> he did a little bit of that, i think, with a proposal endorsing the insurance tax which some republicans have embraced before. charlie,s going to be a very messy process for the next seven weeks. joe califano can talk about what the legislative process is like. it is an absolute can national guard that this thing is a slam dunk in the house. between some liberals who think it doesn't go far enough and some conservative, some blue

dogs who say i won't vote for a public option. they have delicate maneuvering to do in the house. that's the balancing act. that's why he won't throw in the towel yet on the public option. but what he will do at some point, he has to say what he will accept, whether it's a trigger, a co-op, whatever emerges. >> rose: when does he have to do that. >> what emerges from the senate finance committee will be important and then they'll start putting deals together so certainly by early october. >> i think, charlie, there's another factor here, it's not just democrats and republicans and blue dog democrats and liberal democrats. you've got incredible financial interests here. you've got the doctors. you've got the pharmaceutical companies, the medical equipment manufacturers. the hospitals. they're all going to be in into this battle. i mean, as al said, this is going to be quite a bloody battle because believe me in any bill that's going to run a thousand pages, they're going to find language to protect themselves and they're going to fight for it in committees and they're going to fight for it on the floor. >> rose: will recallly, let me

also say for my friends al and david, to to me was a very liberal speech. the medical malpractice business is just window dressing. we're talking about demonstration projects in the states. it doesn't even have to affect the actual legislation. $900 billion over ten years just let me remind everyone, the day before yesterday that was considered a lot of money. and remember a lot of these bills, the real spending doesn't kick in until later in the ten-year window. so you're not really capturing the true cost. i think for a lot of people barack obama's selling this thing as a great act of fiscal restraint and fiscal conservatism. for most people, a nearly trillion dollar new health care entitlement is not a natural intuitive way to address out-of-control government spending. and i thought tonight he was... made a very effective case talking to seniors about medicare. but let me tell you, if they manage to pass hundreds of billions of dollars worth of

savings and medicare without agitating a lot of seniors, newt gingrich will be very, very jealous. >> rose: (laughs) >> he's jealous anyway. >> rose: the president talking about the malpractice issue, congressman mccotter, did republicans... it got a rise out of republicans. how do you weigh that in terms of the president's willingness to listen and to respond? >> well, first it was interesting because it was like watching him have a molar removed spitting out the phrase "tort reform." (laughter) and i don't know that that evidences a real commitment or the passion that we heard talked about for that specific issue. in fact, i would agree... i think it was mr. brooks said this is the quintessential barack obama. what he did is set up a straw man on the left, a straw man on the right and pretended to be a centrist. >> rose: (laughs) >> the reality is, if you're going to come out and... you talked about l.b.j., i mean old

school joseph califano, god love you. l.b.j. is a former legislator, would come in, sit you down from whatever room in his place he was hiding and he would say "i want x, y, and z in this bill." and he'd find a way to make that happen. tonight as i said earlier, the public option, we're still discussing whether or not he thinks that's essential. and that's the key element in the internal democratic debate that has to happen. >> rose: well, i'm not sure we're discussing that. i think david brooks clearly said... and al hunt both said that the public option tonight the president made clear it's not essential. >> well you're going to have i think over 100 progressives and other democrats that have said that the public option is critical to their vote. and, look.... >> rose: okay, so they vote for hit in the house and then it goes to conference and... >> and then it gets taken out. it becomes problematical. >> we used to do this, charlie. we used to do this. we were in minority because of it. we would start a bill on the far right and try to move it to the

center counting our own noses while the public and the democrats held their noses. eventually that doesn't work. an old chairman once told me if you want to get something big done, you start in the middle and work out both ways. and i would hope that they would come back, reset the button and start to seriously work with us because i do think it's possible to get something constructive done. >> rose: so you think he should start all over? >> no, i think that he should come and look at where we're at, where he's at, where his caucuses is at. because while there have been bills put out of committee, the only bipartisan votes against this legislation have been against it. >> rose: this speech was addressed to both congress and to the public. what has to change? what kind of response out there... or is it simply now a case of push and pull in the congress? >> well, the inside game.... >> rose: a dynamic of where we are. >> the inside politics is affected by the outdoor politics in the sense that fe he changed public perceptions a little bit, particularly if he appealed to

some of those independent voters who were getting increasingly skeptical of this plan, that's going to make it easier for the centrist democrats and maybe even a few republicans-- not very many, you're talking about two or three at the mosts-- chuck grassley, mike enzi are never going to vote for this bill. but olympia snowe, as i said earlier, might. so if he changes perceptions out there-- and i don't know that he did, i suspect he did-- that's very important, charlie. that makes the inside game easier. and i would just go and jump in on this. i had just read about medicare. i wasn't around then, joe. but in reading about that medicare debate, which is fascinating, that wasn't as easy... lyndon was a a magician but wilbur mills went through all kinds of machinations. it took months and months and months of changes. that wasn't a simple, easy process. >> no, it wasn't. in fairness, remember johnson really played mills. but think about it. in 1964, in those days social security increases were not every year just... every two years

just before they went home. johnson got the medicare bill attached to the social security increase that passed the senate, wilbur mills had the social security increase in the house. he wouldn't take it. johnson literally killed the social security increase to build up pressure for medicare the next year. i mean, you have to understand. al is right. this is a tough, hard process. and remember, he then came to congress with this whopping liberal majority and the first thing, incidentally, that happened in early 1965 was that wilbur mills had lost three members of his committee that were against medicare. lyndon johnson got the... speaker mccormack to put three members on that committee that were for medicare. i mean, al is right. this is going to be a tough fight. but i think it is time for the president to really get his fingernails dirty and try and

get something. try and get something, charlie, to make it a little easier... the conference is going to be tough. but he has the ability to shape a little... to shape to some extent what comes out of the house, just as he... i agree with what you said in washington. i heard that speech tonight as barack saying i'm with max baucus and the senate finance committee bill. >> but when medicare passed... i saw a poll the other day quoted that it was 6-0-20 in favor, public opinion polls. so you had... sure l.b.j.'s legislative management mattered but you also had the public very strongly behind a very large change in how government worked. there's there's an a.p. poll that shows 6 20% of people support either starting over entirely or nothing happening at all. so prior to tonight the democrats are trying to push through a huge new great society

style government program against the winds of popular opinion. that's a much more difficult task. >> well, i think the president affected popular opinion tonight. i'd also note one other thing. the congress was a different place than it is today. we had roughly half the republicans in the house and half the republicans in the senate voted for medicare when it finally came to the floor. we had liberal republicans in both bodies... legislative bodies. we don't really have much of that today. >> well, also, joe, what you had back then was in addition to a very politically effective president, you had some skillful legislators, including the aforementioned mr. mills. i think that's a problem this president has. in the house, with the exception of henry waxman, i'm not sure they have the skillful legislators and with ted kennedy gone i don't know who you have in the senate to shepherd this through. i think that's a real problem. >> i do agree with that. the number of people who have experienced putting together complicated pieces of legislation just isn't there the way there was in the 160s.

then you have to issue, which rich eluded to. partly... why is the bill unpopular now? i think one, people have had a lot of government shoved down their throats for good reasons and bad over the last couple months, they're a little nervous. it's not a country that's attuned to have having big government. >> rose: are they worried about government or the deficit and the cost? >> many my view... and i think that's why the president understands that, that's why his rhetoric about the american character is so central. america has a tradition. the tradition is limited government. and on top of that you have deficits. you have what's going to be... i don't know, our public debt to g.d.p. will be 83% by 2019. so you have a great deal of anxiety. then the third thing is it's almost impossible, it's very hard, at least, to pass a major piece of legislation in a time of economic anxiety. in 1964, it was boom times. when you have economic anxiety, you tend to have people pulling in, risk averse, historically that's been very hard.

now, having said all that, i still think it's quite likely they will pass something. >> rose: is that perhaps the reason the president is taking credit for stopping the slide of the economy and saying that while people still hurt we have turned the corner, so to speak? >> well, it test build up... listen, this is what i did. i don't buy that argument but in the white house they're firmly convinced the stimulus package was a home run for them and they'll say look, we did this, now you can trust us to do health care. >> rose: is... in washington today, the question of government intervention and some of the issues that have been expressed on the program tonight a huge fear and somehow has the president lost that debate or lost control of that dedate in terms of the roll of government, which he tried to make again tonight? >> well, the country has been this way for 200 some odd years, resistant to big government. we do not have a european welfare system. there are deep reasons we do not have a european welfare system. there's just an innate suspicion. i think when you hear in the town halls....

>> rose: but now they're saying people like medicare. >> well, the country is plit. people like certain programs that benefit themselves but on the whole... in the abstract they don't like the sense of big government. >> rose: they like the veterans health care. >> right. there are certain things once they get used to them they tend to like them and it's often made that people are philosophically libertarian and operationally liberal. so that's a contradiction. nonetheless, when you have a system where 8 20% of the people are satisfied with what they have and you have someone they think is a big government liberal coming up with a plan, well, they're going to be suspicious. >> charlie.... >> rose: hold on one, second, joe. >> i think that 8 20% number is totally fraudulent. i think people are satisfied with insurance until they have to use it. and the people who fear they may have to use it also aren't satisfied with it. i do agree with you there's always this schizophrenia on the role of got. today, prince, people are far more friendly to the idea of regulating financial institutions and the like because of the crisis. but always there's the sense of

will they go too far and that's why the critics were so effective this summer. >> rose: and do they have an exit strategy. congressman mccotter, tell me your response to the argument the president made again when he compared american health care to other countries. when he made this an issue of our character. i'm leading to this point from you. is this the time for health care reform? >> well, i think it's always time when you have issues such as $600 billion in waste and fraud in medicare and medicaid to go fix it. >> rose: but that's the issue, whether you've got fraud in medicare or the fact that we have too many cases of... too many people... >> my point is that there are existing reforms that can be targeted specifically to try to be helpful in the system rather than a big, large, overhaul of this. remember we were told by bill clinton the era of big government is over and now we're finding out that that's no longer the case. charlesly ultimately when you the larger question, why

americans are having trouble with this package and why they don't like it is we are not going through an ordinary time. this is a time when we were continuing to move from an industrialized society to a globalized world to a globalized marketplace. that entails the same types of social economic and political turmoil that we saw as we went through the industrial era. what americans are tired of is chaotic shocks to the system. and when we talk about reverting back to character in a time of crisis, the american republic was founded not just on limited government but what undergirded that was self-government, a sense of continuity between the generations,, birk's eternal contract of society, and what they cannot stand is government making a chaotic time worse. so they want us to do targeted reforms, make things better, but not to do anything that's going to be too large or help to reduce their control over their own lives. and that's really what's undergirding the debate of this. >> rose: but i think the president was arguing tonight that you are going to still have control over your health care. if you like your own health care you can continue with your own

health care. and secondly he seemed to be saying that the reason there's opposition to this is because there's confusion about this. not that there's some dramatic difference on principle. that's his argument. >> his argument is... i would argue errant because when he talks about the fact that you'll keep whatever you have because the bill doesn't force you into a public system, the reality is they're going to encourage it because it's going to be cheaper and easier for businesses. it's going to exacerbate businesses forcing you into a public system. when you look at many of the cost savings... even mr. brooks talked about it. the cost savings that this bill will be revenue neutral and he won't sign it, we had the only us in bill the same thing and it had a bunch of earmarks in it and he signed it. americans want the turbulence they're experiencing to be calmed by their subservient members of congress that are supposed to.... >> rose: and was that the tone

of the president tonight or not? was that the tone of the president tonight, calm, reasoned, or not? >> there were different... there were different... there were different tones. we heard that the president was passionate to want and yet people who passionately oppose this are a new angry mob. so one man's reason, passionate person is another man's angry mob. (laughter) >> rose: who was the person who shouted out "liar"? >> that was representative joe wilson. he's publicly apologized. we cannot do that. he knows that and he's sorry. >> rose: okay. go ahead, joe. >> charlie, there's something else here that's difficult any time you want health care reform. two things i'd note. one, our health care system does have a safety net. it's a very expensive one. it's the emergency room. it's where poor people go. but nobody really dies for lack of a doctor in most cases. number two, everybody wants to control health care costs but if

their wife gets siblg or kids get sick or they get sick or their mother or father gets sick, the sky is the limit. and that ice a human reality that affects this whole debate. and i think it's very important for people to recognize that. >> charlie, let me put an accent on a point that david made a little bit earlier. >> rose: brooks (laughs) >> what was that? >> which point. (laughter) >> what's been dragging down this effort so far, it's not the republican rump in congress, it's no president special interests most of whom have been playing ball with the obama administration on this. it's the c.b.o. and doug al man dorf saying representations that have been made about the virtues of this bill are not true. so, again, we have barack obama's selling this plan and wondrously talented way as the greatest free lunch of all time

where everyone's going to get more coverage and better coverage without really paying anything to get it or with anything significant cost added to government. is that true? when he says he's not going to sign something that adds a dime to the deficit, is that going to be true? when he says these plans are going to cost, is that actually going to be true? those questions matter. the substance matters. >> rose: so are we now waiting... >> what's dealt the most devastating blow to this thing over the last two months. >> well, you know, this gets to the core issue. to me... i mean, brb said we want to keep what we have. so 8 20% of... the people who have insurance can keep exactly what they have. the problem with that is the system is fundamentally screwed up. the incentives are fundamentally screwed up. they reward service, that i don't reward care. and so if you wanted... if you indict fundamentally the system and then preserve it for most people, you've got problems. and i understand politically why

he's doing it. because you don't scare people who are happy with what they have. but it does mean substantively you run into problems. it does mean substantively there's a limit to how much cost control you can do and he's perpetually stuck on the horns of that dlaepl ma and i don't know, frankly, how he gets out of that. >> rose: let me go around in our remaining three or four minutes. this is the most important moment of the obama presidency? >> it is for obama and it is for the democrats. whatever they pass, we may find out later how it works. if the democrats don't pass the bill, if they fail, i will guarantee they will lose 30 or 40 seats in the house and five or six? the senate. if they pass a bill and the economy is okay-- that's a big if-- those losses will be much less. they cannot afford failure. >> i think it was the actual proposal of the bill that was unpopular, not the killing of it. that would just show they were not as competent. >> rose: so the dye cast? >> well, that i've got an uphill fight in 2010, i believe.

>> rose: because? >> because the unemployment rate is still going to be high. >> rose: over 10, yeah. >> you have a lot of democrats elected in republican areas, they are going to face a tough fight. harry reid, the senate majority leader, has 38% approval in his home state. that's not a good sign. so it's going to be a challenge. nonetheless this is the biggest domestic reform in a generation to so to that extents this the center of the obama demost i can policy. >> rose: in what way has the president surprised you? >> well, frankly, to me i always thought he was a moderate. a moderate democrat. i thought he drifted to left in the last couple months, maybe pushed by circumstances. to be honest i thought in his speech today i thought he drifted back towards the center. he was more the guy i sort of admired and approved of during the campaign. and if he backs up some of the moderate rhetoric with real substance over the next few weeks, i figure he will have done a lot to repair some of the damage that's happened in the past couple months. >> rose: do you agree with that, congressman? >> i think he's drafted to the

center of the democratic party. remember, he was elected by the left wing because hillary clinton wasn't liberal enough. so i think he's trying to find his way. in the end, it's going to be passed by a congress or not but it's going to have to be practical. the american people are very practical and they're either going to like it or not regardless of what i say or anyone else says they'll measure their own health care needs, they'll look at the bill and they'll say yes or no and we will hear about it. >> rose: it's defining moment for this president and where is he? >> i think it is the biggest moment of his presidency in terms of any domestic issue. i think he's taking this issue further than anyone has since the mid-1960s. i think he ought to take as much as he can get, cover as many people as he can get. i do think it's imperative for the democrats to pass a bill. and i think he should sell it more as a matter of social justice, fairness.

it's like the minimum wage. it's a minimum.... >> rose: that came into the debate tonight i thought stronger than he has before, don't you think? >> it did and i was happy to see that. i think that will sell and i think he ought to take as much as he can get. we ought to move the ball as far down the field as we can. if you can't get a whole loaf, take a half, take a third. but don't lose. whatever else anybody says, there is more attention to this, more momentum on this than we have seen in 50 years! >> rose: therefore, rich lowrie, do you think we will have health care reform within some broad range of what the president would like to see? >> it's hard to say, charlie. i mean, there are a couple scenarios where you could see it going down. one, it is a complex animal. so when you start pulling parts out of it, you have the risks of the whole thing falling apart or the coalition falling apart. but i think liberals in the house would be extremely foolish to vote this legislation down if

they don't get the public option. because the public option is a relatively minor part of it. you're still talking about effectively making an insurance company's public utilities, a huge new entitlement subsidy to people that's going to cost $900 billion. that is a lot to have on your plate. >> rose: because we're live, rich, i have to get out at that point. thank you so much, thank you, joe, thank you congressman, thank you albert. we'll see you tomorrow night. thank you for being with us. captioning sponsored by rose communications captioned by media access group at wgbh access.wgbh.org