Gregory A+; Sebelius D-

NBC’s David Gregory bores down on Madame Secretary

Last week, Campaign Desk urged reporters to start asking Obama tough questions on health care, so we could learn what kind of reform he stands for. Yesterday on Meet the Press, David Gregory did just that, aggressively questioning Health and Human Services Secretary Kathleen Sebelius.

Sebelius is in the unenviable spot of having to defend President Obama’s positions—or lack of positions—on health reform. The president and his secretary are still long on rhetoric and short on specifics, and Sebelius still clings to her media-trained phrases and bridging techniques (say only what you want to say), but Gregory pressed hard to probe the White House health care psyche. Right off the bat, he asked about controlling health care costs—and Sebelius came across slippery as a snake.

“So if lowering costs is the rationale, the president can’t support what’s going through Congress right now, can he?” Gregory pushed, referring to the Congressional Budget Office’s estimate that the cost containment measures in the bills on the table won’t substantially lower medical costs, which the president has said he wants. Sebelius responded saying that “this is a work in progress,” and that “the good news is the House and Senate are actively working and share the president’s goal that overall costs have to come down for everyone.” Gregory tried again and again to get some red meat out from the cost control discussion. At one point, he said:

But you want to spend a trillion dollars to bring costs down, and that the CBO is saying you won’t bring costs down, and all you’re saying in response to that is, ‘Well, no, they actually will’? I don’t understand the disconnect here.

Sebelius replied that more would be done, and that the House and Senate are committed to working with the president on cost control. How’s that for a media-trained response? Finally, the secretary conceded that the administration needed to come up with another cost control measure, which she described this way: “It’s probably the MedPAC idea, making sure that an independent group a step removed from Congress is able to continue to watch that cost curve and help us drive quality.” MedPAC, cost curve, drive quality—jargon that is meaningless to everyone except Washington insiders. Still, Gregory’s repeated questioning on this point (and Sebelius’s sidestepping) couldn’t help but alert viewers that the administration was not sure what it wanted to do.

Same story on universal coverage, which the president has never been perfectly clear about, and based on the Sebelius interview, still isn’t. Gregory asked point blank: “Is universal coverage the priority? Sebelius answered: “It isn’t the priority, it’s one of the priorities: cost, quality, coverage. All three have to be part of this fundamental reform.” Why, that sounds just like policy speak from health care researchers!

Gregory tried again: “So, if there are, say, millions of Americans who are left uninsured, it would not stop the president from signing a healthcare reform bill? Again, Sebelius evaded the question, saying that insuring everyone was “one of his goals. It’s not one or the other. He wants a bill that covers all Americans, that offers affordable, quality coverage to all Americans.” As you may recall, that language is identical to the focus-grouped mumbo jumbo being peddled by Celinda Lake, the Democratic pollster and strategist.

Gregory pressed on the politically charged issue of paying for reform, asking: “Does the president support a surtax on the richest Americans to get this health care paid for? The surtax seems to be the financing vehicle of choice at the moment. Sebelius answered: “What the president supports is paying for this bill.” (In his Saturday radio address, the president said he would veto a bill that adds to the deficit over the next decade.) “But does he support this?” Gregory tried once more. Sebelius answered: “He knows that the House has a plan to pay for it. That’s very good news.”

When she started to talk about what the Senate is doing, Gregory really came on strong:

But why won’t he commit, Madame Secretary? Why can’t the American people know what it is he’ll support? This is a very concrete plan that is now moving its way through the House.

Still no clear answer from Sebelius, who responded that there were basically five different plans in Congress. There was more “good news,” she said. “This Congress and this president are committed to paying for this over time.”

And so went the interview.

Takeaway Number One: The administration apparently is not ready to tell the American people exactly what it supports and how reform should be paid for.

Takeaway Number Two: Reporters can do a good job of questioning the pols.

Takeaway Number Three: Gregory’s hard-hitting approach shows how it can be done.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.