Campaign Desk was pleased to see This Week’s George Stephanopoulos try to pin down HHS Secretary Kathleen Sebelius yesterday. The effort was a big improvement over his previous health care interviews, when he acted like a shrinking violet, avoiding tough questions for his guests. For her part, Madame Secretary was, of course, evasive—most Sunday talking heads are—offering few clues to her boss’s thinking on two of health reform’s thorniest issues: how to pay for the subsidies the uninsured will require, and the creation of a public plan to compete with those offered by commercial insurers.
Until the last week or so, the president hadn’t shown much generalship on the health care front, apparently preferring to let Congress fire the opening shots, which it will do this week. So the interview was important. Playing off Obama’s weekend pledge that every dime of health care reform will be paid for and “will not add to the federal deficit over the next decade,” Stephanopoulos asked if the president will veto any legislation that is not fully funded. Sebelius wasn’t saying, instead offering White House boilerplate—the president is very serious about passing and paying for health care reform this year; Congress is fully engaged in figuring out the details and working with the president.
Sebelius repeated the rhetoric about the $900 billion Obama has put on the table for reform. Some of that money, she said, would come from minimizing tax deductions for the rich. Stephanopoulos noted that Congress has rejected that idea, but Sebelius claimed that “they haven’t even started to really discuss how they want to pay.” Stephanopoulos responded: “They made it pretty clear what they think about that tax proposal, and some say that the savings the president outlined will be very difficult to realize as well.” He pressed again: “If every dime of this is not paid for, will the president say, no, that’s not good enough, Congress, and send it back?”
The secretary, performing poorly, did what TV guests are taught in media-training school—bridge to something you’d rather say. She acknowledged that the president wants a bill paid in full, and then switched subjects, declaring that the status quo is not an acceptable alternative. After letting her ramble about workers being less competitive and the system being unsustainable, Stephanopoulos tried a third time: “And if it’s not paid for, he’ll send it back?” This time, Sebelius said she didn’t know the details but insisted “I think what he wants is for Congress to pay for it.” Then came a fourth try. “He wants Congress to pay for it, but you’re not willing to say right now—you’re not willing to make a veto threat right now? Sebelius said veto threats were not particularly helpful.
We didn’t get much clarity on whether the president had changed his mind about taxing the health benefits workers get from their employers, something he strongly campaigned against. Stephanopoulos asked if the president is now willing to consider the idea. Again the secretary fudged, saying the president:
“feels strongly that 180 million Americans have employer-provided health care, that taxing those benefits may indeed discourage employers from offering health care to their employees, exactly the opposite of what we want to do in the future.”
Stephanopoulos wanted to know what the secretary (and the president) thought about the emerging Congressional consensus that taxing benefits is a good idea. Again he pushed: “So, again, is the president saying he doesn’t want it but he might accept it, or there’s no way he’s going to accept it?” And again her media training kicked in, as she circled back to earlier points she had made—what’s happening now is what needs to happen; the status quo is unacceptable; the president feels “strongly” that there are other ways to pay for subsidies besides taxing workers’ benefits.
By now, Stephanopoulos was in fine form, and switched the conversation from the controversial to the super controversial—the public plan option. Once more, he pushed the secretary: “Doesn’t a public plan only make sense if it actually does pay lower rates than the private plans so that it’s lower in cost?” That’s a fair question that zooms in on the plan’s key element. But Sebelius wouldn’t bite, instead saying she didn’t think such a plan would have to pay lower rates. Was this a clue that the administration was not supporting a plan that did? Instead, she volunteered that “what you have to do is, maybe, cut some of those overhead costs and have innovative strategies.” Then she moved on to consumer choice—that uniquely American health-care concept that has been focus-grouped to death by Democratic pollsters. Like many others, the secretary conflated insurance coverage with health care in remarks that couldn’t help but confuse ABC’s audience:
”There’s one dominant company and that really doesn’t drive innovation; it doesn’t drive much in terms of quality care. We know that higher cost doesn’t translate into higher quality. And what we want to do is have the highest quality, lower cost care for all Americans.”
Wait a minute! I thought she was talking about a dominant company. In many places, that’s Blue Cross Blue Shield, an insurer that is a payer of care not a provider of care. Insurers don’t give care; doctors do. By higher costs, did she mean medical costs or insurance premiums? I’d wager she was talking about medical costs.
So what was the takeaway from all of this? The secretary of HHS was protecting her boss despite repeated hard-hitting questions; slippery politicians can still be slippery politicians; and the public is none the wiser about what the president is willing to push for. Dear reader, take note: the interview did not mention the proposal for an individual mandate that would require millions of uninsured Americans to buy private insurance. Maybe Stephanopoulos can work on that for next time. By then, perhaps the president and his emissaries will be in the mood to explain to the public why this is such a good idea.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.