MR. GREGORY: But first, the debate on health care. Joining us, Senators John Cornyn and Dick Durbin and former House Speaker Newt Gingrich and former DNC chair Dr. Howard Dean.

Welcome to all of you. A lot to get to.

I want to start with you, Senator Durbin, and get right to it. In light of the president's speech this past Wednesday, what specifically will be achieved on health care this year?

SEN. DICK DURBIN (D-IL): I think we can pass healthcare reform. I really believe the American people are ready for it. We're closer to victory now than we have ever been. And I hope that we understand that failure to pass this healthcare reform this year will make things overwhelmingly worse. Those who are opposing us, those who are criticizing us really don't have an alternative. They would stay with the current situation, which leaves families with health insurance with the uncertainty of its cost and the uncertainty of whether coverage will be there when they need it, and millions of America with no protection at all whatsoever when it comes to healthcare insurance. We can do better. And I hope that the Republicans will join us. We've opened the doors to them in the HELP Committee in the Senate; they had hearings that went on for hours and hours, and Chris Dodd chaired it. They accepted 161 Republican amendments. At the end of the day, more than half the amendments were from the Republican side, and still not a single Republican senator would vote for the bill.

MR. GREGORY: So...

SEN. DURBIN: We need their help, we'd like to have it.

MR. GREGORY: Are we talking about large-scale reform achievable this year?

SEN. DURBIN: Yes, I believe it is. We've got to understand that just taking small steps at this point won't stop the obvious increase in healthcare premiums, which are making it very difficult for individuals and families to pay for health insurance and a lot of businesses are dropping health insurance. And we also have to understand, the insurance industry is fighting this tooth and nail. They understand that real health insurance reform is going to make sure that they can't be denied coverage for pre-existing conditions, there won't be caps on the amount of money that can be spent in a lifetime, that health insurance companies won't abandon you when you need them the most. Those are the kind of reforms that Americans desperately need.

MR. GREGORY: And the White House is sending a not so subtle signal, the vice president saying on the "Today" program this week there will be a bill by Thanksgiving. Will the Senate, will the Congress meet that deadline?

SEN. DURBIN: I believe we can, and we hope that we'll have Republican support to do it. Despite the best efforts of Chris Dodd on the HELP Committee, as well as Max Baucus on the Finance Committee, only three Republican senators have really stepped up to this point. I hope that they will be with us, they'll work with the Finance Committee to pass a bill. But our doors are open. As the president said, anyone who'd like to step forward from the Republican side and help us write this bill in a constructive, positive way, we need their help.

MR. GREGORY: Senator Cornyn, is this a Democratic-only bill?

SEN. JOHN CORNYN (R-TX): Well, I hope not. Republicans would like to see healthcare reform to bring down the costs and make it more accessible to more people who currently don't have health insurance. But I would, I would respectfully suggest that the president's first got to convince members of his own party with this proposal. He's laid out what he called his plan during his speech before a joint session. No one has seen his plan, and what he described is not reflected in any of the bills that have been voted out of House or Senate committees so far. He has at least 13 senators, by my count, who disagree with him on the so-called public option or government-run plan, and about 90 members of the House--either Blue Dogs, the conservative Democrats, or liberals--who disagree with what that bill should look like. We'd like to work with the president and Democrats to try to come up with a commonsense solution. I would suggest that this is a case where the 80/20 rule applies, that 80 percent of this we could probably agree with as long as people would agree to leave the 20 percent we can't agree with for another day.

MR. GREGORY: But, Senator, you're being a lot more diplomatic here this morning. You, you went much farther; you said the president played lip service to the idea of bringing Republicans on board.

SEN. CORNYN: I agree. I think that--I think he has. Because when he's talked about let's deal with waste, fraud and abuse, something that Speaker Gingrich I know has worked on and I've introduced legislation to do, people want to see exactly what the savings can be from that before they agree to some big plan, a big expansion of government, unfunded mandates on the states through Medicaid expansion and huge cuts in Medicare, which is currently unsustainable.

MR. GREGORY: But, but, but you say only lip service. And the White House says, "Wait a minute, in this speech, in the president's plan he's giving a nod to malpractice reform, to tort reform, expanding insurance pools." That was Senator McCain's idea during the campaign. The idea of capping a tax exemption on, on employer plans, fiscal triggers. You know, the White House says, "When do Republicans stop moving the goal post and say he's actually hit something here"?

SEN. CORNYN: It was a good speech. But he said--he described what he called his plan, and so far we have not seen his plan. There's a difference between campaigning, giving a good speech, and actually governing. And I think we're seeing that disconnect here. Because the president needs to work with us to make hard decisions in order to solve the problem, not just give a speech.

MR. GREGORY: Do you concede, those are Republican ideas that he outlined in the speech?

SEN. CORNYN: Those are good ideas. I'd like to see them reflected in legislation.

MR. GREGORY: OK. But you--so--and if they are, that's something you could vote for?

SEN. CORNYN: Well, I certainly would support those. I'd want to see the entire picture. I don't see how we can agree to cut $500 billion out of Medicare, which is currently scheduled to go insolvent by 2017. I disagree we should raise taxes on small businesses that are a primary job-creating engine in our economy. So let's see what the whole package looks like. But those are good ideas.

MR. GREGORY: All right, let me bring in Gingrich and Dean here.

And, Dr. Dean, let me start with you. How is the president doing now leading this fight for healthcare reform?

DR. HOWARD DEAN: I think that Democrats--I think he did two things that he had to do. He showed he was a strong leader. And presidents, regardless of the issue, the American people want to see a strong leader in the presidency. That's the most important thing. The second thing he did is he, he unified the Democrats. And he's going to have to have those. We're not--at the most, we're going to get three Republican senators and probably no Republicans in the House to vote for this, so the Democrats have to be together.

MR. GREGORY: But can you say he's united Democrats yet? You've got about 10 to 12 moderate, more conservative Democrats who are saying, "We're not there yet."

DR. DEAN: Well, I don't think so. I mean, by my vote count, we got 51 votes in the Senate to pass healthcare reform with the public option. So, you know, we'll...

MR. GREGORY: Yeah. That'd be ramming it through. That would be a reconciliation strategy...

DR. DEAN: Look...

MR. GREGORY: ...and...

DR. DEAN: I--you--in this audience, I think we can talk about ramming stuff through. Newt's been the speaker. Republicans and Democrats both rammed things through. The--at, at the end of the day, the American people want a bill. And it's--they're not going to care if it's reconciliation or if, if it's ramming it through. What they want is a decent bill that makes sense to them.

MR. GREGORY: All right, let me get an opening thought from you, Speaker Gingrich. You said this week the president had to make a decision: Show up as president or as a partisan. Who showed up?

FMR. REP. NEWT GINGRICH (R-GA): Well, I think he was about 80 percent president, about 20 percent partisan. I think the partisan parts didn't help him. I think what he did on Monday in giving the campaign speech didn't help him. But, but the big difference--and I'm going to go back to what Senator Cornyn said. I can go through the president's speech and find a lot of things that I like. Then I go to the House Democratic bill and I don't find a single one of those things reflected in the legislation. Now, they, they literally had voted down efforts to make sure that health insurance only went to people who are legally in the United States. So they would have to go back and have very significant changes, which I think would split the Democratic caucus. And I think part of the reason you saw some, some real anger about the speech is he kept describing things that had been explicitly not put in the bill on the House side, and the House bill has no resemblance to the president's speech. Whether or not he can get Speaker Pelosi to agree to rewrite that bill I think is very doubtful. So I'm not convinced yet as president that he's capable of leading his own party.

DR. DEAN: I'm going to disagree with that, if I can, for just a second. First of all, it says in the bill that undocumented aliens can't get health insurance reform. What Newt's talking about is something that said and they have to show proof or something of citizenship. We're, we're talking about small details here. The other thing is I'm going to strongly disagree with Senator Cornyn. This bill is remarkably helpful to small business. Small businesses less than 25 employees in the Senate bill don't have to have--pay anything for health insurance ever again. Less than half a million dollars in the House bill. And this is a--Blue Dogs put this in. Payroll--don't have to pay health insurance ever again. That's a huge boost for the people who create 80 percent of all the new jobs in America.

MR. GREGORY: All right.

DR. DEAN: And that's never talked about, and it ought to be talked about. This bill is a big boost for small businesses.

MR. GREGORY: All right, I want to, I want to get into some of the issues. But I want to ask Senator Durbin quickly here, on the vote count, do you have Senator Snowe? Do you have 60 votes?

SEN. DURBIN: Listen, I'm not going to presume any Republican senators at this point. Senator Baucus is working with Senators Grassley and Enzi and Snowe and others. I spoke to him over the weekend. He's reaching out to other Republican senators. Some of them understand this is an historic opportunity. In terms of the Democratic side, we're going to work closely with our members, too. They have to be set aside that this bill is going to help them, help their states and help this nation. But the fact is we are not going to miss this opportunity. We invite the Republicans to join us for this historic opportunity. If they do not, we are still going to go forward.

MR. GREGORY: Let me ask you about a key policy provision here, what's gotten so much--taken up so much oxygen in the room in this debate, and that is the public option, the idea of a government plan in these exchanges that would compete with private insurance plan. The president stood behind the idea of competition, keeping the insurance companies honest. But this is what he said about the public plan Wednesday night.

(Videotape, Wednesday)

PRES. OBAMA: The public option is only a means to that end, and we should remain open to other ideas that accomplish our ultimate goal.

(End videotape)

MR. GREGORY: Senator, that was an important statement. Is the public option now buried and gone?

SEN. DURBIN: No, it's not. I support the public option, but I also think the president stated it correctly. What we're looking for is real competition. Understand, the health insurance companies hate this public option, as Dale Bumpers used to say, like the devil hates holy water, Because it means that there's going to be a force in place there that is going to put in competition and keep costs under control. The so-called Lewin Group that's been quoted by many senators on the floor about how this is going to get out of control happens to be an organization that is owned by the United Healthcare Group, a health insurance company. So they've been discredited. The fact is that we understand that putting in a public option means that people will have a choice in markets where there are only a handful of private health insurance companies and people have nowhere to turn...

MR. GREGORY: But, Senator, it can't pass the Senate, can it?

SEN. DURBIN: ...they have to have an affordable choice.

MR. GREGORY: It can't pass the Senate.

SEN. DURBIN: Well, it--I wouldn't go that far. I would say at this point that the House of Representatives includes a clear public option. I don't know what the Senate bill will look like coming out of the Finance and HELP Committee. But we've got to have--at least be true to the principle the president said: Make sure there's competition for these private health insurance companies. These companies do not want the competition, but if we don't have it the prices will not come down.

MR. GREGORY: All right. But, Dr. Dean...

DR. DEAN: Yeah.

MR. GREGORY: ...White House officials I've spoken to have been very clear, saying that the left in the Democratic Party has overshot the runway here, overstating the importance of a public option. Did the president put it away?

DR. DEAN: I don't think so at all. I'm, I'm with Dick on this. Look, the president said yesterday that if you can find another way around it to control the insurance companies' costs, that would be fine. There's another way. There's two countries in Europe that have universal health care without--and it's entirely run by insurance companies. But they treat the insurance companies like regulated utilities. If the insurance companies would prefer to be treated like regulated utilities, we'd drop the public option in a heartbeat.

SEN. CORNYN: Well, first of all, the president can't keep his promise that if you have what you like now that you can keep it with a public option or government-run option. It's not just the Lewin Group, it's also the Congressional Budget Office. They've said depending on the shape of the final plan, it could be eight to 10 million, it could be as many as 119 million according to the Lewin Group. Anyway, you cannot keep what you have if you like it now, so the president can't meet that promise. And secondly, I think our goal ought to be let's give the American people the same kind of choices that members of Congress have when it comes to buying health coverage. Right now there is no, there is no public plan for members of Congress. You get a choice between various insurance coverages that suit your family's needs and at a price that you want to buy it at. So I think that ought to be our goal. This whole ideological fixation on the public option is just that, it's not a practical solution to the problem. We're ready to work with practical solutions to cover people, to bring down the price, but not a government takeover.

MR. GREGORY: Speaker Gingrich, let me bring you here and let me just shift a little bit about the speech on Wednesday night, and that is the tone and the tenor of some of the opposition to this. Congressman Joe Wilson has gotten so much attention this week for his outburst this week calling the president a liar in the, in the House chamber. Does he galvanize Republican opposition or does he hurt the party's image?

FMR. REP. GINGRICH: I don't think either one. I think the--you may remember that in 2005 Democrats booed President Bush when he proposed Social Security reform. And there were dozens of Democrats booing him. It didn't seem to be a very big issue that year. The fact is, the country's looking at the speech and the country's asking about the speech. And a good example is what Howard Dean just said. When you, when you say to me no small business under 25 employees will ever again have to buy--pay for health insurance, I want to know who's going to pay for it. I mean, this country--you're going to get to the economy later on. This country's facing $9 trillion in increased deficits. The average American is thinking, you know, life doesn't work like this. You--the idea that every small business in America is going to be able to somehow magically wave a wand and in perpetuity we're going to be given free health insurance?

DR. DEAN: I didn't say free.

FMR. REP. GINGRICH: Well, then, where's the money coming from?

DR. DEAN: There's the--the way, the way the bill works is a government subsidy, and then you go out and choose what kind of health insurance to...

FMR. REP. GINGRICH: So where does the government money come from? Who's going to give the government the money to give me? I have a, I have a couple small businesses, and my small businesses could easily meet this.

MR. GREGORY: Right.

FMR. REP. GINGRICH: As a small business owner, I'd love to have free health insurance.

DR. DEAN: It's not free.

FMR. REP. GINGRICH: Ah.

DR. DEAN: Employees have to pay something for it.

MR. GREGORY: All right. I want to get to deficit question, but I just want to finish up on Congressman Wilson. And I'll ask you, Senator, does he hurt the image of the GOP, or does he become the face of the opposition? You're helping to run the campaign for Senate Republicans next year. Where would you like to see him rank?

SEN. CORNYN: Well, there's a time and a place for everything, and that was not the time or the place for that kind of comment. But, you know, the Democrats have done a pretty consistent job of trying to demonize the people who show up at town halls, anyone who disagrees with their proposal. This is not the time to be demonizing anybody, calling anybody names on either side. This is a time to try to work together to solve a practical problem. And we stand ready to do that if the president will meet us halfway.

MR. GREGORY: Let's talk about the deficit. And the president made a very important pledge during this speech on Wednesday.

(Videotape, Wednesday)

PRES. OBAMA: I will not sign it if it adds one dime to the deficit now or in the future. Period.

(End videotape)

MR. GREGORY: Senator Durbin, a hard pledge to meet when you've got House legislation that already does that, it already breaks the deficit. It can't be paid for over 10 years, according to the CBO. Here's a Washington Post editorial this morning having to do with where are the details, does the math work: "When politicians start talking about paying for programs by cutting `waste and abuse,' you should get nervous. When they don't provide specifics--and when the amounts under discussion are in the hundreds of billions of dollars--you should get even more nervous." How does this get paid for without adding to the deficit?

SEN. DURBIN: Members of Congress should take the president at his word, he will not sign a bill that adds to the deficit. He walked into the White House and inherited a $1 trillion-plus deficit from the Republican administration because they had fought a war in Iraq they didn't pay for, the gave tax breaks to the wealthy they didn't pay for and they had a prescription drug program under Medicare they didn't pay for. This president said that's over, and members of Congress should take that seriously. Now, I disagree with The Washington Post. The fact is, under Medicare now we are providing multibillion-dollar subsidies to health insurance companies for something called Medicare Advantage. The health insurance companies said to us, let us run Medicare. We can show you how the government's not doing it efficiently, we can do it at a lower cost. Guess what, it's not at a lower cost. We are subsidizing private health insurance companies to provide the Medicare benefits that we can provide at a lower cost. That has to change. That subsidy has to end. That is the kind of savings that can come back into the system to help small businesses provide health insurance and help those with lower incomes pay their premiums in America.

MR. GREGORY: How does...

FMR. REP. GINGRICH: Well, first of all...

MR. GREGORY: Speaker Gingrich, how do you keep that pledge?

FMR. REP. GINGRICH: ...listen care--first of all, listen carefully to what he just said. He just said to the senior citizens of America, "We're going to take hundreds of billions of dollars out of Medicare and we're going to divert it to people who aren't senior citizens." Now, this is part of why you're seeing these town hall meetings. People who are on Medicare Advantage in rural America are getting a quality of health care they never got before. I just got an e-mail from somebody at the Gundersen Lutheran Clinic in La Crosse. They're on Medicare Advantage. They don't want to be forced to give this up. And it's interesting; the president says on the one hand, nobody has to give up anything. But by the way, if you're a senior citizen on Medicare Advantage, we're going to take a couple hundred billion dollars away from you. I think this, this section you showed of the president is an example of why we are in the kind of debate we're in right now. I don't believe most Americans believe it's possible to have the plan he wants and not see the deficit go up; unless he's going to propose, in the middle of the deepest recession since the Great Depression, massive tax increases which would further deepen the recession.

DR. DEAN: First of all, the money is not being taken away from senior citizens, it's being taken away from the insurance companies who are responsible for a lot of them problems in the first place. Second of all, it pains me deeply to see one of the great optimists, which is House Speaker Gingrich--you are. I mean, we agree on a lot of stuff. And the great--the thing we have in common is America can do anything. Every other democracy in the world has a healthcare system that covers everybody and we don't. Of course we can do this. How ridiculous.

MR. GREGORY: But, Dr. Dean, you have said, when you were running for president in 2004, people have to understand that you got to pay for it.

DR. DEAN: That's right.

MR. GREGORY: If you want that coverage, you've got to pay for it.

DR. DEAN: And the president is paying for it...

MR. GREGORY: And how do you not raise taxes?

DR. DEAN: And two-thirds of the money that's being--when President Obama talks about taking $500 million out of Medicare, that's not taking $500 million--billion dollars away from seniors. That's taking the waste that the Republicans have been talking about for years, the abuse that the Republicans have talked about for years, the stuff that the insurance companies are getting for profit over and above what their services are. They're--two-thirds of this bill is paid for with savings. And if you don't think the savings are there, then how come we spend 17 percent of our gross national production on health care and, and the Canadians, the British, the French, all of whom insure everybody, spend about 10 percent? There is so much fat in this system, we can pay for it.

SEN. CORNYN: David, we've got to be honest about the cost, and so far we haven't heard the president be clear about the cost. The Senate Budget Committee estimates that the House bill will cost not $1 trillion, but $2.2 trillion. The HELP Committee bill, the Health, Education, Labor and Pensions Senate Committee bill is estimated to cost $2.2 trillion over a full 10-year budget window. We need to be honest about what the cost is, what the pay forwards are going to be in terms of tax increases, cuts into existing programs that are already very fragile and not, and not going to be solvent by 2017, and then I think that's what is making people nervous. That's why people are speaking up and expressing...

DR. DEAN: Right.

SEN. CORNYN: ...their concerns.

MR. GREGORY: Well, Senator Durbin, look, you're in the Senate leadership. Can you say unequivocally that taxes will not have to go up in order to pay for a $900 billion healthcare reform plan?

SEN. DURBIN: Of course not. That's irresponsible. What the president said, if we're going to need new revenue, and some revenue will be needed, it'll come from those who can afford to pay. He's talked about tax increases for those making over $250,000 a year, a tax increase on health insurance companies for certain policies they sell. I mean, those are, those are the realities of the situation.

And let me tell you, I've heard this song before from Mr. Gingrich and from others that we just can't do it, that America's incapable of doing it. But Dr. Dean has it right. This is our chance. If we don't do it this time, we won't have a chance in my lifetime and the situation will get progressively worse. Let us face up to the reality and do this in a responsible way.

MR. GREGORY: Let me bring up another issue that I think has a lot of people worried. I've spoken to some people this week who, who asked me, they're trying to figure out the details of this plan, and they say, "Let me get this straight. So if I'm not old enough yet to afford Medicare, the president says I've got to buy health insurance. He's going to mandate that I buy health insurance. Maybe I've lost my job. And can I afford what it is he's suggesting? Can I afford to buy insurance if I'm mandated to do so?" The National Journal has this headline in an article that it had: "At What Price? It's one thing to require everyone to have health insurance. It's quite another to make sure everyone can afford it."

Speaker Gingrich, is that a real concern here?

FMR. REP. GINGRICH: Sure. If you look at Massachusetts, they now have the most expensive health insurance in the United States. it was an interesting, noble experiment, and the fact is it's going to turn out to be very expensive. You know, James Carville had a sign in 1992, "It's the economy, stupid." It was right in the middle of the Clinton campaign headquarters in Little Rock. This White House ought to put that sign up in the Oval Office. Everything they do should be designed to get this economy growing again, to create jobs again. And what they're doing is they're layering whole new layers of theoretical reform on an economy which is still decaying. And I think it's very dangerous. The reason small businesses aren't excited about this opportunity for free health care is that they've figured out who's going to pay the tax to pay for the free health care. It's the small business owner who's going to have his taxes or her taxes go up dramatically in order to pay for the government's free health care.

MR. GREGORY: Well, and I want to say on this point, Dr. Dean, the point of it, if, if you're forced to buy insurance as a family...

DR. DEAN: Right.

MR. GREGORY: ...and you can't afford it, the government says, "OK, we're going to give you subsidies. We're going to pay for it for you."

DR. DEAN: Right.

MR. GREGORY: But in order to make the bill less expensive, you have to cap those subsidies. You can't do it for everybody.

DR. DEAN: Sure. Look...

MR. GREGORY: So there's still a lot of people who may not be able to afford it.

DR. DEAN: David, we have universal health insurance, essentially, in my state for everybody under 18 years old. The reason we--the way we did that is that we didn't use, use a mandate. We used Medicaid as a substrate, raised the, the, the reimbursement to primary care physicians, got a, got a waiver, and we--for 480 bucks you can pay for, you can pay a premium and every kid in your family'll be insured for under 300 percent of poverty. People over 300 percent don't get a subsidy. I think that's what's being talked about in the bill.

And let me just say one thing about Massachusetts, which was put in by a Republicans governor and a Democratic legislature. I think the jury is out. I agree with Newt, it is too expensive and it is a problem. But they're down to 2 1/2 percent uninsured. That's comparable to some of the European countries. It's an extraordinary achievement. So look, I think--I actually argue that it's--one of the reasons it's so expensive is because they didn't have a public option, and if they had, their costs would be under better control. That's my argument. I--the speaker would probably disagree with that one. But it--the fact is there are a lot of these state experiments that are going on, some of which are successful and some of which are problems. They're going to have to be changed around a little bit. And I think we can learn. We're going to have the exchange mechanism that they developed from Massachusetts in the big bill, and I think that was--that is a good idea.

MR. GREGORY: But ultimately, Senator Durbin, to keep costs under control, can you achieve universal coverage?

SEN. DURBIN: I think we can get close to it. And I also want to add here that there's a hardship deferment in the bills that are being considered for those who, in extraordinary circumstances, cannot have health insurance. And there's also a cap of 13 percent of your income that you would pay in premiums, and help for those who can't afford it. I mean, we're doing everything in our power to bring everyone under the tent. Because understand the current system; the uninsured people today show up at the hospital sick, they are treated and their costs are passed on to the rest of us. The average family pays an additional $1,000 a year in premiums just to cover the uninsured. This notion that we...

MR. GREGORY: But, but, Senator, let's just be clear what we're talking about. If you're in your 50s and, and you can't qualify for the subsidies, under the Senate plan, the Baucus plan as it's called, the insurance companies can charge you, at that age, a higher premium than they would a younger person without insurance.

DR. DEAN: That's a big problem. That has to...

SEN. DURBIN: The Baucus plan...

MR. GREGORY: That's a big problem, you say, though.

DR. DEAN: Yeah. You cannot do that. They got to have--you have to have community rating in this bill. We did it in our state 50 years ago.

SEN. DURBIN: But, but...

DR. DEAN: It works great.

MR. GREGORY: All right. But finish the point doctor--Senator Durbin.

SEN. DURBIN: Well, I can just say that the Baucus plan is now being debated and goes back to Dr. Dean's point, the rating questions are critically important, gender questions and questions of age and whether or not you smoke. Those are important questions. But the bottom line is we've got to understand everybody has to accept the personal responsibility of health insurance. If you are opting out and saying, "I, I have to exercise my freedom here. I'm not going to have health insurance," and then turn up sick, guess who pays for it? The government or other people who are insured. We've got to bring everyone in the system for their own good...

MR. GREGORY: Look...

SEN. DURBIN: ...and the good of everyone in this country.

MR. GREGORY: I've just got about a minute left. Senator Cornyn, let me turn you on the, on the question of politics, because it's a huge question in this fight. What are the consequences of doing nothing here for the Democrats, and what's the upside as you look down the road in the midterm elections for Republicans?

SEN. CORNYN: I don't think doing nothing is an option. And indeed we've said--I've said here today that we have probably 80 percent, whatever the number is, of things that we could probably do in terms of insurance reform and providing lower cost access to health care, providing coverage.

But I think Dr. Dean makes a good point. What works in Vermont, in a relatively homogeneous population, a small state, may not work in a big state like Texas with 24 million people, with a large number of people who are not American citizens who, who are living there and who would not be eligible for this plan according to the president. So one size fits all is part of the problem. And I think we ought to offer flexibility at the state level to have state-based insurance exchange, to let people buy and have the same choices that members of Congress have among private plans and not undermine the private insurance market and provide a pathway, ultimately, to a single payer system, which is my, my concern and, I think, borne out by some of the experts.

MR. GREGORY: Senator Durbin, the political consequences for Democrats if reform does not get through this year is what?

SEN. DURBIN: Listen, this president has committed to this issue like no other president before him. He said he'll spend every penny of his political capital to get this done. That's the kind of leadership that we need and that's a feeling we left with from the House chamber the other night after the speech. We're going to pass healthcare reform. We may not have another chance. We've got to seize this opportunity, otherwise we're going to have overwhelmingly negative results if we don't do it.

MR. GREGORY: Before you go, the other issue is Afghanistan that is dividing Democrats. Senator Levin was quoted as saying this in The New York Times: "The leading Senate Democrat on military matters [Armed Services Committee Chairman Carl Levin] said that he was against sending more American combat troops to Afghanistan until the United States speeded up the training and equipping of more Afghan security forces." Is there a split? Do you support sending more troops to Afghanistan?

SEN. DURBIN: No, I don't. I agree with Senator Levin. And I think that the president is going through a re-evaluation with our new General McChrystal as the commander of the NATO forces. I think at this point sending additional troops would not be the right thing to do. I agree with Senator Levin.

MR. GREGORY: Has the president made a determination that is politically untenable to try to get Congress to approve sending more troops?

SEN. DURBIN: I can't say that. I will tell you the president has not asked for troops, at least not to my knowledge. At this point we should follow Senator Levin's suggestion. Let's get it right on the ground, let the Afghans bring stability to their own country. Let's work with them to make that happen.

MR. GREGORY: All right, I'm going to let that be the last word. From health care to Afghanistan, thank you all very much.