Senators Brown and Thune Debate Health Care

Senators Brown and Thune Debate Health Care

By The Situation Room - September 9, 2009

WOLF BLITZER: Both sides have been digging in their heels on health care reform. Will the president be able to create a new momentum when he speaks before congress tonight? Joining us now from Capitol Hill two U.S. senators; Democratic Senator Sherrod Brown of Ohio and Republican Senator John Thune of South Dakota. Senators, thanks very much for coming in.

Is it okay with you, Senator Brown, if the president says tonight, you know what, it's time for medical malpractice lawsuits to be capped, tort reform as it's called, despite the support that Democrats have received from trial lawyers over the years?

SEN. SHERROD BROWN (D), OHIO: I don't think he's going to say it that way. I don't think caps work because you have patients that are injured badly occasionally by an incompetent doctor and I want to see better licensing on the state level of doctors that have a history of malpractice. I want to see -- I think we can do some kinds of reforms there, but I don't think you start off with caps. Where they have tried that before, places like Texas, places like Ohio, it hasn't -- it saved doctors a little bit of money in malpractice premiums but it hasn't saved the health care system money and in Texas Medicare costs have gone up significantly higher than the national average so I really think it's a bit of a bogus argument. I'm always open to new ideas. I hope the Republicans bring some forward.

BLITZER: I suspect Senator Thune sharply disagrees with you on that, don't you, Senator Thune?

SEN. JOHN THUNE (R), SOUTH DAKOTA: You would expect that, wouldn't you, Wolf. I hope the president does come out and make an argument for tort reform. I don't expect -- he may I think make some statements about it this evening, but I'd be very surprised to see if there's a serious effort here on capitol hill to include that, but it is, if you're going to meaningfully reform health care in this country, you've got to get the issue of the practice of defensive medicine which costs the estimates are $100 billion to $200 billion a year.

BLITZER: Tell Senator Brown -- Senator Thune, tell Senator Brown -- he says it hasn't worked in Texas, for example, where they have caps why he's wrong.

THUNE: Well, I think that the people if you talk to the people in Texas, you'd probably get a different argument. There are lots of states that have implemented caps. In fact, I was in Texas here a couple of weeks ago, and they tell me that physicians are moving to Texas because of the changes that they have made in tort laws down there, so I think medical malpractice reform, the issue of defensive medicine is something that's got to be address federal you're going to meaningfully get after the issue of health care reform and cost containment which everybody says they are for.

BLITZER: As you know, Senator Brown, so many doctors out there, they order all sorts of tests. They themselves think a lot of the tests are useless, but they are expensive to protect themselves preemptively from medical malpractice lawsuits.

BROWN: If I don't deny that's a problem but I also would assert that those -- there are studies that show, including in the book by Andrew Wile who is one of the best known doctors and most prolific writers in the country, has said that image of doctors who own their own MRIs, own imaging machines actually order three times the number of tests than those who don't. That's not defensive medicine. Unfortunately we've built this system, built all kinds of incentives into this system that distort the system and don't provide the best health care. We've got to deal with some of those issues, absolutely.

BLITZER: Senator Thune, anything the president can say tonight that would convince you personally to support him?

THUNE: Well, I think there are things he can say, and I think primarily his message tonight, Wolf, will be directed at wavering Democrats. He's going to try to shore up his own party in the congress and probably to the American people to try and get them back on board. He's got to get on offense. He had a terrible month in august.

BLITZER: If he indicates he's going to give up on the so-called public option which you oppose strongly, a lot of Democrats love that public option of creating a government-run health insurance company to compete with the private insurance companies to create greater competition, if you will, if he says, you know what, let's just have a trigger, we'll try five years and if it -- if did doesn't work without the public option, we'll trigger it then. Is that something you'd be open to?

THUNE: I think the trigger is still problematic because it would be a hair trigger. I think that they would use that as a way of getting to a gate -- a gateway of getting to a public option, a government plan eventually, so I think he can try and repackage it and try to re-label it but it sort of ends up in the same place. If he were to come this evening and talk about tort reform and talk about interstate competition and talk about small business health plans and talk about covering people who have pre-existing conditions and portability and issues like that, there are a lot of things that I think Republicans are anxious to hear from him about and hopefully things we can find some common ground on.

BLITZER: I think he'll speak about those things later on tonight but getting back to the issue of a public option versus a trigger for a public option versus cooperative health insurance programs out there, where do you stand?

BROWN: Senator Whitehouse and I wrote the public option language. It's fair and brings in competition. In John's state of South Dakota, there's one insurance companies writes more than 60 percent of the plans in the state and southwest Ohio in the Cincinnati Ohio two insurance companies write 85 percent of the plans. They need competition. It's like private universities and public universities. The fact that they both exist make both better, and the public option is only an option that will help to drive down costs. It will help provide more choice, and it will -- it will give people the kind of choice that in my mind, particularly in those places that don't have the competition, it will make both the private insurance companies better and private insurance will make public insurance --

BLITZER: He makes a fair point, Senator Thune. There isn't a whole lot of competition in South Dakota.

THUNE: And if this plan were implemented, Wolf, there wouldn't be any. There would be one plan, the government plan, and that's the thing that concerns most people is that the government with a government plan is going to be more involved in the decisions that are traditionally made between doctors and patients. We need to have a robust private insurance market in this country. I think most Americans agree with that, and the other thing that I think is most troubling to a lot of Americans about this is the dramatic expansion at the federal level and the costs of this. I mean, even the most recent proposal that came out of the senate finance committee over a ten-year period about it's fully implement it had going to cost $1.8 trillion. That's a lot of new government spending at a time we're running trillion dollar deficits as far as the eye can see.

BLITZER: We're out of time. If you want greater competition, why not let the insurance companies compete nationally as opposed to only within a state?

BROWN: I don't have a problem with that, but insurance companies have had since World War II, since they have been writing major -- since they have been writing a lot of health insurance, they have had 60 years to do this right. They -- you can talk about competition, but they -- they continue their pre- -- they continue denial of care for pre-existing condition and discriminate against people with disabilities and discriminate based on geography and gender and put lifetime or annual caps on care so that if you really get sick and it's expensive and you really need the insurance company, they do something called recision. They cut you off. The public option will bring competition. I didn't write it. When Sheldon Whitehouse and I wrote it we didn't write it to game the system. We want it to compete. We know if we'll drive costs down insurance companies need more competition. Erasing the state lines might help a little bit but it's not going to make that much difference because insurance go where they can make the most money.

BLITZER: Thanks to both of you. We'll be watching you both in the senate tonight. Senator Whitehouse is the Democratic senator from Rhode Island for those of our viewers not familiar with him. Guys, thanks very much.

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