Navigating the medical system can be confusing and frustrating. We get advice from experts on how to become a smarter health care advocate for yourself and your loved ones.
A Republican effort to repeal the health care law fails in the Senate. The House considers new limits on the growth of Medicare. And a monster winter storm batters one-third of the nation. A panel of journalists joins Diane for analysis of the week’s top national news stories.
- Ron Elving Washington editor for NPR.
- Susan Davis congressional correspondent, National Journal.
- Naftali Bendavid national correspondent, The Wall Street Journal.
Friday News Roundup Video
Diane and the panelists discuss the Supreme Court’s potential role in deciding the constitutionality of the individual mandate portion of the health care law, and they respond to a caller’s concerns about the desperate situation many Americans face who can not afford health care insurance coverage:
MS. DIANE REHMThanks for joining us. I'm Diane Rehm. On Wednesday, Senate Democrats defeated an attempt to repeal the health care law. A vote on repeal came just two days after a federal judge declared it unconstitutional. The House is considering new limits on the growth of Medicare, and a massive snow storm battered one-third of the nation. Joining me for the domestic hour of our Friday News Roundup, Naftali Bendavid of The Wall Street Journal, Susan Davis of National Journal and Ron Elving of NPR. Lots to talk about today. I'm sure you'll want to join us, either by phone, by e-mail. Join us on Facebook or Twitter. Good morning to all of you.
MR. NAFTALI BENDAVIDGood morning, Diane.
MS. SUSAN DAVISGood morning.
MR. RON ELVINGGood morning.
REHMAnd welcome to another week of confusing economic reports. Naftali Bendavid, the Labor Department says the nation's unemployment rate has fallen to 9 percent. But -- and that's the lowest since 2009, but has added only 36,000 jobs. You heard economists projecting 150,000 job -- additional. What's going on here?
BENDAVIDWell, it is confusing. There's a few things going on. Part of it is that the unemployment rate is dependent, in part, on the number of people who are looking for jobs. So there's always this issue of people who don't have a job and want them but have, perhaps, given up looking. But I -- and there's also some sense that the winter weather has interfered with a certain amount of job creation that was anticipated. It's harder to create, for example, construction jobs and things like that when, you know, huge regions of the country are covered with snow. But I do think that, if you look at the past couple of months, the news has, overall, been in a positive direction.
BENDAVIDYou know, it's been halting. It's gone a little bit forward and a little bit backward. But if you talk to most economists, they'll say that the indications, really, are pretty good. They're slow. It's a slow improvement, but at least it seems to be headed in the right direction.
DAVISIt is slow. It is headed in the right direction, but it's still bad. And I think -- one of the things they have agreed on is to get back to a normal unemployment rate, the United States government -- or the economy needs to be adding about 200,000 jobs a month, every month, for the next two years to get back to a normal rate. So, even if it had been this projection that the economists have predicted, it still would have been bad jobs numbers. So I think the question is going to be -- going forward -- how is the government and Congress specifically addressing this? And what are they going to do to sort of spur economic growth?
ELVINGOne number in this report that's interesting is the number of manufacturing jobs being created -- 49,000. That's the greatest number in one month in quite some time. So while it was largely offset by the losses in both construction and transportation, that is a hopeful sign, especially for those who believe that to be fully a healthy economy we really need to add much more in the area of manufacturing, in particular, and become a country that makes things, as well as a country that moves things around and is the financial and largely cultural capital of the world economy.
REHMBut don't you think it's confusing when the numbers come in at such a low additional rate of jobs, and yet the unemployment rate goes down to the lowest point since 2009?
ELVINGIt is unquestionably confusing...
ELVING...but there's a reason for it, and that is that these are two different surveys. These are data that come out at the same time, but which are not functions of the same numbers. So we are measuring this in two completely different ways, and the unemployment percentage number is largely done by household survey. So we're taking in data points from different directions, and they're not always going to move in the same direction. In fact, they often do not. And as a result, it is confusing to all of us laymen and laypersons, and, I think, it's confusing to a lot of economists often times, too.
REHMYeah, I think so, too. Go ahead, Naftali.
BENDAVIDWell, one of the things that you see -- as we were discussing a little bit before the show-- is that people survey economists before these numbers come out, and they make projections. And then based on those projections, people say, aha, job creation fell short, or it exceeded expectations. And so I think, to some degree, that's an artificial construct. But, also, if you look at some of the other numbers that have come out recently, for example, retail sales in January, across the board, were better than people expected despite the snow, right? And productivity numbers were up.
BENDAVIDAnd so those kinds -- in other words, it's -- people are very concerned with unemployment rightly so because it's people's livelihood. But if you look at some of the other figures, again, it suggests to me that things are moving slightly and haltingly, but still basically in the right direction.
REHMWhat is it -- what does it mean that productivity increased while labor costs fell? Explain that.
BENDAVIDWell, I mean, that's sort of related. It means that people -- it means that companies are getting more out of their workers. They're getting their workers to produce more things.
REHMHow much farther can they go?
BENDAVIDWell -- and, I think, that's actually why it's probably a good thing because they probably can't go that much further. And so what happens is, once you've wrung every last bit of production that you can out of your workforce, you don't have much of an alternative except to hire more people. And I think that's where companies are. They're reluctant to hire because they don't know how things are going to go. They're maybe bringing on temporary people if they have to bring on anyone.
BENDAVIDBut it seems like pretty soon, we might get to a point where they've gotten what they can out of the current workforce, and they're going to hire more people. And these things have a sort of momentum situation. So, if more people are hired, then they buy more things. And if they buy more things, then retailers do better. And so there's going to reach a point, I think, where it's going to feel like we've turned a certain corner. We're obviously not there yet. But, as I say, my own impression is that we're moving slowly in the right direction.
REHMAnd 14 percent of Americans still on food stamps.
DAVISYes. That was -- this week, they reported that. Do we get the number of millions of Americans? I think it's 43 million Americans.
REHMI simply have 14 percent.
DAVISYeah, a tremendous amount, and I would say most of them are in Washington, D.C. -- was number one of percentage of residents on food stamps. Twenty-one percent of residents in the District of Columbia are on food stamp assistance.
REHMInteresting. And then, of course, Ben Bernanke took questions from reporters yesterday at the National Press Club.
ELVINGYes, he did.
ELVINGYes, he did. And he was issuing some warnings to elected officials -- maybe particularly to Republicans -- with regard to some of the rhetoric that they're using and what sort of effect it might have on the long-term standing of the United States and its finances in international terms, in the global economy. I think the point that a lot of people have been trying to make about this recovery is that it's unusual from other recoveries. It's different from other recoveries in that it hasn't produced the rapid adding of jobs. What businesses have been doing, as Naftali was saying, is they have been using the higher productivity for profitability, and they've been hoarding a great deal of cash, an unprecedented amount of cash, partly because they're scared about what happened in 2008 and partly because they're apprehensive about what's going to happen in 2011 and '12.
ELVINGThey want to see how some of these new regulations play out. And so both parties are jumping on this and saying, on the Democratic side, these businesses need to create jobs, and on the Republican side, they're scared to do so because you Democrats are regulating them too much.
REHMBut beyond employment, he also talked about concerns regarding the deficit, and he warned people not to play around there.
DAVISBernanke added his voice to the chorus of -- Timothy Geithner is one of them, the president, leaders in Congress, who are saying we can't mess around with the vote for -- on the debt ceiling to raise the debt ceiling, which is going to come, earliest, probably, in late April, early May, the vote is expected, generally. And he said as a warning -- and I think it was the first time Bernanke publicly said it would be catastrophic to not raise the debt ceiling and to be -- use it as a political football would be a big mistake.
REHMAnd then the House Republican leaders proposed cutting more than $38 billion from government spending. That's a lot less than the $100 billion the Tea Party wanted, Naftali.
BENDAVIDWell, it's also a lot less than $100 billion that they had said themselves that they were going to cut. They argue that they are sort of prorating it, that because it'll be starting halfway through the fiscal year -- and there are some other calculations that they're making -- and they said that they're sticking to their pledge. But there's no question that this is causing tensions within the Republican Party because there's a push from the -- not only Tea Party activists but from freshmen -- mostly freshmen -- Republicans who say well, we should be cutting $100 billion. And so -- and this just goes to show how easy it is to talk about these things and how hard it is to do when you actually run part of the government and need to make these cuts.
DAVISYeah, I think Naftali is exactly right. The Tea Party -- the $100 billion was almost a moderate amount for a lot of the Tea Party Republicans. They're saying, there's no limit to what we're willing to cut. So what leadership has, especially in the House, which is controlled by Republicans now, is corralling these new members to say, look, this is our first bite of the apple, this $38 billion. We're going to have another chance to cut spending, probably negotiations over this debt limit vote. We'll have appropriations coming up, spending bills of the year. This is going to be a continual process. Don't vote against this 'cause it's not enough.
REHMAnd what percentage of Democrats are likely to go along, Ron?
ELVINGIn the Senate, where the Democrats are still running the show, they do not regard this number as too small. They regard it as a terrible Draconian cut that cannot be accepted. Now, that's not every Democrat, but that's the prevailing view among Democrats in the Senate. They're going to fight these cuts. So, on the one hand, it's way too large from the standpoint of people who think the spending is justified, and, on the other hand, for the people who want to cut spending, the number does seem rather paltry, especially when the first line of the House budget committees' budget release -- or their press release on this was, Washington's spending spree is over.
ELVINGNow, no matter where you stand on the political spectrum, $30, $35, $40 billion in cuts and a budget of over $3.5 trillion, where the debt in one year -- the deficit, rather -- is $1.5 trillion, this does not mean the Washington spending spree is over.
BENDAVIDI mean, I think, in some ways they should be looked at as the opening shot because we also have the Senate, which is controlled by Democrats, and we also have the White House. So this is what the House Republicans want to do. And it's interesting, and it's coming under attack from all sides as being too big or too small. But it's only the beginning of the negotiations, and so I think...
REHMAnd what they want to do is cut every federal agency, except Pentagon. Isn't that correct?
BENDAVIDThat's correct although Republicans are talking more about being open to cutting military spending. I think for a long time they were resisting that, but, I think, they've come to the conclusion that they can't make a credible case for cutting the deficit, especially if they're no going to deal with entitlement programs, like Social Security and Medicare, and also exempt the Pentagon. So I think they're signaling that they're a lot more open to that.
DAVISThey did offer the poll Ryan. It was sort of the surprise of the numbers they put out this week. He did offer $14 billion in National Security cuts.
REHMSusan Davis of National Journal, Naftali Bendavid of The Wall Street Journal, Ron Elving of NPR. Short break and your calls, your e-mail when we come back.
REHMHere's an e-mail combining the snow storms and jobs. Our listener Scott says, "Consider that snow storms keep many people employed -- shoveling off roofs, plowing lots and driveways -- but that is not a position. It lasts three days. One or 2 percent of folks now say on the phone they got a job this week. But no employer says they created a position. More and more folks are finding ways to get by, but don't hold a real job." Naftali.
BENDAVIDWell, I mean, I certainly think there's some truth to that. I mean, it's hard for me to say whether when some -- whether if you got a call from a pollster and you've been out shoveling snow for a few dollars a day, you're going to tell them you have a job. I'm not sure that that necessarily is going to play out that way. But the caller is certainly right that people are making do in various ways. There's a lot more temporary jobs. And people are taking work where they can find it, as you might expect. And that probably does affect the numbers.
REHMAll right. Let's talk about the health care law. On Wednesday, the Democratic majority in the Senate defeated a repeal of the health care law, voted on party lines. Where are we going with this? We've got 20 more cases facing the courts. Virginia's attorney general says he wants it to get to the Supreme Court quickly. Susan.
DAVISI don't think there's any doubt that this ends up at the Supreme Court. I think both sides agree that the court will decide this. The call to have it picked up earlier is probably not going to happen. The interesting thing is it's more likely to be taken up in 2012 -- is what the expectation is -- which would continue this debate right through the next presidential election, which is what I think a lot of Republicans want exactly to happen.
ELVINGIt is possible the court could hear it sooner. It's always, probably, a bad idea to predict exactly what the court is going to do. If we go back to Bush v. Gore in 2000, the court surprised us in a number of different respects. But let's say they do it in the fall of 2011. That seems to be the most likely time they would take up the case. Then they would probably give us kind of a decision about a year from now, which would put us right smack in the middle of the primary season for the Republican nomination for president and then, of course, take us into the main event of the general election.
ELVINGI don't think there's any question that the health care law is going to be a central issue in that election. And what we do with health care will be a central issue, whatever the Supreme Court does, although, certainly, they could make -- they could put a very large thumb on this thing.
REHMRepublicans and Democrats did agree on one item, and that was an unpopular tax on small business, Naftali.
BENDAVIDWell, what it was was a requirement that businesses file a tax form called a 1099 if they buy more than $600 worth of goods and services from a certain vendor, from one particular vendor in the course of a year. It was very unpopular. It was seen as onerous and burdensome. It was in the health care bill simply because it was a revenue raiser, that people weren't paying these taxes. And so all this was trying to do was get them to pay taxes that they owed, but it was a big paperwork requirement. And so that's why it was unpopular across the board.
BENDAVIDBut, you know, I think that they're, you know -- Republicans didn't have any illusion that they were going to succeed in repealing the health care bill. I think, in part, this was putting down a marker, sending a signal. And I think, in part, it was laying the groundwork for further attempts to chip away at the bill in the months to come, and that's something they've already started doing.
REHMSo how are they going to do that? What's the next step, Susan?
DAVISWell, each part of the implementation of this law is funding. And I think, particularly, they're going to attempt to -- as one member said to me, we're going to starve it to death, and that the House is going to try. They're going to -- because they -- the Republicans control the House, so they'll be much more likely to put forth spending bills that defund it or don't fund it to the levels the administration is seeking. But, again, Democrats control the Senate, and I don't think Harry Reid has any interest in underfunding this law.
ELVINGPlus, much of this law doesn't take effect until 2012, '13, even '14 -- many of the most important parts of it. So a lot of this, I think, is rhetorical. I mean, they're making a point. They're putting -- in a sense, they're taking their money away from where their mouth is, and they're saying, we mean this seriously. We're going to use whatever means are available to us, but those means are not necessarily effective. And, believe me, they will continue to pursue repeal in the Senate. They're going to come back to that.
REHMNow, what about Republicans attempting to put new limits on the growth of Medicare? Is that only within the health care law? Or is it generally speaking?
BENDAVIDIt's generally speaking. It's a debate that's going on now within the party. And the thinking is, you know, if they're going to make a serious stab and have any credibility in terms of reducing government spending, they can't just leave the large entitlement programs untouched. So they, therefore, have to make a serious effort at -- for example, means testing Medicare so that if you're wealthier, you wouldn't get the same benefits. I mean, it has to be said that that's not a decision they've made. In fact, my bet is they don't actually tackle it because it's way too politically volatile.
BENDAVIDAnd anytime you ask John Boehner or Mitch McConnell what should be done about Medicare and Social Security, he says it has to be done on a bipartisan basis. They're essentially not going to move unless the Democrats move with them. They don't want to be the target of political attacks. So while there's this, you know, group of conservatives saying, look, we've got to put some Medicare cuts on the table, there's, I think, if you talk to the actual people who run Congress and who have to run for reelection, they're not in such a hurry to do that.
REHMBut what about spending caps that would, in effect, put certain cuts onto entitlement programs?
ELVINGThat's right. A spending cap is a cut, in somebody's calculation. And if you say, I'm sorry, your particular claim came in over the spending cap, you are cutting the amount of money that would be otherwise available to them. And the problem with all of these rational discussions about how we restrain spending on entitlements -- Social Security, Medicare, other things -- is you start out with something we can all agree on, that these are growing too fast, that they obviously have to be brought under some kind of control.
ELVINGAnd then the political aspect begins. We get into a campaign, and people start saying -- not we tried to rationally restrain these unreasonable growths. They start saying, it was a Medicare cut. We heard this with the health care law. We've heard it every time Republicans have been in power and tried to restrain entitlement growth. The Democrats come after them for cutting Social Security...
REHMBut, you know...
ELVING...for gutting Medicare.
REHM...I must say I'm disappointed that the results of the bipartisan fiscal commission are not being taken more seriously, talked about more constantly, used as the basis for understanding the importance of moving forward here, Susan.
DAVISRight. It was this brief moment of unity.
DAVISRight. And it's all sort of fallen by the wayside. I do think part of the problem that they're going to have is that we need -- everyone -- so many of these ways to actually reduce the deficit, Social Security entitlements. The really way to get at it is so politically volatile. There is no easy answers. When you say to the American public, do you want to lower the deficit? I think the most recent number, 70 percent say, yes, and we have to do it immediately. And when you say, are you willing to take a cut in your Medicare? Seventy percent say, absolutely not.
BENDAVIDThat's true. I mean, I think it's easy to blame politicians. But, to some degree, we're all at fault if we're all sort of theoretically in favor of cutting the deficit but not anything we get. And Social Security is one example, but it's everything from ethanol to agriculture subsidies. Anything that people receive from the government, they have some reason why that's crucial. And one thing that's hanging over all this -- it seems to me -- is, you know, President Bush, after he won reelection, he had this campaign to reform, to change Social Security, and he just got destroyed. I mean, not...
REHMHe got three different results from a commission.
BENDAVIDYeah, and, politically, some people say that was the beginning of the Democratic resurgence. So the last thing anybody wants to do right now is go down that road again.
REHMWell, the other possibility here seems so simple -- raising the age of onset of Social Security over the next 45 years.
ELVINGThat's right. It doesn't have to begin now. It doesn't have to affect anyone now getting benefits. It doesn't have to affect anyone expecting to get benefits in the next 10 years. You can push it way off, and it changes the actuarials on this tremendously. But, again, the only way any of this is going to get done is if a lot of groundwork is laid in private talks. And, I think, the example here, the model here would be that global deal, that was worked out in December between the White House and the Republicans in the Senate by which they pushed through the budget changes, the tax cuts.
ELVINGThey made -- they gave a couple of more years to the Bush tax cuts. They also extended unemployment benefits. They probably got the magic key to release new START and get a vote on that treaty. There was a global deal made. It was made very quietly in backrooms. Everyone was terribly upset about it. But it went through, and it got a lot done. That, I suspect, is the only way we'll ever get anything done on the deficit.
BENDAVIDIt's true. Although it's interesting that, if you look at that deal, what ended up happening is, the deal sort of was, okay, you get to blow a hole in the deficit, and then we get to blow a hole in the deficit. In other words, everybody gets to cut taxes and give benefits to people they want. There was nothing in that deal that involved hardship for anyone.
BENDAVIDAnd so it's a good model. But, at the same time, I think, it will be a much bigger challenge to do something that involved cutting entitlements.
REHMSo is it any surprise to anybody that Mitt Romney has sort of indicated that he'd like the job that President Obama has now, Susan?
DAVISI love that they're calling it the invisible primary, but I don't think there's much invisible about it at all. I don't think there's really been any doubt that Mitt Romney was seriously considering 2012 from the minute he got out of 2008. You know, he's never really stopped running in some certain respect. I do think -- one of the things that struck me about it this time in his appearances in -- several media appearances this week was that a lot of the commentary over him not wearing a tie. You know, in the sense that part of his problem has been image, right, that he's been, like, too uptight, that there's not relatability factor to him to a lot of Americans. And even his attempt to look relatable seems very, you know...
DAVIS...planned and part of a strategy.
REHMIs the Mormon question behind him?
BENDAVIDWell, that's hard to say. I mean, I -- my hunch is that it's not. I mean, I think that, unfortunately -- because I don't think anybody's religion should have anything to do with any of this -- I think there are probably people in the country who do locate your religion and make certain judgments based on that.
REHMAs they did with John F. Kennedy and race as they have with Barack Obama.
BENDAVIDYeah, it would be nice to think that it's not a factor. You know, my hunch is that the electorate is not beyond it. I mean, I think, also, pretty soon, we're going to get beyond the invisible primary to a more visible one. I mean, these candidates don't have that much longer before they probably have to start announcing. And I think...
REHMLike next March?
BENDAVIDYeah, yeah, let's -- wait, what is this, early February? Yeah, I think -- well, I think John Thune is going to decide one way or the other in the next few weeks. Haley Barbour has said in the spring. Mitt Romney has already sent his signals. I mean, I just think that what it takes to run for president right now is such an elaborate fundraising network and network of ground support that you really can't wait that long. So even if candidates feel that, politically, this isn't the right time to jump in, I think, they may feel that, practically, they have to. So I don't think we're going to have to wait that much longer to start seeing the contours of the Republican field.
ELVINGMitt Romney also had another little special Bunsen burner this week that was motivating him, and that was that John Huntsman, Jr., our ambassador to China, submitted his resignation -- not effective immediately, but he's going to come back here to Washington and organize an exploratory committee to run for president.
REHMI thought Barack Obama appointed him ambassador to China just so he wouldn't do that.
ELVINGApparently, he didn't get a long-term work agreement...
ELVING...from John Huntsman, Jr. who, apparently, thought two years was a sufficient commitment. The White House has been kiddingly saying that they're not only giving him credit for a lot of good things that have happened with China, but they want to make sure Republicans know how much John Huntsman, Jr. contributed on health care, on financial re-regulation, on a lot of other subjects that the Clinton -- excuse me, the Obama administration has been pursuing. So this is another figure who is a former governor. He's not very well-known. He is also a Mormon.
ELVINGSo he is something of a challenge to Mitt Romney, even in the Mormon primary, if you will. And he may raise the profile of this issue a little bit. But the main thing he's doing is he is sending notice to Mitt that he is not the only guy who's working that particular part of the field.
REHMRon Elving of NPR, and you're listening to "The Diane Rehm Show." What about Michelle Bachmann? She seems to indicate, by virtue of going to Iowa, by virtue of some of her statements, appearances -- is she quietly edging Sarah Palin off the stage?
BENDAVIDI think there's a little bit of that. I mean, certainly, she would, in some sense, occupy the same political space as Sarah Palin. I think with some of these figures -- and I'd include both of them in that as well as other people -- it's hard to tell whether they're really planning to run for president or whether they know that a certain kind of attention comes to you if you're thought of as a prospective candidate. You know, the Republican field is, in some very rough way, shaping up as the more traditional candidates, like Huntsman, like Pawlenty, like Thune, like Romney, and the more sort of insurgent, let's say, Tea Party-type candidates, like Palin, Bachmann, Gingrich, Huckabee.
BENDAVIDAnd I think one of the things the Republicans are going to have to decide before too long is what candidate they think -- what sort of candidate is the best to take on Barack Obama, a traditional type candidate, a governor or a more insurgent candidate, maybe somebody who doesn't even hold office right now.
REHMAll right. Let's open the phones, 800-433-8850. Let's go first to Cape May Courthouse, N.J. Good morning, Betsy.
BETSYYes, I have a question. This is about the deficit and cutting the budget. The GOP is very anxious to get that done. I haven't heard anything about the cost of their salaries, their benefits, their staff costs. Have they considered cutting them at all? Has there been any mention of it? And it may not be a large part of the budget, but, I think, symbolically, it would be very important for them to make a move to offer to cut their own benefits and salaries and staff costs.
REHMThanks for calling, Betsy. Naftali.
BENDAVIDWell, in fairness, that's the first thing they did. I mean, I think they know that a lot of people feel much as the caller does. And they announced, right off the bat, a 5 percent cut in all of their budgets, saying, as the caller did, that we recognize this isn't a huge amount of money, but it's symbolic that we should be willing to take a cut ourselves if we're going to ask everyone else to.
REHMTo St. Louis, Mo. Good morning, Cliff.
CLIFFYes. I was listening, and I thought that the judges that had decided that they thought the health care bill and the mandating of premium payment would be unconstitutional, I thought that was really ill-advised when you look at how we've set up our structure of paying for automobile insurance and mandating the people coverage, or they're not able to drive. I think that the two are not -- neither of those things are found to be unconstitutional. And I think that they should rethink that. I don't think that was very clearly thought out by those judges or by the constituents who forced that upon them.
REHMCliff, I hope you'll go back and -- perhaps, online -- listen to the discussion we had on this very issue yesterday, in which this whole comparison and contrast were spelled out rather clearly. Ron.
ELVINGYes. And I'll just try to give the most essential difference, I suppose, that is raised by people who feel that the mandate on the individual for health insurance is quite different from car insurance. And that is that everyone needs health, but everyone does not necessarily have to drive a car. I realized that there are parts of the country in which not having a car and not being able to drive a car would be very close to a health issue. But, generally speaking, most people see a difference between the privilege, if you will, of driving a car, getting a driver's license, which is a state function and the much different sort of global responsibility that the government is trying to put on individuals to see after their own health from the federal level, which is what's being tested in the courts right now.
REHMAnd there's the whole Commerce Clause debate. Naftali.
BENDAVIDThere is. I mean, the people who oppose the bill say, look, this is the government telling you you have to do something. It's regulating inactivity. That's something that has never done before and isn't constitutionally authorized to do. The response to that is, no, everybody uses health care. So they're not telling you to do something you wouldn't ordinarily do.
REHMAnd those of us who do pay for health care continue to pay a higher fee for those who don't buy health care because, as you say, everybody needs health. And we need to hear from you. We'll take your calls, your e-mail, your messages in just a moment.
REHMWelcome back. Here is an e-mail from Joseph who says, "I have two complaints about the media's coverage of health care reform. Number one, Obamacare is a derisive term coined by Republicans to refer to health care reform legislation and yet, yesterday, blaring across an op-ed piece on The Wall Street Journal." Naftali, was Obamacare...
BENDAVIDWell, look, I'm neither...
REHMI'm not blaming you. All I'm saying is...
ELVINGYou wrote that headline, didn't you?
REHMI think that it's not just the reporters. It's not just the columnists. It is the headline writers as well who are all part of the media. He goes on to say, "The media consistently underreported legal proceedings in favor of the validity of the health care reform legislation, namely some 16 to 18 suits contesting the bill have been dismissed outright. Number two, exactly the same number of federal judges have ruled the law valid as invalid."
BENDAVIDWell, I think that's a fair point. I think we probably should have done a better job with that. I think the reason for that is it was widely expected to be upheld, and it's sort of less of a surprising or unusual development when a court upholds a law than when it strikes down a major piece of legislation that Congress has been working on for two years. I do think, though, that the writer touches on something kind of interesting, which is that the two judges that upheld the law were both Democratic appointees.
BENDAVIDThe two judges that struck down the law were Republican appointees. And it's sort of widely expected, maybe wrongly. But then, when it gets to the Supreme Court, we all know how the four liberals are going to vote. We know how the four conservatives are going to vote. It's going to come down to one guy, Justice Anthony Kennedy. Whatever he thinks, that's going to be the law of the land. And I think it's unfortunate that there's this perception increasingly of the judiciary, that it's basically one more legislature, that there's Democrats...
BENDAVID...there's Republicans. They all rule in favor of the policies of their parties, and that's what determines the outcome. I'm not saying that's necessarily true, but, certainly, that's a growing perception. And it's too bad because that's not what judges are supposed to be.
ELVINGSo -- and if the Supreme Court then decides that some parts of the law may live and others must die, does it become Anthonycare? Because we all know that it's going to be up to Anthony Kennedy to break that log jam if, in fact, it does devolve to that. And I do think it's unfortunate. And, I think, among the people who don't like it are the members of the Supreme Court. They would very much like to come up with a way to resolve this case that was not 5-4 or 4-5. That would be much more to their liking.
ELVINGThey do not like the comparison to Bush v. Gore, which will surely be made. And they did not like the way the court was characterized by that particular decision. The other thing about those dismissals -- and there have been quite a number. There was one yesterday in Mississippi by a very Republican judge, and that they are mostly based on standing. Mostly, those cases have been dismissed because the judges have found that the people who were bringing the suit did not have proper standing to bring the suit.
REHMAnd what does that mean?
REHMI mean, who were they?
ELVINGIt doesn't go to the issue, for example, of the Commerce Clause. It doesn't go to some...
ELVING...of the most essential issues that are raised by the law and in these controversial decisions from Florida and Virginia.
REHMAll right. To Big Rock, Ill. Good morning, Mike.
MIKEYeah, Diane. In light of a New York Times article on the health care cost associated with the gunshot victims in Tucson and the article on the restrictions inside the NIH for a gun research, a gun versus American health research, I think it's time we consider the insurance cost of gun -- guns in this nation in a serious way and begin to think about taxing guns, licensing guns and insuring guns, so that gun owners, gun manufacturers and gun sellers pick up these costs versus the state and the nation and the non-gun owners of this nation.
BENDAVIDWell, I mean, I think that's legitimate point of view. It makes a lot of sense. I think that, politically, that's probably not something that's going to happen. Over the past few years, the power of the pro-gun lobby has only increased, and they view anything like that as an infringement on Second Amendment rights. They view it as an issue of basic rights, like free speech. So it's not the kind of thing that you necessarily treat as an ordinary policy question, but as a question of basic rights. And I think that whatever the merits of the caller's viewpoint, it's just, politically, going to be something that's difficult to achieve.
DAVISThere's not a lot of certainties, but it is -- I can say it is certain that they will not tax gun ownership. There is just no -- excuse me -- momentum for that, not only because of Republican Party, but a significant amount of Democrats in this country are a pro-Second Amendment. And there is just no momentum in Congress at all to take up something like that.
REHMWhat is the status of Congresswoman Gabrielle Giffords? We seemed to have gotten some good news the other day from her doctors at the rehab center.
ELVINGYes. She has been moved to Houston, and she is in an absolutely first-class rehab facility there, which has a fantastic track record for dealing with injuries of exactly the kind that she has. And while not all of the information about her condition has been made public, what we're learning, what we're hearing is that she is doing remarkably well…
REHMI'm so glad.
REHMI'm so glad.
ELVINGAnd there's a great deal of encouragement among the members of her family.
REHMAll right. And let's go now to Cleveland, Ohio. Hi there, Tim. You're on the air.
REHMYes. Go right ahead, sir.
TIMOh, okay. I didn't hear you.
TIMI was calling 'cause of this unconstitutionality thing about this health care bill and the people who are all for this judge who said it's unconstitutional. They want to make the argument that you don't have to buy a home and you don't have to drive a car, so those insurances are constitutional. Well, the fact is nobody is forcing anybody to eat at McDonald's or Burger King or KFC or drink alcohol or soda or a hundred other things you do to jeopardize your health. So, if this is unconstitutional, then homeowner's insurance and car insurance is unconstitutional.
REHMWhat do you think, Ron?
ELVINGThis is going to be much discussed, and it's not going to be something that we can resolve easily or right here. However, I do think that there is still a definable difference between things that we have traditionally, legally considered privileges, such as driving a car, and the way that we all get involved in the health care system. But, I think, the broad agreement is -- and I -- this is widely recognized, and, I think, the caller is part of this wide recognition -- we are all part of a kind of body politic, if you will.
ELVINGAnd we have been putting a lot of bad things into our body politic that we all share. And there is a shared cost for this, and that includes the cost not only of health insurance, but of all the things that are affected by our bad habits. And this was, to some degree, touched on by the caller who was talking about gun control as well.
REHMHere is an e-mail from Lindy in Alexandria, Va. She says, "I'd like to know what business is not being accomplished because Republicans continue to push for repeal of the health care bill? Also, do you think there is a compromised position that Republicans might be willing to take, short of complete repeal?"
BENDAVIDWell, to answer the first question, Democrats say that if they weren't dealing with health care, then they'd be dealing with job creation. It seems to me that this is probably a period when not a whole lot was going to get done anyway, to tell you the truth, with the Republican-controlled House and a Democratic-controlled Senate and a certain amount of fatigue after all the sweeping legislation that was passed over the last couple of years. They've got to deal with the budget. They've got to deal with the debt limit. But beyond that, I'm not sure a lot was going to happen. As far as the compromise, you know, Republicans say that nothing short of full repeal makes any sense to them.
BENDAVIDHowever, there is some talk, particularly regarding the individual mandate -- that is the requirement that everybody buy health insurance -- of providing an incentive system where maybe you aren't ordered by the government to buy it, but they'd create certain incentives so that it was in your interest to buy. And that might be some kind of a compromise. Personally, I'm not sure there'll be enough support for that to get very far, but that is something that's being discussed.
REHMAll right. To Seattle, Wash. Hi there, Nick.
NICKGood morning. How you all doing?
NICKGiven the discussion about global health and the global health development planning, I was curious -- the application of a national health system essentially bankrupted and disrupted health care in countries that have that system. It's rationed. I'm curious when they're going to allow people that are health care providers to make some of these decisions. These are the same old people that are running Congress for years. So I'm (unintelligible) about that. Thank you.
REHMI'm not quite sure I get that.
BENDAVIDI think that the caller is referring to many of the criticisms that have been levied against the single-payer systems of Canada and Europe and so on, that they transfer costs onto the general taxpaying public and so on and have bankrupted those governments. I think, to some degree, health care costs are bankrupting our own system when you look at Medicare and Medicaid and so on. And so we haven't really figured out how to distribute these costs in terms of our entire system -- our entire body politic, if you will, either. I think the point about getting more health care providers to make the decision about how the system works is, to some degree, being addressed by the large number of health care providers who are joining Congress. We have, I think, a record number of doctors and dentists...
ELVINGA lot of doctors, yeah.
BENDAVID...who have entered Congress in the last couple of years. And the caller would probably not be surprised to learn that most of them are Republicans and very much opposed to the health care law passed.
REHMAll right. To Louisville, Ky. Hi, Deb.
REHMGo right ahead.
DEBOkay. I'm just -- all the talk about constitutionality and all that kind of stuff is good. I'm just amazed that we've just gotten used to this. You know, I haven't had insurance or been to a doctor for five years 'cause I live on grants, working in jails and prisons. But the other day I was driving, stopped to help a woman in distress, turns out her boyfriend has seizures -- mother of her child actually had a seizure while he was driving. She's managed to get the car over to the road. The ambulance was coming. He was turning blue.
DEBAnd in talking to her, calming her down, he just hadn't been able to afford the medicine to keep the seizures from happening. I don't know if he made it, didn't make it, but it's just sad that, in this country, we've just gotten used to the fact that some people are just going to die because they can't afford simple things like seizure medicines. So I just hope...
REHMDeb, that is such a powerful story, and I think Deb is right. There are an awful lot of people out there who cannot afford to go to the doctor. I talked with someone who I know the other day, and I asked her whether she had health insurance. And she said, no, I can't afford it, and she said that when she gets sick, she goes to the emergency room. And that's what people continue to do. Now comes the other part. You and I pay for each and every penny of that because the hospitals pass those costs on. Ron.
ELVINGThat's right. The system has to provide some kind of payment for the services that are rendered. And that gets distributed to all the people who do pay when they use the hospital. Or it gets borne by some governmental entity, and we all pay for that through our taxes, whether it be at the local state or federal level. So, by some estimates, more than 50 percent of the total health care budget of this country, if you will, or entire economy of health care in this industry is already, in some sense or another, government-borne and, thereby, taxpayer-borne. It's a question of how we're going to organize it and distribute it.
REHMRon Elving of NPR. And you're listening to "The Diane Rehm Show." The weather in this country and, indeed, in other parts of the world -- if you think about Australia as well -- has been crazy -- is the only word you can -- I mean, those photographs of Lake Shore Drive, cars abandoned because of accidents, one car tipped over on its head in New Hampshire. I mean, what is going on? And will this kind of weather generate more discussion of global warming, its causes and some movement forward? Susan, you're shaking your head.
DAVISI don't see how it sparks a global warming discussion, but I do think that -- the two things I thought about this -- the weather this week is that, one, it's already -- it's blowing further holes in state budgets. We're already at a point where so many states are strapped.
DAVISAnd that having these -- Illinois, these states that have just been completely hammered by snowstorms, cost a lot of money to clean the streets. So it's added an additional burden on the states. And maybe from one that concerns all Americans is how it's going to affect the Super Bowl on Sunday. There's been a lot of stories out of Dallas of difficulties getting in, how the teams have had to train. And I think that this is an issue that affects many Americans.
REHMIs that an indoor stadium?
DAVISI don't believe it is because...
REHMIt's an open stadium?
DAVIS...I believe it's had problems with ice on the field...
DAVIS….because of the temperatures.
BENDAVIDSo they could actually have a weather effect. That's got to help the Packers though, don't you think?
REHMOh, well, you guys.
BENDAVIDThey are the original Ice Bowl team, and they're slightly favorite maybe just because of the weather.
REHMAll right. I'm going to take one last call in Tallahassee. Good morning, Linus. You're on the air.
LINUSWell, good morning. I just want to make a quick point that, in order to keep our country healthy, everything that we have to do seems like political suicide for one side or the other. On the one hand, considering how much money we spend, so much of it goes to these useless programs, and we really have to reform that. We have to cut that. We have to cut the imperial military system. But on the other hand, it can't just go to tax cuts. You have to keep taxes up in order for us to get out of this mess. And we are probably going to need to be willing to invest in long-term things that will keep the country healthy, like a rail system, energy-efficient power plants and, you know, even single-payer health care system.
REHMLots of good idea out there and certainly from the federal deficit commission. Here's a last comment from Chris in Jacksonville, who says, "As a family of five, we experienced a 40 percent increase in health insurance." And Chris says that he or she also works with seniors medical claims. There's a claim where a provider charged $700, but the Medicare amount was $1,400 for that treatment. No, it must be that the -- well, so Medicare sent $700. Does that make sense to you?
BENDAVIDWell, I don't understand that part of it.
BENDAVIDI do understand the part of it that involved the skyrocketing insurance premiums.
BENDAVIDAnd that's something that a lot of people have been experiencing. Republicans say they agree that changes have to be made. They just don't agree with the Democrats' way of going about it. And they blame some of the premium increases on the new health law. Democrats say premiums have been going up forever. It's a problem. Everybody agrees it's a problem. It's tough to (word?) a solution.
REHMSomebody's got to do something about it. Naftali Bendavid of The Wall Street Journal, Susan Davis of The National Journal, Ron Elving, Washington editor for NPR. Which team are you rooting for?
REHMOkay, you guys. I'm out of here. Have a great weekend. Thanks for listening. I'm Diane Rehm.
ANNOUNCER"The Diane Rehm Show" is produced by Sandra Pinkard, Nancy Robertson, Susan Nabors, Denise Couture and Monique Nazareth. The engineer is Tobey Schreiner. Dorie Anisman answers the phones. Visit drshow.org for audio archives, transcripts, podcasts and CD sales. Call 202-885-1200 for more information. Our e-mail address is firstname.lastname@example.org. And we're on Facebook and Twitter. This program comes to from American University in Washington. This is NPR.
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