April 29th, 2011

Dr. Gupta talks health care reform with former President Clinton

CNN chief medical correspondent and anchor Dr. Sanjay Gupta spoke with former President Bill Clinton for The Last Heart Attack a documentary airing June 12 at 8 p.m. ET. A highlight from the full interview is after the jump.



DR. SANJAY GUPTA, HOST: I’d be remiss if I didn’t ask you quickly about health care reform.  You know, it looks like it is going to the Supreme Court -The Affordable Care Act.  We talked about this last time. What are your thoughts on the likelihood that we’re going to have this act in its entirety?

BILL CLINTON, FORMER PRESIDENT OF THE UNITED STATES: Well, I think — I guess, you know, there’s some chance, given how political it is, the courts, that they would strike down the mandatory purchase, although I find it amazing that they would.  I mean you can make people buy automobile liability insurance.  And the combined impact of the burden of people not being insured on the rest of us economically is nowhere near that of health care.

But I think on the whole, the bill will be kept.  I think the most interesting thing is in the — the Republican budget, the line budget, they proposed to save money on the budget by giving everybody a Medicare voucher in 2022.  But between now and then, they would repeal almost everything in the health care bill that will lower the cost of health care.

So what this bill will do will actually increase the cost of health care.  We can bring the cost of health care much closer to that of our nearest competitors without undermining the quality of health care, but we need some time to do it and to be fair.

And my biggest sympathy for both the Democrats and the Republicans in Congress and the White House is something that you can explain to people better than I can, which is that the things that will make the biggest difference in lowering health care inflation without undermining quality are almost impossible to score.

In other words, if we say, OK, we’re going to give you a $1,600 check or a $2,000 check, whatever it is, for Medicare, that’s what you get — $13,000, whatever it is.  You can score that.  You might actually be able to do better if you published all the results of all the hospitals and all the procedures and you showed there was no connection between cost and quality.  If you had what the VA hospital has now done, uniform sterilization procedures at critical junctures during the hospital, if we had payment systems like the Mayo Clinic plan.  You know, one of the biggest controversies in this health care bill is the provision that 85 percent of your health care money has to go to health care and not profits and promotion.

GUPTA:  Right.

CLINTON:  Minnesota is already at 91. Why? Because they’re organized to pay for health care, not for procedures.  Blue Cross in North Carolina is already at 87. Why? Because they’re trying to push things this way.

So the problem is all those things that will really make us healthier and save the economy at the same time are hard to score. ow, that is something that we all ought to be helping both parties in Congress.  Look, we should be sympathetic here. What’s the real problem?

GUPTA:  Yes.  It’s — it’s — it will be interesting how political the decision is…

CLINTON:  But I think it — I think they’ll frame it.  I think that they’ll have to go back to the political process.  The Supreme Court won’t do all their work for them.  The Congress, the Senate will not vote to repeal it.  The president will not — will veto it if they do. And now that America has seen what’s in this bill from Medicare, I think that they’ll have a hard time doing it.

Which is not to say that we’re not going to have to have some changes in health care.  We are.  But I don’t think we need those changes.