Sebelius: Health Reform By Year's End

In our first hour today, host Tom Ashbrook spoke with Health & Human Services Secretary Kathleen Sebelius about what's at stake in President Obama's much-anticipated speech to Congress this evening.

Asked about the public option plan that has been such a flashpoint of debate, Secretary Sebelius said that the public plan is itself a "compromise position," considering that many Democrats have called for a single-payer plan.

"The public option," she said, "is really a competitive market strategy for a new marketplace."

But Sebelius allowed that there may be viable alternatives to the public option, and went on to predict that health care reform will pass by the end of the year.  Following are excerpts from her interview:

TOM ASHBROOK: The public option issue has become a big tripwire, government-run insurance option for Americans. August 16, you put a new sort of wrinkle on it, saying you [the administration] would not see it as essential to reform. Do you now? Headlines are saying the president will endorse a public option in his speech tonight.

SEC. KATHLEEN SEBELIUS: You know, I said on the 16th of August what I have said for the past three months, which is, the public option, as far as I’m concerned, is one of the best ways to guarantee cost control, keep private insurers honest, and make sure that there is some competitive way to control costs and give consumers choices, particularly in marketplaces where there is no choice. Are there potentially other ways of doing that? Maybe. But I think cost control and consumer choice is essential. And absent, in many parts of the country, having a public plan compete side by side with private plans, you don’t have that.

Ironically, you know, the public plan is a compromise position. There are many members of Congress, and certainly many members of the American public, who are anxious to have a single-payer plan — get rid of all the private insurance companies, and move to a system where you cut out the middle guy altogether. The president has not supported that. I have not supported that.

So the public option is really a competitive market strategy for a new marketplace that really only applies to people who either don’t have affordable coverage right now, because they’re in the private insurance market buying individual coverage, or small business owners who, frankly, are paying the highest coverage of anyone in America.

ASHBROOK: It’s early September. When Americans sing “Auld Lang Syne” on New Year's Eve, at the end of this year, beginning of the next, will there be health care reform done?

SEC. SEBELIUS: I think there will be. I think the American public is still overwhelmingly convinced that the system we have is broken. It doesn’t work for most people. Even if people have coverage they like right now, they’re worried about next week or next month, they’re worried about when their kids graduate from college, they’re worried about a system where the costs are going up three times faster than wages and health inflation beats all other inflation. I think, fundamentally, people understand that we need a change in the system....

This is tough work. This is a big system that’s been in place for years. And fundamentally, an overhaul, and I think the president is absolutely right, needs to be comprehensive. You can’t tackle a bit of it without having bad ramifications on the rest. We need a comprehensive look at how you change outcomes, how you lower costs and how you make coverage affordable for everyone. And change, once and for all, these insurance rules that lock people out of the market.

Later in the hour, we were joined by Jonathan Cohn of The New Republic and Gail Wilensky, a former health policy adviser to President George H.W. Bush and John McCain. You can listen to the full hour here, and join the discussion.