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Transcript of Rahm Emanuel Monitor Breakfast

(Page 3 of 12)



Second, on average, ya know sometimes higher sometimes lower, healthcare costs run around – healthcare inflation runs 10 percent a year, on average. Some years it’s 8, some years it’s more. That is also – those are the two numbers that are relevant in healthcare. Everything else [inaudible] 14,000 people a day lose their healthcare, and costs rise three times the rate of inflation, for lack of a better –

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One of the other things that I also think that’s been accomplished – I shoulda said this in my opening statement. The president should have made the issue of cost co-equal to the expansion of coverage this year. In the past, the whole debate has been about just expanding coverage, which leaves out the 100 plus million people who have healthcare. When you raise the issue of cost, you’re directly dealing – as Amy’s point is – with the thing that matters most to them, which is why they want. They want cost control, because they know they cannot keep up with the pace of healthcare inflation.

Q: Rahm, there are many people out there who suspect or say that what you all are trying to do with the public insurance plan is to eventually drive out the private insurance business, so they will no longer be able to compete, thereby achieving the goal of a government-run healthcare plan. Two questions. One, what do you say to the accusation about motive. And two, what do you say to the substantive question about, how do you design a public plan that isn’t laden with government subsidies in such a way that it does, in fact, cause the private insurance companies to fundamentally exit the system or cause their costs to be so high that the employers reject those plans. [rest of question inaudible]

RE: There’s no part in which I can say something off the record, is there? What are the rules?

DAVE COOK: I can’t bind 40 reporters [inaudible] We can’t go off –

RE: Because I was going to say something as a joke, but I can’t – [laughter]

I’ll have to wait for Thursday night open mic night. It dealt with the motive part. We’ll just leave it at that. Lemme um, first of all, lemme say it this way. Couple parts, hopefully I’ll string this together in a coherent answer.

One, the public plan, as the president said the other day at the press conference, is about competition. And one of the things the insurance system lacks today is competition. OK? It doesn’t exist. The most efficient competitiveness in in the insurance industry is the federal healthcare plan, because it has an organized market.

Now a lotta this discussion, and I hope I’m not switching too fast on you, is focused on the public plan, but it’s done in conjunction with the ru – what should be, as equally discussed, is the rules that you’ll structure around the exchange. The public plan will exist in the exchange. And how you set up the rules of that exchange, like what the federal healthcare plan does, which is an exact model here, or a good prototype, allows you to control costs. So it’s not just a public plan. It’s a public plan in conjunction with regulated, structured – we call it an exchange, in other words, it’s just a fancy word for a marketplace. A public plan – ya know, the president was quite clear about not just having a subsidized federal dollars.

But a nonprofit like the old kind of Blue Cross that competes on that basis allows, I think, a real comparative choo - choice process to go out for the consumer. If the public plan says here’s what a basic healthcare cost will be, here it is, then the consumer can go through and look at the Blue Cross, look at Wellpoint, look at all those other plans, and do comparative shopping that they can’t do and don’t do today. So I would say, I’ve said they work in conjunction.