Sep 6 - Meet the Press Transcript - David Axelrod + Panel

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'Meet the Press' transcript for Sept. 6, 2009

(1) Interview -- David Axelrod
(2) Panel Discussion -- Rudy Giuliani, Tom Brokaw, Tom Friedman, Harold Ford Jr.

updated 1:29 p.m. ET, Sun., Sept . 6, 2009

MR. DAVID GREGORY: This Sunday, going for broke on healthcare reform. After the divisive debate of the summer, the president will detail his plan before a joint session of Congress this week and try to regain control of the debate. While liberals in his party demand a public option, centrists and Republicans oppose it. Is there room for compromise? We'll ask the man behind the president's message and new strategy, senior adviser David Axelrod .

Then the hard choices and political realities as the president pursues his agenda this fall. Health care and the economy, Afghanistan and terrorism eight years after the 9/11 attacks. With us, former mayor of New York City and 2008 Republican presidential candidate Rudy Giuliani; the chairman of the Democratic Leadership Council, former Congressman Harold Ford; New York Times columnist Thomas Friedman; and special correspondent for NBC News Tom Brokaw.

But first, the president's senior adviser, David Axelrod, joins us now live.

MR. DAVID AXELROD: Thanks, David, good to be here.

MR. GREGORY: So here is the state, the landscape that the president now faces on health care. A poll this week shows a majority of Americans oppose, 51 percent, Republican leaders in the past few days have been saying if the president's going to speak before Congress, it's time to hit the reset button and start over. Will he?

MR. AXELROD: Well, look, first of all, understand that when people hear the details of where the president wants to go, bringing stability to people who have insurance today and security for them and helping those who don't have insurance get insurance, they support this plan. So the president has an opportunity on Wednesday to speak to the nation and the Congress on this. I think that he'll engender great support for where he wants to go. We've been through a long debate now. All the ideas are on the table. It's time to bring the strands together and get the job done for the American people here.

MR. GREGORY: Is this his plan that he'll present on Wednesday?

MR. AXELROD: Well, I think there are elements--look, all the ideas are on the table, David. The president set forth principles at the beginning of this discussion at the beginning of the year and now all the ideas are on the table and the president will say we agree on 80 percent of this, let's, let's do the final 20 percent, let's get the job done, and here's how I think we should do it.

MR. GREGORY: But if Americans are confused, if they think this healthcare plan is negative, if they're scared by it, some even think it's socialism, what's the one thing that Americans will come away with on Wednesday? What will they know about this plan?

MR. AXELROD: Well, I think they'll come away with a clear sense of what it is and what it's not. What it is is a plan that, again, will give more security and stability to people who have insurance today and it'll make it easier for those who don't to get it. You said in your open the president's going for broke. The idea here is to keep the American people from going broke as a result of soaring healthcare costs that have doubled in the last 10 years, risen three times the rate of wages. We want to bring security to the people who have insurance so that they're not thrown off their insurance if they get sick, so that if they lose their job or change their job, they'll still have coverage, so that people with pre-existing conditions can get insurance. That's what the American people need to know.

MR. GREGORY: Let's talk about ideas on the table. The big one is the so-called public option, a government plan that would be alongside private insurance plans to try to create competition and drive down costs. This is what the president said back in July about the public option.

(Videotape, July 18, 2009)

PRES. BARACK OBAMA: That's why any plan I sign must include an insurance exchange, a one-stop shopping marketplace where you can compare the benefits, costs and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest, and choose what's best for your family.

(End videotape)

MR. GREGORY: Does the president stand by that statement?

MR. AXELROD: You know, he certainly believes that a public option within this exchange would be important. Let's, let's, let's focus on what the issue is. There are 10...

MR. GREGORY: He said it must be included, David. He said it must be included.

MR. AXELROD: He said there must--he said there must be a, an exchange where people can get insurance at a competitive price. He believes in competition and choice. The public option is a, is an important tool to help promote that where there is no competition. He still believes that. But here's the problem, David. If you don't have insurance today, if don't have insurance through your employer and you need to get a policy, it costs you three times as much, on the average, as it would if you had employer coverage. People simply can't afford it. One of the ways--so we want to create a pool in which people who don't have insurance, and small businesses, can go and get insurance at a competitive price. And a public option would be a valuable tool within that group, that package of plans that would be offered, private and public.

MR. GREGORY: I just want to be clear here because in his statement, he was unequivocal. He said it must be included. A public plan must be included. Is he now signaling that he would compromise on that if you could still have some measure of competition?

MR. AXELROD: Well, first of all, you'd have to take the whole statement. He believes that a health insurance exchange where people can go, small businesses, people who don't have insurance can get insurance at an affordable price is still essential to any health reform and he believes a public option would be an important part of that package. He hasn't changed his view.

MR. GREGORY: This is what the House speaker says, Nancy Pelosi. She draws a line in the sand. She says the following, "Any real change requires the inclusion of a strong public option to promote competition and bring down costs. If a vigorous public option is not included, it would be a major victory for the health insurance industry. A bill without a strong public option will not pass the House. Eliminating the public option would be a major victory for the insurance companies. We have rationed care, increased premiums and denied coverage." Does the president agree with the House speaker?

MR. AXELROD: Well, he certainly agrees that we have to have competition and choice to hold the insurance companies honest. We have to have insurance protections for folks who have insurance, so they can't do the kinds of things that they've done in the past, arbitrarily throwing people off their insurance if they have a pre-existing condition or if they get seriously ill. He agrees with all of that. The idea here is to bring more security and stability to people who have insurance and to help those who don't have insurance get it at a price they can afford. The public option within that exchange is certainly a valuable tool.

MR. GREGORY: The reality is as a political matter, you cannot get Republicans to sign on nor can you get moderate Democrats, maybe 10 or 12 of them to sign on if the president fights for the public option. True or false?

MR. AXELROD: Look, why don't we let the president speak and make his case and then we can have this discussion. I believe that there's enormous consensus around a broad number of issues that would make a great difference for people who have insurance and people who need insurance and we have to build on that. And I think the president will be able to do that on Wednesday night and we'll go from there.

MR. GREGORY: What about the idea of a trigger, which is to say that you can introduce a government plan into states if the private insurance market doesn't succeed at driving down prices? Does the president think that's an idea worth considering?

MR. AXELROD: Well, I'll let the president address the specifics on Wednesday, David. But again, the goal here is to create competition and choice. There are markets where there are insurance companies that, that have 90 percent of the business, states in this countries. So it's very difficult to discipline the insurance companies on price and on the quality of care. Competition would do that and give the consumers a better break. He's for promoting competition and choice.

MR. GREGORY: So a trigger is still possible?

MR. AXELROD: Well, again, I'll let him address this. He believes the public option is a, is a good tool. Now, it shouldn't define the whole healthcare debate, however. There are, you know, the insurance guarantees that are in there for the 160 million people who have employer-based coverage are absolutely essential so that they have, you know, the ability to hang on to their insurance if they get seriously ill and not get thrown off. If they have someone in their family with a pre-existing condition, they can get them covered and so on. We have to--that there's a cap on out of pocket expenses so if you get sick, you don't go broke. These are the that health reform would bring to people who have insurance today as they hold on to the policies that they have.

MR. GREGORY: Let's look at the president's political standing over the course of this summer as this debate has raged on. Among independent voters, these are the voters you know well, who actually delivered the presidency to Mr. Obama, and the numbers have flipped now. Since July, his approval rating overall among independent voters down to 43 percent. Did the administration lose control of the healthcare debate?

MR. AXELROD: Now look, this is a difficult issue, David. We knew that. We've been trying to solve this for four decades and the problem's only gotten worse as Washington dithered. But the reason it's difficult is because it inspires great passions and we, we knew that. But let me tell you something. The president of the United States is not sitting there reading his poll numbers. The president--the numbers he's reading are the 12 million people who've been excluded from insurance in the last few years because they have a pre-existing condition. He's reading letters from people who have lost their insurance simply because they became seriously ill. He's worried about the continued doubling every 10 years of healthcare costs and what that means for families and businesses and the government itself. Those are the numbers that he cares about. That's what he's focused on and he believes that if you do the right thing, you solve problems, that the rest will take care of itself. So you know, we're going to forge forward, get this done. It's going to be an advance for the American people and I think ultimately that will, will, will pay great dividends politically. But that's not the motivation. Solving the problem is what we have to focus on.

MR. GREGORY: Bottom line: what's achievable on health care this year?

MR. AXELROD: I think we're going to have major reform this year, reform, again, that brings stability to people who have insurance so they're not abused within the insurance system and gives the option to--gives the ability to people who don't have insurance to get insurance at a price they can afford. And brings the overall rate of healthcare spending down so we're not on this inexorable, unsustainable climb. I believe those things are going to happen this year. I think there's a will to do it, the American people want us to do it, and I think we're going to get it done.

MR. GREGORY: Let me ask you about this education speech the president plans to give on Tuesday. It's created this firestorm of controversy around the country. He wanted to address students coming back to school, welcome them back, talk about studying, staying in school, personal responsibility. But now you've got school districts around the country saying, "Hold on, we want to look at this thing first. We may not show it in our classrooms, we don't like the lesson plans that necessarily go along with it." It may not go off anywhere near how it was intended. How did you lose control of this?

MR. AXELROD: Well, first of all, we'll be releasing the president's remarks in advance so everybody can have a chance to evaluate it. He's been--he'll say the same thing he's been saying to young people throughout his public life, which is that they have control over their own destiny, they have to work hard, they have to study, they have to make--they're the ones who can make something of their own lives. If--all we can do is give them an opportunity. It's an important message. It is a message about personal responsibility, and I would think it would be welcomed across the country. But that's up to--people will make their own decision about it.

MR. GREGORY: But what happened here? Are you surprised at this reaction?

MR. AXELROD: Well, you know what? I mean, I was. I was a little bewildered by it because it--I think it's an important and wholesome message. There's nothing political about it, and it's a shame that some people have tried to politicize it. But you know, when the president speaks, I think people will make their judgment. I think it's important for a president to stand up for that principle of individual responsibility, and I think if our young people--if he can, if he can help one young--we've got 30--nearly a 30 percent dropout rate in this country, if he can persuade one child in this country to stay in school, to keep at it, to make something of their life, then the whole exercise would have been worth it.

MR. GREGORY: Another domestic matter. Van Jones , who's been an adviser to the White House on environmental policy, resigned overnight because of some inflammatory comments he's made over time, including a petition he signed that blamed the government for the 9/11 attacks. Was this an issue that got to the president? Did he personally order that he be fired?

MR. AXELROD: Absolutely not. This was an, an--this was Van Jones' own decision. You know, he is internationally known as an advocate for green jobs. And that's the basis on which he was hired. He said in his statement that he didn't want his comments to become a distraction from the issue, which is so important to the future of our economy and communities around the country. And I commend him for making that decision.

MR. GREGORY: Was he the victim of a smear campaign as he alleges?

MR. AXELROD: Well, look, this is a--you know, the politician environment is, is, is, is rough and so, you know, these things get magnified. But the bottom line is that he's showed his commitment to the cause of creating green jobs in this country by removing himself as a, as an issue and I think that took, that took a great deal of commitment on his part.

MR. GREGORY: But was the president offended by what he said?

MR. AXELROD: I haven't spoken to the president about this. As you know, this, this thing has bubbled up in the last few days, and frankly, my conversation with the president have mostly been about health care, which is where our focus should be right now.

MR. GREGORY: Do you find it--what he said objectionable?

MR. AXELROD: Well, I haven't read all of, of his comments, either, David. Again, I'm focused on how we get health security for all Americans, how we get this economy moving in the right direction. We've pulled back from the abyss of a potential collapse and now we have to build for the future and get people back to work. I think those are the things that we should be focused on and that's what I am focused on.

MR. GREGORY: David, I want to end on a question about the other huge challenge for this administration and this president and that is Afghanistan. This was The Washington Post headline on Tuesday. "General," speaking of General McChrystal, "Afghan situation is serious and McChrystal expected to seek more resources, but the White House is wary." Will the president be reluctant to commit more U.S. forces to the war in Afghanistan ?

MR. AXELROD: Well, look, we have--we've been in Afghanistan since 2001 when we were attacked by al-Qaeda who were posted there. That's why we went. We drifted for a period of years where we had no strategy. The president ordered a strategic review in the winter and we're executing that, but it called for a review--another review after the election and that's where we are. He's going to get General McChrystal's reports and recommendations as well as those of others and make a decision. But the main thing is, we have to keep focused on what our mission was there, which was to disable and destroy al-Qaeda so they don't threaten us any longer, and that's the prism through which he'll make his judgments.

MR. GREGORY: Should there be a deadline for troop withdrawal just as then Senator Obama called on the Bush administration to get troops out of Iraq? Is it reasonable to set that kind of deadline with regard to troops in Afghanistan?

MR. AXELROD: Well, look, we have a different situation in Afghanistan. Afghanistan is actually the place that--Afghanistan and Pakistan--where the folks who attacked us on 9/11 are holed up and plotting against us still. That's a problem that still exists. It's a threat that still exists. We have to deal with it and so it's a wholly different situation. But the president will evaluate...

MR. GREGORY: So no deadline. No deadline is appropriate?

MR. AXELROD: The president, the, the president will evaluate all that, that--all the information that's coming to, to him now. We have a series of benchmarks and review points set up and, you know, he's going to make the hard judgments that need to be made.

MR. GREGORY: We will leave it there. David Axelrod, thank you very much.

MR. AXELROD: OK, David, thanks for having me.

MR. GREGORY: Now let's go straight to our roundtable. Here in Washington, joining us, Harold Ford Jr. of the Democratic Leadership Council; former mayor of New York City, Rudy Giuliani; Tom Brokaw of NBC News; and Tom Friedman of The New York Times.

Tom Brokaw, first to you. There's a lot to get to. Let's start with health care. David Axelrod used the word security over and over again. Is that a big theme for Wednesday night?

MR. TOM BROKAW: Well, I would think it is. I think what the president needs to do as much as anything is clarify what he really does want out of health care in the next year. I'm pretty dialed into this issue, and I'm with a lot of American people who've been watching all of this. Fifty percent of them saying they don't understand what this debate is all about. My guess is that number is probably closer to 80 percent. A lot of moderate Democrats on the president's side of all this have some real reservations about where they can get to realistically. One of them, Kent Conrad of North Dakota, who is a principal player in that gang of six, is terribly worried about the cost of the public option. That's more than a trillion dollars--David Axelrod didn't raise that. At a time when the country's trying to kick start the economy and other people across America are being told to save more money and to cut back on their expectations, they look at that price tag, which goes with TARP and stimulus and the bailout of the automobiles, and it gives them some real pause about what is achievable. There's no question that the American healthcare system does need to be reformed at several different levels, and I think the White House overstepped at the beginning in not having a clear, simple plan about what we want to achieve and when we want to achieve it.

MR. GREGORY: Harold Ford, the question of cost that Tom raises, a huge issue. Democrats I've talked to said, "Look, you're not--forget about Republicans, you're not going to get moderate Democrats unless that price tag comes down. One of the ways to do that, cover fewer people. Get off this idea of universal health care. Do you think that's what's going to happen?

FMR. REP. HAROLD FORD JR. (D-TN): He may have to. Brokaw has it about right. He's got to also say to the majority of Americans who have health insurance, "How will this new health reform package affect your own health choices? Will you be able to see the doctor that you've seen in the past?" Many Americans with health insurance are worried about just that. Two, I don't think the president can win over a majority of conservative and moderate Democrats with trillion dollar price tag. I hate to say it. We've got to make some tough choices here. Some of my liberal friends in the Congress, my former colleagues, probably are going to be disappointed with what the president says in the next night or so. And some of my Republican friends, who want to be disappointed and want to reject the president may end up supporting the president, because he brings the price tag down, he encourages insurance reform, he ensures that children will be covered, and he says to the country, we can--once the economy gets back on track, we'll have a longer conversation about this.

I was pleased to hear Axelrod say one big thing. Choice and competition. The American people understand those issues, they understand those terms and they resonate. If he's able to convey security with your choices today, your doctor choices today, choice and competition, and bring that price tag down, he might not only win an overwhelming majority of Democrats, he might bring some Republicans along as well.

MR. GREGORY: Mayor Giuliani, you heard David Axelrod say notably, I thought, major reform is still achievable this year. Can he do it with Republicans?

MR. RUDY GIULIANI: Not if he has the public option. I think he gave up the public option. I was trying to listen carefully to what he was saying, but sounds to me like the public option is gone.

MR. GREGORY: A willingness to compromise there is what I heard.

MR. GIULIANI: I think that, I think, but I think the biggest mistake the president has made is he hasn't done cost savings. He, he hasn't put a single realistic cost saving proposal on the table. A trillion dollars, healthcare history is everything costs three times as much when you look at the predictions for Medicare, Medicaid, everything else. So a trillion dollars is the low-ball estimate of what this is going to cost. He took off the table medical malpractice reform. Big mistake. Big, big mistake if you want a bipartisan solution to this. You take off the table one of the biggest ways in which you can save money and create some equity in the system. He took off the table interstate purchase of insurance. That's real competition. Now you can--you have 50 states that are competing with each other, you can really bring the cost down.

MR. GREGORY: Does he have to cover fewer people?

MR. GIULIANI: If he had done what I was talking about, if he had done medical malpractice, interstate, real significant tax reform, maybe he could have achieved universal coverage. But I think he achieves it through subsidies or tax breaks, not through a big government agency trying to run health care for Americans.

MR. GREGORY: Tom Friedman, let me bring you in here. Back in 1993, when you were a mere beat reporter covering the White House...

MR. FRIEDMAN: Oh, my gosh.

MR. GREGORY: And 16 years ago...

FMR. REP. FORD: What year was that?

MR. GREGORY: It was President Clinton.

MR. FRIEDMAN: (Unintelligible)

MR. GREGORY: Right. It was President Clinton giving a major speech on health care. And this is what you wrote. It's very interesting. "The Clinton administration's toughest problem in selling a health care overhaul to the American people will be boiling down into a single evocative slogan. White House officials said today that if they had to distill their message to a bumper sticker, it would be one word in capital letters, SECURITY. `First and foremost will be the theme of security,' said a presidential adviser George Stephanopoulos," who's doing something else now. "That is the emotional core of this plan. It speaks to people's deepest fears, the idea that no matter what happens to you, if you lose your job, if your wife loses her job, if you switch jobs or if your company goes under, your health care will be nationally guaranteed."

It sounds like we're in the same place.

MR. FRIEDMAN: Yeah. That's--David, that's quite interesting, David. You know, I, I, I'm a big believer that to name something is to own it. You can name an issue, you can own the issue. And one of the things that's happened, to pick up on Tom's point, is that Republicans named this issue. They named it pulling the plug on grandma. And what you saw with Axelrod, I think, was trying to retake the naming of this issue. Security, stability, affordability, that's clearly where they're going to go. But I also want to say, you know, one other thing because the president's gotten a lot of criticism for--and fair enough, I think rightly so, for not being clear about what he wants. But what about the opposition? You know, there's only one thing worse, David, than one party autocracy, and that's one party democracy, OK, where you don't actually have two parties that are really truly, honestly trying to solve a problem. When you have one-party democracy, and in this case, the Democrats, you're--if you have to solve this whole problem among Democrats, you're going to get the kind of mess, in my view, that you got in the energy climate bill, OK?

Give President Obama 25 centrist Republicans in the House really ready to work this problem, give him 10 centrist Republicans in the Senate really ready to work this problem, I think you'll see an outcome that assures the American people very, very quickly. So I think he's not the only one.

MR. GREGORY: So why aren't they, why aren't they there?

MR. GIULIANI: The president didn't really invite that. He said, "yes, let's have bipartisan solution."

FMR. REP. FORD: Oh, yes, he did.

MR. GIULIANI: But if you take medical malpractice reform off the table, which is a major Republican objective, so that's gone immediately, you take interstate purchase of insurance off the table, that's gone immediately, it becomes impossible for most Republicans to figure out how you're going to save the money other than pulling the plug on grandma. The president--remember what the president said was this is going to be deficit neutral. Some raise in taxes, but basically deficit neutral. So how do you reduce a trillion dollars or $750 million in--billion in costs, without taking services away from people who get services? And the people who basically get the services are senior citizens . So the president has created this dilemma. He wasn't just not specific about it, the assumptions that he made lead, lead to the conclusion that he had, you have to cut massive numbers of people off.

MR. BROKAW: But what...

FMR. REP. FORD: That's not what...

MR. BROKAW: What has been interesting to me is that the Republicans have raised the public option as some kind of an Orwellian monster. Half the health care in America is already delivered by the government.

MR. GIULIANI: Right.

MR. BROKAW: Medicare, Medicaid, the Veterans Administration, the Federal Employees Health Program...

MR. GIULIANI: Right.

MR. BROKAW: ...is government run.

MR. GIULIANI: That's part of the problem. Part of the problem, half of it already is in the hands of one massive monopoly. You make that monopoly greater and you destroy private, private insurance.

FMR. REP. FORD: But, but, Mr. Mayor...

MR. GIULIANI: Same, same, same idea as the anti-trust law. If one company becomes so large it wipes out all of its competitors. If that company is the government, which right now threatens to wipe out all of its competitors...

FMR. REP. FORD: But...

MR. GIULIANI: ...you add 40 million people to that, forget private insurance companies.

FMR. REP. FORD: But people are...

MR. GREGORY: Harold.

FMR. REP. FORD: People under the government plans are generally pleased, number one. Number two, the cost of private...

MR. GIULIANI: Depends upon the people.

FMR. REP. FORD: The cost of private insurance, you, I'd, I'd go with you, MR. Mayor, we could poll on Medicare. I think an overwhelming majority of Americans like their Medicare, and those in the veterans program want some improvement.

MR. GIULIANI: Three times more expensive.

FMR. REP. FORD: What's not...

MR. GIULIANI: Three times more expensive than ever predicted.

FMR. REP. FORD: That's not true, sir.

MR. GIULIANI: Yes, it is.

FMR. REP. FORD: Private health insurance inflation has gone up at double the rate...

MR. GIULIANI: I use to pay for it.

FMR. REP. FORD: ...that public health insurance has gone up, number one. Number two, the president from the outset, we can be critical of the way he went about doing health care, but you cannot condemn him for reaching out to Republicans. Max Baucus said he would not do a bill without the Republican leader on the committee. What did Grassley do? He went home and labeled the death panel bill. You had the senator from South Carolina, DeMint, say if we stop Obama here, we can stop everything that he stands for.

MR. GIULIANI: But...

FMR. REP. FORD: And three, Mr. Mayor, it's unfair. I appreciate your...

MR. GIULIANI: It's not unfair at all.

FMR. REP. FORD: I appreciate your...

MR. GIULIANI: You can't, you can't...

FMR. REP. FORD: I appreciate your talk about fiscal responsibility now.

MR. GIULIANI: But you can't...

FMR. REP. FORD: But you didn't say a word about the tax cuts, the trillion dollar tax cuts, how we would pay for it. You didn't say a word about the trillion dollar Medicare prescription drug bill, how we would pay for it. You didn't say a word about the trillion dollars for the war. Things we needed to do.

MR. GIULIANI: Right. But...

FMR. REP. FORD: But at least this president is saying, I'm going to pay for it.

MR. GIULIANI: But the problem...

FMR. REP. FORD: So for you to be critical...

MR. GIULIANI: The problem...

FMR. REP. FORD: ...be consistent is the only thing I say.

MR. GIULIANI: Well, well, the reality is you can't tell me they're going to do a bipartisan proposal and then take off the table two of the major things that I want to see compromise or worked out.

FMR. REP. FORD: I would agree with you on malpractice reform.

MR. GIULIANI: That is, that is...

FMR. REP. FORD: It should be a part of it.

MR. GIULIANI: But that is, but that was, that is, that's saying to Republicans, forget the code words, that's saying to Republicans forget the way you look at it. We're going to do it my way. Now let's compromise.

MR. GREGORY: Let me get a break in here. We'll have much more on the political fallout of this, as well as other topics, when we come back with our roundtable. We'll also talk about Afghanistan and the war on terror, right after this break.

MR. GREGORY: And we're back with our roundtable. And I have to say, if I were ever planning a Sunday brunch, it doesn't get any better than this, then these folks around the table. Let's get back to these serious topics. Tom Brokaw, still on health care for just a couple of minutes. One of the things that I'm told from top Democrats is that the idea of reconciliation is still more likely than not. In other words, the president tries to get this through with a simple majority of 51 rather than going for the 60 votes.

MR. BROKAW: Reconciliation is a process that was designed to deal with budget issues, as you know. And they think if they go to reconciliation and try to keep it focused on the cost of health care, that they can get there. What do they get out of all of that? They hope that they get a mandate where everyone has to have health insurance of some kind. And one of the senior advisers to the administration on all of this is also saying we think we can get the exchange process in place where states will organize an exchange, a shopping mall, if you will, for people who are looking for health insurance to go and have a competitive environment. They're not saying anything about the public option in all of that. Let me just say one other thing. At full disclosure, I'm a public trustee of the Mayo Clinic, but I'm not involved in their debate on healthcare reform. The Mayo Clinic, the Cleveland Clinic and other major healthcare delivery systems in America that are doing well believe that the administration is missing a big opportunity to restructure the cost of Medicare and Medicaid so that you pay for performance and not just for tests. And no one is addressing that as well. So there are so many elements in all of this that are in play now and the administration took a big bite and now the question is whether they can digest all of this.

MR. GREGORY: Tom Friedman, let me end on this political question about health care. Let's put up that graphic about the independent voters again.

MR. TOM FRIEDMAN: Mm-hmm.

MR. GREGORY: Because I think it's telling. It shows that Obama's approval ratings slipping down to 43 percent, since July, down 10 points. The issue he's got here in the Democratic Party, he's got a left that really wants that fundamental change that he campaigned on, but he's got a reality among independent voters and centrist Democrats who say, wow, we're spending a lot of money here. We've got bailouts, as Tom, you know, went, went through.

MR. FRIEDMAN: Yeah.

MR. GREGORY: It's just a difficult time to take on all this. What's his message to his party right now?

MR. FRIEDMAN: Well, you know, this is a framing challenge. There's no question about that, David. You know, just a couple of things I would say. You know, one, in terms of health care itself, to me, one way to frame it, it's a huge competition issue. Who needs health care more than American business today, taking the burden off business so they can compete globally? And that is, to me, an independent/Republican issue, you know, tends to be more than a Democratic/left issue. The second is, I keep coming back to this point. If he doesn't have Republicans who already take yes for an answer, let's look where the administration's going, you could hear it from Axelrod. Public option's not going to be there. He's drifting toward what--this idea of insurance exchanges. Where did we see that? Hey, that was Mitt Romney's idea in Massachusetts. He's going to drift, I think, to the idea of paying for this by taxing at least some healthcare benefits of some people. Where did I hear that? That was John McCain. Now, can Republicans say yes to McCain, Romney ideas? And it's not clear to me that they aren't out to pull the plug on Obama much more than anything else.

MR. GREGORY: Mayor:

MR. GIULIANI: I think if he, if he had a set of proposals that I don't hear that talked about real cost containment, real reduction in cost, and then, and then a realistic way to cover more people through tax breaks, tax exemptions, subsidies, things like that, I think Republicans could support it. Republicans have--I supported, along with John McCain, a major reform of health care. If he incorporated a lot of those things in it, I would support it.

MR. GREGORY: Let me get onto a couple of other things here that are also interesting issues.