MSNBC "Moring Joe" - Transcript

Interview

Copyright ©2009 by Federal News Service, Inc., Ste. 500, 1000 Vermont Ave, Washington, DC 20005 USA. Federal News Service is a private firm not affiliated with the federal government. No portion of this transcript may be copied, sold or retransmitted without the written authority of Federal News Service, Inc. Copyright is not claimed as to any part of the original work prepared by a United States government officer or employee as a part of that person's official duties. For information on subscribing to the FNS Internet Service at www.fednews.com, please email Carina Nyberg at cnyberg@fednews.com or call 1-202-216-2706.

MR. SCARBOROUGH: All right, let's bring in right now Senator -- well, actually, he's surgeon and Republican senator from Wyoming, Senator John Barrasso, who's in Chicago to attend President Obama's health care address today.

Senator, I am sure you're excited and you're ready to get on board and just be around that table with everybody else. (Scattered laughter.)

No, actually, you are very skeptical of this plan. Why's that?

SEN. BARRASSO: Well, Joe, you know we do need health care reform. People have grave concerns about the cost of their insurance, the availability of insurance.

But I am concerned about a government takeover of health care, which is what I think is happening with the president's plan.

We need a plan that gets 70 or 80 votes in the United States Senate, something that there is broad, bipartisan support for. That's the best way to improve health care in this country.

When they say they want to model this over Medicare, Joe, Medicare has done a terrible job with prevention. It's done a terrible job of coordinating care. It's done a terrible job in terms of waste and fraud and abuse. That's not the system we want to work with.

We want to give -- and empower people. You want to give the incentives for people to stay healthy. That's where you save on the cost of care.

Half of all the money we spend on health care in this country is on just 5 percent of the people. And those are the people who eat too much, exercise too little, and smoke. And that's it. That's --

MS. BRZEZINSKI: Well --

MR. SCARBOROUGH: But Mika, he's attacking me now.

MS. BRZEZINSKI: Why is he attacking you?

MR. SCARBOROUGH: He's -- because I don't exercise; I eat too much. I don't smoke, but I'm trying to pick up the habit.

MS. BRZEZINSKI: Senator!

MR. SCARBOROUGH: It's just -- he's attacking me.

MS. BRZEZINSKI: You're right. You're right. You should see it that way, Joe.

SEN. BARRASSO: And you're the last best hope we have, Joe. (Laughter.)

MR. SCARBOROUGH: Yeah, baby! That doesn't say much for us, does it?

MS. BRZEZINSKI: Oh, God. Yes, yes, it does.

Senator, the president is supporting one thing that the AMA might like, and that is the fight against malpractice suits.

Does that help in terms of reaching any type of compromise?

SEN. BARRASSO: Well, it certainly helps cut down on the cost of care, which is what this is really about.

This is what all Americans want, Mika, is getting the cost of care under control. And for years doctors and people all across the country have been concerned about lawsuit abuse. And what it means is doctors pay a lot of money in insurance.

But more importantly, in terms of the cost to the person, to the patient, a lot of tests are being ordered that really aren't necessarily going to help that patient get better faster --

MS. BRZEZINSKI: That's right.

SEN. BARRASSO: -- but instead are just going to be covering the concerns in case something doesn't go right and they say, well, did you order this test? And these tests get more and more expensive.

So I think anything we can do to help curb lawsuit abuse is going to be part of it.

MS. BRZEZINSKI: That's going to be tough, though.

SEN. BARRASSO: But a bigger picture is in trying to help people stay healthy, keep --

And that's where they keep down the cost of their care, by giving the incentives to people to stay healthy and giving incentives to doctors and hospitals and nurses to help keep people -- stay healthy.

You started with a piece on Katherine (sic) Sebelius. There's a story in the Wall Street Journal today about the cuts that were mentioned over the weekend by the president in his radio address -- $300 billion.

Well, what are they going to close? They're going to close in New York City next month clinics that have to do with community health and with prevention, primary care.

That's the wrong way to go.

MR. SCARBOROUGH: This was stunning, Mike Barnicle, that the president says he's going to pay for this health care plan by making cuts in Medicare and Medicaid. In Medicaid.

The prevention -- we are actually cutting health care to the poor for this plan. It's strange.

MR. BARNICLE: Well, and it gets to point that I'd like to ask the senator about, because you've been on both sides of the scalpel, so to speak, both from the Senate floor and as a surgeon.

And this notion that we can equate expenditures with quality health care, that the more we spend the better the health care's going to be -- not necessarily true.

I'd like to ask you, Senator, what plan do you envision, what plan do you think could succeed that would get to things like the people who show up in big city hospital emergency rooms on Friday nights and Saturday nights. That's their primary care physician.

And the factors of geography, affluence, family status -- all of those things have to do with the level of health in this country.

What can any plan do to deal with those two issues?

SEN. BARRASSO: It can give discounts and incentives to help people stay healthy in the first place.

But if you can get this huge -- the 5 percent of the people that cost us half the money in this country, there's plenty of money for all of these other things, Mike.

That's really the challenge, is giving the right incentives.

This system we have is not a health care system. It's a sickness system.

It pays doctors and hospitals to do things, not to keep people well.

The more we can do to help people -- well, the better it's going to be for our nation. Because we need to get the costs down.

It's not just about the uninsured; it's about all Americans.

Because health care is a very personal thing, and even for people that have insurance, there are clearly anxieties. But a government takeover is not going to do it.

You look at what's happening now in Canada, a big story this weekend. For people in Calgary, there's a stampeded to get cataract surgery because in Calgary, they've cut 2,000 --

They just lowered the number of cataract operations they're going to pay for by 2,000 a year, which means you have to be almost blind to get that operation.

I don't think anybody in America wants a government takeover of health care where then they start, as Howard Dean said on this program, what, last week -- he said you get a government plan and then the next thing you do is raise taxes and then you limit services.

So that's not what people of America want.

MS. BRZEZINSKI: Good point.

MR. SCARBOROUGH: Jon Meacham.

MR. MEACHAM: Senator, just assuming for a moment that everybody doesn't stay healthy, isn't a great deal of the cost in terms of end- of-life care?

And how one controls that has always been a puzzle to me, because if anything, health care is an irrational market. That is, it's -- we talk about it as though it's -- somehow or another it works according to market forces.

But very few people are going to say no, I don't want that. Most people are going to say yes, I want that procedure if it has any hope at all of making me feel better.

So how do you reconcile those things?

SEN. BARRASSO: Well, and I'd go further than that, Jon, because of what I've seen, practicing medicine for 25 years. And Mike said I've been on both sides of the scalpel.

Also, my wife's a breast cancer survivor. She's had three operations; we've been through two rounds of chemotherapy. I've seen it from all of the different sides and fortunately, my wife is a survivor.

But at these end-of-life decisions, often it's not the person, because with living wills and all those different things that you can do, people can, with advance directives, say what they want.

But what often happens is if someone doesn't have that, you have a family member who comes. And when I'm in Wyoming practicing, sometimes it was a family member who maybe even hadn't seen them for a long time, comes to town and says we want everything. We want the best.

And then that becomes very expensive in those last days or weeks of life.

MR. SCARBOROUGH: Spend a lot of money for a few extra weeks of suffering.

MR. MEACHAM: So is there any answer there? Is there anything we can do to control costs at that point?

MR. SCARBOROUGH: Let's just put it bluntly, Doctor. How do you tell that person that it's not in society's best interest to keep their third cousin alive for another month? We're not going to give them the treatment.

MS. BRZEZINSKI: Now, be nice.

MR. SCARBOROUGH: No, listen. This is what it comes down to, and I'm being very serious here.

MS. BRZEZINSKI: I know it's serious. I know.

MR. SCARBOROUGH: Here is the tough decision we're going to have to make where we -- are we going to extend people's lives for a month or two --

MS. BRZEZINSKI: It's a serious -- (cross talk).

MR. SCARBOROUGH: -- at the expense of poor, young children across America?

MS. BRZEZINSKI: Totally agree with you.

MR. SCARBOROUGH: How do we make that decision? Because, trust me, that's not demagoguery. When those decisions are made, it is the poorest, the weakest, the youngest who suffer on the other side of the spectrum.

Senator, how do you do that without being attacked for wanting to kill people off or ration health care?

SEN. BARRASSO: Well, currently in America people are not going to make that decision to say yes, turn off the machine, unless the patient themselves has done an advance directive and given direction to say I don't want all of this life-extending care.

So that's where it's up to all of us people watching today to make those decisions early on and sign the forms to give the direction to family of what we want.

Because most of us, Joe and Mika, don't really want that care for ourselves. I certainly don't want it for myself, but we might want it for our parents.

So that's what we -- in terms of empowering people to take more control of their own lives and their own health, that's the way to do it.

MR. SCARBOROUGH: All right.

MS. BRZEZINSKI: Senator Barrasso, thank you so much for being on the show. Come back.

MR. SCARBOROUGH: Thank you, Senator. It's always great seeing you.

SEN. BARRASSO: Thanks, Mika. Thanks, Joe.

MS. BRZEZINSKI: All right. Take care.

Source