MSNBC "Hardball With Chris Matthews" - Transcript

Interview

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We start with a big up or down vote tomorrow night on starting the health care debate. Senator Bernie Sanders is an independent from Vermont and Senator Judd Gregg is a New Hampshire Republican.

Let me ask you, first of all, Bernie, what is the difference, Senator, between a Democrat, or an independent like yourself, and a Republican on health care? Because we‘re getting a strict party line vote tomorrow night. So what‘s the difference in their feelings, their attitudes, their philosophy? What‘s the difference in the two parties?

SEN. BERNIE SANDERS (I), VERMONT: Chris, I can only speak for myself. We have a health care system which is disintegrating, 46 million uninsured, 45,000 people a year dying because they don‘t get to a doctor on time. Health care costs are soaring. Of course, you have to do something.

Bush was president for eight years, not a word of substance in the health care reform. Now, I have got to tell you, as an independent, I believe the bill that we‘re now discussing, it ain‘t a great bill. I would prefer to see a Medicare for all single-payer bill, which is the only way, in my view, to have cost-effective comprehensive universal health care. And I will be watching intently as the amendment process goes forward.

But at least Obama and the Democratic leadership are trying to address a problem which impacts million of Americans and the business community and our place in the world.

MATTHEWS: So you, Senator Sanders, believe the federal government should have a major role in ensuring that every American gets health care. You believe that.

SANDERS: I think, Chris, there‘s something wrong with the United States as the only nation in the industrialized world that does not guarantee health care to all people, and yet we spend substantially more than any other country and our outcomes are worse. Clearly, we need major health care reform.

MATTHEWS: OK, that‘s the point of view from the liberal Democrats. Senator Gregg, what‘s the Republican view on health care? How is it different than the Democrat view? Because this is a strict party line vote we‘re seeing tomorrow night.

SEN. JUDD GREGG ®, NEW HAMPSHIRE: Well, clearly, we disagree with Senator Sanders, but I really respect Bernie‘s forthrightness because he‘s really telling it like it is as to where they want to take this bill, which is a single-payer system like the English or the Canadian system.

We genuinely believe that a single-payer system will undermine the quality of health care in this country and is not affordable. This bill is a $2.5 trillion bill. That‘s what it spends when it‘s fully phased in over a 10-year period. It would, if it led to a single-payer system--and we think--I happen to think it‘s basically a precursor for that--put the government in charge of every aspect of health care in a very direct way, so that you would end up with, basically, a bureaucrat between and you your doctor.

And you would end up inevitably--if you were to go to Medicare for everyone, which is what Bernie suggested, you end up with price controls and rationing because Medicare can‘t reimburse the full cost. And so if it can‘t reimburse the full cost today--it‘s paying 80 percent of costs...

MATTHEWS: Yes.

GREGG: ... and Medicaid pays about 60 percent of costs--then that difference can only be picked up by the private sector subsidizing it. Well, if there‘s no private sector, then the only way you can pay it up is by rationing.

MATTHEWS: Well, the problem with that, Senator Gregg, is...

SANDERS: Well, let me...

MATTHEWS: ... that your party‘s pretty good at criticism, but you don‘t have an economic plan of any kind for health care for everybody. How are you going to...

GREGG: No, that‘s absolutely inaccurate, Chris!

MATTHEWS: OK...

GREGG: That‘s absolutely inaccurate.

MATTHEWS: Thirty-one million people are going to--OK, how are you going to give health care? I‘ll give you a minute. You get--and I‘m back to Senator Sanders. How is the Republican Party going to get health care for all Americans? All Americans, not just those with money.

GREGG: OK. There are three major plans on the Republican side. There‘s my proposal, there‘s a proposal by Senator Ryan and Senator Coburn, there‘s a proposal which is co--which is a bipartisan plan, Senator Wyden‘s plan and Senator Bennett. They all accomplish the same thing, which is to get health care to everybody.

Now, I‘ll just take my proposal as an example. What I basically say is we don‘t need to give a Chevrolet plan, a Cadillac plan, an Oldsmobile plan to everybody. We need to insure people in a way that they want to be insured. We let them pick their insurance. And for younger people--who really generally don‘t need a lot of coverage, what they need is catastrophic coverage in case they have an accident or they get really sick so that everybody else doesn‘t have to pick up their care--we would have them pick up catastrophic coverage.

How would we control costs? We‘d do it in a variety of ways. First we address abusive lawsuits. This bill does not do that. That saves a lot of money, $230 billion of cost as defensive medicine. Second, we do a major initiative in the area of preventive care and healthy lifestyle by changing the laws so that companies can reward with you cash if you quit smoking, if you live a healthy lifestyle, if you reduce your weight, if you take the tests you should take, like colonoscopies. This bill does not do that.

We also put in place a very aggressive plan following the Dartmouth model, which I suspect Bernie also supports, which is quality health care over quantity of health care. We also picked the major diseases that‘s drive health care, like...

MATTHEWS: OK...

GREGG: ... obesity and Alzheimer‘s, and focus a lot of effort on them. So don‘t say we don‘t have a plan.

SANDERS: Chris...

GREGG: What we have is a step-by-step approach...

MATTHEWS: OK...

GREGG: ... which would actually reform and make health care better in this country.

MATTHEWS: OK. OK. The problem with that...

GREGG: Rather than nationalize it.

MATTHEWS: Let me go to Senator Sanders.

SANDERS: Chris...

MATTHEWS: The problem with what Senator Gregg said--and it sounds good to those watching for the first time. But I‘ve been watching this since the early ‘60s, when Ronald Reagan started to talk like that. Every time the Democrats move to do something on Medicare or anything in the health department, the Republicans say, Oh, we have a better alternative. But the minute they get power, they do nothing. All this stuff he‘s talking about...

(CROSSTALK)

GREGG: ... drug coverage today.

SANDERS: Wait a minute. You had eight years--you had eight years of the George W. Bush. There was not one serious health care proposal for universal health care brought forth.

GREGG: Did you miss the Part D premiums?

SANDERS: Judd talks--Judd talks about...

(LAUGHTER)

GREGG: I mean, everybody in America has drug coverage today, Bernie!

SANDERS: ... tort reform. That‘s one half of--that‘s one half of 1 percent--one half of 1 percent of health care costs. Judd criticizes Medicare for all. Of course, that is not the bill that‘s on the floor. I support Medicare for all. And Judd has got to tell the American people why, under our private insurance-dominated system, where the function of private insurance companies is to make as much money as possible, where we spend over $300 billion every single year administering thousands and thousands of separate health care plans, all designed to make profits for the company--he‘s going to have to tell the American people how that brings cost-effective health care.

Bottom line is...

GREGG: I‘ll be happy to.

SANDERS: ... the Democratic leadership is not talking about Medicare for all. What they are talking about is something very different. I wish they were talking about Medicare for all. In fact, unfortunately...

MATTHEWS: OK, why...

SANDERS: ... the Democratic proposal...

(CROSSTALK)

MATTHEWS: Senator Sanders, why is socialism...

GREGG: You want me to respond to Bernie‘s question or yours, Chris?

MATTHEWS: Well, I want to ask both of you the same question.

GREGG: Let me respond to...

(CROSSTALK)

MATTHEWS: ... like this question. Here‘s a question for both of you. Why is socialism a pretty OK word in Europe? It‘s not a hated word in Europe, Senator Sanders. But in the United States, it‘s a bad word. What‘s the difference between the two cultures when it comes to medicine?

SANDERS: Well, in Europe, for many, many years, people have seen democratic socialist policies provide health care to all people. They have seen these countries provide free college education to working families. They‘ve seen a much fairer distribution of wealth and income. In this country, for a variety of reasons, you‘ve had a right-wing Republican Party and a centrist Democratic Party, in my view not effectively representing working families, being dominated by big money interests. So what you have seen in recent years is the very richest people becoming richer, while the middle class collapses and poverty increases. I think we have a lot to learn from Scandinavian countries.

MATTHEWS: Same question to you.

GREGG: Well, do I get...

MATTHEWS: Same question to you, Senator Gregg. Why is socialism a bad word in this country when it come to medicine and health?

GREGG: Well, unfortunately, we‘re obviously gravitating towards a European model here in a lot of different areas under this administration where the government is expanding at a rate that we‘ve never seen before and the cost is being thrown on our children through expanded debt.

But why doesn‘t socialism work? Because it undermines basic core American values. First, that people have choice. Second, that people are entrepreneurial and want to go out and be--create better things by being entrepreneurial. And thirdly, that people expect to be rewarded for that. We have a capitalist system, and it works pretty well to have a capitalist system.

Now, Bernie doesn‘t like profit. I understand that. He is a socialist. And it appears a lot of people in his party don‘t like profit, either. But the simple fact is that profit is one way to deliver efficiency into a system. And he will look at Medicare as a more efficient system than a system that has some profit in it. Well, Medicare has a 15 percent to 20 percent fraud factor in it.

MATTHEWS: Well, you--let me...

GREGG: You know, I‘m sure profit may be 5 percent or 7 percent, but it‘s not 15 percent to 20 percent.

MATTHEWS: Senator Gregg, I‘ve been to emergency rooms. I once had malaria and I had to go to the emergency room. It‘s not really an emergency room anymore because there are so many people there.

SANDERS: Absolutely.

MATTHEWS: You have to wait for two hours because everybody who‘s in an emergency who‘s poor and can‘t afford health insurance.

GREGG: No.

MATTHEWS: Are you happy...

GREGG: Everybody goes to the emergency room.

MATTHEWS: ... to live in a country--are you happy to live in a country where emergency rooms are right now filled with people who don‘t have emergency situations but they can‘t afford health insurance? Does that make you happy? Is that...

GREGG: Of course not.

(CROSSTALK)

MATTHEWS: ... the status question?

GREGG: Of course not, Chris. But you‘re not going to correct...

MATTHEWS: Well, what are you going to do about it?

GREGG: You‘re not going to correct that with this bill. In fact, this bill will aggravate that situation because this bill throws another 20 million people into the Medicaid system, which is reimbursing at 60 percent, and doctors won‘t see those folks, so they‘re going to end up in the emergency room. And you want to expand the system in a way that creates a public plan where you will again see a pushing out of doctors, a pushing out of health care so people will get less quality care.

The way you address that is by taking on those elements of the system which are not working well. One of those elements...

MATTHEWS: Why haven‘t you done it before? Why have you never done it? I‘ve heard this argument...

GREGG: What do you mean we haven‘t done it?

MATTHEWS: ... from the Republican side since 1960s...

SANDERS: Yes.

MATTHEWS: ... and every time your party gets in power, you do nothing. Every time the Democrats get in power, you say, We‘ve got a better plan. It‘s the same malarkey you--I mean, the Democrats may have an expensive plan. You never have a plan. Eve!

GREGG: Well, Chris, I think it‘s a bit of an exaggeration to say...

MATTHEWS: No, because-

GREGG: ... we do nothing...

MATTHEWS: Well, I‘m an American. You‘re an American. How come we don‘t have national health care under the Republicans? Why don‘t we have a Republican version...

GREGG: Because we don‘t believe in national health care.

MATTHEWS: ... of a national health care--well...

GREGG: We don‘t believe in nationalizing...

MATTHEWS: ... what is your plan for...

GREGG: ... the health care system.

MATTHEWS: ... the 30 million people who don‘t have health care?

What‘s your plan for those people?

GREGG: I gave you a plan. I gave you an outline of a plan.

Everybody in America would get coverage under my plan...

MATTHEWS: But you‘ve never done it.

GREGG: ... and everybody in America would get coverage under the Coburn plan. Everybody in America...

MATTHEWS: You‘re leaving the Senate--you‘re leaving the Senate after 12 years, and you‘ve never done it. All the senators, every time a Republican retires...

GREGG: Well, we only have 40 votes, Chris.

MATTHEWS: ... he retires without having done it. You‘ve had more than 50 before, sir. You‘ve had a lot of Republicans in the past.

GREGG: Well, I would point out, Chris, that in the last administration...

SANDERS: Well, look...

GREGG: ... we had the single biggest expansion in health care coverage, by picking up Part D drug coverage for Medicare recipients, that this country has seen since the start of the Medicare system. It wasn‘t done correctly...

SANDERS: Well, Chris, I mean, I think you‘ve asked...

GREGG: ... by the way, because it wasn‘t paid for...

MATTHEWS: Senator Sanders?

GREGG: ... but it was a massive expansion of health care.

SANDERS: Chris, you‘ve asked the right...

GREGG: I don‘t think your premise is correct here.

SANDERS: ... question. I think the American people--let me be clear. I‘ve got problems with the bill that‘s on the floor and I‘m going to try to amend and it improve it. But at the end of the day, I think the American people are embarrassed that we continue to spend more money than any other country on earth and we‘ve got 46 million people who are uninsured, 45,000 die every single year because they can‘t get to a doctor. This is unacceptable. It‘s got to change.

MATTHEWS: OK, thank you...

GREGG: But the answer is not--the answer is not to take a trillion dollars out of Medicare, which is already insolvent...

MATTHEWS: OK...

GREGG: ... and headed towards a more severe insolvency, and move it over to start a new entitlement. We can‘t afford a massive new entitlement and fund with it Medicare funds. Those Medicare funds should go to...

SANDERS: You want--you support...

GREGG: ... support making Medicare solvent...

SANDERS: ... the repeal of the estate tax.

MATTHEWS: OK...

SANDERS: Judd, you support the repeal of the estate tax with the trillion dollars to the top of 3 tenths of 1 percent. That doesn‘t make a lot of sense...

GREGG: I‘m not a socialist.

SANDERS: ... if you‘re concerned about the national debt.

(CROSSTALK)

SANDERS: ... want to give tax breaks to billionaires!

GREGG: ... and government. I mean, we have a different approach...

(CROSSTALK)

SANDERS: We sure do.

MATTHEWS: On a different point, I want to ask Judd Gregg...

GREGG: (INAUDIBLE) from different states, I guess.

MATTHEWS: Senator Gregg, it‘s great having you on. I have to ask the same question...

GREGG: It‘s always a pleasure.

MATTHEWS: ... that I asked to the chairman of the Republican Governors Association, Haley Barbour, last night. I asked him--and I think it‘s a reasonable question--is Sarah Palin qualified to be president? What would be your view?

GREGG: Well, of course she is. She was governor of a major state in the United States and she‘s run as vice president. She‘s qualified.

MATTHEWS: OK, great. Thank you very much, Senator Bernie Sanders, Senator Judd Gregg.

Coming up: President Obama‘s got his chin out on just about every front right now--health care, that mammogram report, Afghanistan, that trial coming up in New York for Khalid Shaikh Mohammed. He‘s taken on a lot of political risk. Can he find a way to get a big win? We‘re going to get back to those questions in the next block.

You‘re watching HARDBALL, only on MSNBC.

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