Video Transcript:

GLORIA PENNER (SD week host): The debate over healthcare reform rages on in Congress and town hall meetings across the nation this week.  Language from top Obama administration officials seems to indicate support for public option may be waning.  There's discussion now of a non-profit healthcare cooperative.  Would that model guarantee access to healthcare for all Americans?  Jan Spencely is the executive director of San Diegans for Healthcare Coverage.  She goes 'On the Record' about the direction the healthcare reform is taking.

JAN SPENCELY (San Diegans for Healthcare Coverage executive director):  I don't believe a co-op can guarantee access.  I believe that we need health policy, we need good health policy, and national health reform that guarantees coverage for all Americans.  This is just an insurance company with a little different twist.   It's not any different.  It's building on an existing broken system.  Yes, it's not for profit, I'm glad, but the fact is that most of the health plans today started exactly like this, as consumer-driven, community-based health plans.  And look where we are today.  I don't see how they by themselves could guarantee coverage for anyone.  We still need a health insurance exchange, we still need a public option, we still need competition, we still need healthcare regulation.  We need to fix the broken healthcare system, and this is just rearranging the deck chairs.

PENNER:  So, John, is this the way you see it?  Are we without a good health policy and just moving around what already exists?

JOHN WARREN (San Diego Voice & Viewpoint):  We certainly are without a policy right now there's no question.  And this public option is under title two of the proposed health reform plan for America which we have here.

PENNER:  You brought that in John.

WARREN:  I brought it in so that we can see how voluminous this one bill is that's being discussed.  It's 1,017 pages.  This does not even touch the bills that are presently in the Senate that have not been reported out yet.  And the two bodies will have to get all of these documents together and produce perhaps an even larger volume to address the issue.  But I'd like to say that Jan was absolutely correct.  I do not believe that the co-op approach will work.  It's too limited in terms of how people would be served.  Some of the important points here deal with the lack of punishment for prior existing conditions, supportability of our plan, changes in medicare and how it's funding is done.  All of those things have to be approached from a comprehensive standpoint.  And the cooperative approach does not allow that and the public option plan is just that, it's an option. It is not a mandatory replacement in terms of single payment plan or pushing insurances out of the business. 

PENNER:  But there is some feeling that the public option might be dropped.  I mean there hasn't been that same kind of passion from the administration that we've heard before.  How will there be competition for insurance companies?

JW AUGUST (10News):  It's the only realistic option, and I don't think left liberal wing of the democratic party are going to let that happen, even thought the blue dog Democrats are saying "Well maybe we ought to drop it off" no that's not going to happen.  How are you going to force these for-profit companies to behave, to be competitive in their pricing?  Right now they're not that way, that's why the cost is out through the roof.  One of the issues, is that the profit motive is driving the cost of health care through the roof.

PENNER: But the idea of competition still exists, the insurance companies themselves say that they compete with each other.  

WARREN:  Well they do compete with each other, but it's not a fair statement, I mean this country has always been built on the idea that when there's an imbalance on the part of the people the consumer the government steps in to provide a leverage, and here we need a leverage because no one else other than the government presenting a plan with an option has enough resources to step in and begin to balance the scales with the insurance companies.  This idea will force them to be competitive not just among themselves, which is always a danger in terms of violating anti-trust provisions but it will force them to compete with a third entity, which is an incentive and a benefit to the consumer.

PENNER:  Right, but going back to Jan Spencely's comment.  Have we seen anything in any of these suggestions that would decrease that would lower the total cost of health care in this country, which apparently is a huge percentage of our Gross National Product, like 17%?

AUGUST:  But even basic knowlege of how things work fiscally would tell you that if you have competition and you have lower prices you're gonna force other guys if you were selling that Ford for two grand and everybody else was selling it for four grand the guy that sells it for two grand is going to making most of the sales. They have to be more competitive.

PENNER:  Okay, well we do have more from Jan Spencely.  We asked her why she believed president Obama was opening the door to dropping the public option.

SPENCELY:  The reality is that the vision that we started this with has been lost.  And it's been lost in comprimise, it's been lost in trying to get through political committees, it's been lost in rhetoric, it's been lost in lies, and fear tactics, once again fear tactics.  Why would anyone expect that another model of health plan is somehow going to solve this particular problem. Well, I think this is a political trade-off trying to win votes.  Personally, I don't think the public option is dead.  I don't know why people are not more outraged.  If there are probably 6 or more people a week that die in San Diego as a result of being uninsured.  Now if we could identify those people, maybe because it was tainted water, tainted food, let's say it's spinach, we would move mountains to see that they didn't die or that they didn't even get sick.  But these people go quietly.  And so they're not front page news.  And yet, they should be front page news.  And we should be outraged.  And we should be moving mountains to try and make sure they get the care they need.

PENNER:  We did a little fact checking of that figure of six people a week dying in San Diego because they don't have health insurance.  The numbers come from Families USA April 2008.  But then we checked a little more and we found that this was extrapolated from census estimates from the year 2000, and that was done by the Instutute of Medicine.  And so that's where the numbers come from which makes me wonder the outrage that we're hearing seems to be coming from the people that worry that Obama is going for a government takeover.  Healthcare rationing,  even deciding when old sick maimed people should die.  Where is this all coming from?

WARREN:  It's coming from the insurance companies, it's coming from the Republican party, it's coming from those who stand to lose with the change of the status quo.  And those who stand to lose know that if you do enough sound bytes and pick certain words out that you can motivate other people to get involved.  One of the misrepresentations, for instance, is that veterans will be affected.  This plan does not affect or change or alter the veteran plan in any way, yet people are being told that it does.  People are being told there are death paneled.  There are not death panels involved in this bill.  What's involved here is an option to pay for counseling, hospice or otherwise in terms of end of life situations.  And so we have people taking pieces of this, as she said, but we're not hearing, for instance, in California from the 12 million uninsured, or the 50 million in this country that uninsured.  Their voices are the ones that are not being heard and they're the ones who stand most of the benefit from this bill.  

PENNER:  I'm wondering how one gets or how the nation gets the debate back online into something that deals with the reality rather than the lies and misconceptions.  

AUGUST: I think the president has got to stop pussy footing around  on this and he needs to be the president Obama that was elected and be dynamic and tell people exactly what's going on, what they can expect, present the clear vision he did in his election and I think it'll turn it around.

PENNER:  So you're thinking that he needs to come up with a more detailed blueprint of what he wants to come out of all this?

AUGUST: Absolutely.  In a way that the people can understand it.  In a way that the public, maybe it's not bumper sticker Bush policy-making, but it's still got to be in a way that the public can understand it.

PENNER:  I'm not thinking about Bush though, I'm thinking about Bill and Hillary Clinton, they came up with a very detailed blueprint and Congress shyed away from it immediately.  It seems to me the president is going to the other extreme, saying "this is the goal that I want but I'm not going to carve it out for you."

WARREN:  Well we've never had the approach here that we have to healthcare.  Again, it's coming from different areas because there's so many components, the internal revenue code has to be modified, the small business plans are in there, there are things in terms of how people are going to carry their programs with them in terms of portability and he's covering all of these things.  I don't believe that we are going to lose a public option.  I believe that the Democrats will force this option to stay in the plan as (Nancy) Pelosi said yesterday.  And I believe that as we get away from the sound byte financed propaganda that we have going on with it that the people who really stand the benefit will listen more.  Remember, such entities as AARP are in line with this and they represent a great number of Americans who are not out there opposing the public option.

PENNER:  However, the polls show that even people on government-run programs such as medicare who love their medicare, they are afraid of government role in a new system.  Does it all come down to fear of government takeover?

AUGUST:  It's ironic that in a Democracy we depend on getting the right information and even people that oppose it are on those programs fear government takeover. Sure, because that's always scary.  Big brother 1984, they can always throw that at people and frighten them.  

PENNER:  Thank you very much.  JW August, John Warren.