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Lou Dobbs Tonight

Democrats Going it Alone?; Health Care Deadline; Where are the Jobs?; Health Care in Sweden

Aired August 19, 2009 - 19:00   ET


LOU DOBBS, HOST: Thanks, Suzanne.

The White House is insisting the president wants to sign a health care bill with Republican support but top Democrats are saying they're ready to shut Republicans out of the process to achieve their goals no matter how they do it. Democratic sources telling CNN at the end of the day a win is a win.

Also, after weeks of failing to convince the American people on those health care plans and town halls all across this country, President Obama is changing its pitch, now emphasizing the emotion and moral responsibility of health care.

And the one thing our elected officials and the national media aren't talking about, jobs. Tonight we talk about jobs, continuing our special series of reports on the critical issue of jobs and "JOBS NOW!".

ANNOUNCER: This is LOU DOBBS TONIGHT; news, debate and analysis for Wednesday, August 19th. Live from New York "Mr. Independent", Lou Dobbs.

DOBBS: Good evening.

It seems inevitable tonight that President Obama will have to try to pass his health care plans with Democratic votes alone. Top Democrats are focused on a go it alone strategy trying to repair deep divisions within their own party rather than negotiate with Republicans. A top White House adviser told CNN, quote, "at the end of the day they will remember we got health care reform done, a win is a win." The Obama administration says it has full public support.


ROBERT GIBBS, WHITE HOUSE PRESS SECRETARY: I think there are millions of people out there, that know, that are on -- that are (INAUDIBLE) quite frankly part of our political base, and others that are independents or Republicans that believe it's time that the health care system changed, that we need reform and we can't continue to do what we're doing now.


DOBBS: Recent polls contradicts however the White House claims especially when it comes to independents. A Quinnipiac University policy showing nearly two-thirds of all independents disapprove of the president's handling of health care. About the same number of people disagree with the Democrats go-it-alone strategy, so-called. And the latest Gallup poll puts the president's approval rating at an all-time low of 51 percent.

Joining us now to assess all of this, our team of reporters covering the story -- Ed Henry, Dana Bash and Jessica Yellin -- Ed, what is the latest in the White House, plunging poll numbers reversal and seeming reversals of -- on the public option to the point it's unclear to many exactly where the White House is.

ED HENRY, CNN SENIOR WHITE HOUSE CORRESPONDENT: Well Robert Gibbs insisted today that the president is still hopeful he can get a bipartisan deal. But the fact of the matter is that as you noted at the top, advisers to this president are privately very actively considering that option -- you talked about muscling it through the Senate with the simple majority instead of 60 votes.

And the reason they're doing that is because they're not in good shape, despite what they maybe saying publicly, the fact of the matter is that after speech after speech, P.R. offensive after P.R. offensive this health reform is not selling to Republicans or to some conservative Democrats and that's the real big issue. The reason why they can't get the 60 votes in the Senate is not so much the Republicans have been against the president -- they've been against him essentially since day one -- it's the conservative Democrats in the middle who are just not buying this so far -- Lou.

DOBBS: Dana, what has changed that the Democrats are now talking about bipartisanship and then in the next breath, going it alone?

DANA BASH, CNN CONGRESSIONAL CORRESPONDENT: Not much, except one thing, and that's the calendar, Lou. We're getting closer to September when Congress is going to come back and that really is the time where this is not a joking around deadline. It is the deadline where they're just going to have to decide whether or not they're going to have to move forward on this health care bill.

And for some time privately we've been told for some time by Democrats that they -- despite the fact that they are encouraging these bipartisan talks, publicly, privately, they don't think it is going to -- that they're going to find success. So what they're doing is sort of laying the ground work for what they have believed for some time is the inevitable, which is the fact that they're going to have to probably pull the plug on those bipartisan talks and try to push forward to do this with just Democrats -- Lou.

DOBBS: Well let's return to this idea of going alone or reconciliation, if I may. But first, Jessica, you've been to a lot of these town hall meetings. Let's listen to this question put to Senator Ben Nelson at his town hall meeting today.


UNIDENTIFIED FEMALE: This is not specifically directed towards you, but it is directed towards the White House, and Pelosi, Reid, and Waxman. As a famous columnist wrote, Robert Novak, who recently died, he stated "always love your country, never trust your government and a government that can give you everything can take everything away." And at this time, Senator Nelson, I don't trust my government.


DOBBS: The issue of trust, Jessica -- people across the country, no matter what they think about health care reform, that seems to be underlying a lot of the expression of constituents in those town hall meetings.

JESSICA YELLIN, CNN NATIONAL POLITICAL CORRESPONDENT: Absolutely, Lou. Among the critics of health care reform that is the message we hear most consistently. It's an intense anxiety of deep distrust of government of the politicians, and that of their leadership. They don't believe they're being told the truth. So it's not just the politicians, it's also the media.

If you say these are the fact checks that counter what you've just been told, they don't buy them. So it's become very hard for these members to even engage in a constructive conversation, because so many of these people are unwilling to believe anything that's out there, because there's this deep, deep, deep distrust of the government and the fact that there's not a single health care bill that they can point to as a finished product makes it even harder to dispel any myths.

DOBBS: And just in a sense of some fairness here to those constituents in those town hall meetings, Jessica, there is no plan before them, they've been lied to by the previous administration, by this administration, you can put that in a lot of ways you want, but whether it's on the efficiency, the savings or the budget neutrality of these proposals, they look at that as a lie. I mean there is a great reason, empirical basis, experiential basis for that distrust. It's not because there is some sort of as some in Congress have suggested, some sort of mad lunatic fringe.

YELLIN: Well, the people that you -- I've encountered at these events will talk not just about the mistrust but the next phrase they'll use, Lou is the unfairness of what's happened with the economic policy from the administration, how they're suffering and the companies gets bailouts, so it's this real sense of being squeezed and the government isn't helping them.

DOBBS: Jessica, and now reports from Politico today about a conflict of interest, a possible conflict of interest, for the president's senior political adviser, David Axelrod on health care and health care advertising. What is the White House saying about that now?

HENRY: Well, Lou, what Robert Gibbs said about that yesterday when he was asked about it is basically that while David Axelrod's former firm, the one he founded in Chicago is involved in these health care ads they insist he's not directly benefiting because he's left. He has to do that for ethical reasons of course. Nevertheless he got a big pay-out to leave. Roberts Gibbs defended that by saying look this is the free market. He founded that firm. It's made a lot of money over the years and he got that payday. Obviously as you're talking about with Jessica, she hit the nail on the head in terms of the mistrust, distrust out there about the government. One top White House aide leveled with me a few days ago and said look, one of the things they may have misjudged a little bit is just the depth of the anger in terms of the government bailouts.

And when they were pushing this public option, government run, people are so frustrated with the bailouts that have piled up that, as you say, they don't trust the government. And that really sort of took the White House off its stride in the early part of this debate. Nevertheless they are still confident they're going to pull this out.


BASH: It was a little surprising that they -- that it took them by surprise because you know spending time just with members of Congress before they did leave for the August recess, especially those conservative Democrats who went to the White House many times, they were very open with us that that was what they were already hearing from constituents. Wait a minute -- this bailout -- (INAUDIBLE), you know all of the policies that they have seen from the administration, the stimulus is another great example of huge spending that they, out there, just don't see working. And that is definitely contributing to this health care issue.

DOBBS: And with all of the members back -- nearly all of them -- back in their districts, they are hearing from those constituents, whether they like it or not and that seems to be having a significant effect not only on the direction for health care reform but also on the -- some change in tone pitch and possibly all together, the strategy for this White House, Jessica.

YELLIN: For the White House -- the White House has to do -- the White House first of all knows it has to do a better job and right now they're in a wait and see mode. They don't want to make any final decisions on this until they see if the Republicans leave the table, see what they can get done, but they know that this public is not on board yet and there's -- the outrage is a problem.

DOBBS: All right. Jessica, thank you very much. Dana, thank you. Ed, thank you very much.

Turning now to foreign policy -- North Korea apparently ready to begin talks with the United States, according to an aide to New Mexico Governor Bill Richardson -- Richardson meeting today in New Mexico with two North Korean diplomats. The North Koreans said their release last month of two American journalists entitles them to direct talks with the United States on their nuclear program. White House officials saying there is no change in policy towards North Korea and that Governor Richardson is not negotiating on the behalf of the president, leaving open the question on whose behalf is he negotiating. A series of explosions rocked Baghdad today. At least 95 people were killed. It is Iraq's deadliest day since our combat troops handed over security of major cities to Iraqi forces two months ago. A truck bomb exploded outside Iraq's Foreign Ministry sending shrapnel and debris flying. A total of six bomb blasts were reported in Baghdad. More than 560 people were wounded in those attacks; Iraqi officials blaming al Qaeda and other radical insurgents.

In Afghanistan six of our troops have been killed over the past two days. Five killed on enemy action; the sixth of a non-battle injury. Violence in Afghanistan is on the rise; the country preparing for national elections tomorrow. Six election workers were killed yesterday. Taliban militants have been carrying out attacks across the country trying to disrupt the election. President Hamid Karzai is running for a second term. His former foreign minister is the principle challenger among the more than three dozen presidential candidates.

Up next here tonight's "Face Off" debate -- should the goal of health care overhaul in this country be a government-run system and what lessons can we learn from socialized medicine in other nations. Tonight we report on one that's supposed to be among the very best -- Sweden.

And "JOBS NOW!", our nightly report on who's helping the millions of out of work Americans find jobs and what happened to the promise of millions of new jobs? We'll be right back.


DOBBS: Well, tonight we continue our series of special reports, "JOBS NOW!". We're reporting on what happened to that initiative to create millions of new jobs in this country. Our unemployment rate has nearly doubled in less than two years. It now stands at 9.4 percent; more than 30 million people without jobs are working part time instead of full time.

The Obama administration passed an almost $800 billion economic stimulus package and at the same time promised millions of new jobs would be created or saved. Billions upon billions of dollars have gone out the door, but that has not resulted in job growth that many expected. Lisa Sylvester has our report.


LISA SYLVESTER, CNN CORRESPONDENT (voice-over): At this New York State Labor Department Career Center, laid-off workers tweak their resumes and look for job leads. The job search is tough.

UNIDENTIFIED FEMALE: The way I feel and the way I've been seeing this since I got laid off, if you don't know somebody in the job, you will not get the job.

UNIDENTIFIED MALE: It's a lot of competition out there. And I'm kind of specializing in my field, so there are very few jobs out there, and there's lots mover applicants out there. SYLVESTER: The national unemployment rate, 9.4 percent. That doesn't take into account those who were under employed or working part time. President Obama was optimistic when he took office, promising three to four million jobs would be saved or created by next year but the country is still shedding jobs, an average of 500,000 jobs a month have been lost since January. The White House looks at it as well, things are less bad than they were last year and credits the $787 billion stimulus package.

BARACK OBAMA (D-IL), PRESIDENT OF THE UNITED STATES: Today, we're pointed in the right direction. We're losing jobs at less than half the rate we were when I took office. We've pulled the financial system back from the brink.

SYLVESTER: Where are the labor unions on the issue -- standing squarely behind the president. The AFL-CIO says the stimulus has slowed the rate of job decline but the pink slips continue to pile up. A "USA Today"/Gallup poll finds 57 percent of Americans say the stimulus is not working. Democrats say they inherited the financial mess but it's up to them to fix it, says the left-leaning Economic Policy Institute.

LAWRENCE MISHEL, ECONOMIC POLICY INSTITUTE: And unless further policy action is taken, we're going to see jobs continue to erode and unemployment's arise for most of the next year and I undoubtedly will have the negative impact of the Democrats chances next November.


SYLVESTER: Now, to just keep up with population growth, the U.S. economy needs to add 127,000 jobs a month. But that has not been happening. We've been moving in the opposite direction, losing 6.7 million jobs in the last 19 months. That's a very big hole to dig out of -- Lou.

DOBBS: Absolutely and is there consternation in Washington? No one is talking about more than 30 million people who are -- effectively who are unemployed in this country. It hasn't been the focus of principle public policy discussion in either Congress or the White House, in some time now.

SYLVESTER: Yeah. You're absolutely right about that. In fact what the White House keeps saying is they point -- keep pointing to the stimulus package saying it needs time to work, but for many people who are on the ground, the folks, they don't have time. They have got a mortgage to pay. They have got a family to feed and that help just has not trickled down to them.

DOBBS: Unemployment benefits were for many are nearing their end. And we should point out that only $100 billion of the economic stimulus package has been put into this $14 trillion economy, $100 billion, that is half of what has been spent on one company alone -- AIG. Lisa, thank you very much. Lisa Sylvester.

A major American company recently emerging from bankruptcy is adding jobs. General Motors calling more than 1,300 of its laid-off workers, GM needs them to build an additional 60,000 cars -- about 10,000 GM workers already on the job will also see an increase in their overtime. The "cash for clunkers" program being credited with increasing demand according to GM. One GM executive says he expects additional production increases into next year.

Car dealers across the country still waiting to be paid by the federal government for their participation in the "cash for clunkers" program -- some dealers find themselves in a cash crunch while waiting for reimbursement from the federal government. In New York, hundreds of car dealers have dropped out of the program because of the delays. Transportation Secretary Ray LaHood today said he understands their frustrations and said, quote, "They are going to get their money."

He did not say when. The "cash for clunkers" program offers rebates of up to $4,500 to trade in older cars for newer, more fuel- efficient ones. I'll have a few thoughts about that including the "cash for clunkers" program, job creation and all of the issues of the day. Join me on the radio Monday through Friday for "The Lou Dobbs Show" 2:00 to 4:00 p.m. each afternoon on Wor-710 in New York. Go to to get the local listings for "The Lou Dobbs Show".

Subscribe to our daily pod cast and on today's pod cast Congressman Joe Sestak, who hopes to unseat Senator Arlen Specter next year offering up his support for a public option. Hear that entire interview and much more -- subscribe to our pod cast on and please follow me on Twitter on loudobbsnews on

Up next does the president believe doctors are more interested in making money than practicing medicine and helping their patients?


OBAMA: The doctor may look at the reimbursement system and say to himself you know what, I'll make a lot more money if I take this kid's tonsils out.


DOBBS: We'll ask our experts about that in our "Face Off" debate tonight and we'll report on the quality of Sweden's public health care system -- all in Sweden are covered -- all receive the same care.


DOBBS: We continue our coverage of health care systems all around the world. We're examining public health care systems to see what we might learn. Tonight, it's the state of health care in Sweden -- Sweden ranking fifth in a European survey of health care quality. The life expectancy, by the way, in Sweden is 81 years. That's three years more than in this country.

All in Sweden, by the way, are covered and the level of care in each instance is identical, regardless of financial standing or whether or not you work for the government. Kitty Pilgrim has our report.


KITTY PILGRIM, CNN CORRESPONDENT (voice-over): In Sweden, people go to a publicly run health care center for all medical needs. The clinics are run by the 21 separate counties in Sweden. Doctors work on straight salary for the clinic. Richard Saltman has been studying and working with the Swedish health care system for 25 years.

RICHARD SALTMAN, EMORY UNIV. SCHOOL OF PUBLIC HEALTH: Overall it's a very effective system. The Swedes consider it to be one of the best in the world.

PILGRIM: The statistics are impressive -- life expectancy of 81 years versus 78 in the United States. Sweden's health care costs are nine percent of GDP, less than the U.S. 16 percent, per capita spending half at $3,323 versus 7,290 in the U.S.

And there is one doctor for every 277 people, compared to one in 416 for the U.S. Out of pocket expenses are low. They are capped at $400 a year. But people pay 14 percent income tax to the counties on top of national income taxes. The total tax burden is above 50 percent.

UNIDENTIFIED MALE: From an individual perspective, you do not pay when you get services. Where you do pay, of course, is in the structure of taxes, which is the highest in the OECD, the highest amongst the developed countries.

PILGRIM: The health coverage is very generous. Women receive a year and a half of maternity leave at 80 percent of salary. Also people can take paid sick leave at first through their employer and after two weeks through various government funds. Bianca Frogner has a PhD in health economics and has studied Sweden extensively.

BIANCA FROGNER, HEALTH ECONOMIST, GEORGE WASHINGTON UNIV.: In Sweden, they believe that sickness should not be a punishment, and that if you are out of work due to a illness they do compensate you partly for your income that's lost during that illness.

PILGRIM: New arrivals to Sweden and immigrants are all covered. Politicians and paupers get identical medical care.

UNIDENTIFIED MALE: That is a point of pride in Sweden that a wealthy industrialist or an elected official gets care in exactly the same facilities from exactly the same doctors for their clinical needs. There are no differences between citizens.

PILGRIM: There are downsides. Sweden has problems with waiting lists for elective surgery and other non-critical treatment. There is also a public push for more individual doctor choice.


PILGRIM: Now, Sweden is trying to improve the doctor-patient relationship, trying to link doctors to individual patients. The impersonal nature of the system has caused some discontent in Sweden. And also another issue going forward is a fifth of the population is over the age of 65. And that will start to put pressure on health costs in the future -- Lou.

DOBBS: Yeah, it's something that won't happen in this country for at least what is it, it's about 15 years -- 15 to 20 years -- but I mean people have got to be watching that report thinking, my God, 80 percent of pay for a year and a half for maternity leave.

PILGRIM: You know...

DOBBS: That's pretty -- that's pretty good.

PILGRIM: It's very attractive, but the taxes are very high, so it's...

DOBBS: And what are the taxes...

PILGRIM: (INAUDIBLE) about 50 percent.

DOBBS: Just about 50 percent. Well, you know there's no such thing as a free lunch or free maternity care, I suppose, maternity leave I guess we should call that. After a year and a half, that's really leaving isn't it.

PILGRIM: And the job is guaranteed that you come back.

DOBBS: All right -- terrific -- I can see women all over the country thinking...

PILGRIM: Let's move to Sweden.

DOBBS: All right -- well I was thinking of something else -- moving Sweden here. Thanks a lot Kitty Pilgrim. We'll continue our coverage of health care systems around the world. We'll be reporting tomorrow on health care in Greece.

Friday we'll report on Iceland. Two fascinating examples of public -- excuse me -- Ireland -- which we will be -- two fascinating examples of public health care. Up next, Democrats saying they are ready to go it alone on health care, but what are the risks of shutting Republicans out of the process and can they do it anyway?

And tonight's "Face Off" debate -- is a government-run health care choice the only option or is there a better way? And tonight, a hero mayor speaks out.


UNIDENTIFIED MALE: I think it's fair to say that things got very, very ugly, very, very quickly.


DOBBS: The dramatic account of Milwaukee's mayor. He was beaten with a pipe as he rushed to the aid of a grandmother to save a 1-year- old child.

(COMMERCIAL BREAK) ANNOUNCER: Here again, "Mr. Independent", Lou Dobbs.

DOBBS: Just how would the government provide up to 30 million uninsured Americans quality health care and none of that is spelled out? In fact there is great uncertainty about the numbers. Best guesses range anywhere from 8.2 million to 20 to 30 million. But President Obama has outlined several areas that he wants to overhaul -- first, the insurance companies and now doctors. In July, President Obama had this to say about pediatricians.


OBAMA: Right now, doctors, a lot of times are forced to make decisions based on the fee payment schedule that's out there. So if they're looking and you come in and you've got a bad sore throat or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I'd make a lot more money if I take this kid's tonsils out.


DOBBS: And just last week in a town hall meeting in New Hampshire. President Obama seemed to suggest doctors treating diabetics would choose amputation over preventive medicine.


OBAMA: If a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance, but if that same diabetic ends up getting their foot amputated, that's 30,000, 40,000, $50,000. Immediately the surgeon is reimbursed.


DOBBS: Well, those doctors, men and women who took an oath to practice medicine ethically are not the highest paid members in our society. According to "Modern Health Care" which puts out an annual survey of doctor pay, doctors in emergency medicine made between 224 to $327,000. A doctor of internal medicine makes somewhere between $180,000 to $222,000 a year. Average pediatrician pay, $150,000 to $217,000. Average registered nurse making about $58,000. To put this in some perspective, the average salary for a soccer player, $135,000. The average annual play for a national football league player, $1.5 million a year. Average annual salary major league baseball player, $3 million. Players in the NBA earning per year about per year just $5 million a year.

In tonight's face-off debate, is universal health care the solution for the country's health care system? Legislative policy director for the AARP David Certner says yes. David, great to have you with us. AARP representing some 40 million Americans over the age of 50. In Seattle, policy and public affairs director for the Association of American Physicians and Surgeons, Kathryn Serkes. Her association says universal health care simply just doesn't work. Good to have you both here.

Let's begin with David, first. Is universal health care the so- called public option, single pay, however you want to break it down, why has the AARP not come up with its own solution, and we've heard the president say twice, that you guys are on board with what he's doing.

DAVID CERTNER, LEGISLATIVE POLICY DIRECTOR, AARP: Well, we do have universal coverage available for those age 65 plus. It's obviously called Medicare. It's a program that worked very well. People are happy. We know about our members not yet eligible. Those 50 to 64 have a very difficult time finding an insurance company that will ensure them, especially if they have a pre-existing condition. And even if they can afford it, it's often not an affordable price if it's available. We need to have affordable health insurance that are accessible to all people in the society.

DOBBS: So where is - and the great frustration among many at the AARP isn't clear. Where are you? Do you want the public option? Do you support, as the president said, are you on board with him or are you not? You guys said first it was inaccurate. He repeated the statement, you didn't say anything. This is your opportunity tonight to straighten us all out.

CERTNER: We've been supportive of the president's efforts to reform the health care system and to try to improve coverage, access and lower costs. We've not endorsed any specific plan as of yet. We keep working with congress, members from both sides and the president to try to get a good health care plan because we think we need to reform the health care system.

DOBBS: Kathryn, do the doctors you represent disagree or agree?

KATHRYN SERKES, ASSN. OF AMERICAN PHYSICIANS & SURGEONS: Well, I just can't let it go by. The idea that politicians would be out accusing doctors of just worrying about money is the -- how ludicrous that is almost ridiculous. I just couldn't let that go by.

Also, I would make a note many of the executives at AARP make more than the doctors' averages that you just mentioned.

So back to the public plan, you know, there's a problem here that the dirty little secret is it really doesn't matter whether there's a public plan or not, as long as there's an insurance mandate we'll go down the road and end up with some sort of government medicine.

DOBBS: Do you want to respond to that, Dave?

CERTNER: In some respects she's right. It doesn't matter if there's a public plan option or a private plan option or if there's competition between the two. What we're looking for is the end goal which is to get affordable health insurance. Generally right now that means changing insurance company practices. We know insurance companies will deny people insurance if they have pre-existing conditions. If they're older, they'll charge them sometimes seven times much more to make them unaffordable. DOBBS: Are you in the insurance business at AARP?

CERTNER: No, I'm not in the insurance business.

DOBBS: All right. Is AARP in the insurance business?

CERTNER: No. We put our brand name on some products being sold but we're not in the insurance business.

DOBBS: You have a commercial relationship with the insurance industry?

CERTNER: We do sell through some affiliations and get royalties from it.

DOBBS: That puts an intriguing twist on things, does it not?

CERTNER: No, we've been in the insurance business in terms of us being involved in health insurance from our members from the beginning. That's how AARP was started. Our policy drives what our products are. When we think there's a gap in the market --

DOBBS: I happen to be a great believer in capitalism. I believe in laying things out where they belong. Your thoughts -- I'm sorry, go ahead.

SERKES: I think that that's true. That obviously, they have a financial interest. You know the point is Lou, we all have a financial interest in this as patients or as doctors, or as business owners, we all have financial interests. Whole point is to be transparent about it.

I want to go back to what he just said, which is that there's agreement that there should be universal coverage. We don't agree there should be universal coverage. Universal coverage, universal insurance is not care. Coverage is not care. Having a piece of paper that says that you have an insurance policy, whether it's a private plan or public plan, doesn't matter. Just ask anybody who -- in Canada who has that piece of paper and has a right to care, but they can't get the care that they want, waiting times and there aren't doctors available.

DOBBS: Both of you charge with distortions, we're hearing the president saying misrepresentations, I don't remember the exact expression he used today basically saying people are lying. There's no harm saying exactly what we mean. He's saying people are lying. Those are my words, not precisely his. I don't think there's any doubt people are lying in this debate. How do we sort it all out, because we've heard the president, as I just mentioned, one misrepresentation he made twice, saying that you guys were on board with him, you denied that outright. We have people saying universal health care will be the end of western civilization, we know better than that because we've been reporting here for about three weeks that there are public health care systems in the world that work brilliant. So what is the big lie that's distorting the debate from your perspective and from yours? CERTNER: I think there are many big lies in this debate. It's a complicated bill --

DOBBS: Do you want to start with your own or someone else's.

CERTNER: One thing we're hearing from our members, particularly those on Medicare that they're concerned about is that there is somehow some kind of rationing of the care they get.

DOBBS: What would happen if you cut $500 billion out of Medicare?

CERTNER: If you did it the wrong way, we would have problems.

DOBBS: Just be honest. Whether one calls it rationing or whatever, you're talking about cutting Medicare. There will be consequences.

CERTNER: We're talking about removing wasted inefficiency from the system over a long period of time because for many reasons one we know anyone who has experience with health care system knows there's waste and efficiency that we need to cut back on. We can improve care if we cut back on unnecessary tests and unnecessary health care. We also do it for the Medicare program. Health care costs going out of control. It's costing the Medicare program and our beneficiaries who are paying for it a lot of money.

DOBBS: Absolutely Kathryn, real quickly. Biggest lie concerning you?

SERKES: The biggest lie concerning us is doctors are behind this. The AMA would have you believe all of the doctors are in lock stop behind them supporting this and it's been very clear that the AMA was interested in having a place at the table. They were going to spend lobbying money to get a place at the table. They only represent 20 percent of the physicians in the country. Most of those are academic students or retired.

DOBBS: Let me ask you both something very quickly and let's do this real quickly. Do you believe doctors and nurses should be among the highest paid people in our society?

CERTNER: I think they should get what -- what they pay for.

DOBBS: This is a simple thing.

CERTNER: I think right now what we know we want to make sure doctors are paid fairly so they serve the Medicare patients and the rest of the population.

SERKES: I think that doctors believe they should be paid what the market would pay them. What patients are actually receiving the services think it's appropriate amount to pay them. What we have now is market distortion where the contracts are negotiated by third-party payers who aren't the people actually receiving the service. CERTNER: I just want to add from our members' perspective, what's very important, they can have their choice of doctors. It's a very important issue. One of the things we're fighting for on these bills.

DOBBS: You get the last word, real quick.

SERKES: Another big lie we have is that any of these bills will do anything. Frankly the congress is even trying to solve it. I would say they are political maneuverings to look like they're doing something. If they really wanted solutions, they take a look at real reforms that put patients in control, rather than the government.

DOBBS: All Kathryn, thank you very much. David thank you. Appreciate you being here.

Lisa Sylvester now updating some of the other stories we're following tonight.



Hurricane Bill now a category 4 storm. Forecasters warn it may become stronger. Right now the storm is over the Atlantic Ocean moving northwest toward Bermuda. It's still too early to predict how close Bill will come to the United States but forecasters expect the center of the storm to stay offshore.

The former Las Vegas director of left wing advocacy group A.C.O.R.N. pleaded guilty today to charges of paying for voter registrations. Plea deal includes an agreement to testify against A.C.O.R.N. and specifically former regional director. A Nevada attorney general director said A.C.O.R.N. had a policy of paying bonuses for workers to find more than 21 new voters in a shift. A.C.O.R.N. is under investigation in ten states across the country.

And Mayor Tom Barrett of Milwaukee spoke publicly today for the first time since heroically intervening a domestic dispute. Barrett was attacked with a pipe when he came to the aid of a woman and her 1- year-old granddaughter. He suffered a shattered hand, cuts to his face and head and he lost two of his teeth but the popular mayor shrugged off being called a hero.

MAYOR TOM BARRETT, MILWAUKEE: Anybody at all would have done the same thing. I would hope anybody would do the same thing.

SYLVESTER: Talk about being a hero, Barrett says his wounds are healing fine and he will take the rest of the week off. Those are some stories we're following tonight, Lou.

DOBBS: The mayor in that position because he wasn't using his security detail, even though he would have been entitled because he was taking his family to the fair. I -- you know, just a great story, especially when we have so little good to say about any election officials these days. SYLVESTER: Yeah.

DOBBS: Thanks a lot. Lisa Sylvester.

Up next, an apparent conflict of interest in the white house calls for the president's top adviser. David Axelrod to explain himself. Showdowns across the country as tough talking Americans speak their minds both in congress and constituents.

UNIDENTIFIED MALE: I'm trying to have a conversation with you would be like trying to argue with the dining room table. I have no interest in doing it.

DOBBS: Who says politicians and their constituents, exchange views? Frank exchange of views. We'll be right back.


DOBBS: Joining me now Republican strategist, former white house political director, CNN contributor, Ed Rollins, good to have you here, Ed. White house reporter for Politico, Nia-Makila Henderson. And Democratic strategist, CNN contributor, Robert Zimmerman, Robert, good to see you.

Let's start. When asked which would be better, passage of the current bill working its way through congress, I love that expression. I'm not sure it's working its way through at all or no passage at all, the great majority said it's not better to pass health care this year. Robert it looks like the end game is near.

ROBERT ZIMMERMAN, DEMOCRATIC STRATEGIST: The game has just started. Wall Street Journal, NBC News poll out today said 60 percent of those sampled said the system should be overhauled. When you look at the fact that when you ask people what they feel about Obama's position his approval ratings jumped to 53 percent on this plan. My point is this is a tough process but the process is under way. I think the -- I give the congress extraordinary credit, I give the democratic leadership extraordinary credit for trying to build a bipartisan coalition.

DOBBS: Now we're talking about bipartisanship?

ZIMMERMAN: We're talking for it over a year now.


NIA-MALIKA HENDERSON, WHITE HOUSE REPORTER, POLITICO: I mean bipartisanship I mean it's almost as if at this point I mean as Obama kind of steps away from the publican option in some ways, I think bipartisanship is kind of, you know, he's holding them out there but not quite embracing it. I think bipartisan ship looks a little different. I think he can pull off a few Republicans but whether or not that's bipartisanship is still debatable.

DOBBS: That's right. HENDERSON: It seems to be shifting. A definition of bipartisanship. His strategy too is shifting. It looks like he's going to start talking about this in moral terms. He's been kind of edging around that discussion, mainly talking about it in economic terms. They shift the terms of debate, maybe they feel more focused.

ED ROLLINS, REPUBLICAN STRATEGIST: I don't disagree with that. I disagree with it as a tactic. I think if you talk in terms of morally the country has an obligation to take care of the disadvantaged the counter point is that we do take care of many of the disadvantaged. We take care of elderly with Medicare, our poor with Medicaid.

I think the bottom line here, I think Republicans are mistaken not to participate, they are not going to. It's not going to be a Republican vote because there are some things that need to be fixed. Insurance company things need to be fixed, some of the Medicare stuff needs to be fixed but at the end of the day this thing has been so rushed through and it hasn't been an open process. As they go to these town meetings they find out the country is very concerned about it. My sense is that they'll pass something. Democrats have to pass something, but it's not going to be what the president wants.

ZIMMERMAN: You know what, I would agree in the sense it can't be a moral debate. The fact is the Democratic message got to embrace the 60 percent of Americans who have no insurance and got to bring the elderly to feel comfortable and secure with their proposal. That's really the strategy they have to pursue if they get this health program passed. I would differ with you in terms of this being an open process. This is going on for well over a year. There have been public hearings from five different congressional committees. We're seeing now what transpired in this recess and the debate is just warming up

ROLLINS: A lot of behind the scenes meetings. There's not a republican that's had an amendment added to any of this and -- I don't think -- this is a Democratic plan. It's like the stimulus bill. From the beginning it your bill. You got the 218, you got 60 in the senate, pass whatever you want to pass but you pay a price at the end.


DOBBS: I'm going to intercede, because --

ROLLINS: Welcome to the --

DOBBS: Welcome to the table.

HENDERSON: I mean, I think their innocence, among a lot of folks there is a lot of missing information here. Whether or not that's the fact these have been closed-door sessions. People are still having lots of concerns how to pay for this. Look at the idea they're paying 40 percent cuts in Medicare. Seniors hear that they hear a cut in benefits.

DOBBS: Do you think they're being irrational when they hear they're going to take half a trillion dollars out of Medicare that there's some consequence for them? Doesn't that seem irrational?

ZIMMERMAN: Let me get the facts on the table before we decide whether it's rational or not. Everybody in the government and in the medical community agrees there's waste in Medicare that has to be addressed. That's worth exploring. I don't think we should shut down that debate. But the other point is Senator Grassley for example who has talked about co-op plans, as a bipartisan initiative --

DOBBS: I have to interrupt you, we have to take a commercial break. We'll be back with Nia, not Robert.


DOBBS: The president's approval rating down to 51 percent in the most recent Gallup tracking poll. For the first time, the Democratic Party down below 50 percent for first time since President Obama became president. Today the Obama administration has changed its tune on the defense of marriage October. It is considered by the administration discriminatory. What will be the impact of such a declaration?

ZIMMERMAN: Nothing if they don't change their actions. It is about time the Democratic congress and this Democratic administration came out of the closet on issues like the defensive marriage act or don't ask, don't tell. It is not enough to change rhetoric. It is --

DOBBS: What do they have to do?

ZIMMERMAN: Well first of all, when it comes to the defense of marriage act, this administration has to -- this administration has got to stop pursuing legal actions to enforce it. And also encourage congress to overturn it.

HENDERSON: I mean, there is going to be some movement on the issues. In September don't ask, don't tell becomes part of the argument about discrimination against gays. Senate Armed Services Committee will start taking that up in September. It looks like there is some leadership in the senate and the house with people pushing to repeal it. Obama has been clear that he has been against these but also said he will defer to congress which a lot of people think he is saying one thing.

ROLLINS: It's another case of mixed messages. He's getting very bad at this with the health care and issues like this. He wants to be loved by everybody. The last president we had was just four presidents ago, Jimmy Carter, wanted to be loved by everybody. Early on was. He was a terrible failure. The president is on that road.

DOBBS: You really believe he wants to be loved by everybody.

ROLLINS: I think he wants to be loved by everybody. He got used to be loved in the campaign. I think he got used to the roaring crowds. He's got very thin-skin and I think Gibbs and the rest of them do, too. It is a tough, tough 3 1/2 years ahead.

DOBBS: What do you think Robert? ZIMMERMAN: I think he adjusted pretty well. He has taken on some pretty bold initiatives and major issues. He's suffering in the polls as a result on taking some very tough positions like on the health care issue.

DOBBS: They weren't this tough until he started on them, it seems. I mean -- he went into it with high approval ratings on health care. He had cap and trade through the house. I mean, he had -- economic stimulus. It is as if this health care issue which they tried to closet, if I may continue the metaphor, the discussion within the house, keep it from public view, and the result has been disastrous for both his approval ratings and for that of the party.

ZIMMERMAN: You show me a president with high approval ratings at this time in their presidency and I will show you a president that's not prepared to spend capital. He's put himself on the line and the Democratic congress has on these issues.

HENDERSON: Well, I think that this whole -- we aren't really clear on what he is willing to spend his political capital. I think a lot of people thought he would really push for the public option but seems like he is waffle on that. Even with some of these issues like the employee free choice act or even don't ask, don't tell, he does not seem like he's willing to use political capital. But I also think maybe the numbers will turn around once the economy turns around.

ROLLINS: The problem is he has been on the road three weeks now and he's dropped seven points. It's very much like George Bush when he tried to sell social security. Every time he made a speech his numbers dropped. This president has not made the sale on health care.

DOBBS: Meanwhile, more than 30 million Americans struggling with unemployment and the number almost certain to go considerably higher. Thank you very much. Thank you, Nia, thank you Ed, thank you Robert.

Up at the top of the hour, Campbell Brown.



Tonight can democracy take root in Afghanistan? As you know, voting gets underway in a few hours and the threat of terror very real there.

Also ahead, new details on Hurricane Bill, where this very dangerous storm may land.

And a government informant accused of carrying out the biggest case of I.D. theft in the U.S. had to get away with it for so long.

Also, we have the mayor who has been called a hero. More of what he had to say about trying to stop an attack on a woman and her baby granddaughter.

We will see you in a few minutes. DOBBS: Hero mayor. Absolutely. Look forward to it, Campbell. Thank you very much. We'll be right back.


DOBBS: Television news pioneer and the creator of "60 Minutes" Don Hewitt today died. He was 86. Hewitt had battled pancreatic cancer. He began his career at CBS in 1948 working with Edward R. Murrow, executive producer of the CBS Evening News with Walter Cronkite when it became the first half hour long network new broadcast, that in 1963. Hewitt developed many practices now standard for broadcast journalists but his crowning achievement to creation of "60 Minutes" back in 1968. Hewitt remained the show's executive producer until 2004. The TV news pioneer Don Hewitt dead at the age of 86.

We thank you for being with us tonight. Please join us here tomorrow.

For all of us, we thank you for watching. Good night from New York.

Next, Campbell Brown.