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Lou Dobbs Tonight

Health Care Plan Passes; Afghanistan War Plan; Where is the Vaccine?; California's Approval Ratings Plunge

Aired October 13, 2009 - 19:00   ET


LOU DOBBS, CNN ANCHOR: Wolf: A Senate Finance Committee handing President Obama a rare victory, a vote in favor of health care legislation. The public option, however, is out for right now, at least -- opponents on both sides already demanding changes.

And President Obama still considering his options in Afghanistan -- he says a decision on troop level still weeks away. His top general wants a major escalation. The Afghan president said he would welcome more forces but denies that there are terrorists in his country. Is the size of a troop surge the principle question, what about bringing all of our troops home?

Also tonight, growing concerns about swine flu -- parents uncertain about who is most at risk and where to find the vaccine and when the government will be providing it. The government right now says there isn't enough to go around yet. What should your family do?

ANNOUNCER: This is LOU DOBBS TONIGHT; news, debate and analysis for Tuesday, October 13th. Live from New York, Mr. Independent Lou Dobbs.

DOBBS: Good evening, everybody. Nine months after the president promised a radical overhaul of health care in this country, the Senate Finance Committee today put him closer to that goal. The so-called Obama-Baucus proposal passed 14-9 in the Senate Finance Committee, all of the Democrats supporting the measure, one Republican supporting the vote, Senator Olympia Snowe of Maine, far from a bipartisan effort that the committee thought might happen months ago and unlike other health care plans now in the Senate.

The Baucus concept does not include a government run insurance plan. Candy Crowley has our report from Washington. Candy, is -- what is this? Is this really bipartisanship, one Republican?

CANDY CROWLEY, CNN SR. POLITICAL CORRESPONDENT: Not by a lot of people's definition, Lou. But this is about symbolism, and one is better than none at this point. They had worked so hard to be able to say, oh, thank you Senator Olympia Snowe. You heard the president praise her as brave. It's one of those things that in the end doesn't make any difference I don't think in terms of the total outcome.

What happens here and what the Republicans plan to do and are looking at doing right now is trying to push the bill, whatever comes out of the Senate, whatever comes out of the House, and ultimately comes back for a final vote. They want to push this to the right. The liberals obviously want to push it to the left, so every little bit counts.

And the support of Olympia Snowe at this point was major certainly for Senator Max Baucus because he thinks it underscores the need to go with -- in Maine, his bill, because it did at least attract a little support I think in the end. You will see more Republicans support this when it comes down to a final vote, but we're several weeks away from that.

DOBBS: And Candy, well truthfully, I mean we have got the Senate majority leader, we have Senator Chuck Schumer saying no matter what these mere (ph) senators on the finance committee do, there will be a public option in the final conference, period. What do we -- what should we think of that?

CROWLEY: I think we should think that the fight really has just begun. Here's -- at this point in the process, I don't know if you ever played 52-card pickup where you just took the deck and threw it out there. All these little parts that have been jettisoned by this committee or that committee as they put together their proposals are now pack in play again.

And so when we saw the public option get thrown out of this Baucus bill -- this Baucus proposal, we find that now all of those who want it -- want to put it back in because you know as well as I do, Lou, that the real work is now going to happen behind closed doors, both in the Senate and in the House as they try to take all of these bills they have on either side and combine them into one.

And then the final work comes in that conference committee when House members and Senate members selected by their leaders get together with the White House behind closed doors and talk about what will be the final bill that is sent back to each chamber -- just one bill. That's where it's done. That's where you're going to see the horse trading, and that is where we're going to find how much the president believes he has to have that public option because in the end, this is where the White House input really matters.

Now Max Baucus, as you know, said that he took the public option out because he wanted a bill that could pass the Senate. If it goes back in, will it pass the Senate? At this point, Democrats believe the momentum for a public option, as they see in the public opinion polls is on their side and that they could put this back in and get it passed. So watch the White House and watch those public opinion polls.

DOBBS: We'll try to watch, but as you said, the operative phrase is behind closed doors. Thank you very much, Candy -- Candy Crowley from Washington.

Some Republicans today expressing frustration over the 10-year almost trillion dollar health care proposal -- Senator Orrin Hatch says the real plan will be written in secret.


SEN. ORRIN HATCH (R), UTAH: It almost seems like these hundreds of hours of debate were almost all for not. It's important for Americans everywhere to understand that the bills that we have spent hundreds of hours working on are not the bills that will be discussed on the Senate floor. The real bill is currently been written behind closed doors in the dark corners of the Capitol and the White House, and we can all only hope that all of us, especially American families who have ample opportunity, at least 72 hours to review the full bill and its cost before we're asked to consider this on the floor and vote on it as a bill that affects every American life and every American business. This is too big and too important to not to have full public review.


DOBBS: Senator Hatch also saying he fully expects the so-called public option -- that is government health care, favored by the president to be in the future plans.

The Senate Committee vote today is a small and rare victory for the president and his domestic agenda. The White House is now expected to have a larger role in bringing final legislation to the desk. The president himself called today's vote a critical milestone. Ed Henry joins me now from the White House -- Ed, well, there's got to be some rejoicing. What is the next step?

ED HENRY, CNN SENIOR WHITE HOUSE CORRESPONDENT: Well, they're not quite celebrating, Lou, but they are certainly happy, you're right, because this is a rare victory for this White House in recent days. And as one top aide told me, it's certainly better than the alternative, which would have been not getting even one Republican and maybe even losing a couple of more conservative Democrats or even a liberal who was upset that the public option was not in this bill.

Instead, they held the Democrats. They got one Republican. A second top aide here told me look there were people in the media declaring this whole reform effort dead back in the spring when some of the early budget forecasts suggested it was going to cost too much money. Others declared it dead back in August during all of the town hall meetings, et cetera and so they feel the fact that they have survived this long and now they at least have one Republican onboard, they think they finally have some momentum, but the president was very careful not to over celebrate.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: We are now closer than ever before to passing health care reform, but we're not there yet. Now is not the time to pat ourselves on the back. Now is not the time to offer ourselves congratulations. Now is the time to dig in and work even harder to get this done. And in this final phase, I hope that we will continue to engage each other with the spirit of civility and seriousness that has brought us this far and that this subject deserves.


HENRY: Now, as Candy was pointing out, for the first time now, the White House will be getting their hands a bit dirtier in the process than they had before, leaving most of the work to members of Congress, letting the process play out. The president faced criticism from some fellow Democrats for not being more assertive in this debate and starting tomorrow the White House chief of staff, Rahm Emanuel will be among the negotiators on the Hill meeting with Senate leaders to merge all these various bills, but I can tell you, I'm already picking up from some Democrats on Capitol Hill more frustration.

They think that in the last five, six hours in the reaction to the Baucus bill passing that the White House has been in the words of one top Democratic aide, sort of tepid. That the president is still not stepping out there and clearly defining whether he's going to push hard for a public option, for example, so we'll see how long they're able to celebrate here at the White House, Lou.

DOBBS: Well if the president is not doing that and there's any confusion on the part of the Democratic leadership, why is it then that both the House and Senate leadership are saying there will be a public option in conference?

HENRY: Well, they continue to say that in part because a lot of their constituency groups are demanding it. I mean the labor unions, for example, very important to the Democratic Party are now saying that starting tomorrow, they're going to be running newspaper ads across the country coming out against the Baucus bill.

They're partly doing that because the public option is not in the Baucus bill and they're frustrated by that and so as Candy was suggesting, they're going to try to pressure these negotiators to include it in there. So in part, the Democratic leaders on the Hill want to sort of fight the good fight for some of their constituent groups.

But whether this really has the votes, I have talked to some top Democrats on the Hill insist the votes are not there for a public option. They're kind of going through the motions on that, but at some point, they're going to have to probably face reality that the votes are probably not there for a public option and it's likely that a final bill is going to have to have something less aggressive, Lou.

DOBBS: And also there is the matter as to whether or not the money will be there as well. Ed, thank you very much...

HENRY: (INAUDIBLE) big question.

DOBBS: Ed Henry from the White House...

HENRY: Thank you.

DOBBS: We'll have much more on the health care debate later in the broadcast. Would the Obama-Baucus proposal fit the -- fix the health care system in this country? That's the subject of our "Face Off" debate here tonight.

And turning to the debate over Afghanistan where questions of troop levels have yet to be resolved and won't be resolved apparently for weeks. President Obama today said he will make that decision in the coming weeks, as he put it. President Obama did authorize 13,000 additional support troops in addition to the 21,000 combat troops deployed earlier this year. That part just wasn't mentioned.

Chris Lawrence reports now from the Pentagon. Chris, the Pentagon doesn't categorize these support troops as combat forces, but they're still in the fight, aren't they?

CHRIS LAWRENCE, CNN PENTAGON CORRESPONDENT: Still got guns, still going to be in dangerous situations, Lou, without a doubt. You know, being support doesn't mean necessarily that you're sitting back at a desk at headquarters. We know, for example, that roadside bombs are killing more Americans than anything else in Afghanistan. Some of the support troops will be exploding ordinance and clearing mines.

We know a lot of combat troops are working out of very remote outposts like those soldiers who were nearly overrun during that vicious battle in Eastern Afghanistan last week. Some of these 13,000 could be providing air support, field medics to treat the wounded during battles like this. The thing to remember though in all of this is that a lot of these 13,000 were already authorized under the previous Bush administration. They just physically didn't go while he was still in office, and it doesn't change the big picture, which is 68,000 Americans in Afghanistan by the end of the year.

DOBBS: Well, Chris, turning to that issue, 13,000 support troops not mentioned by the Pentagon or by the White House when the announcement was made that the president, President Obama had raised -- had added 21,000 troops. That seems like an unfortunate omission on the part of both the Pentagon and the White House. How did that occur?

LAWRENCE: Well, I think it's a matter of trying to clarify exactly how you define support. You know, coming up with some sort of definition as to what's combat, what is support. You know when I think of it personally, I think of just anybody who is going to fight in Iraq or Afghanistan is basically going to see or has the possibility of seeing some combat even though they may not be frontline infantry troops.

DOBBS: Right.

LAWRENCE: And another distinction is exactly what has President Obama authorized. He is saying or the White House is saying that these 13,000 were already authorized by President Bush. They just didn't make it into the theater while President Bush was still in office. But they're saying they don't count as to what President Obama personally has authorized.

DOBBS: By the time one gets through explaining that, it begins to sound like a bunch of barracks (ph) lawyers trying to bring something forward. I'm sure that that would not be the intent of either the Pentagon or the White House, but by my count, we're talking about somewhere around 75,000 troops with an additional 40,000 combat troops as requested by General Stanley McChrystal and the same ratio support troops. We're talking about somewhere near the same level of troop commitment in Afghanistan as we currently have in Iraq. Is that correct?

LAWRENCE: That's been the big question. If this 40,000 number is the right number, if it is the number that President Obama agrees to, does that include the support troops or is he talking strictly combat troops with support troops to be added on? And another distinction -- you know when you try to compare this to the surge in Iraq it's going to be vastly, vastly different.

When those 30,000 troops surged into Baghdad, Baghdad is where one out of every four Iraqis lived. Even if you took Kabul, Kandahar, and the 28 largest most populated areas of Afghanistan, you would still only account for 20 percent of the entire population. Most of Afghanistan lives in thousands of tiny, rural villages spread out all over the country. There is no way possible with any sort of troop numbers that you're talking about to cover that entire area.

DOBBS: And as you said, I'm talking about -- let me be clear -- this is the president talking about it, certainly not me. I just think that's a terrific point that you're making. And we tend to conflate the wars in Iraq and Afghanistan. And as you point out, they're very much different, different altogether different theaters. Chris, thanks so much, as always -- Chris Lawrence from the Pentagon.

Up next, is the Obama-Baucus plan the right approach to overhauling health care? That's the subject of our "Face Off" debate here tonight.

And predictions the health care proposal would cut billions of dollars more from Medicare, causing nursing homes to shut down. We're going to show you where nursing homes are being shut down right now, as more and more people are retiring and as the American population ages.

Also, swine flu concerns. The government says vaccine shortages can be expected. They have no specific date or deadline for delivery of the vaccines. What should you do and how soon? We'll have the answers here next.


DOBBS: Concerns tonight about the impact of swine flu on our children and what will be the impact of a shortage of this vaccine necessary to protect them. The Centers for Disease Control is reporting now that 81 children have died from the virus since the outbreak began. Doctors are recommending children be vaccinated against the flu as soon as possible, but the vaccine to protect infants isn't yet available. Kitty Pilgrim has our report.


KITTY PILGRIM, CNN CORRESPONDENT (voice-over): Swine flu vaccines are here -- sort of. The nasal spray vaccine, the only vaccine available up until this point, is only appropriate for those between the ages of 2 and 49. And because it contains a live virus, the nasal spray flu vaccine is approved for use by only what the CDC calls healthy people in those age groups, so anyone older than 49 or who has an underlying medical condition, especially a respiratory problem, has to keep waiting for the injectible (ph) vaccine. Today the CDC said nearly 10 million doses of the injectible (ph) vaccine are quote, "available to be ordered" but with no specific delivery date, only saying the injectible (ph) vaccine will be coming out towards the states relatively soon.

DR. ANNE SCHUCHAT, CDC: It does take time to process the orders, to package them for the right amounts that are heading out towards the many sites that will be delivering vaccine and this is going to be ongoing over the next days and weeks.

PILGRIM: When pressed for more information, the CDC official added the vaccine may be available this week, but will only be out in large numbers later in the month. Meanwhile in Brooklyn, pediatrician Medappa Neravanda (ph) only has 100 doses of the nasal spray vaccine. He can't find out when the New York Public Health Department will be able to replenish his supply of the nasal spray vaccine.

DR. MEDAPPA NERAVANDA, PEDIATRICIAN: I do not know how it's going to be delivered to me. I think the system (INAUDIBLE) because when you call, they're unable to take the calls from us because I guess too many people are calling to see what the status is.

PILGRIM: Today, the CDC announced five more pediatric deaths in addition to the 76 deaths since the outbreak started in April.

DR. PAUL OFFIT, CHILDREN'S HOSPITAL OF PHILADELPHIA: This is a winter virus. It spreads much more easily during the winter because the virus does much better at lower temperatures and lower humidity, so you know we can only expect more deaths.


PILGRIM: Now with more than 80 deaths in children from the disease since it first broke out, the CDC is trying to find out why there are so many childhood deaths. So far, many of the children who died had underlying conditions, but some 20 to 30 percent did not. Now children with underlying conditions are the ones who need to take the injectible (ph) vaccine and they still don't have them, Lou.

DOBBS: Well as we have been reporting here, this is becoming troublesome because there's a certain lack of candor, seemingly on the part of the public health agencies responsible here. Frankly, it's surprising to hear them not offering forthright, direct straightforward language. What was it -- available nine -- what is it -- almost nine million available to be ordered.

PILGRIM: Available to be ordered and then...

DOBBS: That is bizarre.

PILGRIM: ... you know they have to package them and all this sort of language to describe the fact that they're really not giving...

DOBBS: The number of doses required in this country versus nine -- approximately nine million. That sounds woefully inadequate.

PILGRIM: It's a fraction. It's...

DOBBS: And to hear the -- obviously a family practitioner saying that he can't get -- that the system is overwhelmed, we really need to know what is going on here.

PILGRIM: Yes, Dr. Neravanda (ph) told us when we asked him when do you think you'll get the injectible vaccine, which is the thing that he really wants for his high risk patients...

DOBBS: And doctors all over the country.

PILGRIM: Right. He said it's anyone's guess. Your guess is as good as mine. This is a doctor who is not being told by the public health department when to expect the vaccine.

DOBBS: All right and tomorrow we're going to take a look at why the Centers for Disease Control is not being straightforward about these issues. We're going to be reporting on when people can expect to have some sort of response in terms of seasonal flu as well as swine flu tomorrow. We look forward to that, Kitty. Thank you very much -- Kitty Pilgrim.

Well coming up here next, one consequence of the Democrats' health care concept, Medicare cuts, dramatic Medicare cuts that could well force the closing of many more nursing homes across the country, and many are already closing as our aging population is retiring at ever faster rates.

And Governor Arnold Schwarzenegger not so popular after all, Gray Davis, his predecessor, well, he has some hope that Governor Schwarzenegger may set a new record for low approval, but the good news is Californians like their state legislators even less than Schwarzenegger. We'll be right back.


DOBBS: California is facing the biggest fiscal and social challenges in the entire country. The state of California is setting new standards, low standards, but new standards. Its elected officials continue to offer ineffectual incompetent performance at leadership. Therefore, it may not be a surprise to anyone that a poll released today shows Governor Arnold Schwarzenegger's approval rating has sunk to a new low, 27 percent. But it's even worse for the state legislators. Their approval rating stands at a whopping 13 percent, as Casey Wian reports, only in California.


CASEY WIAN, CNN CORRESPONDENT (voice-over): It has been unquestionably a rough year for California's elected officials. The state legislature deadlocked over a record budget deficit, so California paid its bills with IOUs then raised taxes and cut services. State workers must now must take three days off per month without pay. A three-judge panel ordered more than 40,000 California criminals released because its prison facilities are overcrowded and unsafe. And that was all before married State Assemblyman Mike Duval (ph) was captured by an open microphone bragging to a colleague about his alleged sexual exploits with a lobbyist.

UNIDENTIFIED MALE: She wears little eye patch underwear.

WIAN: It's no wonder a Las Vegas business development group ran TV ads mocking California's struggles.

UNIDENTIFIED MALE: Just taking a little break from the state Senate hearing in Sacramento (INAUDIBLE).

WIAN: And no wonder the state legislature's approval rating has sunk to an all time low, 13 percent, according to The Field poll.

MARK DICAMILLO, DIRECTOR, THE FIELD POLL: Voters are seeing that you know their taxes are being increased, their services are being cut, whether it be the schools or higher education or health care, yet they don't see major cuts being made to the state bureaucracy. They think there's a lot of waste, a lot of inefficiency in Sacramento. Yet, there doesn't seem to be much activity in trying to make government more streamline.

WIAN: One nine-year legislator veteran agrees with the public's assessment.

TOM HARMAN (R), CALIF. STATE SENATE: You can name the different issues -- education, transportation, infrastructure, water, prison reform. None of it has been addressed. They're all still in a state of crisis. They were in a state of crisis when I got here and they're in that state today.

WIAN: California Assembly Speaker Karen Bass (ph) said in a statement, "having to close $60 billion worth of deficits isn't going to make anyone popular." Governor Arnold Schwarzenegger fared only a bit better. His approval rating, which hit 65 percent during his first year in office, has now plunged to 27 percent. That's the lowest for a California governor in more than 50 years with one exception, Gray Davis, the man Schwarzenegger replaced after a recall election reached a low of 22 percent.


WIAN: Perhaps surprisingly, The Field poll found that an overwhelming majority of voters supported the idea that the governor call a special session to deal with two pressing issues, water and taxes. Though most Californians have lost faith in their elected officials, they still want them to at least try to do their job, Lou.

DOBBS: Did the Field poll examine why they would -- the voters of California would have any expectation at all? I mean, when you look at those numbers, when you go through everything that is a disaster as the assemblyman did, cutting services, raising taxes, releasing prisoners or being called upon to release prisoners, there isn't a single element of governance in the state of California that is working.

WIAN: And that's why so many people are now favoring the idea of a constitutional convention to basically blow up California's state government and start over from scratch. The ballot initiative is expected to be ready later this month. They're going to start gathering signatures. It should be on the ballot next year, Lou.

DOBBS: All I can say is, only in California. Casey, thank you very much, and of course, our hearts go out to the people of California and good luck.

Up next, the Obama-Baucus concept makes it out of committee -- one Republican vote. Is this the right concept? That's the subject of our "Face Off" debate tonight.

And Medicare cuts mandated by that proposal would have a devastating affect on nursing homes all across the country just when they're needed most -- many of those nursing homes closing right now. That's what we're taking up when we return. Stay with us.


DOBBS: The Senate Finance Committee today approved the Obama- Baucus health care concept calling for billions of dollars in cuts to Medicare. The effect of the cuts on nursing homes would be devastating. Many of those nursing homes simply would be forced to close down at a time when our elderly population is growing rapidly and retirements are accelerating. Ines Ferre with our report.


INES FERRE, CNN CORRESPONDENT (voice-over): West Hartford Health and Rehabilitation Center has been around for over 30 years. It houses some 116 nursing home residents. Like the rest of the industry, it's suffering from flat or lower Medicaid and Medicare reimbursements. Director of operations Russell Schwartz said he's already cut some staff.

RUSSELL SCHWARTZ, WEST HARTFORD HEALTH & REHAB CTR.: While I don't see this facility any time soon closing, the cumulative effect ultimately catches up with itself, and there's only so far and so much you can cut before business is not viable. It's scary. These are scary times for our industry.

FERRE: Just this year, four nursing homes have closed in Connecticut. And over the last year, 15 were in bankruptcy or state receivership. Nationwide in October, Medicare cut home imbursement rates by 3.3 percent. One industry association says that amounts to $16 billion over the next four years, putting 40,000 jobs at risk. Nursing homes are funded primarily by Medicaid, followed by Medicare, insurance and private payments. And there's often a real juggling act that takes place between all of those sources in order to keep that running. If one or more are cut, it could put the whole structure at risk. This year, some 24 states already have cut funding for nursing home care or other services for the elderly or disabled. Industry experts fear some of Congress's health care proposals would cut Medicare funding and reimbursements for nursing homes by up to $32 billion over ten years.

BRUCE YARWOOD, AMERICAN HEALTH CARE ASSN.: That goes into quality of staffing. So the delicate balance is upset, and at the same time, there will be a reduction in the ability to pay staff.

FERRE: Between 1999 and 2005, some 1800 homes in the U.S. closed in part because of lower reimbursements and the migration towards home care.


FERRE: And the average cost for a nursing home in the U.S. is $69,000 a year. Assisted living can cost about half of that. Home care is averaged hourly. That can be very costly depending on how many hours are need. For individuals with medically complex conditions that require chronic care, a nursing home is often their only option. With a growing elderly population, experts say fewer nursing homes could become a real problem in the future, Lou.

DOBBS: Thank you very much, Ines Ferre.

Is the Obama-Baucus concept the right approach to overhauling our health care system? That's the subject of our face-off debate tonight. Joining me now, Tevi Troy, he's senior fellow at the Hudson Institute, former deputy health and human services secretary under President Bush, Tevi, good to have you with us, and Igor Volsky who is health care researcher at the Center for American Progress. Good to have you with us.


DOBBS: Let's turn first to the issue of nursing homes. This is a disaster. Because we have just about 80 million Americans retiring, and as we're watching, as Ines Ferre just reported, this is not a good trend, watching nursing homes close and go bankrupt. What can we done?

TREVI TROY, THE HUDSON INSTITUTE: Well, obviously, there's going to be a lot of crunch in the health care system coming up because there's a lot of costs that we're facing in our nation as you're saying is aging. People are getting older, and costs for benefits are increasing. I would like to see reforms that could help improve the long-term fiscal solacy (ph) of Medicare without necessarily making kind of hard cuts like they're talking about in the segment.

DOBBS: What do you think?

VOLSKY: I agree in part. I think we need to make sure that Medicaid payment rates are adequate and I think some of the health care bills address that but I actually just got off the phone with my uncle. He owns a nursing home in Pittsburgh and he said a challenge he's having as a small business owner is providing health care. He says health care costs are through the roof. He's having trouble affording policies and he's really hoping that some of the bills that have passed Congress will address that. DOBBS: He hoping, yet taxpayers are going to be paying. Against the backdrop here, we have $60 trillion in unfunded liabilities, a $12 trillion national debt, $7 trillion in external debt, 40 percent of all Americans work, 40 percent of their work years just to pay the interest on the national debt. Think about that. 40 percent, people work through April and May just to take care of interest. We're talking about -- let's take this first score on CBO of this concept in the so-called Baucus plan. We're talking about a trillion dollars here. How are we going to do this?

VOLSKY: It's about $829 billion over ten years. And the CBO tells us that not only is it neutral but it will also reduce the deficit by about $81 billion. So here we have a bill that doesn't add, as the president has said, doesn't add a dime to the deficit and it's able to extend coverage to Americans. So I think this is a good proposal, as you call it, to build up from because there is about $70 billion of wiggle room that we can use to improve standards, help middle class families, things like that. I think it's a good concept, a good starting point that doesn't add to the deficit.

DOBBS: We're sitting here in October. The president wanted a bill on his desk on August 1st, and you're taking about a starting point. What's your reaction?

TROY: First of all, it will cost $829 billion over ten years. That doesn't mean just because he says it's costly, we're still paying $829 billion and we're going to have to pay for that through cuts and through tax hikes. It's true that President Obama wanted to see something on August 1st. That didn't happen because the American people have a lot of concerns about the approach. Igor said that the Baucus bill is a good start. Well it also means there's a lot of criticism about the bill. Obviously, people on the Republican side are concerned about it. It's kind of a big, clunky, expensive way of going about it.

DOBBS: A big, clunky way of going about it. A sixth of the economy. We haven't had public hearings on that sixth of the economy. We have had, as you said, we have reached what seems to be a starting point. When did the public hearings start? When will the public begin -- be listened to by this Congress and how much of this will be written behind closed doors?

VOLSKY: We have spent a very long time debating health care. The Senate finance committee has spent seven days in mark-up, 80 hours in marking up this bill, in comparison with the Bush tax cuts, the committee spent just a couple days marking up that bill. I think Senator Baucus has tried to bring --

DOBBS: I'm sorry, did you say for the Bush tax cuts?

VOLSKY: Yes, we have seen a lot more mark-up and a lot more transparency, I would argue, with these health care bills and Senator Baucus --

DOBBS: So we shouldn't pine for the good old days of President Bush. Outrageous suggestion, don't you think? TROY: I think he did a good job, but I also think --

DOBBS: I have to say I didn't.

TROY: Fair enough. The transparency issue and the Democrats and the Senate Finance Committee voted down an amendment that required 72 hours to look at this bill before going to final vote.

DOBBS: Well maybe we'll get a peak in some way, some how. I think there's an instinct in the national media this time to start paying attention. What do you think? I know you're both delighted by that. Thank you very much for being with us.

Still ahead, a Senate panel passes a health care proposal with the support of one little Republican person.

Is this bill all that I would want? Far from it. Is it all that can it be? No, but when history calls, history calls.

Is this the proposal that history is calling for? Can the president and the Democrats win over more Republicans? And why should they? That's next.


DOBBS: Thousands of people turned out in the nation's capital today. They were calling for comprehensive immigration reform. Demonstrators calling for amnesty for illegal immigrants and demanding that Congress act now to pass legislation. They were led by one of those Congressmen. Congressman Luis Gutierrez addressed the crowd and he outlined what he called principles for a comprehensive immigration reform bill. Smaller rallies were held in some cities across the country. President Obama has promised comprehensive immigration reform legislation, but no timetable and every indication that it won't be soon.

Joining me now, political editor for the Washington Examiner Chris Stirewalt, good to have you with us, Chris; editor at large, senior political analyst for Time Magazine, Mark Halperin, good to have you with us, Mark; syndicated columnist, CNN contributor and professor at Lehman College, Miguel Perez, good to have you with us.

Miguel, let's start with Luis Gutierrez and his vigil. Is the fight --

MIGUEL PEREZ, SYNDICATED COLUMNIST: I support the Congressman and his efforts to get some kind of comprehensive immigration reform passed. Unfortunately, the climate, the atmosphere right now is not very conducive to that. Health care reform has held us back, has pushed immigration reform at least to next year, and I don't know if Obama is going to be able to keep all his promises to the immigrant and minority communities regarding immigration reform because of the fact that the atmosphere has been poisoned now by health care reform. As I told you last week, Lou, the situation is now if you leave out of health care reform immigrants, then later on, when you try to pass immigration reform, there's going to be a price tag on them. They're going to be able to say, oh, we cannot allow these people to come in because it's going to cost so much more to give them health care.

DOBBS: Mark, do you think that Miguel has a point there, that debate has been poisoned by new information?

MARK HALPERIN, TIME MAGAZINE: I think that tough issue of any benefits for immigrants as part of reform was going to be there whether they did health care first or not. I think immigration reform like so much else of the Obama agenda will depend on what happens with health care, both in terms of whether he has momentum and the passage of a historic large bill to show he can get things done, and also how much the country is poisoned or not in a partisan way. If he passes health care with just Democratic votes or Democrats plus main Senator Olympia Snowe, doing comprehensive immigration reform in a partisan way is impossible and he needs to get Republicans to agree to work with him. Right now, I think that's an open question.

DOBBS: Is the same true of health care reform, that he needs more Republicans?

HALPERIN: He would be wise to find a way to get them, but I think it's too late. The Republicans are in a reflexive crouch against anything he does even though a lot of Republicans would be for 80 percent of what he passed today.

DOBBS: The opposition has come from Democrats, has it not?

CHRIS STIREWALT, WASHINGTON EXAMINER: The whole issue here all along has been, can the president bring discipline to his own party? Can he get the job done with Democrats? He had 60 votes in the Senate. Well for a minute he had 59 but he has had 60 votes in the Senate. He has had the super majority in Congress. The whole question is then can he bring his stamp to the Democratic Party and can he bring the rest of the members of Congress into line? We still don't know that. We still don't know that by a long shot.

DOBBS: Miguel, the idea, as you suggest, poisoning the debate on health care, poisoning the debate on immigration reform because we now know what the health care costs would be or we have a suggestion of it, what is the rush here for health care reform as we look at it? There seems to -- there seems to have been --

PEREZ: Even in the media today, there was a rush to report it was passed in the Senate. It was a committee that passed it. We're hyping this thing too much. Look, this thing has to go through a process still. We're going to be needing reconciliation counseling all of us because it's going to be reconciliated (ph) and reconciliated (ph). If there's one thing I hope comes out of this is whatever health care plan we have, it includes mental health because we're all going to need mental health care.

DOBBS: We'll be right back with our panel. Give us just a moment. Just a moment for light counseling. We'll be right back.


DOBBS: Violence in Afghanistan is worsening it seems daily. This is already the deadliest year of this conflict for U.S. forces. The president says we're weeks away from a decision by the commander in chief. Your thoughts?

PEREZ: The question is why are we weeks away? Because you know he's getting all of the information he needs from commanders on the field. They're telling him they need support right now and not weeks away and a lot of people keep asking themselves why is this president sending out this message to the rest of the world that he's indecisive on this crucial issue.

DOBBS: Mark?

HALPERIN: It's a lot of meetings. I don't think it's necessarily fair for someone in television news or journalism to complain that it's hard to reach decisions without a lot of meetings. He's being thoughtful. He's hearing from a lot of different people. It's a little strange that they need to have the meetings be public and take so long but I think he realize how big a decision this is and he doesn't want to make a mistake.

DOBBS: Do you think these the criticism that he's holding meetings and taking so long?

HALPERIN: I think in the interim because the media tends to be obsessed with process. I think we're seeing a vigorous debate and the range of advice we know he's getting from Vice President Biden who proposes a rapid scaling down to General McChrystal who would like a very big buildup. Those are big options that are not just substantive and tactical but they've got symbolic importance. I don't think he wants to be seen as cutting and running. I think he has sympathy for scaling down the mission but I think he wants to do it in a way that preserves the new mission and chances of success and not be seen as a Democratic president who has cut from a conflict. That during most of our lives, our adult lives and professional careers, is a big threat for any president, particularly a Democrat.

DOBBS: How so? Which Democrat cut and ran?

HALPERIN: There was concern for Bill Clinton in every conflict he was involved in. In Bosnia there was concern --

DOBBS: But he actually held constant policy and achieved results.

HALPERIN: But in part because he was --

DOBBS: This cut and run specter for the Democratic Party and its president.

HALPERIN: It's been more of a criticism not of Democratic presidents but of Democratic presidential candidates like John Kerry and Michael Dukakis. I think he is stepping up into a world where he wants this is his test of what kind of use of American force he'll project around the world?

DOBBS: Would it be helpful if we got on our hands and knees and prayed that he would make a principle decision not based on public perception and PR and party politics but just for the good of the nation?

HALPERIN: I don't think it's wrong for any president to say this is part of a principle position. You have to preserve American ...

STIREWALT: One gets the sense with this administration though that they are looking for the political window to jump out of. They are waiting and buying time just as they have on other issues to find the opportunity that they can try to spin whatever their decision is as something that's a compromise or moderate choice or in between moment that they're going to do and I think the sense they're laying out from all of these meetings that they have is we're heading for a compromise answer. Not the McChrystal plan and not the Biden plan and I think the president is buying time until he can find a way to present that to the American people that doesn't cause the kind of concern that mark talked about which is that you're cutting and running. He's looking for cover now.

PEREZ: The question is if they're looking for that political window and they are going jump out, how high is the building and how much will they crash?

DOBBS: You use the word Mark mission and the change in the mission. Most Americans can't find any articulation of a mission or a strategy and we're now past eight years since the beginning of this war. How soon do you think -- he said weeks. How soon do we really believe it will be before we have an articulation of a strategy and a declarative statement from the president that where our troops are committed we'll hear about victory?

HALPERIN: Before you're asked if you want marshmallows in your sweet potatoes, Thanksgiving.

STIREWALT: It seems far fetched to me. I don't think victory will come into this discussion. I don't think this will be a victory kind of white house. The original Obama mission, the March mission, was a nation building plan stabilizing Pakistan plan. I don't think you'll hear about winning Afghanistan.

DOBBS: If we're not there to win what are we there to do?

PEREZ: To keep the Taliban out of power which is very important to us.

HALPERIN: It can be done with fewer forces and with less of a strain not only on the military overall but the threat of America's credibility.

DOBBS: I remember a fellow by the name of Rob that said something similar like that in a different place all-together. Thank you very much. Appreciate it. Thank you.

Coming up at the top of the hour, Campbell Brown -- Campbell?

CAMPBELL BROWN, CNN ANCHOR: Hey there Lou. Tonight we're going to have more of our special "The Brain That Heals Itself." We're going to meet a stroke patient who has made an incredible recovery and his doctors say it all has to do with the brain's ability to rewire itself. The latest research on how your brain can come back from a devastating injury coming up just ahead.

Also, did a spiritual retreat turn deadly? We'll take a closer look at what happened at that Arizona sweat lodge where two people died during a five-day retreat and the top stories all at the top of the hour.

DOBBS: Look forward to it Campbell. Thank you. We'll be right back. Stay with us.


DOBBS: Time for some of your thoughts.

Jordan in New Jersey: "I am 14 years old and I loved the debate on the issue of global warming. I have to write a research paper on global warming and the debate was just what I needed to get a jump start on my paper. I really enjoyed the debate and I hope to see many more to come." We're going to try to oblige you. Hope did you well on the paper.

Loretta in Indiana: "Lou, maybe these politicians should spend some money on their own health care and buy hearing aids. They aren't listening." They aren't, are they?

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Thank you for being with us here tonight. Join us here tomorrow. Our face-off debate on whether it's time to bring all of our troops home from Afghanistan and around the world.

Good night from New York.