In hour five, the topic moved to deficit reduction. Sen. Chuck Grassley (R-IA) complained about the Senate bill mandate to buy insurance, which he said would lead to higher costs. House Minority Leader John Boehner (R-OH) reiterated the Republican call to start health care legislation from scratch. The president responded critically that the group kept going back to the same "talking points" instead of moving forward.

Discussion continued on the problems with Medicare and Medicaid, and more on tort reform, particularly from McCain, who described what he said were successful programs in California and Texas. Obama reiterated that Sec. Sebelius was working on state programs for tort reform. Sen. Dick Durbin (D-IL) said tort reform was not the overriding issue; rather working to reduce medical errors and enabling coverage for more Americans were the more vital issues.


In continuing the topic of expanding coverage, Obama asked if those present could make sure that every American can get adequate health care coverage rather than just catastrophic coverage. When Sen. John Barrasso (R-WY) suggested that those who have catastrophic plans were better consumers because they used their health care dollars more carefully, the President asked if Congress would be satisfied with just having catastrophic coverage. While Barrasso said yes, Obama retorted that the idea that the system would be better if people were just better consumers is not realistic as many working Americans cannot afford any coverage or health savings accounts.

In hour six, the discussion on coverage continued. After Rep. Henry Waxman (D-CA) offered sharp criticism for segmenting the population into different risk pools, the president asked the Republicans if there were measures for those who don't have insurance that they would agree with beyond what Republicans had already proposed.

Rep. Peter Roskam (R-IL) did not respond to the question directly but emphasized that the reform bills that expanded Medicaid would not be financially sustainable for the states. He advocated the Republican measures that would expand insurance to three million more Americans, but again, that health care reform legislation should start over from scratch. The president pointed out that Medicaid was not relevant to the working families who earn too much for the program and had no other options. Senator Chris Dodd (D-CT) followed with statistics stating that every day 14,000 persons lose health insurance, and the productivity cost to the rest of the nation for those who must use emergency rooms for primary care. The issue defies incremental approach, Dodd said, as soon every state in the country would have a significant increase in the uninsured.

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