Sen. Tom Coburn and President Obama discuss Medicaire at White House health summit

CQ Transcriptions
Thursday, February 25, 2010; 4:49 PM

COBURN: You know, the assumption that's important for the American people to hear. We have Medicare Part D, except no senior in this country ever paid a tax dollar for it. And we're talking about filling a doughnut hole on a program that they're already benefiting from that we're going to leave $11 trillion in debt for our children. I'm not sure the seniors wants us to leave more debt for their children to fill a doughnut hole.

And when we talk about filling the doughnut hole by taking away from people who can't afford to buy a supplemental policy, that's where Medicare Part A helps poor people in Oklahoma is they get to buy Medicare Part C. We never call it Part C, but that's what it is. And they don't have to buy a supplemental policy. So consequently, they get lots of the benefits that other people who have better buying power in Medicare with a supplemental policy. So it's a tradeoff of whether or not we say, "Where are we going to give the benefits?" What we really should be doing is saying, "We're broke. Medicare's broke. We're working, struggling together to try to get there. Let's not add new benefits anywhere and let's make sure the benefits that we have today get applied more equitably."

OBAMA: Well, I think that's a legitimate point. I would just point out that 80 percent of seniors are helping to pay in extra premiums for the 20 percent who are in this Medicare Advantage, and it's not means-tested. So it's not as if the people who in Medicare Advantage are somehow the poor people who can't afford supplementals. It's pretty random.

And what we also know is, and I just want to point this out, Tom, $180 billion of it is going to insurance companies. It's not going to seniors. It's going to insurance companies, including big insurance company profits, (inaudible) appreciable improvement in health care benefits. That's not a good way for us to spend money.

I agree with you about the fact that the prescription drug plan added to our deficits, because we didn't pay for it. And I just add the point that didn't happen under my watch. It happened under the previous Congress. There's some people -- you know, John was an example of somebody who was true to his convictions and didn't vote for it.


OBAMA: But -- but the fact of the matter is that, you know, that was costly, and we do have to deal with that. On the other hand, the problem I don't think is that we gave seniors a prescription drug benefit. I think the problem is that we didn't pay for it, and we should try to find a way to pay for it. Taking some of that money out of Medicare Advantage and putting it into that doughnut hold does pay for it.

All right. I really breached protocol here, but I thought that was important to just get clear. We are talking about Medicare Advantage in terms of where these cuts come from, not Medicare benefits through the traditional Medicare plan.

© 2010 Washingtonpost.Newsweek Interactive