This is a rush transcript from "On the Record," August 27, 2009. This copy may not be in its final form and may be updated.

GRETA VAN SUSTEREN, FOX NEWS HOST: In the great debate over health care reform, President Obama has said this over and over.


BARACK OBAMA, PRESIDENT OF THE UNITED STATES: And no matter how we reform health care, I intend to keep this promise. If you like your doctor, you'll be able to keep your doctor. If you like your health care plan, you'll be able to keep your health care plan.

I've tried to say this over and over again. If you're happy with your health care, you're happy with your doctor, we're not going to force you to change it.

As I've said from the beginning, under the reform we seek, if you like your doctor, you can keep your doctor. If you like your private health insurance plan, you can keep your plan. Period.


VAN SUSTEREN: But many Americans say that is simply not true. They fear that if there is a public option, employers will have no financial incentive to keep offering private insurance. That means companies ditching private insurance plans, leaving the employee with no choice. So is it true or not? What do we know?

Adriel Bettelheim of CQPolitics joins us. So you're a big fact (INAUDIBLE) Adriel. Is it true or not, if you like your health care plan and your doctor, you can keep it and him or her?

ADRIEL BETTELHEIM, CQPOLITICS.COM: This was a good line during the campaign, but as more specifics in these health bills are showing up, it's a little bit harder for him to just say this off the top because there are certain situations where if they set up a changed health insurance market, it could fundamentally change the way that businesses plan. If they set up a public plan, for instance, if they set up this health exchange, this one- stop shopping system that they're talking about and they allow businesses to buy in there, and they see a public plan that's cheaper, they could go for that option and that could change people's arrangement. But it's kind of a triple hypothetical to get to that point.

VAN SUSTEREN: Well, he is saying it not just in the campaign, but he said it as recently as his radio address the other day. But let me ask you this. As this 1,500-page House bill that we think we might understand -- although that's a whole 'nother story. I think it's incomprehensible. If a -- under the plan, the thinking is that if an employee -- an employer doesn't want to provide health insurance, will be penalized 8 percent of payroll, right?

BETTELHEIM: That's correct. This has been what they refer to as "play or pay." And it's a tax, it's a penalty, whatever you want to call it, but it's not for the smallest companies, but if you have a payroll of, say, over $400,000 a year, you'd be subject to it.

VAN SUSTEREN: All right. So let's say that if you offer -- currently, if you have a payroll of over $400,000 a year and currently -- that's costing you 9 percent of your payroll to provide health insurance, you'd be crazy not to drop the private health insurance and tell your employees, I'll pay your -- I'll pay the 8 percent penalty. Go find the public stuff.

BETTELHEIM: This is...

VAN SUSTEREN: Right? Is that right?

BETTELHEIM: Well, we don't know what they're going to do. I mean, right now...

VAN SUSTEREN: Yes, but is that math -- is my math wrong?

BETTELHEIM: No. I think you...


BETTELHEIM: ... you follow -- right now, the employers do it optionally. There's no law that says you have to cover people. You do it to stay competitive in the labor market. You do it to attract and retain the best workers. If in the overhauled health system, it actually is cheaper for people to go out and using these exchanges or whatever is used to buy insurance themselves, maybe they'll have less incentive and maybe they will not feel compelled to cover the employees. We just can't anticipate how these businesses are going to act when we don't have really the sussed-out final deal.

VAN SUSTEREN: But the businesses will be required to provide something or pay a penalty, which is -- which would be a new twist on this.

BETTELHEIM: That's right. This would be a federal mandate of coverage. And you know, we've come up to the edge a couple of times in past health debates, but this is what they are looking at.

VAN SUSTEREN: Do you have a sense that the members of Congress are getting all enthusiastic, getting ready to come back and really push for this thing, or are people losing steam, having gone home and get hammered a little bit, and certainly, some of the more conservative Democrats going home, thinking that they may be at risk?

BETTELHEIM: I think the risk-averse folks are still risk-averse. I think so many people in this debate are dug in pretty deep now. There's been a lot of political capital spent already. There's been a lot of lobbying money spent already. I don't think there's going to be a lot of minds changed.

We have to look to the center, I believe, and see if these six senators who are purportedly trying to work out a deal on the Senate Finance Committee can somehow get Obama out of this by giving him some semblance of a bipartisan plan that then could be the framework. Without that, you're kind of in a quagmire.

VAN SUSTEREN: What I don't understand is that how you could be even, you know, dig your heels in the sand when what's written is incomprehensible and what you're pushing really nobody knows. I mean, that's sort of -- I mean, it's almost bizarre that people have their heels, you know, dug in the sand when they're -- you know, this bill is so incomprehensible.

BETTELHEIM: You and I have been in this town for health debates...


BETTELHEIM: ... Patients Bill of Rights, the Medicare in 2003 -- they're always this thick. And when you purport to change something as complicated as the U.S. health system, it's not pretty.

VAN SUSTEREN: But at least it should be something that everyone can understand, at least as a starter. Thank you very much for joining us.

BETTELHEIM: A pleasure.

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