THE PRESIDENT: Thank you, everybody. Hey! Thank you.
AUDIENCE: Yes we can! Yes we can! Yes we can! Yes we can!
THE PRESIDENT: Thank you. Thank you, everybody. Please have a
seat. This looks like a casual crowd; I'm going to -- (laughter) --
take off my jacket here. Let me begin by thanking Beth not just for
the great introduction, but for the unbelievable dedication that she
showed throughout the campaign, but more importantly almost now trying
to actually get some things done.
I want to thank Congresswoman Debbie Wasserman. Where'd Debbie go?
(Applause.) I hear you were on a scooter. I want to see that at some
point. (Laughter.) That's pretty cool -- always stylish. (Laughter.)
I want to acknowledge my great friend Tim Kaine, who joined us
earlier by phone, and is doing just a great job on behalf of not only
the people of Virginia but also on behalf of Democrats all across the
country.
And to all of my Organizing for America volunteers, thank you so
much for your unbelievable dedication. It is good to be here.
(Applause.)
It's great to be here with all of you because it reminds me of how
we got here in the first place. We're here because you believed that
after an era of selfishness and greed, that we could reclaim a sense of
responsibility and a sense that we have obligations to each other not
just here in Washington but all across the country. You believed that
instead of growing inequality, we could restore a sense of fairness and
balance to our economic life and create lasting growth and prosperity.
You believed that at a time of war and turmoil, we could stand strong
against our enemies, but also stand firmly for our ideals, and reach
out to the rest of the world and describe to them what America is about
and how we can forge together a world of common interests and common
concerns.
That's the change that you believed in. That's why you worked so
hard, knocking on doors and making phone calls and hot sun and --
(laughter) -- cold winds and sometimes having doors slammed in your
faces -- (laughter) -- and your family members all saying, why are you
doing this, because this guy has no chance. (Laughter.) That's
something I'll never forget.
But we all know that winning the election was just the beginning. I
said this election night, I said it at the inauguration, and somehow I
think maybe some people thought I was just fooling. I was serious.
Winning the election was just the start. Victory in an election wasn't
the change that we sought -- it had to manifest itself in the real
day-to-day lives of ordinary Americans all across the country. And I
know that folks like Beth and all of you at OFA have been working to
make that change, doing the same things you were doing during the
campaign -- going block by block, neighbor by neighbor, having doors
slammed in your faces, people telling you, why are you doing this; it
doesn't make any chance.
But just so you don't lose heart as we enter into probably our
toughest fight, let's just recall what we've already gotten done. Not
one month into this administration, we responded to the worst financial
crisis since the Great Depression by putting in place a sweeping
economic recovery program that has already made an enormous difference
in people's lives. You've got millions of people who have unemployment
insurance and got COBRA so they could keep their health insurance, and
states who've been able to avoid layoffs of teachers and firefighters;
a tax cut for 95 percent of working families, a commitment we made
during the campaign that we have already fulfilled; thousands of people
being put back to work all across the country rebuilding our roads and
our bridges and our hospitals.
As a consequence of everything that we did, just in that first
month, we've been able to see a stabilization of the financial system
where a lot of economists thought that we were going to be dipping into
a Great Depression. Obviously we're not out of the woods yet, but
we've taken steps to address the housing crisis and keep people in
their homes. We made some tough choices to keep the financial and the
automotive sectors from collapsing, which would have further shocked
our economy.
That's on the economic side. In the meantime, we lifted the ban on
stem cell research; we expanded health insurance programs to 11 million
more children across the country. (Applause.) We passed a national
service bill that will give thousands of Americans opportunities to
serve. (Applause.) (Coughing.) I get all choked up just talking
about it. (Laughter.)
We passed the Lilly Ledbetter Fair Pay Act -- (applause) -- to make
sure that women are treated the same way as men. We passed legislation
to protect consumers from unfair rate hikes and abusive fees for credit
card companies, and some of those rules went into effect today.
(Applause.) We passed laws to protect our children from marketing by
tobacco manufacturers. We've prohibited torture. We've begun to leave
Iraq to its people. We've taken the fight to al Qaeda in Afghanistan
and Pakistan. We've rebuilt our military and we're restoring our
alliances and our standing the world. So not a bad track record.
(Applause.)
Not a bad track record. We should be proud of what we've
accomplished. But we're not satisfied. And we should be confident but
not complacent. We've got more work to do, and we've got more promises
to keep. And one of those promises is to achieve quality, affordable
health care for every single American, and that is what we intend to do
-- (applause.)
Now, we all know this has been an emotional debate. We've seen
tempers flare. Accusations have been hurled. And sometimes it seems
like one loud voice can drown out all the civil, sensible voices out
there. But remember one thing: Nothing is more powerful than millions
of voices calling for change. That's how we won this election. You
know this and that's why since OFA launched its health reform campaign
in June you've hosted 11,000 events in more than 2,500 towns in every
single state and every single congressional district, which is
remarkable. (Applause.)
And of course, the TV cameras aren't there when you're doing all
this. (Laughter.) And when you notice that nobody is paying attention
to what you're doing, just remember we've been through this before.
Some of you were involved when we were in Iowa, 30 points down, and all
of Washington said, oh, it's over -- hand-wringing and angst and
teeth-gnashing. (Laughter.) And then last year just about this time,
you'll recall that the Republicans had just nominated their Vice
Presidential candidate, and everybody was -- the media was obsessed
with it, and cable was 24 hours a day, and "Obama's lost his mojo."
(Laughter.) You remember all that? (Laughter.) There's something
about August going into September -- (laughter) -- where everybody in
Washington gets all wee-weed up. (Laughter.) I don't know what it
is. (Laughter.) But that's what happens.
But instead of being preoccupied with the polls and with the pundits
and with the cable chatter, what you guys consistently did was you just
kept on working steadily, deliberately, sensibly, knocking on doors,
talking to people, talking to your co-workers, just giving people the
facts, explaining to them a vision of how we're going to move forward.
And that's what we're going to have to do today, because we're going to
have to cut through a lot of nonsense out there, a lot of absurd claims
that have been made about health insurance reform.
There was a poll done -- some of you may have seen -- Wall Street
Journal/NBC poll. It turns out that a huge proportion of the American
people are convinced, A, that somehow health reform means illegal
immigrants are going to get health care; B, that it's a government
takeover of health care; C, that all the money is going to be funding
abortions; D, that -- what's the other one? Death panels, that we're
all going to be, you know, pulling the plug on Grandma.
Now, come on. (Laughter and applause.) We can have a -- we can
have a real debate because health care is hard, and there are some
legitimate issues out there that have to be sorted through and worked
on, as Debbie talked about. But what we're going to have to do is to
cut through the noise and the misinformation, and the best ambassadors
for true information, factual information, is all of you. You have
more credibility than anybody on television when it comes to your
family members and your friends and your neighbors. And that's why you
being involved is so important.
Now, I don't have to explain to you why it's so important to pass
health reform for the 46 million people who don't have health
insurance. But it's just as important that Americans who do have
health insurance, which are the majority of Americans, that they
understand what health reform means for them. So let me just make sure
I try to give you some bullet points here, because right now the system
works very well for the insurance companies but it doesn't work so well
for the American people.
First, no matter what you've heard, if you like your doctor, you can
keep your doctor under the reform proposals that we've put forward. If
you like your private health insurance plan, you can keep it. If your
employer provides you health insurance on the job, nobody is talking
about messing with that.
If you don't have health insurance, we do intend to provide you
high-quality, affordable options. And that, by the way, is not just
poor people who don't have health insurance -- in fact, a lot of poor
Americans have health insurance under Medicaid. Mostly it's working
Americans who don't have health insurance on the job, or it's
self-employed Americans, or it's small business owners, or people who
work for small businesses who don't have health insurance. And what we
want to do is to give them a menu of options that they can choose from,
and then a little bit of help in terms of making their premiums more
affordable.
So that is absolutely critical. Now, one of the options we want to
provide them is a public option, and there's been -- this has been a
confusion around this -- (applause) -- there's been a lot of confusion
about this, so let me just clarify. I think a public option is
important. And let me explain why.
We're going to have a marketplace where people can select the
options that work best for them, the insurance plan that works best for
them. A lot of those choices, the overwhelming majority of those
choices, will be private insurance options, just like members of
Congress have -- they're allowed to choose from various proposals or
various plans that are part of the federal employees' health plan.
But what we do think is if we have a public option in there, that
can help keep insurers honest; it can provide a benchmark for what an
affordable basic plan should look like. And so even though we've got a
whole bunch of insurance regulations that ensure that any private
insurer that's participating in the exchange is giving you a fair deal,
this is sort of like the belt-and-suspenders concept -- it means that
not only do they have to abide by these regulations, but they also have
to compete with somebody whose interest is not just profit but instead
is interested in making sure that the American people get decent care.
Now, having said that -- (applause) -- having said that, I want
everybody to be clear that the public option is just one option. It
will be voluntary. Nobody is talking about you having to be in the
public option. Only -- the only thing that we're talking about is this
being available to you as a choice, expanding consumer choice. And we
think that's a good idea.
Now, there are a whole bunch of other aspects to health insurance
reform, though, that people have to understand. We want to make sure
that, for example, insurance companies can't prevent you from getting
health insurance because of a preexisting condition. That will be the
law whether you're in the health insurance exchange or you're just
keeping the insurance that you already have. You should be able to
keep it regardless of preexisting condition. You should be able to
purchase it. There shouldn't be lifetime caps or yearly caps where you
bump up against it and suddenly you've got huge out-of-pocket costs
that drive you into bankruptcy. We've got to make sure that there are
basic consumer protections on that.
You should be able to keep your health insurance if you get sick or
you lose your job or you change jobs. And all too often what happens
is when you need insurance most, that's when the insurers decide to
drop you. And we've got to make sure that that is against the law.
And that's part of what health insurance reform is all about.
So it's going to bring down skyrocketing costs, it's going to save
families money, it's going to save businesses money, and it's going to
save government money. We are going to make Medicare more efficient,
guaranteeing today's seniors better benefits than they have right now.
We're going to make sure that that doughnut hole in the middle of their
prescription drug plan, that that doughnut hole is closed, because we
want to make sure that seniors who are already living on fixed incomes
during difficult times aren't having to dig even deeper to increase
drug company profits.
So I just want everybody to understand that in addition to providing
health insurance for people who don't have it, even if you have health
insurance, you've got a stake in this debate. Fourteen thousand people
are losing their health insurance every single day. Millions of people
all across the country are vulnerable to exclusions because of things
like preexisting conditions. Millions of Americans have experienced
the fact that premiums have gone up three times faster than inflation
and faster than incomes.
And if we go at the pace that we're going right now, there are going
to be a whole lot of families who make the decision that they can't
afford health insurance because the costs are simply unsustainable.
And if you're a deficit hawk, then you should be especially
concerned about passing health care reform, because at the pace we're
on right now, Medicare is going to run out of money in eight years. It
won't be totally broke, but it will be in the red, because the costs
are going up a lot faster than the money that's coming in.
So when you're talking to seniors out there, tell them, number one,
nobody is talking about cutting their benefits. Talk to them about the
fact that, by the way, Medicare is already a government program --
(laughter and applause) -- so when people say, "Keep government out of
our health care," make sure they know that Medicare is a government
program. But also explain to them that part of what we want to do is
strengthen the program so that it's going to be there over the long
haul. We don't want a situation in which Medicare runs short of money
because we did not make the changes that were needed early on.
I am absolutely confident that we can get this done, but I want
everybody to remember, this has never been easy -- never been easy.
When FDR proposed Social Security, all across what was I guess the
equivalent of today's Internet, right -- (laughter) -- all the
newspapers and the radio shows and all that -- he was accused of being
a socialist. He was going to bring socialism to America. How dare he.
When JFK and then Lyndon Johnson proposed Medicare, everybody
suggested, this is going to be a government takeover of health care;
it's going to destroy your relationship with your doctor. The same
arguments that are being made now have been made every time we've tried
to propose a significant change that ultimately made people more
secure, improved our health care, improved our quality of life.
So we cannot be intimidated by some of these scare tactics. We have
to understand that there a lot of people who are invested in the status
quo and make a lot of money out of it. We've got to also understand
that people are understandably nervous and worried about any
significant changes when it comes to something as important as health
care, because it touches on your lives, it's very personal -- and so
they're more vulnerable to misinformation.
And that's why what all of you do is so important, because people
trust you -- your neighbors, your friends, fellow community members --
they trust you. They know you. And if you are presenting the facts
clearly and fairly, I'm absolutely confident that we're going to win
this debate. But we're going to have a lot of work to do and I'm
grateful that you're willing to do it. Let's go get 'em. Thank you
very much, everybody. (Applause.)
All right. Thank you. All right.
MR. STEWART: Thank you, Mr. President. Thank you for taking time
out of your very busy schedule to talk to all of us, your supporters,
about this critical issue. I would just like to add, for folks who are
interested, either watching this at home or at work, you can sign up to
participate -- (laughter) -- or host a health care event right now by
entering your zip code. And for folks who are listening on the phone,
please go to BarackObama.com and sign up to participate or host an
event near you.
Sir, we've collected thousands of questions from across the country,
and we're going to take three -- one from e-mail, one from the
telephone, and another one from Twitter -- and then we're going to open
it up to your volunteers here -- these are your best volunteers in the
area -- to have you call on them and ask questions there.
So with the first question, Cindy.
Q Good afternoon, Mr. President. Our first question comes from
Julia in Colorado Springs, Colorado. Julia writes: I am a volunteer
community organizer in Colorado. This summer our volunteers have
called 4,800 members of the community and gathered declarations of
support from over 2,600 people. The debate is really heating up. What
do you think is the most compelling argument we can make for health
reform?
THE PRESIDENT: Well, thank you, Cindy, if you're listening. I appreciate the question and the great work that you're doing.
The first thing that you have to explain to folks when we're having
a discussion about health care is that the status quo is
unsustainable. Or another way of putting it, if you like what you have
now, unless we make some changes, you're not going to have exactly what
it is that you like.
And the reason is because health care costs are going up so fast --
as I said, three times faster than wages; much faster than inflation in
every other area of life -- that it's going to gobble up a higher and
higher percentage of your income in terms of premiums and out-of-pocket
costs. More and more employers are going to say, we just can't afford
to provide you health insurance, or if we do, we're going to push more
and more costs onto you.
You're going to lose more and more of your paycheck, even if you
don't know it. It turns out in the 1990s, wages and incomes
flatlined. And part of the reason was because a lot of the company
profits that normally would have gone to salary increases or wage
increases ended up being gobbled up by health care.
So if you've got a private plan, you have something to worry about.
If you are on a public program like Medicare, you have something to
worry about because we're going to be running out of money. And so the
status quo is unsustainable. You've got to make sure that you explain
that to folks. It's not as if if we just stand still, everything is
going to be okay.
Point number two is that if you don't have health insurance, we're
not forcing you to go into a government plan. We in fact just want to
set up a system similar to what members of Congress enjoy where you'd
have a menu of private insurance options, and we're just going to give
you a little bit of help so that you could afford the premiums. That's
all we're talking about.
Now, one of the options will be a public option because we think
that potentially could be a better deal for consumers. But nobody is
going to force you into that option. It will, however, help keep the
private insurers honest because if they're charging a lot more --
higher profits, higher overhead, worst deal in terms of insurance --
then a lot of people will say, well, I might as well take advantage of
the public option. But it will be the choice of the individual.
That's the second thing to emphasize.
The third thing to emphasize and probably the most important thing
to emphasize when you're talking to people about this -- because most
people have insurance, remember that. The people who don't have health
insurance, they're already in favor of reform. But most Americans have
health insurance.
So the most important thing to describe to them is this will be a
set of consumer protections that provide you more safety and security.
You know that you will be provided for if you get sick, because what
we're going to do is we're going to say to insurance companies, you've
got to do certain things like admit people even if they've got
preexisting conditions. You can't hide under the fine print a lot of
terms that allow you to drop people when they get sick or exclude them
from care.
In fact, the House bill actually has a provision that says insurance
companies, if they want to participate in the exchange, they can only
-- they can only charge 15 percent in profits and administrative
costs. The rest of the care has to go to actually making people well.
So that'll be a cost-control element.
But the point is, is that all these forces taken together will help
people know that when they pay their premiums and they've got health
insurance, that in fact it's there when they need it, and that they can
count on it, and they're not going to be jerked around.
And over time, because of the cost-savings measures that we're
putting in place -- for example, making sure that prevention and
wellness is covered -- we're actually going to reduce the costs of
health care overall over the long term. And that's going to be equally
important because eventually that's going to show up in your paychecks
in lower premiums, because right now Americans are paying $5,000 to
$6,000 more per person in health care costs than any other advanced
nation. So not only do these other countries have universal care, but
they're paying $5,000 to $6,000 less per person. We're not getting a
good deal. (Laughter.)
And so nobody is talking about a government takeover of health care.
We are talking about making sure that people are getting a good deal
for the premiums that they're already paying.
And I think that argument, most of the time, will win the day. I
was just on a conservative talk show this morning -- or this afternoon,
and a woman called in and she said, you know, I have to admit that I'm
glad you explained how this public option works because I thought your
whole plan was just the public option.
A lot of people just have a lot of misinformation, partly because,
let's face it, health care is complicated and, you know, it's subject
then to a lot of misinformation out there. And that's why your efforts
are so important.
So thank you, Cindy, wherever you are.
MR. STEWART: All right. Thank you, Mr. President. We have our
second question. And our second question comes from the telephone.
Q Our second question comes from a caller over the phone. Connie
Lind (ph) is a volunteer leader from Florida. Go ahead, Connie.
THE PRESIDENT: Connie, can you hear me?
Q Good afternoon, Mr. President.
THE PRESIDENT: Hi, Connie.
Q Hi, Mr. President. Good afternoon. I'd like to thank you for
taking my question. My name is Connie Lind (ph) and I live in
Florida. I live in Congresswoman Debbie Wasserman Schultz's district.
(Laughter and applause.) I'm a retired health care administrator. I
was a neighborhood team leader during your campaign. And now I'm the
new OFA community organizer. My question, sir: Are we winning support
from members of Congress? Do you think we're making a difference, sir?
THE PRESIDENT: Well, look, the fact is, you've already got one of
the best members of Congress, so if you talk to her you're kind of
preaching to the choir -- especially since she's sitting here right
now. (Laughter.) But can I just say that even if you live in a
strongly Democratic district where there's a strong progressive member
of Congress who's already in favor of health care reform, convincing
people more broadly about the need for reform still makes a difference,
because, unfortunately, Washington is obsessed with the snap poll; they
are obsessed with what is played on talk radio or what's said at a town
hall meeting. You can have 20 really civil, sensible town hall
meetings, but if there's one where somebody is screaming, you know
which one is going to get on television.
And so every single person that you talk to whose mind is changed is
going to make a difference. And in your congressional district, I
think Debbie would confirm there are a lot of senior citizens. Seniors
right now are the most worried of any population group about health
reform. They are the ones who are most nervous. And it's
understandable, A, because seniors need more health care than anybody
else, and they already have good health care under Medicare. And so
their general attitude is, I don't want change; I just want to make
sure that you're not taking away what I already have.
And that's why it's so important to emphasize to seniors, Connie,
that you're talking to that we are not reducing benefits under
Medicare; that we think Medicare is a sacred trust. In fact, part of
what we want to do is strengthen Medicare by closing the doughnut hole
that is making prescription drugs really costly for those who need
prescription drugs most, and by extending the life of the Medicare
trust fund over time, because right now we are spending money on things
like subsidies to profitable insurance companies. About $17 billion a
year is taken out of Medicare to pay to insurance companies who are
already making a big profit without any competitive bidding whatsoever
because they're running a portion of Medicare called Medicare Advantage.
Now, if we just have them compete, have them bid for participation,
even if you still included them as a potential provider, that alone
would save us $17 billion a year. And that would extend the life of
the Medicare trust fund.
So you've really got to emphasize, I think, to seniors that, number
one, nobody is talking about messing with your Medicare benefits; and
number two, reminding seniors that, at the same time, you've got kids
or you've got grandkids -- they need to make sure that they've got the
same security that Medicare provides seniors. There are a lot of
people who are 50, don't yet -- in their mid-50s right now, don't
qualify for Medicare, may have lost their job that used to provide
health care. It is almost impossible for some of them to get health
care because they've already had maybe a heart attack, maybe they've
had an incident of cancer, maybe they've had some sort of other
preexisting condition that makes insurers want to shy away from them.
Their attitude is, no, we'll take the young, healthy ones, and that way
we never have to pay out and we make more profit. And that's part of
what we want to change, as well, and you've just got to remind seniors
that there are a lot of their family members who deserve the same kind
of security that they have. Nobody is talking about taking away their
security. We just want to expand that security to more people.
Okay, great question, Connie. Next question.
MR. STEWART: Cindy.
Q Our third question comes from Brandy, an OFA summer organizer
in Phoenix, Arizona, who submitted her question over Twitter. She
writes: There are too many lies about health insurance reform -- death
panels, rationing, you name it. Where are these lies from? I want
people to know the truth.
THE PRESIDENT: Well, look, we know where these lies are coming
from, I mean -- (laughter.) I mean, I don't think it's any secret. If
you just flick channels and then stop on certain ones -- (laughter and
applause) -- then you'll see -- you know, you'll see who's propagating
this stuff.
I said during the campaign that the best offense against lies is the
truth. And so all we can do is just keep on pushing the truth. The
truth is, there's no plan that has ever been considered under health
care reform in Congress that covers illegal immigrants. Nobody has
proposed that. And yet, a huge percentage believe that that's the
case. So, anybody listening right now, let's dispel that myth.
There are no plans under health reform to revoke the existing
prohibition on using federal taxpayer dollars for abortions. Nobody is
talking about changing that existing provision, the Hyde Amendment.
Let's be clear about that. It's just not true.
Let's be clear about the fact that nobody has proposed anything
remotely close to a government takeover of health care. None of the
plans that are out there, the most liberal, progressive plans that have
come forward and come out of committee -- all of them presume that if
you've got private health insurance, you can keep your health
insurance. Nobody is talking about getting between you and your doctor
and interfering with that relationship.
What we have said is we don't want government bureaucrats
interfering in that relationship. We also don't want insurance company
bureaucrats interfering with that relationship. (Applause.)
The death panel idea -- the genesis of this -- I mean, this is an
interesting example of sort of tracing how misinformation spreads.
There was a provision in the House bill that very sensibly said, you
know, a lot of people towards the end of their life, they haven't
prepared with things like a living will, they don't understand what
their options are in terms of hospice, and we should reimburse people
if they want that counseling. Voluntarily. If they want it, that's
something that Medicare should reimburse for. It shouldn't just be
wealthy people who get good counseling and information about how to
handle their affairs during a very difficult time.
So that voluntary provision that permits reimbursement, which, by
the way, Republicans had supported previously -- this was previously
considered a bipartisan concept -- a Republican senator, former
Republican House member, introduced a even -- a much more aggressive
bill on this issue in the prescription drug bill passed by the
Republican members of Congress; they had a similar provision for
terminally ill patients. So this used to be just a sensible thing that
everybody could agree to -- suddenly became death panels, and scared --
scared Grandma. (Laughter.) And it's just irresponsible.
And I have to say, part of the reason it spreads is the way
reporting is done today. If somebody puts out misinformation, "Obama's
Creating Death Panels," then the way the news report comes across is:
"Today such-and-such accused President Obama of putting forward death
panels. The White House responded that that wasn't true." And then
they go on to the next story. And what they don't say is, in fact it
isn't true. (Laughter and applause.)
I mean, there's never any -- I just -- you know, it's fine to have a
debate back and forth -- he said, she said -- except when somebody else
is just not even telling remotely the truth. Then you should say in
your reports, oh, and by the way, that's just not true. (Laughter.)
But that doesn't happen often enough. And that's why it's so
important that all of you deliver that message, and you've got to be
able to back it up. And all of you are receiving materials where it's
not just us saying this. I mean, these are third-party validators who
are out there and can set the facts straight. And when people get the
facts and you show them, then most people will end up being persuaded.
Not everybody. There are going to be some people who -- look, there
are some people who, for partisan reasons, just want to see this go
down because they see this -- they see a replay of 1993 -- you know, if
we can beat a health care bill like we did with Bill Clinton, then
we'll be able to take over the House, you know, next year. There's
some of that.
And then there are some people who just ideologically, they just
don't believe in government getting involved in anything. And that's a
respectable position. I mean, there's a long American tradition of
saying, government, just leave me alone and get off my back. And those
folks are consistent and they were critical of Bush when he got
involved in government, and they're critical of me, in terms of being
-- believing that government can do some good. And I think there you
can have a honest, philosophical debate, and they're just not going to
agree with it.
But the majority of Americans understand we don't want government in
all our business, but there are certain sensible reforms that we can
pass so that consumers are protected, so that the market is working the
way it should, so that the American people are getting a fair deal.
Those are the people that we're trying to persuade. And I think if the
majority of the people have the facts, then in fact they will be on our
side. Okay?
All right. Next question. Now we can just go to the audience members here, and we'll start with this gentleman right here.
Q Mr. President, I'm Charles Cuttle (ph), I'm from North
Carolina, and thank you for turning North Carolina blue. (Applause.)
It's been a long time. I have two wonderful children and I have four
beautiful grandchildren. And so I'm working for them and I'm working
for people who, unlike me, don't have health insurance -- it's
unconscionable.
Now, you've been outrageously good -- (laughter) -- let me be clear
-- in trying to get a bipartisan bill through this Congress and you've
got three wonderful Republicans willing to stand with you. But America
needs this to happen and you know that. So where are we going to go
from here?
THE PRESIDENT: Well, let me -- we don't know yet whether we've got
any Republican support. We've got three Republicans who've been
working very diligently. Charles Grassley, Mike Enzi, and Olympia Snowe
have been working in the Senate Finance Committee with Max Baucus, the
Senate Finance Chairman, a Democrat, to see if we can craft a
bipartisan bill coming out of the Senate Finance Committee. I give
those three Republicans a lot of credit because they're under enormous
pressure not to engage in any kind of negotiations at all. And in the
current political climate, they are showing some significant resolve.
I don't know if in the end they can get there. I hope they can.
And we're going to just continue to wait to see if they can get a
product done. But at some point in the process, there's going to have
to be a conclusion that either they can get a bill done or they can't
get a bill done. And my commitment to the American people is to get a
good product -- which will include Republican ideas -- but I have no
control over what the other side decides is their political strategy.
And my obligation to the American people says we're going to get this
done one way or another. (Applause.)
All right. I'm going to -- you guys have been to my town hall
meetings so you know I always go boy, girl, boy, girl. (Laughter.)
Q Good afternoon, Mr. President. My name is Teresa McRae (ph), and
I am from Virginia, another state that flipped from red to blue.
(Applause.) I live in Spotsylvania County and it's a rural county, but
when I talk to people as a community organizer for OFA, it all comes
down to money. And I may suggest, well, there's long-term benefits and
quality health care, but they come back to me and say, well, what's
going to stop people from being in their employer-based health care and
just quickly move over into the government health care, and who's going
to pay for it? What do I say?
THE PRESIDENT: Okay. Well, it's a great question. There are a
couple of issues involved here. The first issue is, how are we paying
for health care reform generally? Now, one thing that's very important
to remind people, because you notice there's been a talking point from
opponents -- "trillion-dollar health care bill" -- they love repeating
that -- "trillion-dollar health care bill."
First of all, it's important to remind people that when they say
"trillion dollars," they're talking about over 10 years. So this --
we're talking about $100 billion a year -- which is still a significant
amount of money -- but just to give you a sense of perspective, I mean,
the amount of money that we're spending in Iraq and Afghanistan is --
what's the latest figure, Debbie? You figure nine -- $8 billion to $9
billion a month, right? So for about the same cost per year as we've
been spending over the last five to six years, we could have funded
this health care reform proposal -- just to give you a sense of
perspective. That's point number one.
Point number two. About two-thirds of the costs are actually going
to be paid for from money that's already in the health care system,
that taxpayers are already paying for, but is not a good deal. So it's
reallocating money that's being wasted right now -- taxpayer money
that's being wasted right now, and using it in a way that actually
makes people healthier. That's point number two.
So remember I told you about those subsidies that we're providing to insurance companies? That's an example.
Another example is, the way we reimburse hospitals right now, we
don't incentivize hospitals to get their patients the best treatment
the first time out, because if a patient is immediately readmitted,
well, we just pay them the same rate as they were the first time.
Now, think about if your car needed repairs, and you sent it in and
got it fixed -- you thought. A week later the same thing breaks down.
When you went back to the auto shop, you'd probably want them to give
you a little discount on fixing it the second time.
But we don't do that right now with respect to hospitals. And those
are the kinds of changes that we can make that would pay for about
two-thirds of the cost of health reform.
That leaves one-third -- and we do have to pay for that. I actually
think that we're going to get even more savings with prevention and
wellness, but unfortunately we can't count that. It's not, in
congressional lingo, "scoreable." We can't -- nobody gives us credit
for it because it's not -- it's not provable how much money we'd save
on those things, even though everybody understands that the investment
we're making in prevention and wellness and health IT are going to make
a difference.
So a third of it we're going to have to pay for. And what I've
proposed was that we would pay for it by having people over $250,000 a
year have their itemized deductions go to the same rate as everybody
else's -- 28 percent. Right now they get more because their marginal
tax rates are a little bit higher. And if we just went back to their
deductions that existed under Ronald Reagan, that radical -- (laughter)
-- then we could pay for all of the health care reform that we're
talking about.
Now, there are other ideas that are being floated out there both in
the House and the Senate. But the bottom line is what we're really
talking about is about $30 billion to $40 billion a year that we've got
to come up with. And I am absolutely committed -- and you can say this
to people -- the President is absolutely committed to making sure that
that is not funded on the backs of middle-class families. We're trying
to help middle-class families and give them additional resources to get
health insurance. We're not trying to add to their tax burden, okay?
So that's very important.
Now, there was another question that you asked, though, and that is,
how do I know that my employer is not just going to dump me into the
public plan? Well, there are actually provisions in the law that say
if your employer is already providing you with good health insurance,
then you can't just send your employee over into some sort of public
option. It's what's called a firewall. And so there are provisions to
prevent that kind of shift.
Now, there are going to be a lot of employers, small business
owners, who immediately are going to qualify for signing up for the
health insurance exchange because right now they can't afford to
provide their health -- health insurance to their employees at all.
And we want to make sure that they are getting some help, partly
because small businesses, they don't have any purchasing power when it
comes to insurance companies. If you've only got five employees or 10
employees or 15 employees, and you go to an insurance company and say,
I want to get a good insurance policy, they're not going to give you a
great deal, compared to if Xerox shows up with its thousands of
employees. And so when a small business joins this plan, they are
going to be able to pool their purchasing power with all the small
businesses and individuals out there who don't currently have health
insurance, and that will help drive down cost.
Okay. All right. Who's next? This gentleman right here.
Q Thank you, Mr. President. My name is Michael Perlmutter. I'm
from Durham, North Carolina. I'm the co-chairperson of Durham for
Obama's health care committee. We have 11,000 members.
THE PRESIDENT: Great.
Q And all of my volunteers say the same thing -- they're behind
reduced cost, they're behind guaranteed choice, they're behind health
care for all. And they believe, and I believe, that the only way to do
this is to guarantee a public option available to anybody who wants
one. And my question is, if that's the solution that you believe in,
why aren't we pushing it harder? And if that's not the solution, what
other solutions out there would accomplish all three goals that you
have?
THE PRESIDENT: Well, it's a great question, and this is an example
of sort of a controversy that has been somewhat manufactured this
week. So let me just be clear: I continue to support a public option,
I think it is important, and I think it will help drive down costs and
give consumers choices.
The only thing that we have said -- and this continues to be the
truth -- and I mean, sometimes you can fault me maybe for being honest
to a fault -- is that the public option is just one component of a
broader plan. So let's just talk -- let's just use the example of
making sure that insurance companies are treating their customers right.
One way that we're doing this in this health reform bill is very
directly through insurance reforms. We're saying to them, you have to
take people with preexisting conditions, you cannot have caps on
lifetime expenses or yearly expenses that people bump up against and
suddenly have to pull out a lot of money out of pocket that they may
not have. So we're putting in place a whole bunch of insurance reforms
that regulate the behavior of insurance companies.
Now, alongside that, if there's a public option that is also
offering a good deal to consumers, then the insurance companies have to
look over their shoulder and they say, gosh, you know, if the public
option is providing that good deal to consumers, then maybe we can't
just charge exorbitant rates and then mistreat our consumers. So it
gives them a benchmark from which to operate.
Now, my point is, this is sort of like the belt-and-suspenders
concept, to keep up your pants. You know, the insurance reforms are
the belt. The public option can be the suspenders. And what we're
trying to just suggest to people is, is that all these things are
important, and that if the debate ends up being focused on just one
aspect of it, then we're missing the boat.
If all we're talking about is the public option, then the 80 percent
of the American people who already have health insurance in the private
insurance market, they say to themselves, well, what's in it for me?
Their attitude will be, this is not relevant to me, and in fact they
start getting scared thinking, maybe what the public option means is
that you're going to force me to give up my current private insurer and
go into a public option.
That's what those who are opposed to reform have been counting on,
is to try to twist the debate and feed into Americans' natural
suspicion about government and to use that to cloud the fact that right
now people are not getting a good deal from their insurance companies.
So I just want to make sure that we're focusing on all the elements
of reform -- what will benefit people without health insurance, what
will benefit small businesses, what will benefit people who do have
health insurance -- so that we can build the largest coalition possible
to finally get this done.
Okay. All right. Go ahead. Here, you got a mic right behind you.
Q Thank you. Hello, Mr. President. I'm Katina Rojas Joy. I was a convention delegate.
THE PRESIDENT: Good to see you.
Q Prince George's County, Maryland. I have a two-part question.
One is choice -- the choice that we make to eat the foods that we eat
and the lifestyle that we choose to engage in. And the second part --
your family is very fit. What do you and the First Lady and the girls
do to encourage physical fitness, and what can we -- not the
government, not private corporations -- do to encourage activity in the
public school system and in young people?
THE PRESIDENT: Well, this is a great question. Look, this is an
interesting statistic. If we went back to the obesity rates that
existed back in the 1980s, the Medicare system over several years could
save as much as a trillion dollars. I mean, that's how much our
obesity rate has made a difference in terms of diabetes and heart
failure and all sorts of preventable diseases.
And so what we want to do is to, first of all, in health care
reform, in the legislation, encourage prevention and wellness programs
by saying that any health care plan out there has to provide for free
checkups, prevention, and wellness care. That's got to be part of your
deal, part of your package. And that way nobody has got an excuse not
to go in and get a checkup.
Now, even if we do all that -- and there are a lot of businesses out
there that on their own are already providing incentives to their
employees -- Safeway, for example, is a company that has given
financial incentives to employees to make sure that they are taking
care of themselves and getting regular checkups and mammograms and
colonoscopies and so forth, and it has saved them a lot of money in
terms of their premiums. So there's a financial incentive for a lot of
businesses to get in the business of prevention and wellness.
But you're absolutely right that even if we've got legislation, even
if companies are encouraging it, part of what we also have to do,
though, is teach our children early the importance of health. And that
means that all of us have to, in our communities, in our places of
worship, in our school systems, encourage nutrition programs, provide
young people outdoor activities that give them exercise. Michelle and
I always talk about the fact, when we were kids during the summer, you
know, basically Mom just said, "see ya" after breakfast -- you were
gone. (Laughter.) You might run in, get some lunch, go back out. And
you wouldn't be back till dinner. And that whole time, all you're
doing is moving.
Now, unfortunately, times have changed. Sometimes safety concerns
prevent kids from doing that. Sometimes a lot of kids just don't have
a playground. Little leagues may be diminished. That means that we as
adults in the community may have to provide more and more outlets for
young people to get the kind of exercise that they need.
When it comes to food, one of the things that we are doing is
working with school districts, and the child nutrition legislation is
going to be coming up. We provide an awful lot of school lunches out
there and reimburse local school districts for school lunch programs.
Let's figure out how can we get some fresh fruits and vegetables in the
mix, because sometimes you go into schools and you know what the menu
is. You know, it's French fries, Tater Tots, hot dogs, pizza. Now,
that's what kids -- let's face it, that's what kids want to eat
anyway. So it's not just the school's fault. A, that's what kids may
want to eat; B, it turns out that that food is a lot cheaper because of
the distributions that we've set up. And so what we've got to do is to
change how we think about, for example, getting local farmers connected
to school districts, because that would benefit the farmers delivering
fresh produce, but right now they just don't have the distribution
mechanisms set up.
So, you know, Michelle set up that garden in the White House. One
of the things that we're trying to do now is to figure out, can we get
a little farmer's market outside of the White House -- I'm not going to
have all y'all just tromping around -- (laughter) -- but right outside
the White House so that we can -- and that is a win-win situation. It
gives suddenly D.C. more access to good, fresh food, but it also is
this enormous potential revenue maker for local farmers in the area.
And those kids of connections can be made all throughout the country
and has to be part of how we think about health.
Okay.
MR. STEWART: Sir, sir, we have time for one more question.
THE PRESIDENT: One more question. All right. This gentleman gets
the last question here. Here, you got a microphone right there.
Q Thank you, Mr. President. Fred Smalls (ph), the city of
Laurel, Maryland. Mr. President, there is a large number of young
adults who are trying to figure out where they fall into the health
reform plan. Many of them are too old to be continued carrying on
their parents' insurance plan, yet they may be underemployed and cannot
afford good health care. How does your plan account for these young
people?
THE PRESIDENT: Well, it's a great question. Look, first of all,
one of the things that we've proposed is to extend the number of years
that young people can stay on their parents' insurance plan, to 25 or
26. That then fills the gap between college, where typically they can
get health care, and those first few jobs they get. I remember my
first few jobs -- (laughter) -- and, you know, you're broke.
(Laughter.) And a lot of times they're not giving you any health
care. And if they do offer you health care, you're opting out of it
because you're trying to buy food, which you think is important for
your health. (Laughter.) So being able to stay on a parent's health
care plan a little bit later, until you've got a more stable job, that
can help pull in a whole lot of young people.
Now, after that -- it turns out that young people are actually
relatively cheap to ensure. And so them being part of this pool, part
of the exchange where they can go directly and buy health insurance,
they will be able to get a premium that's priced comparable to if they
worked for a big company. Now, it's still going to cost them some
money. And there are going to be some young people out there who still
would opt -- you know, prefer, even if they can afford it, just not to
get health insurance. And this is where there are going to be some
young people who may be frustrated, because what we're going to tell
them is, you know what, we don't want to treat you in the emergency
room where everybody else has to subsidize you if you get hit by a
truck. So you are going to have to buy some minimal coverage, just
like you have to do with auto insurance, to make sure that at the very
least you're protected against some sort of catastrophic illness, and
that you're also able to get some regular checkups. But it will be
affordable based on a sliding scale based on their income.
And then there are going to be hardship exemptions. There are going
to be some folks who fall in a different category. They may be a
little bit older. They're quite poor. But even with the subsidies,
they still just can't afford health insurance. And we may have to give
some hardship exemptions to folks like that, where basically we say to
you, okay, if you make -- you have the option of buying insurance at,
let's say, 10 percent of your income. But if you are just in such a
strapped situation that you just can't afford that, then you are
exempted, okay?
So here is my closing message, everybody. The easiest thing to do
as a politician is to do nothing. You don't offend anybody. You say
all the right things. You don't rock the boat. Your poll numbers go
up. Everybody in Washington says, boy, that guy is a great
politician. Look at his poll numbers. (Laughter.) And you can get
away with doing that for years. But that's not why I came here. And
that's not why you worked so hard to win this election. You came here
because you knew that America can be a little fairer, a little more
just, a little more efficient. We can provide better health care
coverage; we can make sure that we use less foreign oil and develop
clean energy here in the United States; that we can make our school
system work for every child and not just some, and produce more
scientists and engineers that are going to be the key to unlocking a
21st-century economy.
We understood that we're human, and government is a human
enterprise, so it's imperfect, but we can do better than we've been
doing. And this debate that we're having right now, this health care
debate, is a test to that proposition. There are a whole bunch of
folks in this town who were just waiting for this debate to take place
because the storyline they want to write about is, all the naïve,
idealistic folks -- "Change We Can Believe In," "Yes We Can" -- that
all their hopes were dashed, because this is a tough, cynical town, and
we are going to be able to show them that basically you can't get
anything done in this town. You can't change things. Everything
always immediately becomes partisan. Government is way too complicated
and Congress is way too paralyzed and the special interests are way too
powerful to bring about meaningful, big changes that help the American
people.
That's the storyline they're operating on, but that's the storyline
we've been fighting against this entire time. From the day we
announced this race, we were fighting against that. And they have been
trying to write that story again and again and again. We are not going
to give up now. (Applause.) We are not going to give up now. We are
going to get this done, and show the American people that government
can work for them.
Thank you, everybody. God bless you. (Applause.)
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