Today’s Q for O’s WH – 7/22/2009


TAPPER: Thank you, Mr. President. You said earlier that you wanted to tell the American people what's in it for them. How will their family benefit from the health care reform? But experts say that in addition to the benefits that you're pushing, there is going to have to be some sacrifice in order for there to be true cost-cutting measures, such as Americans giving up tests, referrals, choice, end-of-life care. When you describe health care reform, you don't -- understandably, you don't talk about the sacrifices that Americans might have to make. Do you think -- do you accept the premise that other than some tax increases on the wealthiest Americans, the American people are going to have to give anything up in order for this to happen? OBAMA: They're going to have to give up paying for things that don't make them healthier. And I -- speaking as an American, I think that's the kind of change you want. Look, if, right now, hospitals and doctors aren't coordinating enough to have you just take one test when you come because of an illness, but instead have you take one test, then you go to another specialist, you take a second test, then you go to another specialist, you take a third test, and nobody is bothering to send the first test that you took, same test, to the next doctors, you're wasting money. You may not see it, because if you have health insurance right now, it's just being sent to the insurance company. But that's raising your premiums. It's raising everybody's premiums. And that money, one way or another, is coming out of your pocket. Although we are also subsidizing some of that because there are tax breaks for health care. So, not only is it costing you money in terms of higher premiums, it's also costing you as a taxpayer. Now, I want to change that. Every American should want to change that. Why would we want to pay for things that don't work? That aren't making us healthier? And here's what I'm confident about. If doctors and patients have the best information about what works and what doesn't, then they're going to want to pay for what works. If there's a blue pill and a red pill, and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that's going to make you well? But the system right now doesn't incentivize that. Those are the changes that are going to be needed -- that we're going to need to make inside the system. It will require, I think, patients to -- as well as doctors, as well as hospitals, to be more discriminating consumers. But I think that's a good thing, because ultimately we can't afford this. We just can't afford what we're doing right now. And -- and -- and just to -- to raise a broader issue that I think has colored how we look at health care reform, let me just talk about deficit and debt, because part of what's been happening in this debate is the American people are understandably queasy about the huge deficits and debt that we're facing right now. And the feeling is, all right, we had the bank bailout, we had the recovery package, we had the supplemental, we've got the budget, we're seeing numbers, trillions here and trillions there. And so I think, legitimately, people are saying, "Look, we're in a recession. I'm cutting back. I'm having to give up things. And yet all I see is government spending more and more money." And that argument, I think, has been used effectively by people who don't want to change health care to suggest that somehow this is one more government program. So I just want to address that point very quickly.

First of all, let's understand that, when I came in, we had a $1.3 trillion deficit -- annual deficit that we had already inherited. We had to immediately move forward with a stimulus package because the American economy had lost trillions of dollars of wealth. Consumers had lost through their 401(k)s, through home values, you name it, they had lost trillions of dollars. That all just went away. That was the day I was sworn in; it was already happening. And we had 700,000 jobs that were being lost. So we felt it was very important to put in place a recovery package that would help stabilize the economy. Then we had to pass a budget by law, and our budget had a 10-year projection. And I just want everybody to be clear about this. If we had done nothing, if you had the same, old budget as opposed to the changes we made in our budget, you'd have a $9.3 trillion deficit over the next 10 years. Because of the changes we've made, it's going to be $7.1 trillion. Now, that's not good, but it's $2.2 trillion less than it would have been if we had the same policies in place when we came in. So the reason I point this out is to say that the debt and the deficit are deep concerns of mine. I am very worried about federal spending. And the steps that we've taken so far have reduced federal spending over the next 10 years by $2.2 trillion. It's not enough. But in order for us to do more, we're not only going to have to eliminate waste in the system -- and, by the way, we had a big victory yesterday by eliminating a weapons program, the F- 22, that the Pentagon had repeatedly said we didn't need -- so we're going to have to eliminate waste there. We're going to have to eliminate no-bid contracts. We're going to have to do all kinds of reforms in our budgeting. But we're also going to have to change health care. Otherwise, we can't change that $7.1 trillion gap in the way that the American people want it to change. So to all -- everybody who's out there who has been ginned about this idea that the Obama administration wants to spend and spend and spend, the fact of the matter is, is that we inherited an enormous deficit, enormous long-term debt projections. We have not reduced it as much as we need to and as I'd like to. But health care reform is not going to add to that deficit. It's designed to lower it. That's part of the reason why it's so important to do, and to do now.

- jpt

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