Obama on health care policy: ‘No free lunch’

Snyderman: There is language, buzz words, that just seem to get under people's skin, a few of them: mandates. We mandate auto insurance. Why not mandate health insurance, universal health care; tax it, ration it, which I think is a big, you know, elephant that nobody wants to talk about in the room?

How do you change the language so that people don't wrestle, and we all recognize that ...

Obama: Well, I think that the most important thing for people to understand is that the system, as it is, is unsustainable. And if people understand that; if you look at the trend lines, where your premiums have doubled over the last nine years; your out-of-pocket costs have gone up 62 percent; the federal government is being bankrupt by Medicare and Medicaid — if you look at all these things, then you know that, just standing still, we are going to be overrun by health care costs.

Once the American people understand that, then it's a matter of us making intelligence choices.

I — I was opposed to the idea of an individual mandate, each person had to get health insurance, like car insurance.

Snyderman: But why?

Obama: I'm still — well, because my concern was, if we post a mandate, then people who couldn't afford it still would not have the ability to pay for the health insurance that was out there that was available, except now they were also being punished.

But I've changed my mind on this because what I've — was persuaded of was that, if we can phase this in so that we know there's affordable insurance out there — and, in fact, a lot of the uninsured are relatively young people who could be insured fairly cheaply — that that actually will drive down the cost for everybody.

So there's an example of, if the president of the United States can get educated on something and change their mind.  I have confidence that the American people, when they get all the facts, will see that we can improve quality.

People will still have a choice of doctors and choice of plans.  And over the long term, we're going to save everybody money.

Snyderman:  If you can change your mind on that, would you consider changing your mind on taxing health care benefits so that everyone ponies up a little bit?

Obama:  Well, you know, I have to tell you that I think the way that we are approaching it, the way I've suggested we approach it ... I'm very worried about people who are reliant on existing insurance plans suddenly being told, "You know what?  You are going to have to change your insurance plan, even though you may have negotiated with your employer for that higher benefits. That's an out-of-pocket cost for you."

And what I've said is that the better way to do this is to finance most of reform through reallocating dollars that are already being paid into the system. And you know, you're hearing a lot of noise out there about this is a $1.2 trillion reform effort, or a $1 trillion reform effort.  Actually, about $600,000 — $600 billion of that $1 trillion is money that's already being spent subsidizing insurance companies, subsidizing pharmaceutical companies, spending unwisely on health care through the government.

And if we took that $600 billion and reallocate it, then what we're really talking about is a cost of somewhere around $400 billion over 10 years, or $30 billion to $40 billion a year.

Snyderman:  And budget neutral by the time...

Obama:  Budget neutral. Won't add to the deficit. And, by the way, we'll get that $40 billion back by things like wellness and health I.T., etc. 

The problem is, is that that money may come later, once all these changes and reforms are in place, so we're going to have to do something up front.  I think the best way to do it is to lower the itemized deductions for people who make a lot of money — like me.  And if we do that, we can pay for it. And ultimately, this will pay for itself.

Snyderman:  Mr. President, I'd like to ask you about your new nomination for surgeon general.  You've had two surgeons general nominees — Dr. Sanjay Gupta, high-profile, academic neurosurgeon, Dr. Regina Benjamin, under the radar, family practitioner in rural America. They seem on paper to be diametrically opposed.

Obama: Could I say, I have great respect for Sanjay Gupta, but I never nominated him.  

The press nominated him. I never — you know, that was not — there were people who had suggested that he might make a good surgeon general.  And I think, in fact, he could have made a good surgeon general. He's a very well-spoken person and a lot of the job of the surgeon general is to get a message out.

Snyderman:  Did you pick the right person?

Obama: Oh, I'm confident I picked the right person.  The — when you look at Dr. Benjamin's track record, she is a family physician who's worked in some of the toughest areas, in a diverse community of low-income people, a lot of under-insured, under very adverse circumstances.  And yet, somehow, always made the best of it. 

She cares deeply about prevention.  She cares deeply about making sure that the American people are healthy. She is going to be an excellent surgeon general.

Snyderman: Mr. President, I know you hate this, but really, is the battle with the cigarettes going OK? I'd be remiss as a cancer surgeon not to ask you how you're doing.  

Obama: I'm doing quite well, thank you.

Snyderman: Good luck.

Obama:  I appreciate it.

Snyderman: Thank you for your invitation today.

Obama: You bet. I enjoyed it. Thank you. Thank you.

MORE FROM HEALTH CARE

Health care Section Front

U.S. tops world in health spending, results lag   Dems stick together on public plan compromise Senate votes on Medicare in Saturday session Deals cut on health bill may be at peril Surgeon general wants more minority docs Medicare cuts stay in Senate's health care bill Poll: Most in U.S. want public health option AARP backs Dems in Senate health care fight Breast-screening debate splits along party lines Orszag: Health efficiencies could take 'decades' Health care Section Front   Add Health care headlines to your news reader: