EXCLUSIVE: President Obama Defends Right to Choose Best Care

June 24, 2009— -- President Obama struggled to explain today whether his health care reform proposals would force normal Americans to make sacrifices that wealthier, more powerful people -- like the president himself -- wouldn't face.

The probing questions came from two skeptical neurologists during ABC News' special on health care reform, "Questions for the President: Prescription for America," anchored from the White House by Diane Sawyer and Charles Gibson.

Dr. Orrin Devinsky, a neurologist and researcher at the New York University Langone Medical Center, said that elites often propose health care solutions that limit options for the general public, secure in the knowledge that if they or their loves ones get sick, they will be able to afford the best care available, even if it's not provided by insurance.

Devinsky asked the president pointedly if he would be willing to promise that he wouldn't seek such extraordinary help for his wife or daughters if they became sick and the public plan he's proposing limited the tests or treatment they can get.

The president refused to make such a pledge, though he allowed that if "it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care.

"There's a whole bunch of care that's being provided that every study, that every bit of evidence that we have indicates may not be making us healthier," he said.

Gibson interjected that often patients don't know what will work until they get every test they can.

"Oftentimes we know what makes sense and what doesn't," the president responded, making a push for evidence-based medicine.

Gibson asked the president if it doesn't make sense to decide what the limitations will be on options in any health care reform proposal before voting on it.

"That's what people are afraid of," Gibson said.

The president said he understood the American people "know they're living with the devil, but the devil they know instead of the devil they don't."

On the "Nightline" edition of the health care forum, Gibson read the president a letter from Republicans on the Senate Finance Committee expressing concern about the creation of a government-run health care plan.

"At a time when major government programs like Medicare and Medicaid are already on a path to fiscal insolvency, creating a brand new government program will not only worsen our long-term financial outlook but also negatively impact American families who enjoy the private coverage of their choice," the senators wrote.

"The end result would be a federal government takeover of our health care system, taking decisions out of the hands of doctors and patients and placing them in the hands of a Washington bureaucracy."

"They're wrong," the president said, arguing that in a Health Insurance Exchange, the public plan would be "one option among multiple options."

The concern, Gibson articulated, is that such a plan wouldn't be offered on a level playing field.

The president rebuffed that, arguing that "we can set up a public option where they're collecting premiums just like any private insurer and doctors can collect rates," but because the public plan will have lower administrative costs "we can keep them [private insurance companies] honest."

Obama said he didn't understand those advocates of the free market who constantly say the private sector can do things better and are yet worried about this plan.

"If that's the case, no one will choose the public option," the president said. He also suggested, however, that the private sector might not necessarily be better, point out that users of Medicare and Veterans Administration hospitals constantly rate "pretty high satisfaction."