TRANSCRIPT: 'Questions for the President: Prescription for America'

health I.T., et cetera. We will have some upfront costs, and the

estimates, as Charlie has said, have been anywhere from $1 trillion to

$2 trillion.

But what we've said is, what my administration has said, what I've

said, is that whatever it is that we do, we pay for, so it doesn't add

to our deficit.

Now, we've put forward some specific ways of paying for the health

reform that we talked about. About two-thirds of the cost would be

covered by re-allocating dollars that are already in the health care

system, taxpayers are already paying for it, but it's not going to stuff

that's making you healthier.

So a good example of that -- we spend $177 billion over 10 years on

providing subsidies to insurers. And if we can take that money and use

it to help train young doctors for primary care, to provide more

coverage, to improve prevention and wellness, that's a good way of

spending money that we're already spending.

About a third of the costs will come from new revenue. And so what

I've proposed is, is that we cap the itemized deductions that the top 2

or 3 percent get, people making over 250 a year, me and Charlie, so that

our item -- so that we're itemizing our deductions at the same level at

-- as most middle class families are.

With that additional money, we would have paid for all of the health

care that I'm proposing. So there is a way of paying for this that

doesn't add to the deficit.

And the last point I'll make, it's a big question -- I was trying to

be quick, because Charlie is looking at his watch, the last point is,

all of this money that I just talked about, those are hard dollars. We

know where they are and so we know that this would not add to the deficit.

It doesn't count all of the savings that may come from prevention,

may come from eliminating all of the paperwork and bureaucracy because

we have put forward health IT. It doesn't come from the evidence-based

care and changes in reimbursement that I've already discussed about.

And the reason is, is because the Congressional Budget Office, the

CBO, which sort of polices what our various programs cost, they're not

willing to credit us with those savings. They say, that may be nice,

that may save a lot of money, but we can't be certain.

So we expect that not only are we going to be able to pay for health

care reform in a deficit-neutral way, but that it's also going to

achieve big savings across the system, including in the private sector

where the Congressional Budget Office never gives us any credit.

But if hospitals and doctors are starting to operate in a smarter

way, that's going to help you even if you're not involved in the

government system. That's how we can end up achieving cost. But it

requires all of us making some up-front investments. And I think we can

find a bipartisan way to do that.

SAWYER: Mr. President, we're going to take a break, come back with

a lot more questions about whether the government should be involved in

all of this, who is going to be covered, and not, and how.

We'll be back.


SAWYER: We have a question from Dr. Gail Wilensky, who ran Medicare in the Bush administration. Your question?

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