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
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?