DAVID HATTENFIELD, Cornerstone Baptist Church, Cumberland, MD: Yes, I guess the -- the -- first of all, I'd like to -- just to say it is good to be here this evening.
OBAMA: Thank you, David.
HATTENFIELD: With the -- with the cost of health care, you know,
I'm pretty satisfied with my own plan. It's not everything that it
should be or could be, but I am concerned that -- of the government
taking over health care. And, you know, Social Security isn't -- isn't
doing real well. At least that's what we're being told. And how can we
know that the government is going to be able to handle the cost of
health care? Isn't that going to tax me? Isn't it going to be taxing my
benefits, those kind of things?
OBAMA: Right. Well, look, I think it's a very legitimate question. I
guess that the first point I'd make is, if we don't do anything, costs
are going to go out of control. Nobody disputes this.
Medicare and Medicaid are the single biggest drivers of the federal
deficit and the federal debt by a huge margin. And at the pace at which
they're going up, if we don't do some of the things that we've talked
about tonight, you know, changing how we pay for quality instead of
quantity, making sure that we are investing in prevention, all those
game-changers that I discussed earlier, if we don't do those things,
Medicare and Medicaid are going to be broke, and it will consume all of
the federal budget.
Every program that currently exists under the federal budget, except
defense and entitlements, all that would be swept aside by the cost of
health care if we do nothing. So that's point number one.
Point number two is that a lot of what we're talking about is
reallocating existing health care dollars that are not being spent
wisely. And almost everybody agrees that there is a lot of room for us
to improve how we're spending existing health care dollars.
And point number three. There is going to be a need initially for some
additional revenue. And I talked about our suggestion -- my
administration's suggestion the best way to do that, capping itemized
deductions for people making over $250,000 a year.
But I also believe that if we are doing this right and we're bending the
curve on health care, then you who keeps a private plan will see
reductions in your out-of-pocket costs over time.
So that instead of your health care premiums going up three times your
wages over the next decade, it may only go up by the amount that
inflation goes up generally. And that's real money in your pocket.
That's real savings that would offset any potential increases.
By the way, I suspect that Charlie and I, again, 2-3 percent of the
population, we're the ones who would see our taxes go up a little bit to
pay for that initial outlay.
GIBSON: But let me -- on this tax question, let me get to this issue of
taxing health care benefits.
GIBSON: It isn't -- there is a massive amount of money that employers
pay for health care benefits, and it is not taxed for me or anybody else
in this room. You went after John McCain when he suggested taxing that
money. That we would have to pay taxes on that.
Should we pay taxes on that? A lot of people question whether there is
enough money to pay for all of this.
GIBSON: Are you willing to entertain the idea of taxing health care
OBAMA: Well, I continue to strongly disagree with John McCain's plan