that he presented during the campaign which was to eliminate the
deduction -- let me finish…
GIBSON: But you went after -- you went after him for suggesting that we
tax that money.
OBAMA: I'm about to answer your question, Charlie.
GIBSON: OK, good.
OBAMA: The -- I continue to believe that it would the wrong way to go
for us to eliminate the deduction -- or the exclusion on health care
benefits that essentially taxes current benefits.
What is being discussed in Congress right now is capping those -- that
deduction or that exclusion at a certain level. I continue to believe
that's not the best way to do it, because I think that what you would
see, certainly if you eliminate it completely, essentially employers
would stop providing health insurance.
And then we would really have to have either a public plan or what John
McCain was proposing, everybody just gets that money back in wages and
then -- or tax credits and you go out and you shop by yourself.
The problem is that the amount of money you're getting back is not going
to be the same as the cost of an average insurance plan, especially if
you're not in a pool. What's being -- that's not what is being discussed
right now in Congress.
They're saying, at a certain level, whether it's $13,000 or $17,000 a
year, which is what they consider to be a high-end or a "Cadillac plan,"
maybe your deduction would phase out. I continue to believe that the
better way for us to fund this is through the capping of the itemized
But I think there are people, you know, in good faith who are saying a
cap would at least prevent these "Cadillac plans" that end up having
people over-utilizing the system. That's a debate that is taking place
in Congress right now.
I'm pushing my idea, other folks are pushing their ideas. There is going
to have to be some compromise at the end of the day.
GIBSON: All right. Mr. President, we'll take another break. NIGHTLINE
continues. Stay with us.
SAWYER: One quick question, if we can here, Charlie. Marissa Milton, skeptical?
MARISSA MILTON, HR Policy Association: A little skeptical on cost, Mr. President. Other industrialized nations provide coverage for all of their residents, they
have higher quality care, and they do so spending about less than half
of what we spend on health care now.
So there's an argument that could be made that we actually don't need to
spend any new money to fix the system if we're willing to make some
tough decisions. Could you comment on that and maybe exploring that as
OBAMA: Well, you're absolutely right that we spend at least 50 percent
more than any other advanced country, and we don't have better outcomes,
in terms of infant mortality, longevity, all those various measures of
Now, a lot of those other countries employ a different system than we
do. Not all of them, by the way, use a -- socialized medicine, as I
think the -- the British National Health Service is called. Some of them
have what would be considered -- almost all of them have what would be
considered a single-payer system, in which the government essentially
operates a Medicare for all, even though doctors and health care
providers are still separate.
The problem is, is that we have an employer-based system that has grown
up over decades. For us to completely change our system, root and
branch, would be hugely disruptive and I think would end up resulting in