people having to completely change their doctors, their health care
providers in a way that I'm not prepared to go.
This is one-sixth of our economy. I think that we can build on what
works, fix what's broken, and still save some substantial money.
SAWYER: Gary -- Gary Cloutier, who is a body shop owner.
GARY CLOUTIER, UNINSURED SMALL BUSINESS OWNER: Yes, body shop owner from Westfield, Massachusetts, Cloot's Auto Body. Got to give myself a plug.
OBAMA: There you go.
CLOUTIER: And I don't have insurance. I'm one of those 46 million
that has none at all. Under Massachusetts policy, I make too much money
and I don't qualify, so I'm on the outside looking in. What are you
going to do for people like me so that we don't fall through the cracks
and we're able to get insurance like everybody else?
OBAMA: Well, I think the self-employed are a huge example, and that's a
growing part of our population. And that's a huge portion of the people
who are having a very difficult time getting health insurance, partly
because, if you're not part of a big pool, you just can't get a good
deal. It ends up being really expensive.
That's why we want to set up these exchanges, because for a person like
you who's self-employed, doesn't have health insurance, for you to be
part of this exchange, this marketplace, along with millions of others,
suddenly you've got a little bit of market clout. Private insurers are
going to want your business, and that means that you can negotiate for a
If we've got a public option in there, then that's also an alternative.
And one of the things that we're going to need to do is to provide some
subsidies for folks who just can't afford it even when the option is
provided to them.
That's where some of the new money is going to come in, is to make sure
that people who don't have health insurance are able to get it without
taking on huge amounts of debt.
GIBSON: Dr. Tim Johnson, our medical editor, we started this with you,
outlining the parameters of this. An observation?
JOHNSON: An observation would be, if you're successful in getting rid of
some of that 30 percent of unnecessary care, you're going to dislocate a
lot of people. Now, some of them are criminals committing fraud; they
ought to go to jail. But a lot of them are real people with real jobs.
Why not right now start talking about retraining these people for
primary care jobs, nurse practitioners, physician assistants? I hear no
talk about that.
OBAMA: Well, I think you make a -- a reasonable point that, if you're
going to change the health care system over time, then to be very
specific, the amount of person power that goes into billing,
administration, all the things that we hate about the health care
system, even though those are wonderful people who are doing great work,
they're over time hopefully going to be moving into the actually
providing care side of the health care industry as opposed to the
bean-counting side of the health care industry.
Keep in mind, though, that this is -- our goal here is to over time
change the system, over time reduce costs, over time transition those
folks into the -- the health care side of it. We already mentioned that
we still have a nurse shortage out there. We still have a shortage of
people who are providing primary care. People who are already in the
health care system, I think, naturally would gravitate towards that.