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

But increasingly, medical students are having to make decisions based on the fact that they're coming out with $200,000 worth of loans. And if they become a primary care physician, oftentimes they are going to make substantially less money and it's going to be much harder for them to repay their loans.

So what we've done in the recovery act, we've started by seeing if we could provide additional incentives for people who wanted to go into primary care. Some loan forgiveness programs, I think, are going to be very important.

But what we're also going to have to do is start looking at Medicare reimbursements, Medicaid reimbursements, working with doctors, working with nurses to figure out, how can we incentivize quality of care, a team approach to care that will help raise and elevate the profile of family care physicians and nurses, as opposed to just the specialists who are typically going to make more money if they're getting paid fee-for-service?

GIBSON: Is Mary Vigil in the room? Mary Vigil, there you are. You're a -- you're a medical student, right? Coming out -- and how much debt will you -- can we get a microphone to Mary? How much debt...

SAWYER: (OFF-MIKE)

GIBSON: How much debt will you have?

MARY VIGIL, MEDICAL STUDENT: I'll be in about $300,000 in medical education debt.

GIBSON: And you would -- you would like to go into primary care?

VIGIL: Definitely. That's -- that was my primary motivation in going in to medical school.

GIBSON: But you know you will be remunerated at a lesser level than a specialist?

VIGIL: Yes.

OBAMA: Right. And so one of the things that we've got to figure out is how to change that calculation. Now, you may still go into primary care -- and I hope you do -- but I don't want to make it tougher for you. I want to make it easier for you.

And one of the things that I'd like to explore -- and I've been working with the administration and with Congress is -- are there are loan forgiveness programs where people commit to a certain number of years of primary care. That reduces the costs for their medical education. That would make a significant difference.

GIBSON: But let me ask a basic question, which may sound silly and naive. But we've got 46 million people who are uninsured in this country.

OBAMA: Right.

GIBSON: And one of your goals, one of the goals of health care reform is to get those 46 million people insured.

OBAMA: Right.

GIBSON: We only have X number of doctors in the country. If you add 46 million people to the insurance rolls, you can't get an appointment now, Mr. President. How are you going to get an appointment then, when there's 46 more million people competing for that doctor's time?

OBAMA: Well, this is going to be a significant issue. First of all, I think it's important that, whatever we do, we're going to phase it in. It's not going to happen overnight.

If we provide the right incentives, I think we're going to start seeing more young people say that going into medicine is a satisfying, fulfilling profession, especially if we can eliminate some of the paperwork and bureaucracy that they have to deal with right now.

And I -- I have a lot of friends who are doctors, and they complain to me all the time about the administrative and business sides of the practice when they actually got into medicine because they wanted to heal people.

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