JOHNSON: Let's assume you get all that figure out... (LAUGHTER) ... a big job obviously, and now you're able to increase coverage and so now you got a lot of people with new coverage seeking out primary care. And they can't find doctors. We sent out a little note to the doctors, telling them about this interview and asking them what they most feared. And I just want to read you what a couple of them said. It's very poignant, actually, what they said. One of them said, "I fear that the plan will increase insurance coverage without increasing the ability of primary care physicians to take care of everyone who needs care. Massachusetts provides the obvious example of what happens, long waits, increased costs.
JOHNSON: One guy wrote, a sports analogy, "I fear that he won't shoot the puck and really fix it." So what if we get all these people with insurance and there is no primary care available? It's a nightmare situation. They'll got to the emergency room.
OBAMA: It's a big risk. We've already got a lot of problems…
JOHNSON: and its going to get worse…
OBAMA: Yes, but keep in mind, that the status quo is we don't have enough primary care physicians. We've got no incentive to create more primary care physicians. And those people who don't have access to primary care physicians are going to the emergency room where we're giving them the most expensive care and all of us are subsidizing that to the tune of about 900… (CROSSTALK) (JOHNSON: That's a bad scenario.)
So with the new insurance -- keep in mind that we're going to be phasing this in. And what we want to do is to provide a powerful set of incentives for more and more young people who are interested in health care, interested in medicine, to go into primary care.
Part of that may be adjusting the reimbursements, so that primary care physicians are getting a greater reimbursement and we're closing the gap between specialists and primary care physicians. Part of it may be how we finance medical education and saying to the young people who are going into medical school, "If you are committed to primary care, we are going to pay your way."
And so, putting in a sizable chunk of money into making life better for primary care physicians, particularly those who are willing to serve in under-served areas, I think we can solve some of those problems.
We're not going to solve all of them immediately overnight, and that's why I think we have to anticipate this program's not going to start up probably until 2013. That gives us four or five years to start developing programs to solve this problem.
JOHNSON: You described some of the maybes. I'd like to respectfully say that at least one of them isn't a maybe – you HAVE to increase salaries for primary care physicians or you're not going to get them relatively. 2% of medical students today say they are going into primary care. (CROSSTALK)
OBAMA: It is a huge problem and one that we've got to solve and I want to make sure that in the final bill that I sign there are strong incentives to help primary care physicians.