So if we could get a system where that one test is properly distributed, we all save money. And there are examples of that kind of breakdown in the system across the board. We don't spend enough money on prevention and wellness. We know that. So, as I've mentioned again in the town hall meeting, that a hospital or a medical system may not get reimbursed for a nutritionist who's helping somebody control their diet, but, they will reimburse for a $30,000 foot amputation.
So the real issue is, are we getting the best value for the money that we are already spending? And the answer is no.
MORAN: And under your plan, it's the government that will put real muscle ... into rationalizing or structuring the health care system so that we use less, use it more efficiently, or we use less. It's the government that will play that major role.
OBAMA: The government would play that role with respect to money that the government is spending. Right? Which it always -- it currently plays that role. That's not a change.
So Medicare and Medicaid -- those programs in which the government is involved and honing up dollars, I think taxpayers would expect that we spend that money wisely. We don't want to see that money wasted on weapons systems that aren't needed. We don't want it spent on welfare programs that don't work. And we shouldn't want that spent on tests that aren't making people better.
So that's true of the public dollars that are going to be used. With respect to the private sector, what we're hoping is, is that by advertising what best practices are that doctors and patients are going to have better information and they're going to start saying, hey, you know what, it turns out that this treatment, which is cheaper, leads to better results than that treatment. And they will start making changes in how they practice.
And we also do want to reform the insurance industry so that, as I mentioned before, practices like excluding people for pre-existing conditions, or dropping people for coverage unfairly, that those reforms are put in place. That will affect the private marketplace.
MORAN: When you were campaigning for president you said, if you were starting from scratch you would want the single-payer, government-run national health care system.
But, we are starting from scratch.
OBAMA: That's not exactly what I said, Terry.
What I said was, if I am starting from scratch I think that the single-payer system could make a lot of sense. But that's not the tradition that we've inherited over the last 50 years. We have an employer-based system. And so as a consequence, for us to simply transition and scrap the old system would be extraordinarily disruptive and I don't want to disrupt people's care. I don't want to add to their insecurities right now. I want to add to their securities.
And that's why what we're trying to do is in a very steady way, build onto the existing system. Make it work better and give people more security and make sure that more people have coverage at the same time as we're making it more cost efficient.
MORAN: But you also said that this public option, this government program that you're proposing for health care, could be, you said, a transition to a single-payer national health care system.
In your heart of hearts, is that what you would like to see, that gradually we would transition to national health care?