TRANSCRIPT: Charles Gibson Interviews President Barack Obama

OBAMA: Well, actually, I've been clear that our job is to degrade Taliban capacity. Look, there are members of the Taliban who don't have some global jihadist view. They're just a member of a tribe. They're looking for a job. They see this as an opportunity. And those are the folks who I think potentially you can reintegrate into Afghan society.

So it's absolutely true -- and this was part of the review process -- that we had to work with our military to define the mission and be clear. Look, our -- our job here is not to get a body count on the Taliban, because that, I think, takes us down an open-ended commitment that is not required for our narrow security interests. What is required is making sure that you don't have an entire nation, Afghanistan, or huge swaths of Afghanistan and Pakistan that are so lawless that it is difficult for us to keep up the pace of offensive activities against Al Qaida.

One of the unwritten stories this year is we have been very successful in going after Al Qaida and keeping them pinned down. And I believe that that has saved American lives and the lives of our allies, because they really can't operate with the kind of impunity that they did prior to 9/11.

But in order to do that, we've got to make sure that we've got a platform in that region that allows us to keep that pressure on. And we can't expect to have that same kind of ability to be on the offensive against Al Qaida if you've got Afghanistan in utter chaos or if you've got a Taliban that is controlling huge parts of the region and are actively engaged in planning with Al Qaida.

GIBSON: Let me turn to health care. When we talked in the White House and throughout the early stages of health care reform discussion, you talked about the absolute need to bend the cost curve of health care, that we had to bring costs into line if we're going to right the country. If there's no government insurance program, if we're not even going to expand Medicare to keep insurance companies competitive, how does the cost curve bend?

OBAMA: Well, a couple of things. Number one -- and something that hasn't been discussed, partly because there's been some broad-based agreement on this -- we're setting up an exchange in which you've got 30 million people and small businesses who are now able to pool their buying power and negotiate, essentially, with insurance companies by choosing the best price from a range of different plans, forcing insurance companies to compete the same way they compete for the business of federal employees. That drives costs down.

Every single what's called game-changer, every idea that's out there about changing delivery systems, how hospitals are built, how doctors are reimbursed, how we can incentivize them to plan better, reduce numbers of tests in order to improve quality of testing and diagnoses, all those things are embodied in the bill.

There was a terrific article in the New Yorker just about a week ago by a doctor, Atul Gawande, who pointed out that there is not an idea out there for cost control that is not in this health care bill. The problem is, is that a lot of these things proceed by trial and error, because what we're trying to do is change behavior of hospitals and doctors and health systems all across the country.

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