And the goal here is to create a system in which people try things out. Suddenly, somebody says, "You know what? We're saving money. The hospital here is saving money and reducing errors because we've got a protocol or a checklist of procedures in terms of how doctors and nurses work together to deal with a patient in a more effective way." Another hospital down the road starts learning from that, and you start seeing these changes cascade through the system.
So, you know, all I can do is talk to the smartest people in this country, the health economists, people who are involved in health care each and every day, find out from them what ideas they have and make sure that's incorporated into the bill.
GIBSON: And then there's the problem of getting the darn thing passed, which is proving to be devilishly difficult.
GIBSON: You thought you had a compromise last week that was going to expand Medicare to younger people, and Senator Lieberman says, "Well, I'm not sure I want that," and then all of a sudden, we hear it's out of the -- out of the bill. Do you feel as if individual senators are holding you hostage?
OBAMA: I think that what we have right now in the Senate is a situation where the opposition party has made a political decision that we are going to say no to everything, we're going to not be at the table, we're going to just not get involved. What that -- what that...
GIBSON: Which leaves you needing all 58 Democrats and two independents.
OBAMA: What that means is...
GIBSON: Every one of them.
OBAMA: Every single one of them.
GIBSON: Every single one.
OBAMA: Every single one of them. And...
GIBSON: Anyone can tell you, "If I back off, you have to do what I need you to do."
OBAMA: You know, I -- I spend a lot of time talking to individual senators.
GIBSON: Yes, you do.
OBAMA: And -- and it's not just on health care. I mean, there are -- health care is the most prominent example, but, you know, one of the...
GIBSON: But do you feel like they're holding you hostage on this?
OBAMA: Well, here's what I'll say. Each of them have very strong opinions.
GIBSON: Don't they ever. You think?
OBAMA: And -- and, you know, many of them, I think, sometimes feel that they've got a better idea than we do. We try to incorporate as many as possible. The problem is, each one of them may have ideas that are completely contrary to what the other senator wants.
And so there is a balancing act. But and one of the challenges that we as a country are going to have is that, for our system of government to work, for our deliberative democracy to work, for the Senate especially to work, because of all the arcane procedures that are involved, you have to have a sense that occasionally we're willing to rise above party. You've got to have a sense on the part of each individual senator that -- that every once in a while, we are...
GIBSON: You think there's 60 senators doing that?
OBAMA: Well, I think it's hard. And -- and -- and there's got to be a sense sometimes that we're willing to rise above our particular interests, our particular ideas in order to get things done. Right now, that culture has, I think, broken down over the last several years, and one of my jobs over the next three years is to try to see if we can revive that. But that's tougher than I would have liked.