PART 2
MR. OBAMA: I don't think that's accurate. Track what I've been saying. Right after the election I said that we had profound concerns about the nature of the election, but that it was not up to us to determine what the outcome was.
As soon as violence broke out -- in fact, in anticipation of potential violence -- we were very clear in saying that violence was unacceptable, that that was not how governments operate with respect to their people.
So we've been entirely consistent, Major, in terms of how we've approached this. My role has been to say the United States is not going to be a foil for the Iranian government to try to blame what's happening on the streets of Tehran on the CIA or on the White House, that this is an issue that is led by and given voice to the frustrations of the Iranian people.
And so we've been very consistent the first day, and we're going to continue to be consistent in saying this is not an issue about the United States, this is about an issue of the Iranian people.
What we've also been consistent about is saying that there are some universal principles, including freedom of assembly and freedom of speech, making sure that governments are not using coercion and violence and repression in terms of how they interact with peaceful demonstrators. And we have been speaking out very clearly about that fact.
QUESTION: Are Iranian diplomats still welcome at the embassy on Fourth of July, sir?
MR. OBAMA: Well, I think as you're aware, Major, we don't have formal diplomatic relations with...
(CROSSTALK)
MR. OBAMA: ... we don't have formal -- we don't have formal diplomatic relations with Iran. I think that we have said that if Iran chooses a path that abides by international norms and principles, then we are interested in healing some of the wounds of 30 years in terms of U.S.-Iranian relations.
But that is a choice that the Iranians are going to have to make.
QUESTION: But the offer still stands?
MR. OBAMA: That's a choice the Iranians are going to have to make.
QUESTION: Thank you, Mr. President.
Two of the key players in the insurance industry, America's Health Insurance Plans and Blue Cross/Blue Shield, sent a letter to the Senate this morning saying that a government health insurance plan would, quote, "dismantle," end quote, private insurers.
QUESTION: Why are they wrong?
And, secondly, this public plan, is this non-negotiable? Would you sign a health care bill without it?
MR. OBAMA: Well, let's -- let's talk first of all about health care reform more broadly. I think in this debate there's been some notion that if we just stand pat, we're OK. And that's just not true.
You know, there are polls out that show that 70 percent or 80 percent of Americans are satisfied with the health insurance that they currently have.
The only problem is that premiums have been doubling every nine years, going up three times faster than wages.
The U.S. government is not going to be able to afford Medicare and Medicaid on its current trajectory. Businesses are having to make very tough decisions about whether we drop coverage or we further restrict coverage.
So the notion that somehow we can just keep on doing what we're doing, and that's OK, that's just not true. We have a long-standing critical problem in our health care system that is pulling down our economy. It's burdening families. It's burdening businesses. And it is the primary driver of our federal deficits. All right?
So -- so if we start from the premise that the status quo is unacceptable, then that means we're going to have to bring about some serious changes. What I've said is our top priority has to be to control costs.
And that means not just tinkering around the edges. It doesn't mean just lopping of reimbursements for doctors in any given year because we're trying to fix our budget.
It means that we look at the kinds of incentives that exist, what our delivery system is like, why it is that some communities are spending 30 percent less than other communities, but getting better health care outcomes, and figuring out how can we make sure that everybody is benefiting from lower costs and better quality by improving practices. It means health I.T. It means prevention.
So all of these things are the starting point, I think, for reform. And I've said very clearly, if any bill arrives from Congress that is not controlling costs, that's not a bill I can support. It's going to have to control costs. It's going to have to be paid for. All right?
So there's been a lot of talk about, well, a trillion-dollar price tag. What I've said is, if we're going to spend that much money, then it's going to be largely funded through reallocating dollars that are already in the health care system, but aren't being spent well.
If we're spending $177 billion over 10 years to subsidize insurance companies under Medicare Advantage, when there's no showing that people are healthier using that program than the regular Medicare program, well, that's not a good deal for taxpayers.
And we're going to take that money and we're going to use it to provide better care at a cheaper cost to the American people. So, that's point number one.
Number two, while we are in the process of dealing with the cost issue, I think it's also wise policy and the right thing to do to start providing coverage for people who don't have health insurance or are underinsured, are paying a lot of money for high deductibles.
I get letters, two, three letters a day that I read, of families who don't have health insurance, are going bankrupt, are on the brink of losing their insurance, have deductibles that are so high that, even with insurance, they end up with $50,000, $100,000 worth of debt, are at risk of losing their homes.
And that has to be part of reform, making sure that, even if you've got health insurance now, you are not worried that, when you lose your job or your employer decides to change policies, that somehow you're going to be out of luck.
I think about the woman who was in Wisconsin that I was with, who introduced me up in Green Bay, 36 years old, double mastectomy; breast cancer has now moved to her bones. And she's got two little kids, a husband with a job. They had health insurance, but they're still $50,000 in debt.
And she's thinking, my main legacy, if I don't survive this thing, is going to be leaving $100,000 worth of debt.
So, those are the things that I'm prioritizing.
Now, the public plan, I think, is an important tool to discipline insurance companies. What we've said is, under our proposal, let's have a system, the same way that federal employees do, same way that members of Congress do, where we call it an exchange, but you can call it a marketplace, where, essentially, you've got a whole bunch of different plans.
If you like your plan and you like your doctor, you won't have to do a thing. You keep your plan; you keep your doctor. If your employer's providing you good health insurance, terrific. We're not going to mess with it.
But, if you're a small-business person; if the insurance that's being offered is something you can't afford; if you want to shop for a better price, then you can go to this exchange, this marketplace, and you can -- look, OK, this is how much this plan costs; this is how much that plan costs; this is what the coverage is like; this is what fits for my family.
As one of those options, for us to be able to say, here's a public option that's not profit-driven, that can keep down administrative costs, and that provides you good, quality care for a reasonable price as one of the options for you to choose, I think that makes sense.
QUESTION: Wouldn't that drive private insurance out of business?
MR. OBAMA: Why would it drive private insurance out of business? If -- if private -- if private insurers say that the marketplace provides the best quality health care; if they tell us that they're offering a good deal, then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business? That's not logical.
Now, the -- I think that there's going to be some healthy debates in Congress about the shape that this takes. I think there can be some legitimate concerns on the part of private insurers that if any public plan is simply being subsidized by taxpayers endlessly that over time they can't compete with the government just printing money, so there are going to be some I think legitimate debates to be had about how this private plan takes shape.
But just conceptually, the notion that all these insurance companies who say they're giving consumers the best possible deal, if they can't compete against a public plan as one option, with consumers making the decision what's the best deal, that defies logic, which is why I think you've seen in the polling data overwhelming support for a public plan.
(CROSSTALK)
QUESTION: Is that non-negotiable?
MR. OBAMA: Chip?
QUESTION: Thank you, Mr. President.
Following up on Major's question, some Republicans on Capitol Hill, John McCain and Lindsey Graham, for example, have said that up to this point your response on Iran has been timid and weak.
Today it sounded a lot stronger. It sounded like the kind of speech John McCain has been urging you to give, saying that those who stand up for justice are always on the right side of history, referring to an iron fist in Iran, deplore, appalled, outraged.
Were you influenced at all by John McCain and Lindsey Graham accusing you of being timid and weak?
MR. OBAMA: What do you think?
(LAUGHTER)
Look, the -- you know, I think John McCain has genuine passion about many of these international issues. And, you know, I think that all of us share a belief that we want justice to prevail.
But only I'm the president of the United States. And I've got responsibilities in making certain that we are continually advancing our national security interests and that we are not used as a tool to be exploited by other countries.
I mean, you guys must have seen the reports. They've got some of the comments that I've made being mistranslated in Iran, suggesting that I'm telling rioters to go out and riot some more. There are reports suggesting that the CIA is behind all this. All of which patently false. But it gives you a sense of the narrative that the Iranian government would love to play into.
So the -- you know, members of Congress, they've got their constitutional duties, and I'm sure they will carry them out in the way that they think is appropriate. I'm president of the United States, and I'll carry out my duties as I think are appropriate.
QUESTION: By speaking so strongly today, aren't you giving the leadership in Iran the fodder to make those arguments...
MR. OBAMA: You know...
(CROSSTALK)
QUESTION: ... that it is about the United States?
MR. OBAMA: Look, I mean, I think that we can parse this as much as we want. I think if you look at the statements that I've made, they've been very consistent. I just made a statement on Saturday in which we said we deplored the violence.
And so I think that in the hothouse of Washington, there may be all kinds of stuff going back and forth in terms of Republican critics versus the administration.
That's not what is relevant to the Iranian people. What's relevant to them right now is are they going to have their voices heard. And, you know, frankly, a lot of them aren't paying a lot of attention to what's being said on Capitol Hill and probably aren't spending a lot of time thinking about what's being said here.
They're trying to figure out how can they make sure justice is served in Iran.
QUESTION: No news in your statement today.
MR. OBAMA: Chuck Todd?
QUESTION: Mr. President, I want to follow up on Iran. You have avoided, twice, spelling out consequences. You've hinted that there would be from the international community, if they continue to violate -- and you said "violate these norms." You seemed to hint that there -- there are human rights violations taking place.
MR. OBAMA: I'm not hinting. I think that when a young woman gets shot on the street when she gets out of her car, that's a problem.
QUESTION: Then why won't you spell out the consequences that the Iranian people...
MR. OBAMA: Because I think that we don't know yet how this thing is going to play out. I know everybody here is on a 24-hour news cycle. I'm not. OK?
QUESTION: Shouldn't -- I mean, shouldn't the world...
(CROSSTALK)
MR. OBAMA: I answered -- I answered...
QUESTION: ... present regime know that there are consequences?
MR. OBAMA: I answered your question, which is that we don't yet know how this is going to play out. OK?
QUESTION: Thank you, Mr. President. Before I ask my question, I wonder if you could actually answer David's: Is the public plan non- negotiable?
MR. OBAMA: All right, if that's your question.
(LAUGHTER)
You think you're going to -- are you the ombudsman for the White House press corps? What's your question -- is that your question?
(LAUGHTER)
QUESTION: Then I have a two-part question.
(LAUGHTER)
(inaudible) non-negotiable?
And, while I appreciate your Spock-like language about the logic of the health care plan and the public plan, it does seem logical to a lot of people that if the government is offering a cheaper health care plan, then lots of employers will want to have their employees covered by that cheaper plan, which will not have to be for-profit, unlike private plans, and may, possibly, benefit from some government subsidies, who knows.
And then their employees would be signed up for this public plan, which would violate what you're promising the American people, that they will not have to change health care plans if they like the plan they have.
So...
MR. OBAMA: OK. You're pitching; I'm catching.
QUESTION: OK.
(LAUGHTER)
MR. OBAMA: I got the question.
First of all, was the reference to Spock, is that a crack on my ears?
(LAUGHTER)
QUESTION: No.
MR. OBAMA: All right. I just wanted to make sure. No?
QUESTION: Never make fun of you (inaudible).
MR. OBAMA: In answer to David's question, which you co-opted, we are still early in this process. So, you know, we have not drawn lines in the sand, other than that reform has to control costs and that it has to provide relief to people who don't have health insurance or are under-insured. You know, those are the broad parameters that we've discussed.
There are a whole host of other issues where ultimately I may have a strong opinion, and I will express those to members of Congress as this is shaping up. It's too early to say that.
Right now, I will say that our position is that a public plan makes sense.
Now, let me go to the -- the broader question you made about the public plan. As I said before, I think that there is a legitimate concern, if the public plan was simply eating off the taxpayer trough, that it would be hard for private insurers to compete.
If, on the other hand, the public plan is structure in such a way where they've got to collect premiums and they've got to provide good services, then, if what the insurance companies are saying is true, that they're doing their best to serve their customers, that they're in the business of keeping people well and giving them security when they get sick, they should be able to compete.
Now, if it turns out that the public plan, for example, is able to reduce administrative costs significantly, then you know what, I'd like the insurance companies to take note and say, hey, if the public plan can do that, why can't we?
And that's good for everybody in the system. And I don't think there should be any objection to that.
Now, by the way, I should point out that part of the reform that we've suggested is that, if you want to be a private insurer as part of the exchange, as part of this marketplace, this menu of options that people can choose from, we're going to have some different rules for all insurance companies, one of them being that you can't preclude people from getting health insurance because of a pre-existing condition. You can't cherry-pick and just take the healthiest people.
So there are going to be some ground rules that are going to apply to all insurance companies. Because I think the American people understand that, too often, insurance companies have been spending more time thinking about how to take premiums and then avoid providing people coverage than they have been thinking about how can we make sure that insurance is there; health care is there when families need it.
But, you know, I'm confident that, if -- you know, I take those advocates of the free market to heart when they say that, you know, the free market is innovative and is going to compete on service and is going to compete on, you know, their ability to deliver good care to families.
And if that's the case, then this just becomes one more option. If it's not the case, then I think that that's something that the American people should know.
QUESTION: I'm sorry, but what about keeping your promise to the American people that they won't have to change plans even if employers...