Interviewer: Jim Lehrer
JIM LEHRER: Mr. President, it must have been a little unpleasant for you to wake up this morning and see this headline: Washington Post poll shows Obama slipping on key issues, approval rating on health care falls below 50 percent. What's that mean?
U.S. PRESIDENT BARACK OBAMA: It means that what we're doing is hard and, you know, the truth is I feel pretty good about the fact that our polls have held up under extraordinarily difficult circumstances. You know, I think we may have set a very high bar for ourselves. Normally at 59 percent, folks would say, "We'll take it."
On health care in particular, look, there's a reason why this hasn't been done in 50 years and that is because this is a big, complex situation, a lot of special interests here in Washington who are very protective of the status quo. But what the American people understand is that the status quo is unsustainable, that their premiums are doubling, their out-of-pocket expenses have skyrocketed.
We've got 46 million people without health insurance. It is bankrupting families; it is bankrupting businesses and ultimately could bankrupt the federal government. So they know that. They want change. Now, when you start getting into details, it's pretty easy to get people wondering, "Gosh, you know, is the devil -- I know better than the devil I don't."
And that's why it's so important for me to be consistently clear about the fact that under every proposal that I've discussed people would not have to give up their health care plan if they're happy with it. They don't have to change doctors if they're happy with it.
We want to give them more choices -- make sure that they have the kind of insurance reforms in place so that we don't have to see people excluded because of a preexisting condition from care, if they lose their job, if they change jobs.
So the congressional process, people are always a little suspicious of. I'm confident, though, that in the end, any bill I sign is going to make more people secure in their health care and it's going to drive down costs over the long term.
JIM LEHRER: You still believe the House and Senate will pass something by the August recess, which is barely three weeks away?
PRESIDENT OBAMA: I am -- I think this is actually a good example of where the focus tends to be on what we haven't gotten done yet rather than what we've done. We have three out of the five committees that have jurisdiction over this thing have already passed a bill. We've got support from the American Medical Association -- so the nation's doctors have said we are supportive of the president's approach.
We have the nurses -- so the people who know health care best have said we're supportive. We've got the hospitals saying we're supportive. We've got AARP, the American organization of retirees, saying we're supportive. And so we actually have made, I think, extraordinary progress. Now, we've got this last little bit to go and that includes some very tough questions: primarily, how do you pay on the front end for coverage of the people who don't currently have it? Because what I've said is I'm not going to add to the deficit. We've got to pay for whatever we're doing.
And how are we going to then make sure that we're controlling health care inflation on the back end? Those two questions are tough, difficult questions, but that's why presumably these folks got elected -- that's certainly why I got elected -- to solve these hard problems. Here's what I think -- that people like myself, who can afford to pay a little bit more in taxes, should do so in order to help people who are desperate for a little bit of security when it comes to their health care.
Communicating health reform goals
JIM LEHRER: As you know a lot of the commentary over the weekend was that nothing's going to happen getting from here to the final hurdle here unless you really start cracking some heads, and really say, "Hey, this is the Obama plan, this is what I want. So much for what this committee wants and what that committee wants. Here's what I want. I'm going to push and go." Are you ready to do that?
PRESIDENT OBAMA: You know, the interesting thing is we've actually been very clear on what we want. I've said that I want to make sure that if you have health care you're going to keep it. I've said that we've got to reform the insurance industry so people aren't being excluded for preexisting conditions, that it's not as easy for insurance companies to dump people when they change jobs or if they lose their job. I've been very clear about the fact that it has to be paid for. I've been very clear about the fact that we should have a public plan.
So we've laid a whole bunch of markers out there. And this week, as members of Congress have worked their way through this process and examined what all the options are, what we're going to be doing is bringing some of them into the White House and --
JIM LEHRER: To crack heads?
PRESIDENT OBAMA: Oh, I don't know about cracking heads -- facilitating --
JIM LEHRER: Facilitating! OK.
PRESIDENT OBAMA: Facilitating a discussion that solves these problems.
JIM LEHRER: All right, but there are several things out there. Taxing the wealthy to pay for this -- are you in favor of that?
PRESIDENT OBAMA: Well, here's what I think -- that people like myself, who can afford to pay a little bit more in taxes, should do so in order to help people who are desperate for a little bit of security when it comes to their health care. Now, I actually think that the best way to do that is simply to cap deductions that wealthy people can take at a 35- or a 36-percent rate, compared to ordinary folks who are only taking a 28-percent rate. I think that's going --
JIM LEHRER: Rather than tax them.
PRESIDENT OBAMA: Rather than tax them, right. And that would raise a sufficient amount of money to pay for any new people who are joining into this health insurance reform package. But I understand that there are other ideas that are being bandied about and not all of them are going to be the same.
There are going to be some folks in the House who want to impose a surcharge; there are some in the Senate who are looking at a whole menu of different options in terms of raising the money. The gap, though, is one that I think can be closed relatively easily if everybody is committed to making sure that we get this done.
JIM LEHRER: What about taxing health benefits?
PRESIDENT OBAMA: Well, I said during the campaign -- when this was raised by John McCain, he had proposed to eliminate completely the exclusion on the taxation of health benefits. I had said that this would be the wrong way to go because it would be too disruptive. Essentially employers would stop providing health care. John McCain had suggested everybody gets a tax credit, but the concern was that the tax credit wouldn't be sufficient to actually buy health insurance on the market. So I am still opposed to that and would veto a bill if that was the approach.
What's being talked about now, I understand, is the possibility of penalizing insurance companies who are offering super, gold-plated, Cadillac plans. I haven't seen the details of this yet, but it may be an approach that doesn't put additional burdens on middle-class families. My whole goal is not to add burdens to folks who are already having tough times affording insurance, but actually to relieve it. And so I've got to look at the details of that before I make any kind of final determination.
Make no bones about it, I am pushing hard because I think that it's important not only for American families but also for our long-term competitiveness and I think it's important for our long-term deficit and debt.
Flexibility on August deadline?
JIM LEHRER: But do I read you correctly that you're backing off the August deadline, kind of thing -- that you wanted it passed by the August session?
MR. OBAMA: Here, I think, is a fair assessment, Jim: I want this done now. Now, if there are no deadlines, nothing gets done in this town. You've been around here long enough to know that you have to say, get this done. If somebody comes to me and says, it's basically done; it's going to spill over by a few days or a week -- you know, that's different. If people say, as, for example, a Republican senator said over the weekend, that we just want to keep on delaying and delaying this thing because we think this is going to be Obama's Waterloo -
JIM LEHRER: Yeah, Sen. DeMint of South Carolina said that.
PRESIDENT OBAMA: And we can break him by -
JIM LEHRER: What's that all about? What is he talking about?
PRESIDENT OBAMA: Well, I think what he is talking about is there is a certain portion of the Republican Party that views this like they saw '93, '94, the last time there was a major health-reform effort. They explicitly went after the Clintons, said we're not going to get this done. That went down and the -- at least the history, the way it's viewed here in Washington -- is that that is what helped defeat Democrats. So it was a pure political play, a show of strength by the Republicans that helped them regain the House.
I think there are folks who think that we should try to dust off that old playbook. What they don't recognize is, this isn't about me; it's about the American people. And things have gotten worse since 1993. More people are uninsured. Everybody's expenses are higher. The system is even more inefficient. And so rather than play political games, I think I expect people to try to be constructive.
And, to their credit, I think that there are Republicans on the Senate Finance Committee -- you know, Chuck Grassley, Olympia Snowe, Mike Enzi -- who are engaged in some very difficult, very serious negotiations despite some pressure from the political operatives in their party that say, you shouldn't try to be constructive or responsible. So I give them credit for that.
JIM LEHRER: You say it's not about you, but, Mr. President, this is now the Obama push for health care reform in this country, is it not? I mean, isn't this your -
PRESIDENT OBAMA: Oh, yes. No, no, no, no. I -
JIM LEHRER: You'll take the heat for this. The good heat or the bad heat?
PRESIDENT OBAMA: I am proud of the fact that I think this has to be done. And make no bones about it, I am pushing hard because I think that it's important not only for American families but also for our long-term competitiveness and I think it's important for our long-term deficit and debt.
Here is the irony of some of the debates that I hear from the other side: Everybody acknowledges that the single biggest threat to our fiscal stability is Medicare and Medicaid. It's not even close. That is the single thing that could drive us into long-term staggering and difficult debt.
And, yet, the other side doesn't want to reform the system in a way that would actually reduce costs. And when you ask them, well, what is it that you want to do, they kind of mumble and mutter, but don't have an answer. And so we're very specific. What we have said is, we want to reform Medicare, reform Medicaid, stop providing $177 billion worth of subsidies to the insurance companies for a Medicare Advantage program that offers no additional benefits to seniors compared to regular old Medicare.
We have provided very specific measures to reduce costs. And I -- if folks are sincere and serious about deficit reduction over the long term then they can't deny that we have to reduce our health care costs. And it's not easy to do because it involves changing how delivery systems work; it involves changing how doctors are reimbursed so that they are rewarded for quality of care and not just quantity of care. And that's why we have suggested taking a Republican idea of something called a MedPAC board, a commission of medical experts -- doctors and health professionals -- to determine ongoing changes and continuing improvement in how the Medicare system works. We actually think that will help drive a lowering of costs across the system.
JIM LEHRER: And you're not -- you will not be satisfied by somebody or some group or somebodies that say, "Well, OK, let's do it -- but we can't do it now; we have economic things to do. We have other things in the economy to deal with; let's wait a year, let's wait six months. Forget it, huh?"
PRESIDENT OBAMA: If not now, when? We have literally been waiting 50 years and we still haven't gotten it done. And the longer we delay, the more those special interests that benefit from the system as it is, the more they are going to fight change. And when you've got doctors, nurses, hospitals, the AARP and even the drug companies -- as well as major employers like Wal-Mart -- saying now is the time for us to bring about some change, I think it's time for us to bring about some change. The problem that I've seen ... is you don't get a sense that folks on Wall Street feel any remorse for having taken all these risks; you don't get a sense that there's been a change of culture and behavior as a consequence of what has happened.
State of the economy
JIM LEHRER: Speaking of the economy, do you share the concern and growing anger by some people over the fact that these big Wall Street banks are suddenly making these huge profits while the unemployment rate continues to go up, foreclosures continue to rise, all kinds of other bad things are happening to individual Americans on the economy. Do you share that? What's going on?
PRESIDENT OBAMA: Well, here's what happened. You had a Wall Street that took excessive risks, acted irresponsibly and almost dragged the entire economy into a depression. We had to intervene and did to stabilize the financial system because if you had a complete meltdown, then things would actually be far worse. Unemployment would be higher and it would be even harder for us to get out of the hole.
The problem that I've seen, at least, is you don't get a sense that folks on Wall Street feel any remorse for having taken all these risks; you don't get a sense that there's been a change of culture and behavior as a consequence of what has happened. And that's why the financial regulatory reform proposals that we put forward are so important. And I know that people think that we're doing a lot.
Well, this is one more thing that we're going to have to make sure that we do, is to institute the financial regulatory programs that prevent them from taking some of the wild risks they took previously. And I also think that when it comes to issues like compensation, that at the very least, shareholders should be able to weigh in before these companies are giving these massive bonuses to high-level executives.
JIM LEHRER: But, Mr. President, the point here is in the last week or so, you know, JPMorgan Chase, Goldman Sachs -- huge profits. And these are companies that survived because of federal rescue or federal bailout money -- whatever you want to use -- and so Wall Street got help but a lot of these other people didn't get help. That's the question I'm getting at.
PRESIDENT OBAMA: Well, I think two points. One is, the financial system, if we didn't stop the bleeding in the financial system, then it would have been even worse for everybody.
Everything that we're doing right now is designed not only to get through this immediate crisis but to set the stage for long-term economic growth in the future.
Help for main street
JIM LEHRER: So you don't have any second thoughts about that?
PRESIDENT OBAMA: That I don't have second thoughts about. I do have some concerns about how it was initially structured before I was sworn in -- keep in mind that the bank bailout was structured back in '08 before we were sworn in -- but the need to intervene I completely agree with. I also think that we did the right thing by capping executive compensation for banks that are still getting TARP money -- still getting bailout money.
Now, there are some companies, like Goldman Sachs, that have paid the money back and that means that we don't have the same kind of levers on them that we might have. And that's why I think it's important to pass this broader financial regulatory reform package. In the meantime, what we're trying to make sure of is that -- everything I do, every morning, I ask my economists: "How can we create more jobs in the economy? How can we help small businesses? How can we make sure that the housing market is stabilized?"
And we are succeeding in making sure that we are stopping some of the job loss that would have otherwise been there. The help that we've given to the governors alone: $144 billion -- that means teachers and police officers and firefighters aren't being laid off. The green energy jobs that we're creating -- that is making a difference. On the housing side, there are hundreds of thousands of folks out there who have been able to modify their homes so that they're not losing them.
But what is absolutely true is that we can't do everything, because the economy is so massive and the hit that it took from this economic crisis was so big. And so our job is to -- with the resources that we've got -- try to maximize the help that we're getting to Main Street and to try to pressure Wall Street to do its part in making sure that credit is available so that businesses can start picking up again.
JIM LEHRER: People should be optimistic?
PRESIDENT OBAMA: Here's how I'd put it: I think that we have stepped back from the abyss. I think we've put out the fire. The analogy I use sometimes is, we had this beautiful house. And there was a fire. We came in and we had to hose it down. The fire is now out, but what we've discovered is, we need some new tuckpointing, the roof's leaking, the boiler's out, oh, and by the way, we're way behind on our mortgage.
And so you've got to make a series of decisions about, with the limited resources that you've got, OK, you've got to pay the mortgage down a little bit -- that's the equivalent of our fiscal problems on our debt -- but we've also got to make sure the roof doesn't collapse, we've got to do some tuckpointing -- all that stuff is going to take some time. And so we're not out of the woods yet, and nobody's more mindful than I am of the difficult, difficult times that people are feeling right now.
And all I can tell them is that the steps we are taking are designed to improve the job prospects and the economic prospects of ordinary families. That's my whole orientation. Everything that we're doing right now is designed not only to get through this immediate crisis but to set the stage for long-term economic growth in the future.
JIM LEHRER: Mr. President, thank you very much.
PRESIDENT OBAMA: Thank you, appreciate it, Jim.