The president said the government already runs Medicare and Medicaid and regulates the health industry. Furthermore, he said, government involvement can improve health care because the private sector has not done all it can to provide quality care at the lowest possible cost.
"That initiative hasn't been forthcoming," Mr. Obama said. "The average family has seen their premiums double in the last nine years. If you're happy with your health care, ten years from now, you're not going to be happy because it's going to cost twice as much or three times as much as it does right now."
Held in the East Room of the White House and hosted by ABC, Mr. Obama used the town hall forum to defend the idea of comparative effectiveness research, a potential part of health care reform in which more support would be given for research-backed treatment. Members of the 164-person audience questioned, though, whether the government should be involved in determining what treatments are worth paying for.
"Those decisions," he said, "if they're not being made by Medicare and Medicaid, they're being made by private insurers."
The president spoke about how his mother and her doctors had to decide whether she should receive a hip replacement, even after she had been diagnosed with cancer. Those decisions, he said, should be left up to patients and doctors -- not bureaucracies -- and be based on science.
"What we can do is make sure at least some of the waste in the system... loading up on additional tests or additional drugs... at least we can let doctors know this isn't going to help those kinds of decisions between doctors and patients," Mr. Obama said. "There is a whole bunch of care that's being provided that every study, every bit of evidence we have, indicates may not be making us healthier."
In spite of the doubtful questions about the president's reform agenda, the audience unanimously agreed at the beginning of the meeting through a show of hands that the nation's health care system must be changed.
"Let's stop now" the president said in response, prompting laughs.
The Republican National Committee criticized the ABC town hall for leaving out the voices of Republican lawmakers, calling it an "infomercial" for the president's plan. Additionally, a group of 40 Republican congressmen signed a letter to ABC, sent by a new group called The Media Fairness Caucus, that said the town hall "gives the American people a slanted view" on the health care debate.
The White House has signaled to senators that it is interested in a bipartisan plan. Sen. Chuck Grassley, the ranking Republican on the Senate Finance Committee, said on MSNBC this morning that in order for a bill to be bipartisan, it cannot include a public option -- a government-sponsored insurance plan.
Mr. Obama has strongly supported the public option but has stopped short of calling it non-negotiable. The necessary elements for reform, he has said, are cost control and access to coverage for the currently uninsured.
Mr. Obama said in the town hall that about two thirds of the cost of his plan would be covered by re-allocating dollars already in the system. He mentioned ways to raise revenue that he has discussed before, such as limiting tax deductions for wealthy Americans. Furthermore, he said, there will be savings from the improvement of preventative care and other reforms that are currently unaccounted for.
"We expect that not only are we going to be able to pay for health care reform, but that it's also going to achieve big savings in the system," he said.