With the cost of health care reform looming over current legislative efforts, President Obama today told CBS News Medical Correspondent Dr. Jon LaPook that he would support measures designed to tax the wealthiest Americans.
In legislation introduced yesterday, House Democrats proposed raising the taxes of those who make more than $1 million a year by 5.4 percent.
The president acknowledged the House and the Senate may have different ideas about how to pay for reform. He did not specifically express support for House Democrats' proposed tax increases or another particular proposal on the table.
However, he said, "The general notion that those of us who are the best off can pay a little bit more upfront to help reform a system that will save us money over the long term, I think that's a good idea."
He also advocated an employer mandate, which would require employers to either provide insurance to their workers or pay into the public system.
"If a company can afford it, it needs to pony up a little bit if it's not providing insurance directly," Mr. Obama said -- otherwise, taxpayers are left to foot the bill for emergency room costs.
Many small businesses are simply not providing health care coverage because it is too expensive, he said. By entering into the health insurance exchange the final reform package is likely to include, small businesses and individuals would have the negotiating power to get lower costs.
"That is something that a lot of small businesses want," he said.
The president acknowledged that in order to create the efficiencies in health care he is calling for, some more experimental treatments may not be eligible for insurance coverage.
"We're going to have to make some difficult decisions as a society about that," he said. He added, however, that "right now, we're just wasting so much (money), we don't even have to wrestle with those more difficult ethical questions."
The main focus now, Mr. Obama said, should be creating cost efficiencies in simple ways like replacing prescriptions for brand name drugs with prescriptions for generic medications.
"What we know is that right now there's a whole lot of care that's not improving health," he said. "Those are the situations that we should immediately be focused on."
LaPook pointed out there are many examples of treatments that could come into question under the president's plan. For instance, 30 percent of angioplasties -- the technique of opening up a clogged artery-- are unnecessary.
For those cases, a reimbursement scheme must be developed, Mr. Obama said, so "at the very least, you're not taking money out of physician's pocket for making the better choice."
There will be other tough decisions for the nation to grapple with, the president said, such as improving end-of-life care.
"My hope is as a culture and a society we're going to be able to have an in-depth discussion," Mr. Obama said, so people can agree to "control this end of life process in a dignified way that's good for (one's) family."