President Obama Talks to Katie Couric

Katie Couric and President Barack Obama, July 21, 2009
CBS Evening News Anchor Katie Couric interviewed President Obama at the White House on July 21, 2009.

Katie Couric: Mr. President, I know you met with House Democrats earlier this afternoon who were opposed to the House bill on health care, because of concerns about the deficit, taxing the wealthy, controlling long term spending. In fact, 40 House Democrats opposed the bill as it's currently written. Did you make any progress?

President Obama: We did. And they acknowledged that we made progress. You know, my working principle has been, number one, let's make sure that this package provides more choices to the American people, gives them more security, if they've got a preexisting condition, or they lose their job, or they're changing jobs.

It's got to be deficit neutral. It can't add to our deficits. And it's got to bring long term costs down. And I think, rightly, a number of these so called Blue Dog Democrats - more conservative Democrats - were concerned that not enough had been done on reducing costs.

It's the same concern that I shared. And we talked today with Henry Waxman, the chairman of the committee that was relevant. And I think that we're moving in the direction where, at the end of the day, by the time we have a bill on the floor, we will be able to say, unequivocally, that this is going to bend to the cost curve so that health care inflation is reduced. That's going to be good for American families. That's going to reduce their costs and make the system work better for everybody.

Katie Couric: But it's not going to add to the deficit?

President Obama: It will not add to the deficit. I will not sign a bill that adds to the deficit. Period.

Katie Couric: What about the nonpartisan Congressional office figures. As you know, you've heard that, that the House plan, as it stands, would add $230 billion to the deficit over 10 years.

President Obama: I mean, part of what you know, I haven't been in Washington as long as some of these folks, but you find out that you go forward in fits and starts. And I think that what is fair to say is that the Congressional Budget Office did not see enough of the cost savings to offset the increases for expanding coverage for all people.

And that's what we talked about today. That we've got to make sure that the cost savings are there, because there's so much waste in the system, Katie, that we know can be reallocated to reduce cost for families, make sure they've got health insurance, if they can't currently afford it.

The problem is grabbing onto those costs. Making sure that if we're subsidizing insurance companies that are already profitable, to the tune of $177 billion, let's take that money out. Let's make sure that that's going to families that could use some help to get health care.

Katie Couric: But aren't a lot of these cost savings, Mr. President, theoretical? I know you've said that the CEO and some leading economists say this plan has a good chance of working. But there are no guarantees these projected savings will really happen.

President Obama: Well here's what we know. Here is a guarantee: If we do nothing then health care inflation is going to keep on going up at eight percent, nine percent, 10 percent a year. It means that family premiums are going double over the next ten years at least.

It'll go up three times faster than wages go up. People's out of pocket costs are going to be higher. So we know that standing still means that more and more people are going to lose their health care or it's going to be less and less affordable. That's if we do nothing.

If we take these actions, we are confident that we can actually see some serious reductions in health care inflation. And, in fact, there have been times, for example, in the 1990s, where you actually saw health care inflation drop down to zero. But then it started jumping back up again. And so what we have to do is have to have a sustained effort. And all the ideas that have been put forward by health economists and the congressional budget office are ideas that, I think, we're going to try to make sure are incorporated into this bill.

Katie Couric: One of the sticking points in the House bill is a tax on people who make $280,000, or over that amount. Nancy Pelosi is reportedly saying, "Hey, let's raise taxes on people who make $500,000 a year, and on joint filers for those who make a million dollars. So it could be a millionaire's tax." It might be more politically palatable. What do you think of that?

President Obama: Well, here's what I think. Nobody wants to pay more taxes. I don't want to pay more taxes. You don't want to pay more taxes. On the other hand, I think we all recognize that, in a country like ours, we shouldn't have 46 million people without health insurance, and we shouldn't have a whole lot of other people who have health insurance, but the deductibles are so high, or the premiums are so high, that they can barely afford it. And so if we've rung out all the waste and inefficiency in the system, if we've reallocated, as I've proposed, that money that is being wasted that is already in the system, taxpayers are already paying for this. For example, on these subsidies to insurance companies.

We've taken that money and we've reallocated it so it's being spent well. And there's a little bit left that we've got to cover. Then I would rather have somebody like myself pay for it, who can afford to pay a little bit more, than I would to see middle class families burdened with higher and higher health care cost. So you know, I think that the proposal that Nancy Pelosi put forward is one way of doing it. The Senate Finance Committee is exploring a whole range of other options.

And I'm confident, that at the end of the day, that we will have found a way to pay for this that meets my earlier pledge that we're not going to see taxes increase for anybody making less than $250,000 a year. And we're going to do it in a deficit neutral way so that this thing is actually paid for.

Katie Couric: So you are not opposed to a tax hike for some of the wealthiest Americans. Either for those who make over $280,00 a year, or those who make over $500,000 a year.

President Obama: I am not opposed to people, like myself, who are at the, you know, top of the income bracket, paying a little bit more, if …

Katie Couric: You can't come up with another way to pay for it.

President Obama: If, as a consequence, middle class families are seeing their cost reduced, and if we've taken all of the waste out of the system that we can, and put that into the kitty. Because I don't think what's fair for people is to feel like we're not doing anything about the waste and we're going to tax folks. I think that's the kind of thing that the American people would be opposed to, and I would be, too.

Katie Couric: You said that if Congress doesn't have a deadline things don't get done in this town. But Democrats, like, Kent Conrad, are also saying, quote, "Sometimes, when you move too quickly, you make mistakes." So is this really something you want to dig in your heels on? I mean, is there any flexibility on this August deadline?

President Obama: Well, I want to keep the pressure on. Because we're making steady progress. People are working hard. I just met with these House Democrats. And they were in there for three hours. I could only join them for an hour. I understand that the Senate Finance Committee is meeting three times today.

That kind of work is going to produce good results. And it means that people are really digging in and getting to know how can we make sure that we're preserving people's choice of plan and option? If they already have health insurance, how can we reduce cost?

How can we make sure that preexisting conditions don't bar people from getting health insurance? If we figure out all those things over the next several weeks, then I think the American people are going to be happy with the end product. Here's what I won't do. I won't, as I said before, I won't sign a bill that I think does not reduce costs - does not keep deficit neutral. And does not benefit middle class families in America. So I want to put the pressure on. But, ultimately, the test is: Is this a bill that I think is going to be better for the American people or not? And, if it's not, then, you know, we'll keep at it.

Katie Couric: So, if it's not, you'll have some flexibility on this deadline.

President Obama: If I'm not happy with the end product, I will not sign a bill.

Katie Couric: Because, surely, you don't want to ram something through. After LBJ took a year and a half to get Medicare passed. As I know Senator Olympia Snow reminded you recently.

President Obama: She did. And I think that's fair. Look, part of what's going on, though, is remember we've been talking about this for four years. We've been studying this at infinitum. Starting in November, after my election, a lot of members of Congress, including the chairman of the Finance Committee, Max Baucus, started-- meeting and working through ideas.

So we've actually been working on this for a good solid nine months now. And I think that if we keep working, that I'm confident that we can get this done. ButI want the American people to understand I have no interest in creating a bad bill. That doesn't serve me. And it certainly doesn't serve the American people. Well, if we've got a bill that doesn't work.

Katie Couric: You are really putting yourself out there, front and center, on this issue. Which may be risky. Are you concerned at all that if health care reform fails it will be a huge and devastating setback to your presidency? And may put some of the rest of your agenda in peril?

President Obama: I think that the easiest way to keep your poll numbers up, and to garner good press, is to do not that much here in this town, and not to cause a lot of controversy. And there's some people who would probably advise that that's the approach you should take.

You know, take it slow. Don't make too many sudden moves. But that's not why the American people sent me here. They sent me here to solve problems. And my attitude is that I would rather work as hard as I can on the things that matter most to the American people, bringing down their health care costs, getting control of our energy agenda, improving our education system, regulating our financial system so that we don't have another crisis again.

Those things need to be done. Sometimes, in Washington, inaction is sort of the preferred way of doing business. I want to make sure that during the time that I'm here, that we're as productive as possible. And so far, at least I think if you look back, over the last six months, we have done an extraordinary amount of good even though my staff reminds me that they're not getting enough sleep.

Katie Couric: There's a lot of talk about momentum right now. And, of course, in the first month of the presidency, that's when the political wind is with you. Are you worried, if you can't get something passed soon, health care reform will be DOA?

President Obama: There have been so many times, during my political career, certainly, during the presidential race and even over the the last six months, where people have said, "Boy, this is make or break for Obama." That was true when I was in Iowa.

And people were sure that we weren't going to win. That was true, you know, during periods in the general election. When the stock market went down everybody was saying, "This is a disaster." And what I found is that as long as we are making good decisions, thinking always what's going to be best for the American people, that eventually, as long as we're persistent, and we're listening to the American people, that things get done.

So I think that we have a lot of work to do before we finally sign a health care bill. I think that the American people, understandably, are wary of changes such a big part of our lives as health care. And they want to make sure they understand it.

I've got to make sure I'm doing a good job explaining it. I think congress has to work with our administration to meet the demands of deficit neutrality and serious cost savings. But you know, we really don't have a choice. If we don't do this then Medicare and Medicaid costs are going to keep on spiraling.

The deficit will become out of control. We'll have a situation in which family premiums are going to keep on going up. And, you know, the worst thing that I could do is to not take the steps that are necessary, and then look back, four years or five years from now, and realize that more families don't have health insurance, and costs have been going up, and the deficit has gone up even higher.