awards for people who sue for medical malpractice. the president also told a town hall meeting that he understand the complaint of doctors and other health-care professionals that the threat of lawsuits is driving up costs. that town hall meeting is next on c-span. after that, a forum on the future of the republican party. we will hear from the national review and congressman paul ryan of wisconsin. >> how c-span funded? >> publicly funded. >> donations? >> government? >> it is a public funding thing? >> policies been funded? 30 years ago, they created it as a public service, a private business initiative.

no government mandate or money. . . >> and the largest trainer of health care work force

professionals in the washington metropolitan area. i want to thank the president and the community college assistant for being such great hosts today. we are joined by numerous officials, and i will name them all, but we have federal, state, local, from boards of supervisors to senators here on such an incredible topic. we are glad to have them. the president has had plenty to do in the last five months working to bring our american economy back, regulate credit cards, regulate tobacco so our kids will be safe. so many issues, pay equity for women. but in the massive issues, he has not failed to pay to virginia. he has not failed to pay attention to fambing -- fairfax county. we stood at the edge of the fairfax parkway, a long

project, and thanks to the support of our representatives from congress, that bill was passed, and the president signed it. and today of the dollars going to virginia from the transportation infrastructure, the two largest projects are the two sections of the parkway. that happened balls of this president. [applause] >> and in may, at mount vernon, i stood together with lisa jackson, the present e.p.a. administrator as she announced a first, the first-ever presidential executive order about chesapeake bay to truly save the bay. it was a historic day and again, it happened because of this president right here in fairfax county. today her here to talk about an important issue, the issue of health care. we have done some wonderful things in virginia, but we are working at the margins, because in virginia and in the nation, one in seven americans and one

in seven vearns don't have health insurance, and those that do find serious difficulties in costs and quality. our president is joining us today to talk about that, and it is so great to welcome him here. i want to introduce the moderator of the session today as the president gives remarks and takes questions from the add conference. valerie is the senior advisor to the president who is both the senior advisor and assistant for intergonchtal affairs. she is a long long-time friend of the president and has worked in several capacities in washington. of particular note, this topic, the need for health care reform, is one that she knows a lot about. she was the chairman of the university of chicago medical center board of trustees working on training of health

professionals and provision of care through the university of chicago hospital. please join me in giving a great northern virginia welcome to valerie jarrett? [applause] >> thank you, governor kaine, and good afternoon everybody. we are delight delighted to have you all here. we are going to really try to get everyone engaged. i want to first start by thanking the people from the northern virginia community college. we have students, we have administrators, faculty and staff. thank you all for being here, and we look forward to your participation. also all of those who are here from the annandale community, a community that has been very hard hit by the health care crisis that we face here in america. as health care reform moves

through congress, it is important to president obama that we take the time to engage the american people. we want to hear their questions. owe about want to engage them and have the president have an opportunity to answer their questions. in addition to the people we have here today, we are also live-streaming this session over the internet. we want to make sure that everybody has a chance to get in the action and participate. so we are going to have a multidimensional session, if you win, three different ways. first of all, we are going to have a chance to hear the video responses to the questions that were put to us here today. over the we could the president did a youtube video, and he actively solicited questions, and so we will have video questions first. in addition, the white house is doing a live chat on white house.com and our facebook page. my guess is we are going to also have some questions coming across from twitter. all this is going on while the president is answering questions.

if you see a nice gentleman come across the stage and hand me a question, it is because we are going information coming across. and then of course we want to hear from those of you in the audience as well. so the audience, the facebook as well as the videos all coming at us at the same time. so, let's get started. without any further adieu, i would like to introduce to you the person whose first priority is passing health care reform this year. please welcome to our town hall, president barack obama. [cheers and applause] [cheers and applause]

>> good to see you guys. thank you, everybody. thank you. [cheers and applause] >> thank you, northern virginia. thank you very much. everybody please have a seat. have a seat. what a wonderful welcome, and i'm so grateful to all of you for taking the time to be here. a couple of quick acknowledgements. i want to thank the college president and others for their hospitality. we have some extraordinary elected officials. first of all, you have got one of the finest governors in the country. please give tim kaine a big round of applause. [applause] >> part of the reason tim is such a good governor is because he took notes while being lieutenant governor to the former governor and now senator for the state of virginia, an outstanding public servant,

mark warner. [applause] >> and three outstanding members of congress, bobbie scott, jim moran, and mr. conley. thank you guys for the great job you do every day. i know there are all kinds of stuff valerie was explaining. don't worry. she is in charge, and she will organize us. i want to give a few remarks at the outset and we will save most of the time for questions. it is wonderful being here in annandale, and i am looking forward to answering questions about what is obviously one of the most important issues faces american families, american businesses and it is american government. but before i begin, i just want to say a few words about where we are as a nation, and where we need to go. we are living through extraordinary times. i don't need to tell you. this generation of americans, our generation, has been called

to confront challenges of a magnitude that we have not seen in decades, perhaps unlike anything we have seen in recent history, challenges that few generations of americans are asked to face. in addition to the immediate threats that we face, we've got two wars going on and a very deep recession. our economy has always been weakened by problems that have plagued us for decades. the question of the cost of health care, the state of schools and and our continuing dependence on foreign oil. i know some say we can't tackle all of these problems. it's too much. congress can't handle it. the president is juggling too many things. my administration has taken on too much too soon. we are moving too fast. what i say is that america has waited long enough for action on these issues. it is not too soon to fix our schools when we know that if

our children are not prepared, they are not going to compete in the 21st century. it is not too soon to wean ourselves off of dirty source of of energy so that we can grab hold after a clean energy future. we have been talking about clean energy since richard nixon, and it's time for us to act. i congratulate, by the way, the house of representatives for beginning action this past week on a historic clean energy bill. it is also not too soon to reform our health care system, which we have been talking about since teddy roosevelt was president. we are add a defining moment for this nation. if we act now, then we can rebuild our economy in a way that makes it strong, competitive, sustainable and prosperous once more. we can lead this century the same way we led the last century. but if we don't act, if we let

this moment pass, we could see this economy just sputter along for decades, a slow, steady decline in which the chances for our children and our grandchildren are fewer than the opportunities that were given to us. and that is contrary to the history of america. one of our core ideas has always been that we leave the next generation better off than us. and that's why we have to act right now. i know that people say the cost of fixing our problems are great, and in some cases they are. the cost of inaction, of not doing anything, are even greater. they are unacceptable. and that's why this town hall and this debate we are having around health care is so important. let me just give you a few statistics. in the last nine years, premiums have risen three times

faster than wages for the average family. i don't need to tell you this because you have seen it in your own lives. even if you have got health insurance, and 46 million people don't -- if you've got health insurance, you have seen your costs double. they have gone up three times faster than wages. if we do nothing, then those costs are just going to keep on going higher and higher. in recent careers, over one third of small businesses have reduced benefits, and many have dropped coverage all together since the early 90's. not because small business owners don't want to provide benefits to their workers, but they simply can't afford it. they don't have the money. if we don't act, that means that more people are going to lose coverage, and more people are going to lose their jobs because those businesses are not going to be competitive. unless we act, within a decade, one out of every five dollars we earn will be spent on health

care. for those who rightly worry about deficits, the amount our government spends on medicare and medicaid will be larger than everything else combined. the congressional budget office just did a study that showed that when you look at the ricing cost of indictlement, 90% of the is medicaid and medicare. 90% of it comes from the federal share of health care costs. so if we want to control our deficit, the only way for us to do it is to control health care costs. those are on subtractions, those are numbers. but many of you know that this translates in the pain and heartache in a very personal way for families all across america. i know because during the two years that i campaigned for president, every town hall meeting i had, people would raise horrible stories about

their experiences in the medical system. and now that i'm president, i'm hearing those same stories. i get 10 letters a day out of the 40,000 or so that the white house receives. my staff selects 10 for me to read every single day. and at least half of them relate to a story who -- a story of somebody who has been denied coverage because of a preexisting condition. or somebody had what they thought was going to be a $500 bill and ends up being a $25,000 bill. i was at a town hall meeting in green bay, wisconsin. met a young woman that is 36, had breast cancer. both her and her husband were employed and had health insurance, and yet she still has $50,000 worth of debt. all she is thinking about right now, instead of thinking about how to get well, she is thinking if i don't survive this, my main legacy to my

children may be another $50,000 worth of debt. everybody here knows stories like that. some of you have experienced them personally. so this is a problem that we can't wait to fix. it is not something that we are going to keep on putting off indefinitely. this is about who we are as a country, and that's why we are going to pass health care reform, not 10 years from now, not five years from now, we are going to pass it this year. that is my commitment. we are going to get it done. [applause] >> we've already started to see some progress in washington. those who said we couldn't do it, they are already being surprised, because as a consequence of us pushing, suddenly the drug companies, the insurance companies and the hospitals, all of them are starting to realize this train's leaving the station, and we had better get on board. just a few weeks ago the

pharmacuticals industry agreed to $80 billion in spending reduction that is we can use to close the so-called dougnut hole. some of you know a what that is, where senior citizens who were on the prescription drug plan under medicare, they get their drugs reimbursed up to a certain moment, and then suddenly there is a gap until it reaches thousands of dollars in out-of-pocket costs. so-and-so we've -- so we've struck a deal with drug companies to cut those costs in half. we have seen when we put pressure to reform the system, then these industries are going to have to respond. lant most, doctors and hospitals, labor and business, all came to go and agreed to decrease the annual rate of health care growth to 1.5%. that would translate into $2

trillion or more of savings over the next decade. that would mean lower costs for everybody, for ordinary families. in the past two weeks, they have made tremendous progress on a plan to hold down costs, improve patient care and insure that you won't lose your coverage even if you lose your job, change your job, or if you have got a preexisting medical condition. now we have to finish the job. there's no doubt we have to preserve what is best in the health care system, and that means allowing americans who like their doctor and health care plan to keep their plan. that is going to be a priority for us. [applause] but we also have to fix what is broken about the system, and that means permanently bringing down costs and giving more choice for everyone. and to do this, we've got to do a couple of things. we have to build on the investments that we have made in electronic medical records. we already made those

investments in the recovery act . because when everybody is digitalized, all your records, your privacy is protected, but all your records in a digital form, that reduces medical errors. it means nurses don't have to read the scrawl of doctors when they are trying to figure out what treatments to apply. that saves lives, saves money, and it will still insure privacy. we need to invest in prevention and wellness that help americans live longer, helter liblings. we know this saves money. if we can help somebody control obesity, they are less likely to get diabetes, and if they are less likely to get diabetes, that means we are going to be saving a whole lot of money in hospital costs. the biggest thing we can do to hold down costs is to change the incentives of the health care system that automatically equate expensive care with good care. this is an important concept,

and so i want everybody to focus on this. we have been under the illusion that the more health care we get, the healthier we become. and it turns out that every study shows that the question is are you getting the right care? are you getting the high quality care, rather than are you having a whole bunch of tests ordered that are unnecessary, getting treatments that are unnecessary, staying in hospitals which may be unnecessary, all of which drifles up your costs but doesn't make you better. we have to ask ourselves why there are places like the health care centers in pennsylvania or salt lake city, that offer high quality health care that is 30% lower than other communities. if they can do it, there is no reason the rest of america can't do it. we have to identify the best

practices across the country and then we have to replicate those successes elsewhere. and we should change the procedures that reward doctors and hospitaling for the tests and procedures they prescribe even if they don't make people better. doctors across this country did not get into this profession just to be bean counters or paper pushers, but more and more time that doctors should be spending with patients is spent on administration and dealing with how they are reimbursed. they have to create a simplified system where they are reimbursed for quality caras opposed to having to distort their practices in ways that don't actually make their patients better. it is also time to provide americans with no health care insurance with more affordable

options. i believe it is a moral and economic imperative. [applause] >> it is a moral imperative because in a country as wealt as ours, people are working and holding up their responsibilities, they shouldn't be bankrupted just because they get sick. on the other hand, it is an economic imperative because every single one of us who do have health insurance, our families on average are paying an extra $1,000 in premiums for uncompensated tears. hospitals and doctors are adding those costs to your premiums. insurance companies are adding those costs to your premiums even if you don't know it. and if we can get a system in which people are getting regular check ups, mammograms, all the things that we know prevent disease from occurring over the long term, or at least allows us to catch them early, that is going to allows us to

drive down costs for everybody. so, what we have been working on is the creation of something called the health insurance exchange, and this is going to be a marketplace which would allow you to one-stop shop for health care plans and compare benefits and prices in simple, easy-to-understand language, and then choose the boast plan for you. none of these plans would be able to deny coverage on the basis of a preexisting condition. all of them would include an affordable basic benefit pang. if you couldn't afford these plans, then we could provide you a little bit of help so that you can afford these plans. i also strongly believe that one of the options in the exchange should be a public option. in order for us to create some competition for the private sure remembers to keep them honest. if they are in fact giving good service and providing high quality coverage, then that is where people will want to go. but there should be a benchmark

there of a public plan, a not-for-profit plan that keeps administrative costs low and focused on providing good service. that way, you can make the decision which deal is going to be better for you and your family. now, i know one of the biggest questions on everybody's mind is how do we pay for all this? how do we finance reform? and i have made a commitment. because our deficit is a genuine problem, that whatever we do, we have to pay for it. this can't add to our deficits. it has got to be deficit-neutral over the next 10 years. here's the good news. about 2/3 of the cost of the reforms that we are proposing will come from reallocating money that is already being spent in the health care system, but isn't being spent wisely. so it doesn't involve more spending. it just involves smarter spending. a lots of the money being spent in the health care system right now adds nothing to the quality

of patient care. i will give you one example. we spend right now -- over the next 10 years, we will spend $177 billion, $177 billion over the next decade in unwarranted subsidies to insurance companies under something called medicaid advantage. this does not make seniors helter. people who are signed for this private insurance subblings diesed program don't get any better care than those who aren't. the subsidies don't go to the patients. they go to the insurance companies. think if we took that $177 billion and helped families so that they could have insurance and that we could have preventive care? so about 2/3 of the cost of the reform we are proposing is reallocating money already in the system, you the taxpayers are already paying for it. now, one third of it we are

going to have to pay for by increased revenues. and what i've promised is that if we capped the itemized deductions that very well thy people do, the top 2% use on their income tax, so that they are getting the same tax breaks as everybody else as opposed to getting higher tax breaks because they have a bigger house, then we can pay for the rest of reform. we have already identified $950 billion over 10 years, a little less than $100 billion a year in order to pay for the reform. 2/3 of it reallocating money, one third of it with increased revenues. that's a sensible investment for us to make in solving an interactible problem that has been dragging down family finances, businesses and it is federal government for far too long. now, keep in mind by the way, what we have identified as paying for the system, that doesn't include the savings we are going to get from

prevention or the savings we are going to get from health i.t., because in using congressional jargon, which i am never supposed to do because nobody understands it, it is not scoreable. that means the budget office can't identify exactly how much you would save even though everybody believes that it will end up saving a lot of money. we can't put a hard number on it. so we will get additional savings that will drive down costs. in the meantime, the costs of reform will be paid for with hard dollars that we've identified. here is the bottom line. i am almost done here. this is a big complicated topic, so i hope you forgive me. we are starting to make progress on capitol hill. we are identifying ways not only to reform the system to make it smarter, more efficient, no user friendly, better for american families, but also ways to pay for it in a way that doesn't bloat our

deficit. but the hardest part is yet to come. because everybody here knows that the easiest thing to do when you're looking at big policy questions like health care is can't be done. the naysayers are starting to line up and finding every excuse and scare tactic in the book for why reform is not going to happen. this is going on as we speak. what i say to these critics is well, what is your alternative? is your alternative just to stand pat and keep on watching more and more families lose their health care, more and more families with higher out of pocket costs for lest insurance, businesses who are not able to compete internationally, a medicare and a medicaid system that has run amok? is that your alternative? what do you say to all those families who can't pay their medicaid businesses? what do we say to the

businesses that have to choose between close are doors or eliminating benefits. what do we say to taxpayers whose dollars are propping up a system that doesn't work and is driving us into debt. this isn't just about those americans without health care. it is about every american, because if we do not act to bring down costs, everybody's health care will be in jeopardy. if you lose your job or have a preexisting condition, you don't know that your family is going to be secure. all of us are in this together. when it comes to energy, when it comes to improving our schools, and when it comes to health care, i don't accept the status quo, and you shouldn't either. i don't think that the american people want to just stand pat. they know the change isn't easy. they know there are going to be set-backs and false starts, but they also know this, that we are in one of those rare moments where everybody is moments where everybody is ready to move into the future.