choose from over 140 menu options, there is no counting carbs, calories or points. i lost 100 lbs. and lowered my blood sugar level. nutrisystem d changed my life. mike is one of many who have lost weight and controlled their diabetes with new nutrisystem d. backed by 35 years of research and low glycemic index science nutrisystem d works. satisfaction guaranteed or your money back! new! nutrisystem d. lose weight. live better. call or click today. any minute now on "andrea mitchell reports," president obama will be speaking about health care at a town hall in portsmouth, new hampshire. it is the first of three town halls this week as the administration aims to regain control of the public debate. but will today's town hall turn into another public shouting match? demonstrators are already in place. just look at what happened

during senator arlen specter's town hall earlier today in pnls. >> now, wait a minute! now, wait a minute a! wait a minute! >> and hillary clinton makes it clear that she, not her husband, is secretary of state. what made her lose her cool in the congo. plus, eunice kennedy shriver, who died today at the age of 88. the younger sister of john f. kennedy jr. -- john f. kennedy, rather, and the founder of the special olympics leaves behind a lasting legacy of helping those with special needs. k carrie kennedy, her niece, talks to us this hour. good day, i'm andrea mitchell in washington. president obama wants americans to know that health care overhaul will not jeopardize the coverage that millions already enjoy. and eahe's doing so in a state where 89% of the population is covered. pennsylvania governor ed rendell joins us now. before we get into health care,

governor, i want to ask you about your longtime friend, secretary of state hillary clinton. this is what happened when she was asked, she thought, about her husband. she was traveling in the congo yesterday. let's watch. >> wait! you want me to tell me what my husband thinks? my husband is not the secretary of state, i am. so you ask my opinion, i will tell you my opinion. i'm not going to be channeling my husband. >> governor, we've seen today the new york tabloids are all over this. look at these headlines. i mean, here she is with the most favorable ratings that she's ever enjoyed in her career, just about, and the loyal team player to barack obama, and in one moment, she shows this kind of anger. what's the impact, politically, of that? >> oh, i think very short run. it's really much ado about nothing. look, hillary clinton is not only expressing frustrations

about being married to a very famous, maybe one of the most famous people in the world, maybe the most famous person in the world, but she's expressing some of the frustrations that women all over, even the most successful women have as they gain and achieve. people are always looking to put them in little categories and talk about the men who are more dominant, et cetera. so i think she was expressing momentary irritation, but she's done a great job as secretary of state. she's been a terrific team player, and i think this will be a little blip on the radar screens. if it wasn't for the 24-hour news cycle, nobody would have even noticed this. >> i'll grant you all of that. but the problem is, she is the secretary of state, she's a diplomat, she's had to take crazy questions on this trip, i can vouch for that. at town hall meetings, one question was raised about a prior offer for chelsea's hand in marriage with 40,000 and a goat or 20 goats or something like that, a dowry from a kenyan

man, but she is expected to keep her cool, despite the heat, the humidity, and bad hair days. >> well, sure, but everyone in public life is expected to keep their cool. but in the end, andrea, and you know this because you've dealt with so many of us, we're human beings too and we have emotions and we try to curtail those emotions or at least control them, but every once in a while you slip. and i think given the job she's done and the confidence i have that she'll continue to do that great job, this won't be a big story a week from now. >> let me ask you about your own situation, your own political situation. we see the effect of a lot of the flag and drag from the economy, from budget problems. a quinnipiac poll in pennsylvania showed a 39% approval rating, 53% disapproval rating. you've been re-elected with huge majority. the most -- the best-known politician, certainly, in pennsylvania. what's going on there? what is happening to well-known

democrats, such as yourself? >> well, i think this is happening to governors, period, republican or democrat. this is a tough time to be a governor, but we get paid for the bad times as well as the good times because we have to make difficult decision. and the decision that i've made is that we've got to get out of this budget crisis with $3.25 billion shortfall in revenue by a combination of cuts. we've made $2.4 billion of cuts, but we need some common sense revenue increase proposals that will increase revenue over a recurring period for the next three years. so i propose some new taxes. and when you propose new taxes in america today, you're going to take a little bit of a battering. but i am not going to sacrifice education. we've done so well. pennsylvania has made more progress than any state in the union in the last six years. i'm not going to sacrifice that to worry about my popularity rating. i said, andrea, can you imagine what abe lincoln's favorable rating would have been the first

term if we had those polls? probably 6%, 7%, 8%. those polls don't bother me. i want to do the right thing for long-term pennsylvania. >> how do you think the president is doing in trying to counteract the opposition to the health care reform proposals? he certainly has distanced himself from an op-ed in "usa today" yesterday by speaker pelosi and majority leader steny hoyer, who says that it's un-american to protest. he and his spokespeople are saying he understands that people are peaking out and that it's a healthy they think. where's the balance here? >> well, i think -- i don't know if speaker pelosi and steny hoyer meant it was un-american to protest. it's clearly not in the tradition of american democracy to protest to the extent where you drown out all other questions, all other discourse. that is counterveiling to everything the american democracy has been about. that's number one. number two, questions and protests on policy, that's fine.

and the president has to do a better job in answering those questions. i think he's going to do that in these three town hall meetings, and the thing that he's got to get across most of all to the american people, whether you've got health care now or not, the status quo is the worst of all possible options. consider this, andrea. in pennsylvania, in 1996, the average employer family health care plan cost $5,100. today it costs $11,000, and by 2016, it's predicted to cost $26,000. over 500,000 pennsylvanians in the last six years have lost employer-based health care. we can't go on like that. there has to be changes. so reform is absolutely necessary, doing nothing is not an option. the president's got to explain that well today and the next three days. >> and as you can see, the president is now being introduced at that portsmouth, new hampshire, town hall meeting. we're going to be going to that

momentarily. just earlier today, arlen specter had a really tough time in lebanon, pennsylvania. is this what's going to happen to democratic candidates? you've got a -- he's got a somewhat tough race for the senate. >> no question. and, again, that stuff is counterproductive. and i think over the period of time, it's going to turn average americans against the people who are protesting and drowning out reasonable debate and reasonable discourse. >> all right. as you can see, the president is taking the stage now. cheers from this crowd. thank you so much, governor rendell. we thank you so much for joining us. >> my pleasure. nice to talk to you. >> and let's listen to the president. >> thank you! oh, thank you so -- i love you back! thank you. it is great to be back in portsmouth. it is great to be back -- it's great to be back in new hampshire. i have to say, though, that most of my memories of this state are

cold, so it's good to be here in august. there are a couple of people that i want to acknowledge who are here today, some special guests. first of all, i want to thank principal jeffrey collins and the portsmouth students, faculty, and staff, thank you, our hosts for today. your own outstanding governor, john lynch is here. and his wonderful wife, dr. susan lynch is here, the first lady of new hampshire. your united states senator, doing a great job, genie shaheen is here. the governor of the great state of maine and we are glad he's here in new hampshire today, john baldacci is here.

two of my favorite people, they are just taking congress by storm, outstanding work, paul hoets, carol shaporter. give them a big round of applause. and we've got your own mayor, tom freeney is here. where's tom? where is he. there he is. now, i want to thank, more than anybody, lori, for that introduction and for sharing her story with the rest of us. thank you, lori. lori's story is the same kind of story that i've read in letters and i've heard in town hall meetings just like this one for

the past five years. in fact, some of you where in those town hall meetings, as i was traveling all throughout new hampshire. it's the story of hard-working americans who are held hostage by health insurance companies that deny them coverage or drop their coverage or charge fees that they can't afford for care that they desperately need. i believe it is wrong. it is bankrupting families and businesses and that's why we are going to pass health insurance reform in 2009. now, this is obviously a tough time for families here in new hampshire and all across america. six months ago, we were in the middle of the worst recession of our lifetimes. i want you to remember what things were like in january and

february. we were losing about 700,000 jobs per month. and economists of all stripes feared a second coming of the great depression. that was only six months ago. that's why we acted as fast as we could to pass a recovery act that would stop the free fall. and i want to make sure everybody understands what we did. one-third of the money in the recovery act went to tax cuts that have already started showing up in the paychecks of about 500,000 working families in new hampshire. 500,000 families in new hampshire. we also cut taxes for small businesses on the investments that they make and over 300 new hampshire small businesses have qualified for new loans backed by the recovery act. now, that was a third of the recovery act. another third of the money in

the recovery act is for emergency relief for folks who have born the brunt of this recession. so we've extended unemployment benefits for 20,000 new hampshire residents. we've made -- we've made health insurance 65% cheaper for families who rely on cobra while they're looking for work. and for states that were facing historic budget shortfalls, we provided assistance that have saved the jobs of tens of thousands of workers who provided essential services, like teachers and police officers. so it's prevented a lot of painful cuts in the state, but also a lot of painful state and local tax increases. now, the last third of the recovery act is for investments that are already putting people back to work. these are jobs refurbishing

bridges and pavement on i-95 or jobs at the community health centers here in portsmouth that will be able to add nurses and extend hours and serve up to 500 new patients. these are good jobs doing the work america needs done. and by the way, most of the work is being done by private, local businesses, because that's how we're beginning to grow this economy again. so there is no doubt that the recovery act has helped put the brakes on this recession. we just saw last friday, the jobs picture is beginning to turn. we're starting to see signs that business investment is coming back. but new hampshire, that doesn't mean we're out of the woods. and you know that. it doesn't mean we can just sit back and do nothing while so many families are still struggling. because even before this recession hits, we had an economy that was working pretty well for the wealthiest americans. it was working pretty well for wall street bankers. it was working pretty well for

big corporations, but it wasn't working so well for everybody else. it was an economy of bubbles and busts. and we can't go back to that kind of economy. if we want this country to succeed in the 21st century, and if we want our children to succeed in the 21st century, then we're going to have to take the steps necessary to lay a new foundation for economic growth. we need to build an economy that works for everybody and not just some people. now, health insurance reform is one of those pillers that we need to build up that new foundation. i don't have to explain to you that nearly 46 million americans don't have health insurance coverage today. in the wealthiest nation on

earth, 46 million of our fellow citizens have no coverage. they are just vulnerable. if something happens, they go bankrupt, or they don't get the care they need. but it's just as important that we accomplish health insurance reform for the americans who do have health insurance. because right now -- because right now, we have a health care system that too often works better for the insurance industry than it does for the american people. and we've got to change that. [ applause ] now, let me just start by setting the record straight on a few things i've been hearing out here about reform. under the reform we're proposing, if you like your

doctor, you can keep your doctor. if you like your health care plan, you can keep your health care plan. you will not be waiting in any lines. this is not about putting the government in charge of your health insurance. i don't believe anyone should be in charge of your health insurance decisions but you and your doctor. i don't think government bureaucrats should be meddling, but i also don't think insurance bureaucrats should be meddling. that's the system i believe in. [ applause ] now, we just heard from lori about how she can't find an insurance company that will cover her because of her medical condition. she's not alone. a recent report actually shows that in the past three years, over 12 million americans were discriminated against by insurance companies because of a

pre-existing condition. either the insurance company refused to cover the person or they dropped their coverage went they got sick and they needed it most, or they refused to cover a specific illness or condition, or they charged higher premiums and out-of-pocket costs. no one holds these companies accountable for these practices. and i have to say, this is personal for lori, but it's also personal for me. i talked about this when i was campaigning up here in new hampshire. i will never forget my own mother, as she fought cancer in her final months, having to worry about whether her insurance would refuse to pay for her treatment. and by the way, this was because the insurance company was arguing that somehow, she would have known that she had cancer when she took her new job, even though it hadn't been diagnosed yet. so if it could happen to her, it could happen to any one of us.

and i've heard from so many americans that have the same worries. one woman testified that an insurance company would not cover her internal organs because of an accident she had when she was 5 years old. think about that. that covers a lot of stuff. you know, they're only going to cover your skin. dermatology, that's covered. nothing else. another lost his coverage in the middle of chemotherapy because the insurance company discovered he had gallstones that he hadn't known about when he applied for insurance. now, that is wrong! and that will change when we pass health care reform. that is going to be a priority. [ applause ] under the reform we're

proposing, insurance companies will be prohibited from denying coverage because of a person's medical history, period. they will not be able to drop your coverage if you get sick. they will not -- they will not be able to water down your coverage when you need it. your health insurance should be there for you when it counts. not just when you're paying premiums, but when you actually get sick. and it will be when we pass this plan. now, when we pass health insurance reform, insurance companies will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. and we will place a limit on how much you can be charged for out-of-pocket expenses, because

no one in america should go broke because they get sick. and, finally, this is important. we will require insurance companies to cover routine checkups and preventative care, like mammograms and col colonoscopies -- because there's no reason we shouldn't be catching diseases like breast cancer and prostate cancer on the front end. that makes sense, it saves lives, it also saves money. and we need to save money in this health care system. so this is what reform is about. for all the chatter and the yelling and the shouting and the noise, what you need to know is this -- if you don't have health insurance, you will finally have quality, affordable options once we pass reform. [ applause ]

if you do have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care that you need. and we will do this without adding to our deficit over the next decade. largely by cutting out the waste and insurance company giveaways in medicare that aren't making any of our seniors healthier. right. now, before i start taking questions, let me just say, there's been a long and vigorous debate about this and that's how it should be. that's what america's about, is we have a vigorous debate. that's why we have a democracy. but i do hope that we will talk with each other and not over each other, because -- [ applause ]

>> -- because one of the objectives of democracy and debate is that we start refining our own views, because maybe other people have different perspectives, things we didn't think of. where we do disagree, let's disagree over things that are real. not these wild with misrepresentations that bear no resemblance to anything that's actually been proposed. [ applause ] because the way politics works, sometimes, is the people who want to keep things the way they are will try to scare the heck out of folks and they'll create bogeyman out there that just aren't real. so this is an important and complicated issue that deserves serious debate. and we have months to go before we're done and years after that

to phase in all these reforms and get them right. and i know this. despite all the hammering pundits and the best efforts of those who are profiting from the status quo, we are closer to achieving health insurance reform than we have ever been. we have the american nurse's association reporting us, we have the american medical association on board. america's doctors and nurses know firsthand how badly we need reform. we have broad agreement in congress on about 80% of what we're trying to do. we have an agreement from the drug companies to make prescription drugs more affordable for seniors. we can cut the doughnut hole in half if we pass reform. we have the aarp on board, because they know this is a good deal for our seniors.

but let's face it, now's the hard part. because the history is clear. every time we come close to passing health insurance reform, the special interests fight back with everything they've got. they use their influence, they use their political allies to scare and mislead the american people, they start running ads, this is what they always do. we can't let them do it again. not this time. not now. [ applause ] because for all the scare tactics out there, what is truly scary, what is truly risky is if we do nothing. if we let this moment pass, if we keep the system the way it is right now, we will continue to see 14,000 americans lose their health insurance every day. your premiums will continue to skyrocket. they have gone up three times faster than your wages and they will keep on going up.

our deficit will continue to grow because medicare and medicaid are on an unsustainable path. medicare is slated to go into the red in about eight to ten years. i don't know if people are aware of that. if i was a senior citizen, the thing i would be worried about right now, medicare starts running out of money, because we haven't done anything to make sure that we're getting a good bang for our buck, not when it comes to health care. and insurance companies will continue to profit by discriminating against people for the simple crime of being sick. now, that's not a future i want for my children, it's not a future i want for the united states of america. new hampshire, i was up here campaigning a long time. a lot of you guys came to my town hall events, some of you votes for me, some of you didn't, but here's one thing i've got to say. i never said that this was going to be easy. i never said that change would be easy. if it were easy, it would have

already been done. change is hard. and it doesn't start in washington. it begins in places like portsmouth, with people like lori, who have the courage to share their stories and fight for something better. that's what we need to do right now and i need your help if you want a health care system that works for the american people, as well as it works for the insurance companies, i need your help! knocking on doors, talking to your neighbors. let's get this done! [ applause ] >> thank you! >> yes, we can!

yes, we can! >> thank you! i remember that. everybody, have a seat. this is the fun part. first of all, let's thank the band. i didn't see the band over here. thank you, band. great job. all right. here's how we're going to do this. we do a lot of town hall meetings in new hampshire, so everybody knows the basic outlines of this thing. if you have a question, just raise your hand. there are people with microphones in the audience. i am going to try to go girl, boy, girl, boy to make sure that it's fair. if i hear only from people who agree with me, i'm going to actively ask some folks who are concerned about health care, give them a chance to ask their questions, because i think we've got to make sure that we've got out, surface some of the debates and concerns that people have. some of them are legitimate.

i'm going to try to get through as many questions as i can, but if you can keep your question or comment relatively brief, then i will try to keep my answers relatively brief. okay? all right. we're just going to go around the room and i'm going to start with this gentleman right here. this gentleman right here. please introduce yourself, if you don't mind. >> thank you, mr. president. welcome to portsmouth and new hampshire. my name is peter schmidt. i'm a state representative from dover. i'm a senior citizen and i have a wonderful government-run health care plan called medicare. i like it. it's affordable. it's reasonable. nobody tells me what i need to do. i just go to my doctor or the hospital and i get care. now, one of the things you've been doing in your campaign to change the situation is you've been striving for bipartisanship. i think it's a wonderful idea, but my question is, if the republicans actively refuse to

participate in a reasonable way, with reasonable proposals, isn't it time to just say, we're going to pass what the american people need and what they want, without the republicans? >> well, let me -- let me make a couple of points. first of all, you make a point about medicare that's very important. i've been getting a lot of letters, proand con for health care reform, and one letter i received recently, a woman was very exercised about what she had heard about my plan. she said, i don't want government-run health care. i don't want you meddling in the private marketplace, and keep your hands off my medicare. true story. and so i do think it's important for particularly seniors who currently receive medicare to

understand that if we're able to get something right, like medicare, then there should be a little more confidence that maybe the government can have a role, not the dominant role, but a role in making sure that people are treated fairly when it comes to insurance. you know, under our proposal, the majority of americans will still be getting their health care from private insurers. all we want to do is just make sure that private insurers are treating you fairly, so that you are not buying something where you failed to read the fine print, next thing you know, when you actually get sick, you have no coverage. we also want to make sure that everybody has some options, so there's been talk about this public option. this is where a lot of the idea of government takeover of health care comes from. all we want to do is set up a set of options so that if you don't have health insurance or

you're underinsured, you can have the same deal that members of congress have. which is that they can look at a menu of options, we're calling it an exchange, but it's basically just a menu of different health care plans and you will be able to select the one that suits your family best, and i do think that having a public option as part of that would with keep the insurance companies honest. because if they've got a public plan out there that they've got to compete against, as long as it's not being subsidized by taxpayers, then that will give you some sense of what's sort of a good bargain for basic health care would be. now, i think that there are some -- my republican friends on capitol hill, who are sincerely trying to figure out if they can find a health care bill that works. chuck grassley of iowa, mike

enzi of wyoming, olympia snowe from maine. yeah, i got to admit, i like olympia too. they are diligently working to see if they can come up with a plan that could get both republican and can democratic support. but i have to tell you, when i listened to folks like lori, and families all across america who are just getting pounded by the current health care system, and when i look at the federal budget and realize that if we don't control costs on health care, there is no way for us to close the budget deficit. it will just keep on skyrocketing. when i look at those two things, i say, we have to get it done. and my hope is we can do it in a bipartisan fashion, but the most important thing is getting it

done for the american people. all right. this young lady right here. all right. this young lady right here. she's still enjoying her summer. when do you go back to school? >> i go back to school september 3rd. >> september 3rd. okay. what's your name? >> julia halls from malden, massachusetts. >> nice to meet you, julia. >> i saw -- as i was walking in, i saw a lot of signs outside saying mean things about reforming health care. how do kids know what is true and why do people want a new system that can help more of us? >> well, i've seen some of those signs. hmm. let me just be specific about some things that i've been hearing lately that we just need

to dispose of here. the rumor that's been circulating a lot lately is this idea that somehow the house of representatives voted for death panels that will, basically, pull the plug on grandma because we've decided that we don't -- it's too expensive to let her live anymore. and there are some variations on this theme. it turns out that, i guess, this arose out of a provision in one of the house bills that allowed medicare to reimburse people for consultations about end of life care, setting up living wills, the availability of hospice, et

cetera. so the intention of the members of congress was to give people more information so that they could handle issues of end of life care, when they're ready, on their own terms. it wasn't forcing anybody to do anything. this is, i guess, where the rumor came from. the irony is that, actually, one of the chief sponsors of this bill originally was a republican then house member, now senator, named johnny isaacson from georgia, who very sensibly thought, this is something that would expand people's options. and somehow it's gotten spun into this idea of death panels. i am not in favor of that. so, just, i want to clear the air here. now, in fairness, the underlying argument, i think, has to be addressed. and that is, people's concern that if we are reforming the

health care system to make it more efficient, which i think we have to do, the concern is that somehow that will mean rationing of care. right? that somehow, some government bureaucrat out there will be saying, well, you can't have this test or you can't have this procedure because some bean counter decides that this is not a good way to use our health care dollars. and this is a legitimate concern. so i just want to address this. we do think that systems like medicare are very inefficient right now, but it has nothing to do at the moment with issues of benefits. the inefficiencies all come from things like paying $177 billion to insurance companies in subsidies for something called medicare advantage that is not competitively bid, so insurance companies basically get $177 billion of taxpayer money to

provide services that medicare already provides. and it's no better -- it doesn't result in better health care for seniors. it is a giveaway of $177 billion. now, think about what we could do with $177 billion over ten years? i don't think that's a good use of money. i would rather spend that money on making sure that lori can have coverage, making sure that people who don't have health insurance get some subsidies than i would want to be subsidizing insurance companies. so the -- another way of putting this is, right now, insurance companies are rationing care. they are basically telling you what's covered and what's not. they're telling you, you know, we'll cover this drug, but we won't cover that drug. you can have this procedure or

you can't have that procedure. so why is it that people would prefer having insurance companies make those decisions rather than medical experts and doctors figuring out, you know, what are good deals for care and providing that information to you as a consumer and your doctor so that you can make good decisions? so i just want to be very clear about this. i recognize there is an underlying fear here that people somehow won't get the care they need. you will have not only the care you need, but also the care that right now is being denied to you, only if we get health care reform. that's what we're fighting for. all right. gentleman back here with the baseball cap. right there. >> good morning. good afternoon, mr. president.

bill anderson from new hampshire. in reference to what you've just said, i'm presently under the new hampshire medicaid system and i have to take a drug called lipitor. when i get on to this program, they said, no, we're not going to cover lipitor, even though i've been on that pill for nearly ten years based on the information that my doctor feels is right for me. and i had to go through two different rile trials of other of drugs before it was finally deemed that i could go back to lipitor through the new hampshire medicaid system. so here it is, the medicaid that you guys are administering and you're telling me that it's good, but then in the next sense, i'm dealing with the same thing that the insurance companies are doing. >> i think that's a legitimate point. i don't know all the details, but it sounds to me like they were probably trying to have you take a generic as opposed to a brand name. is that right? and it turned out that you did

not have as good a reaction under the generic as the brand name and then they put you back on the brand name, is that what happened? well, right, look. there may be, in nine out of ten cases, the generic might work as well or better than the brand name, and we don't want to just subsidize the drug companies if you've got one that works just as well as another. the important thing about the story that you just told me was is that once it was determined that, in fact, you needed the brand name, you were able to get the brand name. now, i want to be absolutely clear here. there are going to be instances where if there is really strong scientific evidence that the generic and the brand name work just as well and the brand name costs twice as much, that the taxpayers should try to get the

best deal possible, as long as, if it turns out that the generic doesn't work as well, you're able to get the brand name. so the basic principle that we want to set up here is that if you're in private insurance, first of all, your private insurance can do whatever you want. if you're under a government program, then it makes sense for us to make sure that we're getting the best deal possible and not just giving drug makers or insurers more money then they should be getting, but ultimately you've got to be able to get the best care based on what the doctor says. and it sounds like that is eventually what happened. it sounds like it maybe wasn't as efficient, wasn't as smooth as it should have been, but that result is actually a good one. and you think about all the situations where a generic actually would have worked. in fact, one of the things i want to do is to speed up generics getting introduced to the marketplace, because right

now drug companyies -- right no, drug companies are fighting so that they can keep, essentially, their patent on their brand name drugs a lot longer. and if we can make those patents a little bit shorter, generics get on the market sooner, ultimately, you as consumers can save money. but it was an excellent question, so thank you. all right, it's a young woman's turn or a lady's turn. right here. yes, you. >> good afternoon, mr. president. i'm jackie millet and i'm from wells, maine. and my question is, i am presently on medicare and i do have a supplement, but if something happens to my husband, i lose the supplement and what will happen -- i take a lot of medications, i need a lot -- i've had a lot of procedures,

and how will medicare under the new proposal help people who are going to need things like this? >> well, first of all, another myth that we've been hearing about is this notion that somehow we're going to be cutting your medicare benefits. we are not. the -- aarp would not be endorsing a bill if it was undermining medicare. okay, so i just want seniors to be clear about this, because if you look at the polling, it turns out seniors are the ones who are most worried about health care reform. and that's understandable, because they use a lot of care, they've got medicare, and it's already hard for a lot of people, even on medicare, because of the supplements that -- and all the other costs out of pocket that they're still paying. so i just want to assure, we're not talking about cutting medicare benefits.

we are talking about making medicare more efficient, eliminating the insurance subsidies, working with hospitals so that they are changing some of the reimbursement practices. right now, hospitals, they are not penalized if there are constant readmission rates from patients that have gone through the hospital. if you go to a car company or an auto shop and you say, can i have my car repaired? you get your car repaired, if two weeks later it's broken down again, if you take it back, hopefully they're not going to charge you again for repairing the car. you want them to do it right the first time. and too often we're not seeing the best practices in some of these hospitals to prevent people from being readmitted. that costs a lot of money. so those are the kind of changes we're talking about. so in terms of savings for you,

as a medicare recipient, the biggest one is on prescription drugs. because the prescription drug companies have already said that they would being willing to put up $80 billion in rebates for prescription drugs as part of a health care reform package. now, we may be able to get even more than that, but think about it. when the prescription drug plan was passed, medicare part "d," they decided they weren't going to negotiate with the drug companies for the cheapest available price on drugs. and as a consequence, seniors are way overpaying, there's that big doughnut hole that forces them to go out-of-pocket, you say you take a lot of medications, that means that doughnut hole is always something that's looming out there for you. if we can cut that doughnut hole in half, that's money directly out of your pocket. and that's one of the reasons that aarp is so supportive, because they see this as a way of potentially saving seniors a lot of money on prescription

drugs. okay? all right. gentleman right here in the white shirt. >> good afternoon, mr. -- good afternoon, mr. president. my name is ben hirschenson. i'm a republican. i don't know when i'm doing here, but i'm here. >> we're happy to have you. we're happy to have you. >> mr. president, you've been quoted over the years, when you were a senator and perhaps even before then, that you are essentially a supporter of a universal plan. i'm beginning to see that you're changing that. do you honestly believe that? because that is my concern. i'm on medicare, but i still worry that if we go to a public option, period, that the private companies, the insurance companies, rather than

competing -- because who can compete with the government? the answer is nobody. so my question is, do you still, as yourself now, support a universal plan or are you open to the private industry still being maintained? >> well, i think it's an excellent question. i appreciate the chance to respond. first of all, i want to make a distinction between a universal plan versus a single payer plan. because those are two different things. a single payer plan would be a plan like medicare for all or the kind of plan that they have in canada, where basically government is the only person -- is the only entity that pays for all health care. everybody has a government paid-for plan, even those, depending on which country, the doctors are still private or the hospitals might still be private. in some countries, the doctors work for the government and the hospitals are owned by the government, but the point is is

that government pays for everything. like medicare for all. that is a single payer plan. i have not said that i was a single payer supporter, because, frankly, we historically have had an employer-based system in this country with private insurers and for us to transition to a system like that, i believe, would be too disruptive. so what would end up happening would be a lot of people who currently have employer-based health care would suddenly find themselves dropped and they would have to go into an entirely new system that we had not been fully set up yet and i would be concerned about the potential destructiveness of that kind of transition. all right, so i'm not promoting a single-payer plan. i am promoting a plan that will assure that every single person is able to get health insurance at an affordable price and that if they have health insurance, they are getting a good deal from the insurance companies.

that's what i'm fighting for. now, the -- the way we have approached it is that if you've got health care under a private plan, if your employer provides you health care or you buy your own health care and you're happy with it, you won't have to change. what we're saying is, if you don't have health care, then you will be able to go to an exchange, similar to the menu of options that i used to have as a member of congress, and i can look and see what are these various private health care plans offering, what's a good deal, and i'll be able to buy insurance from that exchange. and because it's a big pool, i'll be able to drive down costs. i'll get a better deal than if i was trying to get health insurance on my own. this is true, by the way, for small businesses as well.

a lot of small businesses, they end up paying a lot more than large businesses per person for health care, because they've got no bargaining power, they've got no leverage. so we want small businesses to be able to buy into this big pool. okay? now, the only thing that i have said is that having a public option in that menu would provide competition for insurance companies to keep them honest. now, i recognize, though you make a legitimate -- you raise a legitimate concern. people say, well, how can a private company compete against the government? and my answer is that if the private insurance companies are providing a good bargain and if the public option has to be self-sustaining, meaning taxpayers aren't subsidizing it, but it has to run on charging premiums and providing good services and a good network of

doctors, just like any other private insurer would then i think private insurers should be able to compete. they do it all the time. if you think about it, you know, u.p.s. and fedex are doing just fine, right? no, they are. it's the post office that's always having problems. so right now you've got private insurers who are out there competing effectively, even though a lot of people get their care through medicare, medicaid or b.a.? there's nothing inevitable about this destroying the private marketplace, as long as -- and this is a legitimate point you're raising -- that it's not set up where the government is basically being subsidized by the taxpayers so even if they're not provide ago good deal, we

keep ponying out more and more money. i've already said that can't be the way the public option is set up. it has to be self-sustaining. does that answer your question? okay. thank you. all right. right there. go ahead. i my name is linda boettcher, and i've taught at this high school for 34 years. >> what do you teach? >> english and journalism. >> good. >> in those 37 years i've been lucky enough to have good health care coverage. my concerns currently are for those who do not. i guess my question is, if every american who needed it had access to good mental health care, what do you think the impact would be on our society?

>> mental health has always been undervalued in the health insurance market. what we now know is that somebody who has severe depression has a more debilitating and dangerous illness than somebody who's got, you know, a broken leg, but broken leg nobody argues that's covered. severe depression unfortunately obvious times isn't, even under existing insurance policies. so i think -- i've been a strong believer in mental health parity, recognizing those are serious illnesses. and i would like to see a mental health component as part of a

package that people are covered under under our plan. okay? all right. this gentleman right here. >> i'm wondering how we do this without raising the taxes on the middle class. i don't want the burden to fall on my parents. also, i'm a college student. >> they already have enough problems paying your college tuition. >> exactly. >> i hear you. >> also, i'm looking toward my future with career options and opportunities. i don't want inflation to skyrocket by adding this to the national debt. i'm wondering how we can avoid both those scenarios. >> right. that's a great question.

>> first of all, i won't sign a bill that adds to the deficit or the national debt. okay? so this will have to be paid for. that, by the way, is in contrast to the prescription drug bill that was passed that cost hundreds of millions by the previous administration and previous congress that was not paid for at all, and that was a major contributor to our current national debt. that's why you will forgive me if sometimes i chuckle a little bit when i hear all these folks saying, oh, big spending obama, when i'm proposing something that will be paid for, and they sign into law something that wasn't, and they had no problem with it. same people, same folks, and they say it with a straight face

how we've got to be fiscally responsible. now -- having said that, paying for it is not simple. i don't want to pretend that it is by definition if we're helping people that currently don't have health insurance, that's going to cost some money. it's been estimated to cost somewhere between $800 billion and a trillion over ten years. it's important we're talking over ten years, because sometimes the number "trillion" gets out there and everyone thinks it's a trillion a year, gosh, how will we do that so it's about $100 billion a year to cover everybody and implement invite reforms we're talking about. about two thirds of those costs we can cover by eliminating the inefficiencies that i already mentioned.

so i already talked about $177 billion worth of subsidies to the insurance companies. let's take that money, let's put it in the kitty. there's about $500 billion to $600 billion over ten years that can be saved without cutting benefits for people who are currently receiving medicare, actually making the system more efficient over time. that does still leave, though, anywhere from $300 billion to $400 billion over ten years or $30 to $40 billion. that does have to be paid for, and we will need new sources of revenue to pay for it. i've made a proposal that would -- i want to be very clear. my preferred approach to this would have been to take people like myself, who make more than $250,000 a year, and limit the itemized deductions that we can

take to the same level as middle-class folks can take them. right now the average middle-class family, they're in the 28% tax bracket, and so they basically can itemize, take a deduction that's about 28%. i can take -- since i'm in a much higher tax bracket, i can take a much bigger deduction, and so the consequence, if i give a charitable give, i get a bigger break from uncle sam than you do. so what i've said is let's just even it out. that would raise sufficient money. now, that was my preferred way of paying for it. members of congress had different ideas, and we are still exploring these ideas. by the time that we actually have a bill that is set that is reconciled between house and