>> rose: welcome to the broadcast. tonight we take a look at alth care reform, first,he president's primtime press conference thi evening and then peter orszag,resident obama' principal budget officialthe director of th offi of management and budget. >> this is a very impornt sector of the economy it has important implication for households and state governments d all of u and, again, there's a rean this hasn't hapned in 50 years. this is hardto d t if you look at the alignme of forces and lk at the progress thahas been made, it's quite significant. >> rose: we conclude with dr. denis cortese. he a physician and c.e.o. of the mayo clinic one of the leadin medical centers in the

world. >> t problem is we don't have health care system. there's ner been one designed. nobodyas cociously said what do weeally want out of health care? we've never s dow to desn a system because if we've had, where are if stem engines who design it so we can blame them. >> ros can't find them. >> there n't one. so that... frank, though, that thought is powerfly liberati. because it says if w reali we don't have a system maybe we can sit ba and sort of dign on and sit down and say wha do we ally want out of alth care? >> rose: health care rorm th ama, orszag and cortesecoming .

captning sponsored by rose communications from ourtudios in new york city, this is chare ro. >> rose: health care reforis our subject th evening. it hasecome, ang with the economy, the most impoant and pressing domestic concern fo the president. ineasingly, he's giving intervws andonight had prime time press conference to speak to health care refor and other issues. here is what he said abou heth care. >> even as we rese this economy from a full blown crisis we must rebuild it stronger an bere and health insance reform is central to that effort. thiss t just aut the 47 million americans who don't have any alth insurance at all. reforms about every arican who has evereared that they may

lose their coverage if they become too sick or lose their job or chae their job. it's about every small business th's been forced to y off employees or cut back o their corage because itecame too pensive. it'sbout the fact that e biggest driving foe behind ou feral deficit is the skyrocketing cost of medire anmedicaid. so l me be clear: if we do not contl these costs, we will not be ae to control our deficit. if we do not reformealth care, your premiu and out-of-pocket costs will continueo skyrocket. if we don't act, 14,000 americans willontinue to lose their hlthnsurance every single day. these are the consequences o inaction. these are the stakes of the debate that we're having right now. iealize that th all the charges and criticisms that a being thrown around in washington, a lot of americans may bewondering"what's in this for me? how do my family stand to

benet from health insurance reform so tonight iant to answer thos questions because even though congress isstill workg through a few key issues, we already have rough aeement on the following areas. if youave health insurance, the reform we're proposing will provide yowith more security and more sbility. it will keepgovernment out of health caecisions, giving you the option to kp your insurance if you're happy with . it will prevent iurance companies fr dropping your verage if you get too sick. it wl give you t security of knowinthat if you lose your job, if you move, or if you change yr job, you'll still be able to have coverage. it willlimit the amount your surance company can force yo toay for your medical cost out your own pocket and it will cer prentative care likeheckups and mammograms that save lives and money. now, ifou don't have health insurance, or youe a small businessooking to cover yr employees,ou'll be able to oose a quality, affoable

heth plan through a heal insurance exchange, a markplace that promot choice and competition. finally, no insurance company will be allowed to deny you coverage because of pre-exting dical condition. we're now seeing broad agreement thanks to the work th has been done over the st few days. so even though we sll have a few issu toork out, whas remarkable athis point is not how far we have left too, it's how far we have already come. i understand h easy it isor this town to become consumed in the me of politics, to turn every iue into a runningally who's up and who's dn. i've heard one repubcan strategist told his party that even though th may want to comprose, it's betr politics to go for the kill. another rublican sator said that defeating health care refo is about breakin me. so let mee clear. is suspect about me. i have great healthinsurance and so does every member of congress. this debate is about the letters i read when i sit in the oval office eveday and the sties

hear at town hall meetings. if somebody told you thathere is a plan out there tt is guarteed toouble your health care cts over the next ten years, that's guaranteed to relt in more americans losing their healt ca and that is by far the biggest contribut to our federal deficit, i thi mo people would be oppos to at. well, that the status quo. that's what we have right now. if we don't change, we can' expect a different relt. and that's why i think this i so importan not only for those families out there who are struggling and who nee some protection from abuses in the insurance industry or ne some protection from skyrketing costs, but it's also important for our economy and, by the way, it'smportant for families' wages an incomes. one of the thing that doesn get taed about ishe ft

that whe premiums are going up and th costso employers are going up, that's mone tt could b going into people's wages and incomes. and er the last decade, we sically saw middle-class families, their incomes and wages flat lin. part of the reason because health care cos are gobbling that up. chuck todd >> thanks. were just talki in that estion about reducing the health care inflation, rucing costs. n you explain how you're gog to expand covage? is it fair to say... is this bill going to cor all 47 milln americans that are uninsured or is th going to be something... is it gng to take a maate or is is something that isn't... ur bill is probably notoing to get it al e way there and if it's not going to get a the way there can you say how far is enoh? okay, 0 milli more, i can sign that. 10 million more, i can't. >> i want to cover everybody. now, the tths that unless

you have a... what's called a single yer system in which everybods automatically coved, then you're probly not going to reach every single individual becau there's always going to be somebody t there who thin they're indestructib and doesn't want to get health care, doesn't both getting health care, and then unfornately when they get hit by a bus end up in the emergency room and theest of us have to payor it. but thas not the overwhelming majority of americans. the overwhelng majorityf americans want health care b millions of them can afford it. so e plan that has been... that i've put forrd and that whate're seeing in congress would cover the estimates aret least 97% to 98% of american there might still be ople left out there who even thoh there's an individua mandate, ev though they are required t purcha health insuranceight still not get it.

despite a lot of subsidies are still in such dire straits that it's still hard for them to afford it and we m end up givi them some sort of hardship exetion. but... i'm sorry go ahead so i think thatheasic idea should be that in thiscountry if y want health care you should be le to get affordable health care. d given theaste thas already the system rig now, if w just redesign certain elements ohealth care then we can pafor it. we can pay for hit i the short term but we can al pay for i inhe long term. and, in fa, there' going to be a whole lot savings that we obtain from that because for example the average american fami is paying thousands of dollars in hidden costs in their insurance premium to pay for what's called uncompensated care: people who sho up at the emergency room because they

don't have primary ca physician. if wcan get those ople inred an instead of havi a fo amputation becaus of advanced diabetes they're getting a nutritionist who's working with them to make sure that they are keing their diet where it needs to be, that's going to save u all money in thlong term. jake? >> thank you, mr. president. you said earlie that you nted to tell the america people what's in it for them, how will their family benefit from health care reform. bu experts say that inddition to the benefit that y're push there is going to have tbe sacrifice in orderor there to be trueost cutting measures such as americans giving up tests, referrals, choice, end-of-life ca. when you dcribe health care form, youon't...

undetandably you don't talk about the sacrifices that americans might ve to make. do you think... do you acct thpremise that other than some tax increes on the wealthiest americans, the arican people e going to have to give anything up order for this to happen? >> they're going to have to give up paying for things thaton't ke them hlthier. and i... speaking as an american i think that's the kind of change youant. look, if right now hospitals and doctors aren't coordining enough to have you just ke one test when y come in because of an illness but instead hang you take one tt then you go another-to-another spealist you take aecond test,hen you go to another specialist you take a trd test and nobody's boering toend the first test that you took-- same test-- to the next doctors, you're wasting money. you may not seeit because if you have health insurance right now, it's just being sent to the

insurance company. but tt's raising your emiums. it's raising everybody's premiums. and that mey one way or another is coming out of your pocket. althou we are also subsiding some of tha cause there are tax breaks for health care. so not only it costing you moy in terms o higher premiums, it's also costing you as a taxpayer. no i want to change that. every americanhould want to changehat. why would we wanto pay for things that don't work, that aren't making us healthi? and re's what i'm confident about. if docrs and pients have t bestnformation about what works and wha doesn't tn they're going toant to payor what works. there's a blue pill and this a red pill and the blue pill i ha the price of theed pill and works just as wl, whynot pay half pri for thehing

that's going tmake you well? but thsystem right now doesn't incentivize that. those are the changes tt are going to be needed... tha we' going toeed to make inside the syem. it will require i think tients to-- as well as docts, as well asospitals-- to be more discriminating consumers. but i think that's a good thing, because ultimaty we can't ford this. we just can't affor whatwe're doing rightow. >> rose: we continue our conversation aut health care form by talking to onef the principal shapersn the white house. he's peter orszag,the office of managementnd budget. ter orszag has taken an increasily prominent role on heth care issues. the "n yorker" magazine has written that he is program the dominant vce on health ce wiin the white house. earlr today, i corded a

coersation about health care and the economy. the economy portioof that intervw will be seen later tonight, the healthare part of a conversation with peter orszag. let me just start by what you think ts debateis at a criticaltage and what y think the debate ought to be abou >> well, it is at a crital stage. it's nsurprise. i mean,q broad sce healthreform hasn't happen in0 years. i think the debate really needs to be about whether we are goi to not only expand cerage but perhaps if not more importantly transfm the health care system so that it's digitized, s that it's evaluating what'sorking and what's not, and so that we are changing the incentives built into the curre system away from moreare, which is the way they'recurrently oriented. and towards better care, which

ishat what we need to do. >> rose: whatdo you thinkre e more critical e