Remarks by the President at a Facebook Town Hall
Facebook Headquarters
Palo Alto, California
-snip-
Question: Hi, hey. I’m from -- originally from San Jose, California. My question is:
The 2012 budget plan proposed by Paul Ryan has been praised by many in the media as bold or brave. Do you see this as a time that calls for boldness, and do you think that the plan you outlined last week demonstrated sufficient boldness, or is this just a media creation? THE PRESIDENT: No, it’s a great question. Look, here is what I’d say.
The Republican budget that was put forward I would say is fairly radical. I wouldn’t call it particularly courageous. I do think Mr. Ryan is sincere. I think he’s a patriot. I think he wants to solve a real problem, which is our long-term deficit. But
I think that what he and the other Republicans in the House of Representatives also want to do is change our social compact in a pretty fundamental way.
Their basic view is that no matter how successful I am, no matter how much I’ve taken from this country -- I wasn’t born wealthy; I was raised by a single mom and my grandparents. I went to college on scholarships. There was a time when my mom was trying to get her PhD, where for a short time she had to take food stamps. My grandparents relied on Medicare and Social Security to help supplement their income when they got old.
So their notion is, despite the fact that I’ve benefited from all these investments -- my grandfather benefited from the GI Bill after he fought in World War II -- that somehow I now have no obligation to people who are less fortunate than me and I have no real obligation to future generations to make investments so that they have a better.
So what his budget proposal does is not only hold income tax flat, he actually wants to further reduce taxes for the wealthy, further reduce taxes for corporations, not pay for those, and in order to make his numbers work, cut 70 percent out of our clean energy budget, cut 25 percent out of our education budget, cut transportation budgets by a third. I guess you could call that bold. I would call it shortsighted. (Applause.)
And then, as I said,
there’s a fundamental difference between how the Republicans and I think about Medicare and Medicaid and our health care system. Their basic theory is that if we just turn Medicare into a voucher program and turn Medicaid into block grant programs, then now you, a Medicare recipient, will go out and you’ll shop for the best insurance that you’ve got -- that you can find -- and that you’re going to control costs because you’re going to say to the insurance company, this is all I can afford.
That will control costs, except if you get sick and the policy that you bought doesn’t cover what you’ve got. Then either you’re going to mortgage your house or you’re going to go to the emergency room, in which case I, who do have insurance, are going to have to pay for it indirectly because the hospital is going to have uncompensated care.
So they don’t really want to make the health care system more efficient and cheaper. What they want to do is to push the costs of health care inflation on to you. And then you’ll be on your own trying to figure out in the marketplace how to make health care cheaper. The problem is, you’re just one person. Now, you work at Facebook, it’s a big enough company; Facebook can probably negotiate with insurance companies and providers to get you a pretty good deal. But if you’re a startup company, if you’re an entrepreneur out there in the back of your garage, good luck trying to get insurance on your own. You can’t do it. If you’re somebody who’s older and has a preexisting condition, insurance companies won’t take you.
So what we’ve said is let’s make sure instead of just pushing the costs off on to people who individually are not going to have any negotiating power or ability to change how providers operate, or how hospitals or doctors operate, how insurance companies operate, let’s make sure that we have a system both for Medicare but also for people who currently don’t have health insurance where they can be part of a big pool. They can negotiate for changes in how the health care system works so that it’s more efficient; so that it’s more effective; so that you get better care, so that we have fewer infection rates, for example, in hospitals; so there are fewer readmission rates; so that we’re caring for the chronically ill more effectively; so that there are fewer unnecessary tests. That’s how you save money. The government will save money, but you’ll also save money.
So we think that’s a better way of doing it. Now, what they’ll say is, well, you know what, that will never work because it’s government imposed and it’s bureaucracy and it’s government takeover and there are death panels. I still don’t entirely understand the whole “death panel” concept. But I guess what they’re saying is somehow some remote bureaucrat will be deciding your health care for you.
All we’re saying is if we’ve got health care experts -- doctors and nurses and consumers -- who are helping to design how Medicare works more intelligently, then we don't have to radically change Medicare.
So, yes, I think it’s fair to say that their vision is radical. No, I don't think it’s particularly courageous. Because the last point I’ll make is this. Nothing is easier than solving a problem on the backs of people who are poor or people who are powerless or don't have lobbyists or don't have clout. I don't think that's particularly courageous. (Applause.)http://www.whitehouse.gov/the-press-office/2011/04/20/remarks-president-facebook-town-hall
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