Thursday, June 25, 2009

Obama Interview with ABC's Good Morning America: Transcript (6-24-09)

Read the complete transcript. Excerpt below:

DIANE SAWYER: Do you still expect to get health care by the end of the year?


SAWYER: Absolutely?

OBAMA: Absolutely.

SAWYER: If you don't, is it over for four years?

OBAMA: We're going get it done. So, I won't engage in hypotheticals in which we don't. And the reason its going get done is because the American People understand it has to get done. I travel all across the country. And I've done so for the last two years now. Every town I visit, every city I go, people ask me, you know, "Why is it that my premiums have gone up-- two, three times in the last nine, ten years? What can I do when my employer says to me, 'We just can't afford to provide health care anymore'?"

Governors who say Medicaid is-- breaking the bank. We're dealing here in Washington with a enormous federal deficit and debt that is largely driven by health care costs. So, with its families, businesses, or government, we know that we're going have to-- reform this system. And I'm confident that-- if everybody puts their minds to it, we can get it done.

SAWYER: I'd like to start with family experience of health care.

OBAMA: Right.

SAWYER: If I can. Because we hear over and over again, from both sides, from all sides, that we are locked in a vicious cycle of quantity not quality.

OBAMA: Right.

SAWYER: As one doctor wrote. We pay doctors for what they do to to patients, but not what they do for--

OBAMA: Right.

SAWYER: --patients. Is it time for Americans to recognize they're going to get fewer scans, fewer procedures, fewer tests, because the vicious cycle has to stop?

OBAMA: Well, I think what's important is to say to the American People that you should get the best possible care to make you well. And that the measure of the quality of care is not quantity, but whether or not it is making you better. Now, what we've seen is that there's some communities and some health systems that do this very well. Mayo Clinic, a classic example. In Rochester, Minnesota. People go there. They-- spend about 20-30 percent less than some other parts of the country, and yet have better outcomes.

And in other cases, you've got more spending, worse outcome. So, what we've said is let's put out the research. Let's study and figure out what works and what doesn't. And let's encourage doctors and patients to get what works. Let's discourage what doesn't. Let's make sure that our payment incentives allow doctors to do the right thing. Because sometimes our payment incentives don't allow them to do the right things. And if we do that, then I'm confident that we can drive down costs significantly.

SAWYER: Will it just be encouragement? Or will there be a board making Solomonic decisions--

OBAMA: Well, what I-- what I--

SAWYER: --about best practices? And--

OBAMA: What I've suggested is-- is that we have a-- a commission that helps-- made up of doctors, made up of experts, that helps set best-- best practices.

SAWYER: By law?

OBAMA: Well, what it does is-- that if we know what those best practices are, then I'm confident that doctors are going want to engage in best practices. But I'm also confident patients are going insist on it. Because one of the things they're going say is, "Well, gosh, Doctor. If-- if-- if-- what I'm hearing is, is that I just need one test instead of five. Am I paying for the other five?"

Employers are going start asking, when they're shopping around for health systems for their employees, "Are we getting the best deal possible?" So, I-- I think that-- we-- we shouldn't be overly cynical. In some cases, people just don't know what the best practices are. And certain cultures build up. And we can change those cultures, but it's going require some work.