Mr. President. Are you interviewing me . Ive been talking a lot today. That was a good thing you did. Thank you for coming. It is wonderful to be back, and let me start just by saying to all the people who have for years now supported the incredible efforts of cgi, thank you. Because wherever we travel, all across the globe, we see the impact that its making every single day. And were very proud of what you all do. And let me say that we still miss our former secretary of state. And i should add that i should add, there is nothing she said that was not true. Particularly the part about us marrying up. Well that brings me to my First Health Care comment. This is going to be a conversation about domestic and International Health and americas role in it. But i want to begin by telling you that i think the first lady has done a great job in this fight against childhood obesity. We have been honored in our foundation to be asked to represent her effort in 18,000 schools. Where weve lowered the calories and drinks being served in schools by 90 . But she has been great on that. The other thing i think is that i was a little upset, and as you know, called one of your Administration Members when you got to africa. When i read an article that said that you didnt have a Big Initiative in africa. And i said i cant say exactly what i said. But i said that is inaccurate. Thats the sanitized version of what i said. Because when the president took office, our programs begun under president bush was giving anti retro viral medicine to 1. 7 Million People. Because of an agreement that i made with president bush to use generic drugs that were approved by the fda, about half our drugs were being purchased in that way. Under president obama, weve gone to 99 . We are treating more than 5. 1 Million People, three times as many for less money. That is a stunning legacy. So that more money has been put into malaria medicine, bed nets, and so you have saved a lot of money, and saved more lives while doing it. And im very proud of that. And i want to thank you for it. Its important. Now, maybe at the end of this conversation we can give back to some of your current Global Health initiatives. But lets talk a little about the health care law. Because were about to begin on october the 1st open enrollment for six months. And id like to give you a chance, first of all, to tell them why when you took office we were teetering on the brink of a depression. You had to avert it, you had to start the recovery again. Why in the midst of all this grief did you also take on this complex issue . Many people were saying, why doesnt he just focus on the economy and leave this alone . So tell us why you did it. Well, first of all, i think its important to remember that health care is the economy. A massive part of our economy. And so the idea that somehow we can separate out the two is a fallacy. Second of all, the effort for us to deal with a Multifaceted Health care crisis has been going on for decades. And the person who just introduced us, as well as you early in your presidency, had as much to do with helping to shape the conversation as anybody. The fact is that we have been, up until recently, the only advanced industrialized nation on earth that permits large numbers of its people to languish without Health Insurance. Not only is there the cruelty of people who are unable to get Health Insurance, having to use the emergency room as their doctor, or their health service, but were also more efficient than anybody else. And so when we talk about, for example, our deficit, you know this better than anybody. The reason that we have not only current deficits, but also projected longterm deficits, this structural deficit that we have, is primarily based on the fact that we have a hugely inefficient, wildly Expensive Health care system that does not produce better outcomes. And if we spent the same amount of money on health care that canada or france or Great Britain did, or japan or any other industrialized country, with the same outcomes or better outcomes, that essentially would remove our structural deficit. Which would then free up dollars for us to invest in Early Childhood education and infrastructure and medical research and all the other things that can make sure that were competitive and growing rapidly over the longterm. So my view when i came into office was, weve got an immediate crisis. Weve got to get the economy growing. But what we also have to do is start tackling some of these structural problems that had been building up for years. And one of the biggest structural problems was health care. Its what accounts for our deficit, its what accounts for our debt. It causes pain and misery to millions of people all across the country. It is a huge burden on our businesses. And i was out at a ford plant out in missouri, and making the fseries out there, it was a big stamping plant. Ford is now the biggest seller in the United States. We took that lead back from the japanese automakers. But we are still burdened by the fact that every u. S. Automobile that is manufactured requires a couple of thousand dollars in added Health Care Costs that our foreign competitors dont have to pay. So this is has everything to do with the economy, in addition to what i consider to be the moral imperative that a mom should not have to go bankrupt if her son or daughter gets sick. That, you know, a family who is dealing with a layoff and is already struggling to pay the bills, shouldnt also be wondering whether theyre one illness away from losing their home. And i think most americans agree with that. So first of all, folks, for those of you who are from the United States, i thats about as good an overview as youre ever going to hear of what this economic issue is. But do you remember the president said our structural deficit would disappear if we had a comparable Health Care System in terms of cost to the french and germans that are consistently rated the highest . Its about 1 trillion a year. And somewhere around 44 of that money is governmentfunded money. So you just run the numbers. Think of over half of our deficit is already disappeared because of Economic Growth and the revenues you raise and the spending we cut. And you pretty much get rid of the rest of it if we just had come parbly expensive system to any other country. Before you took office, we lost a car company that wanted to locate in michigan that went instead to canada, and they announced they said, look, were a car company that provides Health Care Benefits to their employees who are not Health Care Company that sells cars to cover our bills. We have to go to canada. So i think this is and it was one of the few companies willing to go on record and say this. So thank you for doing it. So lets talk about this. What does this open enrollment mean . How are people going to get involved . When you have universal enrollment, you can manage your costs better and cut inflation down. Ill give the president a chance to talk about all the good stuff thats happened, but i just want you to know one thing. In the last three years, just since we started doing this, inflation in Health Care Costs has dropped to 4 for three years in a row for the first time in 50 years. 50 years. Before that, the costs were going up at three times the rate of inflation. For a decade. So now what . What are you going to do on october 1st . Tell them how this has got to work . Well, let me give folks just a little bit of background about whats already in place, and then what happens on october 1st. When we passed the Affordable Care act, there were a number of components to it. A big part of it was essentially providing a patients bill of rights that americans and advocates have been fighting for for decades. So what we wanted to do was make sure if you already have Health Insurance, that you get a fair deal. That youre being treated well by your insurers. So we eliminated, prohibited Insurance Companies from imposing lifetime limits. Which oftentimes, if a Family Member really got sick, they thought they were covered until suddenly they hit that limit, and now theyre out hundreds of thousands of dollars with no way of paying. We said to Insurance Companies, youve got to use at least 80 of your premium that youre receiving on Actual Health care, not on administrative costs and ceo bonuses. And if you dont, youve got to rebate anything you spent back to the consumer. So there are millions of americans who have received rebates. They may not know they got it because of the Affordable Care act or quote, unquote, obamacare, but i but theyre pretty happy to get those rebates back. Because it made sure that the Insurance Companies were treating folks fairly. We said that any young person who doesnt have Health Insurance can stay on their parents Health Insurance until theyre 26 years old. And as a consequence, what we have seen is steadily the rate of uninsured for young people dropping over the last three years, since the bill passed. And obviously providing a lot of relief to a lot of parents out there, because a lot of the young people, as they have been entering into the job market at a time when jobs are tough to get and oftentimes benefits are slim, this is providing an enormous security until they get, you know, more firmly established in the labor market. We provided additional discounts for Prescription Drugs for seniors under the medicare program. And so seniors have saved billions of dollars when it comes to their Prescription Drugs. So there have been over the last three years a whole array of Consumer Protections and savings for consumers that result directly from the law we passed. And for those who say they want to repeal it, typically when you ask them about what all these various benefits, they said well that one is good and that one is pretty good, and we would keep that. And you pretty much go down the list, and theres not too much people object to. You will recall also at the time that part of the way that we paid for the Health Care Bill was we said, medicare is wasting a lot of money without making seniors healthier. And there was a lot of hue and cry about how we were taking money out of medicare. Well, it turns out that we were right. That we could change how doctors and hospitals and providers were operating, rewarding them for outcomes as opposed to simply how many procedures they did. You started seeing practices change among millions of providers across the country. Medicare rates have actually slowed in terms of inflation. Seniors have saved money. Folks are healthier. And some of those savings we have been able to use to make sure that people who dont have Health Insurance get Health Insurance. Now, this brings me to october 1st. The one part of the Affordable Care act that required several years to set up, but a critical part, was how do we provide Health Insurance for individuals who dont get Health Insurance through the job . Its a historical accident that in this Country Health care is attached to employers. And part of the problem is, if youre out there shopping for Health Insurance on your own, youre not part of a big pool. Well, theres no aggregation of risk taking place for the insurers. So theyre basically going to say lets see. Youre 50 years old. Youve got high blood pressure. And we just look at the actuarial tables and figure youre going to get sick so were going to charge you 1. 500 a ma for Health Insurance which the average person has no way of affording, because there is no pooling of risk. So what we said was, we need to set up a mechanism to pool people who currently dont have Health Insurance so that they have the same purchasing power, the same leverage that a big company does when theyre negotiating with the Insurance Company. And essentially what we have done is, we have created what were calling marketplaces in every state around the across the country, where consumers are now able to be part of a big pool, insurers have to bid, essentially compete for the business of that pool, and what we now have set up are these marketplaces that provide highquality health care at affordable prices, giving people choices so that they can get the Health Insurance that they need and they want, and the premiums are significantly lower than what they were able to previously get. Ill take the example of new york state. The insurers put in their bids to participate in these marketplaces. It turns out that their rates are up to 50 lower than what was available previously, if you just went on the open market and tried to get Health Insurance. 50 lower in this state. California, its about 33 lower. In my home state of illinois, they Just Announced its about 25 lower. So just by pooling and creating competition so that insurers have to go after peoples business the way they go after a group plan, we have drastically reduced premiums and costs. On top of that, what were now doing is were saying, if better deal that youve got, you still cant afford it, were going to give you tax credits to subsidize your purchase of Health Insurance. And heres the net result. Well be continuing to roll out what the actual prices are going to end up being. But i can tell you right now that in many states across the country, if youre say a 27yearold young woman, dont have Health Insurance, you get on that exchange, youre going to be able to purchase highquality Health Insurance for less than the cost of your cell phone bill. And because all the insurers who participate are required to, for example, provide free preventative care, free contraceptive care, that young woman, she may make up what she is spending in premiums just on her monthly use of health care. So this is going to be a good deal for those who dont have Health Insurance, those who already have Health Insurance get better Health Insurance. And the best part of the whole thing is because of these changes we initiated in terms of how were paying providers, Health Care Costs have grown, as you have pointed out, mr. President , at the slowest rate in 50 years. We are bending the cost curve and getting at the problems that are creating our deficits in medicare and medicaid. I should point out that so far in most states, one of the things that at least i didnt know what would happen, is that when we began this in the United States, more than 80 of the american states had only one or two companies writing Health Insurance who had more than 80 of the market. So there was, in effect, no price competition. So i what i was terrified of was, you know, we would open these things and there would only be one company show up and bid, and this whole thing we would be having an academic conversation. Instead, its actually led to the establishment of more companies doing morbiding. And i think part of it is they have greater confidence they can deliver health care at a more modest cost. So so far, its good. But i think its important for you to tell the people why were doing all this outreach. Because this only works, for example, if young people show up and even if they buy the cheapest plan, they claim their tax credit so it wont cost them much, 100 bucks a month or so. Weve got to have them in the pools, because otherwise these projected low costs cannot be held if older people with preexisting conditions are disproportionately represented in any given state. Youve got to have everybody lined up. So explain what all the work youve been doing on the outreach for the opening on october. Well, i think president clinton makes a really important point. And the way pools work any pool is essentially those of us who are healthy, subsidized somebody who is sick at any given time. We do that because we anticipate, well, at some point well get sick, and we hope the healthy person is in our pool, and so those costs and those risks get spread. Thats what insurance is all about. And what happens is, if you dont have pools that are a crosssection of society, then people who are already sick or more likely to get sick, theyll all rush out and buy insurance. People who are healthy, they say, you know what, i wont bother. And you get whats called adverse selection. Essentially what happens is, the premiums start going higher and higher, because the risks arent spread broadly enough across the population. So you want to get a good crosssection in every pool. Thats why Big Companies have an easier time getting good rates for their employees than small companies. Because if you only had had five employees, one person is stricken with breast cancer, lets say. Your rates potentially shoot up. But if its 1,000 employees, then it gets spread out. So on october 1st, open enrollment begins. All these folks can start signing up for the marketplace. And what we want to make sure of is that everybody in every category, every age group, understands why Health Insurance is important, understands why they should sign up, understands the choices that are going to be available to them. Theyre going to be able to go to a computer, tap on the web page and theyre going to be able to shop, just like you shop for an airline ticket. Or a flat screen tv. And see whats the best price for you, whats the plan thats best suited for you. And go ahead and sign up right there and then. And that open Enrollment Period will last from october oh 1st until the end of march. And so there will be six months for folks to sign up. Normally, this would be pretty straight forward. A lot of people dont have Health Insurance, a lot of people realize they should get Health Insurance. But lets face it. Its been a little political, this whole obamacare thing. And so what you have had is an unprecedented effort that you have seen ramp up over the last month or so. In which those who have opposed the idea of universal health care in the first place, and have fought this thing tooth and nail through congress and through the courts and so forth, are have been trying to scare and discourage people from getting a good deal. And so some of you may have seen some of the commercials out there that are a little wacky. And the main message we have, and were using social media, were talking to churches, were talking to various civic groups. And what were saying to people is, look, just go to the website yourself. Go to healthcare. Gov. Take a look at whether this is a good deal or not. Make your own decision about whether this is good for you. Because what we are confident about is that when people look and see that they can get highquality, Affordable Health care for less than their cell phone bill, theyre going to sign up. They are going to sign up. And part of what i think the resistance we have seen ramp up, particularly over the last couple months is all about is the opponents of Health Care Reform know theyre going to sign up. In fact, one of the major opponents, when asked, why is it that you potentially would shut gown the government at this point just to balk obamacare, he basically fessed up. He said, well, once consumers get hooked on having Health Insurance, and subsidies, then they wont want to give it up. Thats you can look at the transcript. This is one of the major opponents of Health Care Reform. It is an odd logic. Essentially theyre saying, people will like this thing too much, and then it will be really hard to roll back. So it is very important that people just know whats out there. Whats available to them. And let people make up their own minds as to whether it makes sense or not. Now, one last thing i want to say. Because i do think sometimes people come up to me and they say, well, if this is such a good deal, how come the polls show that its not popular . Well, one of the things you and i both know, when you come to health care, theres no more personal and intimate decision for people. I mean, this is something that people really care about. And frankly, the devil you know is always better than the devil you dont know. And thats what harry and louise was all about back in the 90s, right . It was scaring people with the prospect of change. And so part of our goal here is just to make sure people have good information. And theres been billions of dollars spent making people scared and worried about this stuff. And rather than try to disabuse people of every single bit of misinformation thats been out there, what were saying is just look for yourself. Take a look at it. And you will discover that this is a good deal for you. Well, first of all, i completely agree with that. I think what we have got to just drive people to the websites. The states that are participating. The Supreme Court decision would have upheld the health care law. Said that states didnt have to set up these marketplaces if they didnt want to, but if they didnt, the federal government would set it up. They also said that states didnt have to expand medicaid coverage to help people whose incomes are up to 138 of the federal Poverty Level by buy Health Insurance. There are some states, believe it or not, that want the marketplace, but dont want the medicaid. And thats going to lead to a cruel result. Theres nothing the president can do, and its not his fault. Thats what the Supreme Court said. So we can have this bizarre situation where lets say a business with 60 employees can or an individual going into an individual market will get the benefit of tax credits for everybody with incomes of 138 of the federal Poverty Level or above. But they wont get it for people who work between 100 and 138 . So lower income people who desperately need the Health Insurance, we would have the cruelest of all situations in those states. And theres nothing the president can do about it, because of the Supreme Court decision. So we had to persuade the states to come on. But more and more states with republican governors, republican legislators are doing it. Well, and tell them about arkansas. Because were doing well down there. No, the you know, a little hometown bias here, nothing wrong with that. A couple things that are happening that i think are very interesting. First of all, look, im sympathetic to some of these republican governors who are under a lot of pressure, because the whole issue of whether youre for obamacare or not has become a litmus test to the other party. So some have politically its been tough. Sometimes state legislatures have refused to allow governors to go ahead and implement. But as you indicated, what we have seen is that when republican governors take a look at the deal theyre getting, where in addition to these exchanges were also providing a much more significant match, much more federal money to provide Health Insurance from the states perspective, theyre not paying. The federal government is picking up the tab. And this is helping them, because people are no longer going to the emergency room, and they now have good health care, theyre now getting prevent active care. Youre seeing some republican governors step up and saying, you know, i may not like obamacare, but im going to go ahead and make sure that my people are benefitting from this plan. So thats one good thing happening. The second thing thats happening is, there are a couple states, arkansas is a good example, kentucky is another good example. Idaho, interesting example. Now, these are states where i just got beat. I mean, i you know, i do not have a big constituency in these states. Well, i take that back. You know what, i mean, 40 is still a lot of people. But im losing by 20 in these states. But the governors were still able to say, were going to set up our own state exchanges. Their own marketplaces. And each state is just using their own name for it. So i had a i had a conference, video conference, with all the state directors of all the marketplaces. And im talking to the director in kentucky and idaho, and you know, kentucky its called, like kentucky connect and in idaho its called the Idaho Health Care exchange. Theres a story that came out of kentucky where some folks were signing people up at a county fair somewhere, and some guy goes up and he starts looking at the rates and decides hes going to sign up. And he turns to his friend and said, this is a great deal. This is a lot better than obamacare. All right . Which is which is fine. Because we you know, i dont have pride of authorship on this thing. I just want the thing to work. And, you know, arkansas just came out with its rates, and as has been true in virtually every single state, not only are premiums lower than they were, theyre a lot lower than even the most optimistic predictions were about how low they would be. And, you know, once these marketplaces are up and running, it turns out that what has traditionally been a pretty conservative principle, which is competition and choice work, well, in the Insurance Market, competition and choice work. And what were seeing is that people are going to be able to get the kind of health care that they have never been able to get before, states are going to benefit from it, because theyre going to save money. And one thing that all of you probably very few people in this room who dont have Health Insurance, although if you dont, you should sign up starting on october 1st. One of the things that many people dont realize is that the the subsidy that all of you provide for the uninsured is about 1,000 per family. You pay 1,000 everybody here who has got Health Insurance, pays about 1,000 more for your familys insurance than you otherwise would have. Because hospitals are mandated, they are required, to provide service to anybody who shows up. And so what happens is, when youve got 15 of the population without Health Insurance, they end up showing up at the emergency room. Typically, at a point when theyre much sicker than if they had been getting regular checkups and preventative care. So you pay for the most expensive care there is, because hospitals have got to recoup that money some way. And the way they do it is to charge higher prices, and people who have Health Insurance end up picking it up. So part of what will help reduce the increase in Health Care Costs is making sure that that hidden subsidy no longer exists. Lets talk a little bit about business, because were out of time, but i think its really important point. You know, as you pointed out, most people who have insurance work for a living or somebody in their family does. And they get their insurance through their workplace. The law says that all employers have to participate if they have 50 employees or more. Many employers with fewer than 50 employees already voluntarily provide some Health Insurance. Both the companies with 50 or more and the companies with fewer than 50 are somewhat concerned. And the employees that have to be insured are those who work 30 hours a week or more. So there were many people who speculated that when this law came into place that it would add to the cost, and there would a lot more parttime workers instead of fulltime workers. Ill save the president the time and energy on this. So far, thats not true. The over weaponing number of people who have been hired coming out of this recession have been they have been hired at lower wages. But they have been fulltime employees. There has not been an increase in the percentage of our employment in parttime work. There has been an increase in relatively lowerwage new jobs, but that means they need Health Insurance even more. So explain very briefly to them how this is going to work. How private employers are helped by their insurance and the requirements. First of all, if youre a Large Employer or an employer with more than 50 employees, youre already providing Health Insurance. You dont have to do anything other than just make sure that you can show that youre providing Health Insurance. And there was a lot of news recently about how we delayed the socalled employer mandate for a year, because under the law, what it says is, if you have more than 50 employees, youre not providing Health Insurance to your employees, then youre going to pay a penalty to help subsidize, to help pay for the fact that we, the taxpayers, are going to have to provide your employees with Health Insurance. Which, by the way, is only fair. A lot of the controversy around the Affordable Care act had to do with these socalled mandates. Both an employer mandate and an individual mandate. And the employer mandate says, if you dont meet your responsibilities by your employees and they end up getting medicaid or theyre ending up in the emergency room, youre basically dumping those costs on to society. Thats not fair. So were going to charge you a couple thousand dollars to help pay for health care for those employees. To the individuals, what we said was, were going to make Health Insurance so affordable, so cheap for you, so heavy hee subsidized if youre not making a lot of money that if youre not getting Health Insurance, then its because you just decided you dont want to. You dont need to. And in that circumstance, what happens when you get hit by a bus, heaven forbid, or somebody in your family gets sick and you havent had them covered. Well, were going to end up having to pay for you anyway, because were not going to just let somebody bleed in front of the emergency room. So what we have said is, youve got to take responsibility. And so there is a small penalty if you dont get Health Insurance. This is where a lot of the controversy and unpopularity came in. Because people generally dont like to be told, youve got to get Health Insurance. And employers dont like to be told youve got to give your employees Health Insurance. But as a society, what we cannot do is to say, you have no responsibilities whatsoever, but youve got guaranteed coverage. And this raises the whole issue of preexisting conditions, which we havent talked a lot about. But is really important. One of the central components of this law, one of the main perversities of the Health Care System before this law passed was there were millions of people around the country who, if you had gotten sick before, you had had a heart attack, if you had had cancer, if you had diabetes, lets say when it first happened, you had a job, you got cured, then you lose your job, or youre trying to change jobs, trying to start a business, you try to go out and get Health Insurance, the Health Insurance company not only could deny you, but had every incentive to deny you. Because basically, they would rather have Healthy People who are paying premiums and never asking for a payout. They dont want somebody who ack arily might get sick. So keep in mind that a huge percentage of our society has some sort of preexisting condition. And they can be locked out. You can do everything right, work hard, build a strong middle class life, but if youve been sick and then you lose your job or something happens, you may suddenly be locked out of the Insurance Market or the premiums may be so high that only somebody fabulously rich could afford it. So what we said is, all right, you know what, Insurance Companies . You can no longer bar somebody from getting Health Insurance, just because theyve got a preexisting condition. But the only way that works is if everybody has a requirement to get Health Insurance. Because think about it. What happens if you dont have that rule . Well, all of us not all of us, but a lot of us who were trying to figure out how to save some money would say well im not going to worry about it until i get sick, and then right when im diagnosed with something thats going to be expensive, ill go to the Insurance Company and say, you cant prevent me from getting Health Insurance, just because ive got a preexisting condition. So they could potentially game the system and it wouldnt work. So now what we have done is said, youve got to provide Health Insurance to anybody, all covers, thats the deal. The flip side is everybody has got some responsibility, and well help you pay f it to get Health Insurance. And thats where a lot of the misunderstandings, the frustrations about Health Care Reform came in. I shoulded add, by the way, that this was the same proposition that was set up in massachusetts under a governor named mitt romney, thats working really well. 99 of people in massachusetts have coverage. And that same principle was ironically considered, you know, a very smart republican, conservative principle. But it was the right one. The economics of it are true. So just to finish up the question, when it comes to businesses, if youre already providing Health Insurance for your employees, thats great. You dont have to do much, other than just make sure that you show us that youve got Health Insurance for your employees. If you have more than 50 employees and youre not providing Health Insurance for them, you now have the opportunity to join a pool of Small Businesses to get a better price and a better deal on Health Insurance. Youre eligible for tax credits in providing Health Insurance for your employees, up to 35 of the premiums for each employee will be a tax benefit, a tax credit from the federal government. But if you still arent providing Health Insurance for your employees after that, then were going to go ahead and peen lies you for it. And you know, i can understand why some businesses wouldnt want to pay for it. If theyre not currently providing Health Insurance for their employees, what that means is that they would rather have, you know, those additional profits than make sure that their employees are, you know, getting a fair deal. In some cases, they may be operating under some very small margins. Keep in mind, since companies are exempted, the average Small Business with five employees, mom and pop shop, ten employees, theyre not under that requirement. So im not that sympathetic to a company, typically. If its got more than 50 employees and generating some significant revenue, were making it affordable for them to provide Health Insurance for their employees, they should do the right thing. I agree with that. We have to close, but i think there is one last issue we ought to deal with. The most important thing, obviously, is just to get people enrolled in this. Well work through it as we go along. But the youve just heard the president say that so far, in virtually every state, the actual prices of the insurance are coming in quite a bit lower than they were originally estimated to. With the original price estimates, and with the government obligated to provide subsidies, which cost money on the budget, right . It was nonetheless estimated that in the first ten years, this would keep the National Debt 110 billion lower than it otherwise would have been. Which means if we come in at even less, we can bring the debt down more, or we can subsidize more Small Businesses and get more Small Businesses into this loop. A lot of people come to me and say, you know, now you sound like the people you used to criticize who say we could cut taxes all day long, increase spending and balance the budget. Dont give me that, this sounds too good to be true. So i think on your before you leave, you should tell people how we can spend more not so much indirect spending, but in tax credits, and still wind up reducing overall federal spending by 110 billion during this decade. Well, couple things just in terms of how this whole thing got paid for. First of all, i think its really important to point out here that the total cost of the Affordable Care act to provide Health Insurance for every american out there at an affordable rate is costing about the same amount over a course of ten years as the costs of the Prescription Drug bill that president bush passed, except that wasnt paid for. We felt obliged to actually pay for it and not just add to the deficit. So what we did its paid for by a combination of things. We did raise taxes on some things. We, for example, said that for highincome individuals, you can pay a slightly higher medicare rate medicare tax. So we bumped that up a little bit. We said that for employers who are currently providing a socalled Cadillac Health care plan, where there are so many bells and whistles, theres no incentive to actually spend wisely when it comes to health care, were actually going to penalize you for that, not only to raise a little bit of money, but also to say youre encouraging the worst aspects of the Health Care System, where you spend a lot of money, you dont get better outcomes. I mentioned to you medicare. We basically said theres a program in medicare called Medicare Advantage. That provides some additional options for medicare recipients above and beyond standard medicare. And its very popular with a lot of seniors. You get, you know, eyeglasses and, you know, other benefits. But it turned out that it was so uncompetitive that we were providing tens of billions of dollars of subsidies to the Insurance Companies under this Medicare Advantage plan without Getting Better outcomes, Health Outcomes for seniors. So what we said was, well keep Medicare Advantage, and well give them a small premium if theyre providing Better Services for seniors. But were going to make you compete for it a little bit, and were going to save tens of billions of dollars in the process, and that will go into paying for the Affordable Care act. So the bottom line is, through these various mechanisms, we have raised enough money to pay for, providing Health Insurance for those who dont have it, to provide these health or these tax credits in the marketplace. And at the same time, because were driving down costs, we actually end up saving a little money. It is a net reduction of our deficit. The irony of those who are talking about repealing obamacare, because its so wildly expensive is, if they actually repeal the law, it would add to the deficit. It would add to the deficit. Now, there have been a couple republicans in the house who have been smart enough to say, were going to repeal all the benefits so that people you know, 20 25, 30 Million People dont get Health Insurance. But were going to keep the taxes that obama raised. We just wont talk about that. And then that way we can say we reduced the deficit. But, you know, obviously youre doing some funny business there with the budget. But look, nothing is free. The bottom line, though, is, do we want to continue to live in a society where weve got the most inefficient Health Care System on earth, leaving millions of people exposed to the possibilities that they could lose everything because they get sick, or weve got little children and families going to the emergency room once a week because theyve got asthma and other preventible diseases because their families arent linked up with a primary care physician who is providing them regular care. Where the costs to society for reduced productivity, illnesses, et cetera, all burden our businesses. Is that the kind of society we aspire to . I think the answer is no. And the notion that we would resist or at least some would resist as fiercely as they would, or as they have, make this their numberone agenda, is perpetuating number one agenda is perpetuating a system in which millions of people across the country, hard working americans dont have access to health care i think is wrong. The we have to close, but i will close with a story. You know, i told you all this morning that the employee that our Health Access program lost was a dutch nurse. We spent a lot of time in the netherlands. We get a lot of support there. O oxy is one of our partners there. I went to celebrate the anniversary with them. They started as a fire Insurance Company with 39 farmers 200 years ago. And we were out there in this big farm field in a tent and the shadow of a 13th Century Church in a big Dutch Windmill and i asked the chairman of the company, are you writing Health Insurance . Because in the netherlands theres no medicare, no medicaid. Everyones on an individual mandate and you subsidize people on their incomes. He says yeah i write it, we all do. He said but we dont make any money on it. And he said we shouldnt. This guys running a huge can you imagine somebody saying that in america . He said we shouldnt. If i cant make money on this business doing traditional insurance business, i got no business in work. He said, look. Health care is a public good. And you got to find a way to finance it for everybody. And he said its just an intermediary function that somebody has to handle. But in the end, its how its delivered, how its priced, and how healthy you can keep your people. So the first ladys trying to keep us all healthier, and youre trying to change the delivery and the pricing. You have to cover everybody to do it. I think this is a big step forward for america. This will over the next decade not only make us healthier, but it will free up in the private sector largely, funds that can then be reinvested in other areas of Economic Growth. And give us a much more wellbalanced economy. But first, we got to get everybody to sign up. Everybody, sign up. Go to healthcare. Gov. Thank you very much. You have been watching a very remarkable moment in the fight for health care in the United States of america. The current president of the United States and former president bill clinton along with barack obama in an unvarnished, unedited, not filtered platform of the clinton global initiative. It was just a fabulous almost one hour. The president of the United States having time to explain the benefits and the reasoning behind the Affordable Care act. Im joined tonight by dr. Corey hebert and also with us tonight, dr. Ronnie whitfield. Gentlemen, i cant get the smile off my face. I just think that this was just a fabulous moment for america because this has been so needed that the platform from president clinton given to president obama to explain exactly what is going to be happening in this country. Dr. Hebert, what was your analysis of this . The most important points made in this discussion tonight . I wrote down a few words because the words like moral imperative, fair, patients bill of rights, high quality Affordable Health care. All these things, they make so much sense. And the way they were broken down by both president s, it was made so clear. Its Crystal Clear that we are a country that must take care of our sick people. And we must do it in a way that people can afford and that the country will not be bankrupt because Insurance Companies want to make too much money. Bottom line. I want the young people to go out there and they need to sign up october 1st, because they definitely do have a lot of preexisting illnesses that they dont know. If you have adhd, thats a preexisting illness as well. Dr. Whitfield i agree what was your thought on the presentation . These two great men took the time to not condemn and confuse the American People, but to explain and educate what this law is about. And i just really am impressed. I was overtaken as well. I thought they did a wonderful job. Good health in my opinion is good business. They talked about the businesses. They talked about the things already put in place. Having those up to the age of 26 years old. Im seeing them where Young Students are able to come get health care. This bill is being implemented and the enrollment is being implemented. Its great to get these guys to not just confuse the American People. Campaigns about whats not true about the Affordable Care law. Now weve got the two powerful many enin the country how this could help people live healthier lives. I thought the president and former president clinton did a masterful job of breaking down all of the negative myths that are out there about this law. And in connecting it to the economy, i thought it was so terribly important. Because that is something that every american can understand. That, you know, if we were to repeal this bill, if the conservatives were to be successful, that the deficit would go up. Yes. And that it would add to the deficit. And also i think the president said what had to be said. Nothing is free. But the benefits certainly outweigh the cost in what were doing as a country. Dr. Hebert, 30 million americans are going to benefit from this. I think thats a low number. The way it was presented tonight, i think the president peaked the curiosity of a lot of americans and broke down the barriers. Really the right wing has been trying to confuse the American People with all the negatives and make them think youre never going to understand this. Youre not going to a website and get a good deal. The president made the case that this is a good deal, dr. Hebert. Yes, he did. And i will tell you, we talked about the young people that need to hit those rolls because it is a great deal. But what i want people to also understand is that women must go out and support this. You know, women never get equal pay for their equal work. And now with obama care, we know that women for the first time will actually pay the same price on their premiums as men. Most of them dont even know they pay 40 more for their premiums than men across the country. So women now are able to do that. Heres what i think if you break it down, rates are going to go down, people arent going to be denied. This is about access. Dr. Whitfield, you see that so much. Access the the linchpin to all this, is it not . Its true. Affordable health care at the cost of a cell phone. Thats amazing. We are two of those young people. I have insurance currently now. But i promise you when open enrollment opens, i will go on the exchanges. Ill be on the website accessing the national. I know a lot of people dont understand now. And i think my only problem with this is we didnt do these education enlightenment sessions sooner. We should have had the president come out maybe six months ago and do this same thing. Other than that, its time to put boots on the ground and get people active in enrolling. If youre following dr. Hebert, go to healthcare. Gov and get involved. Im glad that both president s talked about how theyre trying to scare and discourage the American People away from this. That is what has been happening. But were talking about high quality delivery system. Were talking about rates coming down. Were talking about competition in the market. And every state is going to have an exchange set up. Whether its done by the states or if its implemented by the federal government for the state. So this is a win win across the board. Dr. Hebert, if you can for just a moment, i think the president did the right thing by using the word cruelty. We see a lot of cruelty in america when we see americans who are denied and you have seen that first hand. This is a moral move for america, quickly. It is a total moral move. Right now if you get sick and you dont have insurance, then you will be bankrupt. And that is not fair. Thats not what america is about. We are an altruistic nation, and that is the bottom line. We must take care of our own