BELGRADE, Montana (CNN) - Fixing the nation's ailing health-care system requires both improving health insurance practices and reducing the costs of treatment, President Barack Obama told a largely supportive Montana audience Friday.
Obama sought out questions from skeptics of his proposed health-care overhaul at his second of three town hall meetings this week to reach out to the American public on his top domestic priority for 2009.
One man who identified himself as a proud National Rifle Association supporter and believer in the Constitution in the traditionally conservative stronghold asked how the government would pay to expand health insurance coverage to 46 million uninsured people.
"You can't tell us how you're going to pay for this," said the questioner. "The only way you're going to get the money is to raise our taxes. That's the only way you can do that."
Obama responded with his oft-repeated explanation for how two-thirds of the cost of overhauling health care - estimated at about $900 billion over 10 years - would come from eliminating waste and improving efficiency in the current system that includes the government-run Medicare and Medicaid programs for the elderly and impoverished.
The rest would have to come from new revenue, he agreed with the questioner, and he called for reducing the amount of tax deductions that people making more than $250,000 a year can make on their income taxes.
"If we did that alone, just that change alone ... that would raise enough to pay for health-care reform," Obama said, noting that would meet his election campaign pledge to avoid any tax increase on people earning less than $250,000 a year.
However, Obama said some taxes would have to be raised, and the crowd applauded when he said he believes people with more money, like himself, ought to pay a heavier burden.
"We've got to get over this notion that we can have something for nothing," Obama said. "That's how we got into this deficit and this debt in the first place."
In reference to emotional and heated debate at some other town hall meetings across the country in recent weeks, Obama told the man, "I appreciate your question, the respectful way you asked it, and by the way, I also believe in the Constitution."
Obama noted there is more work to be done, with Congress seeking to merge at least four bills, along with a possible compromise agreement being negotiated by Democratic Sen. Max Baucus and five other members of his Senate Finance Committee, into a single bill in September.
Another questioner chosen when Obama asked for a skeptic identified himself as an insurance provider who wanted to know why Obama and Democrats are vilifying the insurance industry in the health-care debate. Earlier in the meeting, Obama described what he called discriminatory practices by insurance companies that dropped coverage of people who became sick or refused to cover those with pre-existing medical conditions.
Obama noted some insurance companies are contributing to the reform debate, but said others are spending millions of dollars to try to defeat any health-care legislation. For a health-care overhaul to work for everyone, he said, it has to ensure all Americans are covered so that insurance companies have incentive to participate.
They won't be able to exclude coverage for pre-existing conditions or "cherry pick" healthy people while refusing coverage for sick people, Obama said, so increasing the total numbers covered will be the enticement.
On Saturday, Obama will hold another town hall meeting in Grand Junction, Colorado, before vacationing in some national parks with his family next week.
In addition, White House spokesman Robert Gibbs said Obama will hold "some events not yet announced" in coming days.
While Obama has said consensus can be reached on health-care reform, contentious town hall meetings held by lawmakers around the country have created a different impression.
The White House, and many Democrats in Congress, hope that by building support in the West, the president can start to turn the tide. Though the region is largely Republican, Obama made some inroads in the latest election. He won in Colorado and lost by just a slim margin in Montana.
Obama's town hall events are just part of a larger Democratic strategy for winning support in the region.
The Democratic National Committee began a TV ad this week promoting the president's health-care plan. A committee spokesman told CNN the ad will run on national cable as well as on local cable in New Hampshire, Montana, Colorado and the District of Columbia.
The group Families USA, which supports the president's plan, also launched a new campaign Thursday that includes an ad running in a dozen states - among them Montana and Colorado.
But groups opposed to the president's plan have their own campaigns.
One voter in Livingston, Montana, not far from where the president spoke in Belgrade, summarized the kinds of concerns that she and many others in the region have.
"I believe that there is a health-care crisis, I really do," Sonja McDonald, who voted for Obama in 2008, told CNN's Ed Henry on Thursday. "Do I believe that the government needs to be more involved? No!"
Henry met McDonald at a clinic that gets half its funding from taxpayers.
"The government being involved is fine," McDonald said. "It's just ... when they try and overstep, when they try to say, 'No, this is what needs to be done.'"
100% Obama! You're doing a superb job Mr. President. Eventually, your detractors will be forced to admit that, and people across America will thank you for what you're trying to do for them right now with Heath Care and repairing the American Dream.
Just because these loud mouths think they own the country, they need to remember that they lost the last election and Obama won. More importantly, he is doing what the majority wanted him to do when they voted for him. I am sick and tired of those on the right who think they have a God given mandate to get their way. This country is not mob rule, and just because they may think liberals are here to destroy the country, that does not mean they know what they are talking about. I love my country and I went to war to prove it. Now it is time, for those who put most of them in office to get what they asked for in the last election, and not what the minority mob thinks they have a God given right to have. Democrat politicians need to know that those loud mouths that come to these meetings are not going to vote for them anyhow. I voted for them and I expect them to do that the majority wanted in the last election. I want everyone covered with health care, and for the record, I have good health insurance.
its amazing how the 50% that are against the kinds of reform President Obama espouses (a government run takeover, er uh public plan) were kept out of this townhall.
Why can't the Administration and Congress eliminate waste and improving efficiency in the current system first? Why would it be a good idea to create another huge bureaucrat with many loopholes and potential waste at the same time?
At least I can thank Obama for making big insurance very nervous,maybe they will start to treat their customers with respect.
I have absolute confidence in President Obama to do the right thing by the American people.
Thank GOD we have such a great leader.
Only the Filthy-rich Insurance Industry is against this and they are behind the effort to disseminate miss-information. After spending big bucks and researching buzz words that would create fear in STUPID people, they unleash disgruntled republican operatives to organize loudest protest. But the protestors are just obviously STUPID and they do not reflect the desires of the American People.
PASS HEALTH CARE REFORM NOW !!!!
Mr. Obama, the bucket you are trying to dip from is not bottomless. The over $250,000 crowd already have their deductions limited in several ways....(I know..i spent 20 years doing individual tax returns...of all types) THe $$ isn't there to cover the cost of a government take over of the health care industry. This bill should be taken off the table. There are issues, but this bill is not the way to solve them
I watched the town hall meeting and the President handled it with grace and dignity as did the people who sounded like they were opposed. It was a good dialogue which is what is needed not scare tactics. More of this type of respectful dialogue would go a long way to help every one understand the goals.
Its a sad day when our an article about our President spending time informing citizen about the truth of the Health Care Reform debate, get second billing to an industry mouth piece.
It's really quite simple.
A. The health ins. co's and big pharma are making hugely obscene profits and don't want ANY change.
B. The republicans have sold what little soul they have to these big business types.
C. Both of the above groups place profit above the suffering they create.
D. If the american people are stupid enough to buy into all the bull, and oppose reform, they will get what they deserve... huge increases in health ins. premiums, policy cancelations when they become ill, and health ins. executives deciding what treatment you can get.
What I find hard to understand is how all these supposed family values working class types can support opposing reforms... don't they have the sense to realize that they are working against their own interests? Wait! Never mind, anybody stupid enough to support Palin and to listen to Limpbaugh and Beck... yeah, it makes sense after all.
What is the republican health care plan? Did they try and reform it during the last 8 years?
He has quadrupled the deficit and he has not even been in office a year. God Bless the President but he does not have any credability to anyone who has ever run, owned or managed a business by saying he would come up with $900B by eliminating Medicare waste. I do not want the call my President names but that is not being truthful.
Awesome job all the way around. Intelligent, respectful questions, and a great job on the part of the President to address a lot of the questions and concerns of the audience.
What was with the Montana preamble though?
It was a hand picked audience, so I'll take their questions and reactions with a grain of salt.
If congress can actually pass a bill that will actually reform the industry, not simply add an overpriced (from a taxpayer perspective) government option, I will be happy.
So far a lot of what he states are nothing more than conjecture since none of the bills have been finalized, let alone become law.
I hope the house bill HR 3200 dies quickly. The current Senate bill looks more promising.
Yes this was outstanding...REAL people asking geniune questions. Even people that did not agree with Obama were respectful and acted civilized. Great job President Obama! Nice to see MT people have some class too.
It will be passed.
I have never seen a president work so hard to do what is right for the American people. Thank you President Obama!!
Obama is a class act. And he's still getting used to the job. It took Truman a couple of years to come into his own after Roosevelt died. Obama was not planning to inherit the economic mess that Conservatives left the nation in. The economic collapse surprised all of us.
Those who oppose him are not the loyal opposition. They are political guerrilla fighters who are trying to sabotage the Administration. Conservatives would rather rule a poor country in 2012 than help build a prosperous one now.
I understand the impulse to assume that government-controlled health care will ultimately involve "rationing" in a sense. In lean economic times, there will be budgetary pressure to contain medical expenditures by the government. For example, look at what is happening to coverage of poor children in California.
I also understand that there is a certain "the devil you know vs. the devil you don't know" problem here: though most people who have had serious health issues have faced horrifying problems with their insurance companies, they, at least, feel that they know what to expect. To them, the "public option" is a blank slate–they don't know how it will play out.
The fact of the matter is, though, there are limited resources. If there were no limits, none of these things will be an issue. There is NOT NOW, nor would there be in a public system, unlimited, unrestricted, immediately-available health care to all who want it. There ARE NOW and would be under a governmental system checks on doctor/patient autonomy by some board or panel or whatever.
I don't think, however, that there is any reason to believe that the governmental system will necessarily prove more restrictive, delaying or limiting than private insurance. Private insurers have a profit motive that the government would not. If anything, the governmental system will be less restrictive (and, politically, the pressure would be to go into deficit to keep it less restrictive).
Under the current proposals, the government is doing two things (besides mandating certain minimum standards and underwriting guidelines to the insurance industry): 1. Subsidizing insurance coverage for those who cannot afford it and 2. Operating a public insurance option for those who choose it. The first part of that shouldn't have any direct bearing on what care is approved by the private carriers. The second part merely creates a competitor to the private companies, and probably would be relatively self-sustaining, though ultimately guaranteed by the government. It wouldn't, however, necessarily be dramatically cheaper than private coverage, so if it truly began imposing "rationing" in a particularly draconian way, everyone would flee back to theprivate companies.
Thank you, Mr. President. We are praying for you. You have the hardest job in the world right now.
Another day, another campaign speech full of something for everyone one promises without the detail as to how they are going to be accomplished or paid for. Everyone who is against his vision or questions its reality is vilified as anti-American or a stooge for the Republicans or the insurance companies.
We need a leader, not a campaigner and we need a realist, not a dreamer.
Peggy...Have you read the bill? Or even read the portions that some of us have shown concern about? Blindly following any leader without question is unwise...regardless which side of this debate you are on. This bill will cause more problems that it solves, and it gets the government involved in area's where it should stay out. Please read the bill.
Anti-liberal: A check of the last election results would indicate that your math is wrong. Also, clearly, many of the attendees at this meeting had ideas that differed from the President's. Finally, I'll bet you don't even know what your health insurance costs or what is and isn't covered. In my own case, I am self-employed, 58 and married. My wife and I spend just under $25,000 a year for our insurance because my wife requires Enbril to stave off crippling arthritis. That amounts to just over 33% of our total earnings every year. Am I in favor of government health insurance? You betcha.
The roots of this problem go back to when the health industry became a for-profit industry. Why aren't more conservatives complaining about government take-over regarding police, fire service, postal service, corrections facilities, etc...? We still have private security companies, volunteer fire fighters, UPS/FedEx, and, well, I suppose I can't think of an example of a privately owned jail at the moment. Sue me.
The government can co-exist with private business within an industry. Always has. Always will.
GO OBAMA GO!!!