The other reason we can drive your costs down is you’d be part of a huge pool, right? Part of the reason why large companies are typically able to offer lower insurance premiums for their employees than small companies is they’ve got a big pool. The federal government is a classic example. The Federal Health Employees Program is a pretty good deal, because you’ve got several million people who are part of it. So that gives you a lot of bargaining power with the insurers. Well, the exchange will provide that same market power to help negotiate with the insurers to drive prices down.
And the other thing that we do want to do — now, this is controversial, and I understand some people are worried about this — we do think that it makes sense to have a public option alongside the private option. So you could still choose a private insurer, but we’d also have a public plan that you could choose from that would be non-for-profit, wouldn’t have, hopefully, some of the same high administrative costs, and would be potentially more responsive to your needs at a lower cost. I think that helps keep the insurance companies honest because now they have somebody to compete with.
And I have to say, the reason this has been controversial is a lot of people have heard this phrase “socialized medicine” and they say, we don’t want government-run health care; we don’t want a Canadian-style plan. Nobody is talking about that. We’re saying, let’s give you a choice. You can choose the private marketplace, or this other approach.
And I got a letter the other day from a woman; she said, I don’t want government-run health care, I don’t want socialized medicine, and don’t touch my Medicare. (Laughter.) And I wanted to say, well, I mean, that’s what Medicare is, is it’s a government-run health care plan that people are very happy with. But I think that we’ve been so accustomed to hearing those phrases that sometimes we can’t sort out the myth from the reality.
MR. CUTHBERT: In our tele-town hall, we go next to Lawrence, Kansas, and talk with Mitzi. Mitzi, you’re on the tele-town hall.
Q Mr. President, thank you so much for doing the hard work of health care reform.
THE PRESIDENT: Thank you, Mitzi.
Q My question is, historically, older Americans, along with women of child-bearing age and persons with preexisting conditions, have paid more for health care coverage. And I want to know if reform will eliminate the disparity for older Americans.
THE PRESIDENT: Well, one thing that we strongly believe in is you can’t discriminate in the insurance market. And that’s actually what’s happening right now. You’re not seeing it in Medicare if you’re already in Medicare, but if you’re in the private marketplace right now, essentially insurance companies are cherry-picking. They want young, healthy people because they can collect premiums and don’t have to pay out a lot. And then as people get older, then they start suddenly making it harder for those folks to get coverage. And if they do get coverage, it’s wildly expensive.