Guiding Principles

President Obama is committed to working with Congress to pass comprehensive health reform in his first year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans.

* Learn about the fundamental health insurance consumer protections included in reform.

Comprehensive health care reform can no longer wait. Rapidly escalating health care costs are crushing family, business, and government budgets. Employer-sponsored health insurance premiums have doubled in the last 9 years, a rate 3 times faster than cumulative wage increases. This forces families to sit around the kitchen table to make impossible choices between paying rent or paying health premiums. Given all that we spend on health care, American families should not be presented with that choice. The United States spent approximately $2.2 trillion on health care in 2007, or $7,421 per person – nearly twice the average of other developed nations. Americans spend more on health care than on housing or food. If rapid health cost growth persists, the Congressional Budget Office estimates that by 2025, one out of every four dollars in our national economy will be tied up in the health system. This growing burden will limit other investments and priorities that are needed to grow our economy. Rising health care costs also affect our economic competitiveness in the global economy, as American companies compete against companies in other countries that have dramatically lower health care costs.

The President has vowed that the health reform process will be different in his Administration – an open, inclusive, and transparent process where all ideas are encouraged and all parties work together to find a solution to the health care crisis. Working together with members of Congress, doctors and hospitals, businesses and unions, and other key health care stakeholders, the President is committed to making sure we finally enact comprehensive health care reform.

The Administration believes that comprehensive health reform should:

* Reduce long-term growth of health care costs for businesses and government
* Protect families from bankruptcy or debt because of health care costs
* Guarantee choice of doctors and health plans
* Invest in prevention and wellness
* Improve patient safety and quality of care
* Assure affordable, quality health coverage for all Americans
* Maintain coverage when you change or lose your job
* End barriers to coverage for people with pre-existing medical conditions

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WILSON: On compromise, you've heard criticism from both sides. Tell me your thinking about compromise -- when it's necessary, when -- just the way you've thought about it this year -- to achieved what you've achieved.

OBAMA: Nowhere has there been a bigger gap between the perceptions of compromise and the reality of compromise then in the health care bill. If you look back at the commitments I made during the campaign and the guidelines that I set forward for what I wanted to see in the health care bill, when I made my speech to the Joint Session on September 9, we got 95 percent of what we called for. We said we wanted to make sure we covered 30 million Americans who don't have coverage -- that's in both the House and the Senate bills. We said we wanted to end insurance company abuses, like people with preexisting conditions not being able to get coverage, or sky high out of pocket expenses -- those robust reforms.

Essentially, a patient's bill of rights on steroids is embodied in this bill. We said that we wanted to help small businesses provide health insurance for their workers. Those provisions are in this bill. I said that it had to be deficit neutral. It's not just deficit neutral, according to the CBO, it actually reduces the deficit over the next 20 years by over a trillion dollars. Every serious economist out there says there's not an idea about getting more bang for our health care dollars that has been followed out there that is not embodied in this bill.

So, every single criteria for reform that I put forward is in this bill. It is true that that the Senate version does not have a public option and that has become a source of ideological contention between the left and the right, but I didn't campaign on a public option. I think it is a good idea but as I said on that speech on September 9, it just one small element of a broader reform effort.

So we don't feel that the core elements to help the American people that I campaigned on ¿ and that we've been fighting for all year -- have been compromised in any significant way. Do these pieces of legislation have exactly everything that I'd want? Of course not. But they have the things that are necessary to reduce costs for businesses, families and the government. So the way I generally think about compromise has been that I start with a set of core principles about what it is we're trying to achieve. We work with House and Senate members -- and there are some red lines that can't be crossed from our perspective -- and there are other areas where there are legitimate debates about how to achieve those goals. If someone can show me a different way of getting things done that accomplishes that endpoint, I'm happy to consider those.

But when it comes to health care reform, as the major example, I'm not just grudgingly supporting that bill. I am very enthusiastic about what we've achieved and I would challenge anybody to take a look at what I campaigned on and what we started with at the beginning of the year to find any significant gap from what I said then and hat we've achieved. In fact, I am pleasantly surprised about how well the House and Senate have performed given the complexities of this issue, and the fact that the insurance industry has spent hundreds of millions of dollars opposing this, that we've seen legislation that conforms as much to our core principles as I had hoped.