Learn English with President Obama and Mark Zuckerberg at Facebook Town Hall English Subtitles

[Music]

there’s so much Facebook for hosting

this first of all my name is Barack

Obama and I’m the guy who got mark to

wear a jacket and time thank you I’m

very proud of that second time I know

III will say and I hate to tell stories

on mark but the first time we had dinner

together he and he wore this jacket and

tie

I’d say halfway through dinner you know

he’s starting to sweat a little bit it’s

really uncomfortable for him so I helped

him out of his jacket and in fact if

you’d like mark we can take our jackets

off

whoo that’s better isn’t yeah but you’re

a lot better at this stuff than me so

first of all I just want to say thank

you to all of you for taking the time

not only people who are here in the

audience but also folks all over the

country and some around the world who

are watching this townhall the main

reason we want to do this is first of

all because more and more people

especially young people are getting

their information through different

media and obviously what all of you have

built together

is helping to revolutionize how people

get information how they process

information how they’re connecting with

each other and you know historically

part of what makes for a healthy

democracy what is is a good politics is

when you’ve got citizens who are

informed who are engaged and what

Facebook allows us to do is make sure

this isn’t just a one-way conversation

make sure that not only am i speaking to

you but you’re also speaking back and

we’re in a conversation we’re in a

dialogue so I love doing town hall

meetings this format and this company I

think is an ideal means for us to be

able to carry on this conversation and

as Mark mentioned I’ll you know

obviously we’re having a very serious

debate right now about the future

direction of our country we are living

through as tumultuous a time as

certainly I’ve seen in my lifetime

admittedly my lifetimes a lot longer

than most of yours so far this is a

pretty young crowd but we’re seeing

domestically a whole series of

challenges starting with the worst

recession we’ve had since the Great

Depression we’re just now coming out of

it

we’ve got all sorts of disruptions

technological disruptions that are

taking place most of which hold the

promise of making our lives a lot better

but also mean that there are a lot of

adjustments that people are having to

make throughout the economy we still

have a very high unemployment rate that

is starting to come down but there are

awful lot of people who are being

challenged out there day in day out

worrying about whether they can pay the

bills whether they can keep their home

internationally we’re seeing the sorts

of changes that we haven’t seen in a

generation we’ve got certain challenges

like energy and climate change that no

one nation can solve but we’re going to

have to solve together and we don’t yet

have all the institutions that are in

place in order to do that but what makes

me incredibly optimistic and that’s why

being here at Facebook is so exciting

for me is that at every juncture in our

history whenever we’ve faced challenges

like this whether it’s been the shift

from a agricultural age to an industrial

age or whether it was facing the

challenges of the Cold War or trying to

figure out how we make this country more

fair and more inclusive at every

juncture we’ve always been able to adapt

we’ve been able to change and we’ve been

able to get ahead of the curve

and that’s true today as well and you

guys are at the cutting edge of what’s

happening and so I’m gonna be interested

in talking to all of you about why this

debate that we’re having around debt and

our deficits is so important because

it’s going to help determine whether we

can invest in our future and basic

research and innovation and

infrastructure that allow us to compete

in the 21st century and still preserve a

safety net for the most vulnerable among

us but I’m also going to want to share

ideas with you about how we can make our

democracy work better and our polit

sex work better because I don’t think

there’s a problem out there that we

can’t solve if we decide that we’re

gonna solve it together and for that I’m

grateful for the opportunity to speak to

you and instead of just giving a lot of

long speeches I want to make sure that

we’ve got time for as many questions as

possible so Marquette I understand

you’ve got the first one yes let’s start

off so let’s start off with the

conversation about the dead right so I

understand that yesterday morning you

had a town Town Hall in Virginia where

you talked about your framework not only

for resolving the short term budget

issues but the longer term debt and you

spent some time talking about tax reform

and some cost-cutting but you also spent

a lot of time talking about things that

you didn’t think that we could cut in

education infrastructure and clean

energy so my question to kind of start

off is what specifically do you think we

should do and what specifically do you

think we can cut in order to make this

all at a good well let me first of all

mark share with you sort of the nature

of the problem because I think a lot of

folks understand that it’s a problem but

but aren’t sure how it came about in in

2000 at the end of the Clinton

administration we not only had a

balanced budget but we actually had a

surplus and that was in part because of

some tough decisions that had made had

been made by President Clinton

Republican Congress Democratic Congress

and President George HW Bush and what

they had said was let’s make sure that

we’re spending wisely on the things that

matter let’s spend less on things that

don’t matter and let’s make sure that

we’re living within our means that we’re

taking in enough revenue to pay for some

of these basic obligations what happened

then was we went through 10 years where

we forgot what had created the surplus

in the first place so we had a massive

tax cut that wasn’t offset by cuts in

spending we had two wars that weren’t

paid for and this was the first time in

history where we had gone to war and not

asked for additional sacrifice from

American citizens

we had a huge prescription drug plan

that wasn’t paid for and so by the time

I started office we already had about a

trillion dollar annual deficit and we

had massive accumulated debt with

interest payments to boot then you have

this huge recession and so what happens

is less revenues coming in because

company sales are lower individuals are

making less money at the same time and

there’s more need out there so we’re

having to help states and we’re having

to help local governments and that a lot

of what the recovery was about was us

making sure that the economy didn’t tilt

over into a depression by making sure

that teachers weren’t laid off and

firefighters weren’t laid off and there

was still construction for roads and so

forth all of which was expensive I mean

that added about another trillion

dollars worth of debt so now what we’ve

got is a situation not only do we have

this accumulated debt but the baby

boomers are just now starting to retire

and what’s scary is not only that the

baby boomers are retiring at a greater

rate which means they’re making greater

demands on Social Security but primarily

Medicare and Medicaid but health care

costs go up a lot faster than inflation

and older populations use more health

care costs you put that all together and

we have an unsustainable situation so

right now we face a critical time where

we’re gonna have to make some decisions

how do we bring down the debt in the

short term and how do we bring down the

debt over the long term in the short

term Democrats and Republicans now agree

we’ve got to reduce the debt by about

four trillion dollars over the next 10

years and I know that sounds like a lot

of money it is but it’s doable if we do

it in a balanced way what I proposed was

that about two trillion dollars over 10

10 to 12 years is reduction in spending

you know government wastes just like

every other major institution does

and so there are things that we do that

we can afford not to do now there’s some

things that I’d like to do are fun to do

but we just can’t afford them right now

so we’ve made cuts in every area a good

example is Pentagon spending where

Congress oftentimes stuffs weapons

systems in the Pentagon budget that the

Pentagon itself says we don’t need but

special interests and constituencies

help to bloat the Pentagon budget so

we’ve already reduced the Pentagon

budget by about 400 billion dollars we

think we can do about another 400

billion dollars so we’ve got to look at

spending both on non-security issues as

well as defense spending and then what

we’ve said is let’s take another

trillion of that that we raise through a

reforms in the tax system that allows

people like me and frankly you mark for

paying a little more in tax I know

you’re okay with that

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keep in mind what we’re talking about is

going back to the rates that existed

when Bill Clinton was president now a

lot of you were I’m trying to say this

delicately still in diapers at that time

but but for those of you who were a call

the economy was booming and wealthy

people were getting wealthier there

wasn’t a problem at that time if we go

back to those rates alone that by itself

would do a lot in terms of us reducing

our overall spending and if we can get a

trillion dollars on the revenue side two

trillion and cutting spending we can

still make investments in basic research

we can still invest in something we call

arpa-e which is like DARPA except just

focused on energy so that we can figure

out what are the next breakthrough

technologies that can help us

reduce our reliance on fossil fuels we

can still make investments in education

so we’ve already expanded the Pell Grant

program so that more young people can go

to college we’re investing more in STEM

education of math and science and and

and technology education we can still

make those investments we can still

rebuild our roads and our bridges and

invest in high-speed rail and invest in

in the next generation of broadband and

and wireless and and make sure everybody

has access to the Internet we can do all

those things while still bringing down

the deficit medium term now there’s one

last component of this and I know this

is a long answer but I want to make sure

everybody had had the basic foundations

for it even if we get this four trillion

dollars we do still have a long term

problem with Medicare and Medicaid

because health care costs the inflation

goes up so much faster than wages and

salaries and this is where there’s

another big philosophical debate with

the Republicans because what I’ve said

is the best way for us to change it is

to build on the health reform that we

had last year and start getting a better

bang for our healthcare dollar we waste

so much on health care we spend about

20% more than any other country on earth

and we have worse outcomes because we

end up having multiple tests when we

could just do one test and have it

shared among physicians on Facebook for

example we could focus on the

chronically ill 20% of the patients

account for 80% of the costs so doing

something simple like reimbursing

hospitals and doctors for reducing their

readmissions rate and managing somebody

with a chronic illness like diabetes so

that they’re taking their meds on a

regular basis so that they don’t come to

the emergency room

that saves huge amounts of money so

that’s what health care reform was about

last year or a year and a half ago and

what we

do is build on that and continue to

improve the system what the Republicans

right now are saying is number one they

can’t agree to any increases in taxes

which means we’d have to cut out of that

four trillion all of it would come from

education transportation areas that I

think are critical for our long-term

future so for example they proposed

seventy percent cuts in clean energy

well III don’t know how we free

ourselves in dependence on foreign oil

and anybody who’s paying gas prices

knows that there’s an economic component

to this as well as an environmental

component to it if we’re not investing

in the basic research and technology

that allows solar wind and others to

thrive and develop at the same time what

they’ve said is let’s make Medicare into

a voucher program so that retirees

instead of knowing that they’re always

going to have health care they’re gonna

get a voucher that covers part of the

cost and whatever health care inflation

comes up is all going to be on them and

if the health insurance companies don’t

sell you a policy that covers your

illnesses you’re out of luck I think it

is very important for us to have a basic

social safety net for families with kids

with disabilities for seniors for folks

who are in nursing homes and I think

it’s important for us to invest in our

basic research we can do all those

things but we’re only going to be able

to do it by taking a balanced approach

and that’s what this big debate is about

all all about right now all right all

right so sorry don’t mean to cut off the

applause no no no no no no the very

thorough answer no they were they were

stunned by the length of that answer but

yeah that’s a complicated stuff so the

next question is from someone watching

Facebook live jf teen from Williamsburg

Virginia

writes in and asks the housing crisis

will not go away the mortgage financing

for new homebuyers with low to moderate

income is becoming very difficult

as president what can you do to relax

the policies that are disqualifying

qualified homebuyers from owning their

first home how can you assure the low to

moderate homebuyers that they will have

the opportunity to own their first home

well it’s a good question and I’ll be

honest with you this is probably the

biggest drag on the economy right now

that we have along with I know the

frustrations people have about gas

prices what we’ve really seen is the

housing market which was a bubble had

greatly over inflated in all regions of

the country and I know I probably don’t

get a lot of sympathy about that here

because I can only imagine what rents

and mortgages you guys are paying it is

a real drag

in all sorts of ways people first of all

they feel poor even if they still have a

home where they’ve already purchased a

home because for a lot of folks their

mortgages now what’s called underwater

the mortgage is more than the home is

worth and so if you feel like your most

important asset is now worth less than

your debt that’s going to constrain how

you spend people who want to move have a

great deal of trouble selling and people

who want to buy as you pointed out are

seeing terms a lot more restrictive so

we’ve put in place a bunch of programs

to try to see if we can speed along the

process of reaching a new equilibrium

for example what we did was we went to

the mortgage lender and said why don’t

you renegotiate with your mortgage with

the person with the mortgage renegotiate

the terms of their mortgage so that

their principal is a little bit lower

they can afford the payments and that

way homes don’t get foreclosed on there

are fewer homes on the on the market and

that will raise prices and they’ll be

good for everybody and we’ve seen some

significant progress on that front the

challenge we still have as your

questioner properly points out is the

a lot of people who bought a first home

when credit was easy now we’re finding

the credit is tough and we’ve got to

strike a balance frankly there’s some

folks who are probably better off

renting and what we don’t want to do is

return to a situation where people are

putting no money down and they’ve got

very easy payment terms at the front end

and then it turns out five years from

now because they’ve got adjustable rate

mortgage that they couldn’t afford it

and they lose their home I think the

regulator’s are trying to get that

balance right

there are certain communities with high

foreclosure rates where what we’re

trying to do is see if can we help state

and local governments take over some of

these homes and convert them and provide

favorable terms to first-time home

buyers but frankly I think we’ve got to

understand that the days where it was

really easy to buy a house without any

money down is probably over and what we

what I’m really concerned about is

making sure that the housing market

overall recovers enough that it’s not

such a huge drag on the economy because

if it isn’t then people will have more

confidence they’ll spend more more

people will get hired and overall the

economy will improve but I recognize for

a lot of folks who want to be first-time

homebuyers it’s still tough out there

it’s getting better in certain areas but

in some places particularly where there

was a big housing bubble it’s not so I

think the next question is from Facebook

employee in the in the room today

so Lauren Hale has a question Lauren

where are you from hey Lauren I thank

you so much for joining us today I am

originally from Detroit Michigan and now

I’m out here working at Facebook so my

question for you kind of builds on some

of the things you were just talking

about at the beginning of your term you

spend a lot of time talking about job

creation and the road to economic

recovery and one of the ways to do that

would be substantially increasing

federal investments in various areas as

a way to fill the void left from

consumer spending

since then we’ve seen the conversation

shift from that of job creation and

economic recovery to that of spending

cuts and the deficit so would love to

know your thoughts on how you’re going

to balance these two going forward or

even potentially shift the conversation

back well you’re exactly right that when

I first came into office that our number

one job was preventing us from getting

into a another Great Depression and that

was what the Recovery Act was all about

so we helped States make sure that they

could minimize some of the layoffs and

some of the difficult budget choices

that that they faced we made sure that

we had infrastructure spending all

around the country and in fact we made

the biggest investment in infrastructure

since Dwight Eisenhower built the

interstate highway system we made the

largest investment in history and clean

energy research and it’s really paying

off for example when I came into office

we had about 2% of the advanced battery

manufacturing here in America and as

everybody here knows what’s really

holding us back from that my goal of a

million electric vehicles on the road is

that battery technology is still tough

it’s clunky it’s heavy it’s expensive

and if we can make significant

improvements in battery technology then

you know I think the opportunities for

electric vehicles alternative vehicles

that are much cheaper you know the our

opportunities are limitless

so so those were all investments that we

made in the first two years now the

economy is now growing it’s not growing

quite as fast as we would like because

after a financial crisis typically

there’s a bigger drag on the economy for

a longer period of time but it is

growing and over the last year and a

half we’ve seen almost two million jobs

created in the private sector because

this recession came at a time when we

were already

people in debt and that made the debt

worse if we don’t have a serious plan to

tackle the debt and the deficit that

could actually end up being a bigger

drag on the economy than anything else

if the markets start feeling that we’re

not serious about the problem and if you

start seeing investors feel uncertain

about the future then they could pull

back right at the time when the economy

is taking off so you’re right that it’s

tricky any but you know folks around

here are used to the hills in San

Francisco and if you’ve driven I don’t

know if they still have clutch cars

around here anybody ever driven a clutch

car you know I mean you got a sort of

tap and well that’s sort of what we’ve

faced in terms of the economy right

we’ve got to hit the accelerator but you

know we’ve got to also make sure that we

don’t gun it we can’t let the car slip

backwards and so what we’re trying to do

then is put together a debt and deficit

plan that doesn’t slash spending so

drastically that we can’t still make

investments in education that we can’t

still make investments in infrastructure

all of which would help the economy grow

in December we passed a targeted tax cut

for business investment as well as the

payroll tax that has a stimulus effect

that helps to grow the economy we can do

those things and still grow the economy

while having a plan in place to reduce

the deficit first by 2015 and then over

the long term so I think we can do both

but it does require the balanced

approach that I was talking about if all

we’re doing is spending cuts and we’re

not discriminating about it if we’re

using a machete instead of a scalpel and

we’re cutting out things that create

jobs then the deficit could actually get

worse because we could slip back into

another recession and obviously for

folks in Detroit where you’re from they

know that our investments can make a

difference because we essentially saved

the

US auto industry we’ve now have three

auto companies here in America that are

all turning a profit GM just announced

that it’s hiring back all of the workers

that it was planning to layoff and we

did so by the way at the same time as we

were able to increase fuel efficiency

standards on cars for the first time in

thirty years so it can be done but it

takes a balanced approach all right so

we have a question from the University

of Florida where in in February we

launched this initiative at

whitehouse.gov/youngamericans with this

goal to have a hundred youth roundtables

across the country and a bunch of them

are taking place right now watching this

Facebook live so Cesare Fernandez and

ELISA retinas are participating in one

of those roundtables and they want to

ask you this mr. president in your

deficit-reduction speech last week you

spoke of the need to not only reduce

government spending but to also increase

federal revenue in light of our nation’s

budget challenges will your

administration consider a visiting

policies such as the DREAM Act which the

Congressional Budget Office estimates

will reduce the deficit by 1.4 billion

and increase the government revenue by

2.3 billion over the next 10 years let

me let me talk about not only the DREAM

Act but about immigration policy

generally and I want to thank Sheryl

Sandberg actually participated in

discussion that we had yesterday

bringing together business leaders and

government officials and faith leaders a

broad cross-section of Americans

together to talk about how do we finally

fix an immigration system that’s

fundamentally broken for those of you

who aren’t familiar the DREAM Act is it

deals with a particular portion of the

population kids who were brought here

when they were young by their parents

their parents might have come here

illegally the kids didn’t do anything

they were just doing what kids do which

is follow the

parents they’ve grown up as Americans

they went to school with us or with our

kids they think of themselves as

Americans but many of them still don’t

have a legal status and so what we’ve

said is for especially for these young

people who are our neighbors our friends

our children’s friends you know if they

are of good character and going to

school or joining our military they want

to be part of the American family why

wouldn’t we want to embrace them why

would why would why wouldn’t we want to

make sure that why wouldn’t we want to

make sure that they’re contributing to

our future so that’s the DREAM Act but

that’s just a small part of a broader

challenge that we have immigration in

this country has always been complicated

you know the truth of the matter is that

we are both a nation of immigrants and a

nation of laws sometimes the laws

haven’t been fair sometimes the laws

have been restricted to certain ethnic

groups there have been quotas sometimes

our immigration policies have been

arbitrary and have been determined by

whether industry at a particular time

was willing to bring in workers on the

cheek but what’s undeniable is America

is a nation of immigrants that’s our

history and that’s what makes us

stronger because we’ve got ambitious

people from all around the world who

come here because they’ve got a new idea

and and and they want to create the next

big thing or they just want a better

future for their kids and their family

and that dynamism is part of what’s

propelled our progress and kept us young

now I think most Americans understand

that and most Americans agree with that

at the same time I think most Americans

feel there should be an orderly process

to do it

people shouldn’t just be coming here and

cutting in front of the line essentially

and staying without having gone through

the proper channels so what we’ve said

is let’s fix the whole system first of

all let’s make the legal immigration

system more fair than it is and more

efficient than it is and that includes

by the way something I know that is of

great concern here in Silicon Valley if

we’ve got smart people who want to come

here and start businesses and our PhDs

and math and science and computer

science and why don’t we want them to

stay I mean why would we want to send

them someplace else so

well those are potential job creators

those are job generators you know I

think about somebody like an Andy Grove

of Intel I you know we want more Andy

groves here in the United States we

don’t want them starting companies we

don’t want them starting Intel in China

or starting it in France we want them

starting it here so there’s a lot that

we can do for making sure that

high-skilled immigrants who come here

study we’ve paid for their college

degrees we’ve given them scholarships

we’ve given them this training let’s

make sure that if they want to reinvest

and make their future here in America

that they can so that’s point number one

but point number two is you also have a

lot of unskilled workers who are now

here who are living in the shadows

they’re contributing to our economy in

all sorts of ways they’re working in the

agricultural sector they are in

restaurants and they’re you know in

communities all across the country

looking after children and and helping

to build America but they’re they’re

scared and they feel as if they’re

locked out of their surroundings

and what I’ve said is they did break the

law they came here they have to take

responsibility for that they should pay

a fine they should learn English they

should go to the back of the line so

that they don’t automatically get

citizenship but there should be a

pathway for them to get legalized in our

society so they don’t fear for

themselves or their families so that

families aren’t separated at the same

time let’s make sure we’ve got a secure

border so that folks aren’t wandering

through the desert to get here let’s

make the legal immigration system more

efficient and more effective so there

aren’t huge backlogs this is all part of

what we call comprehensive immigration

reform

and there’s no reason why we shouldn’t

be able to achieve a that is fair is

equitable is an economic engine for

America that helps the people who are

already here get acculturated and make

sure that our laws aren’t being broken

but we’re still true to our traditions

but as I mentioned to Cheryl yesterday I

can’t solve this problem by myself Nancy

Pelosi is a big champion of this the

Democratic caucus in the house I think

is prepared for a majority of them are

prepared to advance comprehensive

immigration reform but we’re gonna have

to have bipartisan support in order to

make it happen and all of you have to

make sure your voices are heard saying

this is a priority this is something

important because if if politicians

don’t hear from you then then it

probably won’t happen I can’t do it by

myself we’re gonna have to change laws

in Congress but I’m confident we can

make it happen

[Applause]

[Music]

all right so the next one is from a

facebook employee Lee or Abraham Leo

where are you from hey leo hey hey I’m

from San originally from San Jose

California my question is the 2012

budget plan proposed by Paul Ryan has

been praised by many in the media as

bold or brave do you see this as a time

that calls for boldness and do you think

that you’re the plan you outlined last

week demonstrates sufficient boldness or

is this just a media creation you know

it’s a great question look here’s what

I’d say the the the Republican budget

that was put forward I would say is

fairly radical I wouldn’t call it

particularly courageous I do think mr.

Ryan is sincere I think he’s a patriot I

think he wants to solve a real problem

which is our long-term deficit but I

think that what he and the other

Republicans in the House of

Representatives also want to do is

change our social compact in a pretty

fundamental way their basic view is that

no matter how successful I am no matter

how much I’ve taken from this country

you know I wasn’t born wealthy you know

I was raised by a single mom and my

grandparents I went to college on

scholarships there was a time when my

mom was trying to get her PhD where for

a short time she had to take food stamps

my grandparents relied on Medicare and

Social Security to help supplement their

income when they got old so their notion

is despite the fact that I’ve benefited

from all these investments my

grandfather benefited from the GI Bill

after he fought in World War two

that somehow I now have no obligation

to people who are less fortunate than me

and I have no real obligation to future

generations to make investments so that

they have a better future

so what his budget proposal does is not

only hold income tax flat he actually

wants to further reduce taxes for the

wealthy further reduced taxes for

corporations not pay for those and in

order to make his numbers work cut 70%

out of our clean energy budget cut 25%

out of our education budget cut

transportation budgets by 1/3 I guess

you could call that bold I would call it

short-sighted on

and then as I said there’s a fundamental

difference between how the Republicans

and and and I think about Medicare and

Medicaid in our health care system their

basic theory is that if we just turn

Medicare into a voucher program and turn

Medicaid into Block Grant programs then

now you a Medicare recipient will go out

and you’ll shop for the best insurance

that you’ve got that you can find and

that you’re going to control costs

because you’re gonna say the insurance

company this is all I can afford that

will control costs except if you get

sick and the policy that you bought

doesn’t cover what you’ve got then

either you’re gonna mortgage your house

or you’re gonna go to the emergency room

in which case I who do have insurance

you’re gonna have to pay for it

indirectly because the hospital’s going

to have uncompensated care so they don’t

really want to make the health care

system more efficient and cheaper what

they want to do is to push the costs of

health care inflation on to you and then

you’ll be on your own trying to figure

out in the marketplace how to make

health care cheaper the problem is

you’re just one person now you work at

Facebook it’s a big enough company

Facebook can probably negotiate with

insurance companies and providers to get

you a pretty good deal but if you’re a

startup company if you’re an

entrepreneur out there in the back of

your garage good luck trying to get

insurance on your own you can’t do it if

you’re somebody who’s older and has a

pre-existing condition insurance

companies won’t take you so what we’ve

said is let’s make sure instead of just

pushing the costs off on the people who

individually are not gonna have any

negotiating power ability to change how

providers operate or how hospitals or

doctors operate how insurance companies

operate

let’s make sure that we have a system

both for Medicare but also for people

who currently don’t have health

insurance where they can be part of a

big pool they can negotiate for changes

in how the healthcare system works so

that it’s more efficient so it’s more

effective so that you get better care so

that we have fewer infection rates for

example in hospitals so there are fewer

readmission rates so that we’re caring

for the chronically ill more effectively

so that there are fewer unnecessary

tests that’s how you save money the

government will save money but you’ll

also save money so we think that’s a

better way of doing it now what they’ll

say is well you know what that’ll never

work because it’s government imposed and

it’s bureaucracy and it’s a government

takeover and they’re death panels and I

you know I still don’t entirely

understand the whole death panel concept

but I guess what they’re saying is

somehow some remote bureaucrat will be

deciding your healthcare for you all

we’re saying is if we’ve got health care

experts doctors and nurses and consumers

who are helping to design how Medicare

works more intelligently then we don’t

have to radically change Medicare so yes

I think it’s fair to say that their

vision is radical no I don’t think it’s

particularly courageous because the last

point I’ll make is this nothing is

easier than solving a problem on the

backs of people who are poor or people

who are powerless or don’t have

lobbyists or don’t have clout

I don’t think that’s particular

courageous

all right the next one’s from the web

we’ve got a question from Kwame Simmons

from Orlando Florida and he asks I

strongly believe that education is the

greatest equalizer with so many problems

plaguing our current system is it

possible to examine a complete overhaul

of the systems that addresses the needs

and modern students and before you jump

in I just want to say if someone who’s

spent a bunch of time researching

education who cares about this I think

that their race to the top stuff that

you guys have done is one of most

underappreciated and most important

things that your administration has done

I appreciate that the this is an area

where actually I think you’ve seen the

parties actually come together and

there’s some good bipartisan work being

done it used to be that the argument

around education always revolved around

the Left saying we just need more money

and the right saying we should just blow

up the system because public schools

aren’t doing a good job and what you’re

now saying is people under recognizing

we need both money and reform it’s not

an either/or proposition it’s a both/and

proposition so what Mark just mentioned

something called race to the top pretty

simple concept most federal dollars are

allocated through a formula you know if

you’ve got a certain number of poor kids

or you’ve got certain number of disabled

kids in your school district there’s a

formula and you get a certain amount of

money in every state and every school

district gets that money according to

the formula what we did was we took

about one percent of the total spending

on education and we said to get this one

percent show us that you’re reforming

the system it’s almost it’s like a

competition model and so every state

every school district could apply and

you had to show us that you had a good

plan to retrain teachers

recruit and and do good professional

development so we got the best teachers

possible you had to have accountability

you had to show us that you were

actually making progress in the schools

and that you were measuring through data

the improvements that were being made

that you were reaching into the schools

that were hardest to reach because there

are about 2,000 schools around the

country that account for the majority of

dropouts in our country there like

dropout factories so show us a plan to

go into those schools and really make a

big difference

and what’s happened is that over 40

states in the process of competing for

this extra money ended up initiating

probably the most meaningful reforms

that we’ve seen in a generation and so

it’s made a huge difference even those

states that didn’t end up actually

winning the competition still made

changes that are improving the potential

for good outcomes in the schools so

that’s the kind of creative approach

that you’ve seen some Democrats and some

Republicans embrace and our hope is we

can build on that a couple of things

that we know work the most important

thing to a good education is making sure

we’ve got a good teacher in front of

that classroom and so providing more

support for teachers recruiting the best

and brightest into teaching making sure

that they’re compensated but also making

sure that they’re performing that’s

hugely important the other thing is good

data so that there’s a constant feedback

not just a bunch of standardized tests

that go into a drawer or the people may

gaym in order not to get penalized

that’s what happened under No Child Left

Behind but instead real good data that

you can present to the teacher while

they’re still teaching that child and

say you know what this child is falling

behind in math here’s some ways to do it

to improve their performance so we’re

starting to see real progress on the

ground and I’m optimistic that we can

actually before the 2012 election

potentially have a federal education law

that will

embody some of the best information that

we have about how to initiate good

school reform now last point I’ll make

on this government alone can’t do it one

of the things every time I come to

Silicon Valley that I’m inspired by but

I’m also frustrated by is how many smart

people are here but also frustrated that

I always hear stories about how we can’t

find enough engineers we can’t find

enough computer programmers you know

what that means our education systems

not working the way it should and that’s

got to start early and that’s why we’re

emphasizing math and science that’s why

we’re emphasizing teaching girls math

and science that’s why we’re emphasizing

making sure that black and Hispanic kids

are getting math and science you know

we’ve got we’ve got to do such a better

job when it comes to STEM education and

that that’s one of the reasons by the

way that we had our first science fair

at the White House in a very long time

just because we want to start making

science cool I I want I want everybody

to feel the same way that they did I

want people to feel the same way about

you know the next big energy

breakthrough or the Beck the next big

Internet breakthrough I want people to

feel the same way they felt about the

moon launch then that that’s how we’re

going to stay competitive for the future

and that’s why these investments in

education are so important but as I said

we’re government alone can’t do it

there’s got to be a shift in American

culture where once again we buckle down

and we say this stuff’s important and

it’s that’s why I mark the work you’re

doing a new work for example the the

work that folks like you know the Gates

Foundation are doing in philanthropic

investments in best practices in

education especially around math and

science training that are going to be so

important we’ve got to lift we’ve got a

pit

lift our game up when it comes to

technology in math and science that’s

hopefully one of the most important

legacies that I can have as president

the United States

all right so the next one is from

another Facebook employee here so

they’re James Mitchell

so James Mitchell where are you from

well here’s James Becker hi mr.

president

hey James Mitchell born in Chicago and

raised out here in Cupertino California

I have yet another question for you

about the debt and healthcare go ahead

so the biggest threat we have fiscal is

that is the rise in health care costs

unfortunately a lot of the solutions we

here to Medicare and Medicaid

don’t involve actually slowing down the

rise in health care costs instead they

involve shifting costs to beneficiaries

and States so my question is can you

talk a bit more about what provisions in

the Affordable Health Care Act are

designed to slow down the rise of health

care costs and what policies you’d like

to see enacted in the future to continue

to slow down the rise of health care

costs let me give you a couple of

examples because you’re exactly right in

how you described it I don’t want to

just shift the health care costs onto

the American people I want to actually

reduce health care costs let’s take the

example of health IT now we’re in

Silicon Valley so we can talk about IT

stuff now I’ll try to sound like I know

what I’m talking about the health care

system is one of the few aspects of our

society where a lot of stuff is still

done on paper right well if last time

you guys went to a doctor’s office or

maybe to your dentist’s office how many

people still had like fill out a form on

a clipboard right and the reason for

that is because a large chunk of our

provider system is is not automated so

what ends up happening is you may go to

your primary care physician he worked he

does some basic tests he sees something

of concern he refers you to a specialist

you go to the specialist he’ll do

another test

you’re getting charged or your insurance

company is getting charged for both

those tests as opposed to the test that

was taken by your primary care physician

being emailed to the specialist or

better yet if it turns out that there

may be three or four specialists

involved because it’s a difficult

diagnosis this is all hypothetical you

look very healthy but let’s say there

are a bunch of specialists what would be

ideal would be if you get all the

specialists together with the primary

care physician the first time you’re

seen so that you’re not paying for

multiple visits as well as multiple

tests that’s not how it works right now

now part of it is technology so what we

did in the Affordable Care Act building

on what we did to the Recovery Act is

try to provide incentives to providers

to start getting integrated automated

systems and it’s tough because the

individual doctor may say to them him or

herself I don’t want to put the initial

capital outlay that’s expensive even

though it may make my system more

efficient later on so providing some

incentives some help for the front-end

investments for a community hospital or

for individual providers so that we can

slowly get this system more effective

that’s priority number one we know it

can be done by the way surprisingly

enough the healthcare system that is

does the best job on this of anybody is

actually the Veterans Administration the

VA healthcare system because it’s a

fully integrated system

you know everybody is working for the VA

all the doctors all the hospitals all

the providers so they’ve been able to

achieve huge cost savings just because

everybody’s on a single system it’s also

though how we reimburse doctors and how

we reimburse hospitals so right now what

happens is when you’ve taken those two

tests if you’re

old enough to qualify for Medicare well

each doctor sends their bill to Medicare

and Medicare pays both bills and let’s

say that you end up getting an operation

they’ll send the bill for that and so

Medicare pays that let’s say they didn’t

do a very good job or you got sick in

the hospital and you are readmitted and

you have to be treated again and they

have to do the operation all over again

Medicare then gets billed for the second

operation I mean imagine if that’s how

it worked at when you bought a car so

you go you buy your car a week later the

car doesn’t work you go back to the

dealer and they charged you to fix the

bad job that they did in the first place

well that’s what Medicare does all the

time so we don’t provide incentives for

performance we just provide we just pay

for the number of qualified items that

that were you know procedures that were

performed or tests that were performed

by the provider so what we want to do is

to start changing how folks are

reimbursed let’s take a hospital we want

to give this sort of like race to the

top what Mark was talking about in

education we want to be able to say to a

hospital if you do a really good job

reducing infection rates in hospital

which kill tens of thousands of people

across America every year and are a huge

cause for readmission rates and we know

that hospitals can drastically reduce

those reinfection rates just by simple

protocols of you know how employees are

washing their hands and how they’re

moving from room to room and so forth

there are hospitals who have done it if

we can say to a hospital you’ll get a

bonus for that Medicare will reimburse

you for instituting these simple

procedures that saves the whole system

money and that’s what we’ve tried to do

in the Affordable Care Act is to start

institutionalizing

these new systems but it takes time

because we’ve you know we’ve got a

private sector system it’s not like the

VA it’s a bunch of individual doctors

individual hospitals you know spread out

all across the country with private

insurers so it’s not something that we

can do overnight our hope is is that

over the next five years we’re able to

see significant savings through these

mechanisms and that will save everybody

not just people who are Medicare and

Medicaid it’ll save everybody money

including folks here at Facebook because

you know I’m sure that you guys provide

health insurance and I suspect if if you

look at your health insurance bills they

don’t make you happy

okay so we have time for only one more

question time it’s a question from from

Terry Atwater from Houston Texas if you

had to do anything differently during

your your first four years what would it

be well it’s only been two and a half so

I’m sure I’ll make more mistakes in the

next year and a half the jury will still

be out the you know there are all sorts

of day-to-day issues where I say to

myself

oh you know I didn’t say that right or I

didn’t explain this clearly enough or

maybe if I had sequenced you know this

plan first as opposed to that one maybe

it would have gotten done quicker health

care obviously was a huge battle and if

it hadn’t been for Nancy Pelosi and her

leadership in the House and and the

great work that

you know and a su and my Conda and

others that we wouldn’t have gotten it

done if it hadn’t been for great work in

Congress but but I I do think that it

was it was so complicated that at a

certain point people just started saying

uh this is typical Washington bickering

and you know I’ve I’ve asked myself

sometimes is there a way that we could

have gotten it done more quickly and in

a way that the American people wouldn’t

have been so frustrated by I’m not sure

I could have because there’s a reason

why it hadn’t gotten done in a hundred

years it is a it’s it’s hard to fix a

system as big as as health care and as

complicated as our health care system I

can tell you that I think the best way

to answer the question is what do I feel

I still have to get done where I still

feel a huge sense of urgency I’ve talked

about a couple of things getting our

deficits and debt under control in a

balanced way I feel needs to happen

while I’m president I don’t want to

leave it to the next president

immigration something I mentioned we

have not gotten done it’s something I

care deeply about it’s the right thing

for the country I want to get that done

while I’m president energy you know we

haven’t talked a lot about energy today

but you know first of all $4 a gallon

gas really hurts a lot of people around

this country it’s not because they’re

wasteful but if you’re driving 50 miles

to work and that’s the only job you can

find and you can’t afford some hybrid so

you’re stuck with the old beater that

you’re driving around to get gets eight

miles a gallon these gas prices are

killing you

right now and so this is the reason why

I’ve said that it is so important for us

to invest in new approaches to energy

we’ve got to have a long term plan it

means investing in things like solar and

wind investing in biofuels investing in

clean car technology it means converting

the federal fleet a hundred percent to

fuel-efficient vehicles because we’re a

huge market maker obviously you know it

turns out that I’ve got a lot of cars as

president and you know if we’re out

there purchasing electric cars and

hybrids and you know that can help boost

demand and drive down prices continuing

to increase fuel efficiency standards on

cars increasing oil production but in an

intelligent way I mean those are all

hugely important and by the way we can

pay for it let me let me say this we

lose the Treasury loses 4 billion

dollars a year on subsidies to oil

companies now think about this the top

five oil companies have made somewhere

between 75 billion and 125 billion every

year for the last five years nobody’s

doing better than Exxon nobody’s doing

better than Shell or these other

companies they are doing great they are

making money hand over fist

well maybe Facebook’s doing a little

better but but you get the idea they’re

doing really well

they don’t need special tax breaks that

cost us four billion dollars and so what

we’ve said is why can’t we eliminate the

tax breaks for the oil companies who are

doing great and invest that in new

energy sources that can help us save the

planet

so so when it comes to energy when it

comes to immigration when it comes to

getting our deficit under control in a

balanced and smart way when it comes to

improving our math and science education

when it comes to reinvesting in our

infrastructure we’ve just got a lot more

work to do and I guess my closing

comment mark would just be I hope that

everybody here that you don’t get

frustrated and cynical about our

democracy I mean it is frustrating lord

knows it’s frustrating I and I know that

some of you who might have been involved

in the campaign or been energized back

in 2008 you know you’re frustrated that

Kasia didn’t get done fast enough and it

seems like everybody’s bickering all the

time just remember that we’ve been

through tougher times before we’ve

always come out ascendant we’ve always

come out on top

because we’ve still got the best

universities in the world we’ve still

got the most productive workers in the

world this is still the most dynamic

entrepreneurial culture in the world if

we come together we can solve all these

problems but I I can’t do it by myself

the only way it happens is if all of you

still get involved still get engaged it

hasn’t been that long since Election Day

and we’ve gone through some very very

tough times and we’ve still gotten a lot

done we’ve still been able to get this

economy recovering we’ve still been able

to get health care passed we’ve still

been able to invest in clean energy

we’ve still been able to make sure that

we overturn Don’t Ask Don’t Tell we

still made sure that we got to women on

the Supreme Court

we’ve made progress so so rather than be

discouraged I hope everybody is willing

to double down and work even harder

regardless of your political affiliation

you’ve got to be involved especially the

young people here your generation if you

don’t give us a shove if you don’t give

the system a push it’s just not going to

change and you’re going to be the ones

who end up suffering the consequences

but if you are behind it if you put the

same energy and and imagination that you

put into Facebook into the political

process I guarantee you there’s nothing

we can’t solve all right thank you Mark

[Applause]

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