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  • The President: Well, thank you so much, Facebook, for hosting this,

  • first of all.

  • (applause)

  • My name is Barack Obama, and I'm the guy who got Mark to wear a

  • jacket and tie.

  • (applause)

  • Thank you.

  • (laughter)

  • I'm very proud of that.

  • (laughter)

  • Mr. Zuckerberg: Second time.

  • The President: I know.

  • (laughter)

  • I will say -- and I hate to tell stories on Mark,

  • but the first time we had dinner together and he wore this jacket

  • and tie, I'd say halfway through dinner he's starting to sweat a

  • little bit.

  • It's really uncomfortable for him.

  • So I helped him out of his jacket.

  • (laughter)

  • And in fact, if you'd like, Mark,

  • we can take our jackets off.

  • Mr. Zuckerberg: That's good.

  • (applause)

  • The President: Woo, that's better, isn't it?

  • Mr. Zuckerberg: Yes, but you're a lot better at this stuff than me.

  • (laughter)

  • The President: 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 town hall.

  • The main reason we wanted 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 historically, part of what makes for a healthy democracy,

  • what 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; makes 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, 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 lifetime is 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 an 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 face challenges like

  • this, whether it's been the shift from a agricultural age to

  • a 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 going to 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 will 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 politics work

  • better -- because I don't think there's a problem out there that

  • we can't solve if we decide that we're going to 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, Mark, I understand you got the first one.

  • Mr. Zuckerberg: Yes, let's start off.

  • So let's start off with the conversation about the debt.

  • So I understand that yesterday morning you had a 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 add up?

  • The President: 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 aren't sure how it came about.

  • 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

  • been made by President Clinton, Republican Congresses,

  • Democratic Congresses, and President George H. W. 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 revenue is coming in -- because

  • company sales are lower, individuals are making less

  • money -- at the same time 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 going to 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 $4 trillion 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 $2 trillion over 10 to 12 years

  • is reduction in spending.

  • 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 are 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 helped to bloat

  • the Pentagon budget.

  • So we've already reduced the Pentagon budget by about $400 billion.

  • We think we can do about another $400 billion.

  • 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 reform in the tax system that

  • allows people like me -- and, frankly, you,

  • Mark -- for paying a little more in taxes.

  • (laughter)

  • Mr. Zuckerberg: I'm cool with that.

  • The President: I know you're okay with that.

  • (laughter)

  • 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 --

  • (laughter)

  • -- I'm trying to say this delicately --

  • still in diapers at that time.

  • (laughter)

  • But for those of you who recall, 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,

  • $2 trillion in 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 -- math and science

  • 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 the next

  • generation of broadband and wireless,

  • 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 wanted to make sure everybody had the basic

  • foundations for it.

  • Even if we get this $4 trillion, 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 we had last

  • year and start getting a better bang for our health care 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 want to 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 $4 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 70% cuts in clean energy.

  • Well, I don't know how we free ourselves from dependence on

  • foreign oil -- and anybody who is 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 going to 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 about right now.

  • All right?

  • Mr. Zuckerberg: All right, so -- sorry, don't mean to cut off the applause.

  • The President: No, no, no, no, no.

  • (applause)

  • Mr. Zuckerberg: That was a very thorough answer.

  • The President: No, they were -- they were stunned by the length

  • of that answer.

  • (laughter)

  • But it's complicated stuff.

  • Mr. Zuckerberg: So the next question is from someone watching Facebook live.

  • Jay Aptine [phonetic] 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?"

  • The President: 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 poorer even if they still have a

  • home or they've already purchased a home,

  • because for a lot of folks their mortgage is 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 market,

  • and that will raise prices and that will 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 that a lot of people who bought a first home when credit

  • was easy now are finding that 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 an adjustable rate mortgage,

  • that they couldn't afford it and they lose their home.

  • I think the regulators 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.

  • Mr. Zuckerberg: So I think the next question is from a Facebook employee

  • in the room today.

  • So Lauren Hale has a question.

  • Lauren, where are you from?

  • Audience Member: Hi -- over here.

  • The President: Hey, Lauren.

  • Audience Member: Hi, Mr. President.

  • 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 we

  • were just talking about.

  • At the beginning of your term you spent 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 I would love to know your thoughts on how you're going to

  • balance these two going forward, or even potentially shift the

  • conversation back.

  • The President: Well, you're exactly right that when I first came into office

  • our number-one job was preventing us from getting into

  • 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 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 in 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 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 I think the opportunities for electric

  • vehicles, alternative vehicles that are much cheaper -- our

  • opportunities are limitless.

  • 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 2 million

  • jobs created in the private sector.

  • Because this recession came at a time when we were already deeply

  • in debt and it 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.

  • 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 every driven a clutch car?

  • (laughter)

  • I mean, you got to sort of tap and -- well,

  • that's sort of what we faced in terms of the economy, right?

  • We got to hit the accelerator, but 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 U.S. auto industry.

  • We now have three auto companies here in America that are all

  • turning a profit.

  • G.M. just announced that it's hiring back all of the workers

  • that it was planning to lay off.

  • 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 30 years.

  • So it can be done, but it takes a balanced approach.

  • (applause)

  • Mr. Zuckerberg: All right, so we have a question from the University of Florida,

  • where in February, you launched this initiative at

  • WhiteHouse.gov, younger Americans 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 Cesar Fernandez [phonetic] and Elisa Rectanas [phonetic]

  • are participating in one of those roundtables,

  • and they wanted 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 revisiting 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?"

  • (applause)

  • The President: Let me talk about not only the DREAM Act but about immigration

  • policy generally.

  • And I want to thank -- Sheryl Sandberg actually participated

  • in a 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 -- 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 their 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, especially for these young

  • people who are our neighbors, our friends,

  • our children's friends, 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 wouldn't we want to make sure that --

  • (applause)

  • 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.

  • 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 restrictive 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 cheap.

  • 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 they want to

  • create the new 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 are PhDs in math and science and computer

  • science, why don't we want them to say?

  • (applause)

  • I mean, why would we want to send them someplace else?

  • (applause)

  • So those are potential job creators.

  • Those are job generators.

  • I think about somebody like an Andy Grove of Intel.

  • 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 in communities all

  • across the country looking after children and helping to build America.

  • But 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

  • system 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 Sheryl 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 going to 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 politicians don't hear from you,

  • then it probably won't happen.

  • I can't do it by myself.

  • We're going to have to change the laws in Congress,

  • but I'm confident we can make it happen.

  • (applause)

  • Mr. Zuckerberg: All right.

  • So the next one is from a Facebook employee, Leo Abraham.

  • Leo, where are you from?

  • The President: Hey, Leo.

  • Audience Member: Hi, hey.

  • I'm from -- 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 the plan you outlined last week

  • demonstrated sufficient boldness,

  • or is this just a media creation?

  • The President: No, it's a great question.

  • Look, here is what I'd say.

  • 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 -- I wasn't

  • born wealthy; 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 II -- 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 reduce 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 a third.

  • I guess you could call that bold.

  • I would call it shortsighted.

  • (applause)

  • And then, as I said, there's a fundamental difference between

  • how the Republicans and I think about Medicare and Medicaid and

  • 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 going to say to 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 going to mortgage your house or you're

  • going to go to the emergency room, in which case I,

  • who do have insurance, are going to have to pay for it indirectly

  • because the hospital is 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 preexisting 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 to people who individually are not going to

  • have any negotiating power or 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 health care system

  • works so that it's more efficient;

  • so that 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 will never work because it's government imposed and it's

  • bureaucracy and it's government takeover and there are death panels.

  • 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 health care 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 particularly courageous.

  • (applause)

  • Mr. Zuckerberg: All right, the next one's from the web.

  • We've got a question from Kwami Simmons [phonetic] 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 system

  • so that it addresses the needs of modern students?"

  • And before you jump in, I just want to say as someone who has

  • spent a bunch of time researching education and who

  • cares about this, I think the Race to the Top stuff that you

  • guys have done is one of the most under-appreciated and most

  • important things that your administration has done.

  • The President: I appreciate that.

  • (applause)

  • 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 seeing is people 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.

  • If you've got a certain number of poor kids or you've got a

  • certain number of disabled kids in your school district,

  • there's a formula, and you get a certain amount of money.

  • And every state and every school district gets that money

  • according to the formula.

  • What we did was we took about 1% of the total spending on

  • education and we said, to get this 1%,

  • 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 and recruit and do good professional development so

  • we've 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.

  • They're 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 that people may game 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 are 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 system is 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.

  • (applause)

  • That's why we're emphasizing making sure that

  • black and Hispanic kids are getting math and science.

  • (applause)

  • We've got to do such a better job when it comes to STEM education.

  • And 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 want everybody to feel the same way that they did --

  • (applause)

  • I want people to feel the same way about the next big

  • energy breakthrough or the next big Internet breakthrough,

  • I want people to feel the same way they felt about the moon

  • launch -- 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, government alone can't do it.

  • There has got to be a shift in American culture,

  • where once again we buckle down and we say this stuff is

  • important and it's -- that's why, Mark,

  • the work you're doing in Newark, for example,

  • the work that folks like the Gates Foundation are doing in

  • philanthropic investments, in best practices and education --

  • especially around math and science training -- are going to

  • be so important.

  • We've got to lift -- we've got to lift our game up when it

  • comes to technology and math and science.

  • That's, hopefully, one of the most important legacies that I

  • can have as President of the United States.

  • (applause)

  • Mr. Zuckerberg: All right.

  • So the next one is from another Facebook employee.

  • Here's James Mitchell.

  • So, James Mitchell, where are you from?

  • The President: Here's James back here.

  • Audience Member: Hi, Mr. President.

  • The President: Hey, James.

  • Audience Member: I'm James Mitchell, born in Chicago and raised out

  • here in Cupertino, California.

  • I have yet another question for you about the debt and health care.

  • The President: Go ahead.

  • Audience Member: So the biggest threat we have fiscally is the rise in

  • health care costs.

  • Unfortunately, a lot of the solutions we hear 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?

  • The President: Let me give you a couple of examples,

  • because you're exactly right in how you describe it.

  • I don't want to just shift the health care costs on to the

  • American people, I want to actually reduce health care costs.

  • Let's take the example of health IT.

  • We're in Silicon Valley, so we can talk about IT stuff.

  • I'll try to sound like I know what I'm talking about.

  • (laughter)

  • The health care system is one of the few aspects of our

  • society where a lot of stuff is still done on paper.

  • The last time you guys went to a doctor's office or maybe to your

  • dentist's office, how many people still had, like,

  • to fill out a form on a clipboard?

  • Right?

  • And the reason for that is because a large chunk of our

  • provider system is not automated.

  • So what ends up happening is you may go to your primary care

  • physician; 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.

  • (laughter)

  • But let's say there were 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 with 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 him

  • or herself, I don't want to put out 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 health care system that is -- does the

  • best job on this of anybody is actually the Veterans

  • Administration, the VA health care system,

  • because it's a fully integrated system.

  • 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 is 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 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 were 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 is 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 the

  • 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 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 got a private sector system --

  • it's not like the VA -- a bunch of individual doctors,

  • individual hospitals 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 on Medicare and Medicaid -- it will save everybody money

  • including folks here at Facebook.

  • Because I'm sure that you guys provide health insurance and I

  • suspect if you look at your health insurance bills they

  • don't make you happy.

  • Okay?

  • Mr. Zuckerberg: So we have time for only one more question.

  • The President: All right.

  • Mr. Zuckerberg: It's a question from Terry Atwater [phonetic] from Houston,

  • Texas: "If you had to do anything differently during your

  • first four years, what would it be?"

  • The President: 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.

  • (laughter)

  • 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 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 the great work that --

  • (applause)

  • -- Anna Eshoo and Mike Honda and others did -- we wouldn't have

  • gotten it done if it hadn't been for great work in Congress.

  • But I do think that it was so complicated that at a certain

  • point people just started saying, oh,

  • this is typical Washington bickering.

  • And 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 it?

  • 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 hard to fix a system as big 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 -- we haven't talked a lot about energy today,

  • but 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 that 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 100% to fuel-efficient

  • vehicles, because we're a huge market maker.

  • Obviously it turns out that I've got a lot of cars as President.

  • (laughter)

  • And if we're out there purchasing electric cars and

  • hybrids, 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 say this.

  • We lose -- the Treasury loses $4 billion 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 is doing better than Exxon.

  • Nobody is doing better than Shell or these other companies.

  • They are doing great.

  • They are making money hand over fist.

  • Well, maybe Facebook is doing a little better.

  • (laughter)

  • But you get the idea.

  • They're doing really well.

  • They don't need special tax breaks that cost us $4 billion.

  • 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?

  • (applause)

  • 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.

  • (laughter)

  • And I know that some of you who might have been

  • involved in the campaign or been energized back in 2008,

  • you're frustrated that, gosh, it didn't get done fast enough and

  • it seems like everybody is 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 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 two women on the Supreme Court.

  • (applause)

  • We've made progress.

  • (applause)

  • 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

  • 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)

The President: Well, thank you so much, Facebook, for hosting this,

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オバマ大統領とのFacebookタウンホール (Facebook Town Hall with President Obama)

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    Jake Lee に公開 2021 年 01 月 14 日
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