Interview with David Gregory on NBC News' "Meet the Press"

MR. GREGORY: But first, the president of the United States. Friday afternoon I sat down with President Obama in the Roosevelt Room at the White House.

Mr. President, welcome back to MEET THE PRESS.

PRESIDENT OBAMA: Great to see you.

MR. GREGORY: This is a critical moment in the healthcare debate. And you've been able to assess the landscape, you've got a bill now that's working its way through the Senate, you've spoken to Congress. As you assess the situation, I wonder whether you approach this with a minimum threshold of what you'll accept for reform, or at this point have you said, "I've laid out my plan, take it all or nothing"?

PRESIDENT OBAMA: You know, I, I think that my focus is on some core principles. I have to have a plan that is good for middle-class families, who we know last year ended up seeing a 5.5 percent increase in their premiums even though inflation was actually negative on everything else, that have seen a doubling of their premiums over the last decade, that are less secure than ever in terms of the insurance they can actually count on, and more and more of them can't get insurance because of pre-existing conditions or they change jobs or they lost jobs. So it's got to be good for them. Now, the principles that we've talked about--making sure that there's an insurance exchange that'll allow people to buy in and get health insurance and negotiate as a big pool to drive down costs, making sure that we have insurance reforms that make sure you can still get health insurance even if you've got a pre-existing condition, cap out of pocket expenses and so forth--those core things that make insurance a better deal for American consumers; making sure that it's deficit-neutral both now and in the future, making sure that it is driving down healthcare inflation so that we can actually deal with our long-term budget deficits, those are the core principles that are critical to me. And I actually think that we've agreed to about 80 percent of that, if you look at all the bills that are coming through all these committees. The key is now just to narrow those differences. And if I don't feel like it is a good deal for the American people, then I won't sign a bill.

MR. GREGORY: Those narrow differences can also, in some cases, be very big differences. And as you were president-elect last year, you said to the nation--in light of the huge challenges that the country faces, you said, "We're going to have to make hard choices. ... And not all of these choices are going to be popular." What are the hard choices that you are now asking the American people to make? And who are you going to say no to in order to get health care done?

PRESIDENT OBAMA: Well, I, I've already made some pretty substantial changes in terms of how I was approaching health care. When I was...

MR. GREGORY: Like the public option. You effectively said to the left it's not going to happen.

PRESIDENT OBAMA: Well, what--no. No, that's not true. What I, what I've said is the public option I think should be a part of this, but we shouldn't think that somehow that's the silver bullet that solves health care. What I've said, for example, on what's called an individual mandate--during the campaign I said, "Look, if health care is affordable, then I think people will buy it." So we don't have to say to folks, "you know what, you have to buy health care." And when I talk to healthcare experts on both the left and the right, what they tell me is that even after you make health care affordable, there's still going to be some folks out there who, whether out of inertia or they just don't want to spend the money, would rather take their chances. Unfortunately, what that means is then you and I and every American out there who has health insurance and they're paying their premiums responsibly every month, they've got to pick up the costs for emergency room care when one of those people gets sick. So what we've said is as long as we're making this genuinely affordable to families, then you've got an obligation to get health care just like you have an obligation to get auto insurance in every state.

MR. GREGORY: Are these the hard choices, though? Who are you saying no to?

PRESIDENT OBAMA: Well, that--I mean, that's an example of a, of a hard choice, because that's not necessarily wildly popular, but it's the right thing to do. You know, I, I have said that it is very important that we take into account the concerns of doctors and nurses who, by the way, support our efforts. And I--and that's something that doesn't get noticed much. The people who are most involved in the healthcare system know that it's got to be reformed. But I've said that we've got to take into account their concerns about medical malpractice. Now, that's not popular in my party, never has been. But I've talked to enough doctors to know that even though it's not the end-all, be-all of driving down healthcare costs, it's very important to providers to make sure that their costs are going down. So I think there are going to be a whole series of Republican ideas, ideas from my opponents during the campaign that we have incorporated and adopted. And this is hard. And, and, you know, one of the things I've always said is if this had been easy, it would've been taken care of by Teddy Roosevelt.

MR. GREGORY: But you're not really taking on--I mean, you're not saying to the left they've got to accept malpractice reform or, or caps on, on jury awards. You don't even think that that contributes to the escalating costs of health care. What do you--what are you really doing to say to the left, "Look, you may not like this, but you've got to get on board and we've got to do this"?

PRESIDENT OBAMA: Well, listen, I, I think I was awfully clear--and I'm surprised, David. Maybe you haven't been paying attention to what both the left and the right have been saying about my speech to Congress. I laid down some pretty clear parameters. And what I said was we're going to take ideas from both sides. The bottom line is that the American people can't afford to stay on the current path, we know that, and that both sides are going to have to give some. Everybody's going to have to give some in order to get something done. We wouldn't have gotten this far if, you know, we hadn't been pretty insistent, including to folks in my own party, that we've got to get past some of these ideological arguments to actually make something happen.

MR. GREGORY: This healthcare debate, as you well know, can sometimes be about bigger things. And, and among your harshest critics...

PRESIDENT OBAMA: Mm-hmm.

GREGORY: ...is the view somehow that government is out of control.

PRESIDENT OBAMA: Mm-hmm.

GREGORY: And in some cases, it's gotten very personal.

PRESIDENT OBAMA: Right.

GREGORY: Your election, to a lot of people, was supposed to mark America as somehow moving beyond race.

PRESIDENT OBAMA: Right.

GREGORY: And yet this week you had former president Jimmy Carter saying most--not just a little, but most of this Republican opposition against you is motivated by racism. Do you agree with that?

PRESIDENT OBAMA: Hm. No. Look, I said during the campaign, are there some people who still think through the prism of race when it comes to evaluating me and my candidacy? Absolutely. Sometimes they vote for me for that reason, sometimes they vote against me for that reason. I'm sure that was true during the campaign, I'm sure that's true now. But I think you actually put your finger on what this argument's really about, and it's an argument that's gone on for the history of this republic. And that is what's the right role of government? How do we balance freedom with our need to look after one another? I talked about this in the joint session speech. This is not a new argument, and it always invokes passions. And I--there--it was a passionate argument between Jefferson and Hamilton about this. You know, Andrew Jackson built a whole political party around this notion that somehow, you know, there, there is populist outrage against a federal government that was overintrusive. And so what, what I think is going on is, is that we've got a healthy debate taking place. The vast majority of people are conducting it in a very sensible way. I think that every president who's tried to make significant changes along these lines, whether it was FDR or Ronald Reagan, illicit very strong, passionate responses. But I do think that we all have an obligation to try to conduct this conversation in a civil way and to recognize that each of us are patriots, that each of us are Americans and that, by the way, the--my proposals, as much as you may not like them if you're a Republican or on the right, recognize that this is well within the mainstream of what Americans have been talking about for years in terms of making sure that everybody in this country gets decent health care and that people who have health care are protected.

MR. GREGORY: Just to be clear, though...

PRESIDENT OBAMA: Yeah.

MR. GREGORY: ...it wasn't just President Carter. There are others in the Congressional Black Caucus, other thinkers who have said that they agree, that there is racism out there in that opposition to you. I just want to be clear. Are you, are you saying to the former president and others to speak this way is counterproductive?

PRESIDENT OBAMA: Well, look, David, here's what I'm saying. I, I think that the media loves to have a conversation about race. I mean, this is, is catnip to, to the media because it is a running thread in American history that's very powerful and it invokes some very strong emotions. I'm not saying that race never matters in, in any of these public debates that we have. What I'm saying is this debate that's taking place is not about race, it's about people being worried about how our government should operate. Now, I think a lot of those folks on the other side are wrong. I think that they have entirely mischaracterized the nature of our efforts. And I think it's important that we stay focused on solving problems as opposed to plucking out a sentence here or a comment there and then the entire debate, which should be about how do we make sure that middle-class families have secure health care, doesn't get consumed by other things.

MR. GREGORY: In that vein...

PRESIDENT OBAMA: Yeah.

MR. GREGORY: ...House Speaker Pelosi worried about the opposition, the tone of it perhaps leading to violence as it did in the '70s. There's more recent examples of anti-government violence occurring even in the mid-'90s. Do you worry about that?

PRESIDENT OBAMA: Well, look, I think that we have an obligation in Washington as leaders to make sure that we are sending a strong message that we can disagree without being disagreeable, without, you know, questioning each other's motives. When we start caricaturing the other side, I think that's a problem. And unfortunately, we've got, as I said before, a 24-hour news cycle where what gets you on the news is controversy. What gets you on the news is the extreme statement. The easiest way to get 15 minutes on the news or your 15 minutes of fame is to be rude. And that's a, that's something that I think has to change. And it starts with me, and I've tried to make sure that I've sent a clear signal and I've tried to maintain an approach that says, "Look, we can have some serious disagreements, but at the end of the day I'm assuming that you want the best for America just like I do."

MR. GREGORY: You get a lot of airtime too, though, and you--yours are not rude. I don't think you'd...

PRESIDENT OBAMA: Well, you know, the--I, I do occupy a pretty special seat at the moment. But, but I do think that--look, I mean, let's face it. If, if you look at the news cycle over the last, over the last week, you know, it, it hasn't been the sensible people who, you know, very deliberately talk about the important issues that we face as a country. That's not the folks who've getting a lot of coverage.

MR. GREGORY: Let me ask you about another important issue facing you and your administration, and that is Afghanistan.

PRESIDENT OBAMA: Yeah.

MR. GREGORY: We've now been in Afghanistan for eight years. The Soviets pulled out of Afghanistan after 10 years.

PRESIDENT OBAMA: Right.

MR. GREGORY: Are we committed to this war for an indefinite period of time, or do you think in your mind is there a deadline for withdrawal?

PRESIDENT OBAMA: I don't have a deadline for withdrawal, but I'm certainly not somebody who believes in indefinite occupations of other countries. Keep in mind what happened when I came in. We had been adrift, I think, when it came to our Afghanistan strategy. And what I said was that we are going to do a top to bottom review of what's taking place there. Not just a one-time review, but we're going to do a review before the election in Afghanistan and then we're going to do another review after the election. And we are going to see how this is fitting what I think is our core goal, which is to go after the folks who killed 3,000 Americans during 9/11 and who are still plotting to kill us: al-Qaeda. How do we dismantle them, disrupt them, destroy them? Now, getting our strategy right in Afghanistan and in Pakistan are both important elements of that. But that's our goal, and I want to stay focused on that. And, and so right now what's happened is, is that we've had an election in Afghanistan. It did not go as smoothly as I think we would have hoped, and that there are some serious issues in terms of how that--how the election was conducted in some parts of the country. But we've had that election. We now finally have the 21,000 troops in place that I had already ordered to go.

MR. GREGORY: Are you skeptical about more troops, about sending more troops?

PRESIDENT OBAMA: Well, can I just say this? I am--I have to exercise skepticism any time I send a single young man or woman in uniform into harm's way, because I'm the one who's answerable to their parents if they don't come home. So I have to ask some very hard questions any time I send our troops in.

The question that I'm asking right now is to our military, to General McChrystal, to General Petraeus, to all our national security apparatus is, whether it's troops who are already there or any troop request in the future, how does this advance America's national security interests? How does it make sure that al-Qaeda and its extremist allies cannot attack the United States ' homeland, our allies, our troops who are based in Europe ? That's the question that I'm constantly asking, because that's the primary threat that we went there to deal with. And if, if supporting the Afghan national government and building capacity for their army and securing certain provinces advances that strategy, then we'll move forward. But if it doesn't, then I'm not interested in just being in Afghanistan for the sake of being in Afghanistan or saving face or in some way, you know, sending a message that America is here for, for the duration. I think it's important that we match strategy to resources. What I'm not also going to do, though, is put the resource question before the strategy question. Until I'm satisfied that we've got the right strategy, I'm not going to be sending some young man or woman over there beyond what we already have.

MR. GREGORY: On a lighter note; before I let you go, Mr. President, you were brazen this summer at the All-Star game, wearing your Chicago White Sox jacket out there to throw out the first pitch. Hate to break it to you, but doesn't look so good for your White Sox here. So I want to know, who is your pick to win the World Series?

PRESIDENT OBAMA: You know, I am--I think mathematically the White Sox can still get in the playoffs.

MR. GREGORY: They can, mathematically.

PRESIDENT OBAMA: So...

MR. GREGORY: You're an optimist.

PRESIDENT OBAMA: ...until they are eliminated, I will make no predictions.

MR. GREGORY: Oh, come on.

PRESIDENT OBAMA: I've got to say, though, that the, the Cardinals have been, been coming on strong. And Pujols is unbelievable.

MR. GREGORY: He is.

PRESIDENT OBAMA: But--this is tough to say. The Yankees are also doing pretty well. And a shout-out to Derek Jeter for breaking Lou Gehrig's record. He's a, he's a classic.