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 [Music] 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] [Music]

Channel: Learn English Online

Views: 1,748,721

Keywords: Learn English with President Obama, President Obama, Mark Zuckerberg, Facebook Town Hall, English Subtitles

Id: V91tqFUhwjU

Length: 64min 19sec (3859 seconds)

Published: Mon Jan 22 2018