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President Obama on the Issues

An open discussion on Medicare, Social Security and the health of our economy

En Español\ Presidential nominees Barack Obama and Mitt Romney discussed the future of Medicare and Social Security, the health of the economy and Washington gridlock — all major concerns for older Americans. (As a nonpartisan, nonprofit organization, AARP neither endorses nor contributes to political candidates.)

President Barack Obama

Marvin Joseph/The Washington Post/Getty Images

President Obama attends a campaign event at Bowling Green State University.

Barack Obama, talking about what's important to older Americans, circles back to the grandparents who helped raise him in their Honolulu apartment. "It's important to recognize that Medicare, along with Social Security, are the linchpins of our system to ensure seniors security in their golden years," Obama said in an exclusive interview in the Oval Office. "This is personal for me because I was raised with the help of my grandparents, and I saw how important both Social Security and Medicare were to my grandparents and the peace of mind it gave them."

See Also: Where Obama and Romney stand on your issues

As the campaign focuses on issues important to older voters, such as Medicare, health care costs and jobs, his late grandparents, Madelyn and Stanley Dunham, likely will be on his mind. So will a 50-year-old Ohio woman who struggled to find a job until trying a training program that Obama said could be key for older workers.

Medicare

On Medicare, Obama sees some of the sharpest distinctions between his approach and that of Republican nominee Mitt Romney. Romney's vice presidential choice, Wisconsin Rep. Paul Ryan, is a leading proponent of giving older people subsidies to buy private health insurance. Obama said that this Republican plan undermines Medicare's traditional guarantee of coverage for sick older people and said he wants to continue reforms begun under the sweeping Affordable Care Act. That law added new preventive care coverage, discounts on prescription drugs and help for those whose prescription costs landed them in the so-called doughnut hole.

"My goal is to continue these types of reforms that will produce a better bang for our health care dollar and will make sure beneficiaries aren't seeing higher out-of-pocket costs, but at the same time are able to control Medicare costs over the long term," he said. "What I reject is those who are interested in undermining the very concept of Medicare as a guarantee for seniors who get sick."

Obama defended the elimination of $716 billion in Medicare costs through his health care reform law, saying those savings did not affect beneficiaries. The reduction in costs came from providers and insurance company payments.

Social Security

Republicans have argued major changes are needed to save Medicare and Social Security so the trust funds that finance them don't run out of money in the long run. Obama wants to work within the current framework.

"I am open and eager to work with both parties, but just as is true when it comes to Medicare, I will reject proposals that slash benefits for current beneficiaries or to undermine the basic structure of the system," Obama said.

Obama said the nation's recent financial crisis proves the folly of plans by Romney and Ryan to allow workers to invest Social Security money in the stock market; he believes "there should be a floor that allows us to still live with dignity and respect. That's what Medicare is about, and that's what Social Security is about."

Health care reform

Obama defended the signature legislation of his presidency: "Whenever I hear people say there's a government takeover of health care, we've now seen over the last two years people who have health insurance who still are relying on that health insurance. But what we have been able to do is to start encouraging and incentivizing providers to think and act more effectively in how health care is delivered."

At the heart of reform is changing the model of medicine, he said, "shifting the medical profession away from a fee-for-service model where you get paid no matter what you do … [to] getting rewarded for doing the right thing and … instituting best practices."

As Obama talked health care, the door to the Oval Office burst open and daughters Malia, 14, and Sasha, 11, bounded in, followed by first lady Michelle Obama. After a month away from their dad, they were back from camp early. The president bolted from his chair by the fireplace to be engulfed by the girls. "Excuse me. I haven't seen my daughters," he said before grilling them about camp and getting a full report of the menu for their welcome home dinner.

Deficit and gridlock

Rising health care costs are a major factor driving national spending. Mandatory health care programs are expected to double to 10 percent of the economy by 2037, according to the Congressional Budget Office.

Obama, despite campaign promises, was unable to enact a long-term solution to budget deficits. To trim the deficit, Republicans have fought for spending cuts, while Obama has pushed for a mix of reduced spending and increased taxes. The battle brought the nation to the brink of a credit default last year before Obama and Congress agreed to trim future spending by almost $1 trillion, with an additional $1.2 trillion over the next decade. Obama reiterated his view that taxpayers earning $250,000 or more should no longer receive the tax cuts passed under President George W. Bush.

Obama's recipe for fiscal reform is a package that "reduces our deficit, keeps taxes low for middle-class families but asks wealthier individuals like me to pay a little bit more."

Jobs

Obama said finding jobs for older Americans, who were hit hard by the recession, is a priority. "The most important thing I can do is grow the economy as a whole," he said. But for older workers it's also important that they get job training, chances to pair up with employers for part-time work to build their résumés, and retraining through community colleges that get input from businesses that are hiring. The Ohio woman he met found work in a new field — technology — after finishing a short course.

"The key to all of this is helping employers and the public at large understand what an incredible asset older workers are," he said, adding that he's become more sensitive to the issue as his own hair has turned grayer.

Caregiving

Like many in his generation, Obama, 51, has seen the challenge of caring for older relatives. "It is an enormous strain on the family," he said. It's an enormous strain on the person who is receiving care."

Obama's maternal grandmother lived in her Honolulu apartment until her death, frail from various illnesses, the president said, but unwilling to give up her independence. He added, "Wherever we can help people stay independent, they are better off and the costs to society as a whole are greatly reduced."

Tamara Lytle is a Washington-based freelance reporter and writer.

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