Of course saying and doing are different things, but saying is a part of doing in politics. He spoke strongly on the public option for health care, in a measured but principled way on Iran. He even acknowledged the shortcomings in his stimulus plan enacted in February.

In short, he spoke like a President I fully support. Now to put those words into actions.

QUESTION: Thank you, Mr. President. Two of the key players in the insurance industry, America’s Health Insurance Plans and Blue Cross/Blue Shield, sent a letter to the Senate this morning saying that a government health insurance plan would, quote, "dismantle," end quote, private insurers. Why are they wrong?

And, secondly, this public plan, is this non-negotiable? Would you sign a health care bill without it?

MR. OBAMA: Well, let’s — let’s talk first of all about health care reform more broadly. I think in this debate there’s been some notion that if we just stand pat, we’re OK. And that’s just not true.

You know, there are polls out that show that 70 percent or 80 percent of Americans are satisfied with the health insurance that they currently have. The only problem is that premiums have been doubling every nine years, going up three times faster than wages. The U.S. government is not going to be able to afford Medicare and Medicaid on its current trajectory. Businesses are having to make very tough decisions about whether we drop coverage or we further restrict coverage.

So the notion that somehow we can just keep on doing what we’re doing, and that’s OK, that’s just not true. We have a long-standing critical problem in our health care system that is pulling down our economy. It’s burdening families. It’s burdening businesses. And it is the primary driver of our federal deficits. All right?

So — so if we start from the premise that the status quo is unacceptable, then that means we’re going to have to bring about some serious changes. What I’ve said is our top priority has to be to control costs. And that means not just tinkering around the edges. It doesn’t mean just lopping of reimbursements for doctors in any given year because we’re trying to fix our budget.

It means that we look at the kinds of incentives that exist, what our delivery system is like, why it is that some communities are spending 30 percent less than other communities, but getting better health care outcomes, and figuring out how can we make sure that everybody is benefiting from lower costs and better quality by improving practices. It means health I.T. It means prevention.

So all of these things are the starting point, I think, for reform. And I’ve said very clearly, if any bill arrives from Congress that is not controlling costs, that’s not a bill I can support. It’s going to have to control costs. It’s going to have to be paid for. All right?

So there’s been a lot of talk about, well, a trillion-dollar price tag. What I’ve said is, if we’re going to spend that much money, then it’s going to be largely funded through reallocating dollars that are already in the health care system, but aren’t being spent well.

If we’re spending $177 billion over 10 years to subsidize insurance companies under Medicare Advantage, when there’s no showing that people are healthier using that program than the regular Medicare program, well, that’s not a good deal for taxpayers.

And we’re going to take that money and we’re going to use it to provide better care at a cheaper cost to the American people. So, that’s point number one.

Number two, while we are in the process of dealing with the cost issue, I think it’s also wise policy and the right thing to do to start providing coverage for people who don’t have health insurance or are underinsured, are paying a lot of money for high deductibles.

I get letters, two, three letters a day that I read, of families who don’t have health insurance, are going bankrupt, are on the brink of losing their insurance, have deductibles that are so high that, even with insurance, they end up with $50,000, $100,000 worth of debt, are at risk of losing their homes.

And that has to be part of reform, making sure that, even if you’ve got health insurance now, you are not worried that, when you lose your job or your employer decides to change policies, that somehow you’re going to be out of luck.

I think about the woman who was in Wisconsin that I was with, who introduced me up in Green Bay, 36 years old, double mastectomy; breast cancer has now moved to her bones. And she’s got two little kids, a husband with a job. They had health insurance, but they’re still $50,000 in debt.

And she’s thinking, my main legacy, if I don’t survive this thing, is going to be leaving $100,000 worth of debt.

So, those are the things that I’m prioritizing.

Now, the public plan, I think, is an important tool to discipline insurance companies. What we’ve said is, under our proposal, let’s have a system, the same way that federal employees do, same way that members of Congress do, where we call it an exchange, but you can call it a marketplace, where, essentially, you’ve got a whole bunch of different plans.

If you like your plan and you like your doctor, you won’t have to do a thing. You keep your plan; you keep your doctor. If your employer’s providing you good health insurance, terrific. We’re not going to mess with it.

But, if you’re a small-business person; if the insurance that’s being offered is something you can’t afford; if you want to shop for a better price, then you can go to this exchange, this marketplace, and you can — look, OK, this is how much this plan costs; this is how much that plan costs; this is what the coverage is like; this is what fits for my family.

As one of those options, for us to be able to say, here’s a public option that’s not profit-driven, that can keep down administrative costs, and that provides you good, quality care for a reasonable price as one of the options for you to choose, I think that makes sense.

QUESTION: Wouldn’t that drive private insurance out of business?

MR. OBAMA: Why would it drive private insurance out of business? If — if private — if private insurers say that the marketplace provides the best quality health care; if they tell us that they’re offering a good deal, then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical.

Now, the — I think that there’s going to be some healthy debates in Congress about the shape that this takes. I think there can be some legitimate concerns on the part of private insurers that if any public plan is simply being subsidized by taxpayers endlessly that over time they can’t compete with the government just printing money, so there are going to be some I think legitimate debates to be had about how this private plan takes shape.

But just conceptually, the notion that all these insurance companies who say they’re giving consumers the best possible deal, if they can’t compete against a public plan as one option, with consumers making the decision what’s the best deal, that defies logic, which is why I think you’ve seen in the polling data overwhelming support for a public plan.

Speaking for me only