(CNSNews.com) - "The real problem that we have when it comes to debt is very simple," President Obama told the nation's governors on Monday. "It is that our population's getting older, and we use a lot of health care.
"And health care -- we spend more for less, frankly, than most other advanced nations, partly because we do a lot of emergency room care. Some of it is because we, you know, overprescribe, we over-test. Some of it is we drive innovation and technology, and people always want the best stuff, but that costs money.
"Some of it is because -- the accident of how our health care system evolved means that we got private-sector involvement, and they've got to make a profit, and they've got overhead, and so forth. So there are a whole bunch of reasons, but essentially, we spend about 6 to 8 percent more than our wealthy nation counterparts, per capita, on health care. That delta -- that difference -- is our debt."
Obama told the National Governors Association that concerns about the debt are why he pushed for transformation of the health care system.
"It was not just the compassion I felt for people personally being impacted -- getting sick and losing their home, or not being able to get care for their kids, or having to go to the emergency room because of -- of routine issues that should have been dealt with by a primary care physician.
"It also had to do with the fact that this system is hugely inefficient, and if we don't make it more efficient, then we're not going to solve our debt problem."
Obama said his Fiscal Year 2017 budget has "stabilized" the amount of discretionary spending added to the debt each year, but over the long-term, "we're going to have to tackle...health care spending," he said.
"And if we don't do that, then, you know, we -- we can cut food stamps and we can cut WIC (welfare) programs and we can cut education programs and you can cut out Head Start. You can cut out every single discretionary program that Democrats support and a lot of...Republican governors support, but sometimes, members of Congress say are a waste, or big government, or what have you.
"You can get rid of all that discretionary spending. It won't matter, because the big-ticket item is Medicare, Medicaid, and in the private sector, the big-ticket item, that's where the inflation is, is on the health care side."
Obama called for a "serious conversation" about health care spending: "Maybe it'll have to happen once I'm gone because the Affordable Care Act and the debate around health care has gotten so politicized, so toxic that we can't have a sensible conversation about it, despite the fact that I implemented a measure that was passed by a Republican governor (Mitt Romney in Massachusetts), but that's a whole other question."
Obama said he's embraced cost-saving measures that Republican governors also have used, "and then suddenly now, this is some Obama scheme or plot.
"But maybe once I'm gone, we can go back to have a sensible conversation between Democrats and Republicans about how we should...incentivize greater efficiency, better outcomes, higher quality for lower cost in our health care system. And if we do that, that's going to make the biggest difference. The single biggest thing that we were able to do to bring down any additions to the debt since I've been in office was over the last three to four years, we've kept health care inflation at its lowest rate in 50 years since the Affordable Care Act."
Obama said his efforts to make health care "more efficient" have saved the Medicare Trust Fund over $100 billion. "And by the way, people got just as good or better care. This wasn't done through rationing, it wasn't done through us cutting people out of the program, it just had to do with better delivery."
Obama also plugged Medicaid expansion as a "smart" way for the states to save money over the long-term.
According to the Congressional Budget Office, growth in spending -- particularly for Social Security, health care, and interest payments on the federal debt -- is expected to outpace growth in revenues over the coming 10 years.
Those projected rising deficits would push debt held by the public up to 86 percent of GDP by the end of 2026, which is more than twice the average over the past five decades.
President Obama's own deficit-reduction commission in 2013 offered four steps to deficit reduction, including reductions in defense and nondefense discretionary spending; higher taxes on incomes above $450,000; entitlement reforms, including reduced Medicare and Medicaid spending; reforming Social Security to make it solvent, and making Medicare spending "sustainable."
Neither the Obama administration nor Congress has acted on the commission's recommendations.