[ applause ] if you have other ideas about things that we should be looking at, we want to hear them, and thats part of the purpose of this town hall discussion. Im interested in hearing your stories, getting your questions, and this will be a pretty informal affair. Well, as informal as it gets when the president comes and there are a bunch of cameras everywhere. So with that, id just like to start the discussion. And what im going to do is im just going to call on folks, just raise your hand. I would ask you to stand up, introduce yourself. There are people with mikes, and theyll bring the mike to you and im going to go girl, boy, girl, boy, to make sure that its fair. All right . So well start with this young lady right here in the striped top. Thank you. Its an honor to have you here today. Hold on a second. Here we go. Thank you. Its an honor to have you here today, mr. President. My name is nicole rohan from the Decker School of nursing here, which is an Outstanding School of nursing that has excellent outcomes. My question today is because advanced Practice Nurses, primarily Nurse Practitioners and nurse midwives have such an outstanding reputation, we have good outcomes and the Affordable Care act is ready to be rolled out soon. Nurse practitioners and advanced Practice Nurses are in an excellent position to really serve vulnerable populations and people who dont have care. Im wondering if theres any provisions within your educational act that would support Health Care Workers and Nurse Practitioners to create a sustainable workforce that would be tiebl support caring for people as we roll out the Affordable Care act. It is a great question. Now, first of all, let me without buttering you up, i love nurses. Michelle and i have been blessed, we havent been sick too much, knock on wood. But every interaction weve had at the hospital, doctors are wonderful and we appreciate them, but i know when malia and sasha were being born, we spent 90 of the time with the nurses and 10 with the ob gyn. When my grandmother got sick and was passing away at the end, it was nurses who were caring for them and incredibly compassionate but also a professional way. And youre absolutely right, that one of the keys to reducing our Health Care Costs overall is recognizing the incredible value of advanced Practice Nurses and giving them more responsibilities, because theres a lot of stuff they can do in a way that, frankly, is cheaper than having a doctor do it. But the outcomes are just as good. The challenge we have is we still have a nursing shortage in too many parts of the country. My understanding, you probably know this better than i do, part of the problem is, is that too many professors of nursing or instructors in nursing are getting paid less than actual nurses. So what ends up happening is we dont have enough slots in some of the nursing schools. That may not be true here, but there are parts of the country where thats true. So we have to upgrade a little bit the schools of nursing and make sure that theyre properly resourced so that we have enough instructors. And in fact as part of the Affordable Care act, one of the things that we thought about was how are we going to expand and improve the number of nurses and making sure that they can actually finance their educations. And so there are some special programs for nurses who are committing themselves, as well as doctors who are committing themselves to serving in underserved communities, and we will be happy to get that information to the school of nursing here. One other element to this that i think is really interesting, weve been spending a lot of time thinking about making sure that our veterans coming back from iraq and afghanistan are getting the opportunities they need. So we instituted something called the post9 11 g. I. Bill that provides the same kind of support that my grandfather got when he came back from world war ii. And the young people who have served in our Armed Forces Just do extraordinary work. One of the problems, though, is that they dont always get credit for the skills that they already possess when they come home. So one and weve got a gentleman here whos a veteran. And one great example actually is in the medical profession. When you get army medics coming back who served in the worst possible circumstances, out in theater, having to make lifeordeath decisions, i met a young man up in minnesota. He had come back, wanted to continue to pursue his career and become a professional nurse and he was having to start from scratch taking the equivalent of nursing 101. And what were trying to do is to make sure that states and institutions of Higher Learning recognize some of the skills because as we bring more and more of our veterans home, well be ending the war in afghanistan by the end of next year, we want to make sure that those folks have the opportunity to succeed here in america. Great question, though. All right. Its a guys turn. Right here. Yeah. Hold on, lets get a mike all the way to the back. Hello, mr. President. Im glad for you to come to Binghamton University. Im the director of Rainbow Pride Union here, the largest lbgt organization on campus. My main concern is that i know a lot of stories of people who are lbgt who come out to their parents and their parents are supporting them financially for college and when they come out, their parents cut out that support. I was wondering if maybe in the future part of your affordability for college would be able to include lbgt people. Well, first of all, the programs that we have in place dont discriminate and shouldnt discriminate, and the good news is, i think the phenomenon that you just described is likely to happen less and less and less with each successive year. Think about the incredible changes that have been made just over the last decade. Doma is gone. Dont ask, dont tell is gone. More importantly, peoples hearts and minds have chamber of commerced changed and i think thats reflective of parents as well. I think more and more what we recognize is that just as we judge people on should judge people on the basis of their character and not their color or religion or gender, the same is true for their sexual orientation. So i dont suspect that well have special laws pertaining to young people who were cut off from support by their parents because their parents hadnt gotten to the place i think they should be when it comes to loving and supporting their kids regardless of who they are, but we are going to make sure that all young people get the support that they need so that if their parents arent willing to provide them support and theyre functionally independent, that theyre still able to go to college and succeed. All right . Right here in the obama tshirt. You know, so if you heres a general rule in the president ial town hall. If you want to get called on, wear the president s face on your shirt. Good afternoon, president obama. My name is ivana smith. I am a graduate student in the college of community and public affairs. I study Eastern Affairs administration w that being said, as we are all students, we know how vital it is to have a Good Foundation in your education. How does your Administration Plan to address the major budget cuts that are happening with headstart schools around the u. S. . Well, thats a great question and this will be a major topic over the next several months. First of all, i want to expand Early Childhood education so that it is accessible for every young person in america. And i talked about this i talked about this in my state of the union address. It is just common sense. We know, study after study has shown that the biggest bang for the buck that we get when it comes to education is to invest early. If we get 3yearolds, 4yearolds well prepared when they start school, that momentum continues. If they start behind, too often they stay behind. Kids are resilient, they can make up for some tough stuff early on in life, but its a lot harder for them an if we get them young. In fact studies have shown theres some very smart programs out there where you identify low income single moms in the maternity ward. And nurses talk to them immediately not just about the health of their child but also parenting and create a little packet with some books and toys and talk about engagement and expanding vocabulary. All that can make a difference. And high quality, Early Childhood education can continue that process so that by the time the kid starts school, they know their colors, they know their letters, theyre ready to go. Now, unfortunately right now the federal budget generally has been a political football in washington. Partly this came out of the financial crisis. We had a terrible crisis. We had to immediately pump money into the system to prevent a great depression, so we cut taxes for middle class families, we initiated programs to rebuild our roads and our bridges, we helped states so they wont have to layoff as many teachers and firefighters and police officers, and thats part of the reason why we avoided a depression, although we still had a terrible recession. But the combination of increased spending and less revenue meant that the deficit went up. And by the time the republicans took over the house in 2011, they had made this a major issue. And understandably a lot of families said were having to tighten our belts, the federal government should too. Although part of what you want the federal government to do when everyone else is having a hard time is to make sure that youre providing additional support. As the economy has improved, the deficit has gone down. Its dropped at the fastest rate in 60 years. I want to repeat that because a lot of people think if you ask the average person whats happening with the deficit, theyd tell you its going up. The deficit has been cut in half since 2009 and is on a downward trajectory. And its going down faster than any time since world war ii. So we dont have a problem in terms of spending on education. We dont have a problem when it comes to spending on research and development. We do have a longterm problem that has to do with our health care programs, medicare and medicaid. The good news is, is that in part because of the Affordable Care act, obama care, costs have actually gone down Health Care Inflation has gone down to the slowest rate that weve seen in a long time. So were starting to get Health Care Costs under control. Well still have to make some modifications when it comes to our longterm entitlement programs so theyre here for young people here when theyre ready for retirement, but we dont have an urgent deficit crisis. The only crisis we have is one thats manufactured in washington, and its ideological. And the basic notion is, is that we shouldnt be helping people get health care and we shouldnt be helping kids who cant help themselves and whose parents are underresourced, we shouldnt be helping them get a leg up. And so some of the proposals weve seen now are talking about even deeper cuts in programs like headstart, even deeper cuts in education support, even deeper cuts in basic science and research. And thats like eating your corn seed. You know, its like being penny wise and pound foolish, because if young people arent succeeding, if were not spending on research and maintaining our technological edge, if were not upgrading our roads and our bridges and our Transportation Systems and our infrastructure, all things that we can afford to do right now and should be doing right now and would put people to work right now, if we dont do those things, then 20 years from now, 30 years from now, we will have fallen further and further behind. So when we get back to washington, when Congress Gets back to washington, this is going to be a major debate. Its the same debate weve been having for the last two years. The difference is now, deficits are already coming down. What we should really be thinking about is how do we grow an economy so that were creating a growing, thriving middle class and were creating more ladders of opportunity for people willing to work hard to get in the middle class. And my position is going to be that we can have a budget that is sensible, that doesnt spend on programs that dont work, but does spend wisely on those things that are going to help ordinary people succeed. All right. Good. Lets see, it is a gentlemans turn. This gentleman right here, hes had his hand up for a while. You have a little cheering section there. Im a faculty member of the Computer Science department. Im very excited and encouraged by your plan on the affordability. My question is related about the quality of future higher education. As you know, many are trying their best to provide the best value by doing better with less, but the challenges are real. Its getting tougher and tougher as the budget cuts are getting tougher and tougher. So my question is what your administration will do to ensure the best american universities remains to be the best in the world in the 21st century. Thank you. Well, first of all, whats really important is to make sure that were supporting great teachers. And since you got an applause line, you must be a pretty good one. And i dont think that there is a conflict between quality and paying attention to costs as its affecting students. Now, i mentioned earlier one of the big problems that weve seen in public universities is a diminished level of support from states, state legislatures. And part of what were going to try to do is to provide more incentives to states to boost the support that theyre giving to colleges and universities. Traditionally, when you think of the Great State University systems, it was because those states understood if we invest in our people, well have a better trained workforce, which Means Companies will want to locate here, which creates a Virtuous Cycle and everybody benefits. But starting, lets say, 15 years ago, 20 years ago, you saw a trend in which state legislatures who were trying to balance their budgets kept on cutting support to state education. What happened was that and i dont know whether this is true, mr. President , for suny, but around the country on average what youve seen is a drop from about 46 of the revenues of a Public College coming from states down to about 25 . Its almost been cut in half. And essentially the only way these schools have figured to make it up is to charge higher tuition. So states have to do their jobs. But what is true also, though, is that universities and faculty need to come up with ways to also cut costs while maintaining quality, because thats what were having to do throughout our economy. And sometimes when i talk to College Professors and keep in mind, i taught in a law school for ten years, so im very sympathetic to the spirit of inquiry and the importance of not just looking at xs and os and numbers when it comes to measuring colleges. But what i also know is, is that there are ways we can save money that would not diminish quality. This is probably controversial to say, but what the heck. Im in my second term so i can say it. You know, i believe, for example, that law schools would probably be wise to think about being two years instead of three years, because by the third year in the first two years, young people are learning in the classroom. The third year theyd be better off clerking or practicing in a firm, even if they werent getting paid that much, but that step alone would reduce the cost for the student. Now, the question is can law students can law schools maintain quality and keep good professors and sustain themselves without that third year. My suspicion is, is that if they thought creatively about it, they probably could. Now, if thats true at a graduate level, there are probably some things that we could do at the undergraduate level as well. Thats not to suggest that there arent some real problems. Colleges, for example, they have got Health Care Costs like everybody else. Personnel is one of the most important its the biggest cost youve got. And if Health Care Costs to provide insurance for your employees is going up as fast as its been going up, that affects folks. So our idea is not just to have some cookie cutter approach that doesnt take quality into account. The idea is understanding weve got to maintain high quality, are there ways that we can reorganization schools, use technology, think about what works, so that overall were creating a better value for the student . And one of the best things that we could do for students is to make sure that they graduate in a more timely fashion. And, you know, unfortunately too many young people go to schools where theyre not getting the kind of support and advice on the front end that they need and they drift and four years, five years, six years into it, they have got a bunch of credits, but it all doesnt result in actual graduation. And then they get discouraged. And thats an area where we know we can be making improvement as well. Okay . And if youve got any other ideas, let me know. All right. Okay. Lets get a young person in here. Right there. Yeah. Welcome to binghamton. Thanks. President obama. Im camison, im a doctoral student here as well as a writer instructor at syracuse university. Im interested in the giving of federal funds to students who are going to forprofit colleges or colleges i might even call predatory. Im very conflicted about this issue and so id like to hear your insight. Thank you. Well, you probably know more about it than i do, since youve written about it, but let me describe for the audience what the challenge is. Forprofit institutions in a lot of sectors of our lives obviously is the cornerstone of our economy, and we want to encourage entrepreneurship and new ideas and new approaches and new ways of doing things. So im not against forprofit instituti