Medicare and Medicaid are huge problems because health care costs are rising even as the population is getting older.  And so what I've said is that I'm prepared to work with Democrats and Republicans to start dealing with that in a serious way.  We made a down payment on that with health care reform last year.  That's part of what health care reform was about.  The projected deficits are going to be about $250 billion lower over the next 10 years than they otherwise would have been because of health care reform, and they’ll be a trillion dollars lower than they otherwise would have been if we hadn’t done health care reform for the following decade.

But we're still going to have to do more.  So what I've said is that if you look at the history of how these deals get done, typically it’s not because there’s an Obama plan out there; it’s because Democrats and Republicans are both committed to tackling this issue in a serious way.

And so what we've done is we've been very specific in terms of how to stabilize the discretionary budget, how to make sure that we're not adding additional debt by 2015.  And then let’s together, Democrats and Republicans, tackle these long-term problems in a way that I think will ensure our fiscal health and, at the same time, ensure that we're making investments in the future.

Q    But when is that happening?

THE PRESIDENT:  Well, we're going to be in discussions over the next several months.  I mean this is going to be a negotiation process.  And the key thing that I think the American people want to see is that all sides are serious about it and all sides are willing to give a little bit, and that there’s a genuine spirit of compromise as opposed to people being interested in scoring political points.

Now, we did that in December during the lame duck on the tax cut issue.  Both sides had to give.  And there were folks in my party who were not happy, and there were folks in the Republican Party who were not happy.  And my suspicion is, is that we’re going to be able to do the same thing if we have that same attitude with respect to entitlements.

But the thing I want to emphasize is nobody is more mindful than me that entitlements are going to be a key part of this issue -- as is tax reform.  I want to simplify rates.  And I want to, at the same time, make sure that we have the same amount of money coming in as going out.

Those are big, tough negotiations, and I suspect that there’s going to be a lot of ups and downs（沉浮，盛衰） in the months to come before we finally get to that solution.  But just as a lot of people were skeptical about us being able to deal with the tax cuts that we did in December but we ended up getting it done, I’m confident that we can get this done as well.

Now, with respect to the situation in the Middle East, obviously, there’s still a lot of work to be done in Egypt itself, but what we’ve seen so far is positive.  The military council that is in charge has reaffirmed its treaties with countries like Israel and international treaties.  It has met with the opposition, and the opposition has felt that it is serious about moving towards fair and free elections.  Egypt is going to require help in building democratic institutions and also in strengthening an economy that's taken a hit as a consequence of what happened.  But so far at least, we’re seeing the right signals coming out of Egypt.

There are ramifications（分枝，分叉） , though, throughout the region.  And I think my administration’s approach is the approach that jibes with how most Americans think about this region, which is that each country is different, each country has its own traditions; America can’t dictate（命令，听写） how they run their societies, but there are certain universal principles that we adhere to.  One of them is we don't believe in violence as a way of -- and coercion（强制，强迫） -- as a way of maintaining control.  And so we think it’s very important that in all the protests that we’re seeing in -- throughout the region that governments respond to peaceful protesters peacefully.

The second principle that we believe in strongly is in the right to express your opinions, the freedom of speech and freedom of assembly that allows people to share their grievances（抱怨，不平） with the government and to express themselves in ways that hopefully will over time meet their needs.

And so we have sent a strong message to our allies in the region, saying let’s look at Egypt’s example as opposed to Iran’s example.  I find it ironic that you’ve got the Iranian regime pretending to celebrate what happened in Egypt when, in fact, they have acted in direct contrast to what happened in Egypt by gunning down and beating people who were trying to express themselves peacefully in Iran.

And I also think that an important lesson -- and I mentioned this last week -- that we can draw from this is real change in these societies is not going to happen because of terrorism; it’s not going to happen because you go around killing innocents -- it’s going to happen because people come together and apply moral force to a situation.  That’s what garners（获得） international support. That’s what garners internal support.  That’s how you bring about lasting change.

Patricia Zengerle.

Q    Thank you, Mr. President.  Getting back to the unrest in the Middle East and North Africa, what concerns do you have about instability, especially in Saudi Arabia, as the demonstrations spread?  Do you see -- foresee any effects on oil prices?  And talking about Iran, can you comment about the unrest there more?  What is your message to the Iranian people -- in light of there was some criticism that your administration didn’t speak out strongly enough after their last -- the demonstrations in Iran after their elections?  Excuse me.

THE PRESIDENT:  That’s okay.  Well, first of all, on Iran, we were clear then and we are clear now that what has been true in Egypt should be true in Iran, which is that people should be able to express their opinions and their grievances（抱怨，不平） and seek a more responsive government.  What's been different is the Iranian government’s response, which is to shoot people and beat people and arrest people.

And my hope and expectation is, is that we’re going to continue to see the people of Iran have the courage to be able to express their yearning for greater freedoms and a more representative government, understanding that America cannot ultimately dictate what happens inside of Iran any more than it could inside of Egypt.  Ultimately these are sovereign countries that are going to have to make their own decisions.  What we can do is lend moral support to those who are seeking a better life for themselves.

Obviously we’re concerned about stability throughout the region.  Each country is different.  The message that we’ve sent even before the demonstrations in Egypt has been, to friend and foe alike, that the world is changing; that you have a young, vibrant generation within the Middle East that is looking for greater opportunity, and that if you are governing these countries, you’ve got to get out ahead of change.  You can’t be behind the curve.

And so I think that the thing that will actually achieve stability in that region is if young people, if ordinary folks end up feeling that there are pathways for them to feed their families, get a decent job, get an education, aspire to（渴求） a better life.  And the more steps these governments are taking to provide these avenues for mobility and opportunity, the more stable these countries are.

You can’t maintain power through coercion（强制，强迫） .  At some level, in any society, there has to be consent（同意，赞成） .  And that’s particularly true in this new era where people can communicate not just through some centralized government or a state-run TV, but they can get on a smart phone or a Twitter account and mobilize hundreds of thousands of people.

My belief is that, as a consequence of what’s happening in Tunisia and Egypt, governments in that region are starting to understand this.  And my hope is, is that they can operate in a way that is responsive to this hunger for change but always do so in a way that doesn’t lead to violence.