Tuần vừa qua, Anthony tôi khơi khơi nhận được hai nguồn tin xem ra có vẻ
thật, xin chia sớt với bạn đọc. Dĩ nhiên những tin này viết bằng tiếng Mỹ
cho nên Anthony tôi phải nín thở chuyển qua lối tiếng Việt ăn đong của một
tên coi như là... mất gốc. Xin hoan hỷ. Nguồn tin đó như sau:
Vào ngày Thứ Tư - 09-09-2009 Văn phòng Truyền Thông Vụ Tòa Bạch Ốc
<whitehous-list-noreply@lis.whitehouse.gov ghi rằng:
Từ: Văn phòng Truyền Thông Vụ Tòa Bạch Ốc
<whitehous-list-noreply@lis.whitehouse.gov Về việc: Bức thư của Thượng Nghị
Sĩ Edward M. Kennedy gửi Tổng Thống ngày Thứ Tư, 09-09-2009, 6.15PM
Tòa Bạch Ốc Văn phòng Tùy viên Báo chí Để phổ biến ngay 09-09-2009 Dưới
đây là lá thư của Thượng Nghi Sĩ Edward M. Kennedy gửi Tổng Thống được công
bố trong phiên khoáng đại lưỡng viện Quốc Hội tối nay.
Trích thông điệp của Tổng Thống gửi khoáng đại lưỡng viện Quốc Hội họp
tối nay:
py THE WHITE HOUSE
Office of the Press Secretary
http://www.whitehouse.gov/the_press_office/Text-of-letter-to-the-President-from-Senator-Edward-M-Kennedy/
______________________________________________________________________
FOR IMMEDIATE RELEASE September 9, 2009
Below is the text of the letter from Senator Edward M. Kennedy referenced
by the President in tonight’s address to a Joint Session of Congress.
May 12, 2009
Dear Mr. President,
I wanted to write a few final words to you to express my gratitude for
your repeated personal kindnesses to me – and one last time, to salute your
leadership in giving our country back its future and its truth.
On a personal level, you and Michelle reached out to Vicki, to our family
and me in so many different ways. You helped to make these difficult months
a happy time in my life.
You also made it a time of hope for me and for our country.
When I thought of all the years, all the battles, and all the memories of
my long public life, I felt confident in these closing days that while I
will not be there when it happens, you will be the President who at long
last signs into law the health care reform that is the great unfinished
business of our society. For me, this cause stretched across decades; it has
been disappointed, but never finally defeated. It was the cause of my life.
And in the past year, the prospect of victory sustained me-and the work of
achieving it summoned my energy and determination.
There will be struggles – there always have been – and they are already
underway again. But as we moved forward in these months, I learned that you
will not yield to calls to retreat - that you will stay with the cause until
it is won. I saw your conviction that the time is now and witnessed your
unwavering commitment and understanding that health care is a decisive issue
for our future prosperity. But you have also reminded all of us that it
concerns more than material things; that what we face is above all a moral
issue; that at stake are not just the details of policy, but fundamental
principles of social justice and the character of our country.
And so because of your vision and resolve, I came to believe that soon,
very soon, affordable health coverage will be available to all, in an
America where the state of a family’s health will never again depend on the
amount of a family’s wealth. And while I will not see the victory, I was
able to look forward and know that we will – yes, we will – fulfill the
promise of health care in America as a right and not a privilege.
In closing, let me say again how proud I was to be part of your campaign-
and proud as well to play a part in the early months of a new era of high
purpose and achievement. I entered public life with a young President who
inspired a generation and the world. It gives me great hope that as I leave,
another young President inspires another generation and once more on
America’s behalf inspires the entire world.
So, I wrote this to thank you one last time as a friend- and to stand
with you one last time for change and the America we can become.
At the Denver Convention where you were nominated, I said the dream lives
on.
And I finished this letter with unshakable faith that the dream will be
fulfilled for this generation, and preserved and enlarged for generations to
come.
With deep respect and abiding affection,
[Ted]
pypy OBAMA HEALTH CARE SPEECH: FULL
http://www.huffingtonpost.com/
Madam Speaker, Vice President Biden, members of Congress, and the
American people:
When I spoke here last winter, this nation was facing the worst economic
crisis since the Great Depression. We were losing an average of 700,000 jobs
per month. Credit was frozen. And our financial system was on the verge of
collapse.
As any American who is still looking for work or a way to pay their bills
will tell you, we are by no means out of the woods. A full and vibrant
recovery is still many months away. And I will not let up until those
Americans who seek jobs can find them -- (applause) -- until those
businesses that seek capital and credit can thrive; until all responsible
homeowners can stay in their homes. That is our ultimate goal. But thanks to
the bold and decisive action we've taken since January, I can stand here
with confidence and say that we have pulled this economy back from the
brink. (Applause.)
I want to thank the members of this body for your efforts and your
support in these last several months, and especially those who've taken the
difficult votes that have put us on a path to recovery. I also want to thank
the American people for their patience and resolve during this trying time
for our nation.
But we did not come here just to clean up crises. We came here to build a
future. (Applause.) So tonight, I return to speak to all of you about an
issue that is central to that future -- and that is the issue of health
care.
I am not the first President to take up this cause, but I am determined
to be the last. (Applause.) It has now been nearly a century since Theodore
Roosevelt first called for health care reform. And ever since, nearly every
President and Congress, whether Democrat or Republican, has attempted to
meet this challenge in some way. A bill for comprehensive health reform was
first introduced by John Dingell Sr. in 1943. Sixty-five years later, his
son continues to introduce that same bill at the beginning of each session.
(Applause.)
Our collective failure to meet this challenge -- year after year, decade
after decade -- has led us to the breaking point. Everyone understands the
extraordinary hardships that are placed on the uninsured, who live every day
just one accident or illness away from bankruptcy. These are not primarily
people on welfare. These are middle-class Americans. Some can't get
insurance on the job. Others are self-employed, and can't afford it, since
buying insurance on your own costs you three times as much as the coverage
you get from your employer. Many other Americans who are willing and able to
pay are still denied insurance due to previous illnesses or conditions that
insurance companies decide are too risky or too expensive to cover.
We are the only democracy -- the only advanced democracy on Earth -- the
only wealthy nation -- that allows such hardship for millions of its people.
There are now more than 30 million American citizens who cannot get
coverage. In just a two-year period, one in every three Americans goes
without health care coverage at some point. And every day, 14,000 Americans
lose their coverage. In other words, it can happen to anyone.
But the problem that plagues the health care system is not just a problem
for the uninsured. Those who do have insurance have never had less security
and stability than they do today. More and more Americans worry that if you
move, lose your job, or change your job, you'll lose your health insurance
too. More and more Americans pay their premiums, only to discover that their
insurance company has dropped their coverage when they get sick, or won't
pay the full cost of care. It happens every day.
One man from Illinois lost his coverage in the middle of chemotherapy
because his insurer found that he hadn't reported gallstones that he didn't
even know about. They delayed his treatment, and he died because of it.
Another woman from Texas was about to get a double mastectomy when her
insurance company canceled her policy because she forgot to declare a case
of acne. By the time she had her insurance reinstated, her breast cancer had
more than doubled in size. That is heart-breaking, it is wrong, and no one
should be treated that way in the United States of America. (Applause.)
Then there's the problem of rising cost. We spend one and a half times
more per person on health care than any other country, but we aren't any
healthier for it. This is one of the reasons that insurance premiums have
gone up three times faster than wages. It's why so many employers --
especially small businesses -- are forcing their employees to pay more for
insurance, or are dropping their coverage entirely. It's why so many
aspiring entrepreneurs cannot afford to open a business in the first place,
and why American businesses that compete internationally -- like our
automakers -- are at a huge disadvantage. And it's why those of us with
health insurance are also paying a hidden and growing tax for those without
it -- about $1,000 per year that pays for somebody else's emergency room and
charitable care.
Finally, our health care system is placing an unsustainable burden on
taxpayers. When health care costs grow at the rate they have, it puts
greater pressure on programs like Medicare and Medicaid. If we do nothing to
slow these skyrocketing costs, we will eventually be spending more on
Medicare and Medicaid than every other government program combined. Put
simply, our health care problem is our deficit problem. Nothing else even
comes close. Nothing else. (Applause.)
Now, these are the facts. Nobody disputes them. We know we must reform
this system. The question is how.
There are those on the left who believe that the only way to fix the
system is through a single-payer system like Canada's -- (applause) -- where
we would severely restrict the private insurance market and have the
government provide coverage for everybody. On the right, there are those who
argue that we should end employer-based systems and leave individuals to buy
health insurance on their own.
I've said -- I have to say that there are arguments to be made for both
these approaches. But either one would represent a radical shift that would
disrupt the health care most people currently have. Since health care
represents one-sixth of our economy, I believe it makes more sense to build
on what works and fix what doesn't, rather than try to build an entirely new
system from scratch. (Applause.) And that is precisely what those of you in
Congress have tried to do over the past several months.
During that time, we've seen Washington at its best and at its worst.
We've seen many in this chamber work tirelessly for the better part of
this year to offer thoughtful ideas about how to achieve reform. Of the five
committees asked to develop bills, four have completed their work, and the
Senate Finance Committee announced today that it will move forward next
week. That has never happened before. Our overall efforts have been
supported by an unprecedented coalition of doctors and nurses; hospitals,
seniors' groups, and even drug companies -- many of whom opposed reform in
the past. And there is agreement in this chamber on about 80 percent of what
needs to be done, putting us closer to the goal of reform than we have ever
been.
But what we've also seen in these last months is the same partisan
spectacle that only hardens the disdain many Americans have towards their
own government. Instead of honest debate, we've seen scare tactics. Some
have dug into unyielding ideological camps that offer no hope of compromise.
Too many have used this as an opportunity to score short-term political
points, even if it robs the country of our opportunity to solve a long-term
challenge. And out of this blizzard of charges and counter-charges,
confusion has reigned.
Well, the time for bickering is over. The time for games has passed.
(Applause.) Now is the season for action. Now is when we must bring the best
ideas of both parties together, and show the American people that we can
still do what we were sent here to do. Now is the time to deliver on health
care. Now is the time to deliver on health care.
The plan I'm announcing tonight would meet three basic goals. It will
provide more security and stability to those who have health insurance. It
will provide insurance for those who don't. And it will slow the growth of
health care costs for our families, our businesses, and our government.
(Applause.) It's a plan that asks everyone to take responsibility for
meeting this challenge -- not just government, not just insurance companies,
but everybody including employers and individuals. And it's a plan that
incorporates ideas from senators and congressmen, from Democrats and
Republicans -- and yes, from some of my opponents in both the primary and
general election.
Here are the details that every American needs to know about this plan.
First, if you are among the hundreds of millions of Americans who already
have health insurance through your job, or Medicare, or Medicaid, or the VA,
nothing in this plan will require you or your employer to change the
coverage or the doctor you have. (Applause.) Let me repeat this: Nothing in
our plan requires you to change what you have.
What this plan will do is make the insurance you have work better for
you. Under this plan, it will be against the law for insurance companies to
deny you coverage because of a preexisting condition. (Applause.) As soon as
I sign this bill, it will be against the law for insurance companies to drop
your coverage when you get sick or water it down when you need it the most.
(Applause.) They will no longer be able to place some arbitrary cap on the
amount of coverage you can receive in a given year or in a lifetime.
(Applause.) We will place a limit on how much you can be charged for
out-of-pocket expenses, because in the United States of America, no one
should go broke because they get sick. (Applause.) And insurance companies
will be required to cover, with no extra charge, routine checkups and
preventive care, like mammograms and colonoscopies -- (applause) -- because
there's no reason we shouldn't be catching diseases like breast cancer and
colon cancer before they get worse. That makes sense, it saves money, and it
saves lives. (Applause.)
Now, that's what Americans who have health insurance can expect from this
plan -- more security and more stability.
Now, if you're one of the tens of millions of Americans who don't
currently have health insurance, the second part of this plan will finally
offer you quality, affordable choices. (Applause.) If you lose your job or
you change your job, you'll be able to get coverage. If you strike out on
your own and start a small business, you'll be able to get coverage. We'll
do this by creating a new insurance exchange -- a marketplace where
individuals and small businesses will be able to shop for health insurance
at competitive prices. Insurance companies will have an incentive to
participate in this exchange because it lets them compete for millions of
new customers. As one big group, these customers will have greater leverage
to bargain with the insurance companies for better prices and quality
coverage. This is how large companies and government employees get
affordable insurance. It's how everyone in this Congress gets affordable
insurance. And it's time to give every American the same opportunity that we
give ourselves. (Applause.)
Now, for those individuals and small businesses who still can't afford
the lower-priced insurance available in the exchange, we'll provide tax
credits, the size of which will be based on your need. And all insurance
companies that want access to this new marketplace will have to abide by the
consumer protections I already mentioned. This exchange will take effect in
four years, which will give us time to do it right. In the meantime, for
those Americans who can't get insurance today because they have preexisting
medical conditions, we will immediately offer low-cost coverage that will
protect you against financial ruin if you become seriously ill. (Applause.)
This was a good idea when Senator John McCain proposed it in the campaign,
it's a good idea now, and we should all embrace it. (Applause.)
Now, even if we provide these affordable options, there may be those --
especially the young and the healthy -- who still want to take the risk and
go without coverage. There may still be companies that refuse to do right by
their workers by giving them coverage. The problem is, such irresponsible
behavior costs all the rest of us money. If there are affordable options and
people still don't sign up for health insurance, it means we pay for these
people's expensive emergency room visits. If some businesses don't provide
workers health care, it forces the rest of us to pick up the tab when their
workers get sick, and gives those businesses an unfair advantage over their
competitors. And unless everybody does their part, many of the insurance
reforms we seek -- especially requiring insurance companies to cover
preexisting conditions -- just can't be achieved.
And that's why under my plan, individuals will be required to carry basic
health insurance -- just as most states require you to carry auto insurance.
(Applause.) Likewise -- likewise, businesses will be required to either
offer their workers health care, or chip in to help cover the cost of their
workers. There will be a hardship waiver for those individuals who still
can't afford coverage, and 95 percent of all small businesses, because of
their size and narrow profit margin, would be exempt from these
requirements. (Applause.) But we can't have large businesses and individuals
who can afford coverage game the system by avoiding responsibility to
themselves or their employees. Improving our health care system only works
if everybody does their part.
And while there remain some significant details to be ironed out, I
believe -- (laughter) -- I believe a broad consensus exists for the aspects
of the plan I just outlined: consumer protections for those with insurance,
an exchange that allows individuals and small businesses to purchase
affordable coverage, and a requirement that people who can afford insurance
get insurance.
And I have no doubt that these reforms would greatly benefit Americans
from all walks of life, as well as the economy as a whole. Still, given all
the misinformation that's been spread over the past few months, I realize --
(applause) -- I realize that many Americans have grown nervous about reform.
So tonight I want to address some of the key controversies that are still
out there.
Some of people's concerns have grown out of bogus claims spread by those
whose only agenda is to kill reform at any cost. The best example is the
claim made not just by radio and cable talk show hosts, but by prominent
politicians, that we plan to set up panels of bureaucrats with the power to
kill off senior citizens. Now, such a charge would be laughable if it
weren't so cynical and irresponsible. It is a lie, plain and simple.
(Applause.)
There are also those who claim that our reform efforts would insure
illegal immigrants. This, too, is false. The reforms -- the reforms I'm
proposing would not apply to those who are here illegally.
AUDIENCE MEMBER: You lie! (Boos.)
THE PRESIDENT: It's not true. And one more misunderstanding I want to
clear up -- under our plan, no federal dollars will be used to fund
abortions, and federal conscience laws will remain in place. (Applause.)
Now, my health care proposal has also been attacked by some who oppose
reform as a "government takeover" of the entire health care system. As
proof, critics point to a provision in our plan that allows the uninsured
and small businesses to choose a publicly sponsored insurance option,
administered by the government just like Medicaid or Medicare. (Applause.)
So let me set the record straight here. My guiding principle is, and
always has been, that consumers do better when there is choice and
competition. That's how the market works. (Applause.) Unfortunately, in 34
states, 75 percent of the insurance market is controlled by five or fewer
companies. In Alabama, almost 90 percent is controlled by just one company.
And without competition, the price of insurance goes up and quality goes
down. And it makes it easier for insurance companies to treat their
customers badly -- by cherry-picking the healthiest individuals and trying
to drop the sickest, by overcharging small businesses who have no leverage,
and by jacking up rates.
Insurance executives don't do this because they're bad people; they do it
because it's profitable. As one former insurance executive testified before
Congress, insurance companies are not only encouraged to find reasons to
drop the seriously ill, they are rewarded for it. All of this is in service
of meeting what this former executive called "Wall Street's relentless
profit expectations."
Now, I have no interest in putting insurance companies out of business.
They provide a legitimate service, and employ a lot of our friends and
neighbors. I just want to hold them accountable. (Applause.) And the
insurance reforms that I've already mentioned would do just that. But an
additional step we can take to keep insurance companies honest is by making
a not-for-profit public option available in the insurance exchange.
(Applause.) Now, let me be clear. Let me be clear. It would only be an
option for those who don't have insurance. No one would be forced to choose
it, and it would not impact those of you who already have insurance. In
fact, based on Congressional Budget Office estimates, we believe that less
than 5 percent of Americans would sign up.
Despite all this, the insurance companies and their allies don't like
this idea. They argue that these private companies can't fairly compete with
the government. And they'd be right if taxpayers were subsidizing this
public insurance option. But they won't be. I've insisted that like any
private insurance company, the public insurance option would have to be
self-sufficient and rely on the premiums it collects. But by avoiding some
of the overhead that gets eaten up at private companies by profits and
excessive administrative costs and executive salaries, it could provide a
good deal for consumers, and would also keep pressure on private insurers to
keep their policies affordable and treat their customers better, the same
way public colleges and universities provide additional choice and
competition to students without in any way inhibiting a vibrant system of
private colleges and universities. (Applause.)
Now, it is -- it's worth noting that a strong majority of Americans still
favor a public insurance option of the sort I've proposed tonight. But its
impact shouldn't be exaggerated -- by the left or the right or the media. It
is only one part of my plan, and shouldn't be used as a handy excuse for the
usual Washington ideological battles. To my progressive friends, I would
remind you that for decades, the driving idea behind reform has been to end
insurance company abuses and make coverage available for those without it.
(Applause.) The public option -- the public option is only a means to that
end -- and we should remain open to other ideas that accomplish our ultimate
goal. And to my Republican friends, I say that rather than making wild
claims about a government takeover of health care, we should work together
to address any legitimate concerns you may have. (Applause.)
For example -- for example, some have suggested that the public option go
into effect only in those markets where insurance companies are not
providing affordable policies. Others have proposed a co-op or another
non-profit entity to administer the plan. These are all constructive ideas
worth exploring. But I will not back down on the basic principle that if
Americans can't find affordable coverage, we will provide you with a choice.
(Applause.) And I will make sure that no government bureaucrat or insurance
company bureaucrat gets between you and the care that you need. (Applause.)
Finally, let me discuss an issue that is a great concern to me, to
members of this chamber, and to the public -- and that's how we pay for this
plan.
And here's what you need to know. First, I will not sign a plan that adds
one dime to our deficits -- either now or in the future. (Applause.) I will
not sign it if it adds one dime to the deficit, now or in the future,
period. And to prove that I'm serious, there will be a provision in this
plan that requires us to come forward with more spending cuts if the savings
we promised don't materialize. (Applause.) Now, part of the reason I faced a
trillion-dollar deficit when I walked in the door of the White House is
because too many initiatives over the last decade were not paid for -- from
the Iraq war to tax breaks for the wealthy. (Applause.) I will not make that
same mistake with health care.
Second, we've estimated that most of this plan can be paid for by finding
savings within the existing health care system, a system that is currently
full of waste and abuse. Right now, too much of the hard-earned savings and
tax dollars we spend on health care don't make us any healthier. That's not
my judgment -- it's the judgment of medical professionals across this
country. And this is also true when it comes to Medicare and Medicaid.
In fact, I want to speak directly to seniors for a moment, because
Medicare is another issue that's been subjected to demagoguery and
distortion during the course of this debate.
More than four decades ago, this nation stood up for the principle that
after a lifetime of hard work, our seniors should not be left to struggle
with a pile of medical bills in their later years. That's how Medicare was
born. And it remains a sacred trust that must be passed down from one
generation to the next. (Applause.) And that is why not a dollar of the
Medicare trust fund will be used to pay for this plan. (Applause.)
The only thing this plan would eliminate is the hundreds of billions of
dollars in waste and fraud, as well as unwarranted subsidies in Medicare
that go to insurance companies -- subsidies that do everything to pad their
profits but don't improve the care of seniors. And we will also create an
independent commission of doctors and medical experts charged with
identifying more waste in the years ahead. (Applause.)
Now, these steps will ensure that you -- America's seniors -- get the
benefits you've been promised. They will ensure that Medicare is there for
future generations. And we can use some of the savings to fill the gap in
coverage that forces too many seniors to pay thousands of dollars a year out
of their own pockets for prescription drugs. (Applause.) That's what this
plan will do for you. So don't pay attention to those scary stories about
how your benefits will be cut, especially since some of the same folks who
are spreading these tall tales have fought against Medicare in the past and
just this year supported a budget that would essentially have turned
Medicare into a privatized voucher program. That will not happen on my
watch. I will protect Medicare. (Applause.)
Now, because Medicare is such a big part of the health care system,
making the program more efficient can help usher in changes in the way we
deliver health care that can reduce costs for everybody. We have long known
that some places -- like the Intermountain Healthcare in Utah or the
Geisinger Health System in rural Pennsylvania -- offer high-quality care at
costs below average. So the commission can help encourage the adoption of
these common-sense best practices by doctors and medical professionals
throughout the system -- everything from reducing hospital infection rates
to encouraging better coordination between teams of doctors.
Reducing the waste and inefficiency in Medicare and Medicaid will pay for
most of this plan. (Applause.) Now, much of the rest would be paid for with
revenues from the very same drug and insurance companies that stand to
benefit from tens of millions of new customers. And this reform will charge
insurance companies a fee for their most expensive policies, which will
encourage them to provide greater value for the money -- an idea which has
the support of Democratic and Republican experts. And according to these
same experts, this modest change could help hold down the cost of health
care for all of us in the long run.
Now, finally, many in this chamber -- particularly on the Republican side
of the aisle -- have long insisted that reforming our medical malpractice
laws can help bring down the cost of health care. (Applause.) Now -- there
you go. There you go. Now, I don't believe malpractice reform is a silver
bullet, but I've talked to enough doctors to know that defensive medicine
may be contributing to unnecessary costs. (Applause.) So I'm proposing that
we move forward on a range of ideas about how to put patient safety first
and let doctors focus on practicing medicine. (Applause.) I know that the
Bush administration considered authorizing demonstration projects in
individual states to test these ideas. I think it's a good idea, and I'm
directing my Secretary of Health and Human Services to move forward on this
initiative today. (Applause.)
Now, add it all up, and the plan I'm proposing will cost around $900
billion over 10 years -- less than we have spent on the Iraq and Afghanistan
wars, and less than the tax cuts for the wealthiest few Americans that
Congress passed at the beginning of the previous administration. (Applause.)
Now, most of these costs will be paid for with money already being spent --
but spent badly -- in the existing health care system. The plan will not add
to our deficit. The middle class will realize greater security, not higher
taxes. And if we are able to slow the growth of health care costs by just
one-tenth of 1 percent each year -- one-tenth of 1 percent -- it will
actually reduce the deficit by $4 trillion over the long term.
Now, this is the plan I'm proposing. It's a plan that incorporates ideas
from many of the people in this room tonight -- Democrats and Republicans.
And I will continue to seek common ground in the weeks ahead. If you come to
me with a serious set of proposals, I will be there to listen. My door is
always open.
But know this: I will not waste time with those who have made the
calculation that it's better politics to kill this plan than to improve it.
(Applause.) I won't stand by while the special interests use the same old
tactics to keep things exactly the way they are. If you misrepresent what's
in this plan, we will call you out. (Applause.) And I will not -- and I will
not accept the status quo as a solution. Not this time. Not now.
Now, I have no interest in putting insurance companies out of business.
They provide a legitimate service, and employ a lot of our friends and
neighbors. I just want to hold them accountable. (Applause.) And the
insurance reforms that I've already mentioned would do just that. But an
additional step we can take to keep insurance companies honest is by making
a not-for-profit public option available in the insurance exchange.
(Applause.) Now, let me be clear. Let me be clear. It would only be an
option for those who don't have insurance. No one would be forced to choose
it, and it would not impact those of you who already have insurance. In
fact, based on Congressional Budget Office estimates, we believe that less
than 5 percent of Americans would sign up.
Despite all this, the insurance companies and their allies don't like
this idea. They argue that these private companies can't fairly compete with
the government. And they'd be right if taxpayers were subsidizing this
public insurance option. But they won't be. I've insisted that like any
private insurance company, the public insurance option would have to be
self-sufficient and rely on the premiums it collects. But by avoiding some
of the overhead that gets eaten up at private companies by profits and
excessive administrative costs and executive salaries, it could provide a
good deal for consumers, and would also keep pressure on private insurers to
keep their policies affordable and treat their customers better, the same
way public colleges and universities provide additional choice and
competition to students without in any way inhibiting a vibrant system of
private colleges and universities. (Applause.)
Now, it is -- it's worth noting that a strong majority of Americans still
favor a public insurance option of the sort I've proposed tonight. But its
impact shouldn't be exaggerated -- by the left or the right or the media. It
is only one part of my plan, and shouldn't be used as a handy excuse for the
usual Washington ideological battles. To my progressive friends, I would
remind you that for decades, the driving idea behind reform has been to end
insurance company abuses and make coverage available for those without it.
(Applause.) The public option -- the public option is only a means to that
end -- and we should remain open to other ideas that accomplish our ultimate
goal. And to my Republican friends, I say that rather than making wild
claims about a government takeover of health care, we should work together
to address any legitimate concerns you may have. (Applause.)
For example -- for example, some have suggested that the public option go
into effect only in those markets where insurance companies are not
providing affordable policies. Others have proposed a co-op or another
non-profit entity to administer the plan. These are all constructive ideas
worth exploring. But I will not back down on the basic principle that if
Americans can't find affordable coverage, we will provide you with a choice.
(Applause.) And I will make sure that no government bureaucrat or insurance
company bureaucrat gets between you and the care that you need. (Applause.)
Finally, let me discuss an issue that is a great concern to me, to
members of this chamber, and to the public -- and that's how we pay for this
plan.
And here's what you need to know. First, I will not sign a plan that adds
one dime to our deficits -- either now or in the future. (Applause.) I will
not sign it if it adds one dime to the deficit, now or in the future,
period. And to prove that I'm serious, there will be a provision in this
plan that requires us to come forward with more spending cuts if the savings
we promised don't materialize. (Applause.) Now, part of the reason I faced a
trillion-dollar deficit when I walked in the door of the White House is
because too many initiatives over the last decade were not paid for -- from
the Iraq war to tax breaks for the wealthy. (Applause.) I will not make that
same mistake with health care.
Second, we've estimated that most of this plan can be paid for by finding
savings within the existing health care system, a system that is currently
full of waste and abuse. Right now, too much of the hard-earned savings and
tax dollars we spend on health care don't make us any healthier. That's not
my judgment -- it's the judgment of medical professionals across this
country. And this is also true when it comes to Medicare and Medicaid.
In fact, I want to speak directly to seniors for a moment, because
Medicare is another issue that's been subjected to demagoguery and
distortion during the course of this debate.
More than four decades ago, this nation stood up for the principle that
after a lifetime of hard work, our seniors should not be left to struggle
with a pile of medical bills in their later years. That's how Medicare was
born. And it remains a sacred trust that must be passed down from one
generation to the next. (Applause.) And that is why not a dollar of the
Medicare trust fund will be used to pay for this plan. (Applause.)
The only thing this plan would eliminate is the hundreds of billions of
dollars in waste and fraud, as well as unwarranted subsidies in Medicare
that go to insurance companies -- subsidies that do everything to pad their
profits but don't improve the care of seniors. And we will also create an
independent commission of doctors and medical experts charged with
identifying more waste in the years ahead. (Applause.)
Now, these steps will ensure that you -- America's seniors -- get the
benefits you've been promised. They will ensure that Medicare is there for
future generations. And we can use some of the savings to fill the gap in
coverage that forces too many seniors to pay thousands of dollars a year out
of their own pockets for prescription drugs. (Applause.) That's what this
plan will do for you. So don't pay attention to those scary stories about
how your benefits will be cut, especially since some of the same folks who
are spreading these tall tales have fought against Medicare in the past and
just this year supported a budget that would essentially have turned
Medicare into a privatized voucher program. That will not happen on my
watch. I will protect Medicare. (Applause.)
Now, because Medicare is such a big part of the health care system,
making the program more efficient can help usher in changes in the way we
deliver health care that can reduce costs for everybody. We have long known
that some places -- like the Intermountain Healthcare in Utah or the
Geisinger Health System in rural Pennsylvania -- offer high-quality care at
costs below average. So the commission can help encourage the adoption of
these common-sense best practices by doctors and medical professionals
throughout the system -- everything from reducing hospital infection rates
to encouraging better coordination between teams of doctors.
Reducing the waste and inefficiency in Medicare and Medicaid will pay for
most of this plan. (Applause.) Now, much of the rest would be paid for with
revenues from the very same drug and insurance companies that stand to
benefit from tens of millions of new customers. And this reform will charge
insurance companies a fee for their most expensive policies, which will
encourage them to provide greater value for the money -- an idea which has
the support of Democratic and Republican experts. And according to these
same experts, this modest change could help hold down the cost of health
care for all of us in the long run.
Now, finally, many in this chamber -- particularly on the Republican side
of the aisle -- have long insisted that reforming our medical malpractice
laws can help bring down the cost of health care. (Applause.) Now -- there
you go. There you go. Now, I don't believe malpractice reform is a silver
bullet, but I've talked to enough doctors to know that defensive medicine
may be contributing to unnecessary costs. (Applause.) So I'm proposing that
we move forward on a range of ideas about how to put patient safety first
and let doctors focus on practicing medicine. (Applause.) I know that the
Bush administration considered authorizing demonstration projects in
individual states to test these ideas. I think it's a good idea, and I'm
directing my Secretary of Health and Human Services to move forward on this
initiative today. (Applause.)
Now, add it all up, and the plan I'm proposing will cost around $900
billion over 10 years -- less than we have spent on the Iraq and Afghanistan
wars, and less than the tax cuts for the wealthiest few Americans that
Congress passed at the beginning of the previous administration. (Applause.)
Now, most of these costs will be paid for with money already being spent --
but spent badly -- in the existing health care system. The plan will not add
to our deficit. The middle class will realize greater security, not higher
taxes. And if we are able to slow the growth of health care costs by just
one-tenth of 1 percent each year -- one-tenth of 1 percent -- it will
actually reduce the deficit by $4 trillion over the long term.
Now, this is the plan I'm proposing. It's a plan that incorporates ideas
from many of the people in this room tonight -- Democrats and Republicans.
And I will continue to seek common ground in the weeks ahead. If you come to
me with a serious set of proposals, I will be there to listen. My door is
always open.
But know this: I will not waste time with those who have made the
calculation that it's better politics to kill this plan than to improve it.
(Applause.) I won't stand by while the special interests use the same old
tactics to keep things exactly the way they are. If you misrepresent what's
in this plan, we will call you out. (Applause.) And I will not -- and I will
not accept the status quo as a solution. Not this time. Not now.
Everyone in this room knows what will happen if we do nothing. Our
deficit will grow. More families will go bankrupt. More businesses will
close. More Americans will lose their coverage when they are sick and need
it the most. And more will die as a result. We know these things to be true.
That is why we cannot fail. Because there are too many Americans counting
on us to succeed -- the ones who suffer silently, and the ones who shared
their stories with us at town halls, in e-mails, and in letters.
I received one of those letters a few days ago. It was from our beloved
friend and colleague, Ted Kennedy. He had written it back in May, shortly
after he was told that his illness was terminal. He asked that it be
delivered upon his death.
In it, he spoke about what a happy time his last months were, thanks to
the love and support of family and friends, his wife, Vicki, his amazing
children, who are all here tonight. And he expressed confidence that this
would be the year that health care reform -- "that great unfinished business
of our society," he called it -- would finally pass. He repeated the truth
that health care is decisive for our future prosperity, but he also reminded
me that "it concerns more than material things." "What we face," he wrote,
"is above all a moral issue; at stake are not just the details of policy,
but fundamental principles of social justice and the character of our
country."
I've thought about that phrase quite a bit in recent days -- the
character of our country. One of the unique and wonderful things about
America has always been our self-reliance, our rugged individualism, our
fierce defense of freedom and our healthy skepticism of government. And
figuring out the appropriate size and role of government has always been a
source of rigorous and, yes, sometimes angry debate. That's our history.
For some of Ted Kennedy's critics, his brand of liberalism represented an
affront to American liberty. In their minds, his passion for universal
health care was nothing more than a passion for big government.
But those of us who knew Teddy and worked with him here -- people of both
parties -- know that what drove him was something more. His friend Orrin
Hatch -- he knows that. They worked together to provide children with health
insurance. His friend John McCain knows that. They worked together on a
Patient's Bill of Rights. His friend Chuck Grassley knows that. They worked
together to provide health care to children with disabilities.
On issues like these, Ted Kennedy's passion was born not of some rigid
ideology, but of his own experience. It was the experience of having two
children stricken with cancer. He never forgot the sheer terror and
helplessness that any parent feels when a child is badly sick. And he was
able to imagine what it must be like for those without insurance, what it
would be like to have to say to a wife or a child or an aging parent, there
is something that could make you better, but I just can't afford it.
That large-heartedness -- that concern and regard for the plight of
others -- is not a partisan feeling. It's not a Republican or a Democratic
feeling. It, too, is part of the American character -- our ability to stand
in other people's shoes; a recognition that we are all in this together, and
when fortune turns against one of us, others are there to lend a helping
hand; a belief that in this country, hard work and responsibility should be
rewarded by some measure of security and fair play; and an acknowledgment
that sometimes government has to step in to help deliver on that promise.
This has always been the history of our progress. In 1935, when over half
of our seniors could not support themselves and millions had seen their
savings wiped away, there were those who argued that Social Security would
lead to socialism, but the men and women of Congress stood fast, and we are
all the better for it. In 1965, when some argued that Medicare represented a
government takeover of health care, members of Congress -- Democrats and
Republicans -- did not back down. They joined together so that all of us
could enter our golden years with some basic peace of mind.
You see, our predecessors understood that government could not, and
should not, solve every problem. They understood that there are instances
when the gains in security from government action are not worth the added
constraints on our freedom. But they also understood that the danger of too
much government is matched by the perils of too little; that without the
leavening hand of wise policy, markets can crash, monopolies can stifle
competition, the vulnerable can be exploited. And they knew that when any
government measure, no matter how carefully crafted or beneficial, is
subject to scorn; when any efforts to help people in need are attacked as
un-American; when facts and reason are thrown overboard and only timidity
passes for wisdom, and we can no longer even engage in a civil conversation
with each other over the things that truly matter -- that at that point we
don't merely lose our capacity to solve big challenges. We lose something
essential about ourselves.
That was true then. It remains true today. I understand how difficult
this health care debate has been. I know that many in this country are
deeply skeptical that government is looking out for them. I understand that
the politically safe move would be to kick the can further down the road --
to defer reform one more year, or one more election, or one more term.
But that is not what the moment calls for. That's not what we came here
to do. We did not come to fear the future. We came here to shape it. I still
believe we can act even when it's hard. (Applause.) I still believe -- I
still believe that we can act when it's hard. I still believe we can replace
acrimony with civility, and gridlock with progress. I still believe we can
do great things, and that here and now we will meet history's test.
Because that's who we are. That is our calling. That is our character.
Thank you, God bless you, and may God bless the United States of America.
(Applause.)