GREEN BAY - Thank you. It is wonderful to be back here in Green Bay. I wantto thank Southwest High School for hosting us today, and I want tothank Laura for sharing her story. It takes courage to do that, andit takes even more to battle a disease like cancer with such graceand determination.
Laura’s story is incredibly moving. Sadly, it is notunique. Every day in this country, more and more Americans areforced to worry not simply about getting well, but whether they canafford to get well. Millions more wonder if they can afford theroutine care necessary to stay well. Even for those who have healthinsurance, rising premiums are straining their budgets to thebreaking point – premiums that have doubled over the lastnine years, and have grown at a rate three times faster than wages.Desperately-needed procedures and treatments are put off becausethe price is too high. And all it takes is a single illness to wipeout a lifetime of savings.
Employers aren’t faring any better. The cost of healthcare has helped leave big corporations like GM and Chrysler at acompetitive disadvantage with their foreign counterparts. For smallbusinesses, it’s even worse. One month, they’re forcedto cut back on health care benefits. The next month, they have todrop coverage. The month after that, they have no choice but tostart laying off workers.
For the government, the growing cost of Medicare and Medicaid isone of the biggest threats to our federal deficit. Bigger thanSocial Security. Bigger than all the investments we’ve madeso far. So if you’re worried about spending and you’reworried about deficits, you need to be worried about the cost ofhealth care.
We have the most expensive health care system in the world. Wespend almost 50% more per person on health care than the next mostcostly nation. But here’s the thing, Green Bay: we’renot any healthier for it. We don’t necessarily have betteroutcomes. Even within our own country, a lot of the places where wespend less on health care actually have higher quality than placeswhere we spend more. Right here in Green Bay, you get more qualityout of fewer health care dollars than many other communities acrossthe country. And yet, across the country, spending on health caregoes up and up and up – day after day, year after year.
I know that there are millions of Americans who are content withtheir health care coverage – they like their plan and theyvalue their relationship with their doctor. And no matter how wereform health care, we will keep this promise: If you like yourdoctor, you will be able to keep your doctor. If you like yourhealth care plan, you will be able to keep your health careplan.
But in order to preserve what’s best about our health caresystem, we have to fix what doesn’t work. For we have reacheda point where doing nothing about the cost of health care is nolonger an option. The status quo is unsustainable. If we do not actand act soon to bring down costs, it will jeopardizeeveryone’s health care. If we do not act, every American willfeel the consequences. In higher premiums and lower take-home pay.In lost jobs and shuttered businesses. In a rising number ofuninsured and a rising debt that our children and their childrenwill be paying off for decades. If we do nothing, within a decadewe will spending one out of every five dollars we earn on healthcare. In thirty years, it will be one out of every three. That isuntenable, that is unacceptable, and I will not allow it asPresident of the United States.
Health care reform is not part of some wish list I drew up whenI took office. It is central to our economic future – centralto the long-term prosperity of this nation. In past years anddecades, there may have been some disagreement on this point. Butnot anymore. Today, we have already built an unprecedentedcoalition of folks who are ready to reform our health care system:physicians and health insurers; businesses and workers; Democratsand Republicans. A few weeks ago, some of these groups committed todoing something that would’ve been unthinkable just a fewyears ago: they promised to work together to cut national healthcare spending by two trillion dollars over the next decade. Thatwill bring down costs, that will bring down premiums, andthat’s exactly the kind of cooperation we need.
The question now is, how do we finish the job? How do wepermanently bring down costs and make quality, affordable healthcare available to every American?
My view is that reform should be guided by a simple principle:we fix what’s broken and build on what works.
In some cases, there’s broad agreement on the steps weshould take. In the Recovery Act, we’ve already madeinvestments in health IT and electronic medical records that willreduce medical errors, save lives, save money, and still ensureprivacy. We also need to invest in prevention and wellness programsthat help Americans live longer, healthier lives.
But the real cost savings will come from changing the incentivesof a system that automatically equates expensive care with bettercare – from addressing flaws that increase profits withoutactually increasing the quality of care.
We have to ask why places like the Geisinger Health system inrural Pennsylvania, Intermountain Health in Salt Lake City, orcommunities like Green Bay can offer high-quality care at costswell below average, but other places in America can’t. Weneed to identify the best practices across the country, learn fromthe success, and replicate that success elsewhere. And we shouldchange the warped incentives that reward doctors and hospitalsbased on how many tests or procedures they prescribe, even if thosetests or procedures aren’t necessary or result from medicalmistakes. Doctors across this country did not get into the medicalprofession to be bean counters or paper pushers; to be lawyers orbusiness executives. They became doctors to heal people. Andthat’s what we must free them to do.
We must also provide Americans who can’t afford healthinsurance with more affordable options. This is both a moralimperative and an economic imperative, because we know that whensomeone without health insurance is forced to get treatment at theER, all of us end up paying for it.
So what we’re working on is the creation of somethingcalled a Health Insurance Exchange – which would allow you toone-stop shop for a health care plan, compare benefits and prices,and choose the plan that’s best for you. None of these planswould be able to deny coverage on the basis of a pre-existingcondition, and all should include an affordable, basic benefitpackage. And if you can’t afford one of the plans, we shouldprovide assistance to make sure you can. I also strongly believethat one of the options in the Exchange should be a publicinsurance option – because if the private insurance companieshave to compete with a public option, it will keep them honest andhelp keep prices down.
Now, covering more Americans will obviously cost a good deal ofmoney at a time where we don’t have extra to spend.That’s why I have already promised that reform will not addto our deficit over the next ten years. To make that happen, wehave already identified hundreds of billions worth of savings inour budget – savings that will come from steps like reducingMedicare overpayments to insurance companies and rooting out waste,fraud and abuse in both Medicare and Medicaid. I will be outlininghundreds of billions more in savings in the days to come. AndI’ll be honest – even with these savings, reform willrequire additional sources of revenue. That’s why I’veproposed that we scale back how much the highest-income Americanscan deduct on their taxes back to the rate from the Reagan years– and use that money to help finance health care.
In all these reforms, our goal is simple: the highest-qualityhealth care at the lowest-possible cost. We want to fixwhat’s broken and build on what works. As Congress movesforward on health care legislation in the coming weeks, Iunderstand there will be different ideas and disagreements on howto achieve this goal. I welcome those ideas, and I welcome thatdebate. But what I will not welcome is endless delay or a denialthat reform needs to happen. When it comes to health care, thiscountry cannot continue on its current path. I know there are somewho believe that reform is too expensive, but I can assure you thatdoing nothing will cost us far more in the coming years. Ourdeficits will be higher. Our premiums will go up. Our wages will belower, our jobs will be fewer, and our businesses will suffer.
So to those who criticize our efforts, I ask, “What is thealternative?” What else do we say to all those families whonow spend more on health care than housing or food? What do we tellthose businesses that are choosing between closing their doors andletting their workers go? What do we say to all those Americanslike Laura, a woman who has worked all her life; whose family hasdone everything right; a brave and proud woman whose child’sschool recently took up a penny drive to help pay her medicalbills? What do we tell them?
I believe we tell them that after decades of inaction, we havefinally decided to fix what is broken about health care in America.We have decided that it’s time to give every American qualityhealth care at an affordable cost. We have decided that if weinvest in reforms that will bring down costs now, we willeventually see our deficits come down in the long-run. And we havedecided to change the system so that our doctors and health careproviders are free to do what they trained and studied and workedso hard to do: make people well again. That’s what we can doin this country; that’s what we can do at this moment, andnow I’d like to hear your thoughts and answer your questionsabout how we get it done. Thank you.
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