The president right now:

Good afternoon. We began our push to reform health insurance last
March with the doctors and nurses who know the system best, and so it
is fitting to be joined by all of you as we bring this journey to a
close.
Last Thursday, I spent seven hours at a summit where Democrats and
Republicans engaged in a public and substantive discussion about
health care. This meeting capped off a debate that began with a
similar summit nearly one year ago. Since then, every idea has been
put on the table. Every argument has been made. Everything there is
to say about health care has been said and just about everyone has
said it. So now is the time to make a decision about how to finally
reform health care so that it works, not just for the insurance
companies, but for America’s families and businesses.
Where both sides say they agree is that the status quo is not working
for the American people. Health insurance is becoming more expensive
by the day. Families can’t afford it. Businesses can’t afford it.
The federal government can’t afford it. Smaller businesses and
individuals who don’t get coverage at work are squeezed especially
hard. And insurance companies freely ration health care based on
who’s sick and who’s healthy; who can pay and who can’t.
Democrats and Republicans agree that this is a serious problem for
America. And we agree that if we do nothing – if we throw up our
hands and walk away – it’s a problem that will only grow worse. More
Americans will lose their family’s health insurance if they switch
jobs or lose their job. More small businesses will be forced to
choose between health care and hiring. More insurance companies will
deny people coverage who have preexisting conditions, or drop people’s
coverage when they get sick and need it most. And the rising cost of
Medicare and Medicaid will sink our government deeper and deeper into
debt. On all of this we agree.
So the question is, what do we do about it?
On one end of the spectrum, there are some who have suggested
scrapping our system of private insurance and replacing it with
government-run health care. Though many other countries have such a
system, in America it would be neither practical nor realistic.
On the other end of the spectrum, there are those, including most
Republicans in Congress, who believe the answer is to loosen
regulations on the insurance industry – whether it’s state consumer
protections or minimum standards for the kind of insurance they can
sell. I disagree with that approach. I’m concerned that this would
only give the insurance industry even freer rein to raise premiums and
deny care.
I don’t believe we should give government bureaucrats or insurance
company bureaucrats more control over health care in America. I
believe it’s time to give the American people more control over their
own health insurance. I don’t believe we can afford to leave
life-and-death decisions about health care to the discretion of
insurance company executives alone. I believe that doctors and nurses
like the ones in this room should be free to decide what’s best for
their patients.
The proposal I’ve put forward gives Americans more control over their
health care by holding insurance companies more accountable. It
builds on the current system where most Americans get their health
insurance from their employer. If you like your plan, you can keep
your plan. If you like your doctor, you can keep your doctor.
Because I can tell you that as the father of two young girls, I
wouldn’t want any plan that interferes with the relationship between a
family and their doctor.
Essentially, my proposal would change three things about the current
health care system:
First, it would end the worst practices of insurance companies. No
longer would they be able to deny your coverage because of a
pre-existing condition. No longer would they be able to drop your
coverage because you got sick. No longer would they be able to force
you to pay unlimited amounts of money out of your own pocket. No
longer would they be able to arbitrarily and massively raise premiums
like Anthem Blue Cross recently tried to do in California. Those
practices would end.
Second, my proposal would give uninsured individuals and small
business owners the same kind of choice of private health insurance
that Members of Congress get for themselves. Because if it’s good
enough for Members of Congress, it’s good enough for the people who
pay their salaries. The reason federal employees get a good deal on
health insurance is that we all participate in an insurance
marketplace where insurance companies give better rates and coverage
because we give them more customers. This is an idea that many
Republicans have embraced in the past. And my proposal says that if
you still can’t afford the insurance in this new marketplace, we will
offer you tax credits to do so – tax credits that add up to the
largest middle class tax cut for health care in history. After all,
the wealthiest among us can already buy the best insurance there is,
and the least well-off are able to get coverage through Medicaid. But
it’s the middle-class that gets squeezed, and that’s who we have to
help.
Now, it’s true that all of this will cost money – about $100 billion
per year. But most of this comes from the nearly $2 trillion a year
that America already spends on health care. It’s just that right now,
a lot of that money is being wasted or spent badly. With this plan,
we’re going to make sure the dollars we spend go toward making
insurance more affordable and more secure. We’re also going to
eliminate wasteful taxpayer subsidies that currently go to insurance
and pharmaceutical companies, set a new fee on insurance companies
that stand to gain as millions of Americans are able to buy insurance,
and make sure the wealthiest Americans pay their fair share of
Medicare.
The bottom line is, our proposal is paid for. And all new money
generated in this plan would go back to small businesses and
middle-class families who can’t afford health insurance. It would
lower prescription drug prices for seniors. And it would help train
new doctors and nurses to provide care for American families.
Finally, my proposal would bring down the cost of health care for
millions – families, businesses, and the federal government. We have
now incorporated most of the serious ideas from across the political
spectrum about how to contain the rising cost of health care – ideas
that go after the waste and abuse in our system, especially in
programs like Medicare. But we do this while protecting Medicare
benefits, and extending the financial stability of the program by
nearly a decade.
Our cost-cutting measures mirror most of the proposals in the current
Senate bill, which reduces most people’s premiums and brings down our
deficit by up to $1 trillion over the next two decades. And those
aren’t my numbers – they are the savings determined by the CBO, which
is the Washington acronym for the nonpartisan, independent referee of
Congress.
So this is our proposal. This is where we’ve ended up. It’s an
approach that has been debated and changed and I believe improved over
the last year. It incorporates the best ideas from Democrats and
Republicans – including some of the ideas that Republicans offered
during the health care summit, like funding state grants on medical
malpractice reform and curbing waste, fraud, and abuse in the health
care system. My proposal also gets rid of many of the provisions that
had no place in health care reform – provisions that were more about
winning individual votes in Congress than improving health care for
all Americans.
Now, despite all that we agree on and all the Republican ideas we’ve
incorporated, many Republicans in Congress just have a fundamental
disagreement over whether we should have more or less oversight of
insurance companies. And if they truly believe that less regulation
would lead to higher quality, more affordable health insurance, then
they should vote against the proposal I’ve put forward.
Some also believe that we should instead pursue a piecemeal approach
to health insurance reform, where we just tinker around the edges of
this challenge for the next few years. Even those who acknowledge the
problem of the uninsured say that we can’t afford to help them – which
is why the Republican proposal only covers three million uninsured
Americans while we cover over 31 million. But the problem with that
approach is that unless everyone has access to affordable coverage,
you can’t prevent insurance companies from denying coverage based on
pre-existing conditions; you can’t limit the amount families are
forced to pay out of their own pockets; and you don’t do anything
about the fact that taxpayers end up subsidizing the uninsured when
they’re forced to go to the Emergency Room for care. The fact is,
health reform only works if you take care of all these problems at
once.
Both during and after last week’s summit, Republicans in Congress
insisted that the only acceptable course on health care reform is to
start over. But given these honest and substantial differences
between the parties about the need to regulate the insurance industry
and the need to help millions of middle-class families get insurance,
I do not see how another year of negotiations would help. Moreover,
the insurance companies aren’t starting over. They are continuing to
raise premiums and deny coverage as we speak. For us to start over
now could simply lead to delay that could last for another decade or
even more. The American people, and the U.S. economy, just can’t wait
that long.
So, no matter which approach you favor, I believe the United States
Congress owes the American people a final vote on health care reform.
We have debated this issue thoroughly, not just for a year, but for
decades. Reform has already passed the House with a majority. It has
already passed the Senate with a supermajority of sixty votes. And
now it deserves the same kind of up-or-down vote that was cast on
welfare reform, the Children’s Health Insurance Program, COBRA health
coverage for the unemployed, and both Bush tax cuts – all of which had
to pass Congress with nothing more than a simple majority.
I have therefore asked leaders in both of Houses of Congress to finish
their work and schedule a vote in the next few weeks. From now until
then, I will do everything in my power to make the case for reform.
And I urge every American who wants this reform to make their voice
heard as well – every family, every business owner, every patient,
every doctor, every nurse.
This has been a long and wrenching debate. It has stoked great
passions among the American people and their representatives. And
that is because health care is a difficult issue. It is a complicated
issue. As all of you know from experience, health care can literally
be an issue of life or death. As a result, it easily lends itself to
demagoguery and political gamesmanship; misrepresentation and
misunderstanding.
But that’s not an excuse for those of us who were sent here to lead to
just walk away. We can’t just give up because the politics are hard.
I know there’s a fascination, bordering on obsession, in the media and
in this town about what passing health insurance reform would mean for
the next election and the one after that. Well, I’ll leave others to
sift through the politics. Because that’s not what this is about.
That’s not why we’re here.
This is about what reform would mean for the mother with breast cancer
whose insurance company will finally have to pay for her chemotherapy.
This is about what reform would mean for the small business owner who
will no longer have to choose between hiring more workers or offering
coverage to the employees she has. This is about what reform would
mean for the middle-class family who will be able to afford health
insurance for the very first time in their lives.
And this is about what reform would mean for all those men and women
I’ve met over the last few years who’ve been brave enough to share
their stories. When we started our push for reform last year, I
talked about a young mother in Wisconsin named Laura Klitzka [KLITZ
kah]. She has two young children. She thought she had beaten her
breast cancer but then later discovered it spread to her bones. She
and her husband were working – and had insurance – but their medical
bills still landed them in debt. And now she spends time worrying
about that debt when all she wants to do is spend time with her
children and focus on getting well.
This should not happen in the United States of America. And it
doesn’t have to. In the end, that’s what this debate is about – it’s
about the kind of country we want to be. It’s about the millions of
lives that would be touched and in some cases saved by making private
health insurance more secure and more affordable.
At stake right now is not just our ability to solve this problem, but
our ability to solve any problem. The American people want to know if
it’s still possible for Washington to look out for their interests and
their future. They are waiting for us to act. They are waiting for
us to lead. And as long as I hold this office, I intend to provide
that leadership. I don’t know how this plays politically, but I know
it’s right. And so I ask Congress to finish its work, and I look
forward to signing this reform into law. Thank you.