Transcript: Obama's Health Care Speech

Full Remarks of the President's Address to Congress on his Health Care Reform Plans

(CBS) 
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.

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.)

[henrine]

what will this plan do to help college students once they turn 27 and they are off of their parents? including them not beable to have the finances to suppor themselves?

[4agreements]

In actuality the "Extreme American Dream" has played out a most complex and imbalanced experiment. Which choice, Corporate Control or Government Control??? Obviously, some very "LARGE SYSTEM" needs to be in place to pool funds to cover the costs. Of course Insurance Lobbyists who are extremely powerful with mega profits will inject fear tactics to remain in "control". Taking the "Profits" out of the "Big Business Health Care system" is the first step in redirecting the dollar towards more focused health care. Of course, it is a major undertaking of "Health Care" in a "Toxic World", but more often, it begins with personal responsibility to educate, and practice discipline in controlling our personal health care. Let's stop blaming and start looking at our own choices. Why not prioritize taking care of one another? The Capitalistic Model is dangerously saturated, so why not direct the fictitious dollar towards caring for the people who need it most? "We the People" are the "Social System". We limit ourselves with labels we really don't understand.

[gotanychange]

Having worked in the health-care field for 28 years as a registered nurse, 18 in management, and also held a supervisory position in the medical claims unit of an insurance company, I have first hand knowledge of what insurance companies will deny, and do to cut costs. The company I worked for denied it's own employees reasonable insurance (My deductible was almost $1,800/year on my employee plan). Health-care is so glutted with overkill in spending, extortionistic in it's charges, and stingy in paying out, that it's no wonder we rank so low in the world for the quality of our health-care. (Recently, we ranked around 45th in the world for quality of care. Go figure.)

What I found so amazing in the face of these statistics (that have been created by our history of "It's broke, but don't fix it") was that the calls for unity were met with such a blatant show of stalwart resistance from our Republican representatives. Certainly an embarrassing situation for our country. I was embarrassed watching it. I am glad to see we finally have a president who can face-down with succinct intelligence and dignity the stiff-necked old school mentality. BUT, the only way this will reach any type of reasonable resolution in this debate is if there is truly a bi-partisan approach to passing an equitable reform plan. Therein, lies the rub. For the first time in this administration, I have hope. From his reassurances during this speech, I have a clearer understanding of his goals, and with cooperation from Congress, it is possible to achieve them. The question is, is it possible to get that cooperation?


Something's got to give here, people. If President Obama were successful in bringing about the changes he's stated are his goals, successfully, mind you, without increasing our deficits... WHO will this not benefit?! Let's see...health-care corporations, physicians, insurance companies (in the initial stages, at least)... Pharmaceutical companies... medical supply companies... special interest lobbyist groups... and on and on the list goes... ad nauseaum.

Think about it. Who is really being represented in our Congress? Hmm...

[itorgo]

"...a faceless mass, waiting for handouts."
--Ronald Reagan, 1965. (Description of Medicaid recipients.)

[MrDistinct]

If Obama can call people liars, why is it when someone else calls him a liar, he is forced to write a letter of apology? The immediate manner in which it came out makes be believe that there was at least tons of pressure. Even if there was a little pressure, it is completely inappropriate. Calling people liars (which Obama started) is the lowest form of politics there is, especially when it is not in the context of a debate, but a public delivery through media. Obama should not be calling anybody a liar - he created that situation and should take responsibility for it.

[carpfest09]

Last time I checked, the constitution doesnt say squat about healthcare.

[Undecided447]

That is a rather silly asssertion, as it is obvious that a document which predates modern medicine is not going to say anything about a comprehensive health care system. In any case, the relevant portion of the U.S. Constitution is Article 1, Section 8: "The Congress shall have Power to lay and collect Taxes [...] to provide for the [...] general Welfare of the United States [...]."

The more general interpretation of this clause was established in the United States Supreme Court Case _United States v. Butler_ (297 U.S. 1, 65, 66 (1936)): for the most part, the U.S. court system defers to the U.S. Congress as to the meaning of "general Welfare," and so the U.S. Congress has great leeway as to determining what this means. The U.S. Congress obviously has decided that health care is part of this "general Welfare" category, so everything regarding health care reform is clearly valid under the U.S. Constitution.

[CMA2009]

Most members of Congress, Democrats and Republicans, applauded last night when President Obama pledged to safeguard Medicare, calling it a "sacred trust" with older Americans.

What the President didn't say, and what too many people forget, or try to, is that Medicare IS a public health insurance program. It was created and is broadly implemented by the federal government; claims are administered by private insurance companies. For everyone who applauds Medicare - and most people do - support a public option so we can pass the sacred trust of health care security on to younger generations!
Judith Stein, Esq.- Executive Director
Center for Medicare Advocacy, Inc.

[raskal_2]

The Government at a local level charges us to park our cars, at a state level taxes us to smoke and drink, taxes us to buy products we need and the federal government is a festering sore everyone must bear. We live in this country in a frenzy of immediate gratification and bear witness in a convulsive tangle of gossip.

In this muddle a President now says that he will pass a law that penalizes us for not carrying health insurance much the same way as not having car insurance. Personally I don't get that a natural failure of a human body is a criminal act that has an imposed penalty.

My wife said it best during tonight's address. "I need a drink"

[pedalingpragmatist]

Ugh....the "socialism" slant.

To clear it up for all of those that simply are mimicing their favorite fearmongering pundit, a "socialist" system is one where ALL doctors, ALL health care facilities work for (and are paid by) the government...like the US Veterans Administration, which you may have heard of. That is not was is being proposed at all. Now, some may argue that it is a lead-in for a single-payer system whereby the funding to doctors, insurance companies, etc is funneled through a single goverment-run sources, but this is NOT Socialism.

[MBDebbie31]

The president was specific about health reform; he stated that Medicare benefit would not change, adding no extra cost to senior. That health care for the un-insurance would be available and that there would be no take over of private insurance creating only government insurance. He also stated that illegal immigrant would not be eligible for the insurance. I have health insurance however, I still must choose between seeing my specialist or my husband, because it's $90 a visit and that?s not fair. Lastly the congressman that yelled the President was a lie was disrespectful and rude! Shame on him. It is my hope that all watched this address, but I sure all did not
If you wanted to know what the president and ideas were on health reform he gave them. Thank you

[tngreen]

I can assure you that no Conservative is paying my way. I make a good living and have great insurance. And every American deserves the same access to health care that I have, whether or not he makes as much money as I do or even if he is stupid enough to vote against his own interests, that is, Republican.

[wdh3007]

The people have spoken to the fraud in chief no public or government option so move on to other things. You see it is quite simple if they the government control your healthcare then in essense they control your medications, medical records, your doctor, how much care you can receive and when you can receive it. Control of the people is slavery and the ultimate goal of many socialists and communists and all you have to do is look at history to see where this can go. It is their holy grail but remember the people will realize this and rise up eventually and that's when the fun will begin.

[gotanychange]

The public option was only a miniscule portion of what he discussed. What he proposed in this speech was AFFORDABLE private insurance, incentives to have health insurance either privately or through our employers, (among other things) which is utilized with great success in China.
You've been listening to too much hype, and you obviously didn't listen to this speech. President Obama couldn't have been clearer if he'd drawn diagrams on an over-head projector.

[carlos1274]

What a terrible response by the Dr. Now the Republicans want to start debating? What happen to them for the past two months?

[AmericanoMe]

They have been ignored by the Democrats, what do you think the congressmen were holding up during the presidents speeech?

[carlos1274]

It was a very clear, understandable and focused speech and argument to the American People for Health Reform. All lies, myths and misunderstandings regarding what people have heard was put to rest. I'm a Republican who believes that Pres. Obama is standing for All Americans! He gave Republicans in the House and Senate to debate and now is time to move on! That is true leadership!

[BeckieBest]

Republicans will predictably say no to this an every health care reform proposal just as they have for 40 years.

Health care costs doubled while they were in power and yet they did nothing but protect the status quo.

They will double again in the next 7 years if they get their way.

They've been fighting hard for your right to pay more and get less for 4 decades.