# The Promise of Health Care

Delivered from the East Room of the White House in Washington, DC on 5 March 2009.
Thank you so much, Travis, for the wonderful introduction. Thank you for Melody Barnes, who has done more than anyone to help coordinate this forum and its extraordinary work. And so we appreciate her leadership.
We're here today to discuss one of the greatest threats not just to the well-being of our families and the prosperity of our businesses, but to the very foundation of our economy -- and that's the exploding costs of health care in America today.
In the last eight years, premiums have grown four times faster than wages. An additional 9 million Americans have joined the ranks of the uninsured. The cost of health care now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. Even for folks who are weathering this economic storm, and have health care right now, all it takes is one stroke of bad luck -- an accident or an illness, a divorce, a lost job -- to become one of the nearly 46 million uninsured or the millions who have health care, but really can't afford what they've got.
We didn't get here by accident. The problems we face today are a direct consequence of actions that we failed to take yesterday. Since Teddy Roosevelt first called for reform nearly a century ago, we have talked and we have tinkered. We have tried and fallen short, we've stalled for time, and again we have failed to act because of Washington politics or industry lobbying.
And today, there are those who say we should defer health care reform once again -- that at a time of economic crisis, we simply can't afford to fix our health care system, as well.
Well, let me be clear: The same soaring costs that are straining families' budgets are sinking our businesses and eating up our government's budget, too. Too many small businesses can't insure their employees. Major American corporations are struggling to compete with their foreign counterparts. And companies of all sizes are shipping their jobs overseas or shutting their doors for good.
Medicare costs are consuming our federal budget; I don't have to tell members of Congress this. Medicaid is overwhelming our state budgets; I don't need to tell governors and state legislatures that.
At the fiscal summit that we held here last week, the one thing on which everyone agreed was that the greatest threat to America's fiscal health is not Social Security, though that's a significant challenge; it's not the investments that we've made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation's balance sheet is the skyrocketing cost of health care. It's not even close.
That's why we cannot delay this discussion any longer. That's why today's forum is so important -- because health care reform is no longer just a moral imperative, it's a fiscal imperative. If we want to create jobs and rebuild our economy and get our federal budget under control, then we have to address the crushing cost of health care this year, in this administration. Making investments in reform now, investments that will dramatically lower costs, won't add to our budget deficits in the long term -- rather, it is one of the best ways -- in fact maybe the only way -- to reduce those long-term costs.
Now, I know people are skeptical about whether Washington can bring about this change. Our inability to reform health care in the past is just one example of how special interests have had their way, and the public interest has fallen by the wayside. And I know people are afraid we'll draw the same old lines in the sand and give in to the same entrenched interests and arrive back at the same stalemate that we've been stuck in for decades.
But I am here today and I believe you are here today because this time is different. This time, the call for reform is coming from the bottom up and from all across the spectrum -- from doctors, from nurses, from patients; from unions, from businesses; from hospitals, health care providers, community groups. It's coming from mayors and governors and legislatures, Democrats, Republicans -- all who are racing ahead of Washington to pass bold health care initiatives on their own. This time, there is no debate about whether all Americans should have quality, affordable health care -- the only question is, how?
And the purpose of this forum is to start answering that question -- to determine how we lower costs for everyone, improve quality for everyone, and expand coverage to all Americans. And our goal will be to enact comprehensive health care reform by the end of this year. That is our commitment. That is our goal.
Now, in the past month alone, we've done a lot more to advance that goal than we've done in the past decade. We've provided and protected coverage for 11 million children from working families, and for 7 million Americans who've lost their jobs in this downturn. We've made the largest investment in history in preventive care; invested in electronic medical records that will save money, ensure privacy, and save lives; we've launched a new effort to find a cure for cancer in our time. We've also set aside in our budget a health care reserve fund to finance comprehensive reform. I know that more will be required, but this is a significant down payment that's fully paid for, does not add one penny to our deficit. And I look forward to working with Congress and the American people to get this budget passed.
Now, as we work to determine the details of health care reform, we won't always see eye to eye. We may disagree -- and disagree strongly -- about particular measures. But we know that there are plenty of areas of agreement, as well, and that should serve as the starting points for our work.
We can all agree that if we want to bring down skyrocketing costs, we'll need to modernize our system and invest in prevention. We can agree that if we want greater accountability and responsibility, we have to ensure that people aren't overcharged for prescription drugs, or discriminated against for pre-existing conditions -- and we need to eliminate fraud, waste and abuse in government programs. I think most of us would agree that if we want to cover all Americans, we can't make the mistake of trying to fix what isn't broken. So if somebody has insurance they like, they should be able to keep that insurance. If they have a doctor that they like, they should be able to keep their doctor. They should just pay less for the care that they receive.
And finally, we can all agree that if we want to translate these goals into policies, we need a process that is as transparent and inclusive as possible. And that's why I've asked all of you -- representatives of organizations, interests, and parties from across the spectrum -- to join us here today. In fact, this was the hottest ticket in town. (Laughter.) That's why we asked concerned citizens like the folks on this stage to organize open meetings across America where people could air their views. As Travis said, more than 3,000 meetings were held in all 50 states and D.C.; more than 30,000 people attended. I thank them for their input and their ideas, and look forward to reading the report that Travis has presented to me.
In this effort, every voice has to be heard. Every idea must be considered. Every option must be on the table. There should be no sacred cows. Each of us must accept that none of us will get everything that we want, and that no proposal for reform will be perfect. If that's the measure, we will never get anything done. But when it comes to addressing our health care challenge, we can no longer let the perfect be the enemy of the essential. And I don't think anybody would argue that we are on a sustainable path when it comes to health care.
Finally, I want to be very clear at the outset that while everyone has a right to take part in this discussion, nobody has the right to take it over and dominate. The status quo is the one option that's not on the table, and those who seek to block any reform at all -- any reform at any costs will not prevail this time around.
I didn't come here to Washington to work for those interests. I came here to work for the American people -- the folks I met on the campaign trail, the people I hear from every single day in the White House. Folks who are working hard, making all the right decisions, but still face choices that no one in this country should have to make: how long to put off that doctor's appointment; whether to fill that prescription; when to give up and head to the emergency room because there are no other options.
I've read some of the many letters they've sent asking me for help. And they're usually not asking for much. I don't get letters where people are just asking for a free ride, for a handout. Most of them are embarrassed about their situation; they would rather not have to ask for help. They start, usually, by saying that they've never written a letter like this before. Some end by apologizing -- saying they've written to me because they have nowhere else to turn; asking me not to forget about them, not to forget about their families.
But there are a lot of people out there who are desperate. There's a lot of desperation out there. Today I want them, and people like them across this country, to know that I have not forgotten them. We have not forgotten them. They are why we're here today -- to start delivering the change they demanded at the polls in November; that they have continued to demand since the election. And if we're successful, if we can pass comprehensive reform, these folks will see their costs come down, they'll get the care they need, and we'll help our businesses create jobs again so our economy can grow.
So it's not going to be easy. And there are going to be false starts and setbacks and mistakes along the way. But I'm confident if we come together and work together, we will finally achieve what generations of Americans have fought for and fulfill the promise of health care in our time. And what a remarkable achievement that would be -- something that Democrats and Republicans, business and labor, consumer groups and providers, all of us could share extraordinary pride in finally dealing with something that has been vexing us for so long.
So let's get to work. Thank you.
This work is in the public domain in the United States because it is a work of the United States federal government (see 17 U.S.C. 105).
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