09 Health Care Should Save MoneySave LivesP.docx

09 Health Care Should Save MoneySave LivesP.docx

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09HealthCareShouldSaveMoneySaveLivesP

HealthCareShouldSaveMoney,SaveLives

（September9,2009,Washington,USA,国会演讲（呼吁尽快通过医疗改革方案））

MadameSpeaker,VicePresidentBiden,MembersofCongress,andtheAmericanpeople:

WhenIspokeherelastwinter,thisnationwasfacingtheworsteconomiccrisissincetheGreatDepression.Wewerelosinganaverageof700,000jobspermonth.Creditwasfrozen.Andourfinancialsystemwasonthevergeofcollapse.

AsanyAmericanwhoisstilllookingforworkorawaytopaytheirbillswilltellyou,wearebynomeansoutofthewoods.Afullandvibrantrecoveryismanymonthsaway.AndIwillnotletupuntilthoseAmericanswhoseekjobscanfindthem;untilthosebusinessesthatseekcapitalandcreditcanthrive;untilallresponsiblehomeownerscanstayintheirhomes.Thatisourultimategoal.ButthankstotheboldanddecisiveactionwehavetakensinceJanuary,Icanstandherewithconfidenceandsaythatwehavepulledthiseconomybackfromthebrink.

Iwanttothankthemembersofthisbodyforyoureffortsandyoursupportintheselastseveralmonths,andespeciallythosewhohavetakenthedifficultvotesthathaveputusonapathtorecovery.IalsowanttothanktheAmericanpeoplefortheirpatienceandresolveduringthistryingtimeforournation.

Butwedidnotcomeherejusttocleanupcrises.Wecametobuildafuture.Sotonight,Ireturntospeaktoallofyouaboutanissuethatiscentraltothatfuture–andthatistheissueofhealthcare.

IamnotthefirstPresidenttotakeupthiscause,butIamdeterminedtobethelast.IthasnowbeennearlyacenturysinceTheodoreRooseveltfirstcalledforhealthcarereform.Andeversince,nearlyeveryPresidentandCongress,whetherDemocratorRepublican,hasattemptedtomeetthischallengeinsomeway.AbillforcomprehensivehealthreformwasfirstintroducedbyJohnDingellSr.in1943.Sixty-fiveyearslater,hissoncontinuestointroducethatsamebillatthebeginningofeachsession.

Ourcollectivefailuretomeetthischallenge–yearafteryear,decadeafterdecade–hasledustoabreakingpoint.Everyoneunderstandstheextraordinaryhardshipsthatareplacedontheuninsured,wholiveeverydayjustoneaccidentorillnessawayfrombankruptcy.Thesearenotprimarilypeopleonwelfare.Thesearemiddle-classAmericans.Somecan'tgetinsuranceonthejob.Othersareself-employed,andcan'taffordit,sincebuyinginsuranceonyourowncostsyouthreetimesasmuchasthecoverageyougetfromyouremployer.ManyotherAmericanswhoarewillingandabletopayarestilldeniedinsuranceduetopreviousillnessesorconditionsthatinsurancecompaniesdecidearetooriskyorexpensivetocover.

WearetheonlyadvanceddemocracyonEarth–theonlywealthynation–thatallowssuchhardshipsformillionsofitspeople.TherearenowmorethanthirtymillionAmericancitizenswhocannotgetcoverage.Injustatwoyearperiod,oneineverythreeAmericansgoeswithouthealthcarecoverageatsomepoint.Andeveryday,14,000Americanslosetheircoverage.Inotherwords,itcanhappentoanyone.

Buttheproblemthatplaguesthehealthcaresystemisnotjustaproblemoftheuninsured.Thosewhodohaveinsurancehaveneverhadlesssecurityandstabilitythantheydotoday.MoreandmoreAmericansworrythatifyoumove,loseyourjob,orchangeyourjob,you'llloseyourhealthinsurancetoo.MoreandmoreAmericanspaytheirpremiums,onlytodiscoverthattheirinsurancecompanyhasdroppedtheircoveragewhentheygetsick,orwon'tpaythefullcostofcare.Ithappenseveryday.

OnemanfromIllinoislosthiscoverageinthemiddleofchemotherapybecausehisinsurerfoundthathehadn'treportedgallstonesthathedidn'tevenknowabout.Theydelayedhistreatment,andhediedbecauseofit.AnotherwomanfromTexaswasabouttogetadoublemastectomywhenherinsurancecompanycanceledherpolicybecausesheforgottodeclareacaseofacne.Bythetimeshehadherinsurancereinstated,herbreastcancermorethandoubledinsize.Thatisheart-breaking,itiswrong,andnooneshouldbetreatedthatwayintheUnitedStatesofAmerica.

Thenthere'stheproblemofrisingcosts.Wespendone-and-a-halftimesmoreperpersononhealthcarethananyothercountry,butwearen'tanyhealthierforit.Thisisoneofthereasonsthatinsurancepremiumshavegoneupthreetimesfasterthanwages.It'swhysomanyemployers–especiallysmallbusinesses–areforcingtheiremployeestopaymoreforinsurance,oraredroppingtheircoverageentirely.It'swhysomanyaspiringentrepreneurscannotaffordtoopenabusinessinthefirstplace,andwhyAmericanbusinessesthatcompeteinternationally–likeourautomakers–areatahugedisadvantage.Andit'swhythoseofuswithhealthinsurancearealsopayingahiddenandgrowingtaxforthosewithoutit–about$1000peryearthatpaysforsomebodyelse'semergencyroomandcharitablecare.

Finally,ourhealthcaresystemisplacinganunsustainableburdenontaxpayers.Whenhealthcarecostsgrowattheratetheyhave,itputsgreaterpressureonprogramslikeMedicareandMedicaid.Ifwedonothingtoslowtheseskyrocketingcosts,wewilleventuallybespendingmoreonMedicareandMedicaidthaneveryothergovernmentprogramcombined.Putsimply,ourhealthcareproblemisourdeficitproblem.Nothingelseevencomesclose.

Thesearethefacts.Nobodydisputesthem.Weknowwemustreformthissystem.Thequestionishow.

Therearethoseontheleftwhobelievethattheonlywaytofixthesystemisthroughasingle-payersystemlikeCanada's,wherewewouldseverelyrestricttheprivateinsurancemarketandhavethegovernmentprovidecoverageforeveryone.Ontheright,therearethosewhoarguethatweshouldendtheemployer-basedsystemandleaveindividualstobuyhealthinsuranceontheirown.

Ihavetosaythatthereareargumentstobemadeforbothapproaches.Buteitheronewouldrepresentaradicalshiftthatwoulddisruptthehealthcaremostpeoplecurrentlyhave.Sincehealthcarerepresentsone-sixthofoureconomy,Ibelieveitmakesmoresensetobuildonwhatworksandfixwhatdoesn't,ratherthantrytobuildanentirelynewsystemfromscratch.AndthatispreciselywhatthoseofyouinCongresshavetriedtodooverthepastseveralmonths.

Duringthattime,wehaveseenWashingtonatitsbestanditsworst.

Wehaveseenmanyinthischamberworktirelesslyforthebetterpartofthisyeartoofferthoughtfulideasabouthowtoachievereform.Ofthefivecommitteesaskedtodevelopbills,fourhavecompletedtheirwork,andtheSenateFinanceCommitteeannouncedtodaythatitwillmoveforwardnextweek.Thathasneverhappenedbefore.Ouroveralleffortshavebeensupportedbyanunprecedentedcoalitionofdoctorsandnurses;hospitals,seniors'groupsandevendrugcompanies–manyofwhomopposedreforminthepast.Andthereisagreementinthischamberonabouteightypercentofwhatneedstobedone,puttingusclosertothegoalofreformthanwehaveeverbeen.

ButwhatwehavealsoseenintheselastmonthsisthesamepartisanspectaclethatonlyhardensthedisdainmanyAmericanshavetowardtheirowngovernment.Insteadofhonestdebate,wehaveseenscaretactics.Somehavedugintounyieldingideologicalcampsthatoffernohopeofcompromise.Toomanyhaveusedthisasanopportunitytoscoreshort-termpoliticalpoints,evenifitrobsthecountryofouropportunitytosolvealong-termchallenge.Andoutofthisblizzardofchargesandcounter-charges,confusionhasreigned.

Wellthetimeforbickeringisover.Thetimeforgameshaspassed.Nowistheseasonforaction.Nowiswhenwemustbringthebestideasofbothpartiestogether,andshowtheAmericanpeoplethatwecanstilldowhatweweresentheretodo.Nowisthetimetodeliveronhealthcare.

TheplanI'mannouncingtonightwouldmeetthreebasicgoals:

Itwillprovidemoresecurityandstabilitytothosewhohavehealthinsurance.Itwillprovideinsurancetothosewhodon't.Anditwillslowthegrowthofhealthcarecostsforourfamilies,ourbusinesses,andourgovernment.It'saplanthataskseveryonetotakeresponsibilityformeetingthischallenge–notjustgovernmentandinsurancecompanies,butemployersandindividuals.Andit'saplanthatincorporatesideasfromSenatorsandCongressmen;fromDemocratsandRepublicans–andyes,fromsomeofmyopponentsinboththeprimaryandgeneralelection.

HerearethedetailsthateveryAmericanneedstoknowaboutthisplan:

First,ifyouareamongthehundredsofmillionsofAmericanswhoalreadyhavehealthinsurancethroughyourjob,Medicare,Medicaid,ortheVA,nothinginthisplanwillrequireyouoryouremployertochangethecoverageorthedoctoryouhave.Letmerepeatthis:

nothinginourplanrequiresyoutochangewhatyouhave.

Whatthisplanwilldoistomaketheinsuranceyouhaveworkbetterforyou.Underthisplan,itwillbeagainstthelawforinsurancecompaniestodenyyoucoveragebecauseofapre-existingcondition.AssoonasIsignthisbill,itwillbeagainstthelawforinsurancecompaniestodropyourcoveragewhenyougetsickorwateritdownwhenyouneeditmost.Theywillnolongerbeabletoplacesomearbitrarycapontheamountofcoverageyoucanreceiveinagivenyearoralifetime.Wewillplacealimitonhowmuchyoucanbechargedforout-of-pocketexpenses,becauseintheUnitedStatesofAmerica,nooneshouldgobrokebecausetheygetsick.Andinsurancecompanieswillberequiredtocover,withnoextracharge,routinecheckupsandpreventivecare,likemammogramsandcolonoscopies–becausethere'snoreasonweshouldn'tbecatchingdiseaseslikebreastcancerandcolon