It is a pleasure to be here at Mercy Medical Center. I just took a tour of the facility with some of your staff and all of the nurses, doctors, and health providers here should be applauded for the health and healing you bring to the people of Des Moines everyday.
I come here today because I think it is about time that America had a health care policy as good as our health care professionals.
Today I am announcing a plan that will reduce the cost of health care for all Americans, allow all Americans to buy into the same health plan that the President and Members of Congress give themselves -- with subsidies for those who can't afford insurance - and provide health care coverage for every child in America. And it will bring us extraordinarily close to our goal of universal coverage. It is paid for by canceling the Bush tax cuts for the wealthiest Americans and closing corporate loopholes, while keeping tax cuts for the middle class. And it makes sure we have enough left over for important priorities like prescription drug coverage for our seniors, the education of our children, homeland security, and a plan to put our economy back on track.
In sum the proposal I offer today breaks new ground in the present health care debate - because it addresses the three great challenges facing us today: it deals first and foremost with bringing costs under control; it offers access to affordable coverage for every American; and it says that no longer will any child in America have to go without health care. This issue is part of the great unfinished business of our society - and central to the purpose of my candidacy for the Presidency.
No health care plan for America can work without the direct personal involvement and leadership of the President of the United States. I intend to be a President who goes to the Oval Office each morning resolved that health care will not merely be the rhetoric of a campaign, a promise made and lost, but that with unwavering determination, for as long as it takes - we will at long last make health care available and affordable - a right and not a privilege - for every American.
We as Democrats must have the courage to lead on health care - responsibly and in a way that makes it affordable not only for our families, but for our nation. And that same leadership must extend to all the great issues before us. So today marks the first in a series of speeches I will be giving around the country advancing major new initiatives that will renew our commitment to fundamental American values.
I believe that today - in the aftermath of September 11th, in the face of the critical and decisive choices we face at home -we must ask more of our leadership and ourselves.
Under this President, America is off course. Time and time again, he has chosen to protect the privileged at the price of progress for the whole nation.
But running for President is about more than pointing out that we're going in the wrong direction. It is about the new direction in which you will lead.
That's why in the coming months I will make clear my vision for America, beginning in the next weeks with the challenge of national service to tap the patriotism of Americans to contribute and make a difference; of energy independence to strengthen national security, create new industries and jobs, and protect our environment; and of a new policy to guarantee every child in America the best possible start in life.
In each of these areas and more - from restoring our economy to restoring our alliances overseas - America needs bold leadership for a new century and ideas as big as both the boundless opportunity ahead of us and the profound challenges all around us.
Nowhere is that more true than in America's health care system. The last century was one of incredible progress and advancement. This hospital opened its doors in 1893 - the same year that Johns Hopkins, America's first modern medical school, was founded. It was two years before the x-ray was discovered and two years before America's first pharmaceutical research laboratory was established.
Over the course of the 20th century, advancements in science, medicine, and technology improved and lengthened our lives. Today, America has the best health care system in the world. But when it comes to trying to afford their health care, too many Americans are one accident or one illness away from financial ruin.
Today, I am offering a plan that improves health care for all Americans - the only plan being offered in this campaign that makes a priority of both holding down costs and expanding coverage. It will cover almost all Americans, cover all of our children, and give our veterans the support they've earned. This is a health care plan that can pass. And if I am President, it is a health care plan that will become the law of land.
This plan focuses in on where the problems are so that we don't spend through the roof for care we already have. It provides help for all Americans - including the middle class Americans whose health care costs are rising and who are too often ignored in these debates. It strengthens our economy even as it secures our health care. And it builds on the system we have now instead of trying to create a government-run bureaucracy. We don't need to reinvent the wheel. But we do need real and far-reaching reform.
We cannot make health care affordable by tiptoeing around the edges -- hoping to make progress without raising the wrath of the guardians of the status quo.
But we do need a realistic plan - a plan that will work - and above all, and as I said at the onset, a president who is committed to this cause - heart, strength, mind and soul - who will bring the key players together, keep this issue in the national spotlight, and never give in until we give America the change it needs and all Americans the health care they deserve.
I will not add bureaucracy - I will slash it. I will not impair research and medical advancement - I will advance it. I will not stick Americans into a one-size-fits-all program - I will give them more options and more choices. But I will make sure every working American has health care they can afford.
My plan strengthens what succeeds now, rewards what's right, helps those who most deserve it, cracks down on those skimming from the top, and employs cutting-edge technology to make Americans healthier and health care more affordable.
Three areas - costs, coverage, and kids - should be at the heart of any proposal. All three are related. All three demand new ideas and reform.
Today, one in six Americans is uninsured -40 million people without health insurance for an entire year. More startling and even more shameful is the fact that one out of every three Americans has gone without health insurance at some point in the last two years - two-thirds of them for six months or more.
One in three Americans. And counting. On George Bush's watch, more than a million Americans a year are losing their health care -- ending progress we made in the 1990s. These are working Americans. Seven out of ten live in a household where they or at least one person is working at least one job.
And they're caught in a trap. They're people like Robert Giles from Indianola. He's a member of the Painters' Union and the father of a two month old girl. He usually works all day and goes to classes in the evening. But in this economy, construction jobs are few and far between. He's can't find work, he's about to lose his health coverage but he's nowhere near able to afford to buy health insurance on his own. Those who claim to care about family values should care more about families like Robert Giles's.
Working Americans without health insurance are part of the neighborhoods we call home. We see them everyday behind the counter and around the corner. They build America's houses, run our small businesses, bag our groceries, and care for our elderly and our kids.
But when it comes to their own children, one-third don't get check-ups. And too often suffer through conditions like childhood ear infections instead of getting the antibiotics that would help them heal.
You at Mercy hospital open your doors to the uninsured every day. Americans without health care coverage get treatment. But they get too little of it and get it too late. Too many emergency room visits and not enough preventive care. We all pay too much for that and too many of them end up paying highest price of all: they get sick more often; they stay sick longer; they live shorter lives.
And that is too high a price to bear.
But we're not being honest if we limit this debate to one of coverage or if we let it be broken down into those without health insurance versus those with insurance.
If we are going to be serious about tackling this problem, then we need to realize this is not just about covering the uninsured but about giving all Americans coverage they can afford.
Focusing on coverage without reducing the costs of health care for all Americans is treating the symptoms and ignoring the causes.
The majority of Americans who do have health insurance now pay costs that are getting harder and harder to bear. About 40 million Americans a year find they can't pay their medical bills. Monthly premiums have gone up by double digits the past two years. Eight times faster than inflation. Last year saw the biggest premium increases since 1990 - during the first Bush Administration.
Americans with health insurance are staggering under the weight of their health care bills, but their plight has been ignored too often. They are the unheard majority in this debate - - and they need a President who will make sure their voices are finally heard. It's time to make health care affordable for them - for the uninsured - and for the nation.
In the year 2000, America spent $1.4 trillion on health care. In 2010, that number is estimated to be twice as high. Our economy - our country - cannot indefinitely carry that kind of escalating weight on its shoulders. It makes it harder for our businesses compete and our families to make ends meet. Unless we do a far better job of containing costs our health care system will literally collapse.
That's why my plan starts with containing costs. Today companies that do the right thing by providing good health insurance for their workers face mounting prices and pressures - - from their employees and their insurers. Skyrocketing costs have wreaked havoc on state budgets, crowding out other priorities like education and law enforcement. And, higher costs are being passed on to Americans who are facing higher premiums each month and higher co-payments every time they go to the doctor's office.
It would be one thing if all those dollars were being spent making Americans healthier. They're not. Our system simply has too much waste and too much fraud; there's too much inefficiency and too much abuse, too much bureaucracy and too much greed. We need to reward those who are doing the right thing, provide incentives so more people do the same, and clamp down on the insider deals that all of us end up paying for.
Here are the critical steps I propose to hold down costs.
First, my plan will stop spiraling health care premiums by containing catastrophic costs so that health care is more affordable for all of us. Only four-tenths of one percent of private insurance claims are in excess of $50,000. However, these claims account for 20 percent of medical expenses for private insurers. Under my plan, the Federal government will cover a portion of these catastrophic claims - 75 percent - for companies that provide affordable coverage for all their workers, guarantee they'll pass back the savings to their employees, and put in place preventive care and health promotion programs that can keep more people healthier longer - which is one of the best ways to keep costs under control. By covering a significant portion of catastrophic costs in this way, we will reduce average premiums by up to 10 percent.
Second, prescription drug costs are rising by almost twenty percent a year. These medications are a miracle and a necessity. Because of them Americans live longer, healthier, happier lives. We need incentives for companies to continue their research into groundbreaking medications. But when drug companies and wholesale drug buyers exploit loopholes to skim from the top, we all pay a price. And it's time it stopped.
Whether they know it or not, about eighty percent of Americans get their prescription drugs through wholesale drug buyers that process hundreds of millions of claims a year. Because these giant middlemen buy in bulk and because of their power to get products sold, drug manufacturers offer them massive rebates. But the middlemen refuse to pass the savings on to consumers. My plan says to these companies: "If you want to do business with the government on health care, you need to disclose the financial incentives you receive." Americans should be paying for prescriptions that help them, not paying extra to subsidize greed.
We also need to require drug companies to disclose the money they spend on influencing doctors and others. We need to close loopholes that prevent more affordable prescriptions from making it to the pharmacy. And we need to make sure that those without drug coverage don't get gouged. My plan does all that. And since it will be cost-effective, we will be able to provide seniors with the prescription drug coverage under Medicare that they've been waiting for too long.
And I will also work to make Medicare reimbursement fairer for states like Iowa that too often end up with the short end of the stick. I was supposed to deliver this speech yesterday, but I flew back to Washington to stand with Tom Harkin on a successful effort to improve Medicare payments for rural states. But we still have more work to do.
The third step to hold down costs is to apply new technology and medical discoveries to cut the amount that goes to bureaucracy and waste by at least 50%.
A quarter of the money America spends on health care goes to non-medical costs - basically the time spent paying bills and handling paperwork. No other industry is so inefficient. While banks have cut their costs to less than a penny per transaction using computers and technology, a single transaction in health care can cost as much as twelve to twenty-five dollars - - and not a penny of that goes to care. Eliminating this inefficiency is our health system is not political rhetoric; it's the only way to bring America's health care into the 21st century.
I have seen the impact that technology can have in veterans' health. It used to cost the Veterans Administration nine dollars to pull an entire medical record. With computerized records, it costs nothing. Putting modern systems in place requires an investment on the front end. Hospitals like Mercy are working all out just to meet your patient needs and don't have the capital available to change the system. That's why I propose to help hospitals and other health care providers pay for up front cost with a technology incentive bonus. And for insurance companies that do business with the government, using modern technology will be required.
These technologies don't just save money, they save lives. A killer like AIDS is responsible for less than seventeen thousand deaths a year. But a recent Institute of Medicine study found that between 44,000 and 98,000 people a year die of medical errors. Computerized medical records and support software can reduce medical errors by as much as 88 percent. As many as 80,000 lives saved each and every year.
We also need to do a better job of holding down medical malpractice costs. No one should ever prevent patients who have been harmed from seeking justice. But we need a national system in place that will weed out the meritless lawsuits without taking away patient's rights. I have supported that in the Senate - and included it in the plan I will pursue as President.
Along with this, my plan calls for a quality bonus to get hospitals to adopt new forms of treatment that offer patients better care and save money in long run. A benchmark of quality health care in a Kerry Administration will be the elimination of radical disparities in health care.
The next imperative is expanding coverage to more Americans. Along with helping Americans afford health care, we need to help employers be able to provide it. The vast majority of our people who have health insurance get it through their workplace. And most Americans work in a small business. Small businesses make up 99 percent of all companies and they employ 60 percent of all our workers. But they are the businesses that can least afford health insurance.
As the former Chairman of the Small Business Committee in the Senate, I have seen small businesses that want to do the right thing try and fail to afford health care coverage. And you don't have to go to a hearing room in Washington to learn this; you just have to walk down the street in Des Moines.
Two blocks from my campaign headquarters here is a sandwich shop called Beggar's Banquet. They're known for their Barbeque Beggar, which the doctors here might recommend you eat in moderation - although it's hard to have only one. The shop's owner, Virginia Noble, wants to be able to cover her 11 employees. But after researching the costs of coverage, she realized it was too expensive - even if her employees picked up half the costs. The costs for a small business are just too high.
She's not alone. If you work in a company with more than 50 employees, you are almost assured that it offers health coverage. But if you work in a business that has less than 10 employees, you only have a 50-50 chance of being covered. Sixty percent of uninsured Americans live in a household where someone works for a small business.
So my plan targets help to small businesses, especially since they - and not big corporations - need the help the most. When premiums rise, they get hit hardest of all. And it's not just that small businesses can't afford the coverage; it's that they can't afford to administer it. Those that try get buried under a mountain of paperwork, lost in a forest of forms. My plan focuses new resources on them - targeted tax credits to make health coverage both manageable and affordable.
Earlier this year, I learned about health care first hand. I had to have prostate surgery. But I saw great physicians and nurses - skilled, caring and unparalleled in their training - do amazing work. I don't think you should have to be a Member of Congress to get that kind of care. The people of this country paid to create the health plan that covers the President, the Vice-President, and the members of Congress. Today I propose to open that plan to all Americans.
Nine million Federal employees and their families now receive health care through a system that offers a wide choice of affordable coverage with group protections and good benefits - and it should be available to every American who wants it. Under my proposal, everyone from large employers to the self-employed or those that buy coverage as individuals will be able to join this system. And small businesses that have the hardest time getting coverage will get a tax credit to buy in at a price they can afford.
In fact, with this tax credit and a more affordable health plan options, small businesses and their employees could save up to 65 percent off what they are paying today.
In the Bush economy, Americans are losing their jobs left and right. And workers that are laid off usually lose their health care with their job. Without a paycheck, they can't afford the cost of coverage. We need to make sure that those who are suddenly without work do not go without health care. My plan offers them a 75 percent tax credit to help them either to buy into the Congressional Health Plan or to pay for the coverage they already have.
It also addresses the fastest growing group of the uninsured -- those between the ages of 55 and 65 - - who are too young for Medicare and who find that insurers don't want to cover them if they lose a job or retire early. Yet they are four times as likely to have had a stroke or cancer as someone between 35 and 44 and they are seven times as likely to have had a heart attack. They desperately need health coverage and my plan offers them a tax credit to help them buy into the Congressional Health Plan - so they too can finally access affordable care.
The other fundamental imperative is to secure health care coverage for every child in America. When my plan becomes law, the days when children go without immunizations and check-ups will be over. The days when children don't get preventive health care will be history. And we will finally give every child in America a healthy start and give every parent peace of mind.
We will achieve this through a new compact with our states that will help boost our economy and help them meet their bottom line.
Today, states all across the country are facing their worst fiscal crisis since World War II. But when state governors, Republicans and Democrats alike, have come to President Bush asking for relief, he has turned them away. Each time his advice has been the same: Take two tax cuts and call me in the morning. And the President refuses to recognize that the medicine isn't working. After his tax cuts failed, he just offered two more.
This is a prescription for disaster for our states and those who live in them. From preschool to colleges, education is being cut. Prisoners are being let out of jail early. Taxes are being raised on the middle class. And more than a million struggling Americans are losing their health care through Medicaid.
I'll make the following deal with America's governors: The federal government will pick up the full cost of the twenty million children enrolled in the Medicaid program if you agree to enroll the children who are eligible for CHIP, expand coverage to their parents, and - when you get back on your feet - assure that low-income adults get health coverage as well. States will be able to close some of their deficits and we'll cover nearly twenty million more Americans who go uninsured today.
This truly is a plan to leave no child behind. Rather than families having to fill out long applications that would give a CPA a meltdown, children will be automatically enrolled - no questions asked. We have a moral obligation to cover them: It's the right thing for their health; it's the right thing to help kids learn; and it's the right thing for our nation.
Finally, and for me a special responsibility, my plan will provide America's veterans with the health care their service and sacrifice have merited. Our nation made a covenant with our fighting men and women. They did their part in defending our country, but America has not been doing its part for them. About four hundred thousand qualified veterans are being denied access to VA health care. And more than 235,000 veterans already in the system are waiting six months or more for their first doctor's visit. Many of them are waiting solely to get a prescription written and filled. Next week, Congressman Boswell and I will join together to put an end to this injustice. It's the least we can do for those who have done so much - from the greatest generation to the latest and the youngest who have put their lives on the line far from home.
So today I offer America a bold new choice. Tax cuts for the wealthiest Americans or health care for all Americans, cost reductions for all Americans, immediate coverage for all of America's children - the plan I propose today meets the tests of boldness and responsibility.
The plan I propose today meets the tests of boldness and responsibility. It builds on what works and fixes what doesn't. It combines basic American values with 21st century science and technology. It's affordable: Instead of squandering our resources on tax cuts for the wealthiest Americans, it invests our resources to create an affordable health care system for all Americans. It makes restraining costs a national priority; it takes care of our nation's children and covers nearly every American; and it leaves us with enough resources to meet other critical priorities - from education to a Medicare prescription drug benefit to breaking the stranglehold of our nation's dependence on foreign oil.
I believe all these great goals are within our reach. I believe reaching them will make America safer, stronger, and more secure. It is time we had the courage to lead us there. And that's why I'm running for President.
Thank you.