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Health Care Reform

Location: Charleston, SC

Thank you for your kind welcome and the opportunity to be with you today.

During my campaign I have had the privilege of meeting many thousands of Americans, rich and poor, young and old -- Americans of every race, creed and background.

Each of them, like us, is blessed to call home the greatest nation in the history of the world. And each of them is a reminder of why I run for President.

I run because I know that unless we restore the people's sovereignty over government, renew their pride in public service, reform our public institutions and reinvigorate our sense of national purpose we will deny our destiny, we will abandon the cause our founding fathers called glorious.

I run for President not to be somebody but to do something. I want to return our government back to whom it belongs so that Americans can believe once again that public service is a summons to duty and not a lifetime of privilege. I run to inspire every American, particularly the next generation, to serve a cause greater than one's self interest.

Health Care Reform—The Time Is Now

I would like to talk with you today about one of those causes -- one that is among the most pressing issues affecting the American family: assuring access to affordable, high quality health care.

America enjoys the best health care on earth. We lead the world in developing the cures and treatments that promise faster and fuller recovery--and a better life for the sick and the injured.

Our values -- American values -- built this system. The values of free enterprise and entrepreneurship; of respecting the family, caring for the most needy, and honoring our commitments.

But our health care system today often fails to reflect our values. For many families, it is too costly, too inaccessible and too bureaucratic to keep its promises.

Too many Americans go to sleep at night desperately fearing illness or injury to themselves or a family member because they are without health insurance to pay the bills.

Too many Americans feel held hostage by HMOs that are more concerned with healthy profits than healthy patients.

Too many Americans doubt politicians' promises to save Medicare from bankruptcy and seniors from the financial ruin of escalating drug bills.

The nation remains woefully unprepared for the long-term health care needs of the aging baby boom generation.

And, our proud veterans--and the brave Americans who serve today--promised access to quality health care in gratitude for their sacrifice for our country, are being cheated because the government finds it too difficult to keep its word to Americans who once risked all to keep their word to our country.

Our Values Call Us To Something Better

Yes, America has the highest quality health care system in the world. But, our values call us to something better. We must have a health care system worthy of a great and generous nation.

We must assure people the health care choice they deserve and the control they demand—and we must contain costs to make care more accessible and affordable for all Americans.

Getting there does NOT require some grand experiment in social engineering, or a "death by a thousand cuts" gradual government take over of our health care.

We need only to consult our values and enact tailored reforms that build on the strengths of the current system. We need to rely on time-tested market principles rather than the placebo of government control, and on human compassion rather than corporate disinterest to focus assistance on the most vulnerable in our society: children and the elderly.

The Prescription for Reform

But let's be realistic. The reform we need is not possible as long as special interests control Washington. As long as the special interests' agendas are greased with unlimited amounts of soft-money contributions to our campaigns -- the interests of average Americans come second.

Taking the 100,000 dollar special interest checks out of politics is the gateway through which all other reforms including the reform of our health care system must pass.

This Thursday, former Senator Bill Bradley and I will share a stage in Claremont, New Hampshire. We will join together in a pledge to rid the political process of the soft money and the special interests that have blocked all efforts to repair a health care system that no longer puts the needs of the patient ahead of the profits of the bureaucrats, the trial lawyers and the HMO's.

Senator Bradley and I have profoundly different ideas for how to repair this broken system. He is a liberal Democrat. I am a conservative Republican. Our core philosophies are very different with respect to the role of government.

But we do agree on one thing: we believe, as do majorities of both houses of Congress and millions upon millions of working Americans, that no reform is possible until we give our government back to the people by cleaning up the scandal that is campaign finance.

Patients Bill of Rights

Nowhere is this more true than in the fight for enactment of a responsible Patients' Bill of Rights. It's long past time we put the needs of patients ahead of the bank accounts of the trial lawyers and the HMO's.

Congressional gridlock is a function of bi-partisan fidelity to the favored special interests that finance our campaigns. Republicans want to protect the insurance companies from lawsuits. The Democrats want to let the trial lawyers sue anyone for anything. And, the American family, whose needs are not well served by either faction, bears the heavy burden of our misplaced priorities.

HMO's were designed to bring new efficiencies to our health care system, but for millions of Americans the cure has become part of the disease. Cost containment has become a goal in and of itself, rather than the means toward better, more affordable health services. In many instances corporate bottom lines have trumped the ability of consumers to choose their own doctor and access critical care. That's got to stop and as President, I'll make sure we put the patient back in charge.

We must put families back in control of their health care, including access to emergency services. Women and children should be free to see specialists without first begging the permission of an insurance bureaucrat. And the sick and injured should have the ability to appeal the wrongful denial of care by their HMO.

As President, I'll make sure you and your families have the health care you deserve.

If you or a loved one is sick or injured and wrongfully turned away from care, you must be assured the ability to resolve that problem rapidly through a fair and independent review process. But if you're not satisfied, no American should be denied the ability to seek redress through the courts. Due process is a fundamental right guaranteed by our Constitution—no politician has the right to take that right away—particularly not when your family's health is at stake.

But let me be clear, due process does not mean penalizing businesses responsible enough to provide their employees with health coverage. The entity to be held accountable must be the one that makes the health care decision in question—in other words the HMO, not the business that pays the bills. If insurance companies and HMO's can't stand behind the decisions they make, like every other business must do with its products or services, they shouldn't be making those decisions at all.

And if we expose small businesses to unlimited liability simply for extending health coverage to employees, not only will we have meted out a terrible injustice, we will have succeeded only in stripping families of the health coverage they must have. My friends, that's not going to happen on my watch.

I am honored to call my friend, Congressman Lindsey Graham, who understands our obligations to working families. He has fought tirelessly to defend their interests on the issue of HMO's and he has taken on the special interests in Washington to do it.

Reining in Trial Lawyers

He knows that rather than slamming shut the courtroom door on patients, we must stop abuses of the system that inflate health care costs by reining in out-of-control trial lawyers who don't care about suing for what's just, but who just want to sue.

Last year, this nation celebrated the graduation of 15,000 new medical doctors and endured the birthing of 40,000 new lawyers. That's two and one-half lawyers to sue every doctor.

Seventy percent of medical malpractice suits are tossed out of court, and of the plaintiff awards, only 40 cents out of every dollar made it to the aggrieved patient. Enormous liability premiums and defensive medicine drain our health care system of over 60 billion dollars per year.

I know there are many lawyers who believe intensely that tort reform is necessary and possible. But unfortunately, Congress only hears from the organized opposition representing those who treat our tort system like a lottery, hoping to hit a jackpot judgement, at the expense of the average American.

We are too great a country to abide a system of health care made less affordable and less accessible because our laws coddle those trial layers, who in their obsession with striking it rich, have lost sight of the purpose of the law—to serve justice.

As President I will not accept reform that undermines an individual's ability to receive just compensation for bona fide damages. But I will demand reform that tames legal predators and addresses the problem of runaway punitive damage awards. And I will do that not only for HMO lawsuits but for all tort and product liability cases affecting health care.

Among the benefits of cost saving tort reforms will be sorely needed relief to the Medicare system—the vital medical lifeline for millions of older Americans—a lifeline that is perilously close to the edge of bankruptcy.

The Medicare trustees report that without reform, the program will be insolvent within 15 years. Medicare, like Social Security, is a sacred contract with our nation's seniors. Honoring this commitment is our solemn obligation.

But rather than rallying to reform these programs to assure their long-term financial health, Congress and the Administration do what we do best -- we point fingers and play politics.

We feed the American people's growing cynicism by treating these programs as props in partisan political theatre. Our tug of war over the surplus is a good example. Democrats want to spend the surplus on bigger government. Republicans claim it all for tax cuts. Each party cynically strikes its best pose to appeal to favored constituencies. Meanwhile, we lose the precious time and resources necessary to save Social Security and Medicare, a loss that makes the eventual solution all the more expensive.

As President, I will see that at least 70 percent of the surplus is dedicated to shoring up Social Security and Medicare so that a promise made by government devised of, by and for the people is a promise kept to those we are sworn to serve.

In good conscience, we can do no less. America's seniors have worked hard and played by the rules. They deserve the peace of knowing that the security and protection of Medicare will be there for them when they need it.

Pharmaceutical Assistance for Seniors

Today, thanks to the marvels of modern medicine, Americans are living longer. Amazing new drug therapies, cures and treatments are improving the quality and length of life. But all advances have their costs, and these drugs are expensive -- too expensive.

It offends our sense of right when a European maker of a top selling heart drug can pay 100 million dollars to a U.S. competitor to squelch the manufacture of a less expensive alternative. That's wrong my friends, and such abuse has no place in our health care system. The first principle of cost control is vigorous competition—a principle as true for the drug industry as every other.

None of us will tolerate a parent or grandparent going without a prescription that could mean a longer, better life because they simply can't afford it. Nor should our parents and grandparents be forced to lose everything they've worked for to pay for the prescriptions they must have to survive.

While the bulk of seniors have prescription coverage, many on fixed incomes must choose between medicine and food. That's not right. Fourteen states have answered the call for help by offering prescription assistance programs for needy seniors. It's time we build on the success of these programs nationwide.

I propose to do just that through a Senior Pharmaceutical Assistance Program that will provide a substantial block grant to every state willing to cost-share the responsibility. Under the program, seniors struggling to make ends meet - those with incomes below 200% of the poverty level--would receive assistance to acquire the medications they need under guidelines established by the state they live in.

We know, however, that seniors with income levels that exceed twice the poverty line need help too, particularly with catastrophic drug expenses that can cruelly snatch away a life's savings and the dream of passing something on. As part of this initiative, I will provide funding for regional pilot projects to extend catastrophic drug expense assistance to seniors regardless of their income.

Again, states participating in the pilot would be required to cost-share the experiment but would remain free to innovate appropriate eligibility criteria and the means of providing assistance. The lessons we learn from this trial will help us craft a national approach that best meets the needs of seniors.

In my opinion, addressing this need is the least we can do for the Americans who helped build this great country and to whom we owe a debt for the prosperity that we enjoy.

I will fund this program by dedicating $2 billion in year one and up to $6 billion when fully implemented and I will pay for it as I will the other top priority initiatives I propose, by cutting billions of dollars I have identified in pork barrel spending, and reordering federal spending priorities, eliminating special tax subsidies doled out to interests favored by Congress.

Making Insurance More Affordable and Accessible

We are a prosperous people. Our productivity should be a source of pride. But it is a source of shame that, in the midst of this prosperity, 44 million Americans still go without health insurance.

Nearly three-quarters of the uninsured live in families in which the primary breadwinner works for a small business.

As President, I will place insurance within the reach of small businesses by making it possible for them to enjoy the same economies of scale in purchasing coverage as large companies. Aggressively promoting the ability of small enterprises to form purchasing pools so that they can negotiate more affordable insurance coverage for their employees, could eliminate millions from the roles of the uninsured.

And for those who still lack coverage, we need not accept the failed philosophy that big problems can be solved only by big bureaucracies.

Instead of using the tax code to indulge pork barrel schemes and to feed the insatiable appetites of big government, let's use it to fund families' vital needs like health care.

As President, I will provide tax relief for the average American who works hard to pay the bills and support a family, beginning with those who need it most: the middle and lower class.

Health insurance coverage is not the government's to dole out in predetermined packages to favored constituencies. As President, I will make sure health care remains in the hands of patients and physicians, not bureaucrats.

And that means giving American families some of their money back, and letting them make better choices about how to spend it. The tax plan I have laid out would provide a family tax relief that will empower more Americans to buy the health insurance they need.

I was pleased to support efforts to make health insurance 100 percent tax deductible for the self employed, but we must go further. I will expand Medical Savings Accounts so that even more families can protect from the taxman the savings they need to meet their health care needs, such as long-term care—an essential as the baby boom generation reaches its retirement years.

Children's Health Care

As President I will make these reforms. But there is one area in which the president cannot act alone; one mission in which the country must join together in consensus or risk staying mired in the status quo.

As we go forward to improve our health care system and honor our commitments, let's agree that our first priority should be to help the most vulnerable in our society: our children. There is no good reason that in the United States of America 11 million children go without health care coverage. My friends we are a better country and a better people than that.

America prevailed in two World Wars, and a Cold War. We survived a depression, won a Civil Rights struggle, and put a man on the Moon. Surely, a nation that is the greatest force for good on earth can prevail in a new mission to ensure that every child has a healthy beginning in life.

Of the 11 million uninsured children, more than 4 million are eligible for coverage under Medicaid but are not enrolled. It's time to enroll these children—and enroll them now. I've introduced legislation to do just that by improving outreach through schools and other institutions where we can most effectively educate families about their options.

Of the uninsured children not eligible for Medicaid, nearly one-third live in families that make over $50,000 per year—nearly triple the poverty level. Again, the tax relief proposals I have already announced would give back to families at that income level over $1,200 per year. Yes, we have an obligation to assist those who can't help themselves, but our system must never substitute itself for personal responsibility. Other than food and shelter, I can't conceive of a higher family priority than child health insurance.

But, still we know there are kids who will need help. That's why Congress established the Children's Health Insurance Program known as CHIP. While an estimated 3 million children are eligible for this program, only half participate. As with Medicaid, the problem is outreach and education.

Today, states are restricted from using a necessary share of their aid to actively reach eligible children. We must reform these restrictions, and bring every eligible child into the system. In doing so, if we find that additional funds are necessary to cover these additional children, then I will make those resources available.

No child in America should be without proper insurance coverage and a healthy start. And if the package of reforms I've outlined isn't enough to do the job, then we'll do more until it's done.

Veterans and Military Health

And just as we must do right by our children, we have a solemn obligation to our nation's veterans and those who serve our country in uniform today. The Clinton Administration and the Congress have for several years under-funded veterans' health care by billions of dollars, and the military health care system is broken. This abrogation of our duty to those who defend our freedom is disgraceful. These brave men and women put their lives on their line for our freedom - and I will not let them down!

We are talking about America's heroes. Men and women who bore great sacrifices for the rest of us but who are now denied the dignity of the proper medical care they were promised.

Last year's increase of $1.7 billion for veterans' health care is not nearly enough to fulfill our pledge. As President, and Commander in Chief, I will fully fund the veterans' health care system by providing the additional $2 billion necessary to improve quality of care, assure timely access to services, and fund the long-term care needs of those who risked their lives in defense of ours.

And, I will reform the military health care system that serves our active duty patriots and our military retirees. I am ashamed when I hear the stories of young military wives about what their families must endure just to receive the care they are due. Our defenders deserve better.

Early next year, I will present a plan to reform our military health care system, so that we can make good on the nation's promise to those who make good on their promise to us every day.

Concluding Remarks

We are a great nation. A bold and good people. Our health care system in the new century should reflect our values and honor our commitments.

I would submit that neither turning the system over to government bureaucrats, nor ignoring the challenges that lay before us is acceptable. While there is no single cure-all to the ills of our health care system, there is much work to be done. It is time we roll up our sleeves and begin that work in earnest. We must begin where it's right, on improving the system, not scrapping it; by focusing our help on the most vulnerable in society, children and seniors; and by seeing to it that promises made, are promises kept.

Then, and only then, will we who are privileged to serve the public trust, be worthy of that distinction.

Thank you for listening.

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