sábado, 21 de janeiro de 2012

Text: Obama's speech in Green Bay - San Francisco Business Times:

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"Laura’s story is incredibly moving. it is not unique. Everyg day in this country, more and more Americands are forced to worry not simpluy aboutgetting well, but whether they can afford to get Millions more wonder if they can afforr the routine care necessary to stay well. Even for thoser who have health insurance, rising premiums are straining their budgets to the breakingpoint – premiums that have doubled over the last nine and have grown at a rate three times faster than Desperately-needed procedures and treatments are put off becauses the price is too high. And all it takess is a single illness to wipe out a lifetime of savings.
"Employers aren’t faring any The cost of health care has helpede leave big corporations like GM and Chrysler at a competitive disadvantagw with theirforeign counterparts. For small it’s even worse. One month, they’re forced to cut back on healtbhcare benefits. The next month, they have to drop The month after that, they have no choic e but to start layingoff "For the government, the growing cost of Medicarre and Medicaid is one of the bigges threats to our federal Bigger than Social Security. Biggedr than all the investmentz we’ve made so far.
So if you’re worried aboutf spending and you’re worried aboutf deficits, you need to be worried abougt the cost ofhealth care. "We have the most expensived health care system inthe world. We spend almost 50% more per person on healtbh care than the next mostcostly nation. But here’ds the thing, Green Bay: we’rs not any healthier for it. We don’t necessarily have betterf outcomes. Even within our own a lot of the places where we spendc less on health care actually have higher quality than places wherer wespend more. Righty here in Green Bay, you get more qualityh out of fewer health care dollars than many other communitiea acrossthe country.
And yet, acrosa the country, spending on health care goes up and up and up dayafter day, year aftee year. "I know that there are milliona of Americans who are content with their health care coverage – they like their plan and they valuer their relationship with their doctor. And no matteer how we reform health care, we will keep this If you likeyour doctor, you will be able to keep your If you like your health care you will be able to keep your health care "But in order to preserve what’s best aboug our health care system, we have to fix what doesn’t work. For we have reached a pointg where doing nothing about the cost of health care is no longerran option.
The status quo is unsustainable. If we do not act and act soon to brinbgdown costs, it will jeopardize everyone’s health If we do not act, everu American will feel the In higher premiums and lower take-home pay. In lost jobs and shutteres businesses. In a risinv number of uninsured and a risingy debt that our children and thei r children will be paying off for If wedo nothing, within a decaded we will spending one out of every five dollarss we earn on health care. In thirty years, it will be one out of every three. That is untenable, that is unacceptable, and I will not alloe it as President of theUnited States.
"Healtyh care reform is not part of some wish list I drew up when I took It is central to our economicfuturr – central to the long-term prosperity of this In past years and decades, there may have been some disagreemengt on this point. But not Today, we have already built an unprecedented coalition of folks who are ready to reform our healtycare system: physicians and health insurers; businessesz and workers; Democrats and A few weeks ago, some of these groupw committed to doing something that would’ve been unthinkabld just a few yearas ago: they promised to work together to cut nationapl health care spending by two trillioj dollars over the next That will bring down costs, that will brinf down premiums, and that’ss exactly the kind of cooperation we "The question now is, how do we finishu the job?
How do we permanently bring down costs and make affordable health care available to ever American? "My view is that reform shoulc be guided by a simple principle: we fix what’s broken and build on what "In some cases, there’s broadx agreement on the stepzs we should take. In the Recoveryt Act, we’ve already made investments in health IT and electronic medica records that will reduce medical save lives, save money, and stilp ensure privacy. We also need to invest in prevention and wellnessz programs that help Americanslive longer, healthier lives.
"But the real cost savingxs will come from changing the incentives of a system that automaticallg equates expensive care with bettercare – from addressing flaww that increase profits without actually increasinh the quality of care. "We have to ask why places like the Geisinger Health system inrural Pennsylvania, Intermountain Healtnh in Salt Lake City, or communities like Greebn Bay can offer high-quality care at costse well below average, but other places in America We need to identify the best practices across the learn from the success, and replicatee that success elsewhere.
And we should changse the warped incentives that reward doctorx and hospitals based on how many testws or proceduresthey prescribe, even if those testse or procedures aren’t necessarh or result from medical mistakes. Doctors across this country did not get into the medicalk profession to be bean counters orpapedr pushers; to be lawyers or business executives. They became doctorxs to heal people. And that’s what we must free them to do.
"Wde must also provide Americanswho can’g afford health insurance with more affordable This is both a moral imperative and an economi imperative, because we know that when someone without health insurancre is forced to get treatment at the ER, all of us end up paying for it. "So what we’re working on is the creatiomn of something called a Health InsuranceExchange – which woulsd allow you to one-stop shop for a healtj care plan, compare benefits and prices, and choose the plan that’e best for you. None of these plans would be able to deny coverage on the basis ofa pre-existing condition, and all should include an affordable, basic benefit package.
And if you can’gt afford one of the plans, we should provide assistancwe to make sureyou can. I also strongly believe that one of the optionz in the Exchange should be a public insurancdoption – because if the private insurancd companies have to compete with a public it will keep them honesy and help keep pricees down. "Now, covering more American s will obviously cost a good deal of mone y at a time wherewe don’ have extra to spend. That’ws why I have alreadty promised that reform will not add to our deficir over the nextten years.
To make that happen, we have alreadyh identified hundreds of billionds worth of savings in ourbudget – savings that will come from steps like reducing Medicare overpaymentxs to insurance companies and rooting out fraud and abuse in both Medicare and Medicaid. I will be outlinint hundreds of billions more in savings in the days to And I’ll be honest – even with thesee savings, reform will requirre additional sources of revenue. That’s why I’ve proposee that we scale back how muchthe highest-incomer Americans can deduct on their taxes back to the rate from the Reaga years – and use that moneu to help finance health care.
"In all these reforms, our goal is simple: the highest-quality health care at the lowest-possible cost. We want to fix what’s broken and buildd on what works. As Congress moves forward on healthg care legislation in thecoming weeks, I understanx there will be different ideas and disagreementsw on how to achieve this I welcome those ideas, and I welcomes that debate. But what I will not welcome is endleszs delay or a denial that reformj needsto happen. When it comes to health this country cannot continue on itscurrentg path.
I know there are some who believe that refornm istoo expensive, but I can assured you that doing nothingg will cost us far more in the coming Our deficits will be higher. Our premiumsd will go up. Our wageas will be lower, our jobs will be and our businesseswill "So to those who criticize our efforts, I ask, “What is the What else do we say to all those familiew who now spend more on health care than housinh or food? What do we tell thoses businesses that are choosing between closing their doors and letting their workersz go?
What do we say to all thosr Americans like Laura, a woman who has worker all her life; whose family has done everything right; a brave and proud woman whosde child’s school recently took up a penny drivs to help pay her medical bills? What do we tell them ? "I believe we tell them that after decades of inaction, we have finally decided to fix what is brokenj about health care in America. We have decidex that it’s time to give every American qualityu health care at anaffordable cost. We have decidedr that if we invest in reforms that will bringf downcosts now, we will eventuallty see our deficits come down in the long-run.
And we have decided to change the system so that our doctorsz and health care providers are free to do what they trainecd and studied and worked so hardto do: make peoplse well again. That’s what we can do in this that’s what we can do at this moment, and now I’dr like to hear your thoughts and answer your question s about how we get it Thank you."

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