Remarks by Senator Barack Obama (D-IL) to the Families USA 2007 Conference; Topic: Health Care

Date: Jan. 25, 2007
Location: Washington, DC


SEN. OBAMA: Thank you. Thank you so much. Thank you. Thank you so much, Ron, and thank you, Families USA, for inviting me to speak here today. This is, I think, my second appearance since I've been in Washington, and I'm thrilled to once again join you and inspired by the great work that you guys are doing all across the country.

And I do pick the Bears, by 7 -- (laughter) -- over Indianapolis. (Scattered applause.) Indianapolis is a fine town, but -- (laughter) -- (chuckles). (Laughter.)

On this January morning of 2007, more than 60 years after President Truman first issued the call for national health insurance, we find ourselves, I think we'd all agree, in the midst of a(n) important historical moment on health care.

From Maine to California, from business to labor, Democrats and Republicans, there's an emergence of a new series of bold proposals from across the spectrum that's effectively ended the debate over whether or not we should have universal health care in this country. Plans that tinker and halfway measures now belong to yesterday. The president's -- (scattered applause) -- latest proposal that he announced this week has some elements that are interesting, but it basically does little to bring down cost or guarantee coverage. It falls into the category of tinkering and halfway measures. There are going to be many others that are offered over the course of a campaign season, and I'm working with experts to develop my own plan as we speak.

But let's make one thing clear right here, right now, right off the bat -- in the 2008 presidential campaign and congressional campaigns all across the country, affordable, universal health care for every single American must not be a question of whether, it must be a question of how. We have -- (interrupted by applause) -- we have the ideas, we have the resources, now we have to find the will to pass a plan by the end of the next president's term.

Let me repeat that. I am absolutely determined that by the end of the first term of the next president we should have universal health care in this country. There's no reason why we can't accomplish that. (Applause.)

Now, I know there's cynicism about whether this can happen, and there's good reason for cynicism. Every four years health care plans are offered up in campaigns with great fanfare and promise. I'm sure that this campaign season will be no exception. People evaluate them for a day, and then they move on to find out who made the latest blooper or gaffe on the campaign trail. And by the time a president is sworn in, the interest groups and the partisans have torn down whatever ideas have been offered, and we're back to business as usual.

The plans collapse under the weight of Washington politics, leaving America to continue to struggle with skyrocketing costs.

For too long, this debate has been stunted by what I call the "smallness of our politics" -- the idea that there isn't much that we can agree on or do much about when it comes to the major challenges facing our country. When somebody does try to propose something bold, the interest groups and the partisans treat it like a sporting event. They decide who's up and who's down, with each side keeping score, using fear and divisions and other cheap tricks to win their arguments, even if we lose our solution in the process.

Well, we can't afford another disappointing charade in 2008 and 2009 and 2010. It's not only tiresome, but it's wrong -- wrong when businesses have to lay off one employee because they can't afford health care for the rest. It's wrong when a parent can't take a sick child to the doctor because they can't afford the bill that comes with it. It's wrong when 46 million Americans have no health care at all, in a country that spends more on health care than any nation on Earth. It's wrong, and we can do something about it.

In recent years, what's caught the attention of those who haven't always been in favor of reform is the realization that the crisis isn't just morally offensive, it's economically untenable. For years, the can't-do crowd have scared the American people into believing that universal health care would mean socialized medicine, burdensome taxes, rationing, and that we should just stay out of the way, let the market do what it will, and tinker at the margins.

You know the statistics, though. Family premiums are up by nearly 87 percent over the last five years, growing five times faster than workers' wages; deductibles are up 50 percent; and copayments for care and prescriptions are through the roof -- nearly 11 million Americans who were already insured spent more than a quarter of their salaries on health care last year, and over half of all family bankruptcies today are caused by medical bills.

But they say it's too costly to act. Almost half of all small businesses no longer offer health care to their workers, and so many others have responded to the rising costs by laying off workers or shutting off -- shutting their doors for good.

Some of the biggest corporations in America, giants like GM and Ford, are watching foreign competitors run circles around them because those countries have universal health care so that GM cars contain twice as much health care costs as Japanese cars. But yet they still say it's too risky to act.

They tell us it's too expensive to cover the uninsured, but they don't mention that every time an American without health insurance walks into an emergency room, we pay even more. Our family premiums are $922 higher because of the cost of care of the uninsured, but they say that there's nothing we can do. We pay 15 billion (dollars) more in taxes because of the cost of care for the uninsured, and it's trapped us in a vicious cycle. As the uninsured cause premiums to rise, more employers drop coverage; as more employers drop coverage, more people become uninsured and premiums rise even further, but the skeptics tell us that reform is too costly, too risky, too impossible for America to achieve.

The skeptics must be living somewhere else. (Laughter.) Because when you see what health care is doing to our families, when you see what the crisis is doing to our economy, to our country, you realize that what is too costly is caution. It's inaction that's too risky, doing nothing. (Applause.) Doing nothing is what's impossible when it comes to health care in America.

It is time to act.

This isn't a problem of money. It's a problem of will, a failure of leadership. We already spend $2.2 trillion a year on health care in this country. My colleague Ron Wyden, who's recently developed a(n) interesting new health care plan of his own, tells it this way. For the money Americans spent on health care last year, we could have hired a group of skilled physicians, paid each one of them $200,000 to care for just seven families, and guaranteed every single American quality affordable health care. That's for the money that we currently spend, right now.

So where does all that money go? We know that a quarter of it, one out of four health care dollars, is spent on non-medical costs, mostly bills and paperwork.

We also know that it's completely unnecessary. Almost every other industry -- (scattered applause) -- almost every other industry in our economy has saved billions on these administrative costs by doing it all online -- every other industry in America. Every transaction that you make at a bank now costs less than a penny. Even at the VA, the Veterans Administration, where it used to cost $9 to pull up your medical records, new technology means you can call up the same record on the Internet for next to nothing. But because we haven't updated technology in the rest of the health care industry, a single transaction still costs, in some cases, up to $25, not one dime which goes towards providing people with treatment or improving quality of care. This is simply inexcusable.

And if we brought our entire health care system online, into the 21st century, something that everybody from Ted Kennedy to Newt Gingrich believes we should do, we'd already be saving $600 million a year on health care costs that we could apply to providing coverage for more people.

It's not a problem of lack of ideas. It's a problem of political will.

And the federal government should be leading the way here. If you do business with the Federal Employee Health Benefits Program, you should move to an electronic claims system. If you're a provider who works with Medicare, you should have to report your patients' health care outcomes, so that we can figure out on a national level how to improve health care quality. These are all things that the experts tell us could be done, must be done, but are not being done. The federal government has to lead.

Another, more controversial area when we look at the health care crisis is how much of our health care spending is going towards record-breaking profits earned by the drug and health care industry. Now, I'm an American, and I'm a capitalist. It is perfectly understandable for a corporation to try and make a profit. That is the way we do business in this country. But when profits are soaring higher and higher each year while millions lose their coverage and premiums skyrocket, we have a responsibility to ask why.

At a time when businesses are facing increased competition and workers rarely stay with one company throughout their lives, we also have to ask ourselves if the employer-based system of health care itself is still the best way for providing insurance to all Americans.

We have to ask what we can do to provide more Americans with preventive care, which would mean fewer doctors visits and less costs down the road. We should make sure that every single child in America is signed up if they don't already have insurance for the Children's Health Insurance Program, and I know that there are going to be proposals in Congress this year to expand it, to make sure that every child that needs it is included under the SCHIP program.

The federal government should make sure that the states have the money to make that happen, and we have to start looking at some of the interesting ideas on comprehensive reform that are coming out of states like Maine, Illinois, California, Massachusetts to see what we can replicate on a national scale and what will move us towards that goal of universal health care for all.

But regardless of what combination of policies and proposals get us to this goal, we have to reach it. We have to act, and we have to act boldly. As one health care advocate recently said, "The most important course" -- excuse me -- "The most expensive course is to do nothing." This wasn't a liberal Democrat or a union leader who said this; it was the president of the very health industry association that funded the Harry and Louise ads designed to kill the Clinton health care plan in the early `90s. Now that is a positive development.

The debate in this country over health care has shifted fundamentally, and one of the things that I think is important for the Democratic Party to understand is we are not in 1992, we are not in 1993, we are not in 1994; we do not have to be intimidated because not only have American families and consumers understood for a long time the pressure and the stress and the strain that they're under, American business has finally awakened to this fact as well. And the possibility of putting together the kinds of alliances that might have been unimaginable 12 or 13 or 14 years ago exist today.

The support for comprehensive reform that organizations like Family USA have worked so hard to build is now widespread, and the diverse group of business and health care industry interests that are part of your health care coverage coalition is a testament to that success.

So the upshot is that Washington has no longer any excuse for caution. Leaders no longer have any reason to be timid.

America can no longer afford inaction. That is not who we are as a country; that's not who we are as a people; that's never been the story of our nation's improbable march towards progress.

You know, half a century ago, America found itself in the midst of another healthcare crisis. For millions of elderly Americans, the single greatest cause of poverty and hardship was the crippling cost of health care and the lack of affordable insurance. Two out of every three elderly Americans had annual incomes of less than $1,000. Only one in eight had health insurance. As health care and hospital costs continued to rise, more and more private insurers simply refused to insure elderly, believing they were too great a risk for care.

The resistance to action was fierce. Opponents of healthcare reform were opposed by well-financed, well-connected interest groups who spared no expense in telling the American people that these efforts were dangerous and un-American, that they were revolutionary, even deadly. And yet the reformers marched on. They testified before Congress. They took their case to the country and they introduced dozens of different proposals, but always they stood firm on their goal to provide health care for every American senior.

And finally, after years of advocacy and negotiation and plenty of setbacks, President Lyndon Johnson signed the Medicare bill into law on July 30th of 1965. Signing that bill, the signing ceremony took place in Missouri in a town called Independence, with the first man who was bold enough to issue the call for universal health care, and that's a president named Harry Truman.

And as he stood with Truman by his side and signed what would become the most successful government program in history, a program that had seemed impossible for so long, President Johnson looked out at the crowd and said, "History shapes men, but it's a necessary faith of leadership that men can shape history." As long as we include women on that -- (laughter) -- that adage remains. Never forget -- (interrupted by applause). Never forget that we have it within our power to shape history in this country. That's one of the great legacies that have been left to us by our parents and our Founders.

It's not in our character to sit idly by as victims of fate or circumstance, for we're a people of action and innovation, forever pushing the boundaries of what is possible.

Today, right now, this moment, this conference, is the time to push those boundaries forward once more. We've come so far on this debate, on the need for universal health care in this country. But now we must finally answer the call first issues by Truman, advanced by Johnson, and fought for by so many leaders and Americans throughout the last century.

The time has come for universal health care in America, and I look forward to working with all of you in the coming months to meet that challenge. I am absolutely confident that we are going to get there -- not just because of the leadership in Washington, not just because of the leadership in the state capitals, but because of the leadership of all of you.

Thank you very much, everybody. Thank you. (Applause.)