For Immediate Release
Office of the Press Secretary
October 21, 2004
President Discusses Medical Liability Reform and Health Care in Downington, Pennsylvania
United Sports Training Center
Downingtown, Pennsylvania
1:37 P.M. EDT
President Bush: Thank you all for coming. (Applause.) I appreciate you
all being here. Thanks for coming. I appreciate such a warm welcome.
I'm proud to be back in Chester County, Pennsylvania. (Applause.) I'm
here to ask for your help. We're less than two weeks away when the
people get to go express their opinion in the polls, and I believe,
with your help, we're going to win the state of Pennsylvania.
(Applause.)
I know a lot of people are working hard in this campaign, and I am
here to thank you. I want to thank you for putting up the signs. I want
to thank you for making the phone calls. I want to thank you for
reminding our fellow citizens we have a duty to go to the polls in a
democracy. And when you get them headed to the polls, remind them if
they want a safer America, a stronger America, and a better America, to
put me and Dick Cheney back in office. (Applause.)
So ever since Barbara and Jenna were young I've been telling them
we're going to go on the great family camping trip. (Laughter.) I'm
sure they envisioned the Colorado River, or the wilds of Alaska, but,
no, the great family camping trip turned out to be the campaign of
2004. (Applause.) And I can't tell you -- I cannot tell you how great
it is to have my daughter introduce me in front of you all. I'm proud
of Barbara. I love her dearly. And I thank you for joining me,
darling. (Applause.) My only regret, which is I'm sure your regret, is
that Laura is not here. (Applause.) And Jenna, of course, but she's
with Laura. See, when I asked Laura to marry me she said, fine, I will
marry you, so long as I never have to give a speech. (Laughter.) I
said, okay, you've got a deal. Fortunately, she did not hold me to
that deal. Laura is giving a lot of speeches, and when she does, the
American people see a warm compassionate, strong First Lady.
(Applause.)
AUDIENCE: Four more years! Four more years! Four more years!
THE PRESIDENT: Thank you all. I am proud of my running mate. I met
with the Vice President this morning at our national security briefing.
It -- taking a look at him reminded me I didn't pick him because of his
hairdo. (Laughter.) He does not have the waviest hair in the race.
(Laughter.) But I picked him because of his experience and sound
judgment. He's doing a great for the American people. (Applause.)
By the way, a fellow you trained is doing a great job in Washington,
and that would be your former governor, Tom Ridge. (Applause.) He is a
fine member of a very strong Cabinet. And he is doing a fine job of
helping protect this homeland. I want to thank your two United States
Senators for their service to your state. First, I hope you put Arlen
Specter back into office. He's a good Senator. (Applause.) And I'm
proud to work with your other Senator, Rick Santorum. (Applause.)
I want to thank Congressman Jim Gerlach for his service to the this
district. I appreciate you, Congressman. (Applause.) He's somewhere
around here. Where -- there you are, Congressman. Good to see you. I
see you're sitting next to a good fellow in Congressman Joe Pitts --
appreciate you coming, Joe. And Congressman Tom Feeney from the state
of Florida is with us. (Applause.) Feeney? Yes, what are you doing
here? Get back to your district and turn out the vote. (Laughter and
applause.) I'll see you down there Saturday. (Laughter.)
I want to thank all the local folks who are here. I want to thank my
friend Alan Novak, who is the party chairman. I want to thank --
(applause.)
Barbara and I just had a chance to meet with four doctors from the
area, and a patient, Charlene Ware. And the docs were all telling me
you got a problem here. We're going to talk about health care here
today. I want to thank the docs for taking time to visit with me to
share their concerns. And part of my address today is to share their
concerns with you, because in order to make sure we've got a good
health care system, we've got to make sure you have good professionals
remain right here in your neighborhood to help solve the problems you
have. (Applause.)
We have a lot at stake in this election. There are big issues that
we're discussing. When I ran for President four years ago none of us
could have ever envisioned the horror of September the 11th. Since that
day, I have led a comprehensive strategy to defeat the terrorists, to
keep the homeland safe and secure. (Applause.) I pledged to the
American people we would be resolute and determined and do our duty to
protect you, and I kept my pledge. (Applause.)
Our economy -- our economy has been through a lot. When you're out
rounding up the vote, remind people about what we have been through.
The stock market was in serious decline six months prior to my arrival
in Washington, D.C. And then we went through a recession. We had some
corporate scandals. We passed tough laws, by the way. We have made it
abundantly clear we will not tolerate dishonesty in the board rooms of
America. And then -- (applause.) We got attacked. It costs us about a
million jobs in the three months after September the 11th. I pledged to
the American people, we would reduce your taxes to get our economy
going again. I kept my word. (Applause.) Our economy is strong, and it
is getting stronger. (Applause.)
I promised to reform our public schools and to challenge the soft
bigotry of low expectations. I kept my word. (Applause.) We passed the
No Child Left Behind Act, and we're closing an achievement gap all
across America. And we're not going to go back to the days of
mediocrity and low standards. (Applause.)
Another major area that needs reform is health care. We have made a
good start. And in a new term, I will build on our efforts to improve
America's health care. Health care is an essential issue in this
campaign, and it's an essential issue in Pennsylvania. And that's why
I'm delighted to come here to talk about it. Across America, small
business owners are struggling with the high cost of providing health
insurance for their employees. Some workers have lost good coverage
because they have changed jobs. Women have lost doctors they trust
because of frivolous lawsuits. We need to act on these concerns. And
we need to act in a practical, responsible way.
Here, America faces a clear choice. When it comes to health care,
Senator Kerry's prescription is bigger government with higher costs; my
reforms will lower costs and give more control and choices to the
American people. (Applause.)
The United States of America has a world-class health care system that
leads the world in providing amazing treatments and cures for millions
of people. As a candidate for President, I had pledged to double the
budget of the National Institutes of Health, to make sure we stay on
the leading edge of change and reform. I kept my word. (Applause.) We
have the most advanced hospitals in the world who do the most
innovative research. We have the finest, most highly trained health
care professionals in the world. We lead the world because we believe
in a system of private medicine that encourages innovation and change.
(Applause.)
Yet, rising costs and changes in the way Americans live and work are
putting affordable health care out of the reach of too many of our
citizens. Today I want to talk about a common-sense way to make health
care more affordable and accessible, while preserving America's system
of private medicine.
Our reforms will help our families and individuals afford health
insurance and save for health care expenses. They will help more small
businesses provide health care coverage for their employees. And that's
important, because more than one-half of the uninsured working
Americans work for small businesses.
My reforms will make sure low-income Americans, especially children,
get the health care they need. They will ensure preventative care and
prescription drug coverage for our seniors on Medicare, and provide
quality health care for our nations veterans. And my reforms address
the root causes of rising health care costs, which make health care
more expensive for everyone. In a new term we'll take five practical
steps to make health care more affordable and accessible in America,
and here they are:
First, we'll expand health savings accounts, or HSAs. (Applause.) An
HSA is an innovative approach to health care that gives you affordable
coverage for major illness and allows you to save money, tax-free, up
to a set limit, to use for routine medical expenses. You can make a
contribution to this account; your government can make a contribution
to the account; or your employer can make a contribution to the
account. If you don't use all the money in a year you can roll it over,
tax-free, to meet future expenses. (Applause.)
Health savings accounts protect you against catastrophic medical
expenses, because you can take your savings account from job to job. It
provides you more security if you change jobs. This approach will help
our nation confront the rising cost of health care, and this is how.
One of the reasons why health care costs are on the rise is that
consumers are not involved in the decision-making process. Most health
care costs are covered by third parties, and therefore, the user of
health care is really not the purchaser of health care. With HSAs we
introduce market forces. It means you can shop around for the health
care that's best for you. It means you'll be able to get better health
care at better prices, because you're the decision-maker. (Applause.)
To help more people own HSAs, I proposed allowing individuals to
deduct the cost of their insurance premiums from their taxes.
(Applause.) To help employers cover more workers, I proposed tax
credits for small businesses to pay into HSAs for their employees.
(Applause.) To help the uninsured I proposed a $3,000 refundable tax
credit to help low-income families buy their own HSAs. (Applause.)
These incentives will allow many more of our fellow citizens to have a
health care account that they manage and that they call their own.
(Applause.)
To help people afford health care, we will pass association health
plans which allows small firms to join together, to pool risk so they
can buy insurance at the same discounts big companies are able to do.
(Applause.) That means a stand-alone family restaurant in Pennsylvania
can join together with other small restaurants all around the country
so they can spread the risk, so they don't have to buy insurance in the
market as a stand-alone entity. This is a practical way to enable small
businesses to better afford health care for their employees.
(Applause.)
I view a health savings account or an association health plan as
common-sense ideas. It makes sense. Yet my opponent is against both of
them. He doesn't agree. And there's a reason why -- Senator Kerry's
idea of reform always involves bigger and more intrusive government.
AUDIENCE: Booo! (Laughter.)
THE PRESIDENT: And his health care proposal proves my point. In one of
our debates, Senator Kerry looked into the television camera, with a
straight face, and said -- quote -- "Government has nothing to do with
it." That was in reference to his health care plan. I could barely
contain myself. (Applause.) In fact, government has a whole lot to do
with his plan, and that's important for you to know. Senator Kerry's
proposal would expand the government health care rolls by nearly 22
million Americans. It would be the largest expansion of government
health care in American history. Eight out of ten people who get health
coverage under his plan would be placed on a government program.
He would make Medicaid a large -- a program so large that employers
would have the incentive to drop private coverage so the government
would pick up the insurance tab for their employees. Now, think about
that. When you make Medicaid more accessible, the small business will
have the incentive to say, well, the government will provide the
insurance, so I don't have to. That's why I say that some 8 million
Americans will go from private insurance to government-run insurance.
And Medicaid is a government-run program.
The Senator wants the federal government to pick up the tab for large
medical bills that private employer-sponsored plans now pay for. In
other words, the federal government is going to become like an
insurance company, a re-insurer, which sounds fine on the surface,
except, remember this, when the federal government writes the check,
the federal government also writes the rules. And when the federal
government starts to write the rules, the government decides who's
covered, and who gets the coverage, and how much care you get.
In addition, an independent study estimates that John Kerry's plan
would impose at least 225 new regulatory mandates on small businesses.
One group looked at the plan and described it as an overpriced
albatross. (Laughter.) That's being kind. (Laughter.) This is a plan
that will create burdens that our job creators cannot afford and do not
deserve. (Applause.) And the plan costs a lot -- $1.2 trillion. That's
with a "The." That's a lot. (Laughter.) And he says, oh, don't worry,
I'm going to pay for it all by taxing the rich. You can't raise enough
money by taxing the rich to pay for a $1.2 trillion health care plan.
Matter of fact, if you run up the top two brackets, it raises between
$600 billion and $800 billion, so there is a gap between what he
promises and how he says he's going to pay for it. And guess who
usually fills the gap? Yes, you do.
There's also something else wrong with saying to tax the rich. The
rich hire lawyers and accountants for a reason, to slip the tab to
you. We're not going to let him tax you. We're going to carry
Pennsylvania on November the 2nd. (Applause.)
AUDIENCE: Four more years! Four more years! Four more years!
THE PRESIDENT: Thank you all. When you're out the campaigning and
rounding up the vote, remind people about the facts of his plan. The
Kerry plan would move America down the road toward federal control of
health care, which would lead to lower quality and health care
rationing. Other countries have tried centralized health care and it
didn't work. We have great quality health care in America because it is
a private center system. And I intend to keep it that way. Health care
decisions ought to be between doctors and patients, not by officials in
Washington, D.C. (Applause.)
Third, we must fix our broken legal system. (Applause.) Junk lawsuits
-- junk lawsuits are expensive for doctors and hospitals to fight in
court. They are expensive to settle out of court. They drive up the
cost of liability insurance for every doctor, and they increase the
cost of health care for all Americans. (Applause.)
To avoid junk lawsuits, many doctors practice defensive medicine.
They order tests and write prescriptions that aren't really necessary
just to protect themselves from lawsuits. That's what happens in a
society that has too many lawsuits. The practice of defensive medicine
raises costs for patients and small businesses and adds about $28
billion a year to the federal budget. Remember, the federal budget
takes care of Medicare and Medicaid and veterans, and the practice of
defense medicine runs up the cost to the federal government, which
really runs up your tab. See, you pay for it. When we're talking about
the government's money, we're really talking about your money.
(Applause.) We want our doctors focused on fighting illness, not on
having to fight lawsuits. (Applause.)
The effects of the litigation culture are real in the state of
Pennsylvania. They are hurting the quality of life in this state.
Medical liability premiums are skyrocketing in this state, as they are
in other states. For specialists in high-risk fields, like OB/GYN,
those premiums have doubled or tripled in some counties since 2000. And
guess what happens. Docs leave the practice of medicine. In the past
two years, Mercy and Methodist Hospitals in Philadelphia both stopped
delivering babies. The quality of life is deteriorating because of
these lawsuits. Brandywine's only trauma center was forced to close.
The quality of life is deteriorating because of the junk lawsuits.
According to a recent poll, one in four people in Pennsylvania have
been forced to change doctors in the last year because liability costs
have forced their doctor to move, to stop practicing, or to discontinue
procedures. And every time a good doctor is forced out of a community
by lawsuits, or the fear of lawsuits, the quality of life deteriorates.
(Applause.)
Not long ago I met Mary Coar from Honesdale. Her OB/GYN had to give up
delivering babies because of liability concerns. When Mary was four
months pregnant she started driving 50 miles each way to see a
different doctor. When Mary's daughter arrived this summer she was
delivered by a doctor she had never met. When a mother is looking
forward to having a baby, the last thing she needs is uncertainty about
her health care. For the sake of women and families across this state
and this country, we need medical liability reform. (Applause.)
The difference between my opponents point of view and mine is very
clear on this issue. He has voted ten times against medical liability
reform during his Senate career. This year when the Senate considered
bills to protect OB/GYNs and trauma physicians Senator Kerry opposed
them. Now, I know we're in a campaign, and he's paying lip service to
legal reform, but it's his votes and his actions, not his words, that
really count. (Applause.) He can run from his record, but he cannot
hide. (Applause.)
In a new term, we'll pass real caps on non-economic damages. This is a
national problem requiring a national solution. And I will lead the
United States Congress to pass medical liability reform. (Applause.)
Fourth, we'll reduce health care costs by applying modern information
technology to our medical system. Many doctors offices practice 21st
century medicine -- many hospitals practice 21st century medicine, but
still have 19th century filing systems. And in hospitals, there's more
risk of medical error when all the records are handwritten on paper,
instead of cross-checked on a computer. That makes sense. Doctors don't
write very well anyway. (Laughter.) They write about as well as I speak
English. (Laughter and applause.)
The current system is costly and is wasteful, and sometimes horrible
-- sometimes harmful. And we're on our way to fixing it. I've set a
goal to make electronic medical records available for most Americans
within the next decade. We're working with states and private hospitals
to set standards for information storage and sharing. When the health
care community fully maximizes the use of information technology, we
will reduce medical costs by as much as 20 percent. We will cut medical
errors and we will save lives. (Applause.)
Fifth, we're cutting health care costs by moving cheaper generic drugs
to the market faster. My administration is making sure that drug
companies do not use delaying tactics to keep cheaper generic
equivalents from getting to the consumers. Our actions will save
Americans at least $35 billion on the medicine over the next 10 years.
And that will make life-saving drugs more affordable to our seniors.
(Applause.)
As we move forward and make health care more affordable and accessible
we'll also keep the commitments we've made, commitments necessary for a
compassionate country. We have strengthened and modernized Medicare. I
told the American people we had a problem with Medicare when I was
campaigning. I brought Republicans and Democrats together and I kept my
word in modernizing Medicare. (Applause.)
Listen, Medicare would pay thousands of dollars for a heart surgery,
but not one dime for the prescription drug that could prevent the heart
surgery from being needed in the first place. It didn't make any
sense. (Applause.) And so we've strengthen and modernized Medicare. I
signed a bill to strengthen the system. Now seniors are getting
discounts on their medicine with drug discount cards. And low-income
seniors are getting $600 worth of help a year to buy those medicines.
And beginning in 2006, all seniors will be able to get prescription
drug coverage under Medicare. (Applause.)
We have another difference of opinion on this issue. My opponent voted
against the Medicare bill that included prescription drug coverage for
seniors, even though that bill was supported by AARP and other seniors
groups. Later, he said -- quote -- "If I'm the President we're going to
repeal that phoney bill." Then he said -- then he said a little later
--
AUDIENCE: Booo!
THE PRESIDENT: -- no, I don't want to repeal it. That sounds
familiar.
AUDIENCE: Flip-flop! Flip-flop!
THE PRESIDENT: As President for the next four years, I will defend the
reforms we have worked so hard to pass so we can keep the promise to
our seniors. (Applause.)
We'll keep our commitment to America's children by helping them get a
healthy start in life. I'll work with governors and community leaders
and religious leaders to make sure every eligible child is enrolled in
our government's low-income health insurance program. We will not allow
a lack of attention, or information, to stand between millions of
children and the health care they need. (Applause.)
I know some of you here are worried about -- about the upcoming flu
season. I want to assure our seniors and families with young children
that our government is doing everything possible to help seniors and
children get their shots, despite the major manufacturing defect that
has caused this problem. We have millions of vaccine doses on hand, and
millions more will be shipped in the coming weeks. We're working
closely with state and local officials to get the flu vaccine to the
most vulnerable Americans throughout our country. If you're feeling
healthy, like I'm feeling healthy these days, don't get in line for the
flu shot. (Applause.)
To make sure health care is available, we will keep our commitment to
low-income Americans by expanding America's community health centers.
Community health centers take the pressure off of local emergency
rooms, improve care for the needy, and lower costs for us all. Since I
took office, we have opened or expanded more than 600 community health
centers. In a new term, we'll open or expand 600 more, and bring
healing to areas with the greatest need. Every poor county in America
should have a rural or community health center. (Applause.)
And finally, we will keep our commitment to American veterans who have
served our country so well. (Applause.) We have increased -- we have
increased spending for the veterans during my time by $22 billion,
which is double the amount my predecessor did in the eight years he
served as President of the United States. (Applause.) We're reducing
the backlog in veterans' health care claims. We're modernizing our VA
health centers and building new ones. Men and women who wore this
nation's uniform deserve first-class medical care, and we are getting
the job done. (Applause.)
Health care is one of the most important issues facing our country.
I'm glad you came today to let me talk about it. I'm passionate in
understanding there is a right way to make sure health care is
available and affordable, and a wrong way. I feel strongly that the way
I have proposed is the right way for America. (Applause.)
There is a big difference of philosophy in this campaign. If you think
about it, on issue after issue after issue, my opponent wants the
government to dictate to the American people. I want the American
people to decide. He trusts government; I trust the people. (Applause.)
I'm ready for the work ahead. I know what we need to do to make sure
this country is a more hopeful country and a more secure country. I've
set out a set of clear priorities based upon a political philosophy
that says government will help people realize their dreams, not tell
them how to live their lives. We'll move forward -- (applause.) We'll
move forward on a health care system that makes sure we got the best
health care system in the world, a health care system where the
decisions will be made by doctors and patients, not by officials in our
nation's capital. (Applause.)
We'll continue -- continue to promote excellence in every public
school, so no child is left behind. I'll continue to -- (applause) --
continue to promote a pro-growth, pro-entrepreneur, pro-small business,
pro-farmer economic agenda so people can find work. (Applause.)
But all progress ultimately depends on the security of our nation.
We're in the middle of a global war on terror. We face an enemy that is
determined to kill the innocent and convert our country into a
battlefield. In this war on terror, there is no place for confusion,
no substitute for victory. (Applause.)
AUDIENCE: Four more years! Four more years! Four more years!
THE PRESIDENT: The most -- the most solemn duty of the American
President is to protect the American people. If America shows
uncertainty or weakness in this decade, the world will drift toward
tragedy. This will not happen on my watch. (Applause.)
Since that terrible morning of September the 11th, 2001, we've fought
the terrorists across the Earth -- not for pride, not for power, but
because the lives of our citizens are at stake. Our strategy is clear:
We'll defend the homeland; we'll strengthen our intelligence services;
we will transform our all-volunteer army -- I will keep our
all-volunteer army and all-volunteer army. (Applause.) We will be
relentless. We will stay on the offense. We will strike the terrorists
abroad so we do not have to face them here in America. (Applause.) We
will spread freedom and liberty, and we will prevail.
I want to tell you -- I want to talk about two quick examples of what
I'm talking about, about spreading freedom and liberty. I want you to
remind people, particularly the young, about what is taking place in
Afghanistan. Three-and-a-half years ago, the Taliban ran that country
and Al Qaeda was using Afghanistan as a place to train killers, some of
whom came and took lives here in America -- three-and-a-half years
ago. Three-and-a-half years ago, young girls couldn't go to school
because the vision of the Taliban was so dark. Three-and-a-half years
ago, women were pulled in the public square and whipped if they didn't
toe the ideological line of those ideologues of hatred. It was a grim
world. And we acted to defend ourselves.
Remember, I set out a doctrine -- and when the American President
speaks the American President better mean what he says. (Applause.) And
I said if you harbor a terrorist, you're just as guilty as the
terrorists. And I meant what I said. And we removed the Taliban for
our own security -- but because we did, millions of citizens of
Afghanistan voted in the presidential election that took place a couple
of weeks ago. (Applause.) The first voter in the presidential election
was a 19-year-old woman. (Applause.) Afghanistan has gone from
darkness to light because freedom is on the march. (Applause.) And
America is better off for it. Free nations will be an ally on the war
on terror. Free nations will serve as a great example for others.
Iraq will have presidential elections in January. Think about how far
that society has come. (Applause.) It's gone from torture chambers and
mass graves to elections. Freedom is on the march.
One of my friends -- one of our friends -- Laura and my friends in the
world is Prime Minister Koizumi of Japan. That probably doesn't sound
like much; so what. Well, let me tell you what the "so what" is. It
wasn't all that long ago that we were at war with the Japanese. It's an
eternity if you're 58 years old, but really in the march of history it
wasn't all that long. After we won the war against the Japanese -- and
it was a brutal war. My dad fought there; your dads and granddads
fought there, as well. (Applause.) Harry S. Truman believed in the
power of liberty to transform an enemy into an ally. There was a lot of
people that were skeptical about that. A lot of people said, why do we
want to care about an enemy? Or, this enemy can't conceivably become an
democracy. Why should we pay attention to somebody who -- some country
that killed a lot of our citizens.
But there was great faith in the power of liberty to transform.
That's what I believe. I believe in the power of liberty to transform
societies. And as a result of that belief, I sit down with Prime
Minister Koizumi talking about how to achieve the peace we all want,
talking about tough problems in the world, so we can make a better
world for our children and our grandchildren. Some day an American
president will sit down with a duly-elected leader from Iraq, talking
about the peace in the Middle East. And our children and our
grandchildren will be better off for it. (Applause.)
I believe in the power of liberty. I believe that people in the Middle
East want to be free. I believe women in the Middle East long to live
in a free society. I believe mothers and dads in the Middle East want
to raise their children in a free and peaceful world. I believe all
these things, because freedom is not America's gift to the world;
freedom is the Almighty God's gift to each man and woman in this world.
(Applause.)
Over the past nearly four years, we've done a lot of hard work
together. We climbed the mountain and we see the valley below. The
valley below is of a more peaceful world, of a hopeful America. You
know, when I campaigned in your state in 2000 I said if you gave me the
chance to serve I would uphold the honor and the dignity of the office.
(Applause.) With your help, I will do so for four more years.
Thanks for coming. God bless. Thank you all. I appreciate your coming.
(Applause.)
END 2:24 P.M. EDT
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