thank you __PUNCT__
i appreci the hospit of the univers of south florida __PUNCT__ and thi opportun to meet with you at the moffitt cancer center and research institut __PUNCT__
speaker moffitt __PUNCT__ dr __PUNCT__ dalton __PUNCT__ dean klasko __PUNCT__ thank you for the invit __PUNCT__ and for your year of dedic that have made thi campu a center of hope for cancer victim everywher __PUNCT__
it good to see some other friend here __PUNCT__ includ your board member and my friend and former colleagu conni mack __PUNCT__
and my thank especi to the physician __PUNCT__ administr __PUNCT__ and staff of thi wonder place __PUNCT__
sometim in our polit debat __PUNCT__ america health __PUNCT__ care system is critic as if it were just on more thing to argu about __PUNCT__
those of you involv in run a research center like thi __PUNCT__ or manag the children hospit that i visit yesterdai in miami __PUNCT__ might grow a littl discourag at time listen to campaign debat health care __PUNCT__
but i know you never lose sight of the fact that you ar each involv in on of the great vocat __PUNCT__ do some of the greatest work there is to be done in thi world __PUNCT__
some of the patient you meet here ar in the worst hour of their live __PUNCT__ fill with fear and heartach __PUNCT__
and the confid presenc of a doctor __PUNCT__ the kind and skill attent of a nurs __PUNCT__ or the knowledg that research like you ar on the case __PUNCT__ can be all thei have to hold onto __PUNCT__
that is a gift onli you can give __PUNCT__ and you deserv our countri gratitud __PUNCT__
i had a tour here thi morn __PUNCT__ and though i can't sai i absorb everi detail of the research i certainli understand that you ar make dramat progress in the fight against cancer __PUNCT__
with skill __PUNCT__ ingenu __PUNCT__ and persever __PUNCT__ you ar turn new technolog against on of the oldest enemi of human __PUNCT__
in the live of cancer patient __PUNCT__ you ar ad decad where onc there were onli year __PUNCT__ and year where onc there were onli month __PUNCT__
you ar close in on the enemi __PUNCT__ in all it form __PUNCT__ and on dai you and other like you ar go to save uncount live with a cure for cancer __PUNCT__
in all of thi __PUNCT__ you ar show the medic profess at it most heroic __PUNCT__
in ani seriou discuss of health care in our nation __PUNCT__ thi should alwai be our start point __PUNCT__ becaus the goal __PUNCT__ after all __PUNCT__ is to make the best care avail to everyon __PUNCT__
we want a system of health care in which everyon can afford and acquir the treatment and prevent care thei need __PUNCT__ and the peac of mind that come with know thei ar cover __PUNCT__
health care in america should be afford by all __PUNCT__ not just the wealthi __PUNCT__
it should be avail to all __PUNCT__ and not limit by where you work or how much you make __PUNCT__
it should be fair to all __PUNCT__ provid help where the need is greatest __PUNCT__ and protect american from corpor abus __PUNCT__
and for all the strength of our health __PUNCT__ care system __PUNCT__ we know that right now it fall short of thi ideal __PUNCT__
some __NUM__ million individu __PUNCT__ nearli a quarter of them children __PUNCT__ have no health insur at all __PUNCT__
roughli half of these famili will receiv coverag again with a mother or father next job __PUNCT__ but that doesn't help the other half who will remain uninsur __PUNCT__
and it onli draw attent to the basic problem that at ani given moment there ar ten of million of american who lost their health insur becaus thei lost or left a job __PUNCT__
anoth group is known to statistician as the chronic uninsur __PUNCT__
a better descript would be that thei have been lock out of our health insur system __PUNCT__
some were simpli deni coverag __PUNCT__ regardless of need __PUNCT__
some were never offer coverag by their employ __PUNCT__ or couldn't afford it __PUNCT__
some make too littl on the job to pai for coverag __PUNCT__ but too much to qualifi for medicaid or other public program __PUNCT__
there ar mani differ reason for their situat __PUNCT__
but what thei all have in common is that if thei becom ill __PUNCT__ or if their condit get wors __PUNCT__ thei will be on their own __PUNCT__ someth that no on want to see in thi countri __PUNCT__
underli the mani thing that troubl our health care system ar the fundament problem of cost and access __PUNCT__
rise cost hurt those who have insur by make it more expens to keep __PUNCT__
thei hurt those who don't have insur by make it even harder to obtain __PUNCT__
rise health care cost hurt employ and the self __PUNCT__ emploi alik __PUNCT__
and in the end thei threaten seriou and last harm to the entir american economi __PUNCT__
these rise cost ar by no mean alwai accompani by better qualiti in care or coverag __PUNCT__
in mani respect the system ha remain less reliabl __PUNCT__ less effici __PUNCT__ more disorgan and prone to error even as it becom more expens __PUNCT__
it ha also becom less transpar __PUNCT__ in wai we would find unaccept in ani other industri __PUNCT__
most physician group and medic provid don't publish their price __PUNCT__ leav american to guess about the cost of care __PUNCT__ or els to find out later when thei try to make sens of an endless seri of __PUNCT__ explan of benefit __PUNCT__ form __PUNCT__
there ar those who ar convinc that the solut is to move closer to a nation health care system __PUNCT__
thei urg univers coverag __PUNCT__ with all the tax increas __PUNCT__ new mandat __PUNCT__ and govern regul that come along with that idea __PUNCT__
but in the end thi will accomplish on thing onli __PUNCT__
we will replac the ineffici __PUNCT__ irration __PUNCT__ and uncontrol cost of the current system with the ineffici __PUNCT__ irration __PUNCT__ and uncontrol cost of a govern monopoli __PUNCT__
we have all the problem __PUNCT__ and more __PUNCT__ of privat health care __PUNCT__ rigid rule __PUNCT__ long wait and lack of choic __PUNCT__ and risk degrad it great strength and advantag includ the innov and life __PUNCT__ save technolog that make american medicin the most advanc in the world __PUNCT__
the kei to real reform is to restor control over our health __PUNCT__ care system to the patient themselv __PUNCT__
right now __PUNCT__ even those with access to health care often have no assur that it is appropri care __PUNCT__
too much of the system is built on get paid just for provid servic __PUNCT__ regardless of whether those servic ar necessari or produc qualiti care and outcom __PUNCT__
american famili should onli pai for get the right care __PUNCT__ care that is intend to improv and safeguard their health __PUNCT__
when famili ar inform about medic choic __PUNCT__ thei ar more capabl of make their own decis __PUNCT__ less like to choos the most expens and often unnecessari option __PUNCT__ and ar more satisfi with their choic __PUNCT__
we took an import step in thi direct with the creation of health save account __PUNCT__ tax __PUNCT__ prefer account that ar us to pai insur premium and other health cost __PUNCT__
these account put the famili in charg of what thei pai for __PUNCT__
and __PUNCT__ as presid __PUNCT__ i would seek to encourag and expand the benefit of these account to more american famili __PUNCT__
american need new choic beyond those offer in employ __PUNCT__ base coverag __PUNCT__
american want a system built so that wherev you go and wherev you work __PUNCT__ your health plan is goe with you __PUNCT__
and there is a veri straightforward wai to achiev thi __PUNCT__
under current law __PUNCT__ the feder govern give a tax benefit when employ provid health __PUNCT__ insur coverag to american worker and their famili __PUNCT__
thi benefit doesn't cover the total cost of the health plan __PUNCT__ and in realiti each worker and famili absorb the rest of the cost in lower wage and diminish benefit __PUNCT__
but it provid essenti support for insur coverag __PUNCT__
mani worker ar perfectli content with thi arrang __PUNCT__ and under my reform plan thei would be abl to keep that coverag __PUNCT__
their employ __PUNCT__ provid health plan would be larg untouch and unchang __PUNCT__
but for everi american who want it __PUNCT__ anoth option would be avail __PUNCT__ everi year __PUNCT__ thei would receiv a tax credit directli __PUNCT__ with the same cash valu of the credit for employe in big compani __PUNCT__ in a small busi __PUNCT__ or self __PUNCT__ emploi __PUNCT__
you simpli choos the insur provid that suit you best __PUNCT__
by mail or onlin __PUNCT__ you would then inform the govern of your select __PUNCT__
and the monei to help pai for your health care would be sent straight to that insur provid __PUNCT__
the health plan you chose would be as good as ani that an employ could choos for you __PUNCT__
it would be your and your famili health __PUNCT__ care plan __PUNCT__ and your to keep __PUNCT__
the valu of that credit __PUNCT__ __NUM__ dollar for individu __PUNCT__ __NUM__ dollar for famili __PUNCT__ would also be enhanc by the greater competit thi reform would help creat among insur compani __PUNCT__
million of american would be make their own health __PUNCT__ care choic again __PUNCT__
insur compani could no longer take your busi for grant __PUNCT__ offer narrow plan with escal cost __PUNCT__
it would help chang the whole dynam of the current system __PUNCT__ put individu and famili back in charg __PUNCT__ and forc compani to respond with better servic at lower cost __PUNCT__
it would help extend the advantag of stai with doctor and provid of your choic __PUNCT__
when american speak of __PUNCT__ our doctor __PUNCT__ it will mean someth again __PUNCT__ becaus thei won't have to chang from on doctor or on network to the next everi time thei chang employ __PUNCT__
thei have a medic __PUNCT__ home __PUNCT__ again __PUNCT__ deal with doctor who know and care about them __PUNCT__
these reform will take time __PUNCT__ and critic argu that when my propos tax credit becom avail it would encourag peopl to purchas health insur on the current individu market __PUNCT__ while signific weak in the market remain __PUNCT__
thei worri that american with pre __PUNCT__ exist condit could still be deni insur __PUNCT__
congress took the import step of provid some protect against the exclus of pre __PUNCT__ exist condit in the health insur portabl and account act in __NUM__ __PUNCT__
i support that legisl __PUNCT__ and noth in my reform will chang the fact that if you remain emploi and insur you will build protect against the cost of treat ani pre __PUNCT__ exist condit __PUNCT__
even so __PUNCT__ those without prior group coverag and those with pre __PUNCT__ exist condit do have the most difficulti on the individu market __PUNCT__ and we need to make sure thei get the high __PUNCT__ qualiti coverag thei need __PUNCT__
i will work tirelessli to address the problem __PUNCT__
but i won't creat anoth entitl program that washington will let get out of control __PUNCT__
nor will i saddl state with anoth unfund mandat __PUNCT__
the state have been veri activ in experi with wai to cover the __PUNCT__ uninsur __PUNCT__
the state of north carolina __PUNCT__ for exampl __PUNCT__ ha an agreement with blue cross to act as insur of __PUNCT__ last resort __PUNCT__
over thirti state have some form of __PUNCT__ high __PUNCT__ risk __PUNCT__ pool __PUNCT__ and over twenti state have plan that limit premium charg to peopl suffer an ill and who have been deni insur __PUNCT__
as presid __PUNCT__ i will meet with the governor to solicit their idea about a best practic model that state can follow __PUNCT__ a guarante access plan or gap that would reflect the best experi of the state __PUNCT__
i will work with congress __PUNCT__ the governor __PUNCT__ and industri to make sure that it is fund adequ and ha the right incent to reduc cost such as diseas manag __PUNCT__ individu case manag __PUNCT__ and health and well program __PUNCT__
these program reach out to peopl who ar at risk for differ diseas and chronic condit and provid them with nurs care manag to make sure thei receiv the proper care and avoid unnecessari treatment and emerg room visit __PUNCT__
the detail of a guarante access plan will be work out with the collabor and consent of the state __PUNCT__
but __PUNCT__ conceptu __PUNCT__ feder assist could be provid to a nonprofit gap that oper under the direct of a board that i nclude all stakehold group __PUNCT__ legisl __PUNCT__ insur __PUNCT__ busi and medic commun repres __PUNCT__ and __PUNCT__ most importantli __PUNCT__ patient __PUNCT__
the board would contract with insur to cover patient who have been deni insur and could join with other state plan to enlarg pool and lower overhead cost __PUNCT__
there would be reason limit on premium __PUNCT__ and assist would be avail for american below a certain incom level __PUNCT__
thi cooper among state in the purchas of insur would also be a crucial step in rid the market of both needless and costli regul __PUNCT__ and the domin in the market of onli a few insur compani __PUNCT__
right now __PUNCT__ there is a differ health insur market for everi state __PUNCT__
each on ha it own rule and restrict __PUNCT__ and often guarante inadequ competit among insur compani __PUNCT__
often these circumst prevent the best compani __PUNCT__ with the best plan and lowest price __PUNCT__ from make their product avail to ani american who want it __PUNCT__
we need to break down these barrier to competit __PUNCT__ innov and excel __PUNCT__ with the goal of establish a nation market to make the best practic and lowest price avail to everi person in everi state __PUNCT__
anoth sourc of needless cost and troubl in the health care system come from the trial bar __PUNCT__
everi patient in america must have access to legal remedi in case of bad medic practic __PUNCT__
but thi vital principl of law and medicin is not an invit to endless __PUNCT__ frivol lawsuit from trial lawyer who exploit both patient and physician alik __PUNCT__
we must pass medic liabil reform __PUNCT__ and those reform should elimin lawsuit direct at doctor who follow clinic guidelin and adher to patient safeti protocol __PUNCT__
if senat obama and senat clinton ar sincer in their convict that health care coverag and qualiti is their first prioriti __PUNCT__ then thei will put the need of patient befor the demand of trial lawyer __PUNCT__
thei can't have it both wai __PUNCT__
we also know from experi that coordin care __PUNCT__ provid collabor to produc the best health outcom __PUNCT__ offer better qualiti and can cost less __PUNCT__
we should pai a singl bill for high __PUNCT__ qualiti diseas care __PUNCT__ not an endless seri of bill for pre __PUNCT__ surgic test and visit __PUNCT__ hospit and surgeri __PUNCT__ and follow __PUNCT__ up test __PUNCT__ drug and offic visit __PUNCT__
pai for coordin care mean that everi singl provid is now unit on be respons to the need of a singl person __PUNCT__ the patient __PUNCT__
health inform technolog will flourish becaus the market will demand it __PUNCT__
in the same wai __PUNCT__ clinic __PUNCT__ hospit __PUNCT__ doctor __PUNCT__ medic technolog produc __PUNCT__ drug compani and everi other provid of health care must be account to their patient and their transact transpar __PUNCT__
american should have access to inform about the perform and safeti record of doctor and other health care provid and the qualiti measur thei us __PUNCT__
famili __PUNCT__ insur compani __PUNCT__ the govern __PUNCT__ whoever is pai the bill __PUNCT__ must understand exactli what their care cost and the outcom thei receiv __PUNCT__
famili also place a high valu on quickli get simpl care __PUNCT__ and have shown a willing to pai cash to get it __PUNCT__
if walk __PUNCT__ in clinic in retail outlet ar the most conveni __PUNCT__ cost __PUNCT__ effect wai for famili to safe meet simpl need __PUNCT__ then no polici of govern should stand in their wai __PUNCT__
and if the cheapest wai to get high qualiti care is to us advanc in web technolog to allow a doctor to practic across state line __PUNCT__ then let them __PUNCT__
as you know better than i do __PUNCT__ the best treatment is earli treatment __PUNCT__
the best care is prevent care __PUNCT__
and by far the best prescript for good health is to steer clear of high __PUNCT__ risk behavior __PUNCT__
the most obviou case of all is smoke cigarett __PUNCT__ which still account for so much avoid diseas __PUNCT__
peopl make their own choic in thi countri __PUNCT__ but we in govern have respons and choic of our own __PUNCT__
most smoker would love to quit but find it hard to do so __PUNCT__
we can improv live and reduc chronic diseas through smoke cessat program __PUNCT__
i will work with busi and insur compani to promot the avail and us of these program __PUNCT__
smoke is just on caus of chronic diseas that could be avoid or better manag __PUNCT__ and the nation resourc that could be save by a greater emphasi on prevent care __PUNCT__
chronic condit __PUNCT__ such as cancer __PUNCT__ heart diseas __PUNCT__ high blood pressur __PUNCT__ diabet and asthma __PUNCT__ account for three __PUNCT__ quarter of the nation annual health __PUNCT__ care bill __PUNCT__
in so mani case thi suffer could be avert by earli test and screen __PUNCT__ as in the case of colon and breast cancer __PUNCT__
diabet and heart diseas rate ar also increas todai with rise of obes in the unit state __PUNCT__ even among children and teenag __PUNCT__
we need to creat a __PUNCT__ next gener __PUNCT__ of chronic diseas prevent __PUNCT__ earli intervent __PUNCT__ new treatment model and public health infrastructur __PUNCT__
we need to us technolog to share inform on __PUNCT__ best practic __PUNCT__ in health care so everi physician is up __PUNCT__ to __PUNCT__ date __PUNCT__
we need to adopt new treatment program and fi nancial incent to adopt __PUNCT__ health habit __PUNCT__ for those with the most common condit such as diabet and obes that will improv their qualiti of life and reduc the cost of their treatment __PUNCT__
watch your diet __PUNCT__ walk thirti or so minut a dai __PUNCT__ and take a few other simpl precaut __PUNCT__ and you won't have to worri about these afflict __PUNCT__
but mani of us never quit get around to it __PUNCT__ and the wake __PUNCT__ up call doesn't come until the ambul arriv or we face a tough diagnosi __PUNCT__
we can make tremend improv in the cost of treat chronic diseas by us modern inform technolog to collect inform on the practic pattern __PUNCT__ cost and effect of physician __PUNCT__
by simpli document and dissemin inform on best practic we can elimin those costli practic that don't yield correspond valu __PUNCT__
by reform payment system to focu on payment for best practic and qualiti outcom __PUNCT__ we will acceler thi import chang __PUNCT__
govern program such as medicar and medicaid should lead the wai in health care reform that improv qualiti and lower cost __PUNCT__
medicar reimburs now reward institut and clinician who provid more and more complex servic __PUNCT__
we need to chang the wai provid ar paid to focu their attent more on chronic diseas and manag their treatment __PUNCT__
thi is the most import care for an ag popul __PUNCT__
there have been a varieti of state __PUNCT__ base experi such as cash and counsel or the program of all __PUNCT__ inclus care for the elderli __PUNCT__ pace __PUNCT__ that ar differ from the inflex approach for deliv care to peopl in the home set __PUNCT__
senior ar given a monthli allow that thei can us to hire worker and purchas care __PUNCT__ relat servic and good __PUNCT__
thei can get help manag their care by design repres __PUNCT__ such as rel or friend __PUNCT__ to help make decis __PUNCT__
it also offer counsel and bookkeep servic to assist consum in handl their programmat respons __PUNCT__
in these approach __PUNCT__ particip were much more like to have their need met and be satisfi with their care __PUNCT__
moreov __PUNCT__ ani concern about consum __PUNCT__ safeti appear misplac __PUNCT__
for everi ag group in everi state __PUNCT__ particip were no more like to suffer care __PUNCT__ relat health problem __PUNCT__
govern can provid leadership to solv problem __PUNCT__ of cours __PUNCT__
so often it come down to person respons __PUNCT__ the duti of everi adult in america to look after themselv and to safeguard the gift of life __PUNCT__
but wise govern polici can make prevent care the standard __PUNCT__
it can put the best practic of prevent care in action all across our health __PUNCT__ care system __PUNCT__
over time that on standard alon __PUNCT__ consist appli in everi doctor offic __PUNCT__ hospit __PUNCT__ and insur compani in america __PUNCT__ will save more live than we could ever count __PUNCT__
and everi year __PUNCT__ it will save mani billion of dollar in the health __PUNCT__ care economi __PUNCT__ make medic care better and medic coverag more afford for everi citizen in thi countri __PUNCT__
good health is incent enough to live well and avoid risk __PUNCT__ as we all remind now and then when good health is lost __PUNCT__
but if anyon ever requir further motiv __PUNCT__ thei need onli visit a place like the moffitt center __PUNCT__ where all the brillianc and resourc of human ar focus on the task of save live and reliev suffer __PUNCT__
you an inspir __PUNCT__ and not onli to your patient __PUNCT__
you a remind of all that good in american health care __PUNCT__ and we need that remind sometim in washington __PUNCT__
i thank you for your kind attent thi morn __PUNCT__ i thank you for the heroic work you have done here __PUNCT__ and i wish you success in the even greater work that li ahead __PUNCT__
