thank so much for that kind introduct __PUNCT__
it all true __PUNCT__
it an honor for me to be here in iowa todai __PUNCT__
and i want to thank you for join me in thi nation discuss about our healthcar system __PUNCT__
afford health coverag is a fade dream for mani famili __PUNCT__ famili who all too often ar wake to the nightmar of a sick child or parent __PUNCT__
these ar the fact __PUNCT__
over __NUM__ million of our fellow american do not have health insur __PUNCT__
sinc __NUM__ health care premium for famili have nearli doubl __PUNCT__
by some estim __PUNCT__ __NUM__ american live ar lost each year becaus of inadequ health insur __PUNCT__
we need univers healthcar now __PUNCT__
despit republican hand __PUNCT__ wring about the cost of univers care __PUNCT__ it is clear that the cost of do someth __PUNCT__ in live and dollar __PUNCT__ pale in comparison to the cost of do noth __PUNCT__
we cannot afford a healthcar system that doesn't cover everi american __PUNCT__
the cost to our economi and the well __PUNCT__ be of our peopl is just too high __PUNCT__
todai __PUNCT__ we as a nation need to be respons steward of the health of our children and parent __PUNCT__ our brother and sister __PUNCT__ our husband and wive __PUNCT__
presid bush ha fail thi basic test of american decenc __PUNCT__
the respons of the bush administr to the healthcar crisi ha been predict pervers __PUNCT__
not content to sit back and do noth __PUNCT__ presid bush is now threaten to veto the s __PUNCT__ chip legisl __PUNCT__ which would effect forc state to drop coverag for up to a million children __PUNCT__
let be clear __PUNCT__ right now __PUNCT__ presid bush health care plan is to elimin the health coverag of nearli a million children __PUNCT__
that not polici __PUNCT__ it punish __PUNCT__
we need a govern that make it easier __PUNCT__ not harder __PUNCT__ to keep our kid healthi __PUNCT__
we need a presid who believ that everi american should have access to qualiti healthcar __PUNCT__
everi american __PUNCT__
period __PUNCT__
but we should also rememb that good intent ar not a polici __PUNCT__
we need a common __PUNCT__ sens __PUNCT__ american solut to thi american problem __PUNCT__
we need a system that work __PUNCT__
my plan is built on common __PUNCT__ sens principl __PUNCT__
we have to rememb the virtu of person respons __PUNCT__ but we cannot forget we all in thi togeth __PUNCT__
we need to recogn that choic is good __PUNCT__ but onli if there ar good choic for everyon __PUNCT__
i believ that your health and the health of your love on should not depend on your station in life __PUNCT__
all american deserv qualiti healthcar __PUNCT__ whether you a ditchdigg or a ceo __PUNCT__ or a bu driver or a teacher __PUNCT__ or a doctor __PUNCT__
even the rich suffer the poverti of sick __PUNCT__
cancer and diabet don't ask for bank statement befor thei strike __PUNCT__
and so __PUNCT__ first __PUNCT__ we guarante coverag for all american __PUNCT__
the path to univers health coverag will not be easi __PUNCT__ but it is both the right and righteou thing to do __PUNCT__
univers healthcar is not onli a moral imper __PUNCT__ it is also an econom imper __PUNCT__
the lack of guarante __PUNCT__ qualiti healthcar coverag cost us up to __NUM__ billion dollar each year in lost product __PUNCT__
by __NUM__ the averag famili that doe have insur will pai an extra __NUM__ hundr dollar to cover those that don't __PUNCT__
coverag my plan build on exist model to rapidli expand coverag __PUNCT__
my plan doe not build new bureaucraci __PUNCT__
the last thing we need between patient and doctor is anoth sticki web of red tape __PUNCT__
and we don't need a on __PUNCT__ size __PUNCT__ fit __PUNCT__ all system __PUNCT__ american deserv better than that __PUNCT__
my plan offer five effect option for deliv qualiti coverag __PUNCT__ plan for veteran __PUNCT__ lower __PUNCT__ incom children and famili __PUNCT__ young adult __PUNCT__ american __NUM__ to __NUM__ and work famili and small busi __PUNCT__
some of my colleagu in washington seem to have forgotten that work famili and small busi __PUNCT__ not politician __PUNCT__ ar the engin that make our economi work __PUNCT__
we need a healthcar system that work for them __PUNCT__
and when i am elect __PUNCT__ thei will be abl to purchas the same plan that member of congress and the presid have __PUNCT__
under my plan __PUNCT__ we will expand medicar as a choic for american __NUM__ to __NUM__ __PUNCT__
thi is just plain common sens __PUNCT__
new research from the new england journal of medicin show that thi could reduc cost by ensur that older adult get the cancer screen and other prevent servic that thei need __PUNCT__
it about time that thi great societi program reach more of our societi member __PUNCT__
young adult up to ag twenti __PUNCT__ five will be given the option of keep their famili coverag regardless of student statu __PUNCT__
too mani young peopl ar left exclud and vulner as thei transit into adulthood __PUNCT__
our young peopl ar too valuabl a resourc to leav unprotect __PUNCT__
with my plan __PUNCT__ lower __PUNCT__ incom children and famili will obtain coverag through expand medicaid and s __PUNCT__ chip program __PUNCT__
and my plan doesn't forget about the well __PUNCT__ be of our nation veteran __PUNCT__
our veteran ar not ask for the parad or honor thei earn so mani time over __PUNCT__ thei simpli ask for the same decent medic coverag that so mani of us civilian take for grant __PUNCT__
and __PUNCT__ thei shouldn't have to ask __PUNCT__
that why i will creat a hero health card that provid veteran with the care thei deserv __PUNCT__ where thei need it __PUNCT__ without bureaucrat hassl __PUNCT__
at the same time __PUNCT__ we will strengthen the va system by guarante fund from year to year __PUNCT__ so that thei can directli access the high __PUNCT__ qualiti care thei were promis __PUNCT__
these men and women fought the enemi abroad __PUNCT__
thei should not have to fight their govern at home to get the health care thei need __PUNCT__
cost my vision of american healthcar begin with individu choic and share respons __PUNCT__
to ensur that everi american get qualiti coverag __PUNCT__ we need to ensur that everi american ha a stake in the system __PUNCT__
therefor __PUNCT__ by the end of my first term __PUNCT__ my plan will requir that all american obtain coverag for themselv and their famili __PUNCT__
all american will be respons for their fair share __PUNCT__
employ will be requir to contribut to their employe __PUNCT__ healthcar premium __PUNCT__ or pai to help the uninsur purchas coverag __PUNCT__
make no mistak __PUNCT__ we ar go to pai for thi __PUNCT__ on wai or anoth __PUNCT__
we ar pai hundr of billion for the uninsur now __PUNCT__ peopl who delai and skip the care thei need wind up in emerg room and have the cost of their chronic diseas spiral unnecessarili out of control __PUNCT__
my plan fairli distribut the cost and will dramat reduc the expens we ar alreadi pai __PUNCT__
insur compani have to be part of the healthcar solut __PUNCT__ not part of the problem __PUNCT__
we will requir these compani to insur anyon who want coverag __PUNCT__ instead of cherri __PUNCT__ pick the healthiest of our citizen __PUNCT__
if onli the healthi need health insur __PUNCT__ we wouldn't have a problem __PUNCT__
i believ that everyon deserv coverag regardless of health or financi statu __PUNCT__
we ar build a nation hous of healthcar __PUNCT__ and we cannot afford to turn ani american awai __PUNCT__
we must also recogn that avail coverag is meaningless unless it afford __PUNCT__
american who need help pai for coverag will get a slide __PUNCT__ scale tax credit to help out __PUNCT__
mani famili ar forc to charg medic expens to their credit card __PUNCT__ often result in outrag interest rate that quickli spiral out of control __PUNCT__
american household with a major medic expens in the past three year have an averag of almost __MONEY__ more credit __PUNCT__ card debt __PUNCT__
i will set limit on the interest rate that can be impos on medic expens charg to credit card __PUNCT__
it is simpli wrong for credit __PUNCT__ card compani to exploit the ill and misfortun of famili __PUNCT__ and we will stop thi practic __PUNCT__
control cost __PUNCT__ overal just as import as help some afford health coverag __PUNCT__ is make sure that healthcar cost ar lower for all __PUNCT__
we spend __NUM__ trillion dollar a year on health care in thi countri __PUNCT__
__NUM__ trillion dollar __PUNCT__
we all know that we not get what we paid for __PUNCT__
first of all __PUNCT__ we spend too much on bureaucraci __PUNCT__ up to __NUM__ percent of nation health care expenditur go toward administr __PUNCT__
we need more doctor treat patient and fewer bureaucrat push paper __PUNCT__
how do we do that __PUNCT__ i would requir insur compani to spend less on administr and at least __NUM__ __PUNCT__ on direct care __PUNCT__ i would standard their form __PUNCT__ and i would simplifi report requir for physician and hospit __PUNCT__
right now __PUNCT__ there ar nearli thirti feder agenc involv in regul hospit __PUNCT__ not to mention state __PUNCT__ local and privat organ __PUNCT__
we can do better __PUNCT__
in addit __PUNCT__ we could save almost __NUM__ billion dollar everi year by improv our health inform technolog __PUNCT__
thi is a modern problem and we need to us modern tool to fix it __PUNCT__
i would allow medicar to negoti directli for prescript drug __PUNCT__
perhap most importantli __PUNCT__ we need to drastic shift our focu from the endgam to the pre __PUNCT__ game __PUNCT__
that mean seriou invest in prevent __PUNCT__
a wise man onc said that __PUNCT__ an ounc of prevent is worth a pound of the cure __PUNCT__
but i doubt even he imagin that our feder govern would spend __NUM__ billion dollar per year to treat diabet __PUNCT__ but onli four billion to prevent and manag the diseas __PUNCT__
that just doesn't make sens __PUNCT__
we need to requir that all health plan cover a standard set of proven prevent servic __PUNCT__
if there on thing better than a patient be cure of a diseas __PUNCT__ it hi never have had it at all __PUNCT__
as presid __PUNCT__ i will help commun get junk food out of their school and physic educ back in __PUNCT__ just like we done in new mexico __PUNCT__
i would also sign a nationwid smoke ban in workplac __PUNCT__ as i have in new mexico __PUNCT__
smoke caus over four hundr thousand death per year and cost us at least __NUM__ billion dollar __PUNCT__
we cannot claim to be seriou about public health unless we ar seriou about get smoke out of public place __PUNCT__
qualiti of care final __PUNCT__ we need to improv qualiti of care __PUNCT__
it the right thing to do for our peopl and for our economi __PUNCT__
medicar alon could save nearli __NUM__ billion dollar a year __PUNCT__ while improv patient outcom __PUNCT__ if everybodi in the program got the highest __PUNCT__ qualiti __PUNCT__ most __PUNCT__ effici care __PUNCT__
there ar six common __PUNCT__ sens step we can take to improv care __PUNCT__ first __PUNCT__ i will ensur that health care provid have the tool thei need __PUNCT__
these includ electron medic record and reimburs for provid proven prevent care __PUNCT__
these tool ar just as import to improv care as stethoscop and syring __PUNCT__
second __PUNCT__ i will promot evid __PUNCT__ base care __PUNCT__
i will form a public __PUNCT__ privat partnership to research the compar effect of new drug __PUNCT__ devic __PUNCT__ test and treatment __PUNCT__
again __PUNCT__ thi is simpl common sens __PUNCT__
treatment should be determin by ration research __PUNCT__ not by the size of an advertis budget __PUNCT__
third __PUNCT__ i will improv patient safeti __PUNCT__
we have to expand train program __PUNCT__ requir healthcar facil to report prevent error __PUNCT__ and support hospit that ar work to improv patient safeti and prevent avoid hospit __PUNCT__
prevent medic error cost our nation up to __NUM__ billion dollar and __NUM__ live everi year __PUNCT__
fourth __PUNCT__ we need to expand our healthcar workforc __PUNCT__ includ more primari care provid __PUNCT__
we need to recruit and train an armi of doctor and nurs to fight off the scourg of sick __PUNCT__
i expand incent to encourag primari care and rural physician through an expand train and scholarship program __PUNCT__
fifth __PUNCT__ i will promot chronic diseas and mental health manag __PUNCT__
state __PUNCT__ of __PUNCT__ the __PUNCT__ art program provid to va and medicar patient with sever chronic diseas have alreadi achiev dramat result __PUNCT__ includ a __NUM__ __PUNCT__ reduct in hospit among patient with chronic heart failur i will continu to champion full pariti between mental health and physic health benefit in all health plan __PUNCT__
and i will promot better mental health care by support the format of integr primari care team that includ primari care and mental health provid __PUNCT__
expand these program and thi approach could dramat improv qualiti of life __PUNCT__ reduc avoid hospit __PUNCT__ and save ten of billion of dollar per year __PUNCT__
and sixth __PUNCT__ i would reduc healthcar dispar base on race and ethnic __PUNCT__
these dispar ar simpli unaccept and un __PUNCT__ american __PUNCT__
by expand insur and outreach to underinsur minor group __PUNCT__ we can address such dispar in aid __PUNCT__ diabet and other diseas __PUNCT__
todai __PUNCT__ i have tri to lai out the principl __PUNCT__ object __PUNCT__ and detail method that i think should guid healthcar in america __PUNCT__
my plan provid choic __PUNCT__ includ the choic to keep your current coverag __PUNCT__ and exist program to expand coverag option __PUNCT__
we reduc the cost of healthcar for all and we pai for univers coverag by creat save __PUNCT__ not rais tax __PUNCT__
we reduc bureaucraci and administr and invest in qualiti of care __PUNCT__
as with ani worthwhil invest __PUNCT__ my plan will requir capit up front __PUNCT__ about __NUM__ billion dollar per year __PUNCT__
by make healthcar more coordin __PUNCT__ safe __PUNCT__ and effici __PUNCT__ by invest in health inform technolog __PUNCT__ and by spend what we have wise in the wai i have describ __PUNCT__ my plan will save us up to __NUM__ billion dollar everi year __PUNCT__
so __PUNCT__ thi is a fiscal respons plan __PUNCT__
i a governor __PUNCT__ i am requir to balanc my state budget __PUNCT__
i have done that five time while expand access to health care and make hundr of million in new health care invest for new mexico famili __PUNCT__
we cannot afford a healthcar system that doesn't cover everi american __PUNCT__
and we cannot afford to wait ani longer __PUNCT__
now is the time __PUNCT__
for the forti __PUNCT__ five million uninsur who have suffer the loneli of indiffer __PUNCT__ now is the time __PUNCT__
for the hard __PUNCT__ work american strangl by the cost of care __PUNCT__ now is the time __PUNCT__
for the wound veteran who have serv their nation honor __PUNCT__ now is the time __PUNCT__
for everi daughter who ha watch her mother slowli pass from a treatabl diseas __PUNCT__ for everi father who li awak at night becaus he can't afford hi son insur __PUNCT__ now is the time __PUNCT__
for everi american who want to look a suffer love on in the ey and tell them that tomorrow will be better than todai __PUNCT__ now is the time __PUNCT__
for the good of our nation __PUNCT__ now must be the time __PUNCT__
thank you __PUNCT__
