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requires us to come forward with more spending cuts if the savings we promised don t materialize. [Applause.] Now, part of the reason I faced a trillion-dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for from the Iraq war to tax breaks for the wealthy. [Applause.] I will not make that same mistake with health care. Second, we ve estimated that most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse. Right now, too much of the hard-earned savings and tax dollars we spend on health care don t make us any healthier. That s not my judgment it s the judgment of medical professionals across this country. And this is also true when it comes to Medicare and Medicaid. In fact, I want to speak directly to seniors for a moment, because Medicare is another issue that s been subjected to demagoguery and distortion during the course of this debate. More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years. That s how Medicare was born. And it remains a sacred trust that must be passed down from one generation to the next. [Applause.] And that is why not a dollar of the Medicare trust fund will be used to pay for this plan. [Applause.] The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies subsidies that do everything to pad their prof-
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its but don t improve the care of seniors. And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead. [Applause.] Now, these steps will ensure that you America s seniors get the benefits you ve been promised. They will ensure that Medicare is there for future generations. And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pockets for prescription drugs. [Applause.] That s what this plan will do for you. So don t pay attention to those scary stories about how your benefits will be cut, especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past and just this year supported a budget that would essentially have turned Medicare into a privatized voucher program. That will not happen on my watch. I will protect Medicare. [Applause.] Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody. We have long known that some places like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania offer high-quality care at costs below average. So the commission can help encourage the adoption of these commonsense best practices by doctors and medical professionals throughout the system everything from reducing hospital infection rates to encouraging better coordination between teams of doctors.
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Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan. [Applause.] Now, much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers. And this reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money an idea which has the support of Democratic and Republican experts. And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long run. Now, finally, many in this chamber particularly on the Republican side of the aisle have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. [Applause.] Now there you go. There you go. Now, I don t believe malpractice reform is a silver bullet, but I ve talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. [Applause.] So I m proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. [Applause.] I know that the Bush administration considered authorizing demonstration projects in individual states to test these ideas. I think it s a good idea, and I m directing my Secretary of Health and Human Services to move forward on this initiative today. [Applause.] Now, add it all up, and the plan I m proposing will cost around $900 billion over ten years less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress
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passed at the beginning of the previous administration. [Applause.] Now, most of these costs will be paid for with money already being spent but spent badly in the existing health care system. The plan will not add to our deficit. The middle class will realize greater security, not higher taxes. And if we are able to slow the growth of health care costs by just one-tenth of 1 percent each year one-tenth of 1 percent it will actually reduce the deficit by $4 trillion over the long term. Now, this is the plan I m proposing. It s a plan that incorporates ideas from many of the people in this room tonight Democrats and Republicans. And I will continue to seek common ground in the weeks ahead. If you come to me with a serious set of proposals, I will be there to listen. My door is always open. But know this: I will not waste time with those who have made the calculation that it s better politics to kill this plan than to improve it. [Applause.] I won t stand by while the special interests use the same old tactics to keep things exactly the way they are. If you misrepresent what s in this plan, we will call you out. [Applause.] And I will not and I will not accept the status quo as a solution. Not this time. Not now. Everyone in this room knows what will happen if we do nothing. Our deficit will grow. More families will go bankrupt. More businesses will close. More Americans will lose their coverage when they are sick and need it the most. And more will die as a result. We know these things to be true. That is why we cannot fail. Because there are too many Americans counting on us to succeed the ones who suffer
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