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Remarks of President Barack Obama – As Prepared for DeliveryAmerican Medical AssociationChicago, Illinois June 15, 2009
 From the moment I took office as President, the central challenge we have confronted asa nation has been the need to lift ourselves out of the worst recession since World WarII. In recent months, we have taken a series of extraordinary steps, not just to repair theimmediate damage to our economy, but to build a new foundation for lasting andsustained growth. We are creating new jobs. We are unfreezing our credit markets.And we are stemming the loss of homes and the decline of home values. But even as we have made progress, we know that the road to prosperity remains longand difficult. We also know that one essential step on our journey is to control thespiraling cost of health care in America. Today, we are spending over $2 trillion a year on health care – almost 50 percent moreper person than the next most costly nation. And yet, for all this spending, more of ourcitizens are uninsured; the quality of our care is often lower; and we aren’t anyhealthier. In fact, citizens in some countries that spend less than we do are actuallyliving longer than we do. Make no mistake: the cost of our health care is a threat to our economy. It is anescalating burden on our families and businesses. It is a ticking time-bomb for thefederal budget. And it is unsustainable for the United States of America. It is unsustainable for Americans like Laura Klitzka, a young mother I met in Wisconsinlast week, who has learned that the breast cancer she thought she’d beaten had spreadto her bones; who is now being forced to spend time worrying about how to cover the
 
$50,000 in medical debts she has already accumulated, when all she wants to do isspend time with her two children and focus on getting well. These are not worries awoman like Laura should have to face in a nation as wealthy as ours. Stories like Laura’s are being told by women and men all across this country – byfamilies who have seen out-of-pocket costs soar, and premiums double over the lastdecade at a rate three times faster than wages. This is forcing Americans of all ages togo without the checkups or prescriptions they need. It’s creating a situation where asingle illness can wipe out a lifetime of savings.Our costly health care system is unsustainable for doctors like Michael Kahn in NewHampshire, who, as he puts it, spends 20 percent of each day supervising a staffexplaining insurance problems to patients, completing authorization forms, and writingappeal letters; a routine that he calls disruptive and distracting, giving him less time todo what he became a doctor to do and actually care for his patients. Small business owners like Chris and Becky Link in Nashville are also struggling.They’ve always wanted to do right by the workers at their family-run marketing firm,but have recently had to do the unthinkable and lay off a number of employees – layoffsthat could have been deferred, they say, if health care costs weren’t so high. Across thecountry, over one third of small businesses have reduced benefits in recent years andone third have dropped their workers’ coverage altogether since the early 90’s. Our largest companies are suffering as well. A big part of what led General Motors andChrysler into trouble in recent decades were the huge costs they racked up providinghealth care for their workers; costs that made them less profitable, and less competitivewith automakers around the world. If we do not fix our health care system, Americamay go the way of GM; paying more, getting less, and going broke. When it comes to the cost of our health care, then, the status quo is unsustainable.Reform is not a luxury, but a necessity. I know there has been much discussion aboutwhat reform would cost, and rightly so. This is a test of whether we – Democrats andRepublicans alike – are serious about holding the line on new spending and restoringfiscal discipline.
 
 But let there be no doubt – the cost of inaction is greater. If we fail to act, premiums willclimb higher, benefits will erode further, and the rolls of uninsured will swell to includemillions more Americans. If we fail to act, one out of every five dollars we earn will be spent on health care withina decade. In thirty years, it will be about one out of every three – a trend that will meanlost jobs, lower take-home pay, shuttered businesses, and a lower standard of living forall Americans. And if we fail to act, federal spending on Medicaid and Medicare will grow over thecoming decades by an amount almost equal to the amount our government currentlyspends on our nation’s defense. In fact, it will eventually grow larger than what ourgovernment spends on anything else today. It’s a scenario that will swamp our federaland state budgets, and impose a vicious choice of either unprecedented tax hikes,overwhelming deficits, or drastic cuts in our federal and state budgets. To say it as plainly as I can, health care reform is the single most important thing we cando for America’s long-term fiscal health. That is a fact.And yet, as clear as it is that our system badly needs reform, reform is not inevitable.There’s a sense out there among some that, as bad as our current system may be, thedevil we know is better than the devil we don’t. There is a fear of change – a worry thatwe may lose what works about our health care system while trying to fix what doesn’t.I understand that fear. I understand that cynicism. They are scars left over from pastefforts at reform. Presidents have called for health care reform for nearly a century.Teddy Roosevelt called for it. Harry Truman called for it. Richard Nixon called for it. Jimmy Carter called for it. Bill Clinton called for it. But while significant individualreforms have been made – such as Medicare, Medicaid, and the children’s healthinsurance program – efforts at comprehensive reform that covers everyone and bringsdown costs have largely failed.
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