Tuesday, April 29, 2008


4/28/08 Remarks as prepared for delivery at Miami Children's Hospital, in Miami, FL, today at 10:00 a.m. EDT:

It is indeed an honor to be here today at Miami's Children's Hospital. I am humbled to be in the presence of a group that has displayed such overwhelming strength, fortitude, and love of life. And I look forward to hearing your stories, stories that will be a testament as well to the power of innovation and medical science to improve our lives.

I join with all Americans in looking forward to a future of exciting breakthroughs, exploration of the human genome, and technological advances. The vibrancy of American medical science is the envy of the world.

Advances of this sort allow an infant born with complex congenital heart disease to survive and thrive, a vigorous young boy to survive an awful accident, and another to fight the ravages of brain cancer. Our medical professionals have developed surgical procedures to correct bilateral cleft, and our medical device industries invent innovative breathing support. But those efforts are surpassed by the willingness of American families to overcome obstacles, take responsibility for their futures, and look forward to a better life.

As President, I pledge to preserve the foundations that deliver innovation and hope to those who are in need of modern medicine. I will work to eliminate the worries over the availability and cost of health care that trouble the waking hours and disturb the sleep of more Americans than any other single domestic issue.

Despite its many virtues, the health care system as a whole does not mirror the successes in this room. As a nation, we do not uniformly deliver the best possible care. Shortfalls in patient safety and medical errors remain a dangerous reality, and too many Americans do not have health insurance.

But most importantly, our health care is too expensive. We spend a staggering amount of money on health care -- over $2 trillion and almost twice as much as any other country per person. Within the decade total health care spending will more than double and consume nearly one out of every five dollars in America.

These costs are a threat to the ability of Americans to have health insurance, the gateway to better health care. These costs are a threat as well to the ability of American workers to build a better life. Rising costs of health care and health insurance have squeezed the wages that workers earn and consumed the budgets of their families.

I have devoted much of my campaign to a discussion with Americans of my commitment to better care, at lower cost, for all Americans. I understand how important it is for families to be in control of their health care system, and not the reverse. And I want to help chart the right path to that laudable goal.

I am convinced that the wrong way to go is to turn over your lives to the government and hope it will all be fine. It won't. That route ignores the lessons of other countries where governments pay the bills, but real people pay a deeper cost through long waits for treatment or settling for care that does not take advantage of the latest medical science. It ignores the lessons of our own experience where Medicare beneficiaries have "access" on paper while doctors stop taking patients; where our promise to take care of our veterans is betrayed by inaccessible locations and long lines.

My approach to transforming health care is to put families in charge. I believe Americans want to be part of a system that offers better care at lower cost for all Americans, and that respects their individual dignity. We must reform the health care system to make it responsive to the needs of American families. Not the government. Not the insurance companies. Not tort lawyers. Not even the doctors and hospitals.

The next president will have to take on the parochial interests that thrive in the health care system. Doctors must do a better job of managing our care and keeping us healthy and out of hospitals and nursing homes. We will need alternatives to doctors' offices and emergency rooms. Hospitals must do a better job of taking care of us when we are there, commit fewer deadly and costly medical errors and generally operate more efficiently. Pharmaceutical companies must worry less about squeezing additional profits from old medicines by copying the last successful drug and insisting on additional patent protections and focus more on new and innovative medicine. Insurance companies should spend more on medical care and less on "administration."

We must move away from a system that is fragmented and pays for expensive procedures toward one where a family has a medical home, providers coordinate their efforts and take advantage of technology to do so cheaply, and where the focus is on affordable quality outcomes.
America can have a health care system that is characterized by better prevention, coordinated care, electronic health records, cutting-edge treatments -- and lower costs. America can have a health insurance system that innovates to provide policies that meet the needs of families, and that travel with Americans from job to job.

Government can play its part with public health programs that teach the need for personal responsibility to address chronic diseases, especially with the epidemic of obesity among our adults and children. We should again teach nutrition and physical education to our children, and better inform adults what our foods contain and the importance of exercise.

We can build a health care system that is more responsive to our needs and is delivered to more people at lower cost. The "solution," my friends, isn't a one-size-fits-all-big government takeover of health care. It resides where every important social advance has always resided - with the American people themselves, with well informed American families, making practical decisions to address their imperatives for better health and more secure prosperity. The engine of our prosperity and progress has always been our freedom and the sense of responsibility for and control of our own destiny that freedom requires. The public's trust in government waxes and wanes. But we have always trusted in ourselves to meet any challenge that required only our ingenuity and industry to surmount. Any "solution" that robs us of that essential sense of ourselves is a cure far worse than the affliction it is meant to treat.

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