Wednesday, April 30, 2008

"McCain's Progress"

"John McCain delivered another speech yesterday on health care that offered a sophisticated set of policies that could lead to some of the most constructive changes to the system in decades." -- Wall Street Journal

"McCain's Progress"
Editorial
The Wall Street Journal
April 30, 2008

The Grand Guignol between Hillary Clinton and Barack Obama has to end eventually, and then the public discomfort over health care will resurface as a genuine policy dispute between the Democratic and Republican nominees. For a man whose heterodoxies have no doubt triggered GOP heartburn, John McCain delivered another speech yesterday on health care that offered a sophisticated set of policies that could lead to some of the most constructive changes to the system in decades.

It is good news for his candidacy if Mr. McCain is making space now for political creativity and policy risks. Last week he laid down an economic plan, even venturing to Democratic redoubts like Youngstown, Ohio, and New Orleans's Ninth Ward. Now he has returned to his health-care reform, based on market principles and increased consumer choice, which he first outlined during the primaries.

The Senator is also starting to enfold these ideas in a larger narrative that will be indispensable in the philosophical fight that is so clearly ordained for the general election between private and government health care. Mr. McCain undertook yesterday to recast this looming argument in a new mold. He contended that the health insurance and delivery system is in fact failing many Americans -- but that it was failing because of market distortions mostly created by the government itself. Fixing these irrationalities would both make insurance more affordable and increase overall coverage in the bargain. Nor would it require the vast new entitlement programs Democrats are eyeing.

His major proposal would change the tax treatment of insurance. To review: Today's tax code permits businesses to deduct the cost of providing insurance to their employees, but it doesn't do the same for individuals. This creates third-party payment problems; workers aren't aware of the full, true costs of many treatment decisions, part of the reason the U.S. has double-digit health-care inflation. And it makes insurance less affordable for everyone outside the employer-based system, who must pay with after-tax dollars besides. Mr. McCain would correct this imbalance with a refundable tax credit, restoring the parity of health dollars.

As the Senator argued, coverage shouldn't be "limited by where you work" and said that "Americans need new choices beyond those offered in employment-based coverage." Focusing on equity is a canny political argument. For those who don't get insurance through their employers, the current system is patently unfair. As the private market for health insurance became revitalized, everyone else would be more liberated from their bosses' system. A significant portion of the uninsured population at any given point is people who left or lost employment; but portable individual policies would follow them from job to job.

That's a broader political and economic argument than the exclusive liberal concentration on the uninsured. Mr. McCain is saying that the health-care system isn't working as it should, or delivering the quality it should, for the large majority of Americans. "The real reform," he noted, "is to restore control over our health-care system to the patients themselves," introducing more competition on price into the system.

It's true that individual subsidies might be required for some people with severe chronic illnesses who might have a harder time finding private insurance in this kind of world. So Mr. McCain sharpened his proposal for high-risk pools to cover "uninsurables," building on current insurance experiments in about two dozen states. Such provisions are crucial to a functioning market but also blunt a political liability that Democrats were eager to exploit in the fall's debates, suggesting that Mr. McCain is preparing to frontally assault liberal health-care assumptions.

If Mr. McCain's plan is short of ideal, the innovative portions outweigh its false lunges. It also energizes the intellectual progress conservatives have made in recent years in their health-care thinking. Not least, it marks significant progress for Mr. McCain, who often hasn't seemed as engaged with domestic policy as he ought to be. Fortunately, it looks as though the curtain is rising for a necessary debate about the role of government in health care.

Read The Full Editorial On The Wall Street Journal

Tuesday, April 29, 2008

"CALL TO ACTION" ON HEALTH CARE REFORM

A "Call To Action":

Today, In Florida, John McCain Outlined His Plan For Health Care Reform. John McCain believes we can and must provide access to health care for every American. He has proposed a comprehensive vision for achieving that. For too long, our nation's leaders have talked about reforming health care. Now is the time to act.

· Americans Are Worried About Health Care Costs. The problems with health care are well known: it is too expensive and 47 million people living in the United States lack health insurance.
John McCain's Vision For Health Care Reform:

John McCain Believes The Key To Health Care Reform Is To Restore Control To The Patients Themselves. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need. Health care should be available to all and not limited by where you work or how much you make. Families should be in charge of their health care dollars and have more control over care.

A Specific Plan Of Action: Making Health Insurance Innovative, Portable And Affordable:
John McCain Will Reform Health Care Making It Easier For Individuals And Families To Obtain Insurance. An important part of his plan is to use competition to improve the quality of health insurance with greater variety to match people's needs, lower prices, and portability. Families should be able to purchase health insurance nationwide, across state lines.

John McCain Will Reform The Tax Code To Offer More Choices Beyond Employer-Based Health Insurance Coverage. While still having the option of employer-based coverage, every family will also have the option of receiving a direct refundable tax credit -- effectively cash -- of $2,500 for individuals and $5,000 for families to offset the cost of insurance. Families will be able to choose the insurance provider that suits them best and the money would be sent directly to the insurance provider. Those obtaining innovative insurance that costs less than the credit can deposit the remainder in expanded Health Savings Accounts.

John McCain Proposes Making Insurance More Portable. Americans need insurance that follows them from job to job. They want insurance that is still there if they retire early and does not change if they take a few years off to raise the kids.

John McCain Will Encourage And Expand The Benefits Of Health Savings Accounts (HSAs) For Families. When families are informed about medical choices, they are more capable of making their own decisions and often decide against unnecessary options. Health Savings Accounts take an important step in the direction of putting families in charge of what they pay for.

A Specific Plan Of Action: Ensuring Care For Higher Risk Patients:

John McCain's Plan Cares For The Traditionally Uninsurable. John McCain understands that those without prior group coverage and those with pre-existing conditions have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need.

John McCain Will Work With States To Establish A Guaranteed Access Plan. As President, John McCain will work with governors to develop a best practice model that states can follow -- a Guaranteed Access Plan or GAP -- that would reflect the best experience of the states to ensure these patients have access to health coverage. One approach would establish a nonprofit corporation that would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.

John McCain Will Promote Proper Incentives. John McCain will work with Congress, the governors, and industry to make sure this approach is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs.

A Specific Plan Of Action: Lowering Health Care Costs:

John McCain Proposes A Number Of Initiatives That Can Lower Health Care Costs. If we act today, we can lower health care costs for families through common-sense initiatives. Within a decade, health spending will comprise twenty percent of our economy. This is taking an increasing toll on America's families and small businesses. Even Senators Clinton and Obama recognize the pressure skyrocketing health costs place on small business when they exempt small businesses from their employer mandate plans.

· CHEAPER DRUGS: Lowering Drug Prices. John McCain will look to bring greater competition to our drug markets through safe re-importation of drugs and faster introduction of generic drugs.

· CHRONIC DISEASE: Providing Quality, Cheaper Care For Chronic Disease. Chronic conditions account for three-quarters of the nation's annual health care bill. By emphasizing prevention, early intervention, healthy habits, new treatment models, new public health infrastructure and the use of information technology, we can reduce health care costs. We should dedicate more federal research to caring and curing chronic disease.

· COORDINATED CARE: Promoting Coordinated Care. Coordinated care -- with providers collaborating to produce the best health care -- offers better outcomes at lower cost. We should pay a single bill for high-quality disease care which will make every single provider accountable and responsive to the patients' needs.

· GREATER ACCESS AND CONVENIENCE: Expanding Access To Health Care. Families place a high value on quickly getting simple care. Government should promote greater access through walk-in clinics in retail outlets.

· INFORMATION TECHNOLOGY: Greater Use Of Information Technology To Reduce Costs. We should promote the rapid deployment of 21st century information systems and technology that allows doctors to practice across state lines.

· MEDICAID AND MEDICARE: Reforming The Payment System To Cut Costs. We must reform the payment systems in Medicaid and Medicare to compensate providers for diagnosis, prevention and care coordination. Medicaid and Medicare should not pay for preventable medical errors or mismanagement.

· SMOKING: Promoting The Availability Of Smoking Cessation Programs. Most smokers would love to quit but find it hard to do so. Working with business and insurance companies to promote availability, we can improve lives and reduce chronic disease through smoking cessation programs.

· STATE FLEXIBILITY: Encouraging States To Lower Costs. States should have the flexibility to experiment with alternative forms of access, coordinated payments per episode covered under Medicaid, use of private insurance in Medicaid, alternative insurance policies and different licensing schemes for providers.

· TORT REFORM: Passing Medical Liability Reform. We must pass medical liability reform that eliminates lawsuits directed at doctors who follow clinical guidelines and adhere to safety protocols. Every patient should have access to legal remedies in cases of bad medical practice but that should not be an invitation to endless, frivolous lawsuits.

· TRANSPARENCY: Bringing Transparency To Health Care Costs. We must make public more information on treatment options and doctor records, and require transparency regarding medical outcomes, quality of care, costs and prices. We must also facilitate the development of national standards for measuring and recording treatments and outcomes.

Confronting The Long-Term Care Challenge:

John McCain Will Develop A Strategy For Meeting The Challenge Of A Population Needing Greater Long-Term Care. There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are pioneering approaches for delivering care to people in a home setting. Seniors are given a monthly stipend which they can use to: hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.

Setting The Record Straight: Covering Those With Pre-Existing Conditions:

MYTH: Some Claim That Under John McCain's Plan, Those With Pre-Existing Conditions Would Be Denied Insurance.

· FACT: John McCain Supported The Health Insurance Portability And Accountability Act In 1996 That Took The Important Step Of Providing Some Protection Against Exclusion Of Pre-Existing Conditions.

· FACT: Nothing In John McCain's Plan Changes The Fact That If You Are Employed And Insured You Will Build Protection Against The Cost Of Any Pre-Existing Condition.

· FACT: As President, John McCain Would Work With Governors To Find The Solutions Necessary To Ensure Those With Pre-Existing Conditions Are Able To Easily Access Care.

REMARKS BY JOHN MCCAIN ON HEALTH CARE ON DAY TWO OF THE "CALL TO ACTION TOUR"

U.S. Senator John McCain will deliver the following remarks as prepared for delivery at the University of South Florida -- Lee Moffitt Cancer Center & Research Institute, in Tampa, FL, today at 10:00 a.m. EDT:

Thank you. I appreciate the hospitality of the University of South Florida, and this opportunity to meet with you at the Moffitt Cancer Center and Research Institute. Speaker Moffitt, Dr. Dalton, Dean Klasko, thank you for the invitation, and for your years of dedication that have made this campus a center of hope for cancer victims everywhere. It's good to see some other friends here, including your board member and my friend and former colleague Connie Mack. And my thanks especially to the physicians, administrators, and staff of this wonderful place.

Sometimes in our political debates, America's health-care system is criticized as if it were just one more thing to argue about. Those of you involved in running a research center like this, or managing the children's hospital that I visited yesterday in Miami, might grow a little discouraged at times listening to campaigns debate health care. But I know you never lose sight of the fact that you are each involved in one of the great vocations, doing some of the greatest work there is to be done in this world. Some of the patients you meet here are in the worst hours of their lives, filled with fear and heartache. And the confident presence of a doctor, the kind and skillful attentions of a nurse, or the knowledge that researchers like you are on the case, can be all they have to hold onto. That is a gift only you can give, and you deserve our country's gratitude.

I've had a tour here this morning, and though I can't say I absorbed every detail of the research I certainly understand that you are making dramatic progress in the fight against cancer. With skill, ingenuity, and perseverance, you are turning new technologies against one of the oldest enemies of humanity. In the lives of cancer patients, you are adding decades where once there were only years, and years where once there were only months. You are closing in on the enemy, in all its forms, and one day you and others like you are going to save uncounted lives with a cure for cancer. In all of this, you are showing the medical profession at its most heroic.

In any serious discussion of health care in our nation, this should always be our starting point -- because the goal, after all, is to make the best care available to everyone. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need, and the peace of mind that comes with knowing they are covered. Health care in America should be affordable by all, not just the wealthy. It should be available to all, and not limited by where you work or how much you make. It should be fair to all; providing help where the need is greatest, and protecting Americans from corporate abuses. And for all the strengths of our health-care system, we know that right now it falls short of this ideal.

Some 47 million individuals, nearly a quarter of them children, have no health insurance at all. Roughly half of these families will receive coverage again with a mother or father's next job, but that doesn't help the other half who will remain uninsured. And it only draws attention to the basic problem that at any given moment there are tens of millions of Americans who lost their health insurance because they lost or left a job.

Another group is known to statisticians as the chronically uninsured. A better description would be that they have been locked out of our health insurance system. Some were simply denied coverage, regardless of need. Some were never offered coverage by their employer, or couldn't afford it. Some make too little on the job to pay for coverage, but too much to qualify for Medicaid or other public programs. There are many different reasons for their situation. But what they all have in common is that if they become ill, or if their condition gets worse, they will be on their own -- something that no one wants to see in this country.

Underlying the many things that trouble our health care system are the fundamental problems of cost and access. Rising costs hurt those who have insurance by making it more expensive to keep. They hurt those who don't have insurance by making it even harder to obtain. Rising health care costs hurt employers and the self-employed alike. And in the end they threaten serious and lasting harm to the entire American economy.

These rising costs are by no means always accompanied by better quality in care or coverage. In many respects the system has remained less reliable, less efficient, more disorganized and prone to error even as it becomes more expensive. It has also become less transparent, in ways we would find unacceptable in any other industry. Most physicians groups and medical providers don't publish their prices, leaving Americans to guess about the cost of care, or else to find out later when they try to make sense of an endless series of "Explanation of Benefits" forms.

There are those who are convinced that the solution is to move closer to a nationalized health care system. They urge universal coverage, with all the tax increases, new mandates, and government regulation that come along with that idea. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We'll have all the problems, and more, of private health care -- rigid rules, long waits and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

The key to real reform is to restore control over our health-care system to the patients themselves. Right now, even those with access to health care often have no assurance that it is appropriate care. Too much of the system is built on getting paid just for providing services, regardless of whether those services are necessary or produce quality care and outcomes. American families should only pay for getting the right care: care that is intended to improve and safeguard their health.

When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices. We took an important step in this direction with the creation of Health Savings Accounts, tax-preferred accounts that are used to pay insurance premiums and other health costs. These accounts put the family in charge of what they pay for. And, as president, I would seek to encourage and expand the benefits of these accounts to more American families.

Americans need new choices beyond those offered in employment-based coverage. Americans want a system built so that wherever you go and wherever you work, your health plan is goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn't cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep.

The value of that credit -- 2,500 dollars for individuals, 5,000 dollars for families -- would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.

It would help extend the advantages of staying with doctors and providers of your choice. When Americans speak of "our doctor," it will mean something again, because they won't have to change from one doctor or one network to the next every time they change employers. They'll have a medical "home" again, dealing with doctors who know and care about them.

These reforms will take time, and critics argue that when my proposed tax credit becomes available it would encourage people to purchase health insurance on the current individual market, while significant weaknesses in the market remain. They worry that Americans with pre-existing conditions could still be denied insurance. Congress took the important step of providing some protection against the exclusion of pre-existing conditions in the Health Insurance Portability and Accountability Act in 1996. I supported that legislation, and nothing in my reforms will change the fact that if you remain employed and insured you will build protection against the cost of treating any pre-existing condition.

Even so, those without prior group coverage and those with pre-existing conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won't create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate. The states have been very active in experimenting with ways to cover the "uninsurables." The State of North Carolina, for example, has an agreement with Blue Cross to act as insurer of "last resort." Over thirty states have some form of "high-risk" pool, and over twenty states have plans that limit premiums charged to people suffering an illness and who have been denied insurance.

As President, I will meet with the governors to solicit their ideas about a best practice model that states can follow -- a Guaranteed Access Plan or GAP that would reflect the best experience of the states. I will work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs. These programs reach out to people who are at risk for different diseases and chronic conditions and provide them with nurse care managers to make sure they receive the proper care and avoid unnecessary treatments and emergency room visits. The details of a Guaranteed Access Plan will be worked out with the collaboration and consent of the states. But, conceptually, federal assistance could be provided to a nonprofit GAP that operated under the direction of a board that i ncluded all stakeholders groups -- legislators, insurers, business and medical community representatives, and, most importantly, patients. The board would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. Right now, there is a different health insurance market for every state. Each one has its own rules and restrictions, and often guarantees inadequate competition among insurance companies. Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it. We need to break down these barriers to competition, innovation and excellence, with the goal of establishing a national market to make the best practices and lowest prices available to every person in every state.

Another source of needless cost and trouble in the health care system comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform, and those reforms should eliminate lawsuits directed at doctors who follow clinical guidelines and adhere to patient safety protocols. If Senator Obama and Senator Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers. They can't have it both ways.

We also know from experience that coordinated care -- providers collaborating to produce the best health outcome -- offers better quality and can cost less. We should pay a single bill for high-quality disease care, not an endless series of bills for pre-surgical tests and visits, hospitalization and surgery, and follow-up tests, drugs and office visits. Paying for coordinated care means that every single provider is now united on being responsive to the needs of a single person: the patient. Health information technology will flourish because the market will demand it.

In the same way, clinics, hospitals, doctors, medical technology producers, drug companies and every other provider of health care must be accountable to their patients and their transactions transparent. Americans should have access to information about the performance and safety records of doctors and other health care providers and the quality measures they use. Families, insurance companies, the government -- whoever is paying the bill -- must understand exactly what their care costs and the outcome they received.

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in Web technology to allow a doctor to practice across state lines, then let them.

As you know better than I do, the best treatment is early treatment. The best care is preventative care. And by far the best prescription for good health is to steer clear of high-risk behaviors. The most obvious case of all is smoking cigarettes, which still accounts for so much avoidable disease. People make their own choices in this country, but we in government have responsibilities and choices of our own. Most smokers would love to quit but find it hard to do so. We can improve lives and reduce chronic disease through smoking cessation programs. I will work with business and insurance companies to promote the availability and use of these programs.

Smoking is just one cause of chronic diseases that could be avoided or better managed, and the national resources that could be saved by a greater emphasis on preventative care. Chronic conditions -- such as cancer, heart disease, high blood pressure, diabetes and asthma -- account for three-quarters of the nation's annual health-care bill. In so many cases this suffering could be averted by early testing and screening, as in the case of colon and breast cancers. Diabetes and heart disease rates are also increasing today with rise of obesity in the United States, even among children and teenagers. We need to create a "next generation" of chronic disease prevention, early intervention, new treatment models and public health infrastructure. We need to use technology to share information on "best practices" in health care so every physician is up-to-date. We need to adopt new treatment programs and fi nancial incentives to adopt "health habits" for those with the most common conditions such as diabetes and obesity that will improve their quality of life and reduce the costs of their treatment.

Watch your diet, walk thirty or so minutes a day, and take a few other simple precautions, and you won't have to worry about these afflictions. But many of us never quite get around to it, and the wake-up call doesn't come until the ambulance arrives or we're facing a tough diagnosis.
We can make tremendous improvements in the cost of treating chronic disease by using modern information technology to collect information on the practice patterns, costs and effectiveness of physicians. By simply documenting and disseminating information on best practices we can eliminate those costly practices that don't yield corresponding value. By reforming payment systems to focus on payments for best practice and quality outcomes, we will accelerate this important change.

Government programs such as Medicare and Medicaid should lead the way in health care reforms that improve quality and lower costs. Medicare reimbursement now rewards institutions and clinicians who provide more and more complex services. We need to change the way providers are paid to focus their attention more on chronic disease and managing their treatment. This is the most important care for an aging population.

There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are different from the inflexible approaches for delivering care to people in the home setting. Seniors are given a monthly allowance that they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.

In these approaches, participants were much more likely to have their needs met and be satisfied with their care. Moreover, any concerns about consumers' safety appear misplaced. For every age group in every state, participants were no more likely to suffer care-related health problems.

Government can provide leadership to solve problems, of course. So often it comes down to personal responsibility -- the duty of every adult in America to look after themselves and to safeguard the gift of life. But wise government policy can make preventative care the standard. It can put the best practices of preventative care in action all across our health-care system. Over time that one standard alone, consistently applied in every doctor's office, hospital, and insurance company in America, will save more lives than we could ever count. And every year, it will save many billions of dollars in the health-care economy, making medical care better and medical coverage more affordable for every citizen in this country.

Good health is incentive enough to live well and avoid risks, as we're all reminded now and then when good health is lost. But if anyone ever requires further motivation, they need only visit a place like the Moffitt Center, where all the brilliance and resourcefulness of humanity are focused on the task of saving lives and relieving suffering. You're an inspiration, and not only to your patients. You're a reminder of all that's good in American health care, and we need that reminder sometimes in Washington. I thank you for your kind attention this morning, I thank you for the heroic work you have done here, and I wish you success in the even greater work that lies ahead.

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JOHN MCCAIN 2008 LAUNCHES NEW TELEVISION AD: "HEALTH CARE ACTION"

U.S. Senator John McCain's presidential campaign today released a new television ad, entitled "Health Care Action," highlighting John McCain's agenda to reform health care. The ad will air in Iowa.

VIEW THE AD HERE: http://www.youtube.com/watch?v=m6I61-zIXOE

Script For "Health Care Action" (:60)

JOHN MCCAIN: The problem with health care in America is not the quality of health care, it's the availability and the affordability. And that has to do with the dramatic increase in the cost of health care.

Let's give every American family a $5,000 refundable tax credit so that they can go out across state lines and get the insurance policy that suits them best.

I can characterize my approach on health care by choice and competition, affordability and availability.

We need community health centers. We need walk-in clinics. We understand that emergency room care is the most expensive in America.

There's many, many solutions to this problem. I think we can address them. The fundamental problem is not the quality of health care; it's the cost of health care. So health care must be made affordable and available.

I'm John McCain and I approve this message.

REMARKS BY JOHN MCCAIN ON DAY ONE OF THE "CALL TO ACTION TOUR"

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.

Governor Charlie Crist On Fox News' "Your World"

Governor Charlie Crist
Fox News' "Your World"
April 29, 2008

FOX NEWS' NEIL CAVUTO: "John McCain touting his health care plan today. It would give individuals a $2,500 tax credit, $5,000 for families, to help pay for health insurance of their choosing. It relies on the free market, not national health care. Florida Governor Charlie Crist here to explain and back it. He is a McCain supporter, as you know, and a man many say could be a McCain running mate. That's for another day. Governor, good to have you this day."

GOV. CRIST: "Neil, it's great to be with you. This is a great plan. It's the right thing to do. It empowers the consumer -- $2,500 tax credit for individuals, as you said, $5,000 tax credit for families. That gives them that money essentially to utilize to be a smart consumer, to invest in their families, to invest in their health care and make the choice as it relates to health insurance coverage. It's the right thing to do for America."

CAVUTO: "But, you know, Governor, a lot of people hate their insurance companies, and there are a lot of people who argue that the insurance companies are the gouging middleman in all of this, and, essentially what you would be doing is rewarding tax credits to make them richer."

GOV. CRIST: "The way I view it is you give the opportunity for the individual consumer to be empowered to make that choice instead of some bureaucrat in Washington making the choice for you about what your health insurance coverage is going to be and who it's going to be provided by. You empower the consumer to have the power of choice, as Milton Friedman would love or Adam Smith. It's the right way to go in my view, and philosophically, I think it's better for the American people, because it gives them that power of choice to make their decisions about what's best for them on an individual and/or family basis."

Watch Governor Charlie Crist On Fox News' "Your World"
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Sunday, April 27, 2008

The McCain Update - April 25, 2008

We are running a different kind of campaign because John McCain is a different kind of candidate. This week, he traveled to some of the forgotten areas of our nation. From rural Alabama to hurricane-ravaged Louisiana, many places across the country have been ignored and left behind. As president, John McCain will change that and will ensure that impoverished areas are not only remembered and helped, but are rebuilt to be stronger and prosper.

We need your support today so we can continue to pursue this mission all the way to the White House. John McCain knows that he will be president of all Americans, not just those who voted for him. He wants to hear from all Americans, regardless of their background or where they live.
Your on-going dedication to John McCain is invaluable and we ask for your support again. Your contribution to John McCain's campaign today will give us a better tomorrow. Please click here to make a contribution and then continue reading about this week's travels.

As John McCain has said, "America is only as strong as its people." Our campaign is only as strong as our supporters and we need your help today.

Many thanks,
Rick Davis
Campaign Manager

On Monday, John McCain traveled to Selma, Gee's Bend and Thomasville, Alabama to begin his weeklong It's Time for Action Tour. In Selma, John McCain visited the Edmund Pettus Bridge, which in 1965 was the scene of a seminal moment in the Civil Rights Movement. He then traveled to Gee's Bend, which has been isolated by a river, economic difficulties and racial tensions over the years. He then journeyed on to Thomasville where he talked about the need for education and its importance to rural development. Click here to learn more about these areas.

Below is an excerpt from John McCain's speech in Selma on Monday:

"There must be no forgotten places in America, whether they have been ignored for long years by the sins of indifference and injustice, or have been left behind as the world grew smaller and more economically interdependent. In America, we have always believed that if the day was a disappointment, we would win tomorrow." Click here to continue reading the speech and watch the video from the first day of the tour.

On Tuesday, John McCain went to Youngstown, Ohio to discuss the economic challenges facing the area and solutions for a brighter future. In Youngstown, John McCain visited Fabart Inc., a heavy metal fabricating facility that shut down after struggling in Chapter 11 status. John McCain then held a Town Hall meeting at Youngstown State University (YSU). His final stop of the day was at Fire Line Inc., a company that works with YSU to develop and place students in advanced manufacturing and technical jobs. Click here to learn more about Youngstown.

Below is an excerpt from John McCain's speech on Tuesday:

"The struggles of this community and others like it matter when we talk about our nation's economy - they are not just a problem, they're a priority. What matters most of all is that you didn't give up." Click here to continue reading the speech.

On Wednesday, John McCain visited Inez, Kentucky to discuss the challenge of poverty in America and how it affects rural communities. In Inez, John McCain participated in a town hall meeting at the Old Martin County Courthouse. This historic community faces many economic challenges, particularly struggling with poverty. During this event, John McCain highlighted a student-mentoring program that encourages students in Eastern Kentucky to finish their education and serve their local communities.

Below is an excerpt from John McCain's speech on Wednesday:

"We all have choices to make in our lives, and you don't expect government to make yours for you. But you have a right to expect that the people you elect to office will help and not hinder your efforts to make a better future for your community and families. You have a right to expect us to show as much concern for helping you create more and better choices to make for yourselves as we show any other community in America or we show the special interests who claim so much of Washington's attention." Click here to continue reading the speech and watch the video from the third day of the tour.

On Thursday, John McCain went to Louisiana to discuss the role of the federal government in preparing, assisting and recovering from calamities such as Hurricanes Katrina and Rita.
In New Orleans, John McCain took a walking tour of the 9th Ward and went to Xavier University, the nation's only predominately black Roman Catholic university. John McCain visited with Xavier President Dr. Norman Francis, a recipient of the Presidential Medal of Freedom, and university dignitaries before holding a town hall meeting. Women of the Storm, a non-partisan alliance of Louisiana women who in the aftermath of Hurricanes Katrina and Rita educated elected officials about the urgent needs of those affected, participated in the town hall.

Below is an excerpt from John McCain's speech on Thursday:

"Katrina and its aftermath were a moment of truth for our federal government, requiring focused action and immediate, effective aid. What we saw instead was the confusion, inefficiency, and poor judgment that trouble many agencies of government every day, when no one's paying close attention. We need to make government far more transparent in its way of doing business ... more accountable for its day-to-day decisions and expenditures ... and in every way more responsive to the people it serves." Click here to continue reading the speech and watch the video from the fourth day of the tour.

Today, John McCain will continue his It's Time for Action Tour in Little Rock, Arkansas. On the fifth day of his tour, he is visiting communities where hope, innovation and local solutions are helping to lift these communities up. John McCain will visit Arkansas Baptist College where he will address a class of college students. Arkansas Baptist College, founded in 1884, is the only black Baptist higher education institution west of the Mississippi River. The college is committed "to the development of graduates who are exceptionally educated, spiritually and culturally aware, and able to meet the demands of our rapidly advancing society." This is a four-year college offering degrees in business administration, human services, criminal justice, public administration and religious studies.

Click here to learn more about the last day of the It's Time for Action Tour.

Latest News
Below are some of the top news articles from this week. For more news articles and press releases, go to www.JohnMcCain.com.

USA Today: Republican Candidate's Economic Plan is Responsible
McClatchy Newspapers: McCain Visits Poor Kentucky Town To Slam Big Government
The Youngstown Vindicator: McCain Makes Three Stops In Youngstown
Pittsburgh Post-Gazette: McCain Makes Inroads In Rust Belt
Akron Beacon Journal: McCain Speaks At YSU, Reaches Out To Democrats
Cleveland Plain Dealer: McCain Stumps In Youngstown
USA Today: McCain Promotes Government 'Partnerships'
Times-Picayune (LA): McCain to Visit New Orleans on Thursday
Reuters: McCain Visits "War on Poverty" Kentucky Coal Town
Birmingham News: John McCain Shakes Hands, Touches Hearts in Alabama
Sunday Paper (GA): McCain Praises Rep. John Lewis and Lewis Responds
Pittsburgh Post-Gazette: In Youngstown, McCain Focuses on Jobs
Cleveland Plain Dealer: McCain Says Ohio Rust Belt Cities Can Come Back
The Montgomery Advertiser: McCain tours Black Belt today
USA Today: McCain Listens During 'Time for Action' Tour in South
Tuscaloosa (AL) News: McCain Brings Campaign to Alabama Today
The Weekly Standard: The Right Stuff

WHAT THEY'RE SAYING ABOUT THE "IT'S TIME FOR ACTION TOUR" DAY FOUR

"In a strong tone, McCain said 'never again will there be a mismanaged natural disaster,' later assuring the crowd that 'it will never happen again in this country, you have my commitment and my promise.'" -- CNN

McCain Says "Never Again":
The Wall Street Journal: McCain "Clearly Disturbed By The Crumbling State Of The Lower Ninth Ward." "Even so, Sen. McCain was clearly disturbed by the crumbling state of the Lower Ninth Ward. He toured a four-block area with Louisiana Gov. Bobby Jindal, a popular young Republican rumored to be among potential vice-presidential picks." (Elizabeth Holmes, "McCain Condemns Federal Response To Katrina," The Wall Street Journal, 4/25/08)

USA Today: "McCain Promised Thursday That The Federal Government Won't Be So Slow After The Next Big Storm." "Surrounded by gutted homes in the Lower 9th Ward, Sen. John McCain promised Thursday that the federal government won't be so slow after the next big storm." (Rick Jervis, "McCain Pledges Faster Disaster Response," USA Today, 4/25/08)

· CBS News: McCain "Promised, If President, That The Government Won't Mishandle A Disaster Response The Way Katrina Was." "John McCain toured the lower 9th ward of New Orleans today, an area heavily damaged by Hurricane Katrina, and promised, if president, that the government won't mishandle a disaster response the way Katrina was." (Dante Higgins, "McCain Promises New Orleans: 'Never Again,'" CBS News' "From The Road" Blog, 4/24/08)

· Fox News' Carl Cameron: McCain "Condemned The Government's Actions Before, During And After The Storm In Harsh Terms." "Republican presidential candidate John McCain toured five blocks in the Lower Ninth Ward of Katrina- ravaged New Orleans. He strolled past 10-foot piles of debris and homes that three years after the storm still remain uninhabitable. Then he condemned the government's actions before, during and after the storm in harsh terms." (Fox News' "Special Report With Brit Hume," 4/24/08)

· McClatchy: McCain Makes "Bold Promise" To New Orleans. "John McCain made a bold promise Thursday to this still-staggering city, where the legacy of Hurricane Katrina is evident in blocks of abandoned homes and trash-strewn streets. 'Never again,' McCain said during a press conference in the city's Lower Ninth Ward. 'Never again will a disaster of this nature be handled in the terrible and disgraceful way that it was handled.'" (Matt Stearns, "McCain Vows 'Never Again' To New Orleans," McClatchy, 4/24/08)

Ninth Ward Resident Mary Croom: "I'm just happy to see him coming here. He's interested in what's happening here." (Juliet Eilperin, "McCain, In Lower Ninth Ward, Blasts Bush Katrina Response," The Washington Post's "Trail Blog," 4/24/08)

Calvin Young Of The Ninth Ward "Glad To See" McCain. "Calvin Young, 83, a retired civil servant, said he was glad to see McCain's entourage moving through his neighborhood. He hopes something comes of it. Young is still waiting for his home to be rebuilt, he said. 'He now knows what's wrong,' Young said. 'Now he just has to remedy it.'" (Rick Jervis, "McCain Pledges Faster Disaster Response," USA Today, 4/25/08)

The Associated Press: McCain Says "It Is Time To Stop Studying How To Build A Costly Category 5 Levee System And Get Working On It." "Sen. John McCain, the presumptive Republican presidential nominee, said Thursday it is time to stop studying how to build a costly Category 5 levee system and get working on it. During a tour of New Orleans, McCain said building more robust levees and restoring the Mississippi River delta's wetlands and barrier islands is imperative." (Cain Burdeau, "McCain For Big Levee, Wetlands Projects In Louisiana," The Associated Press, 4/25/08)

McCain Wraps Up Week Going "Where Republicans Rarely Go":
The New York Times: McCain Spent A Week Going "Where Republicans Rarely Go." "The visit was near the end of a weeklong tour of swaths of the country where Republicans rarely go: the Black Belt of Alabama, the Lower Ninth Ward of New Orleans, the Appalachian coal-mining hollow in Appalachia where President Lyndon B. Johnson declared his war on poverty in the 1960s." (Elisabeth Bumiller, "McCain Criticizes Katrina Response As 'Disgraceful,'" The New York Times, 4/25/08)

CNN's Campbell Brown: "And Louisiana Is The Latest Stop On McCain's Time For Action Tour. He's Targeting Now Voters That Republicans Almost Never Win." (CNN's "Election Center," 4/24/08)

CNN's Dana Bash: McCain Visiting "Places Republican Candidates Rarely Go." "This is the finale of a weeklong tour of places Republican candidates rarely go, a civil rights symbol in Selma, a shuttered plant in a blue-collar town, impoverished Appalachia, all intended to appeal to independents and some Democrats by creating an image of a different kind of Republican." (CNN's "Election Center," 4/24/08)

The Washington Times: Katrina Recovery And The Economy Dominate McCain Visit. "The continuing Katrina recovery and the U.S. economy dominated Mr. McCain's visit to this city, in the fourth day of his tour through areas in the U.S. hard-hit by economic woes." (Jon Ward, "McCain Slams Bush For Katrina," The Washington Times, 4/25/08)

In The Headlines:
Baton Rouge Advocate: "Senator Vows Better Crisis Response" (Sarah Chacko And Joe Gyan, "Senator Vows Better Crisis Response," Baton Rouge Advocate, 4/25/08)

CBS News: "McCain Promises New Orleans: 'Never Again'"(Dante Higgins, "McCain Promises New Orleans: 'Never Again,'" CBS News' "From The Road" Blog, 4/24/08)

Los Angeles Times: "McCain Says: Never Again"(Maeve Reston, "McCain Says: Never Again," Los Angeles Times, 4/25/08)

McClatchy: "McCain Vows 'Never Again' To New Orleans" (Matt Stearns, "McCain Vows 'Never Again' To New Orleans," McClatchy, 4/24/08)

New Orleans Times-Picayune: "McCain Says Federal Katrina Response 'Disgraceful'" (David Hammer, "McCAin Says Federal Katrina Response 'Disgraceful,'" New Orleans Times-Picayune, 4/25/08)

USA Today: "McCain Pledges Faster Disaster Response"(Rick Jervis, "McCain Pledges Faster Disaster Response," USA Today, 4/25/08)

The Wall Street Journal: "McCain Condemns Federal Response To Katrina" (Elizabeth Holmes, "McCain Condemns Federal Response To Katrina," The Wall Street Journal, 4/25/08)

IT'S TIME FOR ACTION TOUR: DAY FIVE

4/25/08 Today, John McCain will continue his "It's Time for Action Tour" by traveling to Little Rock, Arkansas. Little Rock, Arkansas:

In Arkansas, John McCain will visit Arkansas Baptist College where he will address a class of college students. College President Dr. Fitzgerald (Fitz) Hill and Mr. Donald Northcross, Director of Our Kids, a mentoring program that partners with schools and the Little Rock Police Department to mentor disadvantaged young males in the community, will join John McCain.

Arkansas Baptist College, founded in 1884, is the only black Baptist higher education institution west of the Mississippi River. The college is committed "to the development of graduates who are exceptionally educated, spiritually and culturally aware, and able to meet the demands of our rapidly advancing society." This is a four-year college offering degrees in business administration, human services, criminal justice, public administration and religious studies.

Although Dr. Hill never saw himself in his current job, he's provided strong leadership for Arkansas Baptist College. In April 2008, Dr. Hill outlined a clear vision for his school: "I want this school to lead the way to tackle the black-on-black violence in this city by creating educational opportunities for the underserved population. I want this school to be able to restore the spirituality of this community. I want this school to lead the way in serving the less fortunate." Dr. Hill brings a wealth of experience to the job. He has preserved in the face of extraordinary challenges. When his father died, Dr. Hill gave up a college football scholarship just months into his freshman year to care for his mother who suffered an aneurysm rupture and was left unable to speak. He enrolled at Ouachita Baptist University and joined the ROTC program. While engaged in his graduate studies at the University of Arkansas , Dr. Hill was deployed to the Persian Gulf, and for his service, was awarded the Bronze Star and Army Commendation Medal. He left the Army reserve when his tour ended and returned to school at the University of Arkansas where he earned his Doctorate of Education.

Located in inner-city Little Rock, Dr. Hill is working to make Arkansas Baptist College "the engine that revitalizes and restores the surrounding dilapidated community." He has implemented a five-year plan to revitalize the college by building new dormitories and acquiring several old building around the campus to either tear down or renovate. In 2005, there were only 59 students enrolled at Arkansas Baptist, today there are over 600. He has created academic outreach programs, a new music department, and a football program.

Part of the Arkansas Baptist College community is the Our Kids (OK) program. Partnering with the Little Rock Police Department, Our Kids mentors young males in the Little Rock community in grades 6-12. Mentors comes from across the Little Rock community, including the Police Department and Arkansas Baptist College. Program participants must maintain a 2.5 grade-point average and every Saturday, OK plans and organizes presentations, social events, and sporting events. This week, they are moving their regular Saturday discussion to Friday, giving the students will have an opportunity to talk with John McCain.

STATEMENT BY JOHN MCCAIN ON MALARIA AWARENESS DAY

U.S. Senator John McCain today issued the following statement on Malaria Awareness Day:

"Malaria kills more than a million people a year in Africa -- and a child every thirty seconds. Yet it is well within our grasp to defeat this disease. If elected President, I will pledge to end malaria in Africa.

"The United States has honored its proud history of global service by being a leader in the fight against malaria. At present, the federal government is on track to commit $1 billion each year. But America is more than its government. I call upon the private sector to meet its obligation to serve a cause greater than its self-interest by matching the federal commitment dollar for dollar. Meeting this goal will achieve a level of funding that will rapidly roll back the dreadful impact of malaria on the global community."

John McCain On CBS' "Early Show"

CBS' MAGGIE RODRIGUEZ: "Senator, you're connecting with people who are facing two of the biggest issues in this election and in our country right now, the economy and health care. If you're elected president, where would your immediate focus be?"

JOHN MCCAIN: "My immediate purpose would be to get our economy going again. And to make sure that families make the decisions in health care in America and not the big government, as Senator Obama and Senator Clinton want to do. As far as the economy is concerned, don't raise taxes the way Senator Obama wants to do on capital gains. If you want to raise taxes, then don't vote for me."

Watch John McCain On CBS' "Early Show"

REMARKS BY JOHN MCCAIN ON DAY FOUR OF THE IT'S TIME FOR ACTION TOUR

U.S. Senator John McCain delivered the following remarks as prepared for delivery at the 25th Annual Business Awards and Hall of Fame Banquet presented by Business Report and Junior Achievement in Baton Rouge, LA, 4/24/08 at 7:30 p.m. CDT:

Thank you, Governor Jindal, for that kind introduction, and thank you all for the warm welcome to Baton Rouge. I appreciate the hospitality of Mayor Kip Holden ... former Governor Buddy Roemer ... members of Junior Achievement ... and the editors and staff of The Business Report. And my congratulations to all of this evening's honorees.

Tonight's awards recognize the qualities that make for excellence in business. And though many different types of business are represented here, I suspect the basic qualities are the same. I've had two careers, neither one in the corporate world for any length of time. But I've been around business leaders enough to know what makes the best companies stand apart -- why some enterprises succeed and others don't.

The best companies respect public opinion, among other reasons because they know their customers have the option of going elsewhere. They're focused on outcomes, not just process. They steer far clear of bureaucracy, because they know that bureaucracy can be the death of creativity, initiative, commonsense, and the spirit of service. Above all, the finest business leaders never lose their sense of responsibility -- both corporate and personal responsibility. They insist on transparency, having nothing to fear from the inquiries of reporters or auditors. And even if shareholders and the public did not expect a full accounting of budgets, costs, plans and commitments, the best companies would demand it of themselves.

Now I don't want to disillusion the business community of Louisiana, but I'm afraid that these same standards of efficiency, commonsense, and honesty are not always observed by government. At both the state and federal level, government has been known to act in an arbitrary, inflexible, and irresponsible manner, indifferent to the wishes of the people it is supposed to serve. Too often, government has its own peculiar way of doing things, following practices that in the private sector would invite financial ruin or worse. Even in this information age, often our federal government still relies on the old bureaucratic model, in which little offices in Washington are assumed to be the centers of knowledge. Regardless of which party controls Congress or the Executive Branch, our federal government is far too process-oriented -- measuring success by rising budgets instead of actual results ... forever d eclaring new goals but so seldom meeting any of them.

All of this is bad enough in the day-to-day routine of many federal departments and agencies, in the confusion and air of futility that often hangs over their work. But the ineptitude of government can have far graver consequences, as the people of this state know better than anyone, from events still fresh in memory. At a very minimum, we depend on our government to protect us from danger when the danger is greatest. We assume that when the worst happens, it will bring out the best in our government. We trust that police, emergency workers, federal authorities, and elected officials will do their duty and do it well. But that is not what happened here in Louisiana. That is not what you and the world witnessed in the fall of 2005.

What happened, instead, was a series of failures that shook of the confidence of Americans in their government as much as any event in recent memory. There were heroic exceptions, as there always are. There were some who performed with courage, speed, and presence of mind in the most difficult of conditions. But as to the overall performance of government during and after the crisis, the verdict is in, and first impressions were correct. With many thousands of lives in the balance, across 90,000 square miles of misery, there was a failure of foresight, a failure of planning, a failure in execution and a failure in follow-up. And the incompetence of leadership didn't end with the rescue efforts. In the conduct of Congress in the year after Katrina and Rita, we saw the same excesses, lack of focus, and short-term thinking that left New Orleans vulnerable in the first place. As one critic observed, while the hu rricanes "proved to be the worst and costliest natural disaster in our history, the waste and fraud uncovered ... has been a disaster all in itself." Apparently a lot of Louisianans agreed with this critic, because you elected him governor.

Bobby Jindal has had some very able predecessors in office. But last year, after all this state had been through, the moment was right and the people were ready for breakthrough reforms. He stands for a new way of doing business in this state, and it's a model I intend to apply elsewhere. Some people think that it's just our youthful vitality that the governor and I have in common. But we share important convictions as well, and it starts with an intolerance of ineptitude, waste, and self-dealing of any kind in any agency of government.

With a special session of the Legislature devoted to ethics reform, he and allies in both parties have made a clean break from many corrupt practices of the past. Just because legislators have grown comfortable with certain privileges ... or accustomed to doing business in a certain way ... doesn't make those practices right, or acceptable, or beyond the reach of reform. Your new governor understands that, and he's changing the culture of Baton Rouge. You and I understand it too, and together we can change the culture of Washington.

There was another special session here devoted to workforce development, and tax reform, and economic growth -- because your governor understands that the deep problems of the Ninth Ward and beyond did not begin with a catastrophe of nature, and they did not end with the relief programs of government. With merciless force, Katrina laid bare the failures and stagnant ideas of generations of government policy. Despite years of grand promises from their government, and years of costly programs, so many of these citizens still lived in persistent poverty ... with no jobs or the hope of a good job ... no skills to speak of and no chance to learn them.

Even the basics of life, like health care and protection from violent crime, could not be counted on in a city that had the highest murder rate in our country. This was life as many thousands knew it before the levees broke and the waters rose. This is life as so many know it now, in places the rescue teams and camera crews have never had to go. And more of the same in Washington -- the same tired ideas, patronizing rhetoric and self-serving practices -- will accomplish exactly nothing. Lofty lectures on change won't do much good, either, when they are just a new version of the same old ideas. The time for talking about change is over. It's time for action in Washington, with serious reforms to make a difference in the lives of the American people.

We must start as you have begun here in Louisiana -- with ethics reforms that go to the heart of the problem of a dysfunctional federal establishment. Maybe you remember how the Congress responded to the tragedy of Katrina with billions of dollars in new spending that had, in many cases, nothing whatever to do with the victims of Katrina. One reason for this is that the House and Senate routinely squander tens of billions of dollars on projects and favors sought by lobbyists. For some legislators, even Katrina was just another excuse to lard up another bill with another batch of earmarks.

This practice is not only bad in itself, revealing a disregard of the common good. The abuses of lobbying and earmark spending are also symptomatic of even larger problems in Washington, like the broken windows of buildings in a badly governed city. When we attack these abuses with aggressive reform, we are signaling an entirely new attitude, a higher and better standard in how we conduct the people's business. By ending the practice of pork-barrel spending altogether, members of Congress can show the best kind of reform -- self-reform. And this alone will go a long way toward regaining the confidence of the people in their government.

As president, I will veto every earmark spending bill that the Congress sends me, until the Congress stops sending me earmark bills. And I will apply precisely the same standards of conduct to all who serve in the Executive Branch. All officials in my administration will have their interactions with lobbyists fully disclosed to public view. Lobbying is not an inherently corrupt profession, despite the frequent discredit brought to it by a relatively few. At its best, lobbying is an honorable exercise of the right of petition. But just as vital is the right of the people to know who the petitioners are and what they want. And I intend to make that information public in every instance. In my administration, there will be no such thing as a closed-door meeting with a lobbyist. If a lobbyist's case is important enough for my administration to hear it, then it will be important enough for the public to know about it too.

Katrina and its aftermath were a moment of truth for our federal government, requiring focused action and immediate, effective aid. What we saw instead was the confusion, inefficiency, and poor judgment that trouble many agencies of government every day, when no one's paying close attention. We need to make government far more transparent in its way of doing business ... more accountable for its day-to-day decisions and expenditures ... and in every way more responsive to the people it serves.

To this end, as president, I will order a prompt and thorough review of the budgets of every federal program, department, and agency. And we will institute a one-year pause in discretionary spending increases, with the necessary exception of military spending and veterans benefits. I'll hold every agency accountable for the public money they spend. I'll make sure the public helps me, and I'll provide federal agencies with the best executive leadership that can be found in America. We're going to make every aspect of government purchases and performance transparent. There will be no exceptions, least of all in the case of our military procurement system, where the costs of mismanagement and waste are far-reaching. Information on every step of all contracts and grants will be posted on the Internet in plain English, so that anyone can know what their government is buying and how much we're paying.

In all of this, the aim is to assure that federal spending serves the common interests. We need to know which agencies of government are meeting goals, and which agencies are just talking about goals. We need to make certain that good programs are rewarded, and that failed programs aren't. Only then can we be certain that discretionary spending is going where it belongs -- to essential priorities like job training, the care of our veterans, and the safety of our citizens in times of emergency.

One of the worst aspects of Katrina, as a measure of emergency-response by government, is that Americans are renowned for their ingenuity and resourcefulness in a tough spot. Ask the military historians, and they'll tell you that the ability of American men and women in war to react quickly to crisis, to think fast and solve any problem of logistics, has been one of our greatest assets. And yet with the exception of our Coast Guard, our National Guard, reservists, and others, these qualities were hard to find in the response of federal and state agencies to an enormous danger that, as a congressional report put it, was "not only predictable, it was predicted." There were all those school busses lined up in a parking lot, and no one in authority with the sense to use them. Wal-Mart had the ice, water, and generators ready ... Federal Express the planes ... and other companies and groups stood ready to help. But they were leaderless. And some of the most inspiring work was done by churches and charities and volunteers, working around FEMA instead of with it.

My friends, it is not in our power to turn back hurricanes, but I assure you it is within our power to respond to crisis better than this -- and I intend to make sure that happens. We're going to clear away the bureaucratic obstacles to disaster response, and establish clear, straight lines of communication among federal, state, and local agencies. We're going to give first-responders in our states and cities every tool they need to move fast, work together, and save lives. We're going to give them allies, too -- the same kind of partners who rushed to the Gulf Coast after Katrina but were turned away or told to wait. Every Emergency Operations Center will have a unit run by trained experts from local businesses, with the skills and technology to track assets and send them where they are needed, when they are needed. At any given moment, UPS, FedEx, and Wal-Mart can tell you in real time where a pa ckage is anywhere in the world. But FEMA, when it mattered most, often couldn't even locate its own assets or its own people. We're going to change all that, to make certain that our federal government is ready for whatever comes, and that the failures during Katrina are never repeated.

Part of helping vulnerable cities is also helping vulnerable people. It is not enough, when those who were poor are left with even less, to set up trailers, hand out debit cards, and wish them the best. These men and women ask more of life than that. They have more to offer than that. And we need policies that give them that chance.

I was in the lower Ninth Ward today with the governor, and it's inspiring to see the labor and care that is going into the rebuilding of that community. There may be some who wonder from afar: Why even bother rebuilding parts of what was lost in Katrina? But the people who live there in the Ninth Ward don't feel that way. They are even hoping that life will be better than before. And businesses like yours can help, by taking risks and investing in those very communities where the harm was greatest. They need jobs there, and job training and good wages. The business people of New Orleans and of this state can make all the difference in the life of those communities, and I hope you'll consider it. The government of Louisiana is doing its part, with the workforce and tax policies of Gov. Jindal. And with low tax policies, a new approach to job training, and a plan of spending restraint in Washington, I assure y ou that more reforms are on the way if I am given the privilege of serving as president of the United States.

I am a believer in the good that government can do in the lives of people. I have seen it in my own life. And you will never hear me speak scornfully, as a candidate or as president, about the institutions of government, or about the honor of serving in any position of public responsibility. In all of these reforms, the goal is not to diminish government but to make it better ... not to deride government but to restore its good name. It will be hard work in Washington, but it is a cause worthy of our best efforts. And if we do it well, in the right spirit, then we will finally reclaim the confidence of the people we serve.

Thank you.

IT'S TIME FOR ACTION TOUR: DAY FOUR

Today, John McCain will continue his "It's Time for Action Tour" by traveling to New Orleans, Louisiana. On the fourth day of his tour, John McCain will visit a city still recovering from the devastation of Hurricane Katrina.

New Orleans, Louisiana:
In New Orleans, John McCain will take a walking tour of the 9th Ward with Governor Bobby Jindal, Major General Bennett C. Landreneau, the Adjutant General of the Louisiana National Guard, and National Guard Colonel Danny Bordelon. He will then go to Xavier University, the nation's only predominately black Roman Catholic university. There Senator McCain will visit with Xavier President Dr. Norman Francis, a recipient of the Presidential Medal of Freedom, and University Dignitaries before holding a town hall meeting. Women of the Storm, a non-partisan alliance of Louisiana women who in the aftermath of Hurricanes Katrina and Rita educated elected officials about the urgent needs of those affected, will participate in the town hall. John McCain will conclude his visit to Louisiana at the Business Report and Junior Achievement 25th Annual Business Awards and Hall of Fame Banquet where he will speak about the federal government's r esponsibility in preparing, assisting, and recovering from calamities such as Hurricanes Katrina and Rita.

New Orleans was founded in 1718 and is located between the Mississippi River and Lake Pontchartrain in southeastern Louisiana. Much of the land upon which New Orleans stands today was once swamp marsh. In 1899, engineer A. Baldwin Wood was hired by the Sewerage and Water Board of New Orleans to improve the city's drainage and spearhead the reclamation and development of the land now occupied by the city of New Orleans. While its geographic location and development has certainly contributed to New Orleans' uniqueness, it has also made it vulnerable to major storms. And Hurricane Katrina and its aftermath exposed the extent of this vulnerability when it hit the city on August 29, 2005.

Recovery from Katrina has been a slow struggle. On February 14, FEMA announced its plan to relocate the 35,000 hurricane victims living in FEMA trailers and had also previously announced a plan to find victims permanent housing by June 1. Schools have reopened. Charter Schools are flourishing. With the highest percentage of students in charter schools among U.S. cities, New Orleans has become a proving ground for charter schools in urban areas. Businesses are gradually reopening too. And a crime coalition, which includes members of the business and good-government communities, is working to rebuild a police force and criminal justice system that was broken long before Katrina.

But issues remain to be resolved: the rise in crime and mental health issues after Katrina, the allocation of offshore oil revenues, coastline erosion, whether insurance providers should be required to offer special coverage for natural disaster prone areas, the Housing Authority of New Orleans' housing project redevelopment, and funding for the Army Corps of Engineers' 100 year storm protection project.

Before Hurricane Katrina, it was estimated that 452,170 were living in the city (2005 census estimates). The racial make-up of the city at the time of the 2000 census was 67.3% African American, 28.1% White, 0.2% Native American, 2.3% Asian and 1.1% Other.

Thursday, April 24, 2008

WHAT THEY'RE SAYING ABOUT THE "IT'S TIME FOR ACTION TOUR" DAY THREE

"John McCain continues this week to go where few Republican candidates have gone before, to draw attention to communities that are struggling." -- Fox News' Brit Hume (Fox News' "Special Report With Brit Hume," 4/23/08)

The Lexington Herald Leader: "It Was An Unlikely Setting For Republican Presidential Hopeful John McCain To Campaign In Wednesday." "It was an unlikely setting for Republican presidential hopeful John McCain John McCain -Search using: to campaign in Wednesday: the tiny coal-mining town of Inez, where there are only three stoplights and a few hundred residents and you can count the number of fast-food restaurants on one hand." (Cassondra Kirby, "'I Will Not Forget,'" The Lexington Herald Leader, 4/24/08)

McCain Will Come Back To Inez:
The Washington Post: "Unlike The Other National Politicians Who Have Come To Appalachia Once, Never To Return, McCain Insisted He Would Come Back." "And unlike the other national politicians who have come to Appalachia once, never to return, McCain insisted he would come back to town if he becomes president. 'I will not make this my last visit to Inez,' he said, sparking another round of applause." (Juliet Eilperin, "In Johnson's Footsteps, McCain Finds Republicans," The Washington Post's "Trail" Blog, 4/23/08)

McCain "Greeted With Whoops And Cheers":
The Washington Post: "He Was Greeted With Whoops And Cheers By A Crowd In The Courthouse As He Pledged To Return To Inez If He Becomes President." (Juliet Eilperin And Michael D. Shear, "For McCain: Different Place, Same Message," The Washington Post, 4/24/08)

The Lexington Herald Leader: "In Inez, It Appeared The Whole Town Had Turned Out To See McCain." "In Inez, it appeared the whole town had turned out to see McCain. Hundreds lined Main Street outside the old stone courthouse to catch a glimpse of him. They included war veterans in uniform, mothers with children clinging to them and coal miners current and retired." (Cassondra Kirby, "'I Will Not Forget,'" The Lexington Herald Leader, 4/24/08)

· The Lexington Herald Leader: Town Hall Meeting "Was Standing Room Only." "Inside the courthouse, there was standing room only, as more than 450 people filed in to participate in the town hall meeting." (Cassondra Kirby, "'I Will Not Forget,'" The Lexington Herald Leader, 4/24/08)

Louisville Courier-Journal: "For Martin County ... The Visit Was Important." "For Martin County, which is about 3-to-1 Republican, the visit was important. Main Street was shut off to traffic for most of the morning, and a number of businesses left their doors locked so employees could hear McCain." (Joseph Gerth, "McCain Visits Inez, Focuses On Economy, Taxes," Louisville Courier-Journal, 4/24/08)

McClatchy: Inez Crowd "Greeted McCain Rapturously." "The crowd of several hundred -- in a town with fewer than 500 residents -- greeted McCain rapturously, with several standing ovations as he delivered a speech and held a town-hall meeting in an old county courthouse." (Matt Stearns, "McCain Visits Poor Kentucky Town To Slam Big Government," McClatchy, 4/23/08)

The Washington Post: McCain "Greeted With Whoops And Cheers By A Crowd In A Packed Courthouse." "Greeted with whoops and cheers by a crowd in a packed courthouse here this morning, Sen. John McCain (R-Ariz.) pledged to help small rural communities that have been largely overlooked by national politicians." (Juliet Eilperin, "In Johnson's Footsteps, McCain Finds Republicans," The Washington Post's "Trail" Blog, 4/23/08)

CBS News: "Standing Ovation" For Defense Against "Bitter" Comments. "While John McCain courted the rural vote in Inez, Kentucky today, a local leader got a standing ovation for defending his constituents against Barack Obama's comments that were taken to mean that small town people are 'bitter.'" (Dante Higgins, "Obama's 'Bitter' Comment Comes Up During McCain Event In Kentucky," CBS News' "From The Road" Blog, 4/23/08)

Los Angeles Times: McCain "Warmly Received" In Inez. "The several hundred people who lined Inez's main street, a thoroughfare of mostly closed shops, warmly received McCain, the presumptive Republican presidential nominee." (Maeve Reston, "McCain Talks Poverty In Appalachia," Los Angeles Times, 4/24/08)

Local Voices On John McCain's Visit:
Democrat And McCain Supporter Martin County Judge-Executive Kelly Callaham: "This Is Huge." (Joseph Gerth, "McCain Visits Inez, Focuses On Economy, Taxes," Louisville Courier-Journal, 4/24/08)

Democrat Martin County Magistrate Greta Ward: "Oh, I Just Loved Him, He Gave All The Right Answers." "Afterward, at least one Democrat in what appeared to be a majority Republican crowd said she liked what she heard. 'Oh, I just loved him, he gave all the right answers,' said Greta Ward, 39, a Martin County magistrate..." (Elisabeth Bumiller, "McCain Says Government Isn't Poverty's Sole Solution," The New York Times, 4/24/08)

Retired Coal Miner Virgil Fletcher: "I think it's important not to forget about the people of Eastern Kentucky. ... I think McCain shows that he cares and I think he will do things to help this area. It's a bad time here. People are struggling to live." (Cassondra Kirby, "'I Will Not Forget,'" The Lexington Herald Leader, 4/24/08)

Support For John McCain's Economic Message:
The New York Times: "McCain Distinguished Himself From Johnson As A Republican Who Would Not Turn Solely To Government For Solutions To Poverty." "In his formal remarks, Mr. McCain distinguished himself from Johnson as a Republican who would not turn solely to government for solutions to poverty." (Elisabeth Bumiller, "McCain Says Government Isn't Poverty's Sole Solution," The New York Times, 4/24/08)

McClatchy: "In The Heart Of Appalachia ... McCain Told Voters Wednesday That The Government Couldn't Solve All Their Problems." "In the heart of Appalachia, in the town where Lyndon Johnson declared the war on poverty but where poverty still reigns, John McCain told voters Wednesday that the government couldn't solve all their problems." (Matt Stearns, "McCain Visits Poor Kentucky Town To Slam Big Government," McClatchy, 4/23/08)

· Inez First Assistant Prosecuting Attorney Tony Skeans: "Mountain People Are Proud People, And We Like To Take Care Of Our Business. ... We Want The Federal Government To Help Us The Best It Can, But We Don't Want It To Tell Us What To Do With Our Guns Or Our Religion." (Juliet Eilperin, "In Johnson's Footsteps, McCain Finds Republicans," The Washington Post's "Trail" Blog, 4/23/08)

· Inez Community Center Carolea Mills: Government Should "Not Give Us Things, But Give Us Tools." "Carolea Mills, executive director of an Inez community center, said after McCain's talk that government should 'not give us things, but give us tools,' particularly educational opportunities." (David Jackson, "McCain Follows LBJ Footsteps To Talk Economics," USA Today, 4/24/08)

· McClatchy: Irene McCoy "Agrees With McCain That Now The Area's Biggest Need Is More Money For Job-Training Education." "Irene McCoy works at a Wal-Mart with her daughter. Her son works in a coal mine. 'It's a hard way to go around here. We're just poor folks,' she said. Yet in many ways the area has changed since Johnson visited in 1964, Packett said. 'It's a lot better than it was. A lot of people didn't have electricity or indoor plumbing. Now they might be in trailers or double-wides, but they're better off. There has been progress.' He said LBJ's big government aid was helpful in its day, but he agrees with McCain that now the area's biggest need is more money for job-training education." (Matt Stearns, "McCain Visits Poor Kentucky Town To Slam Big Government," McClatchy, 4/23/08)

In The Headlines:
The Lexington Herald Leader: "'I Will Not Forget'"(Cassondra Kirby, "'I Will Not Forget,'" The Lexington Herald Leader, 4/24/08)

Los Angeles Times: "McCain Talks Poverty In Appalachia"(Maeve Reston, "McCain Talks Poverty In Appalachia," Los Angeles Times, 4/24/08)

Louisville Courier-Journal: "McCain Visits Inez, Focuses On Economy, Taxes" (Joseph Gerth, "McCain Visits Inez, Focuses On Economy, Taxes," Louisville Courier-Journal, 4/24/08)

McClatchy: "McCain Visits Poor Kentucky Town To Slam Big Government"(Matt Stearns, "McCain Visits Poor Kentucky Town To Slam Big Government," McClatchy, 4/23/08)

The New York Times: "McCain Says Government Isn't Poverty's Sole Solution" (Elisabeth Bumiller, "McCain Says Government Isn't Poverty's Sole Solution," The New York Times, 4/24/08)
Politico: "McCain Takes Tour To Appalachia" (Jonathan Martin, "McCain Takes Tour To Appalachia," Politico, 4/23/08)

USA Today: "McCain Follows LBJ Footsteps To Talk Economics" (David Jackson, "McCain Follows LBJ Footsteps To Talk Economics," USA Today, 4/24/08)

John McCain On Fox News' "Studio B"

John McCain
Fox News'
"Studio B"
April 24, 2008

SHEPARD SMITH: "I wanted to ask you about gas. You have called for a holiday over the summer between Memorial and Labor Day from the federal gas tax. What would we sacrifice were such a thing to happen?"

JOHN MCCAIN: "Very little. Maybe a Bridge to Nowhere. Maybe another pork barrel project. It should be made up by general revenues. Look, all I'm asking for is a little holiday. We continue to see gas prices go up dramatically at the gas stations. It's 18 cents a gallon for regular gasoline, and 24 cents on diesel. And you know, when I mentioned it, the special interests in Washington -- you'd of think I had said I'm declaring the end of Western civilization as we know it. Oh my God! Look, the lowest income Americans drive the furthest in America. They want to take a little vacation this summer. Let's give them a little break. Is it a huge impact? Maybe not, but it might be nice to give them a little break."

Watch John McCain On Fox News' "Studio B"

STATEMENT BY JOHN MCCAIN ON SYRIA AND NORTH KOREA

U.S. Senator John McCain today issued the following statement on today's news regarding Syria and North Korea:

"The latest news about North Korean proliferation to Syria is very troubling, but not surprising. North Korea has not acted in good faith for more than a decade, despite intense efforts by the United States and others to engage it in diplomacy. Nor has North Korea met the terms of the Six Party February 13, 2007 agreement. Now Pyongyang is refusing to disclose full details of their own nuclear programs and has actively aided another dangerous regime acquire the wherewithal to develop nuclear weapons in the future -- a regime that directly threatens the survival of the state of Israel. These activities stand in clear violation of United Nations Security Council Resolutions and deserve the widest possible condemnation by the international community.

"The goal of our diplomacy must be an agreement that advances America's national interests in the full denuclearization of North Korea and the cessation and full accounting of North Korea's proliferation activities. Any agreement must be completely verifiable, and must take into account the interests of our democratic allies in South Korea and Japan. In addition, it would be a serious mistake to exclude from the negotiations our legitimate concerns regarding North Korea's egregious human rights abuses.

"Those who say that we only need to meet unconditionally with Kim Jong Il rather than apply meaningful multilateral pressure should explain to the American people how talking unconditionally to dictators like Kim Jong Il in the aftermath of recent disclosures advances American interests. Our diplomacy must be based on more than hope."

Wednesday, April 23, 2008

REMARKS BY JOHN MCCAIN ON DAY THREE OF THE TIME FOR ACTION TOUR

Remarks as prepared for delivery at a town hall meeting at the Old Martin County Courthouse, in Inez, KY, today at 11:15 a.m. EDT:

Thank you. I'm pleased to be here and appreciate the welcome. I've never had the pleasure before of coming to Martin County, Kentucky. I regret that I've been so long in coming to this naturally beautiful part of our country, and that my stay will be a brief one. But my purpose in coming is not to admire the Appalachian scenery or to proclaim my Scots-Irish kinship with so many of the hardworking people who settled here, and carved a rugged life from the wilderness, and whose descendents still live here: proud of your heritage; self-reliant despite challenges many places in America do not experience; faithful to the values that have passed from one generation to the next; and intent on making for better lives for yourselves and your children.
You've had presidential candidates come to eastern Kentucky before. You've even had a president come to Inez before, forty-four years ago, where he issued a declaration of war on Tom Fletcher's front porch. Like me, he brought a lot of reporters with him so the moment and the pictures could be broadcast throughout the country. I am running for president, and I am intent on winning that office. And I cannot claim that the circumstances of our lives are similar in every respect. I am not the son of a coal miner. I wasn't raised by a family that made its living from the land or toiled in a mill or worked in the local schools or health clinic. There isn't any place in America like Appalachia that I can claim has always been mine, which I often regret. I grew up in a lot of different places. I was raised in the United States Navy, and after my own naval career, I became a politician. My work isn't as hard as yours. I had an easi er start in life and an easier time since than many folks in Martin County. And although I pride myself on being a pretty resilient man, I cannot say that I have half the strength and determination of people in Inez. But you are my compatriots; my fellow Americans. That shared distinction means more to me than almost any other association. And if I am elected president, I intend every day to prove myself worthy of the office, of our country and of your respect.

I have no doubt President Johnson was serious and had the very best of intentions when he declared the war on poverty in America. But the army he enlisted was mostly drawn from the ranks of government bureaucracies. Government has a role to play in helping people who through no fault of their own are having a hard time. But government can't create good and lasting jobs outside of government. It can't pay lost wages. It can't dig coal from the earth. It can't buy you a house or send all your kids to college. It can't do your work for you. And you've never asked it to.

You've never wanted government to make your living for you. You just expect us to show a decent concern for your hard work and initiative; and do what we can to help make sure you have opportunities to prosper from your labor. We all have choices to make in our lives, and you don't expect government to make yours for you. But you have a right to expect that the people you elect to office will help and not hinder your efforts to make a better future for your community and families. You have a right to expect us to show as much concern for helping you create more and better choices to make for yourselves as we show any other community in America or we show the special interests who claim so much of Washington's attention.

The modern economy offers new opportunities for communities like Inez. In particular, through access to high-speed Internet services that facilitate interstate commerce, drive innovation, and promote educational achievements, there is the potential to change lives. These kinds of transformations of our way of life require the infrastructure of modern communication, and government has a role to play in assuring every community in America can develop that infrastructure. This country has a long history of ensuring that rural areas have the same access to communication technology as other places. In 1934, Congress mandated that every American, regardless of where they lived, receive basic telephone service at approximately the same rate, and established the universal service fund to provide Americans with that service. Unfortunately, in a tale that is too familiar, the program became a breeding ground for waste, corruption, an d grossly inefficient spending.

We need to widely reform the way we do business in Washington; to end wasteful spending that does little if anything to meet government's obligations to the American people. Government should accurately identify areas where the market truly is not working and provide companies that are willing to build the information infrastructure to serve these areas incentives like tax reductions and more generous depreciation.

I think we should establish a "People Connect Program" that rewards companies that offer high-speed Internet access services to underserved, low-income customers by allowing these companies to write off the cost of this service. The government should enlist the help of private/public partnerships to devise creative and successful solutions to the lack of access to information technology. In many places, cities and towns are working with businesses that have experience providing high-speed Internet services to share the cost of building and improving that service. Where companies are unwilling to build information infrastructure, the federal government can support towns through government-backed loans or by issuing bonds with a low interest rate.

An aggressive effort to knit together all of the United States with 21st century information networks will make location less of a factor in the potential for economic success. Instead, the prime determinant will be the skills, energy, imagination, and persistence of Americans -- attributes that have traditionally been in great supply in America, and certainly exist here, where people have always prided themselves on hard work and self-reliance.

We can make sure necessary skills are acquired through more extensive use of our community colleges. Community colleges have a proven track record of tailoring training programs to the business climate in the local community. Big Sandy Community and Technical College has a unique partnership with local coal companies, and provides exceptional classroom instruction in areas like Mine Certification, Basic Computers, Safety and First Aid, Business and Personal Finance, Hydraulics and others. Community college training in the region and elsewhere in our country is one of the most convenient, cost efficient and effective things we can do to stimulate economic growth locally.

Everyone recognizes that educational opportunities are indispensible to greater prosperity for all Americans, whether they live in Los Angeles, California, Washington, D.C. or Martin County, Kentucky. And in a country as prosperous and as good and decent as ours, there is no excuse for accepting anything other than the highest quality public education.

Rural areas often struggle to attract young highly qualified and motivated new teachers. At the same time, we make it very difficult for Americans with exceptional skills for teaching to enter the field of education through non-traditional means. These are often people who would like nothing better than to take advantage of the quiet beauty and traditional values that are the foundation of rural America. But the path to teaching is often made up of more barriers than gateways. You can be a Nobel Laureate and not qualify to teach in most public schools today. The next president should aggressively support state and national initiatives that attract exceptionally qualified candidates into teaching and that provide certification based on the candidates' demonstrated knowledge of the subjects they will teach, as well as their knowledge of how to teach. Terrific organizations like Teach for America attract the very best young co llege graduates from all disciplines to enter the teaching profession. The Troops to Teachers program takes advantage of the sense of heightened responsibility and duty that military veterans were taught in the discipline of the armed forces, and which makes many of them excellent candidates to impart those virtues to our children, and help them see the value of learning as a means to self-improvement.

New education technologies offer great partners, and bring the best teachers and most advanced technologies into the classroom where students and teachers alike benefit. Technology allows teachers in the smallest school in America to team up with the greatest math, English, and science teachers in the country. Nobody has to be isolated in their teaching. And students can be constantly challenged by a class that offers a fantastic teacher on-line and a supportive, quality teacher in the classroom when the going gets rough. The measure of success should be individual student achievement, regardless of how it's achieved.

My purpose in coming to Inez isn't, however, to roll out a long list of policy initiatives I intend to launch if I am elected president or to make vague promises to you that I will forget making once in office. I came here to listen to and learn from you, about what you're doing to grow your economy and increase opportunities here, and to find out what government is doing and not doing to help your initiatives. I know some of the initiatives you have undertaken here. A good example of a successful public-private partnership is your own Bluegrass State Skills Corporation, which develops customized business training programs, offers funding through grants and credits, and provides administrative services to ensure that these programs have their maximum impact. That is an initiative designed locally by people who know and understand Martin County and the strengths, resourcefulness and needs of the people here better than any b ureaucrat in Washington could ever hope to.

Before I take your questions and ask you a few of my own, which is why I came here today, I want to close by saying that if I am president, I will not forget that the decisions I make will affect, for good or ill, your ability to make decisions for your families. I will not forget my responsibilities to every American community. I will not offer talk as a substitute for action. I will not make promises I intend to forget. And I will not make this my last visit to Inez. If I'm elected, I will come back here in the course of my administration; hold another townhall meeting, and invite you to hold me accountable for the decisions I have made and the promises I have sworn to keep. Thank you.
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