Page last updated at 01:56 GMT, Sunday, 21 March 2010

Full text: Obama's healthcare appeal to Democrats


President Obama: "Don't do it for me, don't do it for the Democratic Party, do it for the American people"

One day before a landmark vote on healthcare reform, US President Barack Obama went before the House Democratic Congress, urging lawmakers to "get it done".

Here is the full text of Mr Obama's remarks, delivered at the Capitol Visitor Center Auditorium in Washington, DC.

I have the great pleasure of having a really nice library at the White House. And I was tooling through some of the writings of some previous presidents and I came upon this quote by Abraham Lincoln: "I am not bound to win, but I'm bound to be true. I'm not bound to succeed, but I'm bound to live up to what light I have."



A year later, we're in different circumstances. Because of the actions that you've taken, the financial system has stabilized. The stock market has stabilized. Businesses are starting to invest again. The economy, instead of contracting, is now growing again. There are signs that people are going to start hiring again. There's still tremendous hardship all across the country, but there is a sense that we are making progress -- because of you.

Stronger system


But even before this crisis, each and every one of us knew that there were millions of people across America who were living their own quiet crises. Maybe because they had a child who had a pre-existing condition and no matter how desperate they were, no matter what insurance company they called, they couldn't get coverage for that child. Maybe it was somebody who had been forced into early retirement, in their 50s not yet eligible for Medicare, and they couldn't find a job and they couldn't find health insurance, despite the fact that they had some sort of chronic condition that had to be tended to.

Every single one of you at some point before you arrived in Congress and after you arrived in Congress have met constituents with heart-breaking stories. And you've looked them in the eye and you've said, we're going to do something about it -- that's why I want to go to Congress.

And now, we're on the threshold of doing something about it. We're a day away. After a year of debate, after every argument has been made, by just about everybody, we're 24 hours away.

As some of you know, I'm not somebody who spends a lot of time surfing the cable channels, but I'm not completely in the bubble. I have a sense of what the coverage has been, and mostly it's an obsession with "What will this mean for the Democratic Party? What will this mean for the President's polls? How will this play out in November? Is this good or is this bad for the Democratic majority? What does it mean for those swing districts?"


But it may also be possible that they realize after health reform passes and I sign that legislation into law, that it's going to be a little harder to mischaracterize what this effort has been all about.

There are some things I'd like to see that's not in this legislation. But is this the single most important step that we have taken on health care since Medicare? Absolutely

Because this year, small businesses will start getting tax credits so that they can offer health insurance to employees who currently don't have it. Because this year, those same parents who are worried about getting coverage for their children with pre-existing conditions now are assured that insurance companies have to give them coverage -- this year.

Because this year, insurance companies won't suddenly be able to drop your coverage when you get sick or impose lifetime limits or restrictive limits on the coverage that you have. Maybe they know that this year, for the first time, young people will be able to stay on their parents' health insurance until they're 26 years old and they're thinking that just might be popular all across the country.

And what they also know is what won't happen. They know that after this legislation passes and after I sign this bill, lo and behold nobody is pulling the plug on Granny. It turns out that in fact people who like their health insurance are going to be able to keep their health insurance; that there's no government takeover. People will discover that if they like their doctor, they'll be keeping their doctor. In fact, they're more likely to keep their doctor because of a stronger system.


Tough reforms

Now, there are some who wanted a single-payer government-run system. That's not this bill. The Republicans wanted what I called the "foxes guard the henhouse approach" in which we further deregulate the insurance companies and let them run wild, the notion being somehow that that was going to lower costs for the American people. I don't know a serious health care economist who buys that idea, but that was their concept. And we rejected that, because what we said was we want to create a system in which health care is working not for insurance companies but it's working for the American people, it's working for middle class families.

Don't do it for me. Don't do it for the Democratic Party. Do it for the American people. They're the ones who are looking for action right now.

So what did we do? What is the essence of this legislation? Number one, this is the toughest insurance reforms in history. We are making sure that the system of private insurance works for ordinary families. A prescription -- this is a patient's bill of rights on steroids. So many of you individually have worked on these insurance reforms -- they are in this package -- to make sure that families are getting a fair deal; that if they're paying a premium, that they're getting a good service in return; making sure that employers, if they are paying premiums for their employees, that their employees are getting the coverage that they expect; that insurance companies are not going to game the system with fine print and rescissions and dropping people when they need it most, but instead are going to have to abide by some basic rules of the road that exemplify a sense of fairness and good value. That's number one.


And that's why the Congressional Budget Office says this will lower people's rates for comparable plans by 14 to 20%. That's not my numbers -- that's the Congressional Budget Office's numbers. So that people will have choice and competition just like members of Congress have choice and competition.

Number three, if people still can't afford it we're going to provide them some tax credits -- the biggest tax cut for small businesses and working families when it comes to health care in history.

And number four, this is the biggest reduction in our deficit since the Budget Balance Act -- one of the biggest deficit reduction measures in history -- over $1.3 trillion that will help put us on the path of fiscal responsibility.

And that's before we count all the game-changing measures that are going to assure, for example, that instead of having five tests when you go to the doctor you just get one; that the delivery system is working for patients, not just working for billings. And everybody who's looked at it says that every single good idea to bend the cost curve and start actually reducing health care costs are in this bill.

So that's what this effort is all about. Toughest insurance reforms in history. A marketplace so people have choice and competition who right now don't have it and are seeing their premiums go up 20, 30, 40, 50%. Reductions in the cost of health care for millions of American families, including those who have health insurance. The Business Roundtable did their own study and said that this would potentially save employers $3,000 per employee on their health care because of the measures in this legislation.

And by the way, not only does it reduce the deficit -- we pay for it responsibly in ways that the other side of the aisle that talks a lot about fiscal responsibility but doesn't seem to be able to walk the walk can't claim when it comes to their prescription drug bill. We are actually doing it. This is paid for and will not add a dime to the deficit -- it will reduce the deficit.

Not perfect

I know this is a tough vote. And I am actually confident that it will end up being the smart thing to do politically because I believe that good policy is good politics.

Now, is this bill perfect? Of course not. Will this solve every single problem in our health care system right away? No. There are all kinds of ideas that many of you have that aren't included in this legislation. I know that there has been discussion, for example, of how we're going to deal with regional disparities and I know that there was a meeting with Secretary Sebelius to assure that we can continue to try to make sure that we've got a system that gives people the best bang for their buck.

So this is not -- there are all kinds of things that many of you would like to see that isn't in this legislation. There are some things I'd like to see that's not in this legislation. But is this the single most important step that we have taken on health care since Medicare? Absolutely. Is this the most important piece of domestic legislation in terms of giving a break to hardworking middle class families out there since Medicare? Absolutely. Is this a vast improvement over the status quo? Absolutely.

Now, I still know this is a tough vote, though. I know this is a tough vote. I've talked to many of you individually. And I have to say that if you honestly believe in your heart of hearts, in your conscience, that this is not an improvement over the status quo; if despite all the information that's out there that says that without serious reform efforts like this one people's premiums are going to double over the next five or 10 years, that folks are going to keep on getting letters from their insurance companies saying that their premium just went up 40 or 50 percent; if you think that somehow it's okay that we have millions of hardworking Americans who can't get health care and that it's all right, it's acceptable, in the wealthiest nation on Earth that there are children with chronic illnesses that can't get the care that they need -- if you think that the system is working for ordinary Americans rather than the insurance companies, then you should vote no on this bill. If you can honestly say that, then you shouldn't support it. You're here to represent your constituencies and if you think your constituencies honestly wouldn't be helped, you shouldn't vote for this.

But if you agree that the system is not working for ordinary families, if you've heard the same stories that I've heard everywhere, all across the country, then help us fix this system. Don't do it for me. Don't do it for Nancy Pelosi or Harry Reid. Do it for all those people out there who are struggling.

Some of you know I get 10 letters a day that I read out of the 40,000 that we receive. Started reading some of the ones that I got this morning. "Dear President Obama, my daughter, a wonderful person, lost her job. She has no health insurance. She had a blood clot in her brain. She's now disabled, can't get care." "Dear President Obama, I don't yet qualify for Medicare. COBRA is about to run out. I am desperate, don't know what to do."

Do it for them. Do it for people who are really scared right now through no fault of their own, who've played by the rules, who've done all the right things, and have suddenly found out that because of an accident, because of an ailment, they're about to lose their house; or they can't provide the help to their kids that they need; or they're a small business who up until now has always taken pride in providing care for their workers and it turns out that they just can't afford to do it anymore and they've having to make a decision about do I keep providing health insurance for my workers or do I just drop their coverage or do I not hire some people because I simply can't afford it -- it's all being gobbled up by the insurance companies.


Regional concerns



I had a wonderful conversation with Betsy Markey. I don't know if Betsy is around here. There she is right there. Betsy is in a tough district. The biggest newspaper is somewhat conservative, as Betsy described. They weren't real happy with health care reform. They were opposed to it. Betsy, despite the pressure, announced that she was in favor of this bill. And lo and behold, the next day that same newspaper runs an editorial saying, you know what, we've considered this, we've looked at the legislation, and we actually are pleased that Congresswoman Markey is supporting the legislation.

When I see John Boccieri stand up proud with a whole bunch of his constituencies -- -- in as tough a district as there is and stand up with a bunch of folks from his district with preexisting conditions and saying, you know, I don't know what is going on Washington but I know what's going on with these families -- I look at him with pride.





Political vindication

Sometimes I think about how I got involved in politics. I didn't think of myself as a potential politician when I get out of college. I went to work in neighbourhoods, working with Catholic churches in poor neighbourhoods in Chicago, trying to figure out how people could get a little bit of help. And I was sceptical about politics and politicians, just like a lot of Americans are sceptical about politics and politicians are right now. Because my working assumption was when push comes to shove, all too often folks in elected office, they're looking for themselves and not looking out for the folks who put them there; that there are too many compromises; that the special interests have too much power; they just got too much clout; there's too much big money washing around.

We are not bound to win, but we are bound to be true. It is in your hands. It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow.







Thank you very much, House of Representatives. Let's get this done.

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