President Obama's Strongsville Speech

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The Plan

Yes votes on health reform

Interview with House Speaker Nancy Pelosi

TRANSCRIPT, The Plain Dealer, 3-15-10

President Barack Obama speaks about health care reform on Monday [3-15-10] at the Walter F. Ehrnfelt Recreation and Senior Center in Strongsville [Ohio].


``Hello, Ohio!

It is good to be here in the Buckeye State ...

That's a good bunch of folks we got here in Ohio, working hard ...

I want to thank Connie -- I want to thank Connie, who introduced me.

I want to thank her and her family for being here on behalf of her sister, Natoma [Canfield].

I don't know if everybody understood that Natoma is in the hospital right now, so Connie was filling in.

It's not easy to share such a personal story, when your sister who you love so much is sick. And so I appreciate Connie being willing to do so here today, and -- (applause) -- and I want everybody to understand that Connie and her sister are the reason that I'm here today.

See, Connie felt it was important that her sister's story be told.

But I want to just repeat what happened here.

Last month, I got a letter from Connie's sister, Natoma.

She's self-employed, she's trying to make ends meet, and for years she's done the responsible thing, just like most of you have.

She bought insurance -- she didn't have a big employer who provided her insurance, so she bought her health insurance through the individual market.

And it was important for her to have insurance because 16 years ago, she was diagnosed with a treatable form of cancer.

And even though she had been cancer-free for more than a decade, the insurance companies kept on jacking up her rates, year after year.

So she increased her out-of-pocket expenses.

She raised her deductible.

She did everything she could to maintain her health insurance that would be there just in case she got sick, because she figured ... she didn't want to be in a position where, if she did get sick, somebody else would have to pick up the tab; that she'd have to go to the emergency room; that the cost would be shifted onto folks through their higher insurance premiums or hospitals charging higher rates.

So she tried to do the right thing.

And she upped her deductible last year ... to the highest possible deductible.

But despite that, Natoma's insurance company raised her premiums by more than 25 percent.

And over the past year, she paid more than $6,000 in monthly premiums.




She paid more than $4,000 in out-of-pocket medical costs, for co-pays and medical care and prescriptions.

So all together, this woman paid $10,000 -- one year.

But because she never hit her deductible, her insurance company only spent $900 on her care.

So the insurance company is making -- getting $10,000; paying out $900.

Now, what comes in the mail at the end of last year?


A bill!


A rate hike!


It's a letter telling Natoma that her premiums would go up again by more than 40 percent.




So here's what happens.

She just couldn't afford it. She didn't have the money.

She realized that if she paid those health insurance premiums that had been jacked up by 40 percent, she couldn't make her mortgage.

And despite her desire to keep her coverage, despite her fears that she would get sick and lose the home that her parents built -- she finally surrendered, she finally gave up her health insurance.

She stopped paying it -- she couldn't make ends meet.

So January [2010] was her last month of being insured.

Like so many responsible Americans -- folks who work hard every day, who try to do the right thing -- she was forced to hang her fortunes on chance.

To take a chance, that's all she could do.

She hoped against hope that she would stay healthy.

She feared terribly that she might not stay healthy.

That was the letter that I read to the insurance companies, including the person responsible for raising her rates.

Now, I understand Natoma was pretty surprised when she found out that I had read it to these CEOs.

But I thought it was important for them to understand the human dimensions of this problem.

Her rates have been hiked more than 40 percent.

And this was less than two weeks ago.

Unfortunately, Natoma's worst fears were realized.

And just last week, she was working on a nearby farm, walking outside -- apparently, chasing after a cow ... when she collapsed.

And she was rushed to the hospital.

She was very sick.

She needed two blood transfusions.

Doctors performed a battery of tests.

And on Saturday, Natoma was diagnosed with leukemia.

Now, the reason Natoma is not here today is that she's lying on a hospital bed, suddenly faced with this emergency -- suddenly faced with the fight of her life.

She expects to face more than a month of aggressive chemotherapy.

She is racked with worry not only about her illness but about the costs of the tests and the treatment that she's surely going to need to beat it.

So you want to know why I'm here, Ohio?

I'm here because of Natoma.


I'm here because of the countless others who have been forced to face the most terrifying challenges in their lives with the added burden of medical bills they can't pay.

I don't think that's right.


Neither do you.

That's why we need ... health insurance reform right now ...



I'm here because of my own mother's story.

She died of cancer, and in the last six months of her life, she was on the phone in her hospital room arguing with insurance companies instead of focusing on getting well and spending time with her family.

I'm here because of the millions who are denied coverage because of preexisting conditions or dropped from coverage when they get sick.


I'm here because of the small businesses who are forced to choose between health care and hiring.


I'm here because of the seniors unable to afford the prescriptions that they need.


I'm here because of the folks seeing their premiums go up 20 and 30 and 40 and 50 and 60 percent in a year.


Ohio, I am here because that is not the America I believe in and that's not the America that you believe in.


What's your plan?


So when you hear people say "start over" --




I want you to think about Natoma.

When you hear people saying that this isn't the "right time," you think about what she's going through.

When you hear people talk about, well, what does this mean for the Democrats?

What does this mean for the Republicans? I don't know how the polls are doing.

When you hear people more worried about the politics of it than what's right and what's wrong, I want you to think about Natoma and the millions of people all across this country who are looking for some help, and looking for some relief.

That's why we need health insurance reform right now.


Part of what makes this issue difficult is most of us do have health insurance, we still do.

And so -- and so we kind of feel like, well, I don't know, it's kind of working for me; I'm not worrying too much.

But what we have to understand is that what's happened to Natoma, there but for the grace of God go any one of us.


Anybody here, if you lost your job right now and after the COBRA ran out ...


So let's just think about -- think about if you lost your job right now.

How many people here might have had a preexisting condition that would mean it'd be very hard to get health insurance on the individual market?

Think about if you wanted to change jobs.

Think about if you wanted to start your own business but you suddenly had to give up your health insurance on your job.

Think about what happens if a child of yours, heaven forbid, got diagnosed with something that made it hard for them to insure.

For so many people, it may not be a problem right now but it's going to be a problem later, at any point.

And even if you've got good health insurance, what's happening to your premiums?

What's happening to your co-payments?

What's happening to your deductible?

They're all going up.

That's money straight out of your pocket.

So the bottom line is this:

The status quo on health care is simply unsustainable.


We can't have -- we can't have a system that works better for the insurance companies than it does for the American people.


And we know what will happen if we fail to act.

We know that our government will be plunged deeper into debt.

We know that millions more people will lose their coverage.

We know that rising costs will saddle millions more families with unaffordable expenses.

And a lot of small businesses are just going to drop their coverage altogether.

That's already what's been happening.

A study came out just yesterday -- this is a nonpartisan study -- it's found that without reform, premiums could more than double for individuals and families over the next decade.

Family policies could go to an average of $25,000 or more.

Can you afford that?




You think your employer can afford that?




Your employer can't sustain that.

So what's going to happen is, they're basically -- more and more of them are just going to say, you know what?

You're on your own on this.

We have debated this issue now for more than a year.

Every proposal has been put on the table.

Every argument has been made.

I know a lot of people view this as a partisan issue, but, look, the fact is both parties have a lot of areas where we agree -- it's just politics are getting in the way of actually getting it done.


Somebody asked what's our plan.

Let me describe exactly what we're doing, because we've ended up with a proposal that incorporates the best ideas from Democrats and Republicans, even though Republicans don't give us any credit ...

And ... this is what a lot of the Republicans are saying right now, there are those who simply believe that the answer is to unleash the insurance industry, to deregulate them further, provide them less oversight and fewer rules.




This is called the fox-guarding-the-henhouse approach to health insurance reform.

So what it would do is it would give insurance companies more leeway to raise premiums, more leeway to deny care.

It would segment the market further.

It would be good if you were rich and healthy.

You'd save money.

But if you're an ordinary person, if you get older, if you get a little sicker, you'd be paying more.

Now, I don't believe we should give the government or insurance companies more control over health care in America.

I believe it's time to give you, the American people, more control over your own health insurance.


And that's what our proposal does.

Our proposal builds on the current system where most Americans get their health insurance from their employer.

So if you like your plan, you can keep your plan.

If you like your doctor, you can keep your doctor.

I don't want to interfere with people's relationships between them and their doctors.

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[The Plan]

Essentially, here's what my proposal would change:

three things about the current health care system, but three important things.

NUMBER ONE, it would end the worst practices of the insurance companies ...

Within the first year of signing health care reform, thousands of uninsured Americans with preexisting conditions will be able to purchase health insurance for the first time in their lives or the first time since they got sick.


This year, insurance companies will be banned forever from denying coverage to children with preexisting conditions.

So parents can have a little bit of security.


This year, under this legislation, insurance companies will be banned from dropping your coverage when you get sick. Those practices would end.


With this reform package, all new insurance plans would be required to offer free preventive care to their customers starting this year -- so free check-ups to catch preventable diseases on the front end.

That's a smart thing to do.


Starting this year, if you buy a new plan, there won't be lifetime or restrictive annual limits on the amount of care you receive from your insurance companies, so you won't be surprised by the fine print that says suddenly they've stopped paying and you now suddenly are $50,000 or $100,000 or $200,000 out of pocket. That won't -- that will not happen if this becomes law this year.


I see -- I see some young people in the audience.

If you're an uninsured young adult, you will be able to stay on your parents" policy until you're 26 years old under this law.


So number one -- number one is insurance reform.

The SECOND THING that this plan would change about the current system is this:

For the first time, uninsured individuals, small businesses, they'd have the same kind of choice of private health insurance that members of Congress get for themselves.


Understand if this reform becomes law, members of Congress, they'll be getting their insurance from the same place that the uninsured get theirs, because if it's good enough for the American people, it's good enough for the people who send us to Washington.


So basically what would happen is, we'd set up a pool of people; millions of people across the country would all buy into these pools that give them more negotiating power.

If you work for a big company, you've got a better insurance deal because you've got more bargaining power as a whole.

We want you to have all the bargaining power that the federal employees have, that big companies have, so you'll be able to buy in or a small business will be able to buy into this pool.

And that will lower rates, it's estimated, by up to 14 to 20 percent over what you're currently getting.

That's money out of pocket.

And what my proposal says is if you still can't afford the insurance in this new marketplace, then we're going to offer you tax credits to do so.

And that will add up to the largest middle-class tax cut for health care in history.

That's what we're going to do ...

Look, I want everybody to understand -- the wealthiest among us can already buy the best insurance there is.

The least well among us, the poorest among us, they get their health care through Medicaid.

So it's the middle class, it's working people that are getting squeezed, and that's who we have to help, and we can afford to do it.


Now, it is true that providing these tax credits to middle class families and small businesses, that's going to cost some money.

It's going to cost about $100 billion per year.

But most of this comes from the nearly $2.5 trillion a year that Americans already spend on health care.

It's just right now, a lot of that money is being spent badly.

So with this plan, we're going to make sure the dollars we make -- the dollars that we spend on health care are going to make insurance more affordable and more secure.

And we're going to eliminate wasteful taxpayer subsidies that currently go to insurance company.

Insurance companies are making billions of dollars on subsidies from you, the taxpayer.

And if we take those subsidies away, we can use them to help folks like Natoma get health insurance so she doesn't lose her house.


And, yes, we will set a new fee on insurance companies because they stand to gain millions more customers who are buying insurance.

There's nothing wrong with them giving something back.

But here's the bottom line:

Our proposal is paid for -- which, by the way, is more than can be said for our colleagues on the other side of the aisle when they passed that big prescription drug plan that cost about as much as my health care plan and they didn't pay for any of it and it went straight to the deficit ...

Now, so let me talk about the THIRD THING, which is my proposal would bring down the cost of health care for families, for businesses, and for the federal government ...

We have incorporated most of the serious ideas from across the political spectrum about how to contain the rising costs of health care.

We go after waste and abuse in the system, especially in Medicare.

Our cost-cutting measures would reduce most people's premiums and bring down our deficit by up to a trillion dollars over the next two decades. Those aren't my numbers. Those are the numbers determined by the Congressional Budget Office.

They're the referee.

That's what they say, not what I say.

Now, the opponents of reform, they've tried to make a lot of different arguments to stop these changes.

You remember.

First, they said, well, there's a government takeover of health care.

Well, that wasn't true.

Then they said, well, what about death panels? that didn't turn out to be true.

You know, the most insidious argument they're making is the idea that somehow this would hurt Medicare ...

This proposal adds almost a decade of solvency to Medicare.


This proposal would close the gap in prescription drug coverage, called the doughnut hole -- you know something about that -- that sticks seniors with thousands of dollars in drug costs.

This proposal will over time help to reduce the costs of Medicare that you pay every month.

This proposal would make preventive care free so you don't have to pay out-of-pocket for tests to keep you healthy.


So yes, we're going after the waste, the fraud, the abuse in Medicare. We are eliminating some of the insurance subsidies that should be going to your care.

That's because these dollars should be spent on care for seniors, not on the care and feeding of the insurance companies through sweetheart deals.

And every senior should know there is no cutting of your guaranteed Medicare benefits ...


This proposal makes Medicare stronger, it makes the coverage better, and it makes the finances more secure.

And anybody who says otherwise is either misinformed -- or they're trying to misinform you.

Don't let them hoodwink you.


So, look, Ohio, that's the proposal.

And I believe Congress owes the American people a final up or down vote.


We need an up or down vote.

It's time to vote.

And now as we get closer to the vote, there is a lot of hand-wringing going on.

We hear a lot of people in Washington talking about politics, talking about what this means in November, talking about the poll numbers for Democrats and Republicans.


We need courage!


We need courage.


Did you hear what somebody just said?


That's what we need.

That's why I came here today.

We need courage.


We need courage.

You know, in the end, this debate is about far more than politics.

It comes down to what kind of country do we want to be.

It's about the millions of lives that would be touched and, in some cases, saved, by making health insurance more secure and more affordable.


It's about a woman who's lying in a hospital bed who just wants to be able to pay for the care she needs.

And the truth is, what's at stake in this debate, it's not just our ability to solve this problem; it's about our ability to solve any problem.

I was talking to Dennis Kucinich on the way over here about this. I said, you know what?

It's been such a long time since we made government on the side of ordinary working folks ... where we did something for them that relieved some of their struggles; that made folks who work hard every day and are doing the right thing and who are looking out for the families and contributing to their communities, that just gave them a little bit of a better chance to live out their American Dream.

The American people want to know if it's still possible for Washington to look out for these interests, for their future.

So what they're looking for is some courage.

They're waiting for us to act.

They're waiting for us to lead.

They don't want us putting our finger out to the wind.

They don't want us reading polls.

They want us to look and see what is the best thing for America, and then do what's right.


And as long as I hold this office, I intend to provide that leadership.

And I know these members of Congress are going to provide that leadership.

I don't know about the politics, but I know what's the right thing to do.

And so I'm calling on Congress to pass these reforms -- and I'm going to sign them into law.

I want some courage.

I want us to do the right thing, Ohio.

And with your help, we're going to make it happen.

God bless you, and God bless the United States of America.''


Posted by Commentator 1 on March 15, 2010

``1) This is a hard working woman and an example of what happens to people who try to keep up with insurance costs on their own if they're self employed, like I am.

2) Insurance companies are a FOR PROFIT entity. They loose money when they pay out for anything substantial -- like cancer. So they jack up rates and give people hassles until they go away.

3) The cost of uninsured is ALREADY WRAPPED up into YOUR INSURANCE payment. [because, for one thing, the hospitals raise their rates to cover the uninsured treated in emergency rooms] ...

4) Who "subsidizes" your insurance payments? Your employer? Your union? People out of work due to the recession (brought to you by the same wonderful people who brought you Dubya) are the people who are at risk for no reason of their own.''

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Yes votes on health reform

NEWS ARTICLE from The Plain Dealer, 3-17-10, By Sabrina Eaton

``Rep. Dennis Kucinich to vote 'yes' on health care:

WASHINGTON, D.C. -- U.S. Rep. Dennis Kucinich ... announced at a Capitol news conference this morning that he'll vote "yes" on the bill's latest draft ...

Kucinich acknowledged this morning that his choice now is to either vote "no" on principle, and thereby possibly block the biggest (though imperfect) advance in health coverage in decades, or compromise for the good of the estimated 30 million more Americans who could gain insurance ...

He told reporters that if they want to see first-hand the tough economic and health-care choices that many Americans face, they should "come to the 10th District in Ohio and you'll understand."

Kucinich's field office on Cleveland's West Side routinely helps constituents with their social services needs, and that includes dealing with insurance matters, he said. He cited his own impoverished childhood, saying, "I grew up understanding what it meant to struggling families who did not get adequate care."

"I understand the connection between poverty and poor health care," he said ... "I know I have to make a decision, not on the bill as I would like to see it, but as it is," Kucinich said ...''


NEWS ARTICLE from The Plain Dealer, 3-17-10, By Sabrina Eaton,

``Rep. Betty Sutton will back health care bill ...

Democratic Rep. Betty Sutton just announced her support for the health care bill that's under consideration in the U.S. House of Representatives. Here's a copy of the statement she sent by email:

"Every year more than 40,000 people die because they don't have health insurance coverage, and in this great nation it should not be that way. The legislation is not perfect and indeed contains provisions that I will continue to strive to improve, but I will vote for the bill.

By passing this legislation we will take the long overdue step toward ending the egregious, discriminatory practices of insurance companies that deny care based on pre-existing conditions and impose outrageous premium increases. This legislation will also strengthen the solvency of Medicare, lower drug costs for our seniors, and make health insurance more affordable and accessible for small businesses and individuals." ...

Democratic Rep. Tim Ryan of Niles announced his backing on Monday after President Obama appeared in Strongsville to promote the bill ...

All Ohio Republicans say they oppose it.''


NEWS ARTICLE from The Plain Dealer, 3-17-10, By KATE ANDERSEN BROWER, Bloomberg News

``Obama says he is confident health bill will pass

WASHINGTON -- President Barack Obama said he is confident his health-care plan will pass Congress because it's "the right thing to do" for the country ...

"We can fix this in a way that is sensible, that is centrist," Obama said. "But what we can't do is perpetuate a system in which millions of people day in and day out are having an enormously tough time and small businesses are sending me letters constantly saying that they are seeing their premiums increase 40, 50 percent."

Obama has been pushing for more than a year for action to cover tens of millions of uninsured Americans without adding to the deficit. Lawmakers, who face elections in November, are trying to complete their votes before they leave Washington for a two-week recess on March 26 [2010] ...

"The vote that's taken in the House will be a vote for health-care reform, and if people vote 'yes,' whatever form that takes, that is going to be a vote for health-care reform, and I don't think we should pretend otherwise," Obama said. "If they vote against it, then they're going to be voting against health-care reform and they're going to be voting in favor of the status quo." ...''


NEWS ARTICLE from The Plain Dealer, 3-17-10, By Associated Press

``Obama's health plan gains support ...

WASHINGTON -- President Barack Obama's sweeping health care legislation won precious support from a longtime liberal holdout in the House on Wednesday and from Catholic nuns representing dozens of religious orders, gaining fresh traction in the run-up to a climactic weekend vote ...

Shortly after Kucinich's announcement, a letter was released from 60 leaders of religious orders urging lawmakers to vote for the legislation.

"Despite false claims to the contrary, the Senate bill will not provide taxpayer funding for elective abortions. It will uphold long-standing conscience protections and it will make historic new investments -- $250 million -- in support of pregnant women," wrote the nuns, in a letter released by Network, A National Catholic Social Justice Lobby. "This is the REAL pro-life stance, and we as Catholics are all for it." ...''


NEWS ARTICLE from The Plain Dealer, 3-19-10, By Sabrina Eaton

``Rep. Marcia Fudge announces support for health care reform bill

Warrensville Democratic Rep. Marcia Fudge added her name today to the growing list of Ohio Democrats who plan to vote for the health care reform package under consideration in the House of Representatives.

"My constituents have spoken," Fudge said in a press release. "Ohioans and all Americans deserve affordable, accessible quality health care that is responsive to their needs ..."

Her move comes the same day that her Democratic colleagues John Boccieri of Alliance, Charlie Wilson of St. Clairsville, and Mary Jo Kilroy of Columbus announced their support ...

"I will vote for the health insurance reform bill that will put our families and small businesses in charge of their health care choices," Kilroy said in a press release. "As many of my constituents know, I live with multiple sclerosis. I understand what millions of Americans with pre-existing conditions face, including my constituent who suffers from Parkinson's disease and who was physically harassed by opponents of health insurance reform just this week in front of my office." ...

Fudge said she was pleased the reforms are "completely paid for and will not increase the deficit. This bill actually reduces the federal deficit by $138 billion in the first ten years and cuts the deficit by $1.2 trillion in (the) second ten years."

"Small businesses will receive tax credits to help them maintain quality insurance for their employees," she continued. "Affordability measures and tax credits for the middle class are implemented to expand access to the uninsured. The unfair practice of denying folks coverage on the basis of pre-existing conditions is also ended. Medicaid is expanded to cover additional youth in need."

The Congressional Black Caucus also held a press conference today to boost the bill. "Simply put, reforming health care is a moral and economic imperative," said its chair, Barbara Lee of California. "If we do nothing, the health care system will continue to work better for insurance companies than it does for the American people ..."''

[AARP, ... [representing] older Americans, reiterated its support for the legislation on Friday. "We believe this legislation brings us so much closer to helping millions of older Americans get quality, affordable health care," Bonnie M. Cramer, the chairwoman of the group's board, said in a statement.]


NEWS ARTICLE from The Plain Dealer, 3-21-10, By Sabrina Eaton

``U.S. Rep. Steve Driehaus of Cincinnati says he will vote "yes" on health care reform today ...

Driehaus, along with Rep. Bart Stupak, a Democrat of Michigan, and about a half-dozen anti-abortion Democrats, worked out language for a presidential executive order that would provide more assurances that no public money would be used for elective abortions ...

"I am going to run on health care reform," Driehaus said after the press conference. "I'm proud of what we've done and what we're doing today. I am proud of the executive order we were able to get the president to draft. We are going to run on the great things in this bill for the American people."''


NEWS ARTICLE from The Plain Dealer, 3-21-10, By Sabrina Eaton

``Toledo Democratic Rep. Marcy Kaptur announced this afternoon that she will vote "yes" on historic health care reform legislation that's under consideration in the House of Representatives ...

In a press release, Kaptur said she concluded the bill will "create and foster competition" in the health insurance industry and relieve families from escalating insurance costs.

"The bill overall addresses a serious problem before the country today, which is that people are finding their insurance plans unaffordable," Kaptur said. "This bill, for the first time in American history, gives small business a chance to get affordable rates -- not from the government, because all the plans that are being allowed to serve on the exchange are private plans." ...''


NEWS ARTICLE from The Plain Dealer, 3-21-10, By Sabrina Eaton

``Health care reform passes House

WASHINGTON -- ... It will extend health insurance coverage to 32 million people who lack it, block insurers from denying coverage to people with pre-existing health conditions or capping their lifetime claims, and cut the federal budget deficit by approximately $138 billion over a decade and $1.2 trillion over twenty years.

Democrats compared its significance to the Civil Rights Act, and the legislation that created Social Security and Medicare. Its passage comes after decades of discussing how to fix a health care system everyone acknowledges to be broken.

"I know this bill is complicated," House Democratic Leader Steny Hoyer of Maryland said on the House floor. "It is also very simple. Illness and infirmity are universal, and we are stronger against them together than alone. Our bodies may fail us. Our neighbors don't have to." ...

It is endorsed by interest groups including AARP, Consumers Union and the American Medical Association, and opposed by groups including the U.S. Chamber of Commerce and health insurers.

The bill passed in a 219 to 212 vote, with no support from Republicans ...''


NEWS ARTICLE from The Plain Dealer, 3-21-10, By JIM KUHNHENN, Associated Press Writer

``In piggybacked student loan plan, Obama looks for another win ...

WASHINGTON - With health care dominating House action, President Barack Obama was looking for another domestic policy victory Sunday -- passage of a vast rewrite of college aid for needy students.

The legislation, piggybacked to the expedited health care bill, would end a four-decades old program and its reliance on private lenders. It would authorize the government to originate all assistance loans and would use the savings to increase Pell Grants to students.

In the biggest piece of education legislation since No Child Left Behind nine years ago, the bill would direct more than $40 billion over 10 years into higher education, with $36 billion going toward the popular but financially strapped Pell Grant program. Historically black colleges and community colleges also would receive a share of the money.

If approved in the House, the Senate would take up the bill next week under the same expedited rules used for health care legislation. That means the Senate could pass the education measure by a simple majority, virtually guaranteeing its success ...''

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Newsmaker: Speaker Pelosi on Finishing Health Care's Uphill Climb


JIM LEHRER: And now to our interview with House Speaker Nancy Pelosi. I spoke with her this afternoon at the Capitol.

Madam Speaker, welcome.

REP. NANCY PELOSI, D-Calif., speaker of the house: My pleasure ...

JIM LEHRER: ... Do you see the way you did health care reform as a model for enacting major legislation?

REP. NANCY PELOSI: I see the way we did health care reform as a model of getting something done for the American people. ... We reached for bipartisanship. We tried to find common ground.

But, if we can't, that doesn't mean we don't go forward. It's urgent for the American people in terms of their personal health, their personal finances. It's urgent for the American people in general, as taxpayers, because we will save $1.3 trillion, as we improve quality, lower costs, expand access, and hold the insurance companies accountable.

JIM LEHRER: But the bottom line was, you have a very thin vote margin, no Republican votes, and a sharply divided public. And you still did it.

REP. NANCY PELOSI: Right. Well, that's a tribute to my colleagues, that they had the courage of their convictions, that they believed that this is an historic opportunity to do something great, sitting right up there with Social Security, Medicare, the Civil Rights Act, health care for all Americans ...

And I think what emerged was, is that the Republicans just will not regulate the insurance companies, and the Democrats will. And that was the major difference ...

Now we have health care with innovation, with wellness, and -- and prevention, about using new technologies and more investments in science to make American healthier. It's not just about health care. It's about health, good health for the American people.

JIM LEHRER: Are you concerned at all about the historic record for these kinds of sweeping pieces of legislation?

For instance, Social Security creation, Medicare creation, civil rights legislation, all of those passed by considerable margins and in a bipartisan -- with bipartisan support, and -- but health care, no. Not a problem?

REP. NANCY PELOSI: Well, let's review the history. Let's go back to Medicare. It's the most recent example ...

Medicare ... didn't have the strong bipartisan vote on the vote that really mattered. This is inside baseball, but the motion to recommit is always -- that's when the Republicans had their chance to change the bill. The Republican motion to recommit on Medicare was to gut Medicare. And only about a dozen -- or a few more -- Republicans voted to support Medicare.

On final passage, after that was resolved, yes, many more Republicans joined in. But the fact is, the fight was over whether Medicare would be what it is -- you know, what it set out to be. And, so, it wasn't as bipartisan as -- as others are describing now ...

JIM LEHRER: What's your own analysis of why the Congress is so sharply divided by party right now?

REP. NANCY PELOSI: ... This is the marketplace of ideas ... -- unfortunately, now, when we're trying to make this real change on health care reform, and some people are still very unhappy about the results of the last election, and we have joblessness in our country that we are continuing to address, you have a combination of forces that is fertile for some of the fear-mongering that is going on.

But the fact is, is that we're on a path. This is -- this bill, this health care bill, is a jobs bill. It will create four million jobs. It's part of the president's fuller agenda in his budget, to lower taxes, reduce the deficit, and to grow the economy in a stabilized way around three pillars, investments in education, health care, energy/climate change.

Two of those pillars are addressed in this legislation. It's about change. It's about something fresh and new. And it's about saying to the special interest insurance companies, no longer will you ... come between patients and their doctors. No longer will the American people have to play on your turf.

It's time for you to play on the turf of the American people. So, again, depending on what your view of is the role of government, you exploit your point of view. And the Republicans have exploited the position of the insurance companies and been very effective in -- in hijacking some of the legitimate concerns of the American people against this legislation.

But I feel very confident the more people know about the legislation -- and that's already coming forth. The polls have definitely made a swing in terms of supporting the legislation ...

JIM LEHRER: And ... it's about the insurance companies?

REP. NANCY PELOSI: I believe that...

JIM LEHRER: It doesn't go any deeper than that?

REP. NANCY PELOSI: Well, it's about regulating insurance companies and the role of government in doing so.

Now, they [Republicans] opposed, by and large, Medicare. Even to this day, you know -- you talk about the vote at the time. In the course of the debate in the last decade, the Republicans have said Medicare should wither on the vine -- wither on the vine.

Take it right up to real time right now. The Republican budget is to privatize Social Security, to give a voucher for Medicare, give a voucher to seniors, and have them be left to their own resources as they go out to the marketplace, and to block grant Medicaid, which is the beginning of the end of Medicaid.

So, this isn't even historic. This is current. This is their budget. This is a big difference between Democrats and Republicans ...

Bipartisanship is not more important than a little child who is sick, being deprived of coverage because he has a preexisting condition.

It's not more important than ... just being a woman is no longer a preexisting medical condition, that -- that, if you lose your job, you lose your insurance, that, if you want to start a business or be self-employed or change jobs, you're not job-locked, that the insurance companies don't have it over your head that they can ... increase your rates, and you're at their mercy.

That's more important than getting a few Republican votes, although the president strove ... tried very hard to do so. And I respect that.

JIM LEHRER: Speaking of -- picking up on your line, losing your job, ... how do you feel about the suggestion that this vote on health care reform could lead to the loss of the majority in the House of Representatives, and, thus, your losing your position as speaker of the House?

REP. NANCY PELOSI: I have said, if passing this bill means I have to walk out of my office that night, it would be with the greatest pride.

But I don't have any intention of losing the Democratic majority. It's too important to the country. It's too important to the lives of the American people. We are there for them. And the president has said, we will measure our success by the progress being made in America for America's working families.

I believe that this is what we came here to do. We didn't come here to self-perpetuate ourselves in office. We came here to make a difference in the public's life. Now we have to go out there and -- and tell people what is in the legislation. I have confidence that my members can do that ...

We are public servants. We have it inside of us to do the right thing for the American people. And that's why -- why I always had confidence that we would pass this historic legislation to make progress for the American people.

JIM LEHRER: Madam Speaker, thank you very much.

REP. NANCY PELOSI: Thank you. My pleasure.

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