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President Discusses Medical Liability Reform and Health Care in PennsylvaniaUnited Sports Training CenterDowningtown, Pennsylvania 1:37 P.M. EDT President Bush: Thank you all for coming. (Applause.) I appreciate youall being here. Thanks for coming. I appreciate such a warm welcome.I'm proud to be back in Chester County, Pennsylvania. (Applause.) I'mhere to ask for your help. We're less than two weeks away when thepeople get to go express their opinion in the polls, and I believe,with your help, we're going to win the state of Pennsylvania.(Applause.) I know a lot of people are working hard in this campaign, and I amhere to thank you. I want to thank you for putting up the signs. I wantto thank you for making the phone calls. I want to thank you forreminding our fellow citizens we have a duty to go to the polls in ademocracy. And when you get them headed to the polls, remind them ifthey want a safer America, a stronger America, and a better America, toput me and Dick Cheney back in office. (Applause.) So ever since Barbara and Jenna were young I've been telling themwe're going to go on the great family camping trip. (Laughter.) I'msure they envisioned the Colorado River, or the wilds of Alaska, but,no, the great family camping trip turned out to be the campaign of2004. (Applause.) And I can't tell you -- I cannot tell you how greatit is to have my daughter introduce me in front of you all. I'm proudof Barbara. I love her dearly. And I thank you for joining me,darling. (Applause.) My only regret, which is I'm sure your regret, isthat Laura is not here. (Applause.) And Jenna, of course, but she'swith Laura. See, when I asked Laura to marry me she said, fine, I willmarry you, so long as I never have to give a speech. (Laughter.) Isaid, okay, you've got a deal. Fortunately, she did not hold me tothat deal. Laura is giving a lot of speeches, and when she does, theAmerican people see a warm compassionate, strong First Lady.(Applause.) AUDIENCE: Four more years! Four more years! Four more years! THE PRESIDENT: Thank you all. I am proud of my running mate. I metwith the Vice President this morning at our national security briefing.It -- taking a look at him reminded me I didn't pick him because of hishairdo. (Laughter.) He does not have the waviest hair in the race.(Laughter.) But I picked him because of his experience and soundjudgment. He's doing a great for the American people. (Applause.) By the way, a fellow you trained is doing a great job in Washington,and that would be your former governor, Tom Ridge. (Applause.) He is afine member of a very strong Cabinet. And he is doing a fine job ofhelping protect this homeland. I want to thank your two United StatesSenators for their service to your state. First, I hope you put ArlenSpecter back into office. He's a good Senator. (Applause.) And I'mproud to work with your other Senator, Rick Santorum. (Applause.) I want to thank Congressman Jim Gerlach for his service to the thisdistrict. I appreciate you, Congressman. (Applause.) He's somewherearound here. Where -- there you are, Congressman. Good to see you. Isee you're sitting next to a good fellow in Congressman Joe Pitts --appreciate you coming, Joe. And Congressman Tom Feeney from the stateof Florida is with us. (Applause.) Feeney Yes, what are you doinghere Get back to your district and turn out the vote. (Laughter andapplause.) I'll see you down there Saturday. (Laughter.) I want to thank all the local folks who are here. I want to thank myfriend Alan Novak, who is the party chairman. I want to thank --(applause.) Barbara and I just had a chance to meet with four doctors from thearea, and a patient, Charlene Ware. And the docs were all telling meyou got a problem here. We're going to talk about health care heretoday. I want to thank the docs for taking time to visit with me toshare their concerns. And part of my address today is to share theirconcerns with you, because in order to make sure we've got a goodhealth care system, we've got to make sure you have good professionalsremain right here in your neighborhood to help solve the problems youhave. (Applause.) We have a lot at stake in this election. There are big issues thatwe're discussing. When I ran for President four years ago none of uscould have ever envisioned the horror of September the 11th. Since thatday, I have led a comprehensive strategy to defeat the terrorists, tokeep the homeland safe and secure. (Applause.) I pledged to theAmerican people we would be resolute and determined and do our duty toprotect you, and I kept my pledge. (Applause.) Our economy -- our economy has been through a lot. When you're outrounding up the vote, remind people about what we have been through.The stock market was in serious decline six months prior to my arrivalin Washington, D.C. And then we went through a recession. We had somecorporate scandals. We passed tough laws, by the way. We have made itabundantly clear we will not tolerate dishonesty in the board rooms ofAmerica. And then -- (applause.) We got attacked. It costs us about amillion jobs in the three months after September the 11th. I pledged tothe American people, we would reduce your taxes to get our economygoing again. I kept my word. (Applause.) Our economy is strong, and itis getting stronger. (Applause.) I promised to reform our public schools and to challenge the softbigotry of low expectations. I kept my word. (Applause.) We passed theNo Child Left Behind Act, and we're closing an achievement gap allacross America. And we're not going to go back to the days ofmediocrity and low standards. (Applause.) Another major area that needs reform is health care. We have made agood start. And in a new term, I will build on our efforts to improveAmerica's health care. Health care is an essential issue in thiscampaign, and it's an essential issue in Pennsylvania. And that's whyI'm delighted to come here to talk about it. Across America, smallbusiness owners are struggling with the high cost of providing healthinsurance for their employees. Some workers have lost good coveragebecause they have changed jobs. Women have lost doctors they trustbecause of frivolous lawsuits. We need to act on these concerns. Andwe need to act in a practical, responsible way. Here, America faces a clear choice. When it comes to health care,Senator Kerry's prescription is bigger government with higher costs; myreforms will lower costs and give more control and choices to theAmerican people. (Applause.) The United States of America has a world-class health care system thatleads the world in providing amazing treatments and cures for millionsof people. As a candidate for President, I had pledged to double thebudget of the National Institutes of Health, to make sure we stay onthe leading edge of change and reform. I kept my word. (Applause.) Wehave the most advanced hospitals in the world who do the mostinnovative research. We have the finest, most highly trained healthcare professionals in the world. We lead the world because we believein a system of private medicine that encourages innovation and change.(Applause.) Yet, rising costs and changes in the way Americans live and work areputting affordable health care out of the reach of too many of ourcitizens. Today I want to talk about a common-sense way to make healthcare more affordable and accessible, while preserving America's systemof private medicine. Our reforms will help our families and individuals afford healthinsurance and save for health care expenses. They will help more smallbusinesses provide health care coverage for their employees. And that'simportant, because more than one-half of the uninsured workingAmericans work for small businesses. My reforms will make sure low-income Americans, especially children,get the health care they need. They will ensure preventative care andprescription drug coverage for our seniors on Medicare, and providequality health care for our nations veterans. And my reforms addressthe root causes of rising health care costs, which make health caremore expensive for everyone. In a new term we'll take five practicalsteps to make health care more affordable and accessible in America,and here they are: First, we'll expand health savings accounts, or HSAs. (Applause.) AnHSA is an innovative approach to health care that gives you affordablecoverage for major illness and allows you to save money, tax-free, upto a set limit, to use for routine medical expenses. You can make acontribution to this account; your government can make a contributionto the account; or your employer can make a contribution to theaccount. If you don't use all the money in a year you can roll it over,tax-free, to meet future expenses. (Applause.) Health savings accounts protect you against catastrophic medicalexpenses, because you can take your savings account from job to job. Itprovides you more security if you change jobs. This approach will helpour nation confront the rising cost of health care, and this is how.One of the reasons why health care costs are on the rise is thatconsumers are not involved in the decision-making process. Most healthcare costs are covered by third parties, and therefore, the user ofhealth care is really not the purchaser of health care. With HSAs weintroduce market forces. It means you can shop around for the healthcare that's best for you. It means you'll be able to get better healthcare at better prices, because you're the decision-maker. (Applause.) To help more people own HSAs, I proposed allowing individuals todeduct the cost of their insurance premiums from their taxes.(Applause.) To help employers cover more workers, I proposed taxcredits for small businesses to pay into HSAs for their employees.(Applause.) To help the uninsured I proposed a $3,000 refundable taxcredit to help low-income families buy their own HSAs. (Applause.)These incentives will allow many more of our fellow citizens to have ahealth care account that they manage and that they call their own.(Applause.) To help people afford health care, we will pass association healthplans which allows small firms to join together, to pool risk so theycan buy insurance at the same discounts big companies are able to do.(Applause.) That means a stand-alone family restaurant in Pennsylvaniacan join together with other small restaurants all around the countryso they can spread the risk, so they don't have to buy insurance in themarket as a stand-alone entity. This is a practical way to enable smallbusinesses to better afford health care for their employees.(Applause.) I view a health savings account or an association health plan ascommon-sense ideas. It makes sense. Yet my opponent is against both ofthem. He doesn't agree. And there's a reason why -- Senator Kerry'sidea of reform always involves bigger and more intrusive government. AUDIENCE: Booo! (Laughter.) THE PRESIDENT: And his health care proposal proves my point. In one ofour debates, Senator Kerry looked into the television camera, with astraight face, and said -- quote -- \"Government has nothing to do withit.\" That was in reference to his health care plan. I could barelycontain myself. (Applause.) In fact, government has a whole lot to dowith his plan, and that's important for you to know. Senator Kerry'sproposal would expand the government health care rolls by nearly 22million Americans. It would be the largest expansion of governmenthealth care in American history. Eight out of ten people who get healthcoverage under his plan would be placed on a government program. He would make Medicaid a large -- a program so large that employerswould have the incentive to drop private coverage so the governmentwould pick up the insurance tab for their employees. Now, think aboutthat. When you make Medicaid more accessible, the small business willhave the incentive to say, well, the government will provide theinsurance, so I don't have to. That's why I say that some 8 millionAmericans will go from private insurance to government-run insurance.And Medicaid is a government-run program. The Senator wants the federal government to pick up the tab for largemedical bills that private employer-sponsored plans now pay for. Inother words, the federal government is going to become like aninsurance company, a re-insurer, which sounds fine on the surface,except, remember this, when the federal government writes the check,the federal government also writes the rules. And when the federalgovernment starts to write the rules, the government decides who'scovered, and who gets the coverage, and how much care you get. In addition, an independent study estimates that John Kerry's planwould impose at least 225 new regulatory mandates on small businesses.One group looked at the plan and described it as an overpricedalbatross. (Laughter.) That's being kind. (Laughter.) This is a planthat will create burdens that our job creators cannot afford and do notdeserve. (Applause.) And the plan costs a lot -- $1.2 trillion. That'swith a \"The.\" That's a lot. (Laughter.) And he says, oh, don't worry,I'm going to pay for it all by taxing the rich. You can't raise enoughmoney by taxing the rich to pay for a $1.2 trillion health care plan.Matter of fact, if you run up the top two brackets, it raises between$600 billion and $800 billion, so there is a gap between what hepromises and how he says he's going to pay for it. And guess whousually fills the gap Yes, you do. There's also something else wrong with saying to tax the rich. Therich hire lawyers and accountants for a reason, to slip the tab toyou. We're not going to let him tax you. We're going to carryPennsylvania on November the 2nd. (Applause.) AUDIENCE: Four more years! Four more years! Four more years! THE PRESIDENT: Thank you all. When you're out the campaigning androunding up the vote, remind people about the facts of his plan. TheKerry plan would move America down the road toward federal control ofhealth care, which would lead to lower quality and health carerationing. Other countries have tried centralized health care and itdidn't work. We have great quality health care in America because it isa private center system. And I intend to keep it that way. Health caredecisions ought to be between doctors and patients, not by officials inWashington, D.C. (Applause.) Third, we must fix our broken legal system. (Applause.) Junk lawsuits-- junk lawsuits are expensive for doctors and hospitals to fight incourt. They are expensive to settle out of court. They drive up thecost of liability insurance for every doctor, and they increase thecost of health care for all Americans. (Applause.) To avoid junk lawsuits, many doctors practice defensive medicine.They order tests and write prescriptions that aren't really necessaryjust to protect themselves from lawsuits. That's what happens in asociety that has too many lawsuits. The practice of defensive medicineraises costs for patients and small businesses and adds about $28billion a year to the federal budget. Remember, the federal budgettakes care of Medicare and Medicaid and veterans, and the practice ofdefense medicine runs up the cost to the federal government, whichreally runs up your tab. See, you pay for it. When we're talking aboutthe government's money, we're really talking about your money.(Applause.) We want our doctors focused on fighting illness, not onhaving to fight lawsuits. (Applause.) The effects of the litigation culture are real in the state ofPennsylvania. They are hurting the quality of life in this state.Medical liability premiums are skyrocketing in this state, as they arein other states. For specialists in high-risk fields, like OB/GYN,those premiums have doubled or tripled in some counties since 2000. Andguess what happens. Docs leave the practice of medicine. In the pasttwo years, Mercy and Methodist Hospitals in Philadelphia both stoppeddelivering babies. The quality of life is deteriorating because ofthese lawsuits. Brandywine's only trauma center was forced to close.The quality of life is deteriorating because of the junk lawsuits.According to a recent poll, one in four people in Pennsylvania havebeen forced to change doctors in the last year because liability costshave forced their doctor to move, to stop practicing, or to discontinueprocedures. And every time a good doctor is forced out of a communityby lawsuits, or the fear of lawsuits, the quality of life deteriorates.(Applause.) Not long ago I met Mary Coar from Honesdale. Her OB/GYN had to give updelivering babies because of liability concerns. When Mary was fourmonths pregnant she started driving 50 miles each way to see adifferent doctor. When Mary's daughter arrived this summer she wasdelivered by a doctor she had never met. When a mother is lookingforward to having a baby, the last thing she needs is uncertainty abouther health care. For the sake of women and families across this stateand this country, we need medical liability reform. (Applause.) The difference between my opponents point of view and mine is veryclear on this issue. He has voted ten times against medical liabilityreform during his Senate career. This year when the Senate consideredbills to protect OB/GYNs and trauma physicians Senator Kerry opposedthem. Now, I know we're in a campaign, and he's paying lip service tolegal reform, but it's his votes and his actions, not his words, thatreally count. (Applause.) He can run from his record, but he cannothide. (Applause.) In a new term, we'll pass real caps on non-economic damages. This is anational problem requiring a national solution. And I will lead theUnited States Congress to pass medical liability reform. (Applause.) Fourth, we'll reduce health care costs by applying modern informationtechnology to our medical system. Many doctors offices practice 21stcentury medicine -- many hospitals practice 21st century medicine, butstill have 19th century filing systems. And in hospitals, there's morerisk of medical error when all the records are handwritten on paper,instead of cross-checked on a computer. That makes sense. Doctors don'twrite very well anyway. (Laughter.) They write about as well as I speakEnglish. (Laughter and applause.) The current system is costly and is wasteful, and sometimes horrible-- sometimes harmful. And we're on our way to fixing it. I've set agoal to make electronic medical records available for most Americanswithin the next decade. We're working with states and private hospitalsto set standards for information storage and sharing. When the healthcare community fully maximizes the use of information technology, wewill reduce medical costs by as much as 20 percent. We will cut medicalerrors and we will save lives. (Applause.) Fifth, we're cutting health care costs by moving cheaper generic drugsto the market faster. My administration is making sure that drugcompanies do not use delaying tactics to keep cheaper genericequivalents from getting to the consumers. Our actions will saveAmericans at least $35 billion on the medicine over the next 10 years.And that will make life-saving drugs more affordable to our seniors.(Applause.) As we move forward and make health care more affordable and accessiblewe'll also keep the commitments we've made, commitments necessary for acompassionate country. We have strengthened and modernized Medicare. Itold the American people we had a problem with Medicare when I wascampaigning. I brought Republicans and Democrats together and I kept myword in modernizing Medicare. (Applause.) Listen, Medicare would pay thousands of dollars for a heart surgery,but not one dime for the prescription drug that could prevent the heartsurgery from being needed in the first place. It didn't make anysense. (Applause.) And so we've strengthen and modernized Medicare. Isigned a bill to strengthen the system. Now seniors are gettingdiscounts on their medicine with drug discount cards. And low-incomeseniors are getting $600 worth of help a year to buy those medicines.And beginning in 2006, all seniors will be able to get prescriptiondrug coverage under Medicare. (Applause.) We have another difference of opinion on this issue. My opponent votedagainst the Medicare bill that included prescription drug coverage forseniors, even though that bill was supported by AARP and other seniorsgroups. Later, he said -- quote -- \"If I'm the President we're going torepeal that phoney bill.\" Then he said -- then he said a little later-- AUDIENCE: Booo! THE PRESIDENT: -- no, I don't want to repeal it. That soundsfamiliar. AUDIENCE: Flip-flop! Flip-flop! THE PRESIDENT: As President for the next four years, I will defend thereforms we have worked so hard to pass so we can keep the promise toour seniors. (Applause.) We'll keep our commitment to America's children by helping them get ahealthy start in life. I'll work with governors and community leadersand religious leaders to make sure every eligible child is enrolled inour government's low-income health insurance program. We will not allowa lack of attention, or information, to stand between millions ofchildren and the health care they need. (Applause.) I know some of you here are worried about -- about the upcoming fluseason. I want to assure our seniors and families with young childrenthat our government is doing everything possible to help seniors andchildren get their shots, despite the major manufacturing defect thathas caused this problem. We have millions of vaccine doses on hand, andmillions more will be shipped in the coming weeks. We're workingclosely with state and local officials to get the flu vaccine to themost vulnerable Americans throughout our country. If you're feelinghealthy, like I'm feeling healthy these days, don't get in line for theflu shot. (Applause.) To make sure health care is available, we will keep our commitment tolow-income Americans by expanding America's community health centers.Community health centers take the pressure off of local emergencyrooms, improve care for the needy, and lower costs for us all. Since Itook office, we have opened or expanded more than 600 community healthcenters. In a new term, we'll open or expand 600 more, and bringhealing to areas with the greatest need. Every poor county in Americashould have a rural or community health center. (Applause.) And finally, we will keep our commitment to American veterans who haveserved our country so well. (Applause.) We have increased -- we haveincreased spending for the veterans during my time by $22 billion,which is double the amount my predecessor did in the eight years heserved as President of the United States. (Applause.) We're reducingthe backlog in veterans' health care claims. We're modernizing our VAhealth centers and building new ones. Men and women who wore thisnation's uniform deserve first-class medical care, and we are gettingthe job done. (Applause.) Health care is one of the most important issues facing our country.I'm glad you came today to let me talk about it. I'm passionate inunderstanding there is a right way to make sure health care isavailable and affordable, and a wrong way. I feel strongly that the wayI have proposed is the right way for America. (Applause.) There is a big difference of philosophy in this campaign. If you thinkabout it, on issue after issue after issue, my opponent wants thegovernment to dictate to the American people. I want the Americanpeople to decide. He trusts government; I trust the people. (Applause.) I'm ready for the work ahead. I know what we need to do to make surethis country is a more hopeful country and a more secure country. I'veset out a set of clear priorities based upon a political philosophythat says government will help people realize their dreams, not tellthem how to live their lives. We'll move forward -- (applause.) We'llmove forward on a health care system that makes sure we got the besthealth care system in the world, a health care system where thedecisions will be made by doctors and patients, not by officials in ournation's capital. (Applause.) We'll continue -- continue to promote excellence in every publicschool, so no child is left behind. I'll continue to -- (applause) --continue to promote a pro-growth, pro-entrepreneur, pro-small business,pro-farmer economic agenda so people can find work. (Applause.) But all progress ultimately depends on the security of our nation.We're in the middle of a global war on terror. We face an enemy that isdetermined to kill the innocent and convert our country into abattlefield. In this war on terror, there is no place for confusion,no substitute for victory. (Applause.) AUDIENCE: Four more years! Four more years! Four more years! THE PRESIDENT: The most -- the most solemn duty of the AmericanPresident is to protect the American people. If America showsuncertainty or weakness in this decade, the world will drift towardtragedy. This will not happen on my watch. (Applause.) Since that terrible morning of September the 11th, 2001, we've foughtthe terrorists across the Earth -- not for pride, not for power, butbecause the lives of our citizens are at stake. Our strategy is clear:We'll defend the homeland; we'll strengthen our intelligence services;we will transform our all-volunteer army -- I will keep ourall-volunteer army and all-volunteer army. (Applause.) We will berelentless. We will stay on the offense. We will strike the terroristsabroad so we do not have to face them here in America. (Applause.) Wewill spread freedom and liberty, and we will prevail. I want to tell you -- I want to talk about two quick examples of whatI'm talking about, about spreading freedom and liberty. I want you toremind people, particularly the young, about what is taking place inAfghanistan. Three-and-a-half years ago, the Taliban ran that countryand Al Qaeda was using Afghanistan as a place to train killers, some ofwhom came and took lives here in America -- three-and-a-half yearsago. Three-and-a-half years ago, young girls couldn't go to schoolbecause the vision of the Taliban was so dark. Three-and-a-half yearsago, women were pulled in the public square and whipped if they didn'ttoe the ideological line of those ideologues of hatred. It was a grimworld. And we acted to defend ourselves. Remember, I set out a doctrine -- and when the American Presidentspeaks the American President better mean what he says. (Applause.) AndI said if you harbor a terrorist, you're just as guilty as theterrorists. And I meant what I said. And we removed the Taliban forour own security -- but because we did, millions of citizens ofAfghanistan voted in the presidential election that took place a coupleof weeks ago. (Applause.) The first voter in the presidential electionwas a 19-year-old woman. (Applause.) Afghanistan has gone fromdarkness to light because freedom is on the march. (Applause.) AndAmerica is better off for it. Free nations will be an ally on the waron terror. Free nations will serve as a great example for others. Iraq will have presidential elections in January. Think about how farthat society has come. (Applause.) It's gone from torture chambers andmass graves to elections. Freedom is on the march. One of my friends -- one of our friends -- Laura and my friends in theworld is Prime Minister Koizumi of Japan. That probably doesn't soundlike much; so what. Well, let me tell you what the \"so what\" is. Itwasn't all that long ago that we were at war with the Japanese. It's aneternity if you're 58 years old, but really in the march of history itwasn't all that long. After we won the war against the Japanese -- andit was a brutal war. My dad fought there; your dads and granddadsfought there, as well. (Applause.) Harry S. Truman believed in thepower of liberty to transform an enemy into an ally. There was a lot ofpeople that were skeptical about that. A lot of people said, why do wewant to care about an enemy Or, this enemy can't conceivably become andemocracy. Why should we pay attention to somebody who -- some countrythat killed a lot of our citizens. But there was great faith in the power of liberty to transform.That's what I believe. I believe in the power of liberty to transformsocieties. And as a result of that belief, I sit down with PrimeMinister Koizumi talking about how to achieve the peace we all want,talking about tough problems in the world, so we can make a betterworld for our children and our grandchildren. Some day an Americanpresident will sit down with a duly-elected leader from Iraq, talkingabout the peace in the Middle East. And our children and ourgrandchildren will be better off for it. (Applause.) I believe in the power of liberty. I believe that people in the MiddleEast want to be free. I believe women in the Middle East long to livein a free society. I believe mothers and dads in the Middle East wantto raise their children in a free and peaceful world. I believe allthese things, because freedom is not America's gift to the world;freedom is the Almighty God's gift to each man and woman in this world.(Applause.) Over the past nearly four years, we've done a lot of hard worktogether. We climbed the mountain and we see the valley below. Thevalley below is of a more peaceful world, of a hopeful America. Youknow, when I campaigned in your state in 2000 I said if you gave me thechance to serve I would uphold the honor and the dignity of the office.(Applause.) With your help, I will do so for four more years. Thanks for coming. God bless. Thank you all. I appreciate your coming.(Applause.) END 2:24 P.M. EDT Printer-Friendly Version Email this page to a friend IssuesBudget ManagementEducationEnergyHealth CareHomeland SecurityHurricanesImmigrationJobs & EconomyMedicareNational SecurityPandemic FluPatriot ActRenewal in IraqSocial SecurityMore Issues 59ce067264

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