Posted by: Jeff | January 28, 2010

The State of the Union: Transcript

Or at least, what I wish he’d said to bolster his argument on health care:

Madam Speaker, Vice President Biden, members of Congress, distinguished guests, and fellow Americans, our Constitution declares that from time to time the president shall give to Congress information about the state of our union. For 220 years, our leaders have fulfilled this duty. They’ve done so during periods of prosperity and tranquility, and they’ve done so in the midst of war and depression, at moments of great strife and great struggle. It’s tempting to look back on these moments and assume that our progress was inevitable, that America was always destined to succeed.

But when the Union was turned back at Bull Run and the Allies first landed at Omaha Beach, victory was very much in doubt. When the market crashed on Black Tuesday and civil rights marchers were beaten on Bloody Sunday, the future was anything but certain.

These were the times that tested the courage of our convictions and the strength of our union. And despite all our divisions and disagreements, our hesitations and our fears, America prevailed because we chose to move forward as one nation, as one people.

Again, we are tested. And again, we must answer history’s call.

I have a whole speech scripted here on my teleprompter, but allow me to speak for a moment directly to you, the American people.  Many of you are frustrated.  The economy is still down, and it is as difficult as ever for many to provide for their families.  Many families are facing difficult choices – to pay mortgages or health insurance premiums.  This is a choice no American should ever have to make.

This is why comprehensive health care reform, among other reforms, is so necessary for millions of families living on Main Streets all across America.

A year ago I asked Congress to create a health care reform bill that would expand affordable coverage to all Americans, subsidizing premiums for those that could not pay, expanding care, eliminating insurance discrimination, and reducing costs and increasing efficiency throughout the system.  I am happy to stand here today and say that we’ve done this.

We have a health care reform bill. And though it may not be perfect in every way, it is important to bear in mind that no legislation is ever perfect in its first form.  The Civil Rights Act passed in 1964, but no American claims that as an end to the Civil Rights movement.  It was a new beginning.

So too with health care reform.  The bill passed through the Senate on Christmas Eve will substantially increase coverage and decrease costs.  Let me say that again.  It will increase coverage – millions of Americans previously uncovered by health insurance will have access to affordable plans free of discrimination on the basis of pre-existing conditions like asthma, or HIV.  And it will decrease costs – over the first ten years, this reform act would decrease the size of the federal deficit by $132 billion.  That’s a number reached by the non-partisan Congressional Budget Office.

Now, you’ve probably heard many things about the health care bill.  Let me address some of the most common allegations head-on.  I believe that in a democracy it is important to have debates on the merits of fact, and not on the mythologies espoused blindly on the radio.  So let’s be clear on the facts.

You may have heard that this bill forces individuals to be on government health care plans.  This is not true.  The bill will set up a government-regulated exchange wherein private insurance companies can compete openly and transparently.  The objective of this exchange is not government control – it is choice.  Americans will be able to purchase private plans on this exchange with all of the information needed to choose a plan that makes the most sense for each individual family.

You may have heard that this bill creates so-called “death panels”, with the government deciding who receives care and who does not.  This is worse than wrong – it is a lie.  The provision so badly mislabeled was one that would provide voluntary counseling for individuals considering hospice care or writing a living will.  This provision has since been dropped and is not even a part of the current bill.

You may have heard that this bill will transform America’s health care system into a single-payer “socialist” model.  This is not only a mischaracterization of single-payer systems like that of Canada, but it is also incorrect.  This bill does not create a single-payer system.

You may have heard that this bill increases the cost burden for government.  This too, is not true.  According to the Congressional Budget Office, which routinely conducts cost analyses for all major pieces of legislation so that the public can see how their tax dollars are being used, the health care bill passed by the Senate would decrease the federal deficit by $132 billion by 2019.

You’ve probably heard that the overall cost of health care with passage of reform is on the order of $800 billion.  This much is true – but keep in mind that the cost of health care without reform would be $930 billion.

According to the CBO, over the 2010–2019 period, the net
cost of the coverage expansions would be more than offset by the combination of other spending changes that CBO estimates would save $483 billion and other provisions that would increase federal revenues by $264 billion.  In total, CBO and JCT estimate that the legislation would increase costs by $366 billion and simultaneously increase revenues by $498 billion between 2010 and 2019.

Furthermore, costs to individual families will decrease.  Those without insurance will be able to afford it – in the event that health care is needed for these families, they will not be faced with the heart-breaking choices that devastate so many uninsured families today.  But costs will fall for Americans that already have coverage as well.  Today the only form of health care available to uninsured Americans is the emergency room.  Heroic doctors in emergency rooms across America save the lives of even those that cannot pay.  In order to defray these costs and do this humanitarian work, costs are passed on to those that can pay, driving up health care bills for others that face emergencies.  With fewer Americans relying on the emergency room for primary care, we will all save money when we need emergency assistance.

To summarize, let’s be clear.

The bill in front of the Senate would increase coverage to 30 million Americans that can currently not afford insurance.  According to a study conducted at Harvard University, over 45,000 Americans die every year because they are not insured.  This is not a partisan issue.  This is an issue of saving lives.

We can save lives and reduce costs at the same time.  This is a tremendous victory for all Americans.

There are those in the media that suggest that America no longer wants health care reform.  I reject this.  There are those that suggest we do not have a mandate for reform.  I reject this too.  America showed its mandate on November 7, when the House of Representatives voted 220-215 in favor of reform.  America again showed a mandate for reform on December 24, when the Senate voted 60-39 in favor of reform.  For those that think this mandate has expired, I say simply that if the Senate were to vote on health care again today, it would pass 59-41.

We stand on the precipice of history, with the opportunity to pass an historic piece of legislation that will save countless lives and reduce the financial burden on our budget in a time of great difficulty.  Americans are tired and frustrated.  It is time to finish what they sent us here to do.

This problem is not going away. By the time I’m finished speaking tonight, more Americans will have lost their health insurance. Millions will lose it this year. Our deficit will grow. Premiums will go up. Patients will be denied the care they need. Small-business owners will continue to drop coverage altogether.

I will not walk away from these Americans, and neither should the people in this chamber.

Here’s what I ask Congress, then: Don’t walk away from reform, not now, not when we are so close. Let us find a way to come together and finish the job for the American people. Let’s get it done.

Let’s get it done.

Thank you, and may God continue to bless the United States of America.



  1. Mervdiddy2020! USA! USA!

  2. dropping the teleprompter – you stole that idea from me last night! honest question – you think most americans want to “hear” facts like that…? Don’t you think spewing out numbers might make millions think “well, here are some numbers, ill zonk out and not pay any attention for 30 minutes, hes being political”

    woops, i sound like Palin/Brown for prez 😦

  3. or – is that sentiment elitist east coast?

  4. When you say the health care bill will decrease costs, you are talking about decreasing costs from the perspective of the federal government. But what about from the perspective of consumers? I don’t know the answer to this. And the bill is too long and abstruse to run projections 10 years into the future with any degree of certainty.

    On one hand, we have insurance companies saying premiums are going to increase on the young and healthy (such as myself) to cover the way the bill mandates taking on the old and the sickly.

    On the other hand, we have politicians categorically rejecting adverse studies as biased and deceptive. But we all know that politicians are perfect examples of impartiality and honesty.

    Both sides have an interest in the bill’s passage or defeat. We’re all balloon boys now.

  5. Well, I think it will drive down costs in both areas. It’s hard to give estimates for the numerical impact on personal costs, but consumers will certainly see emergency care costs go down as the burden on emergency rooms as primary care providers slacks off a bit. And premiums should come down on all but those that make $250,000 in household income per year. The stream-lining of Medicare administration is where a lot of the cost-trimming is coming from, with the bulk of the rest of the funding coming from the so-called Cadillac Tax on premium insurance policies.

    With projections so murky, it comes down to which projections you can trust sometimes, and the claim by insurance companies that premiums will rise across the board for the young and healthy strikes me as something of a threat rather than a prediction. They have a vested interest in seeing no reform pass – this projection of theirs is a surefire way to stoke populist skepticism.

    What’s in it for politicians? You’re right that they’re self-serving – it seems to me that it wouldn’t be in their interest to inflate government and piss off both consumers and insurers just for the hell of it – ideologically, “big government” has never been the endgame – improving the lives of millions of potential voters has.

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