Thursday, February 26, 2009

State of the Union, Part 2

Returning to the discussion of health care costs.

This is a cost that now causes a bankruptcy in America every thirty seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. In the last eight years, premiums have grown four times faster than wages. And in each of these years, one million more Americans have lost their health insurance. It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas. And it’s one of the largest and fastest-growing parts of our budget. Gee, do you think that all might have anything to do with having to absorb the cost of emergency care for the twenty-plus million people living in the country illegally? Or maybe the decreasing caps on Medicare/Medicaid reimbursements that force the rest of us to pay higher rates for the same procedures? It certainly couldn't have anything to do with having to absorb the costs your trial-lawyer friends have added to the burden of doing business as a doctor in this country. Oh, it's also a bogus number according to the Corner.

Already, we have done more to advance the cause of health care reform in the last thirty days than we have in the last decade. When it was days old, this Congress passed a law to provide and protect health insurance for eleven million American children whose parents work full-time. Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives. It will launch a new effort to conquer a disease that has touched the life of nearly every American by seeking a cure for cancer in our time. And it makes the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control.

Where to start? SCHIP coverage for children up to age thirty? No, that's low hanging fruit. How about electronic health records and new technologies? We are to be assured that electronic health records will bring down costs. Take a look at the cost of the ongoing efforts to upgrade the nation's air traffic control system. Chronically overdue and over budget. Health care's got vastly different data needs, and we're to think that a) the government can properly identify those needs, b) get all the players to agree on a standard, and c) actually implement the plan in a way that works better than paper. I don't think so. As to ensuring privacy, ask Joe the Plumber how well those government data secrecy laws worked for him. Do you honestly think that if you raise your courage and challenge the .gov that your college STD, your bout of depression after your parents died, or your treatment for hemorrhoids won't come back to haunt you in the most embarrassing way possible? You can also forget about that “saving lives” bit. The whole point of the exercise is to allow the new bureaucracy, staffed by the same folks who make going to the DMV such a pleasant experience, to exercise control over your health care by “suggesting” that your doctor choose cheaper alternatives or forgo a less “effective” but potentially life-saving treatment. They fully intend to ration your access to care. They also fully intend to pay less for the services they do authorize. That will also inevitably lead to fewer services being available. We already see many practices that won't accept new Medicare/Medicaid patients. The trend will accelerate. One other point, preventive care postpones health care costs, but doesn't eliminate them. You just need them at a later age.

This budget builds on these reforms. It includes an historic commitment to comprehensive health care reform – a down-payment on the principle that we must have quality, affordable health care for every American. It’s a commitment that’s paid for in part by efficiencies in our system that are long overdue. And it’s a step we must take if we hope to bring down our deficit in the years to come.

The plan they propose will, in the end, reduce access to care and increase costs. Ask the Brits how well the NHS works for them. Ask the next Canadian you see how easy it is to get an MRI.

The third challenge we must address is the urgent need to expand the promise of education in America. You mean beyond providing a free primary and secondary education in state mandated curricula by highly trained professional educators to any and all comers? That promise needs expanding?

In a global economy where the most valuable skill you can sell is your knowledge, a good education is no longer just a pathway to opportunity – it is a pre-requisite. No argument with this at all.

Right now, three-quarters of the fastest-growing occupations require more than a high school diploma. Note that this is not synonymous with saying that three-quarters of all jobs require post-secondary education. And yet, just over half of our citizens have that level of education. We have one of the highest high school dropout rates of any industrialized nation. And this is the fault of the system? No, it's a fault of the students who choose not to learn. And half of the students who begin college never finish. In large part because they realize that they were not suited to it. My freshman Aerospace Engineering intro class had 120 students. I graduated with about a tenth that number. If you ask me what class I wish I had taken in High School that I didn't, the answer would be auto shop. Not everyone needs a college degree. I know for a fact that our local IBEW hall is recruiting retirees to come back to work because they don't have enough younger members in the trade.

This is a prescription for economic decline, because we know the countries that out-teach us today will out-compete us tomorrow. That is why it will be the goal of this administration to ensure that every child has access to a complete and competitive education – from the day they are born to the day they begin a career. They already do if they decide to avail themselves of it. Do you really think our urban schools would be cesspools if the kids in them really wanted to learn?

Already, we have made an historic investment in education through the economic recovery plan. We have dramatically expanded early childhood education and will continue to improve its quality, because we know that the most formative learning comes in those first years of life. We have made college affordable for nearly seven million more students. And we have provided the resources necessary to prevent painful cuts and teacher layoffs that would set back our children’s progress. And this is the job of the federal government according to which part of the Constitution?

But we know that our schools don’t just need more resources. They need more reform. That is why this budget creates new incentives for teacher performance; pathways for advancement, and rewards for success. I'm positive the NEA/AFT folks will get solidly behind this plan. They've just always been so supportive of efforts like this in the past. We’ll invest in innovative programs that are already helping schools meet high standards and close achievement gaps. Like No Child Left Behind? I thought that was an evil Bush program. And we will expand our commitment to charter schools. Notice the lack of any mention of vouchers for private schools?

It is our responsibility as lawmakers and educators to make this system work. But it is the responsibility of every citizen to participate in it. And so tonight, I ask every American to commit to at least one year or more of higher education or career training. This can be community college or a four-year school; vocational training or an apprenticeship. But whatever the training may be, every American will need to get more than a high school diploma. And dropping out of high school is no longer an option. It’s not just quitting on yourself, it’s quitting on your country – and this country needs and values the talents of every American. That is why we will provide the support necessary for you to complete college and meet a new goal: by 2020, America will once again have the highest proportion of college graduates in the world. Try finding a good plumber in 2020.

These education policies will open the doors of opportunity for our children. But it is up to us to ensure they walk through them. In the end, there is no program or policy that can substitute for a mother or father who will attend those parent/teacher conferences, or help with homework after dinner, or turn off the TV, put away the video games, and read to their child. I speak to you not just as a President, but as a father when I say that responsibility for our children's education must begin at home. So, if there's no substitute for mothers and fathers, explain to me again why we need these massive new programs. I must have missed something.

There is, of course, another responsibility we have to our children. And that is the responsibility to ensure that we do not pass on to them a debt they cannot pay. With the deficit we inherited, the cost of the crisis we face, and the long-term challenges we must meet, it has never been more important to ensure that as our economy recovers, we do what it takes to bring this deficit down. And that's why I've doubled our deficit this year, am massively expanding the scope and reach of the federal government and borrowing as much money as I possibly can from the Chinese and Saudis.

I’m proud that we passed the recovery plan free of earmarks, and I want to pass a budget next year that ensures that each dollar we spend reflects only our most important national priorities. Okay. We just know that one of our most important national priorities is to build a mag-lev train between LA and Vegas. Nope, no earmarks, not a one.

Yesterday, I held a fiscal summit where I pledged to cut the deficit in half by the end of my first term in office. My administration has also begun to go line by line through the federal budget in order to eliminate wasteful and ineffective programs. As you can imagine, this is a process that will take some time. But we’re starting with the biggest lines. We have already identified two trillion dollars in savings over the next decade. Hell, I can do better than that. Eliminate every cabinet department created since 1949, then take out Agriculture and most of Commerce.

In this budget, we will end education programs that don’t work and end direct payments to large agribusinesses that don’t need them. We’ll eliminate the no-bid contracts that have wasted billions in Iraq, and reform our defense budget so that we’re not paying for Cold War-era weapons systems we don’t use. Such as? Surely you're not suggesting we eliminate our strategic deterrent forces, our carrier battlegroups, strategic airlift and sealift capabilities, etc. We will root out the waste, fraud, and abuse in our Medicare program that doesn’t make our seniors any healthier, and we will restore a sense of fairness and balance to our tax code by finally ending the tax breaks for corporations that ship our jobs overseas. Anyone want to make any bets on how that works out?

In order to save our children from a future of debt, we will also end the tax breaks for the wealthiest 2% of Americans. Yeah, those folks that already pay 40% or so of our taxes are just getting SUCH a good deal now. But let me perfectly clear, because I know you’ll hear the same old claims that rolling back these tax breaks means a massive tax increase on the American people: if your family earns less than $250,000 a year, you will not see your taxes increased a single dime. I repeat: not one single dime. That's right, you won't see it, but you'll be paying it in the form of increased costs for any goods and services which use energy in their creation.In fact, the recovery plan provides a tax cut – that’s right, a tax cut – for 95% of working families. And these checks are on the way. You know what I want to say here. Just fill it in.

To preserve our long-term fiscal health, we must also address the growing costs in Medicare and Social Security. Comprehensive health care reform is the best way to strengthen Medicare for years to come. And we must also begin a conversation on how to do the same for Social Security, while creating tax-free universal savings accounts for all Americans. In other words, we're driving down the value of your 401k so we can nationalize the assets and stick you with another “savings” program trust fund that we can raid to pay our expenses. We're also going to make sure that you don't receive the Social Security and Medicare benefits we've been promising you all these years because we couldn't be trusted with the money you've been giving us, but don't worry, we'll be good this time.

Finally, because we’re also suffering from a deficit of trust, I am committed to restoring a sense of honesty and accountability to our budget. That is why this budget looks ahead ten years and accounts for spending that was left out under the old rules – and for the first time, that includes the full cost of fighting in Iraq and Afghanistan. For seven years, we have been a nation at war. No longer will we hide its price. I don't think the 4000 families who've lost loved ones in the GWOT would consider the costs hidden, you cretin.

And with our friends and allies, we will forge a new and comprehensive strategy for Afghanistan and Pakistan to defeat al Qaeda and combat extremism. Because I will not allow terrorists to plot against the American people from safe havens half a world away. Yeah, that W, he was such a softie when it came to al Qaeda. I notice you're also playing footsie with Syria and Iran. At least you're consistent, they both are closer than Pakistan.

As we meet here tonight, our men and women in uniform stand watch abroad and more are readying to deploy. To each and every one of them, and to the families who bear the quiet burden of their absence, Americans are united in sending one message: we honor your service, we are inspired by your sacrifice, and you have our unyielding support. To relieve the strain on our forces, my budget increases the number of our soldiers and Marines. And to keep our sacred trust with those who serve, we will raise their pay, (the statutory minimum 2% and not a penny more while we cut the overall defense budget 10% and grow the overall federal government 8%) and give our veterans the expanded health care and benefits that they have earned.

To overcome extremism, we must also be vigilant in upholding the values our troops defend – because there is no force in the world more powerful than the example of America. That is why I have ordered the closing of the detention center at Guantanamo Bay, and will seek swift and certain justice for captured terrorists – because living our values doesn’t make us weaker, it makes us safer and it makes us stronger. And that is why I can stand here tonight and say without exception or equivocation that the United States of America does not torture. Nor have we throughout the GWOT, but we have noticed that you'll continue the rendition procedures started under the Clinton administration so other people can do it for us.

In words and deeds, we are showing the world that a new era of engagement has begun. No, you're showing them a weak, feckless foreign policy they've been missing for eight years. For we know that America cannot meet the threats of this century alone, but the world cannot meet them without America. We cannot shun the negotiating table, nor ignore the foes or forces that could do us harm. Unless, of course, we need their money. In that case, we'll suck it up and shut up. We are instead called to move forward with the sense of confidence and candor that serious times demand.

To seek progress toward a secure and lasting peace between Israel and her neighbors, we have appointed an envoy to sustain our effort. Because I just know that I can accomplish what the God of Abraham couldn't. You can't secure a lasting peace until you've broken the will of the people. Get rid of the Team of Rivals crap and try a little Clausewitz. You're the damned Commander in Chief, try learning the job. To meet the challenges of the 21st century – from terrorism to nuclear proliferation; from pandemic disease to cyber threats to crushing poverty – we will strengthen old alliances, forge new ones, and use all elements of our national power.

And to respond to an economic crisis that is global in scope, we are working with the nations of the G-20 to restore confidence in our financial system, avoid the possibility of escalating protectionism, and spur demand for American goods in markets across the globe. For the world depends on us to have a strong economy, just as our economy depends on the strength of the world’s. Let me get this straight, you're going to make it vastly more expensive for American companies to do business in this country, or anywhere else in the world, suck up as much private sector capital as you possibly can to pay for your programs, and that's going to spur investment in our economy and make our goods more competitive. Yeah, that'll work. Oh, and you've put Biden in charge of the recovery. Nope, not a chance anything'll go wrong.

As we stand at this crossroads of history, the eyes of all people in all nations are once again upon us – watching to see what we do with this moment; waiting for us to lead.

Those of us gathered here tonight have been called to govern in extraordinary times. It is a tremendous burden, but also a great privilege – one that has been entrusted to few generations of Americans. For in our hands lies the ability to shape our world for good or for ill. Exactly why those of us who'll have to pay for what you do would prefer you to sit on them.

I know that we haven’t agreed on every issue thus far, and there are surely times in the future when we will part ways. But I also know that every American who is sitting here tonight loves this country and wants it to succeed. That must be the starting point for every debate we have in the coming months, and where we return after those debates are done. That is the foundation on which the American people expect us to build common ground. Unless we disagree with what you want to do, in which case you've told us that you won and get to do whatever you want.

And if we do – if we come together and lift this nation from the depths of this crisis; if we put our people back to work and restart the engine of our prosperity; if we confront without fear the challenges of our time and summon that enduring spirit of an America that does not quit, then someday years from now our children can tell their children that this was the time when we performed, in the words that are carved into this very chamber, "something worthy to be remembered." Thank you, God Bless you, and may God Bless the United States of America. May God give us mercy and deliver us from fools.

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