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My Fellow Americans -- The Speech Obama Should Give on Health Care

A few novel suggestions for how the president might use his speech before the joint session of Congress to break the health-care reform log-jam.

My Fellow Americans:

I stand before you a chastened president. I made a mistake. Two mistakes, really. (wild applause from Republican side)

I thought that Congress could do its job and, through the deliberative process, produce a health care reform plan that would win broad support across the aisle and among all of you.

But I’m afraid I was wrong.

Health care is an enormous industry -- maybe the biggest and most powerful industry in the country -- and it has far too much power in this capitol. Literally thousands of lobbyists, carrying tens of billions of dollars in campaign contributions have invaded these halls (and my house!) (relieved laughter) and distorted the process and, in the end, have stymied reform. (some hissing)

Meanwhile, I have realized that the answer has been staring us in the face all along.

And this was my second mistake: I told the American Medical Association that while single-payer medical plans, where the government is the insurer, might work well in other countries, the idea of government running health care was not part of our American tradition.

In fact, it is, and has been since 1965, when President Lyndon Johnson signed into law the Medicare program. Medicare is a classic example of an excellent single-payer program -- one of the largest in the world -- and polls and surveys show it is enormously popular with older and disabled Americans.

Medicare has relieved our parents and grandparents from the fear that they will not get medical care when they stop working, and it has lifted the enormous burden and worry off of younger Americans over how to pay for the care of their elders. It has done this with enormous efficiency, all while allowing recipients to choose their own doctors and hospitals. (applause)

So we really don’t need to re-invent the wheel here. There is no point in members of Congress having to hold endless hearings, and to sit and listen to the pitches of lobbyists from the medical establishment. We can just expand Medicare to cover everyone. (applause)

How much would that cost? Well, we know that 10 percent of the elderly -- the oldest and sickest among us -- account for 50 percent of total Medicare costs, so that means the other 90 percent only cost some $200 billion a year. Even if we assumed that the rest of the population’s medical bills were as high as those 90 percent of older Americans, it would mean that expanding Medicare to cover them would cost less than $1 trillion a year, and probably closer to $750 billion -- because the truth is, the rest of the population is younger and healthier than are their older parents and grandparents. So roughly speaking, we’re talking about adding $750 billion a year to the cost of Medicare.

Now that’s a big number, and I know that some of you -- a lot of you -- worry about higher taxes. But let me assure you, expanding Medicare to cover everyone is going to save you money -- virtually everyone. Let’s look at why that is, and why you cannot just look at the federal tax when you consider those savings.

Today, the United States spends nearly 20 percent of GDP on health care. That is more than double what any other country in the world spends on health care. And you know what? We don’t get our money's worth for all that dough. Not even close. Canadians, who spend half that percentage of their GDP on health care -- and who have what amounts to Medicare for all with their single-payer system (they call it Medicare, too) -- have longer lifespans and better infant mortality statistics than we do. In fact, Cuba and Mexico have better child health statistics than we do!