[Public Papers of the Presidents of the United States: George W. Bush (2007, Book I)]
[February 21, 2007]
[Pages 165-175]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks in a Discussion on Health Care in Chattanooga, Tennessee
February 21, 2007

    The President. Thank you all very much. Please be seated. Thank you. 
Thank you very much. I'm honored to be here. Jim, thank you. We just toured a pretty fantastic hospital. He 
talked about robotics that are being used to operate on. He said that I 
was on the machine, and he's right, but there wasn't anybody at the 
other end of the machine, you'll be happy to hear. [Laughter]
    I want to talk today about health care. I see people wearing our 
uniform; I want to thank you for wearing the uniform. I am the Commander 
in Chief, and proudly so. I'm also the educator in chief. The job of the 
educator in chief is to try to educate people about different ways to 
solve major problems facing our country, and we've got a problem with 
health care. It's not affordable, and it's not accessible to too many of 
our people. And the fundamental question is how to deal with it. And so 
today we're going to have a conversation with experts. We've got people 
who call themselves experts, like me and the Secretary and the Governor. And we got 
people who are living experts because they're having to deal with the 
health care problems.
    And so I want to thank you for joining us. I particularly want to 
say thanks to Michael Leavitt, who is the 
Secretary of Health and Human Services. I asked him to join my Cabinet. 
He came from the State of Utah, where he was a Governor. I happen to 
believe Governors know how to set agendas and know how to achieve 
results. You've got you such a Governor here in the State of Tennessee 
as well. And, Mr. Governor, we appreciate you 
joining us. Mike and--[applause].
    I think you're going to find it interesting as we discuss the proper 
relationship between the Federal Government and States, as we design 
programs that help individuals be in charge of their health care 
decisions. And so we're going to have a discussion with some of your 
fellow citizens here, and I want to thank you all for joining us. It 
seemed like a pretty good idea when you accepted--[laughter]--and then 
you got out here--look at all the people and cameras. Anyway, I think 
you're going to find it interesting. I know I'm looking forward to 
hearing what you all have to say.
    I'm keeping pretty good company today, as you can see. Not only have 
we got the Governor; we've got the Lieutenant 
Governor with us today. Lieutenant Governor 
Ramsey is with us. Thanks for coming. There he is, yes, Ramsey.
    I am very proud of your--the 
Senators you've got up there--that you sent up 
to Washington. The senior Senator, Lamar Al-
exander--appreciate you coming, Lamar. Proud to be here. He's a good, 
thoughtful guy, who, by the way, paid me and Laura a high compliment the other day in the newspapers in 
Tennessee when he noticed that we had worked hard to increase the budget 
of the National Park System, thereby directly benefiting the people who 
care about the parks in eastern Tennessee. And so thank you for not only 
helping us get that piece of legislation into the process; I'm looking 
forward to getting it passed during the appropriations process.
    The other United States Senator is a 
fellow you know pretty well, a man who made his marks in paving the 
roads and filling the potholes, former mayor Bob Corker. Thanks for 
coming.
    And finally, the United States 
Congressman--all he talks about is ``Chatt-town,'' every time I see him. 
He says, ``You remember Chattanooga, now, Mr. President, don't you?'' 
[Laughter] ``You came here when you were not in public office. We expect 
you to come back in public office.'' And I'm glad, Zach, that I finally 
listened to you when it came to my travel schedule.

[[Page 166]]

I'm really thrilled to be here in this beautiful part of our country, 
and I'm also proud to be in the presence of your Congressman, Zach Wamp. 
Thanks for being here.
    We got the mayor with us today--the 
mayors. We got the mayor, Ron Littlefield, of 
Chattanooga. Mr. Mayor, thank you for coming; proud to have you here. 
Mayor Claude Ramsey of Hamilton County. I told the mayor, I said, ``In 
Texas, we call them county judges.'' [Laughter] So I said, ``I might 
just call you `Judge.''' And he said, ``Well, Mr. President, you can 
call me whatever you want to call me.'' [Laughter] Mayor, thanks for 
coming; appreciate you being here.
    I do want to thank the good folks who work at Erlanger. Thanks for 
putting up with me and the entourage. We really had a wonderful tour. 
And the truth of the matter is, you can put all the robotics you want in 
a hospital, or all the x rays; what really matters is the compassion and 
care given by people. And so I want to thank the docs and the nurses and 
the staff of that wonderful facility for being on the leading edge of 
compassion.
    It was really interesting, a couple of 
docs showed us some stroke recovery 
procedures, and one of the examples was a 26-year-old woman who got a 
stroke, and she couldn't talk. And then the next film they put up there 
was her talking, and how happy she was. And it had to make you feel 
great, doc, to know that you saved somebody's life. And so I thank you.
    And the mission, by the way, of government is to make sure that the 
quality of health care received by our patients around this country 
remains the best in the world. Private medicine works. And we need to 
make sure that we put good policies in place to make sure private 
medicine is the norm, quality care is given to as many Americans as 
possible. And that's what we're here to discuss.
    Now, look, we got a problem, and the problem is, health care costs 
are rising too fast for a lot of our individuals and small-business 
owners. Here's one of them right here. He's about 
to testify--[laughter]--about the rising cost of health care, see. 
Individuals are being priced out of the market. And so what is the 
proper policy to deal with it? You sent us up to Washington to identify 
problems, but you also sent us up there to identify solutions. And so I 
want to share some solutions with you today, some ideas that I hope the 
Members of Congress take seriously.
    A first philosophical note is that the best decisions are made by 
providers and patients, not by government or insurance companies. In 
other words, if you want a health care system that really works, you 
want the decisionmaker to be the individual, in consultation with 
somebody who knows what they're talking about, somebody trained to help 
that person make the proper decision; that would be your doctor.
    Secondly, that when it comes time to helping people who need help, 
it makes sense for us to make sure the Federal Government does its job 
and to work in concert with States. Now, I believe the Federal 
Government has a solemn responsibility to take care of the sick--I mean, 
the disabled, the elderly, and the poor. We have made that commitment, 
and we've got to honor that commitment.
    Recently, we took on a big issue in the Congress, and that was to 
make sure that the Medicare system provided modern medicine for our 
seniors. And we passed new legislation that said, we're going to help 
with pharmaceutical drugs, that for the poor, they'll get their 
pharmaceuticals; but for those who aren't poor, they'll have some 
choices to make about how best to suit their needs when it comes to 
medicine. See, I believe in choice. I told you: I want those patients 
making the decisions.
    And guess what? It's working. Part D reform for Medicare is working. 
I congratulate the Secretary on helping implement this piece of 
legislation.

[[Page 167]]

    My point to you is, is that we take our responsibility seriously. We 
want to make sure there's adequate funding, and we will. We want to make 
sure that funding ends up in the hands of people who need help.
    Other ways to control costs are to make sure that we introduce 
information technology into health care. If you want to be honest about 
it--I think we probably ought to be--a lot of health care is kind of 
lagging behind the rest of the country when it comes to IT. I mean, 
they're still filling out forms by hand, doctors signing things, which 
leads to, sometimes, confusion, since doctors can't write very well. 
[Laughter] Paper gets lost. Files move around, and they get reshuffled 
the wrong way. We need to help make sure that health care is as modern 
as other aspects of our society. We want people to have a medical 
identification record that you can take with you--by the way, that is 
secure from people snooping.
    I'll tell you an interesting example of that is, our Veterans 
Affairs Department has done a good job of providing individualized 
health care records on the computers. And so when Katrina hit in New 
Orleans, all the files were destroyed for a lot of the health care 
providers, but each individual vet had his own health care chip. And so 
when they went to Houston, for example, they were able to take that, 
plug it into a computer. The doctors there at the VA was able to see 
what the previous treatments were or what the person needed, and there 
was a seamless transition from care in New Orleans to care in a VA place 
somewhere else.
    And so we've got--we're working on that, and the Federal Government 
can help. After all, we're a huge provider of health care. We want there 
to be price transparency in health care. I don't know about you, but I 
don't remember ever asking how much something was going to cost when it 
came to health care. I do when it comes to a car--or I used to. 
[Laughter] I will soon. [Laughter] But there's not many consumers 
asking: ``What does it cost, doc? And what's the quality of the 
product?''
    And so there's--transparency in pricing will help control costs. 
It's amazing what happens when consumers are making decisions. And one 
way to help consumers to make decisions is to encourage systems that put 
consumers in charge of health care decisions, like health savings 
accounts. Like, if you're running a small business, you need to look at 
a health savings account. People can save money with health savings 
accounts. These are innovative products, innovative ways of providing 
insurance for yourself and your family, where you actually save money 
tax free if you don't spend money on yourself.
    We believe there needs to be association health plans. I'm very 
worried about small businesses not being able to afford insurance but 
not nearly as worried as the CEOs of small businesses. It's got to pain 
somebody running a small business to know they can't provide their 
employee with the coverage they need. And yet small businesses aren't 
able to have the same advantages that big corporations get when it comes 
time to spreading risk across a lot of people they're insuring.
    And so I believe small businesses ought to be able to pool risk 
across jurisdictional boundary. That's fancy words for, I think a 
restaurant in Chattanooga ought to be able to put their employees in the 
same risk pool as a restaurant from Houston, Texas, so you can spread 
risk. Those are called association health plans.
    Here's another innovative way to help people be able to have 
affordable insurance. I strongly believe we've got to do something about 
lawsuits. I don't want to get too--[applause]. We've got a system in 
some States where you can't find an ob-gyn in a county because the 
lawsuits are running these good people out of the county. And by the 
way, it's running up the cost of medicine. A doc, whether they'll admit 
it to you or not, can't help but think

[[Page 168]]

in the back of their mind: ``I might get sued; I'm going to practice a 
little extra medicine.'' That's called the defensive practice of 
medicine. But it means that you're paying more for health costs than are 
absolutely necessary. If I was a doctor and worried about a lawsuit, I'd 
be doing the same thing. I'd be protecting myself for fear of a lawsuit 
that could conceivably damage my capacity to stay in business.
    And I happen to believe lawsuit reform is a national issue. When I 
first got up to Washington, Governor, I 
thought the States ought to take care of it. And then I found out that 
we're spending about $28 billion of your money as a result of the 
defensive practice of medicine. See, we spend a lot of money on 
Medicare, Medicaid, Veterans Affairs. And so when somebody is practicing 
extra medicine to avoid the consequences of a lawsuit, it's costing our 
taxpayers money.
    And I decided it was a national issue that requires a national 
response. And we hadn't done a very good job of getting that liability 
bill passed out of the Senate, but these two Senators are with us. And 
I'm going to keep pushing, so long as I'm the President, to get good 
national liability reform so to make medicine more accessible and more 
affordable for more of our citizens.
    You probably think I'm going to do all the talking. Yes. [Laughter] 
My wife--by the way, who sends her love--would 
tend to agree with you. [Laughter] By the way, I am a lucky man that 
Laura said yes when I asked her to marry me, and I really--[applause]--I 
know this isn't very objective, but I firmly believe the country is 
lucky to have her as the First Lady, I really do.
    There are some ideas I just laid out for people to think about on 
how to deal with the rising cost of medicine. I've got an idea as to how 
to make sure people can get private insurance. We ought to be striving 
to help people buy insurance so that hospitals like Erlanger don't have 
to pick up the tab.
    So the fundamental question is, how do we help? Well, the Tax Code 
needs to be changed. If you work for a large corporation in Chattanooga, 
Tennessee, you get your health care free, basically. In other words, you 
don't have to pay any tax on the benefits. If you work for a small 
company and that small company can't afford your health care and you go 
out and buy health care on your own, you pay with after-tax dollars. In 
other words, it costs you more than the person who works for a large 
company to buy insurance, and that's unfair.
    We're worried about helping make sure people can afford health care. 
But the Tax Code is so structured that if you're an individual or 
somebody working for a company that can't afford health care, you're 
disadvantaged relative to a company that is a larger company.
    And so here's an idea that Congress needs to consider: If you're 
married, got a family, and buying health care, you get a $15,000 
deduction from your income taxes, right off the top. It doesn't matter 
whether you're working for the largest company in Chattanooga or one of 
the smallest; you get that deduction. If you're single, you get to 
deduct $7,500 from your--not only your income tax but your payroll 
taxes. And the reason you do that--and you're going to hear some 
examples of how this will help our fellow citizens--one, it helps 
somebody afford insurance; two, it will help in the development of a 
market for individuals in the insurance world.
    Right now there's a limited market for the individual. It makes it 
hard to find a product that either suits your needs or you can afford. 
The more policies written to meet the individual--in other words, the 
larger the risk pool--the more likely it is that costs will come down 
for the individualized policy. That's just the way it works. Yet the Tax 
Code discourages the individual from being in the market.
    Now, one of the concerns I have about such a plan is that some 
people can't afford

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insurance, some people won't be able to get insurance. This plan will 
help a lot of people afford it, like the uninsured, the working 
uninsured. Now, remember, the Government is going to take care of the 
poor--that's called Medicaid--and SCHIP, plus what the innovative 
policies Phil is doing here in Tennessee. The 
Government is going to take care of the elderly; we take care of the 
disabled. And here's a way to help people who are working uninsured 
afford insurance. We'll give you some examples here in a minute.
    But I am also worried that there is--that the process will kind of 
leave out people who may have preexisting conditions. In other words, 
it's okay for the individual who's healthy to go get insurance, but how 
about the person that's not healthy? And therefore, Secretary 
Leavitt is designing a plan that says, we 
will give you flexibility with Federal money that we give you--to the 
State to help you design risk pools--like they're doing here in 
Tennessee--that will help you take care of the uninsurable, like you're 
doing here in Tennessee. In other words, it's a collaboration with the 
Federal Government and the State government to come up with innovative 
ways to deal with the issues as a result of adverse selectivity because 
of individual policies being the norm.
    And so I'm going to have Leavitt 
start us off in talking about it. And by the way, in return for 
flexibility, we expect the States to design basic health care coverage--
coverage that doesn't have all kinds of mandates on it; coverage that 
means somebody is more likely to be able to afford health care. And 
again, that's what the Governor has done here 
in Tennessee.
    You've got yourself--you're on the leading edge of some really 
interesting ideas in your State. You really are. And I want 
Mike to kick off the discussions, and 
then we're going to bring the Governor in. And 
then--we're getting ready to talk among ourselves here. Anyway, Michael.

[At this point, Secretary of Health and Human Services Michael O. 
Leavitt and Governor Philip N. Bredesen, Jr., of Tennessee made brief 
remarks.]

    The President. Yes, Governor, thanks. It's 
really important for me and Mike to know 
that we've got Governors on the frontlines of health care 
decisionmaking, designing programs that meet the needs of your State. 
Truth of the matter is, I'd rather, Governor, you be making these 
decisions than some of our brothers and sisters in Washington. 
[Laughter]
    Gov. Bredesen. I would agree with that, 
Mr. President.
    The President. A couple of points--he said--you know, this is an 
interesting statistic--I think it's before age 30, most youngsters will 
have had, like, eight or nine jobs. Isn't that interesting? Baby boomers 
like us, we're not used to that kind of turnover in the job market, 
which means you better have health care policies that are able to follow 
the person.
    One reason there's uncertainty in our economy is, people are worried 
about whether or not they're going to be able to have health insurance 
if they do what is the norm, which is to change jobs. And so I like the 
idea of the Governor designing a plan--health 
savings account has got the same sense of portability--you can take it 
with you. It's your--you own the deal.
    And the other thing he talked about: preventative care. I want to 
remind you; it doesn't cost any money to walk outside and walk for a 
couple of miles. Make sure when you ride your mountain bike, you don't 
crash on caliche. [Laughter]
    We've got Joe Cofer with us--mighty doctor.
    Joe Cofer. Thank you, President Bush.
    The President. What kind of doc are you?
    Dr. Cofer. Surgeon.
    The President. Oh, yes?
    Dr. Cofer. Yes, sir.
    The President. And what kind?
    Dr. Cofer. General surgeon.

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    The President. Feeling pretty good here, by the way, thank you. 
[Laughter]
    Dr. Cofer. If you need something out, let me 
know.
    The President. Yes. You're working at Erlanger?
    Dr. Cofer. Yes, sir.
    The President. Good. Do you like working there?
    Dr. Cofer. I love it.
    The President. I guess otherwise you wouldn't be working there. 
[Laughter]
    Dr. Cofer. I'd still be working there. 
[Laughter]
    The President. Oh, that's right. Yes. That's a smart thing, the old 
boss is sitting over there--[laughter]. Give us 
your concerns. What's on your mind?
    Dr. Cofer. Well, I think that the plans you've 
set forth are very important. I think we've got to develop health care 
for those that are uninsured, and I'd like to tell you about what we've 
done with Project Access.
    The President. I'd like to hear it.
    Dr. Cofer. Okay. First, let me welcome you and 
Secretary Leavitt, from the University of Tennessee College of Medicine, 
from Erlanger Hospital, and all the physicians who practice here in 
Hamilton County. Thank you for coming to Chattanooga, the best kept 
secret in America, and thank you for coming here to talk about health 
care.
    The President. Working the chamber of commerce angle, that's good. 
[Laughter]
    Dr. Cofer. That's right.
    The President. Yes. Don't forget the Governor now; the University of Tennessee has got the budget, 
right?

[Dr. Cofer, surgeon, Erlanger Hospital--Baroness Campus, and chairman, 
Project Access, made further remarks.]

    The President. You know, the great strength of the country is not 
our military, nor the size of our wallets; it's the size of our hearts 
and the compassion for fellow citizens. I appreciate, doc, what you're doing. We have an admonition to love our 
neighbor like we'd like to be loved ourself. A government cannot make 
people love one another. That happens when loving citizens decide: I'm 
going to help solve a problem.
    And I thank you for recognizing that the Federal Government and the 
State government can't solve all the problems. Instead of waiting around 
for them to do something they cannot possibly do, you have stood up and 
done it yourself. And for that, I congratulate you and thank you and the 
citizens.
    Our job is to keep the economy growing as best we can so people are 
able to help themselves and get out of poverty and be able to afford 
health care, and to do smart policies to be able to make sure that the 
uninsured numbers shrink. That's the objective. That's the goal. That's 
why Phil is doing what he's doing. That's why 
I'm suggesting that Congress revisit the Tax Code to make it easier for 
citizens to be able to afford insurance.
    We've got Danny Jennings with us. 
Welcome, Danny. You're married?
    Danny Jennings. Yes.
    The President. Yes, you are. And how many children?
    Mr. Jennings. Two.
    The President. Ages?
    Mr. Jennings. Eight and ten.
    The President. They're Chattanooga baseball fans?
    Mr. Jennings. Probably will be after 
this. [Laughter]
    The President. That's good. Yes. What do you do for a living?
    Mr. Jennings. I manage a nursery in 
McMinnville, Tennessee.
    The President. Really? Fantastic. Now's your chance if you want to 
put a pitch out there for some rhododendron. [Laughter]
    Mr. Jennings. Those are coming in soon, 
by the way. [Laughter]
    The President. Well, yes, see. I'm just showing off a little--flora. 
[Laughter]
    Tell me about your health care. Are you insured?

[[Page 171]]

    Mr. Jennings. No. At the present time, 
no. I'm in between insurance companies. I've had problems in the past 
with the rising cost of health insurance and, of course, the 
deductibles. And then there's preexisting conditions, which drive the 
price up even more.
    The President. Yes. So here's a guy 
that's got two children.
    Mr. Jennings. Yes.
    The President. Eight and ten--and young family in America has got no 
health insurance. And it's got to be a little bit intimidating for you.
    Mr. Jennings. Oh, absolutely. I own my 
own home, and yes, that's very intimidating.
    The President. One of the reasons I've asked Danny to come is because I want to help you understand how 
the standard deduction, in his case, of $15,000, will help him better 
afford health insurance. As I understand it right now, that when you--it 
costs Danny about $450 a month to be able to get insurance to cover his 
family's needs.
    Mr. Jennings. Yes.
    The President. If we can get Congress to change the Tax Code--now, 
here's a fellow working for a small company 
that does not have insurance, can't afford to go in the market himself. 
But if we can get the standard deduction passed so that he's able to 
deduct $15,000 off his income tax and payroll tax, he saves about $4,500 
a year in taxes, which means that the cost per month for him and his 
family for health insurance goes down to $47 a month when you apply the 
tax savings.
    The reason I asked Danny to come is 
because I want you to understand that the standard deduction can mean a 
lot to a fellow who's working and trying to be able to afford private 
health insurance. In other words, there's more money in his pocket as a 
result of the tax standard deduction, and there's more peace of mind 
knowing that his kids and that he and his wife are covered.
    Mr. Jennings. Absolutely.
    The President. So I want you to do me a favor. You don't need to 
write Wamp; he's on board. We'll find you 
another Congressman to write. [Laughter] Sounds pretty good.
    Mr. Jennings. Absolutely.
    The President. Yes, I think it will work for you, Danny. I really do. And Danny, I'm concerned about a lot of 
our citizens, but I don't like to think about a society where the cost 
of health care has gotten such that a fellow who is trying to do the 
best he can for his family--got him a house, got him a steady job, but 
he can't afford health care. And here's one idea for the people of 
this--for the Congress to think about. Lets Danny make the decision; he 
gets to buy health insurance; but he's got 4,500 extra dollars to do so 
on an annual basis.
    Mr. Jennings. Definitely.
    The President. Thanks for coming.
    Mr. Jennings. Thank you.
    The President. Marty Ginn.
    Martha ``Marty'' Ginn. Yes, sir.
    The President. Glad you're with us.
    Ms. Ginn. I'm glad to be here.
    The President. What do you do for a living, besides being--
she's got the toughest job in America, 
and that's being a single mom. That's the toughest job, by the way, in 
my judgment. So what do you do?
    Ms. Ginn. I'm an office manager in 
McMinnville, Tennessee. I've been working there for about 10 years.
    The President. Good.
    Ms. Ginn. And I love it.
    The President. Do you?
    Ms. Ginn. Yes, I do. I'm very good 
at it.
    The President. It's important to have high job satisfaction. Are you 
good at it?
    Ms. Ginn. Yes, sir. [Laughter]
    The President. Give the girl a 
raise, will you? [Laughter] And so do you have health insurance?
    Ms. Ginn. No, sir.

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    The President. Yes, so you work for a company that does not offer 
health insurance?
    Ms. Ginn. Yes, sir. I have a--I 
have inquired on some insurance, but I have a preexisting condition--I 
have trouble with my left knee--and the quotes were just outrageous. So 
I'm just kind of stuck.
    The President. So you'd rather go without insurance--or not rather 
go--you just can't afford it. Let me put it that way.
    Ms. Ginn. Well, there you go.
    The President. It's not a matter of rather; it's a matter of 
necessity.
    Ms. Ginn. Can't afford it.
    The President. Yes. Since Marty is 
a single person, she gets to deduct $7,500 off of income and payroll 
taxes, which would yield her about $1,900 in savings on an annual basis, 
which could then be applied toward health insurance. In other words, 
Marty can't afford health insurance; the plan needs to--we've got to 
have something in government to help encourage people who cannot afford 
health insurance to do so. One is to help deal with the cost, and we've 
laid out some ways to do it, but another is to change the Tax Code.
    She doesn't get the same benefit 
when she buys health insurance as somebody working for a larger company. 
That's patently unfair. I know it wasn't designed that way when they did 
that in the health care system. But it's unfair for her. And all I'm 
going to ask from people in Congress is, be fair. Treat the Martys of 
the world in a fair way. And we believe in treating her fairly; she'll 
be able to better afford health care.
    Ms. Ginn. That would be great. 
[Laughter]
    The President. Yes. Good. And you've got your daughter out there. 
She's 21?
    Ms. Ginn. My son.
    The President. Your son? Yes.
    Ms. Ginn. My son.
    The President. As I said, your son. [Laughter]
    Ms. Ginn. Trust me; he's a son. 
[Laughter]
    The President. That's good. Is he listening to his mother?
    Ms. Ginn. He always does.
    The President. Yes. Mine can't say the same 
thing. [Laughter]
    Ms. Ginn. The Marines taught him 
well.
    The President. He's a marine?
    Ms. Ginn. Yes.
    The President. Yes, ma'am. I 
appreciate it. I know you're proud of him. Where is he? Is he out there? 
Yes, sir. Thanks for serving. Thank you. Yes, sir. He yelled, ``Semper 
Fi,'' at the Commander in Chief--proudly received.
    Audience member. Hooah!
    The President. There you are. [Laughter] Okay. That's enough. 
[Laughter]
    Amy Childers--isn't that right?
    Amy Childers. Yes, sir.
    The President. So are you gainfully employed?
    Ms. Childers. Yes, sir.
    The President. Like, what do you do?
    Ms. Childers. I'm an interior designer in 
Nashville, Tennessee.
    The President. Great. You came over with the Governor?
    Ms. Childers. I did.
    The President. That's good--from the same area. Nashville is an 
exciting town, isn't it?
    Ms. Childers. Yes, sir.
    The President. It really is a vibrant town; it's an exciting place. 
Thanks for coming. And so who do you work for?
    Ms. Childers. I work for Lumen Lamps.
    The President. Yes. That means you sell lamps?
    Ms. Childers. I do. [Laughter]
    The President. I'm occasionally in the market. [Laughter] And so 
what's your--give us a feel--your company--once again, she works for a company that does not provide health 
insurance.
    Ms. Childers. We are a very small company. 
I'm the only full-time employee besides my employer, and he can't afford 
for

[[Page 173]]

us. And so I turned 35 last summer and my----
    The President. You don't look a day over 34. [Laughter]
    Ms. Childers. Most people say 22, but 
thanks. [Laughter]
    The President. Good one. Yes, I'm not running again. [Laughter]
    Ms. Childers. I'll let you slide. 
[Laughter]
    The President. Who invited Amy? Where is 
the guy? [Laughter]
    Ms. Childers. Okay. So I turned 35, and my 
cover went from $130 a month to $210. So my dad wasn't supposed to know 
this--I dropped that health insurance----
    The President. He knows it now. [Laughter]
    Ms. Childers. Yes, he does.
    The President. I hate to tell you, Amy, but 
see those cameras back there? [Laughter]
    Ms. Childers. He's over there.
    The President. Where is your dad? Is he here?
    Ms. Childers. He is.
    The President. Good. Okay, well, I'll see him afterwards.
    Ms. Childers. All right.
    The President. I'll cover for you. [Laughter] So anyway, you dropped 
your health insurance because----
    Ms. Childers. It went up to $210 a month, 
and so I got one that's $5,000 deductible at $100 a month.
    The President. Here's the thing. Amy, look, 
I can't tell you how many people there are that work for small 
businesses who cannot afford insurance. I mean, a big slug of the 
uninsured in America works for small business companies; some, by the 
way, of the uninsured are young people who never think they're going to 
get sick and don't bother to buy insurance. But a big slug work for 
people that are struggling to make ends meet.
    It's hard to be a small-business owner. It's hard to survive in a 
competitive world. And yet we've got to make sure our small businesses 
are strong; after all, they create 70 percent of the new jobs in 
America. We want the entrepreneurial spirit to be strong. One of the 
roadblocks to success is the cost of health care. And so here's a man 
who's got a small business. He has to make a difficult decision not to 
provide insurance for his employee. She has to 
decide.
    Doesn't it make sense to change the Tax Code so that Amy 
Childers can better afford insurance? And so if 
she gets the $7,500 deduction, she saves about $2,000 a year--which 
means something other than the kind of plan you have is more affordable 
to you. Isn't that right?
    Ms. Childers. Yes, sir.
    The President. Yes. See, the reason I've asked these three folks to come to talk about--first of all, I just want people 
to be able to identify with what it means to be in a society in which 
you either don't have health insurance or you don't have adequate 
coverage. And there's a lot of our citizens who are just that way, and 
we've got to do something about it. It's not right, and it's not fair.
    And there's an interesting debate going on--how best to solve the 
problem. Some say, ``Well, maybe the Federal Government ought to do it 
all.'' I don't believe that. I believe we can do a combination of good 
policy with the Tax Code, good policy to help those who we have an 
obligation to help, good policy with State, and good policy with 
charity, to make sure that we're able to provide that mosaic so that 
people can know that the society is better off as a result of accessible 
and affordable health care.
    Now, we've got a man--thank you for coming, 
by the way. You did a wonderful job.
    Will Smith, living the American Dream.
    Will Smith. Thank you, Mr. President.
    The President. Is that an accurate statement?
    Mr. Smith. Yes, it's a correct statement.
    The President. You know, I love a society where a fellow like Will 
Smith says, ``I want

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to start my own business.'' We want people from all across the country 
saying, ``I want to take a risk and start my own business.'' It's good 
for the country. Ownership is good for the country. Creating jobs 
through the small-business sector is good for the country.
    So tell us what you're doing.
    Mr. Smith. All right. I'm a developer, sir. I 
was one of the--we're the largest real estate developer in the city 
right now.
    The President. Really? Good. Married?
    Mr. Smith. Yes, married--four kids.
    The President. That's good. And the name of your company?
    Mr. Smith. It's WAS Properties.
    The President. Put his wife's name in the 
deal. Will, and your wife's name is Andrea?
    Mr. Smith. Andrea.
    The President. See, W-A. Get it? Will and 
Andrea? [Laughter] And Smith--S. [Laughter]
    Mr. Smith. That's correct.
    The President. That is a smart move to put the wife's name in the company. [Laughter] So what are your 
problems?
    Mr. Smith. Well, I have 9 full-time 
employees, and I count my contractors, which is about 50--
subcontractors, which is about 50 employees. And in the nine employees 
that I have full time, they're not only just my employees; they're part 
of my family, because they've been with me for about 4 or 5 years. And 
we just can't afford insurance for them.
    The President. First of all, I want you to hear the spirit that 
he just talked to me. He said, ``These are my 
close friends.'' In other words, these are more than just employees. A 
CEO of a small business views--many times--views the employees as 
family. And so he's concerned about whether or not he is providing for 
his family, which is frankly an obligation of people who run a company. 
But the problem is, insurance has gotten too expensive to be able to do 
that, I guess.
    Mr. Smith. Exactly.
    The President. Yes. So I got an idea for you--two ideas. One is to 
look at health savings accounts--high deductible plans with a cash 
contribution to take care of ongoing medical expenses. If your employee 
does not spend the money, he or she gets to keep it and earn money tax-
free and gets to save it; that's one idea. You ought to take a look.
    The other idea is--I know I'm beating a dead horse, but sometimes 
you have to say the same thing over and over and over again, and I'm 
going to say it one more time: We need to let Will and his employees be able to deduct the cost--a standard 
deduction off their income taxes so that he's got just as good a chance 
to provide insurance for his employees that big companies do here in 
Chattanooga. That's what we need to do. It is a really important idea.
    I know that you're looking and you're scrambling, but it would be a 
lot easier if you were able to work with your employees because of the 
money that they save as a result of tax deductions.
    Mr. Smith. That's correct.
    The President. And so the whole purpose, by the way, of this 
discussion is to help the individual, but to also help the entrepreneur 
do their duty. That's why I've come. I've really come to say thanks to 
your Governor for being innovative. See, he's 
helping lay out a basic health care plan. One of the problems we have at 
State level is that over time, a lot of mandates have been added to 
insurance. You know, the hair follicle benefit, well, you don't need 
hair follicles, particularly if you have hair. [Laughter] If you're 
going bald, you might think you do, but it's probably not a necessary 
part of a health care plan.
    I'm not saying that's happening in Tennessee. [Laughter] But after a 
while--the Governor knows what I'm talking 
about, and so does this Governor--it's 
hard to resist. And so they get--these insurance plans get all kinds of 
things added on to them, which makes the expense beyond the reach.

[[Page 175]]

And so the Governor said: ``Look, we're going to try--well, that's fine; 
we'll have those plans; but we're going to devise another plan too, just 
to provide for basic health care.'' That will help his employees, and so 
will change in the Tax Code.
    I firmly believe we can do a better job in helping people get 
private insurance than we're doing today. Matter of fact--and we need 
to. See, the status quo is unacceptable. And so I've come to talk to you 
about some ideas, and I want to thank you for giving us the forum to do 
that. Ideas matter in the public life. And here's an idea, a series of 
ideas.
    I strongly urge both Republicans and Democrats to take a look at 
what we've announced. We want to work with people in Washington, DC. I'm 
tired of the politics, just like you're tired of the politics. We can do 
a better job of finding common ground on commonsense ideas to solve 
common problems.
    And so I thank you for giving us a chance to come today. I want to 
thank our fellow citizens--my fellow citizens for joining us in helping 
to illuminate the problem and helping me highlight the solution.
    Governor, I'm honored that you came. You 
didn't need to come. It's a great honor that you're here. In return, 
Laura and I will have you for dinner next Sunday 
night. [Laughter] Well, we were going to do it anyway but--[laughter]--
all the Governors are coming to town. I'm looking forward to welcoming 
your Governor. [Laughter] And I thank the Secretary. Doc, thanks for coming.
    God bless you all. Thanks for your time.

Note: The President spoke at 12:33 p.m. at the Chattanooga Convention 
Center. In his remarks, he referred to Jim Brexler, president and chief 
executive officer, Erlanger Health System; and Lt. Gov. Ron Ramsey of 
Tennessee.