[Public Papers of the Presidents of the United States: George W. Bush (2007, Book I)]
[January 25, 2007]
[Pages 57-67]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks in a Discussion on Health Care in Lee's Summit, Missouri
January 25, 2007

    The President. Rich, thank you very 
much for inviting us here to Saint Luke's. We had a fascinating tour of 
your facility. It is safe to say that Saint Luke's hospital--the Saint 
Luke's Health System understands the power of technology to help 
compassionate doctors and nurses better do their job. And technology is 
a--we saw, like, unbelievably interesting medical programs, programs 
that enable doctors to better analyze disease and deal with disease 
before it becomes acute, which is important.
    The reason why I emphasize the information technology aspects of 
this hospital is that part of the role of Government is to encourage 
people to make decisions to help hold the cost of health care down. And 
when a hospital modernizes, when you go from files to electronics, it 
helps hold the cost of health care down.
    One of the interesting things about medicine is that medicine tends 
to have lagged behind the rest of our economy when it comes to 
information technology. And yet under Rich's leadership, this facility and its sister facilities 
are doing some really interesting reforms we'll talk about a little bit.
    I want to thank George Pagels, who is 
the CEO of this facility. George, thank you. He's a doctor and gave us 
the tour--met a lot of really fine nurses and docs, by the way. I 
appreciate Senator Bond joining 
us; thanks for coming. And of course, our Secretary of Health and Human 
Services, who will say something here in 
a minute.
    I want to talk a little bit about a comprehensive strategy to make 
health care available and affordable. There is no question in my mind 
that a proper role for the Federal Government is to help the poor and 
the elderly and the diseased get health care. We'll do that. And to the 
extent that these important programs need to be reformed and 
strengthened, we will do that as well. Witness what we did with 
Medicare. Medicare was old and stagnant; it needed to be reformed. We 
reformed it through a generous prescription drug benefit that has 
actually worked; it's helped our seniors. And so we will do our duty at 
the Federal level, and when we find deficiencies in Federal programs, we 
will work to correct them, for the good of the citizens and the 
taxpayers.
    The second aspect of our responsibility is to work to make health 
care available

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and affordable for all our citizens, and the best way to do that is 
through private health insurance. Therein lies part of the debate we 
have in Washington. We believe the private sector is the best delivery 
of health care. We know there's a role for the Federal Government, but 
it's not to dictate; it's not to be the decisionmaker. And so 
Mike and I and others in my 
administration have been strategizing on how best to make health care 
available and affordable.
    Here are some ways. One, helping spread information technology--
we're the biggest user of health care in the United States, and 
therefore, we can help people understand the benefits of using 
information technology. Secondly, price transparency, one reason we came 
to this hospital is that under Rich's 
leadership, this hospital system has been willing to place its prices 
and its quality ratings out for consumers to see.
    I mean, health care is an interesting industry, isn't it, where a 
lot of times you have no idea about the price of the service you're 
paying for. You just assume it's okay. Somebody says, ``Here's your 
price,'' and you say, ``Okay, I'll pay it.'' We believe that with price 
transparency and quality assessments, consumers will have a better 
decisionmaking process. And we want consumers making the decision in 
health care.
    Think about a system where there's a third-party payer. So you've 
got your insurance, somebody pays your bills for you, and you're not 
involved. You just kind of assume that the third-party payer is making a 
rational decision on your behalf. And our view is, is that in order to 
have--to worry about health care costs, the more a consumer is involved, 
the more likely we'll be able to deal with the increasing cost of health 
care.
    Another reform is medical liability reform. I'm walking around the 
hospital here; a professional comes up to me and says, ``We practice too 
much medicine for fear of lawsuits,'' which raises the cost of your 
bill. See, if the medical provider is worried about getting sued, they 
will make decisions on how to stay out of the court of law more than--as 
important as decisions on how to keep you healthy. Medical liability is 
a real problem in a lot of States.
    And we are trying to get the United States Congress to hear that 
same call. And I'll keep working on medical liability reform. Why--to 
help make health care more affordable. But also, when you get a lot of 
lawsuits, it causes good docs to quit the practice of medicine. There 
are a lot of counties in the country that do not have ob-gyn because 
these lawsuits have run them out of practice. And it's not right, and 
it's not fair. And so we need to have the political will in Washington 
to take on a very powerful lobby, which is the trial lawyers, and 
prevent these frivolous lawsuits from running up the cost of your 
medicine and running good docs out of practice.
    A couple of other points I want to make before we talk to the--talk 
about this new initiative I laid out to the country. I think it's very 
important to help develop plans that make the consumer in charge of as 
much of the health care decision as possible. These are called--one idea 
is health savings accounts. This basically says that there is a product 
available for you to use where you're the decisionmaker and you're able 
to contribute tax free, earn money in your account tax free, take money 
out tax free on medicine. If you don't spend the money in your account 
one year, you can roll it over; it becomes a savings account. It's an 
incentive for you to make good decisions about your life, and it also 
provides catastrophic care in case something bad happens to you. We'll 
talk about health savings accounts here in a minute, and their effect on 
enabling people who do not have insurance to have health care available 
and affordable for them.
    Finally, small businesses need help. I mean, it's hard to be able to 
buy insurance when you're a stand-alone company. And

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insurance is basically a spreading of risk through pooling of risk, and 
we just need to allow small businesses to be able to buy insurance at 
the same discounts that big companies can by pooling risk.
    In other words, a restaurant in Missouri ought to be able to have 
their employees insured with a restaurant in Texas. In other words, put 
them all in the same pool so they can get the benefits of spreading 
risk. Now, these are practical things to get done. And they're hard to 
get done in Washington because people in Washington have a different 
view. They want the Government basically making the decisions for health 
care. The view of the people here is that you ought to be making those 
decisions.
    One way to encourage you to make the right decisions when it comes 
to health care is to take the inequities out of the Tax Code. If you 
work for a company, you pay--you get your health care free, in essence. 
It's part of the benefit package. If you're a stand-alone person, you 
pay your health care on an after-tax basis. In other words, there's 
discrimination in the Tax Code based upon who you work for. It makes it 
harder for people to be able to--individuals or small-company employees 
to be able to buy health care.
    And so what we've said--and Michael 
spent a little time describing this--we've said that all Americans who 
have health care ought to be allowed to have a $15,000 deduction on your 
income taxes if you're a married couple--if you're married, and if 
you're not, $7,500. In other words, the benefits you receive from your 
company become part of your taxable income, offset by a $15,000 
deduction. And so if the benefits you get from your company are $11,000, 
you'll have $4,000 deducted from your income. And that's important.
    It also will help people who are uninsured or on the verge of being 
uninsured. In other words, it encourages the development of an 
individual market. It makes it more likely an individual will be able to 
afford health care. If you've got a family of four with $60,000 income, 
you get a substantial tax savings, which will then enable your health 
insurance to be more affordable. And we'll talk about that.
    The point I'm trying to make to you is, the system is geared toward 
enabling the individual to have more control over his or her 
decisionmaking and make the Tax Code fair for the individual. And 
finally, I've instructed Michael to work 
with States. We believe that there's been some very innovative policy 
that takes place at the State level to cover the uninsured, to help the 
sick, to help those who are poor be able to get insurance. And so we're 
going to have flexibility with Federal money that goes to States, and 
all we request is the States develop a basic health insurance plan that 
becomes more affordable. Oftentimes the plan that is only available for 
the individual is priced out of their control because of mandates and 
add-ons. And Michael is going to say to Governors: Look, we're going to 
help you. You got some interesting ideas. We think it makes sense to use 
Federal money to help you with those ideas, but you need to develop a 
basic plan so that health care is affordable for more of our citizens.
    And here's a comprehensive strategy. A lot of times in Washington, 
they say: ``Well, let's just design it there in the Federal Government; 
it will all work.'' It won't, in my judgment. It will become 
bureaucratic; it will become costly; it won't empower individuals; it 
will make it harder to get affordable health care.
    And so here's a strategy, a multiple-pronged strategy, a strategy 
that says there's a lot of things we need to do to help our American 
citizens be able to buy private health insurance.
    Leavitt is in charge. Michael is the 
Secretary of Health and Human Services. He's spent a lot of time on the 
subject. You might want to add a few comments, and then we can hear from 
some of our citizens here.

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[At this point, Secretary of Health and Human Services Michael O. 
Leavitt made brief remarks.]

    The President. Yes, Leavitt, one 
thing before you get--I see we've got some cameramen here. Why don't you 
give them the cameraman story.
    Secretary Leavitt. I had a terrific 
conversation yesterday.
    The President. For all you cameramen out there.
    Secretary Leavitt. Someone asked me--
actually, it was a news organization here in Missouri, anticipating our 
trip, asked me, ``What are you going to talk about?'' And I said, 
essentially, we've got this problem that we're trying to solve, with 
people who work in restaurants or in daycare centers or are self-
employed, and it's unfair that they should be treated in a way. And I 
could see the cameraman----
    The President. He's an independent contractor; he's on his own, 
basically.
    Secretary Leavitt. But he was behind 
the camera doing this, which is unusual. [Laughter]
    The President. Because he wants to be treated just like the person 
who works for big corporate America, and he wants to be able to have 
that deduction.
    Secretary Leavitt. So before we were 
even off the satellite, he's saying--``And you should have said 
independent cameramen.'' [Laughter] He said, ``Do you know how much I 
pay for insurance?'' He says, ``It's $1,350 a month, and I have to pay 
it after I pay my taxes, and it's just not fair.''
    It isn't fair. This is the right thing to be doing.
    The President. Thank you.
    Rich, thanks for having us. 
Appreciate you inviting--letting us tour your hospital here.

[G. Richard Hastings, president and chief executive officer, Saint 
Luke's Health System, made brief remarks.]

    The President. The other thing that's interesting about what 
Rich is doing--availability of health 
care--they've got, like, a specialist sitting in Kansas City capable of 
analyzing somebody's graphs in a remote region, which, again, remember 
it's affordability and availability for health care. And information 
technology is able to make medicine available throughout rural Missouri 
or rural Kansas, for example. And it's very exciting, and I appreciate 
what you're doing.
    Mr. Hastings. Thank you, sir.
    Secretary Leavitt. I want to make 
certain you all understand here three things that are happening that 
need to happen all over the country--here that are happening. The first 
is, you're a connected system. If a patient wants to get their medical 
records, they can do it in a convenient way. People need to have access 
to their own records in a way that will be convenient to them. And this 
idea that a patient then can have an independent assessment of the 
quality of the care that their provider is giving them is revolutionary 
and very important.
    But then you combine that with the ability for people to know what 
it costs. Once you have the cost and the quality, you're now making 
decisions based on value. And that's what we hope in the future. The 
whole system will become a connected system that has competition based 
on value, where consumers are making decisions, as opposed to someone 
other than the consumer.
    The President. Dr. Jim Kelly. Why don't 
you tell people what you do, Doctor?
    James B. Kelly. Thank you, Mr. President.
    The President. Let me guess. [Laughter]

[Dr. Kelly, anesthesiologist, Saint Luke's Hospital of Kansas City, made 
brief remarks.]

    The President. I don't think people know what you mean by defensive 
medicine. Why don't you describe that?

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    Dr. Kelly. Well, you're always concerned. 
One, we're here to take care of patients, and that's our primary 
objective. But if you are told that you do a poor job or go--everybody 
lives in fear of being sued, and they will go to extreme lengths to 
document that everything they're doing is the right thing. If any of us 
were so unfortunate to fall down right now and bump our head, it would 
be hard to get out of this hospital--if you tell the emergency room 
physician that you hit your head--without a CT scan, maybe even an 
overnight stay in the ICU. They want to make sure that they're okay and 
not just trust their clinical skills that it's a little bump on the 
head.
    The President. In other words, practicing maybe too much medicine--
--
    Dr. Kelly. Too much medicine and extra 
tests.
    The President. It actually costs the Federal Government something 
like 23 billion a year.

[Dr. Kelly made further remarks.]

    The President. Well, I appreciate you. I happen to believe this is a 
Federal issue. When I first came to Washington, I said, we ought to 
allow these--each State to determine their own medical liability reform. 
I believe it's--and I chose to make it a Washington issue because it's 
costing our taxpayers so much money. When I say ``costing,'' we're a big 
consumer of health care through Medicare, Medicaid, veterans' benefits. 
And when doctors' premiums go up, they charge more. And with doctors in 
fear of being sued, they practice more medicine than is necessary.
    And I don't know if 20 billion is the right number, but it is a lot. 
I think it is something like that. And that's extra money for the 
taxpayers. And I'd like to get it done in Washington, DC, frankly. And I 
believe medical liability is a huge--I know it's a huge issue in a lot 
of States, and we'd like to help you. Thanks for working on it. 
Appreciate you being involved.
    Jim Henderson.
    Jim Henderson. Thank you, Mr. President.
    The President. President----
    Mr. Henderson. Not like you, but thank you 
very much. [Laughter]
    The President. ----of Dynamic Sales, Inc. Where are you based, and 
what do you do?
    Mr. Henderson. St. Louis, Missouri. We're 
a construction and industrial supply company----
    The President. Great. How are you doing?
    Mr. Henderson. ----and I'm a second-
generation owner. It's been very good. The economy has been very good to 
us, and the business has been booming. We're on our 11th record year.
    The President. Good.
    Mr. Henderson. So we're very pleased.
    The President. All because of good management.
    Mr. Henderson. From the top down. 
[Laughter]
    The President. That's right. How many employees?
    Mr. Henderson. We have seven employees; 
five full-time, two part-time.
    The President. Right, and your issue with health care?

[Mr. Henderson made further remarks, concluding as follows.]

    Mr. Henderson. So when they say, ``Well, 
we can keep your premiums the same,'' they're not really saving us 
anything, because we're having to pass that along to the employees, of 
which I am an employee of the corporation. So now my health insurance 
costs just went up too. And it's just a vicious cycle that we've been 
dealing with for over 17 years.
    The President. This is probably the biggest problem we hear from 
small businesses around the country. And in that small businesses create 
most new jobs in America, it makes sense to come up with plans to help 
small businesses thrive.

[[Page 62]]

    Michael, I don't know if you want to 
comment on this----
    Secretary Leavitt. I'd be 
interested----
    The President. ----deductibility plan because I think it's going to 
save your employees a lot of money and make it easier for you to be in a 
position to do what you want to do, which is be--consider yourself a 
good employer.
    Mr. Henderson. Well, that's the hard 
thing, is when you're trying to hire more people, health insurance is 
really important. And if you're telling people: ``Well, we've got a 
$2,000 deductible and a 70/30 split, but, hey, we're a good company to 
work for''--well, you might be a nice family company to work for, but I 
can't afford to work here.
    The President. Have you looked at this deal that I proposed?
    Mr. Henderson. Yes, sir; I have. And from 
what I've looked at, off of the information you've sent to me, I think 
that it's going to be very attractive.
    The President. And how does it help you?
    Secretary Leavitt. Jim could describe 
it, or I--well, I mean, Jim is like a lot of other small businesses. If 
he and his employees had this ability to have this standard exemption--
in Jim's case personally, he'd have the exemption; he'd get the tax 
savings. It would be--he'd have about a $2,183 increase in his take-home 
pay. The value of the actual deduction to him would be 7,200, which 
would go a long ways to helping defer some of those costs.
    When you look at that example--and take Martha, for example--Martha 
had a similar problem as Jim did and chose to go to a health savings 
account. When you combine these two, it becomes well within the grasp of 
almost any employee to have an affordable, basic health insurance. 
Martha, maybe you could----
    The President. Yes. Just one point before you go. I think it's very 
important for our citizens to know that as we level the playing field 
between employees of little companies and big companies, it makes it 
easier for small companies to stay in business. The Tax Code, it treats 
a certain group of people in the United States unfairly when it comes to 
health care. People who work for big businesses get their health care on 
a--without--with no--they pay no taxable income on it. Small companies 
who are having trouble staying in business because of the nature of 
their size of the company pass on the increased cost to their employees. 
And we've got to level the playing field from a taxes perspective. It is 
by far the most hopeful and fair option of any medical health care 
option out there today, unless, of course, you want the Federal 
Government running it all, saying, ``Okay, we'll provide you insurance, 
we'll provide everybody insurance,'' which would be a mistake.
    Anyway, listen to health savings accounts, but I don't want to be 
Mr. Lecturer. But she is--it's an interesting option for you.
    Mr. Henderson. I did look at those, but 
for our employees, they weren't as attractive, because our employees 
said: ``If I can set aside $2,000 a year or whatever to put into a 
health savings account, I'd be doing it anyway.''
    Secretary Leavitt. So they'll be able 
to--with this tax change, they'll now have the money that can go to do 
just that.
    Mr. Henderson. That's been what's so 
frustrating about this, is each year those costs go up--we want to make 
it affordable for our employees--the company's paying more for the 
insurance that they're receiving. We don't get to turn around and say to 
our customers, ``Hey, we're raising your prices''----
    The President. No, that's right.
    Mr. Henderson. ----``25 percent because 
our insurance went up.'' And when we ask the insurance: ``Why is it 
going up? We haven't had these major losses.'' Their reply is, ``Because 
we can.'' That's what I was told: ``Because we can.'' I'd like to tell 
all my customers that, hey, I'm raising your prices 25 percent because I 
can.

[[Page 63]]

    The President. Right. It's a problem, and the reason I've come here 
to discuss this with a frustrated small-business owner like you is 
because we believe that we've designed a solution that will help a lot.
    Mr. Henderson. Yes, sir.
    The President. Martha.
    Martha Gelencher. Yes, Mr. President.
    The President. Why don't you tell everybody what you do? Are you as 
passionate about your employees as my man Jim?
    Ms. Gelencher. Yes, I am.
    The President. That's good.
    Ms. Gelencher. I've been in the 
business for 30-plus years, and having health insurance has always been 
a big issue. I think we as employee--individuals now are facing what Jim 
said is--the individual and the employer are facing the same problem 
right now.
    The President. Let me ask you something. How many employees do you 
have?
    Ms. Gelencher. Thirty, of which six are 
full-time.
    The President. Right. And so you started getting squeezed.
    Ms. Gelencher. Yes, from the very 
beginning. In fact, no one wanted--for many years, no one wanted to 
insure someone that had only 30 employees.
    The President. Yes, or six full-timers.
    Ms. Gelencher. Yes. It's like, well, 
you're just not----
    The President. It's one reason why you don't have a lot of leverage.
    Ms. Gelencher. Right.
    The President. People don't want to insure you.
    Mr. Henderson. If we drop below five, 
we've been told----
    The President. Yes. So you're at 6 full-time, 24 part-time. And you 
started looking at options, and what happens?
    Ms. Gelencher. Well, we went with the 
HSAs; we've been with them for 2\1/2\ years. We were able to give more 
full-time people insurance. We save 40 percent of what we had been 
paying.
    The President. Yes, see, that's why I think--get somebody to--HSAs 
really do hold the cost down for small businesses.
    Ms. Gelencher. They really do. They 
really do.
    The President. It's a little difficult to get the employee to sign 
on at first, right? It's a novel concept, as opposed to somebody paying 
your bills. An HSA basically says, you're in charge of your own health 
care.
    Ms. Gelencher. Right, and it gives the 
small-business person a little advantage over the larger-business 
person, because they have their own savings account----
    The President. That's right.
    Ms. Gelencher. ----and they can--it 
grows, and it's theirs, and they become more responsible for how they 
spend their health care.
    The President. A high deductible catastrophic care plan with the 
company and/or the individual contributing tax free the amount of the 
deductible into a savings account. The person owns their savings 
account. In other words, it's beneficial to small business because it's 
cheaper to buy the HSA than it is normal insurance that you're battling 
for. Have you found that to be true?
    Ms. Gelencher. I agree with you 100 
percent. Yes. And our employees are very pleased. And I mean, really, it 
was a lifesaver for us because it just became such a big problem, as we 
see all across the board now, with individuals--low-income, middle 
income--most of our people are middle income, so that's to their 
advantage.
    The President. See, the problem with small businesses and 
individuals is that there's no market relative to--like big companies; 
there just isn't. And we need to help establish a market. Demand will 
yield the supply of insurance policies, so long as States enable there 
to be the development of a basic plan without mandates and things added 
on to it. And that's really one of the benefits of HSAs, by the way. 
It's like a basic health care plan.

[[Page 64]]

    Let me ask you something. Do your employees like the idea of being 
able to--of course they like the idea--your employees are able to take 
their health care with them from job to job--take the savings account 
aspect?
    Ms. Gelencher. Exactly.
    The President. It's theirs, not yours.
    Ms. Gelencher. Right.
    Secretary Leavitt. May I ask Martha a 
question?
    The President. Yes, sure.
    Secretary Leavitt. Martha, I have an 
HSA, so I have some experience with this, but I'm curious as to your 
experience with them. Did it cause you to be more interested in what 
things were costing than when you just had an insurance card?
    Ms. Gelencher. Exactly. Exactly.
    Secretary Leavitt. I remember the 
first time I walked into a drug store with my HSA and presented them 
with my new card. And I knew I was--that my savings--my health savings 
account would be paying part of it. And they--this prescription I had 
was going to be $379. And I'd been getting this prescription for quite 
awhile, and I had no idea what it was going to cost. And I said to the 
druggist: ``Is there a generic version of this?'' It was--it changed my 
way of thinking about this completely. Did you have that experience?
    Ms. Gelencher. Exactly the same.
    Secretary Leavitt. Have you seen any 
kind of change in the way your employees have thought about this as a 
result?

[Ms. Gelencher, owner, Corporate Building Services, made further 
remarks.]

    Secretary Leavitt. Something that 
Rich said and that Martha has said that is important: One of the things 
they are doing here at Saint Luke's is that they are allowing people to 
know what the prices are in advance. A lot of people go to hospitals and 
they say, ``I'd like to know how much this costs.'' And the hospital 
just isn't equipped to answer that question or the doctor just doesn't 
think about what the cost is because usually it's just about processing 
the insurance.
    This very--this gets at the heart of how we keep costs down. 
Suddenly people begin to ask themselves: Is there a generic version of 
this? How much should this cost? Those are the kinds of questions that 
begin to create small businesses with a competitive product. And 
hospitals like the one we're in today have led in that transparency, 
knowing the quality, knowing the cost, being involved in the decision. 
It's a very important way to keep costs down.
    The President. Yes, that's why the best health care system is one 
that recognizes that decisions made by doctors and patients are the best 
decisions. It's best to hold down costs. It's best to enhance quality. 
It is really what happens in most other aspects of our market. It 
doesn't happen--happening in health care. And the policies that we're 
detailing are trying to encourage more consumer involvement in order to 
hold down costs. And it's a foreign concept for a lot of people because 
it hasn't been happening for years. And it's a concept that frankly some 
in Washington don't like because it runs contrary to a philosophy that 
basically says, the Federal Government is a better decisionmaker.
    Anyway, thanks for joining us. Thanks for being an innovator. The 
tax deduction is going to help your folks----
    Ms. Gelencher. Yes, very much so.
    The President. ----$15,000, 7,500 for a single person.
    Ms. Gelencher. And I can't imagine why 
someone would not----
    The President. Be for it?
    Ms. Gelencher. ----think it would. 
[Laughter]
    The President. Well, it's an interesting question, particularly 
since it's a revenue-neutral proposal, which is important. Cost money or 
lose money, it's--according to the experts, it's revenue neutral.
    Jones--Dan Jones, where do you live?
    Dan Jones. I live in St. Louis, Missouri.

[[Page 65]]

    The President. You do--home of the mighty Cardinals.
    Mr. Jones. Yes, sir. Yes, Mr. President.
    The President. They came to the White House recently.

[Mr. Jones, service engineer, Software To Go, made further remarks.]

    The President. Here's the classic guy--young guy in the marketplace, basically priced out of the 
individual market.
    Mr. Jones. Yes, sir.
    The President. And the plan helps him. Matter of fact, what they 
were telling me coming in that you could buy a good health care plan for 
about $1,350.
    Mr. Jones. Yes, we were looking at that. And 
within the State of Missouri, I can get about $1,300 for a really nice 
health care for the year.
    The President. Save 2,270 in taxes.
    Mr. Jones. Over the year.
    The President. So you put $929 in your pocket.
    Mr. Jones. Absolutely.
    The President. Does it make sense to do that? I think it does.
    Mr. Jones. What could you do with just a 
little over--under a thousand dollars? That's Christmas, you know. 
[Laughter]
    The President. Well, why don't you think about saving it? [Laughter]
    Mr. Jones. Yes, well, I got a gigantic family, 
and I got a godchild who: ``Buy me this, buy me that.''
    The President. Anyway, there are plenty of people who feel like 
they're doing just fine when it comes to health insurance, particularly 
those who work for big corporate America, which is fine. It's just that 
the system discriminates against the Dan Joneses 
because the Tax Code that has evolved over time has made it harder for 
him, relative to other people in our society, to purchase insurance.
    And this is exactly what this plan is designed to do. We're trying 
to move somebody like Dan from being a statistic, 
an uninsured person, into insurance. And here is a logical way for the 
Government to do so. And if people in Washington are serious about 
dealing with the uninsured, here is a serious idea for them to consider. 
Instead of just dismissing things because of pure politics, we have put 
forth ideas that are worthy of debate and we believe will work. And I 
know that our citizens, fellow citizens, regardless of their political 
party, expect there to be a serious dialog on constructive ideas that 
are put forward to make sure people like Dan Jones have got private 
insurance. And I thank you for coming and sharing. How many people work 
in your firm?
    Mr. Jones. Three full-time employees right 
now, but hopefully, more.
    The President. But you're growing.
    Mr. Jones. Absolutely.
    The President. There you are.
    Mr. Jones. Small businesses, they grow. And 
the more money you save along the way, the more you can grow.
    The President. There you go. Well, thank you for coming.
    Mr. Jones. Thank you, Mr. President.
    The President. Tom. Appreciate you 
coming, Tom.
    Thomas R. Beauregard. Sure.
    The President. Tom Beauregard. What 
do you do?
    Mr. Beauregard. I lead a business 
within United Health Care that's focused on extending access to the 
uninsured.
    The President. Oh, really?

[Mr. Beauregard, lead strategist, Hewitt Associates LLC, made further 
remarks, concluding as follows.]

    Mr. Beauregard. And then the other 
thing we see is just changes in the labor market, where you've got 
people moving from job to job. So the average individual will have about 
10 jobs across their career now.
    The President. That's right.
    Mr. Beauregard. So there really is 
a need for----

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    The President. That's an interesting point, excuse me. A lot of 
people in America probably know this, but just in case they don't, most 
people change jobs, like, seven or eight times before they're 35 years 
old, in America these days.
    Mr. Beauregard. And it's 
accelerating.
    The President. That means you better have a portable health care 
plan.

[Mr. Beauregard made further remarks.]

    The President. I appreciate your studying it. You may need to come 
up to Washington to testify. [Laughter] Thank you very much.
    Why don't we end with Esmerelda. 
Esmerelda, welcome.
    Esmerelda Wergin. Thank you.
    The President. You are a--where do you work?
    Mrs. Wergin. I work at my grandmother's 
restaurant, Ninfa's Tortillas. I'm a waitress there.
    The President. Ninfa's? You recommend it?
    Mrs. Wergin. Oh, yes. [Laughter] My 
grandma----
    The President. How are your cheese enchiladas?
    Mrs. Wergin. Perfect. [Laughter] And 
she makes them herself.
    The President. Does she really?
    Mrs. Wergin. Yes, she's back there.
    The President. What's her name? Ninfa?
    Mrs. Wergin. Ninfa. Ninfa.
    The President. That's what I thought. [Laughter] Good. Married?
    Mrs. Wergin. Yes, married with two 
children.
    The President. And how old?
    Mrs. Wergin. I have a 2-year-old and a 
7-year-old; both boys.
    The President. Fabulous, fabulous. And so give us your health 
insurance story.

[Mrs. Wergin made further remarks.]

    The President. This plan we've outlined would save Esmerelda and her family 3,500 a year. Does it make sense to 
level the playing field and have a rational Tax Code and enable her to 
be able to purchase health insurance? I think it does. Rather than 
having your family sit outside the system, grinding away on trying to 
find a health care system that they can afford, why not help them afford 
health care system through making the Tax Code fair? That's all we're 
asking.
    Isn't that right?
    Mrs. Wergin. Oh, whatever you say, Mr. 
President. [Laughter]
    The President. Esmerelda, thanks for 
coming.
    Mrs. Wergin. You're welcome.
    The President. I hope people got a flavor of what we're trying to 
get done, that this plan helps people be able to afford private health 
insurance, and that is really the crux of good health care. Good health 
care is a health care system where government helps people who need 
help, like the poor--those who are hard to insure. Part of what we 
recognize is that Mike needs to give States flexibilities to help set up 
risk pools, to be able to add selection when it comes to individualized 
markets. But ultimately, the best health care plan is one that trusts 
people like Esmerelda and her family or 
Jones--Dan Jones--to make decisions, and is one 
that enables our small-business sector to remain economically viable.
    We thought long and hard about what to propose. We proposed a bold 
initiative, an initiative that takes equities--out of the system, so 
people are treated fairly. And I know Americans expect that the United 
States Congress will take a good look at all ideas to determine how best 
to make this health care system run well.
    And I thank you all for coming and giving us a chance to talk with 
you. I appreciate your candor; appreciate what you do for the country. 
Thank you. Good job.

Note: The President spoke at 12:08 p.m. at Saint Luke's East--Lee's 
Summit Hospital. In his remarks, he referred to George A.

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Pagels, chief medical officer, Saint Luke's Health System, and chief 
executive officer, Saint Luke's East--Lee's Summit Hospital.