[Weekly Compilation of Presidential Documents Volume 41, Number 4 (Monday, January 31, 2005)]
[Pages 95-103]
[Online from the Government Publishing Office, www.gpo.gov]
<R04>
Remarks in a Discussion on
Health Care in Bethesda, Maryland
January 26, 2005
The President. Thank you all for coming. Please be seated. Thanks
for the warm welcome. Thanks for coming. I'm looking forward to having
what I think you'll find to be a very interesting dialog about
innovative ways to make sure that our health care system addresses the
needs of our individual citizens.
This is an issue that requires a lot of dialog so people understand
the problems and a lot of innovative thinking to make sure that the
system works. My judgment is the system won't work if medical decisions
are made by Government. I believe the best kind of decisionmaking occurs
when consumers make decisions and the relationship between their doctors
and the patients are--become the cornerstone of good health care policy.
And so we're going to have a dialog. I want to thank our fellow
citizens for being here. We just had a little discussion about how to
make sure this conversation goes without flaw. [Laughter] I'm confident
it will.
First, I want to thank the Governor of the great State of Maryland
for joining us today. As you know, at times I take a little--a brief
weekend retreat in the great State of Maryland at a fine facility called
Camp David. And the last time the Governor was there, was with Laura and
me. He and the first lady were there, and it happened to be the day of
the blizzard. So I've invited him back in the summer. [Laughter]
I want to thank my friend Elias Zerhouni, the Director of the
National Institutes of Health. I appreciate the job you're doing, Doc;
you're doing a fabulous job. I want to thank Les Crawford, who's with us
today, the Acting Director of the--Acting Commissioner of the FDA. Thank
you, Les, for being here. And I want to thank everybody else who has
come. I'm honored that you're interested in this very important subject.
Before we talk about health care, though, I do want to talk about a
couple of other subjects. One, I am, as you could tell from the speech I
gave last week, a firm believer in freedom and the ability of freedom to
bring peace to our world. I am so pleased to watch liberty advance
throughout the world in places that--where people--in places where
people never dreamt liberty would come. I want our fellow citizens to
see what is happening in our world in the last couple of months.
I mean, in Afghanistan millions of people voted for a President for
the first time in 5,000 years. It's a grand moment in history when
people who had been condemned to tyranny--by in this case, the Taliban--
have a chance to express themselves in the ballot box--at the ballot
box, to let their opinions be known as to how Government ought to
respond to their needs.
As well the Palestinians elected new leadership. I am very pleased
by the courage and leadership shown by Abu Mazen, his desire to unify
security forces within the Palestinian territory, so as to defeat the
terrorists there and allow for democracy to advance. I believe a
Palestinian democracy will emerge and will grow, enabling us to achieve
a goal of two
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states, Israel and Palestine, living side by side in peace.
As well the Ukraine swore in a new President, which was a remarkable
advance of democracy in that part of the world. And finally, this
Sunday, after years of brutal tyranny, the long-suffering people of Iraq
will go to the polls to vote for a--freedom is on the march. Freedom
will continue on the march, and therefore the world will be more
peaceful, and we'll be able to say we left behind a more steady and
stable and peaceful world for our children and our grandchildren.
At home, we've got to make sure freedom continues on the march as
well. That starts with making sure every child receives a great
education. The No Child Left Behind Act is the beginning of making sure
high standards and accountability come to our classrooms, so that not
one single child is left behind. We're making progress, and over the
next 4 years, we'll continue to make progress.
The world is watching as to whether or not we're able to manage our
budgets. One of the things people say, ``Are you capable of dealing with
twin deficits?'' On the one hand, we have a fiscal deficit, so I'll be
submitting a budget to the United States Congress that sets clear
priorities. One of the priorities of my administration was doubling the
funding for NIH so we continue to stay on the leading edge of research
and technological change.
We understand how important science is. And we understand it's
important to be the leading nation when it comes to research, and we'll
continue to stay there. But we are funding some things that aren't
effective as well. And so the budget I submit to the United States
Congress will work on reducing our deficit in half by--over a 5-year
period of time, and at the same time, funding much needed priorities.
As terms of the current account deficit--that would be the deficit
as far as our trade goes--the best way to deal with the current account
deficit is to make sure America is the best place in the world to do
business, to risk capital, so that we can continue to grow our economy.
And the first step of doing that is for Congress to bring meaningful
legal reform to my desk early in this legislative session, reforming the
asbestos law, reforming class-action lawsuits, and reforming medical
liability.
We'll continue to work on free and fair trade. I believe we can
compete with anybody, anywhere, so long as the rules are fair. We need
to open up markets around the world so our farmers and entrepreneurs and
manufacturers can sell our products around the world. We need to make
sure that regulations are fair. We've got to make sure that taxes remain
low so as not to snuff out the entrepreneurial spirit in America. Our
economy is growing. Small businesses are vibrant and alive and well. New
jobs are being created by small businesses, and we want to continue that
momentum. People are finding work. We've recovered from recession. And
it's important for Congress to understand that we've got to create an
environment for continued capital expansion if we want our people to
find jobs. And so I'm looking forward to working with them.
We've got a lot of big challenges ahead of us. And one of the
biggest challenges of all is Social Security. And it's a challenge
because if you're a dad, for example, of a
23-, 24-year-old child, when that child comes time to retire, the system
is broke. It's flat bust. In 13 years, the system begins to go negative.
That's more money going out than coming in.
And so it seems like to me, for people like me who have gotten
positions of responsibility, we should deal with this issue and not pass
it on in hopes that it gets better. It's not going to get better unless
Congress works with the administration to have a permanent, long-term
fix for Social Security. If we do not act, the cost becomes more
expensive in the out-years. If we do not act, there's going to be a need
for huge payroll tax increases and/or major benefit cuts. So now is the
time to move. And I understand there's a reluctance by some in Congress
to take on a tough decision. But I believe we've been elected for a
reason, and that is to confront problems and to work together in a
bipartisan spirit.
For those seniors who are worried about the debate on Social
Security, you have nothing to worry about. Nothing will change. But your
children and your grandchildren do have something to worry about. And so
I look forward to working with the Congress to
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come up with a long-term solution to fix Social Security.
As well we need to come up with reasonable, commonsense policies to
address the rising costs of health care. And so today we're going to
talk about some innovative ideas. One is health savings accounts. And
we'll be talking to an employer and somebody--a beneficiary, like me, of
a health savings account. A health savings account enables a person to
be in charge of his or her own health care decisions. Health care
savings account will cover major catastrophic problems and, at the same
time, allow a person to save and/or a business to save tax-free for the
everyday expenses of health care. And if in fact you have not reached
your limit for your catastrophic care--in other words, if you have money
left over, you can roll it over, tax-free, into a savings account that
you call your own.
We've got some people who can probably explain this better than me
here, consumers of health savings accounts. But health savings accounts
all aim at empowering people to make decisions for themselves, owning
their own health care plan, and at the same time bringing some demand
control into the cost of health care. Our view is, is that if you're a
consumer of health care and you're in the marketplace making health care
decisions, it is more likely that there be more cost control in health
care than a system in which the consumer of health care has his or her
health care bills paid by a third-party provider.
Secondly, we're going to talk about association health plans, which
will allow small businesses to pool across jurisdictional boundaries to
be able to afford health care insurance at the same discounts that big
companies get. The principle behind association health plans is that the
more risk you're able to spread amongst beneficiaries, the lower your
cost of health care. And unfortunately, too many laws restrict small
businesses from being able to pool risk. And so we're going to talk
about that.
We're going to talk about an integrative way to establish a national
marketplace for health care by allowing people to get on the Internet
and buy a health care plan in a State other than that in which you live.
It's kind of an interesting way to encourage more consumer activism,
more choices for our citizens here in the country.
And finally, we're going to talk about making sure that we expand
our children's health savings program. And we're going to talk to a lady
who has been very much involved in encouraging people to sign up for
what's called SCHIP, so the youngest citizens can take care [advantage]
* of the Government programs that are now available.
* White House correction.
As well I want to remind you all that we will continue to promote an
adequate safety net for our citizens, and by that, we've got community
health centers in America today. I want to continue to expand community
health centers. This is the place where the poor and the indigent can
get primary care. And they're great centers. And Congress has been very
cooperative in the past of funding our budget requests, and I hope they
do again as we continue to expand these community health centers all
across the United States of America.
We will, obviously, continue to make sure Medicare fulfills its
promise. Obviously, I felt the system needed to be reformed. It was a
system that would pay, for example, for hospitalization of a senior
citizen for heart surgery but not for the medicine that could prevent
the heart surgery from being needed in the first place. It was a system
that needed to be changed, and at the same time, it was a system that
needed to respond to the demands of our senior citizens. And so we
introduced market forces into the Medicare system to make it such that
it can continue to evolve and grow and change as medicine changes and,
therefore, meet the needs of our senior citizens.
Tomorrow I'm going to go to Cleveland to talk about the importance
and need of information technology in the health care field. If you
really think about many industries in America, they've been able to
modernize and become more productive by introducing IT, information
technology, into their industries. It's a little difficult--a little
more difficult task here in health care. We've got 21st century medical
practices but a 19th century paperwork system. Doctors are still writing
prescriptions by hand. Most doctors can't write
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clearly anyway, and so it's a--[laughter]--so there's a better way to
enable our health care system to wring out inefficiencies and to protect
our patients. So medical electronic records is going to be one of the
great innovations in medicine. And I look forward to talking about ways
to advance information technology and health care.
Finally, a way to make sure that our citizens are able to better
afford health care is to speed generic drugs to the market. I want to
thank the FDA for propagating rules that prevent pharmaceuticals from
delaying the advent and access to our consumers of generic drugs. These
drugs do the exact same thing as brandname drugs do and yet cost a
fraction of the cost of the brand names. And so we're doing a better job
of speeding generics to the markets. And that's a positive development
for our seniors and all citizens, for that matter.
So here are some practical ways to address the cost of health care
without allowing the Federal Government to become the health care
decider. The federalization of health care would be bad medicine for the
American people. And one way to prevent that from happening is to
propose positive alternatives. And that's what we're going to discuss
today.
And the first person I'm going to discuss health savings accounts
with is Pat Zakula--correct? Exactly. Pat Zakula. [Laughter] She called
me George Brush. [Laughter]
All right, where are you from?
Patricia Zakula. I'm from northeast Indiana.
The President. Northeast Indiana. Fabulous, yes. And so what do you
do?
[At this point, Ms. Zakula, executive director, Children First Center,
Garrett, IN, made brief remarks.]
The President. Great, thanks for doing that. You're a soldier in the
army of compassion. So you've got employees, right? How many?
Ms. Zakula. Yes, we have 70 employees. Because most of our services
are home-based, it takes a lot of people to do what we do. Most of our
staff are women, some in their twenties to in their fifties.
The President. Right. And you're expected to provide health
insurance.
Ms. Zakula. That's right. And we've been doing--providing health
care--health insurance for people for many years, as we keep growing.
But it became a real struggle, because the costs were just exorbitant,
and they would go up, you know, in double digits every year, and
sometimes twice a year they would go up.
The President. Right, which is a common problem for a lot of smaller
enterprises. So how did you deal with it?
[Ms. Zakula made further remarks.]
The President. This is interesting. Listen to what she's saying.
First of all, they're going broke. They can't afford health care. Like
many small businesses or small enterprise or small nonprofit, she's
faced with a choice: ``Do I keep the doors open and have employees
without health care''--basically, is what you're saying.
The HSA comes along, and so the plan, as I understand it, has a
deductible of 1,700--in other words, you pay for the first $1,700 of
expenses--and then you have insurance to cover the----
Ms. Zakula. That's correct, to cover the 100 percent after you reach
that $1,700.
The President. Right. And the way this HSA works is you take the
high-deductible plan, of $1,700 in your case, and contribute $1,700 into
the plan, tax-free, so that the person has the 1,700 to cover expenses,
up until the insurance policy kicks in. I think that's the way yours
works.
[Ms. Zakula made further remarks.]
The President. If the 1,700 isn't spent, it rolls over to the next
year tax-free and the owner of the HSA can pull the money out tax-free
for health care. And so it's an incentive to save.
Now, think about this, if for example, you make healthy choices in
your life and the 1,700 could be rolled over, the healthier you are, the
less likely you're going to spend on normal health care needs, the more
money you have that you call your own. And secondly, the benefit is,
your employees start making decisions. As opposed to saying, ``You've
got to go buy X, Y, Z for this
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amount,'' people all of a sudden start to shop for that which is best
for them.
Ms. Zakula. That's true. And people who--when they found out that
their visit to the doctor really didn't cost $20, which was our co-pay--
[laughter]--then they're not--then they don't run to the doctor all the
time. However, they are using--they're using preventative care and doing
the things that they need to do, but they're more likely to shop around
and to weigh things, whether I need to do this or not.
The President. Part of the issue with health savings accounts is for
people to even understand they exist. And so you're talking to an owner
who is on the leading edge of change. These are relatively new products
available. And part of the reasons why we're discussing this is we want
small-business owners and individuals to realize that health savings
accounts are now available. And I urge everybody to look into the
benefits of a health savings account.
And you need to listen to Bill Lomel, who is with us. You are an
owner of a health savings account?
William Lomel. Right. I'm Bill Lomel. I'm from Atlanta----
The President. Exactly, Lomel, just as I said. [Laughter] Two for
two. [Laughter]
Mr. Lomel. I have a commercial roofing contracting business with 25
employees and, like Pat, was faced with similar decisions. I mean, the
monthly premium for our family coverage 2 years ago went from 450 to
750, and then it was going up over a thousand. And the group kept
getting smaller because people were dropping out of the plan. The
individuals couldn't afford their portion of the coverage. And it was
kind of an effect going on, making it----
The President. Catch-22.
Mr. Lomel. Yes.
[Mr. Lomel, owner, Titan Roofing, LLC, Suwanee, GA, made further
remarks.]
The President. You getting that? It's important for people to
understand what he's saying. He buys the high-deductible policy to cover
major medical expenses, and the savings on that policy from what he was
paying otherwise more than equals the zero to 5,000 dollars cost up
until the insurance kicks in. It's his own money, the 5,000. He owns it.
It earns interest tax-free. In other words, he's able to put it in an
interest-bearing account. And if he or his three children do not spend
the 5,000, whatever the balance is, it rolls over to the next year. And
it's--and it enables, frankly, small businesses to stay in business and
families to be able to better afford health care.
You enjoying it?
Mr. Lomel. Yes, it's great, and it's made providing that benefit
possible again.
The President. Yes.
Mr. Lomel. So we're meeting with all of our employees to get them
signed up individually on programs that I can kind of help facilitate.
The President. Absolutely. Most of the working uninsured in America
work for small businesses. And so for small-business owners out there
who are worried about being able to pay for insurance for your
employees--and a lot of owners are, like you were--I mean, it must be
nerve-wracking.
Mr. Lomel. Well, one of the key things that has come out of this is
that when I go to the doctor, I'm interested in the cost. [Laughter]
The President. Yes.
Mr. Lomel. And I had----
The President. That's pretty good.
Mr. Lomel. I had a small skin cancer removed this year. And just--I
asked.
The President. Yes.
Mr. Lomel. They offered me two procedures, and I said, ``Well, how
much does this one cost and how much does that one cost, and what are
their effectiveness?'' And they were virtually the same, so----
The President. You know, it sounds simple, but it is a dynamic that
in many cases is absent from the health care markets because if a third
party makes that payment, he never gets to ask the question. He just
accepts the decision. And all of a sudden when you have consumers
starting to ask questions about cost, it is a governor on cost at the
very minimum. And so part of--one way to make sure that costs don't
continue to escalate is to introduce consumer demand into health care
decisionmaking. And since HSAs enable a consumer to own their own
account and manage their own account and
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make decisions for their account, we've introduced demand into the
marketplace.
Thank you two for sharing this. I signed up for an HSA. I'm feeling
pretty good these days, and--[laughter]--I think I'll have some money
left over. But recognizing that I can prevent disease, I want to
encourage people to exercise on a regular basis, make wise choices about
what you put in your body, be mindful of what you eat. And if you happen
to be an HSA owner, like the three of us, you will realize--more likely
realize savings that you can roll over tax-free and call your own.
Hopefully, one of these days when I get to be an old guy, my HSA
will be bulging with money--[laughter]--and I will be comfortable in the
security of retirement because my HSA will be a part of a--you know,
other options to provide good health care for me and my family.
We've got Rich Parsons with us. I actually got it right, two for
three now. What do you do, Rich?
Richard Parsons. I run the Montgomery County Chamber of Commerce,
which is a small nonprofit right here in Montgomery County, Maryland,
and we represent the employer community.
The President. Good, thanks. Welcome. I'm glad you're here. You are
here not only to talk about the wonderful benefits of having a business
in Montgomery County but as well to discuss----
Mr. Parsons. Well, what we want to talk about is really the same
issue you just heard from a consumer standpoint; it's the lack of
choice. It doesn't affect just consumers, but small-business owners in
particular and small nonprofits like ours. We have a very small range of
choices that we can select from when we go to do what we all want to do,
which is provide our employees with good coverage at good prices. We're
finding our choices in a State like Maryland, and even though this is
one of the leading biotech and medical innovations centers of the world
today, we have about four policies--four companies that will even write
policies for small businesses in the State. And we've got to expand
choices, and that's what I wanted to talk about today.
The President. Well, I appreciate that. That's common sense, isn't
it? If you want there to be reasonable price, the more consumers have to
choose in a marketplace, the more likely it is you'll be able to find
something at the price you want. That's how the marketplace works.
You're telling me the marketplace is somewhat restricted here.
Mr. Parsons. Well, because of regulatory factors and just the way
the marketplace has turned out here in Maryland, we are not allowed by
State law to do what some States are allowed to do, which is to offer
association health plans, where my----
The President. Right. Describe what an association health plan is,
please.
[Mr. Parsons, president and chief executive officer, Montgomery County
Chamber of Commerce, Derwood, MD, made further remarks.]
The President. Right. An association health plan will allow people
to pool risk. That's what we're saying. And I happen to think that we
ought to allow small businesses to pool risk across State boundaries. In
other words, I think a restauranteur in Maryland ought to be able to
combine in the same insurance plan as a restauranteur in Texas. I think
we ought to be focusing on the social objective of making sure our
small-business owners can find affordable health care so that fewer
people are working uninsured, rather than jealously guarding
jurisdictional lines for whatever reason.
And so I look forward to working with Congress to get an association
health plan out--bill out that will allow for pooling of risk for small-
business owners across jurisdictional boundaries. And nonprofits, by the
way, should be allowed to pool risk as well.
Have you heard of health savings accounts, in the meantime? I mean,
these are really great. [Laughter]
Mr. Parsons. I learned about them at this event. I'm going to look
into it.
The President. You seriously ought to look into them. [Laughter]
But Congress needs to understand that on the one hand, you cannot
complain about people who don't have insurance and you work for a small
business and then not allow
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small businesses to be able to have the opportunities in the
marketplace, the same opportunities afforded companies with large pools,
large employee bases. You've got to give them the opportunity to be able
to shop.
And so association health plans make a lot of sense. I want to thank
you for sharing that with us, Rich.
Mr. Parsons. Well, thank you. We need the help in Congress.
The President. I agree. That's what we're here to do. We're here to
remind Congress about the benefits.
Jesse Patton.
Jesse Patton. Correct. [Laughter]
The President. Got that right.
Mr. Patton. Just like the general.
The President. Yes, sir. [Laughter] The founder and president of----
Mr. Patton. Associations Marketing Group in Des Moines, Iowa. We're
actually an insurance agency that specializes in the sale and service of
both individual and group health insurance plans. And we do business in
42 States, so we work with individuals not only in Iowa but across all
of the United States.
The President. And Jesse wants to talk about an idea that I broached
early on, and that is to allow consumers to shop.
[Mr. Patton made further remarks, concluding as follows.]
Mr. Patton. The nice thing about this proposal is that people would
be able to go across State lines, but they would still have the safety
feature of having their products still regulated by insurance division,
insurance commissioner.
The President. That's an important point. Sorry to interrupt you.
You were on a roll. [Laughter]
Mr. Patton. Go ahead, you're the President.
The President. Thank you.
Mr. Patton. I'm just the general. [Laughter]
The President. So you're a--you heard Bill talk about--he got on the
Internet. He was trying to find more information. He was worried about
finding a product that he could use. Imagine someone living in Maryland
getting on the Internet and being able to shop nationwide for an
insurance plan that meets his or her specific needs--basically what
you're saying.
Mr. Patton. Correct. If you look at an example that we did for your
staff of a 35-year-old individual with a 35-year-old spouse and two
children on a $500 deductible, premiums from the various States--my home
State of Iowa, that premium actually comes in at $430. Other States that
we looked at, those premiums are at 1,500, 1,200, $1,609. So they're up
to a thousand dollars difference in that individual rate for the same
product, same insurance carrier, just based on the State that you reside
in.
The President. And so, perhaps, one way to encourage reform at the
State level is to allow consumers to actually make choices. And the more
consumers that buy a product in a certain State may cause other States
to have the incentive necessary to change the regulatory burden so that
products can be delivered at a less expensive price in their own State.
But the real question people have is, ``Well, how do I know I'm not
getting cheated?'' In other words, it's one thing to open up additional
consumer price. But how do you know it's not a fly-by-night or a
shyster? We caught a guy the other day flimflamming people on the
tsunami relief effort. There was a lot of innocent folks who think
they're making a contribution, in this case, to help somebody's life,
and it turns out he was a--the FBI found out that he was a flimflam
artist. How do we make sure that the innocent consumer is not buying a
product from a company that doesn't have the capital base necessary to
provide insurance, for example?
Mr. Patton. Correct, and there's actually a couple safety features
here. I, as an insurance agent, am licensed and able to do business
based on a license I hold by the insurance division of the State that I
operate in. I must also get a nonresident license in another State that
I plan to sell business. So I'm actually regulated--if I would sell a
product here in Maryland, I'm actually regulated by the insurance
division in Maryland under my insurance license here, plus I'm also
regulated by the insurance division in Iowa, which is my home base. And
then, again, you
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would have the insurance commissioner's office also regulating the
carrier and the product.
The President. Right. So in other words, if you're a Texan buying
into Iowa, and you feel like you've been cheated, there would be a
complaint mechanism----
Mr. Patton. Correct.
The President. ----and the State would, therefore, make the
decisions as to whether or not the--on the capital-worthiness of a
particular entity offering insurance in that State.
Mr. Patton. Correct. You would actually have two safety features,
your home State and your State that you were buying your insurance from.
The President. Right. I think it's an interesting idea. I think the
more we give choice to consumers and the more consumers are allowed to
be in the marketplace designing and shopping for product that meets
their needs, the more likely it is we'll be able to control costs and
make the marketplace work. It works in other industry, and I think we
need to bring--I know we need to bring market forces into the health
care field.
For those of you who live in Maryland, by the way, you're fortunate
to have a Governor who understands all this. I appreciate your efforts,
by the way, on medical liability reform, addressing the cost. And we
look forward to working with you, Governor, and other Governors as well
to do the best we can to make this system work on behalf of consumers in
the health care field.
Finally, we've got Tammi Fleming with us, from the great city of New
Orleans, Louisiana. Isn't that right?
Tammi Fleming. Yes, you got that right. [Laughter]
The President. Tammi runs an interesting program. Why don't you
describe your program, Tammi.
[Ms. Fleming, program manager, Health Care for All, New Orleans, LA,
made brief remarks.]
The President. The point is, is that we have programs aimed at
helping people who need help, basically is what you're saying. And one
such program is SCHIP--that's the Children's Health Care Insurance
Program. And it's not fully subscribed. In other words, we had the money
available, and States did not access the money to help children with
good health care.
[Ms. Fleming made further remarks.]
The President. The reason we've asked Tammi to come is because it's
very important for States to develop effective outreach programs. At the
Federal level, we're willing to help fund outreach programs. We think
it's important for people who've qualified for the SCHIP program to know
that that program is available without stigma. And it is an effective
way to provide our children with the insurance we want our children to
have.
And so what Tammi is saying is, she's pointing up the fact that we
need a grassroots effort across the country to enable people to know
what is available for the Children's Health Care Program.
[Ms. Fleming made further remarks.]
The President. Well, I appreciate what you're doing. Walkers and
talkers. That's good. Good job.
Well, listen, I want to thank you all for joining the discussion.
The solution is one that--the solution to health care costs is one that
requires a myriad of approaches, as opposed to a single Federal
Government approach. I believe the more we empower people to make
decisions, the better off we are in terms of achieving a national
objective, which is affordable health care that's available. And I want
to thank you all for sharing with people innovative ideas.
I'm pleased to inform you that Dr. Condi Rice has just been
confirmed by the United States Senate. She will be a great Secretary of
State for the United States of America. I'm honored to be working with
her, and I look forward to spreading freedom and peace.
Thank you all for coming. May God bless you all.
Note: The President spoke at 11:49 a.m. at the National Institutes of
Health. In his remarks, he referred to Gov. Robert L. Ehrlich of
Maryland, and his wife, Kendel; President Mahmoud Abbas (Abu Mazen) of
the Palestinian Authority; and President Viktor Yushchenko of Ukraine.
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