[Weekly Compilation of Presidential Documents Volume 43, Number 4 (Monday, January 29, 2007)]
[Pages 74-83]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
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 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

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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 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.

[[Page 76]]

    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.

[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

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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--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?
    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

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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've 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.
    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

[[Page 79]]

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.
    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

[[Page 80]]

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.
    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

[[Page 81]]

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.
    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?

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    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----
    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. Your 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

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