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Skriven 2006-02-15 23:33:28 av Whitehouse Press (1:3634/12.0)
Ärende: Press Release (0602151) for Wed, 2006 Feb 15
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Remarks by the President on Health Care
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For Immediate Release
Office of the Press Secretary
February 15, 2006

President Discusses Health Care
Wendy's International, Inc.
Dublin, Ohio


˙˙˙˙˙Reforming Health Care for the 21st Century
˙˙˙˙˙In Focus: Health Care

12:13 P.M. EST

THE PRESIDENT: Thanks for coming. Please be seated. (Applause.) Jack,
thanks for the introduction, thanks for letting us convert your lobby into
a -- (laughter) -- place to come and visit.

So I get on Air Force One this morning, I said, "Take me to Dublin" -- the
guy heads east. (Laughter.) I said, "Nah-uh, Dublin, Ohio." (Laughter.)
Proud to be here. Thanks for letting me come and visit with you. It's neat
to be in "the House that Dave Built." (Applause.) He was a great American.

George Voinovich and I were sharing Dave Thomas stories, particularly when
he came and helped educate and lead the governors -- that's when we were
governors -- about adoption. And one of his great legacies is inspiring
people to show the ultimate act of love, which is to adopt a child. The
other great legacy is, leave behind a great company that is providing
thousands with good jobs; another great legacy is to leave behind consumer
choice. You can either get your three-quarter pound triple cheeseburger --
(laughter) -- or your salad. (Laughter.)

I appreciate the fact that Wendy's understands that choice for the
consumers is important. I also appreciate the fact that Wendy's understands
that giving employees the opportunity to make rational choices in health
care is an important part of having a workforce that is vigorous, active
and enthused about their jobs. And so, today I'm here to talk about
innovation in the health place, how we can make sure the health care system
in the United States of America remains the best in the world.

And so, Jack, thanks for letting me come. Thanks for being an innovator. I
love the entrepreneurial spirit of America. And the entrepreneurial spirit
doesn't end if you happen to be a big company. As a matter of fact, it's
important to remain entrepreneurial, no matter what your size is. And to
have a company like Wendy's introduce HSAs, which I'm about to talk about,
reminds me that entrepreneurial spirit is alive and well here.

I appreciate the team, the management team, and all the employees for
giving me a chance to come and visit. I will keep my remarks relatively
short so you can get back to work. (Laughter.)

Governor, thank you for coming. I appreciate Governor Bob Taft joining us.
Yesterday I had the privilege of meeting with his wife, Hope. We were
talking about how to rally the great armies of compassion around the United
States to help provide love and help and concern for those amongst us who
need love and help and concern.

I want to thank my friend, Senator George Voinovich. I've known him for a
long time. He's steady, he is capable, he is a great public servant. Thank
you for being here, George.

I want to thank the members of the United States Congress who managed to
get a free flight on Air Force One -- (laughter) -- to come and join us.
I'm better for the fact that you accompanied me, thank you. And that would
be Pat Tiberi, the United States Congressman from this district;
Congressman David Hobson is with us, as well, as well as Congresswoman
Deborah Pryce. Thank you all for coming today. (Applause.)

The Speaker of the House is with us -- Mr. Speaker, thanks for joining us.
The President of the Ohio Senate is with us. Glad you guys are here, thanks
for coming. I also want to mention Senator Steve Stivers, United States
Senator, Lieutenant Colonel in the Ohio National Guard. He served a
12-month tour of duty in the Middle East and Africa. I appreciate your
service. God bless you and your family, and God bless all our troops in
harm's way. (Applause.)

I skipped the Majority Leader -- I didn't mean to, Mr. Majority Leader, in
fact, it's an oversight, you know? Thank you for being here, Larry Flowers.
I want to thank the Mayor of the City of Dublin for joining us. I
appreciate you coming, Mayor. I'm honored you're here. Thanks for taking
time out of your schedule.

I just met with some folks that work here at Wendy's -- I'll talk about
them later. But I also met with the owner of a restaurant here, Frank
Ciotola. I met with Shawn Kessinger, who is the Vice President of Finance
for the Ohio Credit League Union*. I met with a farmer, Debbie Carr. We
talked about health care from the perspective of small business owners,
entrepreneurs. I listened to their concerns, I listened to their solutions.
And as I begin to give this address on the health care system, I want you
to know that many of their thoughts are incorporated in what the vision is
for good health care. So thanks for taking time to be here today.

Let me start by giving you kind of a state of the economy -- it's strong. I
recognize there's parts of Ohio that aren't necessarily as strong as other
parts of the country, but from an overall perspective, when you look at the
nation's economy, it's strong, and it's getting stronger. And the reason I
say that is because we're now in our fifth year of uninterrupted economic
growth.

Last year this economy, in spite of high energy prices and in spite of
natural disasters, grew at 3.5 percent. After-tax income of our people --
and that matters a lot, you know, whether or not people have got money in
their pocket after paying their taxes -- is up 8 percent since 2001.
Productivity is high. It's important to have high productivity growth in an
economy because that's how economies improve their standard of living for
their people. The more productive you are as a citizen, or the more
productive you are as a company, the more likely it is you will generate
higher revenues and higher quality of life.

So productivity is increasing, which is a measurement of not only this
country's competitiveness, but as a measure of whether or not life is
improving for our citizens. Small businesses are thriving. That's really
good news. Most new jobs in America are created by small businesses. And
when the small business sector is thriving, it means people are working.
We've added 4.7 million new jobs over the last two-and-a-half years. The
national unemployment rate is 4.7 percent. That's low. (Applause.)

Things are improving here in Ohio. The unemployment rate is still 5.9
percent, but, nevertheless, the trends are in good shape. You've gone from
6.4 percent to 5.9 percent. Obviously, there's still work to do. George and
members of the delegation are concerned about trade that is fair and free.
He wants the manufacturers here in Ohio to be treated fairly in places like
China. I assured him I understand it's part of my job. I'm going to India
at the end of this month, and I'm going to make it clear with the Indians,
we look forward to trading with you, but just treat us the way we treat
you; that's all we ask. The reason I say that is because we can compete
with anybody, anytime, anywhere, so long as the rules are fair. (Applause.)

The fundamental question is, how do we remain a leader in the world
economy. You know, there's uncertainty in this economy of ours. People are
changing work a lot -- that kind of creates a sense of uncertainty. People
see China and India out there looming as competitors and the reaction with
some is, let's don't compete, let's just kind of shut her down, let's get
protectionist, or, why don't we isolate? I have a different point of view.
My attitude is, we shouldn't fear the future, we ought to shape the future.
My attitude is, the United States of America must continue to be the leader
in the world economy, for the good of our people.

And so here are some ways as to how to make sure this economy remains
strong today, and remains strong for years to come. First, in order for us
to be a leader in the world, we've got to remain a leader when it comes to
technological developments. So I'm proposing to the Congress an American
Competitiveness Initiative, which will double the basic research in basic
sciences over the next 10 years.

And secondly, I recognize most research is done in the private sector, and
yet the incentive for companies to invest in research, which yields
technologies, which increases standard of living and makes sure our economy
is on the leading edge, is through the research and development tax credit.
It expires on an annual basis. It is very difficult for the private sector
to plan when a tax code is uncertain. And so, Congress, in order to make
sure that we invest in the future, should make the research and development
tax credit a permanent part of our tax code.

Finally, in order to remain competitive, we've got to have kids who
understand math and science. (Applause.) And so I laid out an initiative --
I spent some time talking about it last week, I'm going to continue talking
about it. I'm looking forward to working with -- this is an issue, by the
way, where we can put aside needless politics, which tends to dominate
Washington, D.C., and focus on the good for the future of this country. I'm
confident we can get something done on this very important education, as
well as research and technology issue.

In order to make sure we're competitive, we've got to be wise about your
money. The tax relief we passed is working. In order to make sure America
is the most competitive nation in the world, we've got to keep your taxes
low -- (applause) -- and be wise about how we spend your money, which means
we've got to learn to set priorities in Washington, D.C. We can't try to be
all things to all people when it comes to spending your money. We're on the
way to cutting this deficit in half by 2009, and I intend to keep us on
track to cut the deficit in half by 2009.

To be wise -- to be competitive in the future, we've got to get off being
hooked on Middle Eastern oil. (Applause.) In order for us to grow -- I said
something in the State of the Union that probably surprised some of you. I
said, we have a serious problem -- we're addicted to oil. But I meant what
I said. I fully understand that an economy that requires oil from parts of
the world that -- where some countries may not like us puts our economic
security at risk and puts our national security at risk. And I'm serious
about working with members of both parties to advance technological
research that will enable us to drive cars by using switch grass, a base
stock of ethanol, or wood chips, as well as the corn and soybeans we use
today. I can't wait for the day, and I know future Presidents can't wait
for the day, when somebody walks in with the farm report, and says, Mr.
President, the crops are up, and we're less dependent on Middle Eastern
oil. And it's coming, it's coming. (Applause.)

To keep this country competitive, we need a health care system that
provides Americans with high-quality care at good prices. And that's what I
want to talk about today. The health care costs are rising sharply in
America. If they continue rising the way they are, that will make us less
competitive. Many Americans are worried that they're not going to get the
treatments they need. Small businesses, in particular, are struggling to
pay health care for their employees. If two-thirds of the new jobs in
America are created by small businesses, and your small business owner is
struggling to keep their employee base because of health care, then we've
got to do something about it. Workers have lost good coverage because
they're changing jobs. I've told you, there's uncertainty in the
marketplace because people are changing work. And if you fear about losing
health care when you change work, it creates even more uncertainty.

More than 45 million Americans have no health insurance at all, and this is
unacceptable for our country. We've got the best health care system in the
world, make no mistake about it. The question is, how do we keep it that
way. And I've got some ideas for you.

First of all, we've got to choose between two competing philosophies when
it comes to health care. Behind all the rhetoric in Washington, and all the
proposals, there's really a philosophical debate. On the one hand, there's
some folks who -- good-hearted folks, good, decent folks, who believe that
government ought to be making the decisions for the health care industry.
And there are some of us who believe that the health care industry ought to
be centered on the consumer.

I think as we kind of make our minds up about what philosophy works, it's
important to look at the world health care systems. Other nations have
adopted government control of health care for centralized decision-making
when it comes to health care, which has created long waiting lines and
quality of care not as good as the American system, and a significant lag
in technological development.

We've done a different path up to now in our nation's history. We believe
in private medicine that encourages innovation and change. That's been the
cornerstone of American public health up until now. And we have a choice to
make. I made my choice -- I'm going to lead the Congress to make sure that
our health care system preserves America's system of private medicine, that
we strengthen the relationship between doctors and patients, and that we
make the benefits of private medicine more affordable and accessible for
our citizens. That's our strategy.

Obviously, government has a role to play. We have made a commitment to the
poor and the elderly in the United States, and it's a commitment we're
going to keep. When I got to Washington, I took a look at the Medicare
system. It's a very important part of our nation's health care system, and
that is Medicare, except it was old and tired, and hadn't been changed. It
was a centrally-controlled system. I'll give you an example of what I meant
by old and tired. This is a system that would pay $28,000 for ulcer surgery
-- when you've got an ulcer, you check in the hospital, Medicare would
write you a $28,000 check. It wouldn't pay the $500 necessary to prevent
the ulcer from happening in the first place. In other words, medicine had
begun to change, and Medicare didn't change with it. One reason why is
because it's centrally controlled; all decisions had to be made by people
out of Washington, D.C.

And so I worked with members of the United States Congress to modernize the
system. I said, if we've got a commitment to our elderly, let's make the
commitment a good one. We're not going to make the commitment and have it
be a mediocre commitment, it ought to be a good, sound commitment. And we
did. We added the prescription drug benefit to Medicare that modernizes the
system. And at the same time, we gave seniors more options from which to
choose. See, part of making sure a health care system works, seems like to
me, the consumers ought to have more choice. In a centralized system, the
government makes the choice. In a private system that focuses on kind of
the market, people ought to have a choice. People ought to be able to be
given different options from which to choose.

And so we did modernize the system. It's tough sledding up there in
Washington to get things changed. (Laughter.) People like the status quo at
times. Twenty-four million Americans have now signed up to the new Medicare
plan since January 1st. That's a lot of folks, 24 million. Hundreds of
thousands are enrolling each week. Now, needless to say, when you have a
change that size there's going to be some things that need to be adjusted
in the system. And you probably read about kind of the dual- eligible
problem. I don't know if you've had that problem here in Ohio, Governor.
We're dealing with it. Our job is to solve problems when they arise. When
you have that big a shift, you can image there's going to be glitches. But,
by far, the vast majority of people are signing up to a program that's
making a big difference in their lives.

Competition -- in other words, if they have choices it creates a sense of
competition in the marketplace -- is lowering costs for American seniors.
The average premium that seniors now pay for the prescription drug benefit
is a third less than what was expected. In other words, when we started
rolling out the plan it was expected that the prescription drug benefit
would cost the seniors $37 a month. The actual cost is $25 a month. It's an
interesting lesson about what can happen when you give people different
options from which to choose.

The other thing that's important for you all to know is that the typical
senior will end up spending about half of what he or she used to spend on
prescription drugs. I mean, if you want the system to function well, it
seemed like to me and others here that we ought to modernize the system to
make it good for our seniors. It's working.

If you happen to have a mother or father or a neighbor who's a senior, I
strongly urge you to get your loved one or your friend to call
1-800-Medicare, or to go on the web at Medicare.gov. And help that person
realize the great -- the great new options available to him or her.

Medicaid, as well, is a program we take very seriously. It's a program
aimed at helping the poor. It's administered in conjunction with states. It
is health care for low-income families with children, poor seniors, and
disabled Americans. It's a very important program. It needed to be
restructured, however, in order to make the program actually work in a
cost-effective way. And so we decided to work with the states to give
governors and folks at the local level more flexibility in how to structure
the program to meet the needs at the local level.

See, in the past, if you had a good idea -- if old Taft had a good idea, he
had to come to Washington and beg permission for a waiver: "I, the
governor, was elected to do something good for the people. I'm worried
about those who are qualified for Medicaid. Please give me permission to do
what I think is right." The new bill I signed is one which will make the
states -- give states a lot more flexibility when it comes time to signing
up people -- designing eligibility standards, to providing what the
programs ought to look like. In other words, it's flexibility all aiming to
make sure the Medicaid system works well.

We take the program seriously, but we fully understand what happens when
the bureaucracy becomes so encrusted that it's impossible to design
programs that will actually meet states' budgetary needs, as well as the
needs of the people. And we're remedying that fact.

I mentioned to you we have the goal of making sure that our budgets are
responsible. One of -- the budget I just signed -- the bill I just signed
and the budget I proposed is finally beginning to do something about the
growth in Medicare and Medicaid. I want to describe to you a little bit
about what we're doing. Let me give you this story, kind of an analogy --
there is a difference between slowing your car down to the speed limit, or
putting your car into reverse. I want you to think about that as I explain
to you that, in working with the Congress, we have slowed Medicare growth
down from 8.1 percent a year to 7.7 percent a year. In other words, we
found ways to reform the system so that we can slow the growth rate down to
make Medicare more affordable for future generations. We're not putting the
car in reverse, we're just finding the speed limit.

Same thing with Medicaid -- it grows -- slow it down from 6.9 percent a
year to 6.6 percent a year, which means just by slowing the growth rate
down on those two important programs, and at the same time making them more
efficient and delivering better services, we're saving the taxpayers $104
billion over five years. I want to thank the Congress for working on this.
You hear rhetoric, of course, that we're "starving the poor." The car is
going the speed limit -- it's not going backwards.

Now, the long-term solution for Medicare requires -- and Social Security --
requires an understanding that we've got a lot of baby boomers getting
ready to retire. The true strain on our budget is really going to be the
unfunded deficits caused by a baby boom generation retiring with fewer
workers to pay for guys like me. Okay? I mean, a lot of us are retiring --
as a matter of fact, my retirement date is -- I turn 62 on 2008, which is
-- (laughter) -- pretty convenient time to retire. (Laughter.) There's a
lot of us, a whole lot of us. And there are fewer people paying in the
system per person retiring.

And what's interesting -- and you've got to know this -- is that my
generation has been promised greater benefits than a previous generation.
So you can imagine when you start to think about the strain, a lot of us
have been promised greater benefits with fewer people paying for us. And
it's not going to work, it's simply not going to work.

I was very serious in the State of the Union -- and I explained this to
George and the Congressmen -- that I understand a solution to Social
Security and Medicare in terms of dealing with a bulge of retirees is going
to require a bipartisan solution. And I mean it to members of Congress. I
expect there to be a bipartisan effort to come up with a solution. Nothing
will pass the House or the Senate unless there's agreement. And now is the
time to put aside the politics that have stopped rational people from
coming up with a rational answer to a very serious problem -- to set it
aside, sit down at the table, and solve this problem once and for all, so
we can travel the country looking at young workers and saying, you're not
going to pay payroll taxes into a bust system anymore. You're going to pay
payroll taxes into a system which will be around not only for baby boomers
like me, but for a young generation of Americans coming up. Now is the time
for us to get something done. (Applause.)

I want to talk about another program that's working. One of the things that
we've got to do is spend time in Washington actually measuring results of
programs. You know, every title on a bill sounds just fantastic, you know.
(Laughter.) The problem is, is that every bill doesn't deliver the results
it's supposed to. I want to tell you about a program that does. It fits
into a vision of a health care system where the government does have
responsibility, and that's community health centers.

One of the real strains on local hospitals and local health providers is
the fact that the poor and the indigent use emergency rooms for primary
care -- an incredibly inefficient use of assets. It's an important use of
assets if somebody can't find care and they need help -- I'm not
denigrating the people going to the emergency rooms, but I am saying
there's a better way to be wise about how we spend your money and to solve
a very important problem, and that is have the emergency rooms be there for
emergencies, and have primary care facilities like community health centers
being there for primary care for the indigent and the poor.

Since I took office we've opened or expanded about 800 health centers.
There are now 3,700 of these centers around the United States serving 13
million Americans. It is a cost-effective way to provide primary care for
those who need help. And I'm going to call upon Congress and work with
Congress to put 400 more of those health centers in.

So what I'm telling you is, is that the federal government obviously has a
role, to make sure the Medicare system is cost-effective and works well,
make sure Medicaid works well and gives flexibility to states, and to
expand community health centers.

I now want to talk to you about how the rest of us need to have a health
care system if you don't fall into those categories. What should the role
of the government be? And I believe the role of the government ought to be
to empower consumers to make choices. And so let me talk to you about five
ideas I have to make sure that health care is more available and more
affordable.

And the first one is to expand health savings accounts. I call them HSAs.
When you hear me say HSA, that's kind of government-speak for health
savings account. They -- HSAs are helping to begin a movement away from
what's called a third-party payer system to one where the consumer is very
much involved in making wise purchases of health care. That's a very
important philosophical point.

The traditional insurance today will cover your health care costs -- most
of your health care costs -- in exchange for a high premium payment up
front. The costs are generally shared by you and your employer. You may
also pay a small deductible and co-payment at the time of treatment. What's
interesting about this system is that those payments cover only a fraction
of the actual costs of health care, the rest of which are picked up by a
third party, basically your insurance company.

It means most Americans have no idea what their actual cost of treatment
is. You show up, you got a traditional plan, you got your down payment, you
pay a little co-pay, but you have no idea what the cost is. Somebody else
pays it for you. And so there's no reason at all to kind of worry about
price. If somebody else is paying the bill, you just kind of -- hey, it
seems like a pretty good deal. There's no pressure for an industry to lower
price. And so what you're seeing is price going up. If you don't care what
you're paying, and the provider doesn't have any incentive to lower, the
natural inclination is for the cost to go up and the insurance companies,
sure enough, pass on the costs -- the increase in cost to you and your
employer. That's what's happening.

The fundamental problem with traditional coverage is that there's no
incentive to control how their health care dollars are spent. You don't
have any incentive, whatsoever. And that's one of the cost drivers in our
system. If we want to solve health care problems, if we want to make health
care affordable and available, we've got to analyze and address the cost
drivers of health care. And there's one right there. If patients controlled
how their health care dollars are spent, the result is better treatment at
lower cost.

I'll give you an interesting example of a procedure called LASIK -- laser
eye surgeries. It's a good example of how the market can work when there's
not a third-party payer involved. You might remember when LASIK first
appeared, was approved about a decade ago for its use. It went through the
process of getting government approval, and when approved it was an
opportunity for people to have their eyesight -- feeling a little nervous
about LASIK surgery when it first came out, and it was awfully expensive.
Consumers began to, however, inquire as to why something costs the way it
costs, how safe it was; doctors felt more comfortable starting to offer
more and more of the surgery; more providers came in the market, there was
transparency of pricing. You might -- I can remember billboards springing
up with people advertising LASIK surgery. Today the price of LASIK surgery
has dropped dramatically. More people are getting the surgery -- they're
giving up their glasses and contact lenses.

The market is working. I think if you go back and look at the history of
the pricing of LASIK surgery, the availability of LASIK surgery, you'll
find that when consumers start showing up saying, I want to know
information, I'm interested in this idea, how about -- how does your cost
compare to old Joe's over here -- the market began to adjust. LASIK surgery
is now more widespread, at much more reasonable cost for consumers.

And so, how to affect those kinds of cost changes in the health care
industry -- that's what we're really here to discuss. And one way to do so
is to -- to make health care more responsive is through health savings
accounts. Many people in our country don't know what a health savings
account is. I will start to try to explain it here.

First, it is a part of our drive to make health care more consumer-driven.
There's two components to a health savings account; one is low-cost
catastrophic insurance coverage, and a tax-free health savings account.
Those are the two components of what I'm talking about. Catastrophic
coverage protects you and the family in the event of devastating medical
illness -- if you're really sick, a catastrophic plan kicks in.

The health savings account portion of this product allows you and your
employer to contribute tax-free to pay for routine medical costs. In other
words, your company, or yourself, or a combination of the two makes a
tax-free contribution into a health savings plan, a savings plan that you
own. It's yours to call your own. And the savings within that plan are
tax-free. In other words, you're not just going to put it under your
pillow, you put it into a bank until you use it. The interest will be
tax-free. Your money is growing.

It means that if you don't spend money in your savings account on health
care, you can roll it over to the next year, tax-free. You have money
growing for health care to pay incidental expenses; it's growing at a
reasonable interest rate; it's yours you call your own, and if you don't
spend it in a year you can put it into the next year, and the next year,
and the next year.

For many routine medical needs, HSAs mean you can shop around until you get
the best treatment for the best price. In other words, it's your money;
you're responsible for routine medical expenses; the insurance pays for the
catastrophic care. You're responsible for paying for the portion of your
health care costs up to your deductible. And so you -- you talk to your
doctor, you say, can't we find this drug at a little cheaper cost? Or you
go to a specialist, maybe we can do this a little better -- old Joe does it
for X, I'm going -- why don't you try it for Y? It allows you to choose
treatment or tests that meet your needs in a way that you're comfortable
with when it comes to paying the bills. In other words, decisions about
routine medical treatments are made by you and the doc, not by third-party
people that you never know. And all of a sudden, when you inject this type
of thinking in the system, price starts to matter. You're aware of price.
You begin to say, well, maybe there's a better way to do this, and more
cost-effective way.

The combined cost of catastrophic insurance coverage and HSA contributions
are usually less expensive than traditional coverage. That's important to
know. In other words, HSAs are making health care more affordable. By the
way, these HSAs became expanded -- George tried to do it in the mid-1990s,
1996 I think -- yes -- medical savings accounts, he called them. He
couldn't get them going. People who had the business didn't want any
competition, which sometimes happens in the marketplace. (Laughter.) But he
thought of the idea, it made sense. This really -- these HSAs have kicked
off big time because of the Medicare bill I signed. They haven't been
around a long time, they're just kind of a fresh product that the
marketplace is becoming used to.

Forty percent of those who own HSAs have family incomes below $50,000 a
year. In other words, if people are having trouble affording traditional
insurance, all of a sudden the HSA becomes a more affordable product. HSAs
make a difference -- are making health care more accessible to those
without insurance. In the first year HSAs were available, more than a third
of those who bought HSAs had been uninsured. In other words, as health care
becomes more affordable, it makes it easier, obviously, for somebody who is
uninsured to be able to pick up health insurance.

You know, a lot of young folks are uninsured. You might remember the days
when you kind of felt like you were never going to get sick. (Laughter.) So
why should you buy insurance? Why do you need coverage? A lot of young
folks are saying, wait a minute, this is a pretty good deal. If I'm going
to stay healthy and can save a portion of that money, tax-free, and I'm not
going to spend money on health care for a while, all of a sudden a nest egg
really begins to build. By the way, it's a nest egg they call their own,
not something the government -- if there's excess money in your account,
the government can't take it away, or insurance can't take it away, it's
yours. You own the thing. It's -- a vital part of kind of a responsible
society is when there's a sense of ownership in important parts of our
economy.

Over the last 10 months, the number of HSAs has tripled. In other words,
people are becoming aware. One of the reasons I'm here talking about HSAs
at Wendy's is because you've decided to implement this product. I want
people to be aware of it. The number of people who bought HSAs has gone
from a million to 3 million. I'm going to talk today about ways to make
sure that HSAs are -- even expand even further.

You know, I can remember the debate in Washington -- I'm sure you can, as
well -- I remember one person who said, health savings accounts are not a
solution for the uninsured, they're regressive, they favor the wealthy.
It's just not the facts. They've helped the uninsured and a lot of folks
with incomes under $50,000 are buying these plans. It's kind of basically
saying, if you're not making a lot of money you can't make decisions for
yourself. That's kind of a Washington attitude, isn't it -- we'll decide
for you, you can't figure it out yourself. I think a lot of folks here at
Wendy's would argue that point of view is just simply backwards and not
true.

People have said that expanding HSAs would fail to reduce health care
costs. It's just not the case. I just talked to Joe Cava -- he knows what
it's done to your costs. Wendy's decided to take on this product. You were
facing double-digit increases in the cost of providing health care. That's
a strain if you're a CEO. In order to have a workforce you've got to have a
workforce that's comfortable with the health care plan, and all of a sudden
it's beginning to take big bites out of the balance sheet. It's hard to
grow when more and more of your costs are being consumed by health care.
And it provides a real tension for small business owners or large business
managers -- how do you take care of your people? No corporation, no entity
can run unless the people are taken care of, and at the same time expand
your business.

The company wanted to reduce projected health care increases. You didn't
want to keep passing on the high costs of -- increasing costs to your
employees. So they adopted HSAs. About 9,000 of Wendy's full-time employees
and their families have got HSAs. In other words, Wendy's said, why don't
we give people a chance to make health care decisions themselves. They
don't have some of the attitude in Washington. If you believe like
Washington believes, you would never try an HSA, because people can't
decide for themselves, see? That's not what the folks here at Wendy's
thought.

At the end of the first year with HSAs, more than 90 percent of Wendy's
employees had positive balances in their savings accounts. In other words,
there's a sharing ratio. The company helped pay the premium for the
catastrophic care. They shared the money that goes in to help pay for
incidental or routine expenses. But 90 percent of the folks didn't use all
the money for the routine expenses. It's kind of interesting, maybe it
helps preventative medicine, I guess -- when you're watching your own
money, and you realize that if you take care of your body and you exercise
and you don't do stupid things, you end up saving money. (Laughter.) And
when you save money, it's your money, not the company's money. (Applause.)

Medical claims through this company have decreased by 17 percent since
they've implemented HSAs. It's an interesting statistic, I think. After
more than 5 years of health care costs going at double-digit rates, Wendy's
overall health care costs rose only by 1 percent last year. HSAs have had a
positive effect. This has a positive effect on the individual employee,
it's had a positive effect on the income statement of the company. They
work.

And, Jeff, you made a good -- get the boy a raise. (Laughter.) Here's what
he said -- you know, never mind. He said, "We entered into this plan to use
our money more wisely, and to allow our employees to use their money
wisely." Kind of an interesting corporate concept, to allow our employees
to use their own -- more money wisely. "It's making health care more
transparent," Jeff says, "and making improved health more sustainable for
our employees and for all the consumers of health care." I think he gets
it. He gets the philosophy of having a consumer-driven system.

The savings have allowed Wendy's to raise the company's contribution to its
employees' HSA accounts. By saving money on health insurance, it enables
them to put more money into your account, which has got to be a heck of a
good benefit, working for this company. It's your money now, it grows
tax-free. It goes in tax-free, it grows tax-free, and you take it out
tax-free.

I met with Marla Hipsher. Thanks for coming, Marla. She works here. She is
a senior paralegal for four years. She was part of the briefing party that
was there when I arrived. She is a single mom with a 24-year-old daughter
and two teenage sons. As an aside, she has the toughest job in America,
being a single mother. She obviously cares about her health care for
herself, and more importantly, for her children. Marla's sons are on her
HSA plan with her. In other words, it's a family plan. She enjoys the
choice. She's comfortable with the control she has over her HSA. Marla's
premiums with her HSA are 18 percent lower than the traditional plan she
used to have at Wendy's. She's saving money. It makes it easier to do the
hardest job in America, which is being a single mother. She likes her HSA
so much, she's helping her 24-year-old daughter look into setting one up
herself. Listen to your mother, it makes a lot of sense. (Laughter and
applause.)

I want folks who don't understand HSAs to listen to what Marla has to say:
"It has made me more informed, because you discuss it with your doctor
now." She's talking about health care. "You want to know up front what it's
going to cost and what you need to know. You become a better informed
consumer." HSAs are working, they're working. And I'm looking forward to
working with Congress to expand them to more Americans.

I'm going to talk about three ways to make them more attractive, so more
people can have the benefits of an HSA, like Marla, or the small business
owners we've had. The greatest obstacle -- one of the greatest obstacles to
expansion of HSAs is the tax code. One problem is that under current law,
employers and employees pay no income or payroll tax on any health
insurance provided through the workplace. The health care plan here at
Wendy's, you don't pay for it. It's a benefit that's not taxable. Those who
buy their insurance on their own don't get the same tax break. That means
that the self-employed, the unemployed, and workers at companies that do
not provide insurance are at a disadvantage. The playing field isn't level.
And so I believe that one thing Congress needs to do is to give Americans
who purchase their own HSA policies the same tax breaks as those who get
their health insurance from their employers. (Applause.)

Another problem is that under current law, the amount you can put into your
HSA tax-free is limited to the amount of your deductible. But sometimes
your out-of-pocket expenses are greater than your deductible. That's
because on some catastrophic plans, there is an additional co-pay and,
therefore, when you -- you're paying after-tax dollars under the current
law if you exceed the amount of money you spend beyond your deductible. We
can change that. We can raise the cap on the amount of money you put into
your HSA so it remains tax-free, so that all out-of-pocket expenses can be
covered. (Applause.)

And finally, HSAs -- we want to make sure they meet the practical needs of
today's workers. I told you people are changing jobs. And one of the
problems is, a lot of folks fear that when they choose jobs, they're going
to lose their health care. And that means -- people feel like they've got
to get locked into a job because of health care. And that's not right. They
need to be more thoughtful to our workers, and recognize that this is a
changing world in which we live. And so we ought to make sure people can
take their own health savings account with them job to job.

Today the savings in your health account -- health savings account are
portable -- portable means you can take it job to job. So you've got
savings in your own account, you can take it with you. But the health
insurance that comes with the account you can't take with you, because of
outdated laws and practices that prevent insurers from offering portable
policies. So I believe that health insurers should be allowed to sell
portable HSA policies nationwide.

You see, it's like car insurance. If you change jobs, you can take your car
insurance with you. You can't take your insurance in your HSA with you. In
order to make sure this economy works better, in order to make sure the
health care system functions better for our workers, we've got to make sure
portability in HSAs is consistent and real. It's going to make a difference
in people's lives when Congress gets that done.

The second policy -- way to make sure health care is affordable and
accessible is to increase transparency in our health care system.
(Applause.) To be smart consumers, you need to be informed consumers. It's
hard to make wise choices unless you have information available. In order
to spend your HSA dollars wisely, you need to know in advance what your
options are. You need to know the quality of doctors and hospitals in your
area; you need to know the full extent of procedures that someone
recommends to you. You know, like when you buy a new car, you have access
to consumer research on safety, you have access to information on
reliability, you can compare price. There's performance data. You can
become an informed consumer before you purchase your automobile. And that
same sense of transparency and information ought to be available in health
care. A modern health care system recognizes that people ought to be
encouraged to shop for quality and price. And so the health care industry,
and the insurance industry, needs to provide reliable information about
prices and quality on most common medical procedures.

Tomorrow I'm going to have a little visit with people in the insurance
industry and the health care industry and the business industry to
encourage transparency. I know members of Congress are working on a bill.
It would be better this be done with people saying, oh, we understand it's
important to be transparent. There's always a bill out there in case the
volunteerism is not quite as strong as it should be. (Laughter.)

Third policy that's important is to apply modern information technology to
our medical system. Doctors practice 21st century medicine, they still have
19th century filing systems. And this is an important issue. One reason
it's an important issue, because when a doc writes their files by hand, you
generally can't read the writing. (Laughter.) That leads to inefficiency
and error. In hospital there is more risk of preventable medical error when
records are handwritten, instead of being cross-checked on a computer.
Oftentimes doctors duplicate expensive tests because they do not have
access to previous results. In other words, the medical system has not
taken advantage of information technology like I'm sure Wendy's has, or
other industries around the country.

And so I set a goal in 2004 that most Americans would have an electronic
health record within 10 years. You'd have your own health record on a chip.
And we're making pretty good progress toward that goal. Mike Leavitt is the
Secretary of Health and Human Services. He's got a whole division inside
HHS aiming towards getting information technology spread throughout health
care.

First thing is, they've got to have a language that kind of can talk
between a hospital in Dublin and a hospital in Crawford, you know? Well,
they don't have a hospital in Crawford. (Laughter.) How about a hospital
close to Crawford? (Laughter.) And that's important, because there's a lot
of different -- the language needs to be standardized. And Mike is making
pretty good progress on that.

We're developing solutions for a nationwide health information network. One
of the things I've insisted upon is that it's got to be secure and private.
There's nothing more private than your own health records. And so any
system that works is one that is -- it's your record -- you decide the
disclosure of your health records.

So let me give you an example about how such a system can work and what I'm
trying to explain to you about how to help control costs and reduce medical
errors. After Katrina hit, there was hundreds of veterans that had to be
relocated. What's interesting is, is that the Veterans Department has
already started this information technology modernization. There are
medical -- electronic medical records for veterans. And so when these poor
folks got scattered around the country, the doctors and providers had
access to the electronic records of our veterans.

So if a person had a diabetes issue, up pops on the screen the information,
the latest test, the medicine being taken. It was an incredibly efficient
way to make sure that the health care needs of our veterans were met during
this time of catastrophe. It helped people fill out the prescription drugs
of our seniors without fear of error. It helped a local doc say, well,
gosh, look, you've been taking this medicine in the past, I'm going to
prescribe it for you in the future, in order to make sure that your health
care needs continue. If you have your own medical record, your own
electronic medical record, and you get sick in a remote part of our
country, people instantly see your blood type, the issues that you've faced
in the past, really important information about who you are and what you're
going to need to help you.

And we're on our way to providing a nationwide information network. It's
going to help save maybe 25 percent of the costs in medical care. I told
you that one of the important things we've got to be worried about is how
to deal with the cost drivers, how to come up with ways to, practically,
with a common-sense solution, deal with rising costs. One way is to
modernize health care. Another way is to put consumers in charge of making
decisions with transparency in pricing.

I want to talk a little bit about small businesses. Obviously, I've told
you once and I really mean it, I understand how important small businesses
are for the economy. I also love the thought of America being a great place
for entrepreneurship. There's nothing better than talking to somebody and
saying, I started my own business, or, I own my own company. It's
refreshing to me. It's just really an important part of the American
experience. And, obviously, as I mentioned, health care is a really
important issue for small business. If you sat down with a roundtable of
small businesses, the first issue that comes to their mind is, I can't
provide health care for my people; how do you expect me to stay in business
when health care costs are driving us out? Well, HSAs help a lot, and I
really urge American small businesses to take a look at HSAs. They're good
for Wendy's, they'll be good for you, as well.

Here's another idea. One of the problems that small businesses have is that
they enter into the market, if they're trying to provide traditional
insurance, without any risk pool behind them. If you've got three people
you're trying to insure, it's a heck of a lot more expensive then if you're
trying to insure 3,000 people or 10,000 people. In other words, the more
people that are in the risk pool, the lower the cost of traditional
insurance is for a small business. And so I look forward to working with
the Congress to expand what we call associated health plans. That's kind of
Washington-speak for allowing small firms to band together to buy insurance
at the same discounts that big companies get. (Applause.)

I'll give you an example. You've got yourself a family restaurant here in
Dublin, Ohio. They've got 10 employees, and you try to go in the
marketplace and it's prohibitively expensive. It seems to make sense to me
that the family restaurant in Dublin ought to team up with family
restaurants all across the country, so that the employees provide one big
risk pool to help lower the cost for small businesses. It is a practical
way of helping small businesses that choose not to go into HSAs to be able
to buy traditional insurance in a cost-effective way.

The bill passed the House of Representatives; it remains stuck in the
United States Senate. I urge the Senate -- I urge the Senate -- for the
sake of affordable health care for small businesses and their employees, to
pass associated health plans.

I'll talk about one other issue. I hope you're hanging in there with me
here. (Laughter.) And that issue is one that I remember well when I was
traveling your state, and that is the number of good docs that are getting
driven out of practice because of frivolous lawsuits. (Applause.) If you're
worried about affordabilty of health care and availability of health care,
then you have got to be concerned about junk lawsuits. You just have to be,
b