This feels like the massive win of the day - an event I hadn't even known was going to happen - at the Clinton Global Initiative in NYC, today, former President Bill Clinton sat down on stage with President Obama and talked about the Affordable Care Act, a.k.a. Obamacare.
We can see the GOP in maximum spazz-drive to stop the law. As I write this, Ted Cruz and Marco Rubio are engaged in a fake filibuster on the Senate floor:
http://thehill.com/...
So it's encouraging to see the Obama administration bringing out the big guns and big dogs to fight back.
It appears even the Times only heard about this event today, so maybe they were keeping it a surprise for maximum effectiveness.
Complete video and partial transcript after the jump...
wow - 53 minutes of Goposaur PWNing.
And so please join me in welcoming Number 42 and Number 44, Bill Clinton and President Barack Obama. (Applause.)
PRESIDENT OBAMA: Mr. President. (Laughter.)
PRESIDENT CLINTON: Are you interviewing me?
PRESIDENT OBAMA: That would be bad. I've been talking a lot today.
PRESIDENT CLINTON: I want to thank you for giving Hillary a job. That was a good thing you did. (Laughter.) Thank you for coming.
PRESIDENT OBAMA: Well, it is wonderful to be back. And let me start just by saying to all the people who have for years now supported the incredible efforts of CGI, thank you. Because wherever we travel, all across the globe, we see the impact that it's making every single day. And we're very proud of what you all do.
And let me say that we still miss our former Secretary of State. (Applause.) And I should add that there's nothing she said that was not true, particularly the part about us marrying up. (Laughter.)
PRESIDENT CLINTON: Well, that brings me to my first health care comment. This is going to be a conversation about domestic and international health, and America's role in it. But I want to begin by telling you that I think the First Lady has done a great job in this fight against childhood obesity.
We have been honored at our foundation to be asked to represent her effort in 18,000 schools where we've lowered the calories in drinks being served in schools by 90 percent. But she has been great on that one. The other thing I think is that I was a little upset — and, as you know, called one of your administration members when you got to Africa — when I read an article that said that you didn't have a big initiative in Africa. And I said — I can't say exactly what I said — (laughter) — but I said that is inaccurate. (Laughter.) That's the sanitized version of what I said. (Laughter.)
Because when the President took office, our program, begun under President Bush, PEPFAR, was giving antiretroviral medicine to 1.7 million people. Because of an agreement that I made with President Bush to use generic drugs that were approved by the FDA, about half our drugs were being purchased in that way. Under President Obama, we've gone to 99 percent. We are treating more than 5.1 million, three times as many for less money. (Applause.)
That is a stunning legacy — so that more money has been put into malaria medicine, bed nets, so you saved a lot of money and saved more lives while doing it. And I'm very proud of that. And I want to thank you for it. It's important. (Applause.)
Now, maybe at the end of this conversation we can get back to some of your current global health initiatives. But let's talk a little about the health care law, because we're about to begin on October 1st open enrollment for six months. And I'd like to give you a chance, first of all, to tell them why — when you took office, we were teetering on the brink of a depression. You had to avert it. You had to start the recovery again. Why in the midst of all this grief did you also take on this complex issue? Many people were saying, why doesn't he just focus on the economy and leave this alone? So tell us why you did it.
PRESIDENT OBAMA: Well, first of all, I think it's important to remember that health care is the economy. A massive part of our economy. And so the idea that somehow we can separate out the two is a fallacy.
Second of all, the effort for us to deal with a multifaceted health care crisis has been going on for decades. And the person who just introduced us, as well as you, early in your presidency, had as much to do with helping to shape the conversation as anybody.
The fact is that we have been, up until recently, the only advanced industrialized nation on Earth that permits large numbers of its people to languish without health insurance. Not only is there the cruelty of people who are unable to get health insurance having to use the emergency room as their doctor or their health service, but — we’re also more efficient than anybody else and so when we talk about, for example, our deficit — you know this better than anybody — the reason that we have not only current deficits but also projected long-term deficits — the structural deficit that we have is primarily based on the fact that we have a hugely inefficient, wildly expensive health care system that does not produce better outcomes.
And if we spent the same amount of money on health care that Canada or France or Great Britain did, or Japan, or any other industrialized country, with the same outcomes or better outcomes, that essentially would remove our structural deficit, which would then free up dollars for us to invest in early-childhood education and infrastructure and medical research and all the other things that can make sure that we’re competitive and growing rapidly over the long term.
So my view when I came into office was we’ve got an immediate crisis — we’ve got to get the economy growing. But what we also have to do is to start tackling some of these structural problems that had been building up for years. And one of the biggest structural problems was health care. It’s what accounts for our deficit. It’s what accounts for our debt. It causes pain and misery to millions of people all across the country. It is a huge burden on our businesses.
I was out at a Ford plant out in Missouri, making the F series out there, and this is a big stamping plant. Ford is now the biggest seller in the United States. We took that lead back from the Japanese automakers. But we are still burdened by the fact that every U.S. automobile that is manufactured requires a couple of thousand dollars in added health care costs that our foreign competitors don’t have to pay.
So this has everything to do with the economy, in addition to what I consider to be the moral imperative that a mom should not have to go bankrupt if her son or daughter gets sick; that a family who’s dealing with a layoff and is already struggling to pay the bills shouldn’t also be wondering whether they’re one illness away from losing their home. And I think most Americans agree with that. (Applause.)
PRESIDENT CLINTON: So first of all, folks, for those of you who are from the United States, that’s about as good an overview as you’re ever going to hear of what this economic issue is. But you remember the President said our structural deficit would disappear if we had a comparable health care system in terms of cost to the French and Germans that are consistently rated the highest. It’s about a trillion dollars a year, and somewhere around 44 percent of that money is government-funded money. So you just run the numbers. Think — over half of our deficit has already disappeared because of economic growth and the revenues you raised and the spending we cut. And you pretty much get rid of the rest of it if we just had a comparably expensive system to any other country.
Before you took office, we lost a car company that wanted to locate in Michigan that went instead to Canada, and they announced — they said, look, we’re a car company that provides health care benefits to an employee, were not a health care company that sells cars to cover our bills. We have to go to Canada. And it was one of the few companies willing to go on record and say this. So thank you for doing it.
So let’s talk about this. What does this open enrollment mean? How are people going to get involved? When you have universal enrollment you can manage your costs better and cut inflation down.
I'll give the President a chance to talk about all the good stuff that's happened, but I just want you to know one thing. In the last three years, just as we started doing this, inflation in health care costs has dropped to 4 percent for three years in a row for the first time in 50 years. Fifty years. (Applause.) Before that, the costs were going up at three times the rate of inflation for a decade.
So now what? What are you going to do on October 1st? Tell them how this has got to work.
PRESIDENT OBAMA: Well, let me give folks just a little bit of background about what’s already in place and then what happens on October 1st.
When we passed the Affordable Care Act, there were a number of components to it. A big part of it was essentially providing a Patient’s Bill of Rights that Americans and advocates have been fighting for for decades. So what we wanted to do was make sure if you already have health insurance that you get a fair deal, that you're being treated well by your insurers.
So we eliminated, prohibited insurance companies from imposing lifetime limits, which oftentimes if a family member really got sick, they thought they were covered until suddenly they hit that limit and now they’re out hundreds of thousands of dollars with no way of paying.
We said to insurance companies, you’ve got to use at least 80 percent of your premium that you're receiving on actual health care — not on administrative costs and CEO bonuses. And if you don't, you’ve got to rebate anything that you spent back to the consumer. So there are millions of Americans who’ve received rebates. They may not know that they got it because of the Affordable Care Act — or “Obamacare” — but they’re pretty happy to get those rebates back, because it made sure that the insurance companies were treating folks fairly.
We said that any young person who doesn’t have health insurance can stay on their parent’s health insurance until they’re 26 years old. And as a consequence, what we’ve seen is steadily the rate of uninsured for young people dropping over the last three years since the bill passed and obviously providing a lot of relief to a lot of parents out there because a lot of young people, as they’ve been entering into the job market at a time when jobs are tough to get and oftentimes benefits are slim, this is providing enormous security until they get more firmly established in the labor market.
We provided additional discounts for prescription drugs for seniors under the Medicare program. And so seniors have saved billions of dollars when it comes to their prescription drugs.
So there have been over the last three years a whole array of consumer protections and savings for consumers that result directly from the law that we passed. And for those who say that they want to repeal it, typically when you ask them about, what are all these various benefits, they say, well, that one is good, and that one is pretty good, and we’d keep that. And you pretty much go down the list, and there’s not too much people object to.
You will recall also at the time that part of the way that we paid for the health care bill was we said Medicare is wasting a lot of money without making seniors healthier. And there was a lot of hue and cry about how we were taking money out of Medicare — well, it turns out that we were right, that we could change how doctors and hospitals and providers were operating, rewarding them for outcomes, as opposed to simply how many procedures that they did. You started seeing practices change among millions of providers across the country. Medicare rates have actually slowed in terms of inflation. Seniors have saved money. Folks are healthier. And some of those savings we’ve been able to use to make sure that people who don't have health insurance get health insurance.
Now, this brings me to October 1st. The one part of the Affordable Care Act that required several years to set up, but a critical part, was how do we provide health insurance for individuals who don't get health insurance through the job? It’s a historical accident that in this country health care is attached to employers. And part of the problem is if you’re out there shopping for health insurance on your own, you're not part of a big pool, well, there’s no aggregation of risk taking place for the insurers. So they're basically going to say, let’s see, you're 50 years old. You got high blood pressure. And we just look at the actuarial tables and we figure you’re going to get sick, so we’re going to charge you $1,500 a month for health insurance, which the average person has no way of affording — because there’s no pooling of risk.
So what we said was we need to set up a mechanism to pool people who currently don't have health insurance so that they have the same purchasing power, the same leverage that a big companies does when they're negotiating with the insurance company.
And essentially what we’ve done is we’ve created what we’re calling marketplaces in every state across the country where consumers are now able to be part of a big pool. Insurers have to bid, essentially compete for the business of that pool. And what we now have set up are these marketplaces that provide high-quality health care at affordable prices, giving people choices so that they can get the health insurance that they need and they want. And the premiums are significantly lower than what they were able to previously get.
I’ll take the example of New York State. The insurers put in their bids to participate in these marketplaces. It turns out that their rates are up to 50 percent lower than what was available previously if you just went on the open market and you tried to get health insurance. (Applause.) Fifty percent lower in this state. California — it’s about 33 percent lower. In my home state of Illinois, they just announced it’s about 25 percent lower.
So just by pooling and creating competition so that insurers have to go after people’s business the way they go after a group plan, we have drastically reduced premiums and costs. On top of that, what we’re now doing is we’re saying if with the better deal that you got you still can’t afford it, we’re going to give you tax credits to essentially subsidize your purchase of health insurance.
And here’s the net result. We’ll be continuing to roll out what the actual prices are going to end up being, but I can tell you right now that in many states across the country, if you’re, say, a 27-year-old young woman, don’t have health insurance, you get on that exchange, you’re going to be able to purchase high-quality health insurance for less than the cost of your cellphone bill. And because all the insurers who participate are required to, for example, provide free preventive care, free contraceptive care, that young woman, she may make up what she’s spending on premiums just on her monthly use of health care.
So this is going to be a good deal for those who don’t have health insurance. Those who already have health insurance get better health insurance. And the best part of the whole thing is, because of these changes we initiated in terms of how we’re paying providers, health care costs have grown, as you pointed out, Mr. President, at the slowest rate in 50 years. We are bending the cost curve and getting at the problems that are creating our deficits in Medicare and Medicaid. (Applause.)
PRESIDENT CLINTON: I should point out that, so far, in most states, one of the good things that at least I didn’t know whether it would happen is when we began this in the United States, more than 80 percent of the American states had only one or two companies providing health insurance who had more than 80 percent of the market. So there was, in effect, no price competition. So what I was terrified of was we’d open these things and there would only be one company show up and bid, and this whole thing, we’d be having an academic conversation. Instead, it’s actually led to the establishment of more companies doing more bidding.