Text 359, 640 rader
Skriven 2005-01-26 23:34:42 av Whitehouse Press (1:3634/12.0)
Ärende: Press Release (0501265) for Wed, 2005 Jan 26
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President Participates in Conversation on Health Care
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For Immediate Release
Office of the Press Secretary
January 26, 2005

President Participates in Conversation on Health Care
National Institutes of Health
Bethesda, Maryland


˙˙˙˙˙In Focus: Health Care


11:49 A.M. EST

THE PRESIDENT: Thank you all for coming. Please be seated. Thanks for the
warm welcome. Thanks for coming. I'm looking forward to having what I think
you'll find to be a very interesting dialogue about innovative ways to make
sure that our health care system addresses the needs of our individual
citizens.

This is an issue that requires a lot of dialogue so people understand the
problems, and a lot of innovative thinking to make sure that the system
works. My judgment is the system won't work if medical decisions are made
by government. I believe the best kind of decision-making occurs when
consumers make decisions and the relationship between their doctors and the
patients are -- become the cornerstone of good health care policy.

And so we're going to have a dialogue. I want to thank our fellow citizens
for being here. We just had a little discussion about how to make sure this
conversation goes without flaw. (Laughter.) I'm confident it will.

First, I want to thank the governor of the great state of Maryland for
joining us today. (Applause.) As you know, at times I take a little -- a
brief weekend retreat in the great state of Maryland at a fine facility
called Camp David; and the last time the Governor was there, was with Laura
and me, he and the First Lady were there and it happened to be the day of
the blizzard. So I've invited him back in the summer. (Laughter.)

I want to thank my friend, Elias Zerhouni, the Director of the National
Institutes of Health. I appreciate the job you're doing, Doc; you're doing
a fabulous job. (Applause.) I want to thank Les Crawford, who's with us
today, the Acting Director of the -- Acting Commissioner of the FDA. Thank
you, Les, for being here. (Applause.) And I want to thank everybody else
who has come. I'm honored that you're interested in this very important
subject.

Before we talk about health care, though, I do want to talk about a couple
of other subjects. One, I am -- as you could tell from the speech I gave
last week -- a firm believer in freedom and the ability of freedom to bring
peace to our world. I am so pleased to watch liberty advance throughout the
world in places that -- in places where people never dreamt liberty would
come. I want our fellow citizens to see what is happening in our world in
the last couple of months.

I mean, in Afghanistan millions of people voted for a president for the
first time in 5,000 years. It's a grand moment in history when people who
had been condemned to tyranny by -- in this case, the Taliban -- have a
chance to express themselves in the ballot box -- at the ballot box, to let
their opinions be known as to how government ought to respond to their
needs.

As well, the Palestinians elected new leadership. I am very pleased by the
courage and leadership shown by Abu Mazen, his desire to unify security
forces within the Palestinian territory, so as to defeat the terrorists
there and allow for democracy to advance. I believe -- I believe a
Palestinian democracy will emerge and will grow, enabling us to achieve a
goal of two states, Israeli and Palestine, living side-by-side in peace.

As well, the Ukraine swore in a new president, which was a remarkable
advance of democracy in that part of the world. And, finally, this Sunday
after years of brutal tyranny, the long-suffering people of Iraq will go to
the polls to vote for a -- (Applause.) Freedom is on the march. Freedom
will continue on the march, and therefore the world will be more peaceful
and we'll be able to say we left behind a more steady and stable and
peaceful world for our children and our grandchildren.

At home, we've got to make sure freedom continues on the march, as well.
That starts with making sure every child receives a great education. The No
Child Left Behind Act is the beginning of making sure high standards and
accountability come to our classrooms, so that not one single child is left
behind. We're making progress, and over the next four years, we'll continue
to make progress.

The world is watching as to whether or not we're able to manage our
budgets. One of the things people say, are you capable of dealing with twin
deficits? On the one hand, we have a fiscal deficit, so I'll be submitting
a budget to the United States Congress that sets clear priorities. One of
the priorities of my administration was doubling the funding for NIH so we
continue to stay on the leading edge of research and technological change.
(Applause.)

We understand how important science is. And we understand it's important to
be the leading nation when it comes to research, and we'll continue to stay
there. But we are funding some things that aren't effective, as well. And
so the budget I submit to the United States Congress will work on reducing
our deficit in half by over a five-year period of time, and at the same
time, funding much needed priorities.

As terms of the current account deficit -- that would be the deficit, as
far as our trade goes -- the best way to deal with the current account
deficit is to make sure America is the best place in the world to do
business, to risk capital, so that we can continue to grow our economy. And
the first step of doing that is for Congress to bring meaningful legal
reform to my desk early in this legislative session, reforming the asbestos
law, reforming class action lawsuits, and reforming medical liabilities.
(Applause.)

We'll continue to work on free and fair trade. I believe we can compete
with anybody, anywhere, so long as the rules are fair. We need to open up
markets around the world so our farmers and entrepreneurs and manufacturers
can sell our products around the world. We need to make sure that
regulations are fair. We've got to make sure that -- we've got to make sure
that taxes remain low so as not to snuff out the entrepreneurial spirit in
America. Our economy is growing, small businesses are vibrant and alive and
well. New jobs are being created by small business, and we want to continue
that momentum. People are finding work. We've recovered from recession. And
it's important for Congress to understand that we've got to create an
environment for continued capital expansion if we want our people to find
jobs.

And so I'm looking forward to working with them. We've got a lot of big
challenges ahead of us. And one of the biggest challenges of all is Social
Security. And it's a challenge because if you're a dad, for example, of a
23, 24-year-old child, when that child comes time to retire, the system is
broke. It's flat bust. In 13 years, the system begins to go negative.
That's more money going out than coming in.

And so it seems like to me for people like me, who have gotten positions of
responsibility, we should deal with this issue, and not pass it on in hopes
that it gets better. It's not going to get better unless Congress works
with the administration to have a permanent, long-term fix for Social
Security. If we do not act, the cost becomes more expensive in the out
years. If we do not act, there's going to be a need for huge payroll tax
increases, and/or major benefit cuts. So now is the time to move. And I
understand there's a reluctance by some in Congress to take on a tough
decision. But I believe we've been elected for a reason, and that is to
confront problems and to work together in a bipartisan spirit.

For those seniors who are worried about the debate on Social Security, you
have nothing to worry about; nothing will change. But your children and
your grandchildren do have something to worry about. And so I look forward
to working with the Congress to come up with a long-term solution to fix
Social Security. (Applause.)

As well, we need to come up with reasonable, common-sense policies to
address the rising costs of health care. And so today we're going to talk
about some innovative ideas. One is health savings accounts. And we'll be
talking to an employer, and somebody -- a beneficiary, like me, of a health
savings account. A health savings account enables a person to be in charge
of his or her own health care decisions. Health care savings account will
cover major catastrophic problems, and at the same time, allow a person to
save, and/or a business to save tax-free for the everyday expenses of
health care. And if, in fact, you have not reached your limit for your
catastrophic care -- in other words, if you have money left over, you can
roll it over, tax-free, into a savings account that you call your own.

We've got some people who can probably explain this better than me here,
consumers of health savings accounts. But health savings accounts all aim
at empowering people to make decisions for themselves, owning their own
health care plan, and at the same time, bringing some demand control into
the cost of health care. Our view is, is that if you're a consumer of
health care and you're in the marketplace making health care decisions, it
is more likely that there be more cost control in health care than a system
in which the consumer of health care has his or her health care bills paid
by a third party provider.

Secondly, we're going to talk about association health plans, which will
allow small businesses to pool across jurisdictional boundaries to be able
to afford health care insurance at the same discounts that big companies
get. The principle behind association health plans is that the more risk
you're able to spread amongst beneficiaries, the lower your cost of health
care. And, unfortunately, too many laws restrict small businesses from
being able to pool risk. And so we're going to talk about that.

We're going to talk about an integrative way to establish a national
marketplace for health care by allowing people to get on the Internet and
buy a health care plan in a state other than that in which you live. It's
kind of an interesting way to encourage more consumer activism, more
choices for our citizens here in the country.

And, finally, we're going to talk about making sure that we expand our
children's health savings program. And we're going to talk to a lady who
has been very much involved in encouraging people to sign up for what's
called S-CHIP, so the youngest citizens can take care [sic] of the
government programs that are now available.

As well, I want to remind you all that we will continue to promote an
adequate safety net for our citizens, and by that, we've got community
health centers in America today. I want to continue to expand community
health centers. This is the place where the poor and the indigent can get
primary care. And they're great centers. And Congress has been very
cooperative in the past of funding our budget requests, and I hope they do
again as we continue to expand these community health centers all across
the United States of America.

We will, obviously, continue to make sure Medicare fulfills its promise.
Obviously, I felt the system needed to be reformed. It was a system that
would pay, for example, for hospitalization of a senior citizen for heart
surgery, but not for the medicine that could prevent the heart surgery from
being needed in the first place. It's a system that needed to be changed.
And at the same time, it was a system that needed to respond to the demands
of our senior citizens. And so we introduced market -- market forces into
the Medicare system to make it such that it can continue to evolve and grow
and change as medicine changes and, therefore, meet the needs of our senior
citizens.

Tomorrow, I'm going to go to Cleveland to talk about the importance and
need of information technology in the health care field. If you really
think about many industries in America, they've been able to modernize and
become more productive by introducing IT -- information technology -- into
their industries. It's a little difficult -- a little more difficult task
here in health care. We've got 21st century medical practices, but 19th
century paperwork system. Doctors are still writing prescriptions by hand.
Most doctors can't write clearly anyway and so it's a -- (Laughter.) So
there's a better way to enable our health care system to wring out
inefficiencies and to protect our patients. So medical electronic records
is going to be one of the great innovations in medicine. And I look forward
to talking about ways to advance information technology and health care.

Finally, a way to make sure that our citizens are able to better afford
health care is to speed generic drugs to the market. I want to thank the
FDA for propagating rules that prevent pharmaceuticals from delaying the
advent and access to our consumers of generic drugs. These drugs do the
exact same thing as brand name drugs do and, yet, cost a fraction of the
cost of the brand names. And so we're doing a better job of speeding
generics to the markets. And that's a positive development for our seniors,
and all citizens for that matter.

So here are some practical ways to address the cost of health care without
allowing the federal government to become the health care decider. The
federalization of health care would be bad medicine for the American
people. And one way to prevent that from happening is to propose positive
alternatives. And that's what we're going to discuss today.

And the first person I'm going to discuss health savings accounts with is
Pat Zakula -- correct? Exactly. Pat Zakula. (Laughter.) She called me
George Brush. (Laughter.)

All right, where are you from?

MS. ZAKULA: I'm from northeast Indiana.

THE PRESIDENT: Northeast Indiana. Fabulous, yes. And so what do you do?

* * * * *

THE PRESIDENT: Great, thanks for doing that. You're a soldier in the army
of compassion. So you've got employees, right? How many?

MS. ZAKULA: Yes, we have 70 employees. Because most of our services are
home-based, it takes a lot of people to do what we do. Most of our staff
are women, some in their 20s to in their 50s.

THE PRESIDENT: Right. And you're expected to provide health insurance.

MS. ZAKULA: That's right. And we've been doing -- providing health care --
health insurance for people for many years, as we keep growing. But it
became a real struggle, because the costs were just exorbitant, and they
would go up, you know, in double digits every year, and sometimes twice a
year they would go up.

THE PRESIDENT: Right, which is a common problem for a lot of smaller
enterprises. So how did you deal with it?

* * * * *

THE PRESIDENT: That's interesting. Listen to what she's saying. First of
all, they're going broke. They can't afford health care. Like many small
businesses or small enterprise or small non-profit, she's faced with a
choice: Do I keep the doors open and have employees without health care --
basically, is what you're saying.

The HSA comes along and so the plan, as I understand it, has a deductible
of $1,700 -- in other words, you pay for the first $1,700 of expenses --
and then you have insurance to cover the --

MS. ZAKULA: That's correct, to cover the hundred percent after you reach
that $1,700.

THE PRESIDENT: Right. And the way this HSA works is you take the high
deductible plan, of $1,700 in your case, and contribute $1,700 into the
plan, tax-free, so that the person has the $1,700 to cover expenses, up
until the insurance policy kicks in. I think that's the way yours works.

* * * * *

THE PRESIDENT: If the $1,700 isn't spent, it rolls over to the next year,
tax-free, and the owner of the HSA can pull the money out, tax-free, for
health care. And so it's an incentive to save.

Now, think about this, if for example, you make healthy choices in your
life and the $1,700 can be rolled over, the healthier you are, the less
likely you're going to spend on normal health care needs, the more money
you have that you call your own. And, secondly, the benefit is, your
employees start making decisions -- as opposed to saying, you've got to go
by X, Y, Z for this amount, people all of a sudden start to shop for that
which is best for them.

MS. ZAKULA: That's true. And people who -- when they found out that their
visit to the doctor really didn't cost $20, which was our co-pay --
(laughter) -- then they're not -- then they don't run to the doctor all the
time. However, they are using -- they're doing preventative care and doing
the things that they need to do, but they're more likely to shop around and
to weigh things, whether I need to do this or not.

THE PRESIDENT: Part of the issue with health savings accounts is for people
to even understand they exist. And so you're talking to an owner who is on
the leading edge of change. These are relatively new products available.
And part of the reasons why we're discussing this is we want small business
owners and individuals to realize that health savings accounts are now
available. And I urge everybody to look into the benefits of a health
savings account.

And you need to listen to Bill Lomel who is with us. You are an owner of a
health savings account?

MR. LOMEL: Right. I'm Bill Lomel. I'm from Atlanta --

THE PRESIDENT: Exactly, Lomel, just as I said. (Laughter.) Two for two.
(Laughter.)

MR. LOMEL: I'm a commercial roofing contracting business with 25 employees,
and like Pat, was faced with a similar decision. I mean, the monthly
premium for our family coverage two years ago went from $450 to $750, and
then it was going up over a thousand. And the group kept getting smaller
because people were dropping out of the plan. The individuals couldn't
afford their portion of the coverage. And it was kind of an effect going
on, making it --

THE PRESIDENT: Catch-22.

MR. LOMEL: Yes.

* * * * *

THE PRESIDENT: You getting that? It's important for people to understand
what he's saying. He buys the high deductible policy to cover major medical
expenses, and the savings on that policy from what he was paying otherwise
more than equals the zero to $5,000 cost up until the insurance kicks in.
It's his own money, the $5,000. He owns it. It earns interest tax-free. In
other words, he's able to put it in an interest-bearing account. And if he
or his three children do not spend the $5,000, whatever the balance is, it
rolls over to the next year. And it's -- and it enables, frankly, small
businesses to stay in business and families to be able to better afford
health care.

You enjoying it?

MR. LOMEL: Yes, it's great. And it's made providing that benefit possible
again.

THE PRESIDENT: Yes.

MR. LOMEL: So we're meeting with all of our employees to get them signed up
individually on programs that I can kind of help facilitate.

THE PRESIDENT: Absolutely. Most of the working uninsured in America work
for small businesses. And so for small business owners out there who are
worried about being able to pay for insurance for your employees -- and a
lot of owners are, like you were; I mean, it must be nerve-wracking.

MR. LOMEL: Well, one of the key things that has come out of this is that
when I go to the doctor, I'm interested in the cost. (Laughter.)

THE PRESIDENT: Yes.

MR. LOMEL: And I had --

THE PRESIDENT: That's pretty good.

MR. LOMEL: I had a small skin cancer removed this year. And just -- I
asked.

THE PRESIDENT: Yes.

MR. LOMEL: They offered me two procedures, and I said, well, how much does
this one cost and how much does that one cost, and what are their
effectiveness? And they were virtually the same, so --

THE PRESIDENT: You know, it sounds simple, but it is a dynamic that in many
cases is absent from the health care markets because if a third party makes
that payment, he never gets to ask the question. He just accepts the
decision. And all of a sudden when you have consumers starting to ask
questions about cost, it is a governor on cost at the very minimum. And so
part of -- one way to make sure that costs don't continue to escalate is to
introduce consumer demand into health care decision making. And since HSAs
enable a consumer to own their own account and manage their own account and
make decisions for their account, we've introduced demand into the
marketplace.

Thank you two for sharing this. I signed up for an HSA. I'm feeling pretty
good these days -- (laughter) -- I think I'll have some money left over.
(Applause.) But recognizing that I can prevent disease, I want to encourage
people to exercise on a regular basis, make wise choices about what you put
in your body, be mindful of what you eat. And if you happen to be an HSA
owner, like the three of us, you will realize -- more likely realize
savings that you can roll over, tax-free, and call your own.

Hopefully, one of these days when I get to be an old guy, my HSA will be
bulging with money -- (laughter) -- and I will be comfortable in the
security of retirement because my HSA will be a part of a -- you know,
other options to provide good health care for me and my family.

We've got Rich Parsons with us. I actually got it right, two for three now.
What do you do, Rich?

MR. PARSONS: I run the Montgomery County Chamber of Commerce, which is a
small non-profit right here in Montgomery County, Maryland, and we
represent the employer community.

THE PRESIDENT: Good, thanks. Welcome. I'm glad you're here. You are here
not only to talk about the wonderful benefits of having a business in
Montgomery County, but as well, to discuss --

MR. PARSONS: Well, what we want to talk about is really the same issue you
just heard from a consumer standpoint, it's the lack of choice. It doesn't
affect just consumers, but small business owners in particular, and small
non-profits, like ours, we have a very small range of choices that we can
select from when we go to do what we all want to do -- which is provide our
employees with good coverage at good prices. We're finding our choices in a
state like Maryland -- even though this is one of the leading biotech and
medical innovations centers of the world today, we have about four
policies, four companies that will even write policies for small businesses
in the state. And we've got to expand choices, and that's what I wanted to
talk about today.

THE PRESIDENT: Well, I appreciate that. That's common sense, isn't it? If
you want there to be reasonable price, the more consumers have to choose in
a marketplace, the more likely it is you'll be able to find something at
the price you want. That's how the marketplace works. You're telling me,
the marketplace is somewhat restricted here.

MR. PARSONS: Well, because of regulatory factors and just the way the
marketplace has turned out here in Maryland, we are not allowed by state
law to do what some states are allowed to do, which is offer association
health plans, where my --

THE PRESIDENT: Right. Describe what an association health plan is, please?

* * * * *

THE PRESIDENT: An association health plan will allow people to pool risk --
that's what we're saying. And I happen to think that we ought to allow
small businesses to pool risk across state boundaries. In other words, I
think a restaurateur in Maryland ought to be able to combine in the same
insurance plan as a restaurateur in Texas. I think we ought to be focusing
on the social objective of making sure our small business owners can find
affordable health care so that fewer people are working uninsured, rather
than jealously guarding jurisdictional lines, for whatever reason.

And so I look forward to working with Congress to get an association health
plan out, a bill out that will allow for pooling of risk for small business
owners across jurisdictional boundaries, and non-profits, by the way,
should be allowed to pool risk, as well.

Have you heard of health savings accounts, in the meantime? I mean, these
are really great. (Laughter.)

MR. PARSONS: I learned about them at this event. I'm going to look into it.

THE PRESIDENT: You seriously ought to look into them. (Laughter.)

But Congress needs to understand that, on the one hand, you cannot complain
about people who don't have insurance and you work for a small business,
and then not allow small businesses to be able to have the opportunities in
the marketplace -- the same opportunities afforded companies with large
pools, large employee bases -- you got to give them the opportunity to be
able to shop.

And so association health plans make a lot of sense. I want to thank you
for sharing that with us, Rich.

MR. PARSONS: Well, thank you. We need the help in Congress.

THE PRESIDENT: I agree. That's what we're here to do. We're here to remind
Congress about the benefits. (Applause.)

Jesse Patton.

MR. PATTON: Correct. (Laughter.)

THE PRESIDENT: Got that right

MR. PATTON: Just like the general.

THE PRESIDENT: Yes, sir. (Laughter.) The founder and president of --

MR. PATTON: Associations Marketing Group, in Des Moines, Iowa. We're
actually an insurance agency that specializes in the sale and service of
both individual and group health insurance plans. And we do business in 42
states, so we work with individuals not only in Iowa, but across all of the
United States.

THE PRESIDENT: And Jesse wants to talk about an idea that I broached early
on, and that is to allow consumers to shop.

* * * * *

MR. PATTON: The nice thing about this proposal is that people would be able
to go across state lines, but they would still have the safety feature of
having their products still regulated by insurance division, insurance
commissioner.

THE PRESIDENT: That's an important point. Sorry to interrupt you. You were
on a roll. (Laughter.)

MR. PATTON: Go ahead, you're the President.

THE PRESIDENT: Thank you.

MR. PATTON: I'm just the general. (Laughter.)

THE PRESIDENT: So you heard Bill talk about -- he got on the Internet. He
was trying to find more information. He was worried about finding a product
that he could use. Imagine someone living in Maryland getting on the
Internet and being able to shop nationwide for an insurance plan that meets
his or her specific needs. Basically what you're saying.

MR. PATTON: Correct. If you look at an example that we did for your staff
of a 35-year-old -- an individual with a 35-year-old spouse and two
children on a $500 deductible, premiums from the various states -- my home
state of Iowa, that premium actually comes in at $430. Other states that we
looked at, those premiums are at $1,500, $1,200, $1,609. So they're up to a
thousand dollars difference in that individual rate for the same product,
same insurance carrier, just based on the state that you reside in.

THE PRESIDENT: And so, perhaps, one way to encourage reform at the state
level is to allow consumers to actually make choices. And the more
consumers that buy a product in a certain state may cause other states to
have the incentive necessary to change the regulatory burden, so that
products can be delivered at a less expensive price in their own state.

But the real question people have is, well, how do I know I'm not getting
cheated? In other words, it's one thing to open up additional consumer
price. But how do you know it's not a fly-by-night or a shyster? We caught
a guy the other day flimflamming people on the tsunami relief effort. There
was a lot of innocent folks who think they're making a contribution, in
this case, to help somebody's life, and it turns out he was a -- the FBI
found out that he was a flimflam artist. How do we make sure that the
innocent consumer is not buying a product from a company that doesn't have
the capital base necessary to provide insurance, for example?

MR. PATTON: Correct, and there's actually a couple safety features here. I,
as an insurance agent, am licensed and able to do business based on a
license I hold by the insurance division of the state that I operate in. I
must also get a non-resident license in another state that I plan to sell
business. So I'm actually regulated -- if I would sell a product here in
Maryland, I'm actually regulated by the insurance division in Maryland
under my insurance license here, plus I'm also regulated by the insurance
division in Iowa, which is my home base. And then, again, you would have
the Insurance Commissioner's Office also regulating the carrier and the
product.

THE PRESIDENT: Right. So in other words, if you're a Texan buying into
Iowa, and you feel like you've been cheated, there would be a complaint
mechanism --

MR. PATTON: Correct.

THE PRESIDENT: -- and the state would, therefore, make the decisions as to
whether or not the -- on the capital-worthiness of a particular entity
offering insurance in that state.

MR. PATTON: Correct. You would actually have two safety features. Your home
state and your state that you were buying your insurance from.

THE PRESIDENT: Right. I think it's an interesting idea. I think the more we
give choice to consumers, and the more consumers are allowed to be in the
marketplace designing and shopping for product that meets their needs, the
more likely it is we'll be able to control costs and make the marketplace
work. It works in other industry, and I think we need to bring -- I know we
need to bring market forces into the health care field.

For those of you who live in Maryland, by the way, you're fortunate to have
a governor who understands all this. I appreciate your efforts, by the way,
on medical liability reform, addressing the cost. (Applause.) And we look
forward to working with you, Governor, and other governors, as well, to do
the best we can to make this system work on behalf of consumers in the
health care field.

Finally, we've got Tammi Fleming with us, from the great city of New
Orleans, Louisiana. Isn't that right?

MS. FLEMING: Yes, you got that right. (Laughter.)

THE PRESIDENT: Tammi runs an interesting program. Why don't you describe
your program, Tammi.

* * * * *

THE PRESIDENT: The point is, is that we have programs aimed at helping
people who need help, basically is what you're saying. And one such program
is S-CHIP -- that's the Children's Health Care Insurance Program. And it's
not fully subscribed. In other words, we had the money available and states
did not access the money to help children with good health care.

* * * * *

THE PRESIDENT: The reason we've asked Tammi to come is because it's very
important for states to develop effective outreach programs. At the federal
level, we're willing to help fund outreach programs. We think it's
important for people who qualify for the S-CHIP program to know that that
program is available, without stigma. And it is an effective way to provide
our children with the insurance we want our children to have.

And so what Tammi is saying is she's pointing up the fact that we need a
grassroots effort across the country to enable people to know what is
available for the Children's Health Care Program.

* * * * *

THE PRESIDENT: Well, I appreciate what you're doing. Walkers and talkers.
That's good; good job.(Applause.)

Well, listen, I want to thank you all for joining the discussion. The
solution is -- is one that -- the solution to health care costs is one that
requires a myriad of approaches, as opposed to a single federal government
approach. I believe the more we empower people to make decisions, the
better off we are in terms of achieving a national objective, which is
affordable health care that's available. And I want to thank you all for
sharing with people innovative ideas.

I'm pleased to inform you that Dr. Condi Rice has just been confirmed by
the United States Senate. (Applause.) She will be a great Secretary of
State for the United States of America. I'm honored to be working with her,
and I look forward to spreading freedom and peace.

Thank you all for coming. May God bless you all. (Applause.)

END 12:29 P.M. EST

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