John McCain

thank you for the opportun to talk todai about the american health_care_system __PUNCT__

you don't have to be a candid for presid to discov that worri over the avail and cost of health care troubl the wake hour and disturb the sleep of more american than ani other singl domest issu __PUNCT__

inde __PUNCT__ outsid of the pre __PUNCT__ emin challeng of our time __PUNCT__ the threat of islam extremist __PUNCT__ no issu come up more frequent in larg and small public_discuss __PUNCT__ in poll __PUNCT__ debat and media_report __PUNCT__

so it is sure appropri that the subject figur promin in thi presidenti_elect __PUNCT__

and in our eager to appear respons to thi acut public concern __PUNCT__ everi candid will feel_compel to offer hi or her __PUNCT__ solut __PUNCT__ to the problem __PUNCT__

but will these solut actual improv our health_care_system __PUNCT__ or will thei mere serv as the candid __PUNCT__ open ant in what look to becom a bid war __PUNCT__ in our hast will we promis more than we can deliv __PUNCT__ will we misdiagnos the problem and devis a cure that will kill the patient __PUNCT__ will we even ask ourselv that first __PUNCT__ most import of question __PUNCT__ what exactli is the problem with the american health_care_system __PUNCT__ the problem __PUNCT__ my friend __PUNCT__ is not that american don't have fine doctor __PUNCT__ medic technolog and treatment __PUNCT__

the state of our medic_scienc is the envi of the world __PUNCT__

the problem is not that most american lack adequ health_insur __PUNCT__

the vast_major of american have privat_insur and our govern_spend billion each year to provid even more __PUNCT__

the biggest_problem with the american health_care_system is that it cost too much __PUNCT__ and the wai inflationari pressur ar actual built into it __PUNCT__

busi and famili pai more and more everi year to get what thei often consid to be inadequ attent or poor care __PUNCT__

and those who want to bui_insur ar often unabl to becaus of the high_cost __PUNCT__

what more compel evid of the problem do we need than to note that gener_motor now spend more for health_care of it employe and retire than for the materi requir to manufactur it product __PUNCT__ steel __PUNCT__

the price of everi gm car includ over __MONEY__ for health_care_cost compar to toyota whose total_cost for healthcar per car is about __MONEY__

the growth of cost affect everyon __PUNCT__ govern overspend __PUNCT__ busi cost and famili budget __PUNCT__

it hurt those who have insur by make it more expens to keep __PUNCT__

and it hurt those who don't have insur by make it even harder to attain __PUNCT__

we ar approach a __PUNCT__ perfect storm __PUNCT__ of problem that if not address by the next presid __PUNCT__ will caus our health_care_system to implod __PUNCT__

here is what we know __PUNCT__ first __PUNCT__ we current spend __NUM___trillion trillion_dollar __PUNCT__ __NUM___cent of everi dollar we spend __PUNCT__ on health_care __PUNCT__

by __NUM__ just seven year from now __PUNCT__ that number will nearli doubl to four trillion_dollar __PUNCT__

second __PUNCT__ by __NUM__ medicar will be broke __PUNCT__

we ar current spend more on medicar than we ar collect in payrol_tax and cash in the few iou left in the trust_fund __PUNCT__

in the meantim __PUNCT__ more and more of our retire __PUNCT__ social_secur check will also go to pai for medicar leav our senior with less monei for their everydai expens __PUNCT__

third __PUNCT__ by __NUM__ more monei will be go out of social secur than is come in __PUNCT__

the next presid must act to avert the impend __PUNCT__ storm __PUNCT__

for all the grandios promis made in thi campaign __PUNCT__ ha ani candid spoken honestli to the american_peopl about the govern_role and fail about individu_respons __PUNCT__ ha ani candid told the truth about the futur of medicar __PUNCT__ it cost ar grow astronom faster than it financ __PUNCT__ and leav it structur flaw unaddress will hasten it bankruptci __PUNCT__

ha ani candid warn that we have a person_respons to take better care of ourselv and our children __PUNCT__ yet that is the onli wai to prevent mani chronic diseas __PUNCT__

ha ani candid insist that genuin and effect health_care_reform requir account from everyon __PUNCT__ drug_compani __PUNCT__ insur_compani __PUNCT__ doctor __PUNCT__ hospit __PUNCT__ the govern and patient __PUNCT__ yet that is the truth upon which ani so __PUNCT__ call solut must be base __PUNCT__

democrat_presidenti presidenti_candid ar not tell you these truth __PUNCT__

thei offer their usual default posit __PUNCT__ if the govern would onli pai for insur everyth would be fine __PUNCT__

thei promis univers_coverag __PUNCT__ whatev it cost __PUNCT__ and the massiv tax_increas __PUNCT__ mandat and govern_regul that it impos __PUNCT__

i offer a genuin conserv vision for health_care_reform __PUNCT__ which preserv the most essenti valu of american_live __PUNCT__ freedom __PUNCT__

conserv believ in the pursuit of person __PUNCT__ polit and econom_freedom for everyon __PUNCT__

we believ that free_peopl mai voluntarili unit __PUNCT__ but cannot be compel to do so __PUNCT__ and that the limit_govern that result best protect our individu_freedom __PUNCT__

in health_care __PUNCT__ we believ in enhanc the freedom of individu to receiv necessari and desir care __PUNCT__

we do not believ in coercion and the us of state_power to mandat care __PUNCT__ coverag or cost __PUNCT__

i believ american want to be part of a system that offer high qualiti care __PUNCT__ that respect their individu digniti and is avail at reason cost __PUNCT__

unfortun __PUNCT__ the american health_care_system as it is current structur fail thi test __PUNCT__

it is too expens __PUNCT__

it insult our common_sens and digniti with excess paperwork __PUNCT__ disconnect visit with too mani specialist __PUNCT__ and by elabor hide from us ani clear idea of what we ar get for our monei __PUNCT__

we must reform the health_care_system to make it respons to the need of american_famili __PUNCT__

not the govern __PUNCT__

not the insur_compani __PUNCT__

not tort lawyer __PUNCT__

not even the doctor and hospit __PUNCT__

the next presid will have to take on the special_interest that thrive in the health_care_system __PUNCT__

doctor must do a better job of manag our care and keep us healthi and out of hospit and nurs_home __PUNCT__

we will need altern to doctor __PUNCT__ offic and emerg_room __PUNCT__

hospit must do a better job of take care of us when we ar there __PUNCT__ commit far fewer deadli and costli medic_error and gener oper more effici __PUNCT__

pharmaceut_compani must worri less about squeez addit profit from old medicin by copi the last success drug and insist on addit patent protect and focu more on new and innov medicin __PUNCT__

insur_compani should spend more on medic_care and less on __PUNCT__ administr __PUNCT__

my reform ar built on the pursuit of three goal __PUNCT__ pai onli for qualiti medic care __PUNCT__ have insur choic that ar divers and respons to individu need __PUNCT__ and restor our sens of person_respons __PUNCT__

these reform ar also built on the most fundament of medic tenet __PUNCT__ do no harm __PUNCT__

there is much to be admir about medicin in america __PUNCT__ and i want to protect those qualiti __PUNCT__

doctor and other provid want to provid qualiti care __PUNCT__

lower_cost mean that medicar premium don't continu to spiral beyond our abil to sustain it __PUNCT__ and our insur_premium ar stretch farther __PUNCT__

most importantli __PUNCT__ ani reform must respect the freedom to keep your care and insur just as thei ar __PUNCT__

the first princip of real_reform is that american should pai onli for qualiti __PUNCT__

right now __PUNCT__ too much of the system is built on get paid just for provid servic __PUNCT__ regardless of whether those servic ar necessari or produc qualiti care and outcom __PUNCT__

american_famili should onli pai for get the right care __PUNCT__ care that is intend to improv their health __PUNCT__

american famili know qualiti when thei see it __PUNCT__ so their dollar should be in their hand __PUNCT__

when famili ar inform about medic choic __PUNCT__ thei ar more capabl of make their own decis __PUNCT__ less like to choos the most expens and often unnecessari option __PUNCT__ and ar more satisfi with their choic __PUNCT__

health save_account ar tax __PUNCT__ prefer account us to pai insur_premium and other health_cost __PUNCT__

thei put the famili in charg of what thei pai for __PUNCT__ and should be expand and encourag __PUNCT__

i am commit to ensur the finest qualiti medic_care for our veteran __PUNCT__

thei have earn that consider and more __PUNCT__

thei should not have to wait for access to a va facil that is hour awai __PUNCT__

we can give them the option to put the mean for financ their care under their control __PUNCT__ in an electron card or other devic __PUNCT__ so that if thei want thei can choos their care in anoth wai that suit them best __PUNCT__

we cannot let the search for high __PUNCT__ qualiti care be derail by frivol lawsuit and excess damag award __PUNCT__

we must pass medic liabil reform __PUNCT__ and those reform should elimin lawsuit for doctor that follow clinic guidelin and adher to patient safeti protocol __PUNCT__

if the democrat ar sincer in their convict that health_care coverag and qualiti is their first prioriti __PUNCT__ than thei will put the need of patient befor the demand of trial_lawyer __PUNCT__

but thei can't have it both wai __PUNCT__

research_show that coordin care __PUNCT__ provid collabor to produc the best health outcom __PUNCT__ offer better qualiti and cost less __PUNCT__

we should pai a singl bill for high __PUNCT__ qualiti heart care __PUNCT__ not an endless seri of bill for pre __PUNCT__ surgic test and visit __PUNCT__ hospit and surgeri __PUNCT__ and follow __PUNCT__ up test __PUNCT__ drug and offic visit __PUNCT__

pai for coordin care mean that everi singl provid is now unit on be respons to the need of a singl_person __PUNCT__ the patient __PUNCT__

health inform_technolog will flourish becaus the market will demand it __PUNCT__

clinic __PUNCT__ hospit __PUNCT__ doctor __PUNCT__ medic technolog produc __PUNCT__ drug_compani and everi other provid of health_care must be account and their transact transpar __PUNCT__

famili __PUNCT__ insur_compani __PUNCT__ the govern __PUNCT__ whoever is pai the bill __PUNCT__ must understand exactli what their care_cost and the outcom thei receiv __PUNCT__

famili place a high valu on quickli get simpl care __PUNCT__ and have shown a willing to pai cash to get it __PUNCT__

if walk __PUNCT__ in clinic in retail outlet ar the most conveni __PUNCT__ cost __PUNCT__ effect wai for famili to safe meet simpl need why should govern stand in their wai __PUNCT__ i will not __PUNCT__

if the cheapest wai to get high qualiti care is to us advanc in web technolog to allow a doctor to practic across state_line __PUNCT__ then let them __PUNCT__

in disast like katrina we saw how stupid and harm it is to refus the servic of doctor just becaus thei had an out __PUNCT__ of __PUNCT__ state address __PUNCT__

we should have a nation market place __PUNCT__ and if i elect_presid __PUNCT__ we will __PUNCT__

drug ar an import_part of medicin __PUNCT__ of cours __PUNCT__ and ar often quit expens __PUNCT__

here in iowa the attornei_gener is su seventi __PUNCT__ eight drug_compani accus them of inflat drug cost paid by iowa taxpay through the medicaid system __PUNCT__

problem with cost ar creat when market_forc ar replac by govern_regul price __PUNCT__

if drug cost reflect valu __PUNCT__ fine __PUNCT__

but if there ar wai to bring greater competit to our drug market by safe re __PUNCT__ import of drug __PUNCT__ by faster introduct of gener drug __PUNCT__ or by ani other mean we should do so __PUNCT__

if i elect_presid __PUNCT__ we will __PUNCT__

govern_program such as medicar and medicaid should lead the wai in health_care_reform that improv qualiti and lower_cost __PUNCT__

like most of our system __PUNCT__ medicar reimburs now reward institut and clinician who provid more and more complex servic __PUNCT__

we need to chang the wai provid ar paid to focu their attent more on chronic diseas and manag their treatment __PUNCT__

thi is the most import care and expens for an ag_popul __PUNCT__

and in a system that reward qualiti __PUNCT__ medicar should not pai for prevent medic_error __PUNCT__

i am appreci of the therapeut benefit of modern pharmaceut __PUNCT__

howev __PUNCT__ i strongli_oppos ad anoth unfund entitl to the fiscal train wreck that is medicar by provid all senior with a costli drug_benefit __PUNCT__ even those __PUNCT__ like me __PUNCT__ who can more than afford to pai for their medicin __PUNCT__

the second principl of effect reform is to have insur choic so vari and respons to individu need that you could fire your insur_compani if you want to __PUNCT__

right now __PUNCT__ too mani of our citizen don't have an insur_polici at all __PUNCT__ and those who do ar afraid thei will lose the on thei have __PUNCT__ afraid thei will get too sick __PUNCT__ afraid to stai_home and not work_full __PUNCT__ time __PUNCT__ and afraid their benefit will disappear along with their job __PUNCT__

i believ that everyon should get a tax_credit of __MONEY__ for famili __PUNCT__ if thei have health_insur __PUNCT__

it is good tax_polici to take awai the bia toward give worker benefit instead of wage __PUNCT__

it is good_health health_polici to reward have insur no matter where your polici come from __PUNCT__

to us their monei effect __PUNCT__ american need more choic __PUNCT__

we should give addit help to those who face particularli expens care __PUNCT__

if it is done right and the addit monei is there __PUNCT__ insur_compani will compet for these patient __PUNCT__ not turn them awai __PUNCT__

it is a challeng to develop techniqu that alloc the right amount to each of these famili __PUNCT__

i propos that we try a time __PUNCT__ honor approach and let the state work on whatev method thei find most promis __PUNCT__

the feder_govern can help fund thi effort __PUNCT__ but in exchang __PUNCT__ state should allow medicaid and schip fund to be us for privat_insur and develop method to augment medicaid and tax_credit for more expens care __PUNCT__

famili __PUNCT__ base polici translat into broad success when thei ar pair with greater competit among insur on a level plai_field __PUNCT__

you should be abl to bui your insur from ani will provid __PUNCT__ the state bureaucraci ar no better than nation on __PUNCT__

nationwid insur_market that ensur broad and vigor competit will wring out excess cost __PUNCT__ overhead __PUNCT__ and bloat execut compens __PUNCT__

introduc competit into the health_insur insur_market will reduc cost __PUNCT__

some ar alreadi content with the choic and advic offer by their employ __PUNCT__

fine __PUNCT__

but american should be abl to choos who thei trust __PUNCT__

if a church or profession organ wish to sponsor insur for it member __PUNCT__ thei should be abl to do so __PUNCT__

when an american_famili control it own health_care financ __PUNCT__ ha a wide_varieti of low __PUNCT__ cost __PUNCT__ innov choic __PUNCT__ and receiv insur through a sponsor thei trust __PUNCT__ insur_polici will onli disappear when the famili decid it doesn't serv them as well as a competitor would __PUNCT__

the final import principl of reform is to rediscov our sens of person_respons __PUNCT__

we must person do everyth we can to prevent expens __PUNCT__ chronic diseas __PUNCT__

our right in thi countri ar protect by our person sens of respons for our own well be __PUNCT__

case of diabet ar go up __PUNCT__ not onli in the babi boom gener __PUNCT__ but among younger_american obes __PUNCT__ diabet and high blood_pressur ar all on the rise __PUNCT__

parent who don't impart to their children a sens of person_respons for their health __PUNCT__ nutrit and exercis __PUNCT__ vital qualiti of life inform that polit_correct ha expel from our school __PUNCT__ have fail their respons __PUNCT__

also __PUNCT__ parent ar respons for ensur that their children ar cover health_insur if __PUNCT__ as is often the case __PUNCT__ mani option ar alreadi avail to them __PUNCT__

we can build a health_care_system that is more respons to our need and is deliv to more peopl at lower_cost __PUNCT__

the __PUNCT__ solut __PUNCT__ my friend __PUNCT__ isn't a on __PUNCT__ size __PUNCT__ fit __PUNCT__ all __PUNCT__ big_govern govern_takeov of health_care __PUNCT__

it resid where everi import social advanc ha alwai resid __PUNCT__ with the american_peopl themselv __PUNCT__ with well inform american_famili __PUNCT__ make practic decis to address their imper for better health and more secur prosper __PUNCT__

the engin of our prosper and progress ha alwai been our freedom and the sens of respons for and control of our own destini that freedom requir __PUNCT__

the public_trust in govern wax and wane __PUNCT__

but we have alwai trust in ourselv to meet ani challeng that requir onli our ingenu and industri to surmount __PUNCT__

ani __PUNCT__ solut __PUNCT__ that rob us of that essenti sens of ourselv is a cure far wors than the afflict it is meant to treat __PUNCT__