‘My Fellow Americans…’ The Address Obama Should Give to Congress Next Week

ObamaCongressMy Fellow Americans.

I stand before you a chastened president. I made a mistake. Two mistakes really. (wild applause from Republican side)

I thought that Congress could do its job and through the deliberative process, produce a health care reform plan that would win broad support across the aisle and among all of you. But I’m afraid that I was wrong. Health care is an enormous industry—maybe the biggest and most powerful industry in the country—and it has far too much power in Congress. Literally thousands of lobbyists, carrying tens of billions of dollars in campaign contributions—have invaded these halls and distorted the process, and in the end have stymied reform. (some hissing)

Meanwhile, I have realized that the answer has been staring us in the face all along.

And that was my second mistake. I told the American Medical Association that while single-payer medical plans, where the government is the insurer, might work well in other countries, the idea of government running health care was not part of our American tradition. In fact, it is, and has been since 1965, when President Lyndon Johnson signed into law the Medicare program. Medicare is a single-payer program, and polls and surveys show it is enormously popular with older and disabled Americans. Medicare has relieved our parents and grandparents from the fear that they will not get medical care when they stop working, and it has lifted the enormous burden and worry off of younger Americans over how to pay for the care of their elders, and it has done this with enormous efficiency, all while allowing recipients to choose their own doctors and hospitals. (applause)

So we really don’t need to re-invent the wheel. There is no point in members of Congress having to hold endless hearings, and to sit and listen to the pitches of lobbyists from the medical establishment. We can just expand Medicare to cover everyone. (applause)

How much would that cost? Well, we know that 10% of the elderly—the oldest and sickest among them–account for 50% of total Medicare costs, so that means the other 90% only cost some $200 billion a year. Even if we assumed that the rest of the population’s medical bills were as high as those 90%, it would mean that expanding Medicare to cover them would cost less than $1 trillion a year, and probably closer to $750 billion. So roughly speaking, we’re talking about adding $750 billion a year to the cost of Medicare.

Now that’s a big number, and I know that some of you—a lot of you—worry about higher taxes. But let me assure you, expanding Medicare to cover everyone is going to save you money—virtually everyone. Let’s look at why that is, and why you cannot just look at the federal tax when you consider those savings.

Today, the United States spends nearly 20 percent of GDP on health care. That is more than double what any other country in the world spends on health care. And you know what? We don’t get our moneys’ worth for all that dough. Canadians, who spend half that percentage of their GDP on health care, and who have what amounts to Medicare for all with their single-payer system (they call it Medicare too), have longer lifespans and better infant mortality statistics than we do. In fact, Cuba and Mexico have better child health statistics than we do!

By the way, I want to introduce, in the gallery, Shirley Jean Douglass, whose father, Tommy Douglass, was the founder of Canada’s Medicare program. We will be consulting closely with experts and administrators of Canada’s Medicare program as we move forward with our own reform. (applause)

Now I’ve been accused of lecturing (laughs and applause), and I don’t want to sound like a college professor here, but let me just highlight a few reasons why simply expanding Medicare to cover all of us makes not just moral but economic sense. If we were to make that change, we could immediately eliminate the Medicaid program, which as you know is funded by the states, and costs them (and you) about $400 billion a year, mostly to cover low-income families and individuals.

Now that money would not be totally eliminated, because Medicare currently doesn’t cover all health care costs—just 80%. And MEDICAID covers the remaining 20% for those elderly and disabled people who cannot afford to pay for Medi-Gap private plans. Even so, eliminating MEDICAID for the poor, who would be switched to Medicare, would save at least $300 billion. We could also eliminate the Veterans Administration—which incidentally is an excellent example of true government healthcare, with publicly owned hospitals and doctors on salary, and it runs very well and very efficiently.

Something those folks at last month’s town meetings who were saying government can’t do anything right should think about. (wild applause from Democratic side)

Sorry. I just had to say that. (more applause)

Anyhow, eliminating the VA would save another $100 billion so we’ve already saved more than half the amount that was added to the cost of Medicare in order to cover everyone. (applause)

But there are far more savings.

One of the biggest would be the elimination of about $300 billion that is spent each year by hospitals and doctors to provide care to people with no insurance who end up in hospital emergency rooms. The cost of this “charity care” is factored into higher hospital and physician bills, and ultimately into higher insurance premiums paid by the rest of us. Since all those people would now be covered by Medicare, that expense would vanish.

American companies currently pay about 25 billion a year in workers compensation insurance—money that ultimately comes out of workers’ paychecks. That would no longer be necessary, because people injured on the job would be covered by Medicare. (smattering of applause mostly from Republican side)

Car insurance rates would be dramatically lower, because car insurance would no longer have to pay for medical costs following an accident. The same is true for homeowners insurance, which would no longer have to cover the costs of someone being injured on your property. (applause from Pennsylvania delegation, with among the highest car insurance rates in the nation)

And of course, the biggest savings of all—about $3000 per person or $12,000 per family every year—namely the cost of private insurance premiums paid by you and/or your employer, would be gone. Think about that a minute: no more co-pays, no more annual deductibles, no more employee share of insurance premiums for yourself or your family. And for businesses that provide health care coverage, a huge savings that will make them more competitive in the global marketplace, and that will also allow them to pay higher wages to their employees. (prolonged applause)

Oh, and there is one other huge, if unquantifiable savings to consider. If everyone has Medicare, the total cost of health care will go down dramatically, because everyone will be getting timely treatment, instead of having to put of exams and early treatment of illness or injury. And no one will suffer the terrible anxiety or worrying about whether they can pay for health care for themselves and their families.

So yes, your Medicare withholding will be perhaps 25% higher if we expand Medicare to cover everyone. That tax is currently set at 2.9% for you and 2.9% for your employer, so it would go up to about 3.7% of your paycheck. For someone earning $600 a week, that would represent an increased deduction of about $4.50 a week. For someone earning $1200 a week, it would be an increased deduction of $9. That is a pretty good deal for not having to pay for insurance coverage any more, wouldn’t you agree? (applause, plus some boos from largely silent Republican side)

Now for you folks already receiving Medicare, there have been a lot of scare stories out there, some of them being promoted by some irresponsible people right in this chamber (pause for applause and nervous laughter), suggesting that if we expand health care coverage, it will come off of your benefits. Don’t you believe it! (applause)

We live in a democracy, and when a lot of people want something, or benefit from something, they collectively defend that particular thing.  In the case of Medicare, if everyone is receiving it, and receiving it in the same manner as everyone else, that creates a huge voting bloc in favor of defending that benefit, so by expanding Medicare to all, we would be creating a powerful political force that will defend Medicare from attack, just as the universality of Social Security has made that program bullet-proof (something my predecessor learned when he tried to promote the idea of privatizing it). (wild applause from Democratic side)

So here’s the deal.

I’m admitting it was the wrong move to try to lay it on you poor folks in Congress come up with some completely new, complicated reform our existing health care system—if you can even call it that. My good friend and former colleague in this building, Chairman John Conyers, had it right all along: We have a great system that we just need to expand to cover everyone.

So to get it started, I’m going to send Congress a couple of bills. One would immediately shift everyone eligible for Medicare over to Medicare. I’m calling this the States’ Medical Cost Relief and Medicare Expansion Act. It will not only begin the process of expanding Medicare, but will provide badly needed financial relief to states that are suffering from declining tax revenues and rising health care costs because of the recession. (applause)

I will also send Congress a bill that will expand Medicare coverage to all Americans and to legal residents. (applause, some boos from Republicans)

I am sure that as financially sound as this change is, there will be opposition from the medical industry, so let me add that this is, for me, a moral imperative too. For too long, this great country has allowed health care to be a matter of whether or not you had a job with health benefits, or enough money to pay for insurance yourself. That is unacceptable. We are our brothers’ and sisters’ keepers, and just as we believe that every child needs an education, we believe that everyone deserves to have access to quality medical care. (loud applause)

So let me add this: If Congress does not pass these two bills by the end of the current session, in time for the holiday recess in December, I will declare a national emergency because of the recession and the huge rise in the uninsured that it has caused, and will issue executive orders implementing both these measures.  It’s not the way I would prefer to see things done, but if Congress cannot act, I promise you and the American people, I will. (applause and boos)

Let me also say that this program is a priority for me and for all Americans, and anyone—Republican or Democrat—who gets in the way can expect to hear from me, and from the American people, in this coming election year. (applause)

Thank you and good night.  (applause)

Dave Lindorff is a Philadelphia-based journalist. He is author of Killing Time: An Investigation into the Death Penalty Case of Mumia Abu-Jamal (Common Courage Press, 2003) and more recently of The Case for Impeachment (St. Martin’s Press, 2006). His work is available at

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17 Responses for “‘My Fellow Americans…’ The Address Obama Should Give to Congress Next Week”

  1. K Mac says:

    Thank you for the eloquence.

  2. Justin says:


  3. Pagan says:

    Let me just put it very simply, I will not support a tyrannical government who is responsible for everything from an illegal war to a rape of its citizens as in the Wall Street/Banking bailouts to control my healthcare. It completely baffles my mind that those who speak out against this tyrannical government choose to reward them with even more power and control.

  4. dobropet says:

    Well put pagan, I’d also like to see someone cite in the Constitution where the government gets its authority to delve into our health care system.

  5. dobropet, are you familiar with Medicare?

  6. The real question is: are you familiar with the Constitution. Basically, what the Constitution does is say what powers are reserved to the states, and the Bill of Rights enumerates freedoms that we the people have. There’s no ban on the government running a health insurance program like Medicare. There’s no ban on the government running a socialized health system like the VA, where the docs are on salary and the hospitals are owned by the government.

    Dave Lindorff

  7. nicely articulated, Dave.

  8. Pat says:

    Considering that the combined unfunded liablities for Soc Sec, Medicaid & Medicare is close to $100 trillion dollars, I hardly think those programs are something on which we should base health care for all.

    And to paraphrase Margaret Thatcher – the problem with socialism is that eventually you run out of other people’s money to spend.

    BTW – we live in a democratic republic, not a democracy.

  9. the “unfunded liabilities” claim is completely bogus. Just for one example, by merely eliminating the cap on the income that is taxed for Social Security, the “problem” faced by Social Security “running out of money” would be pushed way past 2074 into the next century, at which point the whole notion becomes ridiculous, since the baby boom generation which is the cause of the temporary problem will be long gone. Medicare runs out of money sooner, but that’s because of the baby boomers too. Again, lifting the cap so everyone pays solves most of it, and then, if we had to raise the tax from 2.9% to twice that high–say 5.5%, it wouldn’t exist, and if you explained it to everyone by saying, “you don’t want to have to take care of your parents’ medical bills do you?”, who’d complain? (I’m saying this in the context of everyone having Medicare and nobody having to pay insurance premiums).

    I always have to laugh when right wingers say the sky will be falling in 2070 or 2074 with regard to social security. The same people don’t want to do anything about climate change, which will melt the entire North Pole away by 2030 for gods’ sake, or about the destruction of the Amazon rainforest, which will be gone long before then, or about the end of the world’s fisheries, which will be gone in a decade. But take something so far off that we’ll all be long dead and gone when (if) it happens, and they’re all in a tizzy. Wait! That’s because the other things are about the earth’s survival. This one is about money, and whether they have to pay taxes now for someone else’s (including their own grandchildren’s) benefit.

    The problem with America is it was founded by tax resisters, and the debate is still dominated by tax resisters. The truth? Americans pay less in taxes than any Europeans, and yet Europeans get much more for their tax money than we do.

    If you want to see where our real problem is, look to the one trillion dollars a year we spend on war–all of it pointless. Cut the war budget in half or by two-thirds, and we solve every financial problem faced by the US, Social Security and Medicare included.

    Dave LIndorff

  10. dobropet says:

    Back to the point, Dave & Jason, the existing laws regarding Medicare are unconstitutional period;

    Anybody with the power to attempt to FIX the problem with Medicare would only exacerbate this already broke system;

    Not to mention the even more potentially serious malfunctions within it;

    All the promises the left is giving on healthcare reform mimic all of the past debates on this unconsitutional program;

    As for skyward predictions, I suggest you look to our own scientists for comfort if you have any interest as to what they’ve discovered;

    So keep laughing, calculation regarding this system is what the left counts on to further their agenda;

    Finally, a civil discussion, thanks for the compelling argument guys, nice to see some people still have dignity in this realm.

  11. dobropet says:

    How do I get a cool photo up on here like Jason almighty.

  12. Woody says:

    Way up near the top of the document, the Constitution constitutes the responsibility of the State to <a href="; "…promote the general welfare…"

    Would cover it if you were, say, marginally literate…

    Which of those four words id giving you trouble, cully??

  13. Woody says:

    Snark looks bad when you drop a tag: Way up near the top of the document, the Constitution constitutes the responsibility of the State to “…promote the general welfare…”

  14. dobropet says:

    So you suggest that “promote’ means regulate?

  15. dobropet says:

    Really, marginally literate right?

    welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD

    Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution.

    Once again enlightenment for all.

  16. stillahippie says:

    Why not get the insurance company’s of our backs they add nothing to health care except cost yes I know these guys want to keep they’re big salary big bonus jobs but those big costs are added to the cost we pay for health care. are you afraid of the word SOCIALISM if so you need to drink some warm milk and calm down maybe concentrate on another word EXTORTION. Then run Walgreen’s and fill your prosaic script.Oh you just don’t like president Obama and you are trying to bust his chops, well thats not being a very good American.Lets just stop all this crap if you want public option you better go call your congressmen and senators and the president if you don’t think its worth the effort do nothing it wont pass

  17. dobropet says:

    I ain’t afraid of no ghost….

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