will be good for you too. congressman stark went into that earlier on the program a little bit but one of the mistakes democrats think we've made in the clinton years when they tried to reform health care is they focused on the uninsured, not on the insured, who want their coverage to be better and premiums lower and out of pocket expenses to be lower. if you can't persuade those people this will be good for them, they're going to be against it, especially if they're saying through one means or another they're being asked to pay to help provide coverage to other people. as i've heard said before, altruism is not a good political strategy. if middle class voters are being asked to pay a tax on the health benefits they get from their employer, if they're asking -- if they're being asked to pay a tax on a can of soda or anything, if they see it's only going to provide insurance to other people, they're not going to like it.

>> let me go back to the politics of all of this. are there members of the house or senate and you say if he or she supports or opposes these people, that tells me something. who are they? >> the bellwether in the senate is olympia snowe of maine, she's closely involved in talks with the chairman of the finance committee over there, trying to craft a bipartisan bill, she's a republican, she's probably the most likely republican to support any democratic health overhaul. in the house, there's a guy named jim cooper, i guess, he was kind of infamous in the debate on clinton's plan in the early 1990's, he was one of the first democrats to come out and highlight some problems he thought were in the plan. he's already kind of making some noise now about huh he wants the bill to be bipartisan, he has certain requirements that he wants for this government-run plan that they're going to create he has certain requirements he wants

that to follow, it's not clear yet whether they're going to follow those guidelines. >> and finally, hearings that will begin this week and next week, then what? >> the house will do hearings this week, all week long, in all three committees, i don't know how i'll keep track of that, then congress leaves for a week and goes home. we'll see what they hear from their constituents, we'll see what they do to persuade people. when they come back, in the house, they promised -- the speaker stood next to the president and said they're going to pass the bill by july 31. despite the questions about thousand put the bill together and pay for it, the house being the house, they can -- when they have a bill they can essentially do whatever they like, because the majority rules are very strong there. we can expect, unless there's a collapse, that the house will meet that deadline and have their version of the bill passed by the end of july.

the senate initially set the same timetable but the senate takes longer to do things and have run into a few snags and trying to get agreements, not just with republicans, which they're not trying to do in the house very much, but even among democrats in the senate. what the president told members of congress at the white house he wants something he can sign by the middle of october. a very ambitious goal. >> gentlemen, thank you for being with us this week. appreciate your time. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]

speech last week on health care to the american medical association. that will be followed by house republicans discussing health care legislation. after that, tennessee congressman jim cooper on his opposition to parts of the health care bill. >> people don't want to think of roosevelt's conservation as a policy so much as a passion he put aside 240 -- almost 240 million acres of wild american. now people are talking about environmentalism and green movements, roosevelt is becoming the key figure to understand, because he was the only politician of his day who had absorbed darwin and understood biology and understood birds' migratory patterns and understood mating habits of deer and elk and antelope and did something. >> sunday on "q&a," the first of two hours with douglas brinkley on "the wilderness warrior" tonight on c-span or on xm satellite radio or down

load the podcast. >> on monday, president obama delivered his most detailed speech to date on health care. the president spoke before the american medical association in chicago a group that opposed the clinton administration's health care plan. this is just over an hour. >> the house will come to order. it's my privilege to introduce dr. nancy h. neilsen, president of the american medical association. [applause]

>> thank you. thank you. see, i've watched the president, he goes thank you, thank you, and you sit down. good morning,ern. it's a great, great honor and privilege for us to welcome back home to chicago the president of the united states, barack obama. [applause] the president will be coming in in just a second. just a couple of words to him. mr. president, we appreciate that you've taken the time out of a busy schedule to join us and we're grateful for your efforts to make the path toward health system reform as open and inclusive as possible and

in particular that we have been included in those efforts. you have said that a test of the american ideal is whether we allow ourselves to be shaped by events and history or whether we act to shape them. america's physicians want to help shape a better future for our patience and our country. [applause] we know firsthand that change is needed and that the status quo isn't acceptable. [applause] we appreciate the investment you've already made to help physicians in four areas.

first, the purchase of health i.t. equipment, and we look forward to standards for interoperability. and we thank you for the investment in comparative effectiveness research to enhance quality medical care. [applause] in your budget, you used realistic numbers about the cost of treating medicare patients and you charted a course to replace the senseless medicare physician payment formula and you're the first president to do it and we thank you for that. you've recognized that medical liability concerns contribute

to rising health care costs and we appreciate your interest in addressing this problem. it is critical to the physicians of this country. friends, i've had the opportunity to meet president obama at the white house and i can attest to his willingness to listen and engage. his focus on health care reform and the flight of the uninsured and the concerns of those involved takes a courageous spirit and wise judgment. and we're grateful for his leadership system of please join me as the american medical association welcomes the president of the united states, barack obama. [applause]

>> thank you. [applause] thank you. thank you so much. good to see you. thank you. thank you so much. please, everybody, be seated. thank you very much. you're very kind. thank you. let me begin by thanking nancy for the wonderful introduction. i want to thank the speaker of the house of delegates, thank you all for bringing me home,

even if it's just for a day. from the moment i took office as president, the central challenge we've confronted as a nation has been the need to lift ourselves out of the worst recession since world war ii. in recent months, we've taken a series of extraordinary steps, not just to repair the immediate damage to our economy, but to built a newfoundation for lasting and sustained growth. we're stemming the loss of homes and the decline of home values. all this is important. even as we've made progress, we know that the road to prosperity remains long and it remains difficult. we also know that one essential

step on our journey is to control the spiraling cost of health care in america. in order to do that, we're going to need the help of the a.m.a. [applause] today, we are spending other $2 trillion a year on health care, almost 50% more a person than the next most costly nation. and yet, as i think many of you are aware, for all of this spending, more of our citizens are uninsured, the quality of our care is often lower, and we aren't any healthier. in fact, citizens in some countries that spend substantially less than we do are actually living longer than we do. make no mistake.

the cost of our health care is a threat to our economy. it's an escalating burden on our families and businesses. it's a ticking time bomb for  the federal budget. and it is unsustainable for the united states of america. it's unsustainable for americans like lauren kliss -- klitska, a young mother i met in wisconsin last week who learned the breast cancer she thought she'd beaten has spread to her bone bus who is now being forced to spend time worrying about how to cover the $50,000 in medical debt she's already accumulated, worried about future debts she's going to accumulate, when all she wants to do is spend time with her two children and focus on getting well. these are not the worries that a woman like laura should have to face in a nation as wealthy as ours. [applause]

stories like laura's are being told by women and men all across the country, by families who have seen out of pocket costs soar and premiums double over the last decade at a rate three times faster than wages. this is forcing americans of all ages to go without the checkups or prescriptions they need. that you know they need. it's creating a situation where a single illness can wipe out a lifetime of savings. our costly health care system is unsustainable for doctors. like michael cohn in new hampshire who, as he puts it, spends 20% of each day, supervising a staff, explaining insurance problems to patient, completing authorization form, writing appeal letters a routine he calls disruptive and distracting, giving him less

time to do what he became a doctor to do and actually care for his patients. [applause] small business owners, like chris and becky link in nashville, are also struggling. they've always wanted to do right by their workers and their family-run marketing firm. but they've recently had to do the unthinkable and lay off a number of employees, lay off -- layoffs that could have been deferred if health care costs weren't so high. across the country, over 1/3 of small business have reduced benefits in recent years and 1/3 have dropped workers' coverage altogether since the early 1990's. our largest companies are suffering as well. a big part of what led general motors and chrysler into trouble in recent decades were the huge costs they wracked up

providing health care for their workers, costs that made them less profitable and less competitive with automakers around the world. if we do not fix our health care system, america may go the way of g.m. paying more, getting less, and going broke. when it comes to the cost of our health care, the status quo is unsustainable. [applause] reform is not a luxury, it is a necessity. when i hear people say, well, why are you taking this on right now, you've got these other problems, i keep reminding people, i'd love to be able to defer these issues, but we can't. i know there's been much discussion about what reform would cost. rightly so. this is a test of whether we, democrats and republicans alike are serious about holding the line on new spending and

restoring fiscal discipline. but let there be no doubt, the cost of inaction is greater. if we fail to act -- [applause] if we fail to act, and you know this because you see it in your own individual practice, if we fail to act, the roles of the uninsured will swell to include millions more americans, which will affect your practice. if we fail to act, one out of over $5 we earn will be spent on health care within a decade. in 30 years, it will be about one out of every $3, a trend that will mean lost jobs, lower take home pay, shuttered businesses and a lower standard of living for all americans. if we fail to act, federal spending on medicaid and medicare will grow over the coming decades by an amount

almost equal to the amount our government currently spends on our nation's defense. it will in fact eventually grow larger than what our government spends on anything else today. there's a scenario that will swamp our federal and state budgets and impose a vicious choice of either unprecedented tax hikes or overwhelming deficits or drastic cuts in our federal and state budgets. so to say it as plainly as i can, health care is the single most important thing we can do for america's long-term fiscal health. that is a fact. that's a fact. [applause] it's a fact and most people know it's a fact.

yet as clear as it is that our system badly needs reform, reform's not inevitable. there's a sense out there among some, and perhaps some members who are gathered here today of the a.m.a., that as bad as our current system may be, and it's pretty bad, the devil we know is better than the devil we don't. there's a fear of change. a worry that we may lose what works about our health care system while trying to fix what doesn't. i'm here to tell you i understand that fear. and i understand the citizens -- the cynicism. there are scars left over from past efforts at reform. after our presidents have called for health care reform for nearly a century. teddy roosevelt called for it, truman called for it, nixon, carter, bill clinton all called for it.

but while significant individual reforms have been made, such as medicare, medicaid, and the children's health insurance program, efforts at coomp rehencive reform that covers -- at comprehensive reform thats everyone and brings down cost has largely failed. partly because the different groups involved, doctors, insurance companies, businesses, workers, and others simply couldn't agree on the need for reform or what shape it would take. and if we're honest, another part of the reason has been the fierce opposition fueled by some interest groups and lobbyists, on sigs that has used fear tactics to paint any effort to achieve reform as an attempt to, yes, socialize medicine. despite this long history of failure, i'm standing here because i think we're in a different time. one sign that things are different is just this past

week, the senate passed a bill that will protect children from the dangers of smoker a reform the a.m.a. has long championed. [applause] something this organization championed, it went nowhere when it was proposed a decade ago, i'm going to sign this into law. what makes this -- [applause] what make this is moment different is that this time, for the first time, key stake holders are aligning not against but in favor of reform. they're coming out -- they're coming together out of a recognition that while reform will take everyone in our health care community to do their part, everybody is going to have to pitch in, ultimately, everybody will benefit. i want to commend the a.m.a. in

particular for offering to do your part to curb costs and achieve reform. just a week ago, you joined together with hospitals, labor unions, insurers, medical device manufacturers and drug companies to do something that would have been unthinkable just a few years ago. you promised to work together to cut national health care spend big $2 trillion over the next decade, relative to what it otherwise would have been that will bring down costs, that will bring down premiums, that's exactly the kind of cooperation we need and we appreciate that very much. thank you. [applause] the question is, how do we finish the job? how do we permanently bring down costs and make quality afford health care available to every single american? that's what i've come to talk about today. we know the moment is right for health care reform. we know this is a historic

opportunity. we've never seen it before and may not' sit -- see it again. but we also know there are those who will try to scuttle this opportunity no matter what. we'll so -- who will use the same scare tactics and fear mongering that's worked in the past. that will give warnings about socialized medicine and government takeovers, long lines, rationed care, decisions made by bureaucrats and not doctors. we have heard this all before. and because these fear stactics -- tactics have worked, things have kept getting worse. let me begin by saying this. to you and to the american people. i know that there are millions of americans who are content with their health care coverage. they like their plan and most importantly they value their relationship with their doctor. they trust you. and that means that no matter how we reform health care, we will keep this promise.

to the american people. if you like your doctor, you will be able to keep your doctor. period. [applause] if you like your health care plan, you'll be able to keep your health care plan, period. no one will take it away, no matter what. my view is that health care reform should be guided by a simple principle -- fix what's broken and build on what works. that's what we intend to do. if we do that, we can build a health care system that allows you to be physicians instead of administrators and account ants -- accountants, a system that gives americans the best care at the lowest cost, a system that eases up the pressure on

businesses and unleashes the promise of our economy, creating hundreds of thousands of jobs, making take-home wages thousands of dollars higher, and growing our economy by tens of billions of dollars more every year. that's how we'll stop spending tax dollars to prop up an unsustainable system and start investing in innovations and advances to make our health care system and economy stronger. that's what we can do with this opportunity. that's what we must do with this moment. now, the good news is that in some instances, there's already widespread agreement on the steps necessary to make our health care system work better. first, we need to upgrade our medical records by switching from a paper to an electronic system of recordkeeping. we've already begun to do this with an investment we made as part of our recovery act.

it simply doesn't make sense that patients in the 21st century are still filling out forms with pens and papers. that have to be stored away somewhere. as newt gingrich has rightly pointed out, and i don't quote newt gingrich that often, we do a better job tracking a fedex package in this country than tracking patients' health records. [applause] you shouldn't have to tell every new doctor you see about your medical history or what prescriptions you're taking. you shouldn't have to repeat costly tests. all that information should be stored securely in a private medical record so that your information can be tracked from one doctor to another, even if you change job, even if you move, even if you have to see a number of different specialists. that's just common sense.

and that will not only mean less paper pushing and lower administrative costs, saving taxpayers billions of dollars, it will also mean all of you, physicians, will have an easier time doing your job. it will tell you, the doctors, what drugs a patient is taking so you avoid prescribing a medication that will cause an interaction, it will prevent the wrong dozes going to a patient, it will reduce medical errors that will lead to 100,000 lives lost in our country every year. in shouldn't be an argument there. we want to make sure we're helping providers computerize so we can get the system up and running. a second step we can all agree on is to invest more in preventive care so we can avoid illness and disease in the first place. [applause]

that starts with each of us taking more response b89 for our health and for the health of our children. [applause] it means quitting smoking, going in for they mammogram or colon cancer screening, it means going for a run or hitting the gym and raising our children to step away from the video games and spend more time playing outside. [applause] it also means cutting down on all the junk food that's fueling an epidemic of obesity. it puts far too many americans, young and old, at greater risk of costly chronic conditions. that's a lesson michelle and i tried -- tried to instill in our daughters. some of you know we started a white house vegetable garden, i say we generously because

michelle has done most of the work. that's a lesson we should work with local school districts to incorporate into their school lunch programs. building a health care system that promotes prevention rather than just managing diseases will require all of us to do our parts. it will take doctors telling us what risk factors to avoid and what eventive measures we should pursue. it will take employers following the example of places like safeway that is rewarding workers for taking better care of their health while reducing health care costs in the process. if you're one of 3/4 of safeway workers enrolled in their healthy measures program, you can get screened for problems like high cholesterol or high blood pressure and if you score well, you can pay a lower premium. you can get more money in your paycheck. it's a program that has helped safeway cut health care