be completely clear about this. i keep saying is, but some folks are not listening. if you like your healthcare plan, you keep your healthcare plan. nobody is going to force you to leave your healthcare plan. if you like to doctor, you keep seeing your doctor. i do not want government bureaucrats meddling in your healthcare, but i do not want insurance company bureaucrats meddling in your healthcare, either. [applause] [applause] so just to recap, if you or one of nearly 46 million people who

do not have insurance, it will finally have quality, affordable options. if you do have health insurance, we will help make that insurance more affordable and more secure. under the reform proposals we have put out there, roughly 700,000 middle-class colorado ans will have health care. 87,000 small businesses in colorado will be aided by new tax benefits so when they are doing the right thing for their employees, they are not penalized for it. and we will do all of this without adding to our deficit over the next decade, largely by cutting waste and ending sweetheart deals for insurance companies that do not make anybody any help there.

another is some skepticism -- i know there is some skepticism. you know that lowering costs is possible if you put in place smarter incentives. if you think about how to treat people, not just illnesses. if you look at problems facing not just one hospital, but the many systemwide problems that are shared. now you are getting better results while wasting less money. i know that your center, michael bennett, has been working on legislation based on putting the innovations here in grand junction into practice across the system. there is no reason why we cannot do that. the fact is, we are closer to achieving reform that we have ever been. we have the american nurses association, the american medical association on board,

because america's doctors and nurses know how badly we need reform. [applause] we have broad agreement in congress on about 80% of what we are trying to achieve. we have agreement from drug companies to make prescription drugs more affordable for seniors. $80 billion that can cut the doughnut hole that seniors have to deal with on prescription drug plans in half. [applause] the aarp supports this policy and agrees with us that reform must happen this year. because we are getting close, the fight is getting fierce. history is clear. every time wherein side of reform, special interest are fighting back with everything they have got -- every time we are in sight of reform. let's face it, they get people scared, and understandably. i understand why people are

nervous. health care is a big deal. in fact, whenever america has set about solving our toughest problems, there have always been those who sought to preserve the status quo by scaring the american people. that is what happened when fdr tried to pass social security. they said that was socialism. verbatim, that is what they said. they said everybody would have to wear dog tags, and that this was a plot for the government to keep track of everybody. when jfk and the lyndon johnson tried to pass medicare, they said this was a government takeover of health care. the same argument that is being made today. the struggles have always boil down to a contest between hope and fear. it was true when social security was born, it was true when medicare was created, it is true in today's debate. [applause]

but whether you have health insurance or not, we all know we cannot continue down this path. costs are rising faster than wages. the system works a lot better for insurance companies that it does for america's families. to maintain what is best about our healthcare system is going to require change. we have to keep what is good about the system, especially the relationship between doctors, nurses, and their patients, while fixing what is broken. for all the scare tactic out there, what is truly scary is if we do not do anything. we will continue to see 14,000 americans lose their insurance every day. premiums will continue to skyrocket. the deficit will continue to

grow, because most of it is medicare and medicaid. medicare will go into the red and less than a decade, an insurance woken -- insurance companies will continue to profit by discriminating against people because they are sick. if you want a brighter future, i need your help. i need you to stand for hope, knock on doors, spread the word, because we are going to get this done this year. thank you, grand junction. [applause] thank you. all right, now, i have time for a bunch of questions. we have a bunch of people in the audience with microphones. hold up your microphones, guys. the way we are going to do this is, i am just going to go around the room. to be fair, i'll make sure it is

girl, boy, girl, boy. if you can introduce yourself and ask your question or make your comment. if you can keep it relatively brief, i will try to keep my interest relatively brief so we can get through more questions during the course of this event. let's see hands, and i will start with this young lady right here in the pink blouse. can you check that mike? does it work? >> good afternoon. i work at rocky mount orthopedics here in grand junction. i would like to extend an invitation for you to visit our successful practice to see how

we provide excellent health care at a lower average cost to our patients. my question is, the regional healthcare house bill included funding for federally qualified health centers whose future budget would be based on expenses plus inflation. if private physicians, hospitals, and other providers are going to be given incentives to reduce waste and cost, what will be done to ensure the government programs will do the same? >> is an excellent question. -- it is an excellent question. what is so important about reform is that right now, the way medicare and medicaid operates, if it is starting to go over budget, you basically have two choices, either raise taxes and just keep on pay more and more, and health care inflation is going up at least twice as fast as inflation on everything else, or what we do

is just tell the providers will give you less money. we will reimburse you 80 cents or 90 cents for every dollar of services you provide. and then what happens is that the providers in of discharging people with private insurance to make up for the difference. so that drives everybody's costs up. what has been done here in grand junction and other outstanding programs like mayo, they have started to change the delivery system so you are getting more bang for your health care dollar. let me give you an example. right now, if you go to your doctor and get a test, a lot of times, that test will not be forwarded to the next doctors are specialists that you have to see. you have to take another test. you might have to take three or

four or five tests by the time your treatment is all complete. that is a waste of money, and if we can incentivize the provider to say do one test and then email the results to everybody who might be providing treatment or the patient might be referred to, that right there saves a lot of money. so what we want to do is to do this in medicare and medicaid, which will incentivize a lot of health systems around the country to start using some of the smart practices that you are using. frankly, medicare and medicaid provide a lot of care for a lot of patients, particularly seniors. if they hear from medicare, can you start doing things smarter, they have the incentive to do it. once they put a smarter system in place, the benefits spillover to the private insurance market as well.

we want to do it through medicare and medicaid, but we also want to see in the private insurance market that health providers start thinking smarter and providing better care, which often turns out to be lower-cost care. it is not going to happen overnight, because a lot of these systems have been put in place for a long time. you are in grand junction or the mayo clinic or another good health care system, each year they are continually comparing notes. they have a peer review process where doctors are exchanging ideas, and they are continually making the system better and smarter, and over time, we can bend the cost curve so that instead of having inflation go a lot faster than everything else, it matches everything else. if we could just get health care inflation to match the inflation

on food and other items, all of our long-term deficit problems would be solved. just that alone. if we could just reduce the amount of health care inflation, are long-term deficit problems would be sold. this is the most important thing we can do for deficit reduction. i want everybody to remember that, because in this debate, we have heard a lot people say we cannot afford to do this because our deficits and debt are too high. the biggest driver of our deficit and debt is health care. if we do not change the delivery systems and that some of the innovations that are being used where you work and in really good health care systems run the country, then we are going to be in red ink for ever. thank you so much for the question. [applause] the gentleman in the red shirt back there. wait for the mike, so everybody

can hear you. >> thank you, mr. president, for taking my question. i have been the health insurance business for over 25 years. i am a big steelers fan as well. >> are you allowed to confess that here? [laughter] >> you have asked many times why insurance companies are so afraid of competing with a public plan option of coverage. i understand insurance companies need to get spanked every now and then for sure, but if the public plan option reimburses on average 55 cents a contract of every dollar of care to the provider, the private insurance

plans a contract reimburse an average of 85 cents per dollar of care, how could it be considered fair competition, and thank you for being here today. >> i think it is a good question. for those of you who have not been following the debate as closely, let me just describe what this issue of the public plan is all about. to do so, i have to describe how we are looking to provide health insurance for people who currently do not have it. i spent most of my time talking about what we would do for folks who have health insurance, but we still have 46 million uninsured. i think it is the right thing to do to provide them with some help. most of them work, most of them are responsible, but their employer just cannot afford it because they do not have the bargai