Remarks on the national economy and a question-and-answer session in Maryland Heights, Missouri

Weekly Compilation of Presidential Documents, May 5, 2008

Those are some of the things on my mind. I've got a lot on my mind, by the way. [Laughter] Getting ready to march down the aisle and--[laughter].

What I thought I'd do is answer some questions, any question, any topic. I've been around long enough to dodge them if I can't figure out the answer. [Laughter] I can ask myself one.

Yes, sir, Mr. Chairman--oh, Mr. President. Fine. [Laughter]

Health Care

Q. So as Dave mentioned, we're doing very well as a company. Had a very good first quarter, best first quarter ever. Last year, last 3 years, we've grown about 29 percent. One of the challenges that we have is managing the cost of health care. So with all of our employees here, can you give some of your thoughts in regards to how do we manage the continuing increased cost of health care?

The President. Absolutely. In essence, there's two paths. One is for the Government to basically make most of the decisions. In other words, say, we're going to make sure you have health care, and we'll make sure it's available for you. And the problem with that system is they basically make decisions for you.

I happen to believe in private medicine. I think it is by far the best route to go because private medicine has made American health care the best in the world. I don't care what people tell you, America's health care is on the leading edge of change, and our American people get really good health care.

Now the question is, who pays for it? The question is, is it available and is it affordable? And so the approach I've taken is to, one, remember the most important element in any system is the buyer, is the consumer, is the customer. That would be you, if you're a patient. And therefore, the policies that I've articulated have been all aimed at empowering you to have more decisionmaking in the health care system, so as to help deal with costs. If there's no decisionmaking in the system--in other words, there's no shopping; there's no consumerism--price goes up. It's just--it's an economic fact.

And so I'm a strong believer in health savings accounts. I don't know if you have them here, but they are very empowering instruments. They let you make the decisions. They let you save when you don't spend money. They let you roll the money over tax-free. They let you pull it out tax-free for medical care. It's your money, and it grows.

The other thing is, is that it's portable. When you go from one job to the next, it follows you. So I think it's a very important aspect in a society in which, if you're under 30 years old, you're likely to have worked for seven or eight jobs. In other words, this is a very highly mobile workplace we have now.

Secondly, if you're a small business, you ought to be allowed to pool risk, just like big companies can do. But you ought to be able to do it across jurisdictional boundaries. That's fancy words for, if you're a restaurant in Missouri, you ought to be able to put your employees in a risk pool with a restaurant in Texas. The larger the risk pool--in other words, the more people involved in the insurance-the less price goes up, the easier it is for somebody to find affordable product. But now it's against the law to do that. So small businesses ought to be allowed to pool risk. That's what big companies do. And I believe we ought to treat World Wide just like--give World Wide the same advantages in the marketplace that big companies get to do. Those are called association health plans.