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

Weekly Compilation of Presidential Documents, May 5, 2008

The Tax Code is discriminatory. It says that if you work for a company, you get tax benefits. If you don't, you don't get tax benefits. If you're a very small company trying to provide health care, the Tax Code discriminates against your employees. We ought to change the Tax Code. We ought to treat everybody the same in the Tax Code, all aiming to drive the establishment of an individual market so that people can better afford health care.

Now, look, we spend a lot of money, by the way, on people who need help. My view of America is that we're rich enough to take care of people who can't help themselves, and we do. We got a robust Medicare system, which, by the way, my administration reformed for the first time since Lyndon Johnson--substantially reformed it since Lyndon Johnson was the President. And now you get a prescription drug benefit. So for all you guys my age, get yourself a prescription drug benefit pretty soon. [Laughter]

We take care of the--through Medicaid-community health centers 'all throughout the country, and we're expanding them so that people can get primary care in a place other than an emergency room.

Thirdly, there needs to be transparency in pricing. How many of you ever asked a doctor how much something costs? Have you ever shopped? And the answer is, no, you likely haven't. It's because the system-somebody else pays your bill in a third-party payer system. And so when somebody else pays the bill, there is no incentive to worry about cost. "Hey, what do I care? Somebody else is paying the bill," you think, until your benefit structure starts to change because of inflation in the health care system.

And so the whole purpose is to have transparency in the system. One of the things we're doing--you know, we're a big purchaser of health care, thanks to you--like, veterans, Medicare, Medicaid. And so we're now saying that if you participate with the Government, post price. Let people see what the different prices are. Post quality ratings; it's nice to know if you're a consumer, isn't it, whether or not you got a whether or not somebody you're thinking about paying has got a good record.

The other thing is, is that one of the real cost drivers--there are other cost drivers I want to discuss--so in other words, consumerism helps deal with cost. Transparency helps deal with cost. This is a system in which there's been no cost consciousness whatsoever.

Thirdly, there--information technology-the best way to describe this in health care is that people are still taking handwritten files, putting them under their arms, and delivering it from one office to the next. And that means oftentimes there's medical errors because the files get lost. Doctors can't write very clearly anyway. And so you--something gets illegible.

Most industries--your industry is using high-tech to modernize. There's a lot of cost efficiencies that can be wrung out of the system by the advent of information technology. The dream is that someday you've got a medical record, your own medical record by the way, tamper-proof; in other words, protected that you can use from one office to the next. It's a sign that efficiencies in the system have taken hold.