Remarks On Day Four Of The "Call To Action Tour" in Cleveland, Ohio

Thank you. I appreciate the hospitality of Dr. Cosgrove and staff of the Cleveland Clinic, one of the many fine health institutions in the great city of Cleveland. I thank you for your work and service that has made an enormous difference in the lives of so many.

On Monday, I was at Children's Hospital in Miami, where among the miracles were the technology that allowed an infant born with complex congenital heart disease to survive and thrive and a vigorous young boy to survive an awful accident. Tuesday, I toured the Moffitt Cancer Center and Research Institute in Tampa, where with skill, ingenuity, and perseverance, they are turning new technologies against one of the oldest enemies of humanity -- cancer. Yesterday, I witnessed the power of cutting edge technologies -- ii hospital that is leaving paper behind, embracing information technology and connectivity to improve care and expand access.

This campaign will include a serious discussion of health care in our nation because despite the shining examples of the high achievement of American medical science our health care system falls short of providing quality care at low cost to all Americans. Underlying the many things that trouble our health care system are the fundamental problems of cost and access. Rising costs hurt those who have insurance by making it more expensive to keep. They hurt those who don't have insurance by making it even harder to obtain. Rising health care costs hurt employers and the self-employed alike. And in the end they threaten serious and lasting harm to the entire American economy.

These rising costs are by no means always accompanied by better quality in care or coverage. In many respects the system has remained less reliable, less efficient, more disorganized and prone to error even as it becomes more expensive.

There are those who are convinced that the solution is to move closer to a nationalized health care system. They urge universal coverage, with all the tax increases, new mandates, and government regulation that come along with that idea. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We'll have all the problems, and more, of private health care -- rigid rules, long waits and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

I have a different vision. The key to real reform is to restore control over our health-care system to the patients themselves. Right now, even those with access to health care often have no assurance that it is appropriate care. Too much of the system is built on getting paid just for providing services, regardless of whether those services are necessary or produce quality care and outcomes. American families should only pay for getting the right care: care that is intended to improve and safeguard their health.

When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices.

But for every American who wanted it, another option would be available: Every year, they would receive a $5,000 tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep.

I have also pledged to meet with the governors to solicit their ideas about the best way to provide insurance to those denied coverage under current practices. I will build a Guaranteed Access Plan or GAP that would reflect the best experience of the states. I will work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs.

My reform will change the practice of medicine in America. We know from experience that coordinated care -- providers collaborating to produce the best health outcome -- offers better quality and can cost less. We should pay a single bill for high-quality disease care, not an endless series of bills for pre-surgical tests and visits, hospitalization and surgery, and follow-up tests, drugs and office visits. Paying for coordinated care means that every single provider is now united on being responsive to the needs of a single person: the patient. Health information technology will flourish because the market will demand it.

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in Web technology to allow a doctor to practice across state lines, then let them.

Chronic conditions -- such as cancer, heart disease, high blood pressure, diabetes and asthma -- account for three-quarters of the nation's annual health-care bill. We can make tremendous improvements in the cost of treating chronic disease by using modern information technology to collect information on the practice patterns, costs and effectiveness of physicians. By simply documenting and disseminating information on best practices we can eliminate those costly practices that don't yield corresponding value. By reforming payment systems to focus on payments for best practice and quality outcomes, we will accelerate this important change.

In every dimension, innovation will be at the heart of providing better care, at lower cost, for every American. Innovation is the wellspring that will bring us new treatments, better information, and put families in charge of their health care.

We will see some of that innovation today: an Electronic Medical Record as a path to increase quality, lower cost and improve safety; a Patient Health Record to help deliver better care and put power in the hands of patients; and a way to connect patients with physicians, pharmacies, clinics and hospitals. We need to find ways to organizes patient data to make information accessible and useful, allow patients to manage their medical records, and still protect the privacy of health information.

These innovations are an inspiration, and a reminder of all that's good in American health care. We need that reminder sometimes in Washington. I thank you for your kind attention this morning, I thank you for the work you have done here, and I wish you success in the even greater work that lies ahead.