Remarks on Health Care Policy in Memphis, Tennessee

The answer to the question is 20-years-old. If you do that kind of speech again, I'm going to be out of business.

Elijah, thank you for sharing your story with us – and for being here today. And I can just promise you we're going to do everything we can so that nobody else will have to go through this situation. And if we get it done, you will have been part of the solution, so thank you for all of that.

Good afternoon, everyone. It's great to be here in Memphis.

Earlier this week I was in Charlotte, North Carolina. And before that I had spent a little time in Texas. But there is no truth to the rumor that I am organizing my campaign stops around the places with the best barbeque.

I know some of you are still celebrating Memphis's big basketball win over Tennessee the other day. If there are any Tennessee fans here, just look on the bright side: at least you're not New York Knicks fans.

Actually, by the way, the head coach of the Memphis men's basketball team, Penny Hardaway, actually played on the Knicks for a couple of years while I was mayor.

That was a long time ago. I go to occasional Knicks game, I just don't remember if he was there, but it was only my second term back then, and Donald Trump was only on his fifth bankruptcy.

Back in 2016, I warned that if Donald Trump ran our country like he ran his companies, we'd be in a whole lot of trouble – and I'm sorry to say that's exactly what has happened.

Extorting a foreign head of state for campaign purposes is a gross abuse of power – and the House, I think, did its Constitutional duty by impeaching him yesterday. It's unfortunate, it's terrible.

Unfortunately, it increasingly appears that Senate Republicans will not do their duty. The issue won't be settled until November, by we the American people.

That's why 2020 is not just an election. It is a referendum on how to save our Constitution – or let Trump light a fire on it, and that's just not going to happen. That's why it's so important, I think, that we nominate the candidate who gives us the best chance to defeat Donald Trump, and bring our country back together.

Now, I don't know if you often see many presidential candidates in Tennessee. That's unfortunate, because places like Memphis have different challenges and perspectives than other cities where all the other candidates are focusing their time right now. I believe our party has to put places like Memphis front and center – and that's what I'm trying to do in my campaign.

One of the biggest challenges here in Memphis and across the state – and that's why I'm here – is health care. And if I'm elected president, health care will be right at the top of my agenda – which is my subject of the day.

America pays much more for health care than any other country, and those costs are leaving millions of Americans without enough money to make ends meet.

Last year, more than eight million Americans were pushed into poverty by medical bills. Families sold homes to treat sick children. Others went broke paying for life-saving operations, or started Go Fund Me campaigns to raise money for a loved one's cancer treatment. It just breaks your heart. This is America, we're wealthy enough to provide people with health care. Why on earth don't we do it?

Millions more Americans skipped doctor visits or didn't fill prescriptions because they couldn't afford it. That should not happen in the world's wealthiest country.

It really is a mark of shame on our country, and rather than fix it, I think that President Trump has made it worse.

When Donald Trump was elected, there were 28 million uninsured people in America. During his first two years in office, the number of uninsured people in America increased by two million.

Tennessee has one of the highest rates of uninsured people in America. Why? And last year, the number of uninsured people here increased by another 50,000. Only two states in America had bigger increases.

Today, thanks to President Trump, more Americans are at risk of catastrophic medical bills. More Americans have to choose between going to the doctor or putting food on the table. More Americans have junk insurance plans that don't cover maternal health or pre-existing conditions.

President Trump has spent three years sabotaging the Affordable Care Act – and offering Americans nothing in return but empty promises. He promised to repeal the Affordable Care Act and replace it with something better – but he has never had another plan.

He was determined to throw Americans off the boat, without giving them a lifeline. He just doesn't care if you have a pre-existing condition – he wants to deny you access to coverage. If he is re-elected, he'll keep trying to do that – and I think we can't let that happen.

A famous resident of Memphis of my generation reportedly once said: 'Truth is like the sun. You can shut it out for a time, but it ain't goin' away.' Elvis, just in case you don't remember.

The truth about Donald Trump is this: he doesn't have the first clue of how to unite and create. He only knows how to divide and destroy. We can't accept that. Lives are at stake.

That's why I'm running for president, to defeat Donald Trump and rebuild America. And that includes fixing our health care system once and for all.

Now, I know how urgent and important this issue is. Improving public health has been one of the fights of my life.

When I was mayor, our Administration led a major expansion of public health insurance – and we created new policies that increased life expectancy in New York by three years. When I left New York, life expectancy was three years greater than the rest of the country, and three years greater than when I started there.

My company offers the very best health insurance, and the most generous and comprehensive benefits. I think that's good for our company, I think that's good for our employees, I think it's good for our customers. Every American deserves coverage and quality, affordable care – and we can get it done.

To do it won't be easy. We won't take away private insurance – as some candidates would. My proposal will instead build on what works: President Obama's Affordable Care Act.

We'll make sure that people who like their private insurance can keep private insurance, and also provide coverage to the uninsured. We don't need Medicare for All proposals that are more likely to re-elect Donald Trump than to expand coverage.

So let me tell you what I'll do – I want to emphasize the word 'do.' Because to me, leadership isn't about making big promises, shouting into the wind, or shaking your fist at the world.

Leadership sure isn't dreaming up a plan that can never pass Congress. It's about people coming together and getting things done. And let me tell you what I'm going to do on health care as president.

First, every American will be guaranteed access to affordable health insurance. That means millions of Americans who don't have health insurance can get it – and we'll finally achieve universal coverage in this country.

Second, every American who already has private insurance will be able to keep private coverage if they choose, and they will see out-of-pocket costs go down. That's 175 million Americans who will be paying less for health care. And I'll tell you why afterwards.

Third, we're going to expand the kind of care people can get – including by bringing dental coverage to millions of Americans who right now cannot afford it.

Now, here's how we'll do all this – let's start with universal coverage. Back in 2010, President Obama proposed giving Americans the opportunity to buy public health insurance. It's called a public option – and it's effectively a chance to buy into a Medicare-like policy provided by the federal government that is less expensive than existing options. I supported the idea back then. President Obama was right to push for it. And in 2021, working with Congress, I think we can sell Congress on passing it – we're going to get this done.

To achieve universal coverage, we'll work aggressively to enroll uninsured Americans. I know we can do that – because we did exactly the same thing in New York.

During my 12 years as mayor, we cut the number of uninsured New Yorkers by 50 percent. We can do it nationally by expanding outreach and simplifying enrollment.

We'll also have a plan to deal with states that refuse to expand Medicaid under the Affordable Care Act.

It's simple, actually. We'll enroll into the public option automatically anyone who is eligible for expanded Medicaid coverage, and we will do the same for every American who is eligible for Medicaid, but is not currently receiving it. That will cover another 2.5 million people across America – including another 244,000 people in Tennessee.

The public option will make health care more affordable – including for Americans who already have private coverage, because it will drive down prices. But if we stopped there, health care costs would continue to push people into poverty – and too many people would decide to forgo coverage. You have to make a decision, do I pay for my insurance or I do something else? That's not the kind of options people should have to make.

So here we go further – and today I'm proposing five steps to substantially reduce health care costs for all Americans, and I'll just mention each one briefly.

One, we'll have to cap hospital bills at no more than twice what Medicare pays for some service. Some states in America already do this, so when you say it can't be done, it certainly can be done.

Right now, hospitals and other health care providers often charge patients with private insurance four or five times as much as they charge patients with Medicare – simply because they can.

The insurers then pass those costs on to their customers, in the form of higher monthly premiums, higher deductibles, and higher co-pays. By setting a ceiling that's tied to Medicare, we can bring down those costs for all Americans.

Two, we will ban all surprise medical bills – which can happen when out-of-network doctors are hired by in-network hospitals but the patient isn't told in advance. If you're in the middle of a medical emergency, you shouldn't have to worry about whether the doctor treating you is part of your insurance plan. But when you get home and you get a bill, you sure start worrying about it.

Three, the federal government will cap your monthly premiums if you choose the public option, or if you buy private insurance in the marketplace and your premium amounts to more than 8.5 percent of your income, you'll get a government tax credit to reduce the private cost down to below that level.

Four, we'll charge a small fee to the private insurers to create a fund that will cover 50 percent of very high claims, say those over $100,000 for those tragic extra expensive cases that you read about. The fund will help further drive down premium costs, we think, by an average of 10 percent. Another step in the right direction of more health care, better health care, and not for very much more money, if at all.

And five, we are going to lower drug costs by doing what should've been done decades ago: allowing Medicare to negotiate with drug companies and cap prices for everyone, just like every other nation does.

It is just outrageous that Americans pay many times as much as people in other nations – for the same drug. And usually, those drugs are developed right here in America – often with taxpayer supported funds through National Institute of Health. So we're paying for the development, and then we're paying more for those drugs. If anything, we should be paying less than the other countries, after all we're paying for the research.

We'll also eliminate drug company payments to pharmacy middlemen, which stifle competition and drives up prices for life-saving drugs, like insulin. And we will cap out-of-pocket drug expenses for people in Medicare.

Now, as a candidate and as a president, Donald Trump said he was going to take the pharmaceutical industry on and lower drug prices. After three years and zero progress, this week he said he would allow states to import some drugs from Canada, where they are cheaper.

That wouldn't work to lower drug prices, what are drug companies going to do? They'll get around it easily by just limiting supplies in Canada. But as we know, this president has a long history of not doing what he says he's going to do.

There is an army of lobbyists in Washington working all day long to keep the broken, expensive system we have in place – and they make a lot of campaign contributions unfortunately.

By the way, if you look at my campaign's filing, you will see I don't take a penny from any company that has any connection with any health care whatsoever. You know how certain I am of this? Because I don't take a penny from anybody.

Somebody said to me the other day, 'You're spending a lot of money.' I said yes, I'm making an investment in replacing Donald Trump, and it's the best investment I could make.

In my administration, the lobbyists won't get past the lobby. But with the Trump Administration, the lobbyists are winning – and not just on health care.

President Trump, for reasons I just don't understand, has rolled over for special interests again and again. He's done it for the pharmaceutical lobby, the gun lobby, the coal lobby, the e-cigarette lobby – stop me when you get bored – and he wants people to think that he's strong and tough. Give me a break.

When special interests come calling, he purrs like a pussycat. We need a president who has more courage than the Cowardly Lion. And I can just tell you, I've spent my career taking on the toughest battles and the biggest opponents – including Donald Trump.

I've beaten him before. People say how are you going to beat Donald Trump? I've beaten him before, and I'm ready to beat him again this November.

One of the first things I'll do as president is to reverse President Trump's support for a lawsuit that would invalidate the entire Affordable Care Act.

Just think about how irresponsible that is: the President has never proposed any plan for covering the 20 million people who would lose coverage.

I don't know any business person who would manage an organization that way – and if they tried, they would be fired. That's what we need to do incidentally next November – change the presidency.

The President has already done enough damage to health care in this country – including by introducing junk insurance plans that can bar Americans with pre-existing conditions from getting coverage.

That means an American with high blood-pressure, diabetes, or a disability, can actually be denied health care coverage. In other words, the people who need health care the most are the ones most likely to be rejected. That makes no sense whatsoever. And as president, I'll restore rules barring insurers from excluding people because of pre-existing conditions.

The Affordable Care Act was actually a major achievement that took us in the right direction, and President Obama deserves an awful lot of credit for that. But now we have to finish the job, and we have to make sure that every person in America has access to coverage and affordable care.

And I believe we need to go even further, in a number of important ways. For instance, each year, a third of Americans don't go to the dentist because of the costs. So we should expand Medicare to cover dental care – as well as vision and hearing care – and require that states cover dental care for people on Medicaid.

We'll also take important steps to strengthen healthcare in rural communities – where it has been decimated by many states' refusal to expand Medicaid.

A third of the people in Tennessee get care at rural hospitals. But ten rural hospitals have closed in Tennessee since 2012, and another 15 could be at risk. That means people have to travel further for care – including emergency care – or not get it at all. And that's true in states across this country.

As president, I will stop the bleeding – and bring back care to rural communities. We will increase and stabilize federal funding for rural hospitals and double funding for community health centers so that they can provide mental health, dental health, and substance abuse services, which God knows we need.

We will also give community hospitals incentives to take other steps that improve patient health, including help them get to and from doctors' appointments. That's a problem for people in rural and urban communities – and our plan will help Elijah's family and many others like them get the quality care that they need.

I will also launch a comprehensive national effort that focuses on preventing disease, and stops the decline in life expectancy that has happened in recent years. For the first time in history, life expectancy has gone down three years in a row. It's just an amazing statistic – up every place else around the world, down three years in a row since World War I, in all fairness. Because the most important thing we can do to improve health and reduce health costs is preventing people from getting sick or injured in the first place.

In the coming days and weeks, I'll outline plans to address the problems that are cutting lives short in our country, including the opioid epidemic.

We have an overdose and addiction crisis in America – and the president isn't doing anywhere near enough to get things done.

I've been working on this issue through my foundation, and I'll outline an aggressive plan for preventing and treating addiction – and saving more families from the heartbreak of losing children to drug abuse. It is just unbelievable what is happening with the drugs in our country, even in high schools.

Now, any candidate can talk about a plan. But what I think I offer is leadership – and a record of changing big plans into reality.

That's what we did in New York. That's the job of being president. And that's the message I think we need to beat Trump.

Voters are tired of politics-as-usual. That's why many voters turned to Trump in 2016. But as many people have come to see, Trump is all talk and no action.

Or as they say in Texas, all hat and no cattle. Although it might be more accurate to say, all hair and no cattle.

I'm a doer – and we have a lot of work to do. I'm ready to roll up my sleeves and get working. I was lucky enough to be mayor of New York City, eight million people and 300,000 employees. The most progressive city in the country, and we made an enormous difference. And I hope you'll join me because I think we can do the same thing all across this nation.

So thank you for coming out – and I look forward to spending more time in the great state of Tennessee.

Thank you all.