The Affordable Care Act & The Patient’s Bill of Rights
Articles,  Blog

The Affordable Care Act & The Patient’s Bill of Rights


Paul Brayshaw:
Welcome. My name is Paul Brayshaw,
and my wife, Frances here. We’d like to welcome
you to our backyard. We appreciate you
all being here. We tried to clean up
everything, but just watch your step, you never know,
there could be a fresh one out there. But — President Obama:
He’s got dogs. Paul Brayshaw:
Yeah. So welcome. 36 years ago, I was born
with severe factor IX deficiency, hemophilia. I lack a specific
clotting factor in my
blood to make it clot. And it’s been a bit of a
challenge over the years. In 2006, I reached a lifetime
cap after three years. I was trying to
figure out what to do, whether I should go
on a disability policy, change jobs, or move states. Fortunately my employer came
through and was able to cover my health care costs. But it was a significant
stress for me and my wife. We had an opportunity to
have this employer take care of us, which made
the world of difference. The problem with hemophilia,
90% of the costs are associated with the clotting factor,
the medications I take. So it’s been — that’s really
where I drive up health care. And it’s important to have a
policy that will cover that. You know, when there’s
capitation on plans and other things, it doesn’t
necessarily make my health better, it actually makes
me worse and more expensive. So it’s been something that
I’ve had to work through. Fortunately, the Affordable
Health Care Act is going to remove some of those burdens
and remove the shackles, really. I won’t have to depend on
the job for insurance anymore. So the Affordable Health
Care Act is welcome, and I expect that it will make a
big difference in my life and that of other people
who are affected. So with that, I’d like to thank
you again for being here and I’d like to introduce
President Barack Obama. Thank you for
being here, sir. (applause) The President:
Thank you, everybody. Thank you. Well, it is great to see you. Thanks, all, for taking
the time to be here. I know it’s a little
warm under the sun, so if anybody at some point
wants to shift their chairs into the shade, I’m fine with that. I won’t be insulted. I want to just make a couple of acknowledgments of
people who are here. First of all, I’ve got the
Secretary of Health and Human Services, so she’s charged with
implementing the Affordable Care Act — Kathleen Sebelius. She’s doing a great job — former governor of Kansas, former insurance commissioner, knows all about this stuff. (applause) We’re very proud to
have her on the team. Somebody who helped to champion
the kinds of reforms and patients’ rights that we’re
going to talk about here today — Congressman Jim Moran is here. Thank you so much, Jim. (applause) And Falls Church
Mayor Nader Baroukh. I was just mentioning Baroukh
means “blessings” in Hebrew, one who’s blessed. And Barack means the same thing. So he and I, we’re right there. (applause) And I know he feels blessed to be the mayor of this
wonderful town. When I came into office,
obviously we were confronted with a historic crisis. The worst financial crisis
since the Great Depression. We had lost 4 million jobs in
the six months before I was sworn in, and we had lost almost 800,000 the
month I was sworn in. Obviously the economy has been
uppermost on our minds and I had to take a series of steps very
quickly to make sure that we prevented the country from going
into a second Great Depression, that the financial
markets were stabilized. We’ve succeeded in doing that and now the economy
is growing again. But it’s not growing as fast as
it needs to and you still have millions of people who
are unemployed out there. You still have hundreds of
thousands of people who have lost their homes. There’s a lot of anxiety
and there’s a lot of
stress out there. And so, so much of our focus day
to day is trying to figure out how do we just make sure that
this recovery that we’re slowly on starts accelerating in a way that helps folks all
across the country. But when I ran for office, I ran not just in anticipation
of a crisis. I ran because middle-class
families all across the country were seeing their
security eroded, partly because between
the years 2001 and 2009, wages actually went down for
the average family by 5%. We had the slowest job growth
of any time since World War II. The Wall Street Journal
called it “the lost decade.” And part of the challenge
for families was, is that even as their wages
and incomes were flatlining, their costs of everything from
college tuition to health care were skyrocketing. And so what we realized was we
had to take some steps to start dealing with these underlying
chronic problems that have confronted our economy
for a very long time. And health care was one of those issues that we could
no longer ignore. We couldn’t ignore it because
the cost of health care has been escalating faster than
just about anything else, and I don’t need to
tell you all that. Even if you have
health insurance, you’ve seen your copayments
and your premiums skyrocket. Even if you get health
care from your employer, that employer’s costs have
skyrocketed and they’re starting to pass more and more of those
costs onto their employees. More people don’t get health
care from their employers. And in addition, what you were
seeing was that at the state level and at the federal level,
the costs of health care, because people weren’t getting
it on the job and were trying to get it through the CHIP program
or Medicaid or disability or what have you — all those costs were driving
our government bankrupt. Anybody who’s out there who’s
concerned about the deficit, the single biggest driver of our
deficit is the ever escalating cost of health care. So it was bankrupting families,
companies, and our government. So we said we had
to take this on. And most of all, as I
traveled around the country, I’d hear stories from families
in every single state — you know, they had a child who
had a preexisting condition and they couldn’t get
health insurance. Or they thought they had
insurance, only to find out that in the fine print, there was some sort of lifetime limit of
the sort that Paul described. They bump against it, and
suddenly they’re out of luck and potentially going to lose their
home or lose whatever savings they have because the insurance
that they thought they were getting wasn’t going
to fully cover them. Some people would tell me
stories about how just as they got sick the insurance company
would have gone through their form and saw some innocuous
mistake and just dropped their coverage because
they hadn’t listed — in some extreme cases, we had
folks who had a gall bladder problem 15 years ago that had
nothing to do with the sickness that they were now experiencing,
but the insurance company said, ah, you forgot to list that
and so we’re going to drop you from your insurance. I met young people all
across the country who, starting off in life,
getting their first job, weren’t getting health insurance
and couldn’t stay on their parents’ policies. So the amount of vulnerability that was out there
was horrendous. And what I said to myself and
what I said to my team was even as we were dealing
with this big crisis — immediate crisis with
respect to the economy, we’ve got to start doing
something to make sure that ordinary folks who are feeling
insecure because of health care costs, that they
get some relief. So the reason we’re here today
is that thanks to outstanding work by people like Jim, thanks
to outstanding implementation by folks like Kathleen, we are now
actually able to provide some help to the American people. Essentially, part of the
Affordable Care Act that we can implement right now,
and will take effect — is it today or tomorrow? — tomorrow — see,
Frances knows — (laughter) — that we can — that will take effect tomorrow is the most important patient’s bill of rights that we’ve ever seen in our history. And let me just tick off some of
the things that are going to be the case starting tomorrow. Number one:
Paul already mentioned the
issue of lifetime limits. That is not going to be the
rule anymore after tomorrow. If you’ve got a policy,
you get sick, the insurance company covers you. Number two:
preexisting
conditions for children. Children who have preexisting conditions are going
to be covered. Number three:
We’re going to make sure that if young people don’t have health insurance through
their employer, that they can stay on their
parents’ health insurance up to the age of 26, which is
obviously a huge relief for a lot of parents who are seeing
their young people just coming out of college and not being
able to get insurance. You’re going to be able to make
sure that the insurance company doesn’t drop you because of
an innocent mistake on your insurance form. This rule of rescission, they
are not going to be able to drop you arbitrarily, which
gives you more security. Number four:
You’re going to be able to choose your doctor and not have to go through some network in an
emergency situation as a consequence of these rules, so it gives customers more
choice and more options. There are so many good
things about this, I may have forgotten one. Kathleen, anything else? Secretary Sebelius:
(inaudible) and preventive care. The President:
Right, and preventive care. I knew there was one more. Preventive care will now be
offered under your policy, which, over the long term,
can actually save people money because you get
diagnosed quicker. So all these things are designed
not to have government more involved in health care. They’re designed to make sure
that you have basic protections in your interactions with
your insurance company; that you’re getting
what you pay for; that you have some basic
measures of protection in interacting with the
health care system, which means that you’re
not going to go bankrupt, you’re not going to lose your
house if, heaven forbid, you end up having an accident,
and you’re able to get the quality care that you need. Now, obviously there are a whole
host of other things involved in the health care reforms
that we initiated. Small businesses — 4 million of them are going to get a huge tax break if they start providing health insurance
to their employees. We’ve got measures that
make sure that Medicare — that the life of
Medicare is extended. And in fact, we just got a
report today that the Medicare Advantage program that we have
modified and scrutinized more carefully, that in fact rates
are going to be lower for that than they were before. I just met with state insurance
commissioners from all across the country. They are newly empowered
to look after consumers. And I’ll just give
you one example. In North Carolina, in part
because of the new leverage that insurance commissioners have,
the insurance commissioner there was able to get a $125 million rebate for 200,000 customers in North Carolina. And they are seeing the
lowest rate increases ever. All this is going
to lower premiums. It’s going to make health
care more affordable. It’s going to give
you more security. That’s the concept behind
what we’re implementing. But rather than me
do all the talking, I want to make sure that some
people who have struggled in the past with the health care system
have an opportunity to tell their story, because basically
the reason we did this was because of the stories I had
heard from folks like you all across the country. And I want to make sure that a
couple of you have a chance to tell your stories before
I take some questions. So we’re going to
start with Dawn. Where’s Dawn? Dawn’s right here. Dawn’s already got her own mic. Introduce yourself, Dawn, and
tell us a little about yourself and your situation. Ms. Josephson:
Thank you. I’m Dawn Josephson from
Jacksonville, Florida. And I’ve been a self-employed
entrepreneur since 1998. During that time, the majority
of those years I didn’t even have insurance, because it
was simply too expensive. In 2006, my son Wesley was born. This is Wesley. The President:
Hey, Wes. Come on over here. Ms. Josephson:
Go say hi. There you go. The President:
This is Wesley here. Ms. Josephson:
That’s Wesley. He was born in 2006, and
that’s when we got — we finally got health insurance. We’ve had a few different
policies over the years, always had something
excluded from it — even something as silly
as ear infections. What kid does not
get ear infections? So, I mean, silly stuff. In July of ’09, he
had eye surgery. We discovered he had sudden
onset of a condition called strabismus in the eyes, and
his right eye needed surgery. So we had the surgery, and less
than a year later we said we needed new insurance. What we had was killing
us for our premium. And this was right
around the time — right after the act passed. The insurance company gave
us an affordable rate — we were looking for a
very affordable plan. And when she told
us we were approved, my immediate response was,
“But what’s not covered?” And I knew full well we were
going to have an exclusion for my son’s eye. And she said, “You’re covered. Nothing is not covered.” And I said, “Okay, I’m not being very clear here
with my questioning. What about my son?” She said, “Yes, your
son is covered.” I said, “No, you
don’t understand. What if he needs another
surgery on his eye? Are you going to pay for it?” They said, “Yes, he’s covered.” And I was shocked. And she said, “We can no
longer exclude preexisting conditions for children.” And it didn’t hit me until
later that night when I was talking with my husband as
to why she said that, and we started talking about it. And I said, wow, something
affected me personally from the government — was
really shocking. So not only do we have
a more affordable plan, but my son is now covered
no matter what happens. It is routine for children with strabismus to need
multiple surgeries. And I know now that that’s not
going to have to come out of our pocket, which was a big fear. So we’re very thankful
and very grateful. Thank you so much for everything
you’ve done, President Obama, and everything that you’ve — everyone has done to push this through because it’s really made our life so much less stressful. It’s just an average
American family. The President:
That’s a wonderful story. Thank you, Dawn. Next, I want to talk to Gail, who flew down here
from New Hampshire. And I had a chance to talk to
Gail a couple of days ago. I had actually received —
a letter had been passed on to us from Gail’s husband
telling their story. And so I just was
so touched by it. And it was wonderful to
have a chance to speak to her personally. But, Gail? Ms. O’Brien:
That was awesome, too. You made my day. Yes, in March of this year, I
was diagnosed with high-grade stage-two non-Hodgkin’s
Lymphoma, and I was uninsured. I work full-time as a preschool
teacher at a Montessori school that does not offer
insurance to their employees. So I was scared to death — not as much, “Oh, I’ve got cancer, what am I going to do?” It was, “How am I going to pay
for these outrageous bills that are going to come our way?” So then we would have to have
gone into our retirement fund and used all that up, and we
have one son in college and one on the way to
college in two years. We would have had to use all the
money that we saved for those to pay for my medical bills. And then when we heard about the
high-risk pool and that it was in effect in July 1st,
we got right onto it. We called people. We got all of the criteria in
order so that we were actually insured on July 1st. My doctor let me wait for three months to start chemotherapy
and radiation. And on July 5th I started chemo. And I am doing
radiation right now. I’m feeling great. And if it wasn’t for this bill,
I would’ve probably not been feeling great, because I
would’ve been so stressed out and worried about paying
for my medical bills, that now I can focus on my
health instead of focusing on how am I going to
pay to get better. So I personally thank all of you
and President Obama so much. I mean, you do not know how
this has changed my life and how grateful I am to you. The President:
I really appreciate that. And I should have mentioned,
just for Gail, children are — with preexisting conditions — are covered. We had to phase in the adult
side of preexisting conditions because it’s more complicated trying to get that
whole pool of adults. But what we did
in the interim — by 2014 we’re going to have
in place a rule for insurance companies that they
can’t bar people — anybody, not just kids, but
anybody with preexisting conditions —
from getting insurance. But in that interim, over
the next several years, over the next four years,
we want to make sure that folks like Gail got help. And so we’ve set up these
preexisting insurance pools, state by state. And Gail, I think, was the first person to sign up
in New Hampshire. (laughter) Ms. O’Brien:
— on the ball. (laughter) The President:
So we’ve got thousands of people across the country who are now signing up, and states are
working with Kathleen’s office to get this set up so that
they’re able to get the coverage they need in a way that’s
actually affordable. I mean, in some cases you had
situations where you could get, theoretically, insurance if you
had a preexisting condition, but the costs were so
exorbitant that it was just — Ms. O’Brien:
I couldn’t even get insurance. The President:
— it was just impossible. And then some people,
in certain markets, you just couldn’t
get insurance at all. And so now we’re able to provide
an interim step that helps directly people like Gail, and
we’re really proud of that. So with that, what I want to do
is I just want to open it up for any questions, comments,
concerns that people have. We’re focused mostly
on health care, but if you want me to talk about
what happened to the Redskins on Sunday, I can talk
about that, too. (laughter) Yes. Here, and let’s make sure
everybody gets a mic so that we can hear folks. And introduce yourself,
if you don’t mind. Audience Member:
I’m very curious to know what can be done about the insurance companies and medication. As it stands now, the insurance companies rule when
the doctors order. They either refuse, or it’s a
generic, or they have to go back to the doctor and argue with his
office as to whether or not you can have it. The President:
Well, under Medicare, prescription drugs are covered under Part D. But for a lot of seniors, they
still haven’t been affordable, even under Part D. And so one of the things that
was part of the reform act was us slowly phasing out something
called the doughnut hole, which I’m sure
you’re familiar with. Essentially, the way
the thing was set up, when they set up the
prescription drug plan program under Medicare under the
previous administration, you were covered up to, what
was it, a couple thousand — $3,000, $2,000 — then once
you hit that threshold, there was a hole — hence
the term “doughnut hole” — where you weren’t covered
for another several thousand dollars, and then it became so
extreme that you had to still buy more drugs, then you would
end up being covered again. So you had this doughnut hole. A lot of seniors fell into it. One of our main priorities
was saying let’s close the doughnut hole. And we are beginning
to do that now, first by providing some supplemental
assistance to seniors. A couple of million seniors
have already received — or is it about a million and
a half seniors have already received checks of $250. Audience Member:
I was able to get my heart medication once that check got there. The President:
Well — so you’ve already received it? Audience Member:
Yes. The President:
And it helped you get
some heart medication? Audience Member:
Medicine I couldn’t afford. The President:
Well, that’s a wonderful story. And that’s exactly what we want
to make sure of is that you don’t have to make decisions about do I get this medication or not. Audience Member:
And I thank you from
the bottom of my heart. The President:
Well, I appreciate that. But you’re making, in addition
to that, another point, which is that a lot of times there’s a
process of decision-making between doctors and Medicare
about what drugs are going to be covered. And one of the things that
Kathleen is trying to do is to make sure — I don’t want you to have to use your health care plan right now. (laughter) But one of the things that we
want to do is to make sure that we’re trying to figure out how
can we simplify and make it easier to understand what
prescription drug plans are out there so that you
know ahead of time — if you are primarily concerned
about your heart condition and the drugs you need there, are
you able to find the plan that you need that covers the drugs that your doctor
is recommending. And that’s something where I
think we can still make some significant improvements. Kathleen, do you want to
add something to that? Secretary Sebelius:
Well, just as the President said, one of the things that will become clear when the new Medicare information comes out — about the 8th of October you’ll have a reenrollment period — is I think two pieces of
good news on the drug side. One is that we made plans be
clearer about what drugs are covered so seniors can
make the right choices. If you need heart medication
or liver medication, you make sure you sign
up for the right plan. In the past, that
was very unclear. And secondly,
starting in January, this year there was a
one-time $250 check. Next year a 50% decrease in all
of the brand-name drugs in the doughnut hole will
go into effect. And we received some good news
from companies that every company is going to
participate in that. So the kind of feature that
begins to phase out the doughnut hole, it starts next year
and half of it will be gone. And that’s going
to be a huge help. So $250 didn’t cover a lot of
the drugs that you have to buy in the doughnut hole, but next
year they will be essentially a 50% decrease. And that applies across the
board to all companies. And Congressman, I know that was
a big issue in the House and one that people felt very strongly
had to be part of the Affordable Care Act, getting rid
of the doughnut hole. The President certainly
supported that. But it’s going to
be very good news. People said it would never
happen and drug companies all stepped up and said, we will
continue to participate, and yes, it will happen. The President:
Good. Yes. Audience Member:
Hi, President Obama. The President:
How are you? Audience Member:
Good. I’m a fourth-year medical
student at Howard. And I’m of the people that has
not been able to go the doctor, ironically, because I’m in medical school and
I can’t even go. So I just wanted to know what
steps are we going to take after it’s passed and goes into full
effect to encourage young people to go see the doctor and
to take preventative steps, just as older people? Because I feel like a lot
of times we’re left out. The President:
Well, first of all, as I said, up to the age of 26 you’re going to be able to stay on
your parents’ coverage, and that’s important
for a lot of people. You look like you’re, what, 22? Audience Member:
Yes, I wish — 24. The President:
Okay. (laughter) I mean, I wasn’t that far off. “I wish.” Let me tell you,
24 is just fine. (laughter) But — so first of all, you’ll be able to stay on your parents’ policy for another couple years and that gives you obviously some peace of mind. The second thing that we’re
already doing is all the policies now are going
to cover preventive care. So getting a mammogram, that’s
got to be part of your policy, and you no longer have to pay
significant out-of-pocket costs that may dissuade you from
getting the kind of preventive care that you need. And if you’re a medical student,
you know better than I do that so much of keeping ourselves
healthy is knowing what’s going on and going in and getting
regular checkups and being able to monitor your health. My mother died of ovarian cancer
and she did not have steady health insurance during her life
because she was essentially a self-employed consultant. And ovarian cancer is a tough
cancer once you get it. It’s tough mainly because it’s
typically diagnosed very late. Now, I can’t say for certain
that if she had been diagnosed earlier she might be
with us here today, but I know that the fact that
she did not have regular insurance meant that she was not
getting the kinds of regular checkups that might
have made a difference. And so that’s true for young
people as well as old people, the provision that I
just talked about — preventive care. If you’ve got
insurance, then those — that preventive care is
going to be covered and that should make a difference. And by the way, that should
save us all a lot of money. I mean, one of the toughest
things about this health care debate was — and sometimes I fault myself for not having been able to make the case more clearly to the country — we spend, each of us who have
health insurance, spend about a thousand dollars of our premiums
on somebody else’s care. What happens is, you don’t
have health insurance, you go to the emergency room. You weren’t getting a checkup;
something that might have been curable with some
antibiotics isn’t caught. By the time you get
to the hospital, it’s much more expensive. The hospital cares for you
because doctors and nurses, they don’t want to just
turn somebody away. But they’ve got to figure out
how do they keep their doors open if they’re treating all
these people coming in the emergency room. Well, what they do is they
essentially pass on those costs in the form of higher premiums to the people who do
have health insurance. And so we are already
providing these subsidies, but it’s the most inefficient possible subsidy
we could provide. We’re a lot better off if we are
making sure that everybody is getting preventive care, we’re
encouraging wellness programs where people have access
to doctors up front. And that’s why we feel pretty
confident that over the long term, as a consequence of
the Affordable Care Act, premiums are going to be lower
than they would be otherwise; health care costs overall are
going to be lower than they would be otherwise. And that means, by the way, that
the deficit is going to be lower than it would be otherwise. Understand — I want to make sure everybody is clear. The Congressional Budget
Office, which is made — is independent, it’s
historically bipartisan; this is sort of the scorekeeper
in Washington about what things costs — says that as a consequence of this act, the deficit is going to be over
a trillion dollars lower over the course of the next two
decades than it would be if this wasn’t passed. And the reason this is so
important is because right now there’s a political debate going
on about should we maybe repeal the health care act or — because this is part
of big government. And you’ve heard the Republican
leader in the House saying that’s going to be one
of our priorities — chipping away at
the health care act. Well, first of all, I want to
see them come and talk to Gail or talk to Dawn or talk to
any of you who now have more security as a
consequence of this act, and I want them to look you in
the eye and say, sorry, Gail, you can’t buy health insurance;
or, sorry, little Wes, he’s going to be excluded when
it comes to an eye operation that he might have
to get in the future. I don’t think that’s what
this country stands for. But what they’re also going to
have to explain is why would you want to repeal something that
Congressional Budget Office says is going to save us a
trillion dollars if you’re serious about the deficit? It doesn’t make sense. I mean, it makes sense
in terms of politics. It doesn’t — and polls. It doesn’t make sense in terms
of actually making people’s lives better. Okay. Anybody else? Yes, go ahead. Kathleen has got a mic. Audience Member:
I want to thank you,
first of all. I have a son with intractable
seizures and this bill is going to make a huge difference
in our lives personally. But I also want to speak on
behalf of small business, because small business has been
used as an argument against this bill and I find it very
hard to understand. I think there’s a huge
campaign of misinformation. In fact, we were about ready
to make a choice between not insuring our employees anymore
because we simply couldn’t afford it — it was $90,000 a year and a third of our payroll — or close our doors because
we had no choice anymore. And this bill and the tax
increment that I get back takes that statistic from
30 to about 18%. It makes a massive difference in
the fate of our business and in the fate of all of our
employees who are insured. We did not want to
drop our policy — and in the fate of our son. And I guess my question is,
what can we do about this misinformation? It seems so pervasive
everywhere and it’s so wrong. I think this bill is really
affordable for small business and I want some way
to get that word out. The President:
Well, I appreciate that. Tell me what kind
of business you got. Audience Member:
I own a bookstore,
“The King’s English.” The President:
Oh, do you? Audience Member:
Yes, in Utah. The President:
That’s wonderful. Audience Member:
Thank you. The President:
I love bookstores. Audience Member:
I know you do. I follow your career as
you go from one to another. The President:
I used to be able to roam
around in bookstores. Now it’s a little more
noticeable when I go in there. Audience Member:
We read about it. The President:
And so you’ve been providing health insurance to your employees, but what you were
seeing was because you’re not Xerox or General Motors, you
don’t have this big pool, so you’re essentially in the
small-pool insurance market. And like the individual market,
you were seeing your premiums just going up and up and up. What were they — what was happening to them over the last several years? Audience Member:
Well, in 2008,
three of us hit 60. And of course, that’s the
place where they really go up. And our premiums shot up to
well over 30% of our payroll, which shot our payroll
up to 30% of our gross, which is totally unsustainable. The President:
Right. That’s basically your margin. Audience Member:
That’s it — way more than the margin. The President:
Way more — right, I mean it eats up whatever profits that you’re making. Audience Member:
Yes. The President:
So as a consequence of
the Affordable Care Act, we’ve got 4 million businesses
like yours that are now eligible for significant tax reductions,
that’ll pay for up to a third of the premiums that you’re
paying for yourselves and your employees. I mean, that goes directly to a
small business’s bottom line. Now, what you’ll hear is,
well, but some businesses, they’re now mandated
to provide insurance, and if I have to provide
insurance, then I’m going to — I’ll hire fewer people. But it turns that actually — and Kathleen will correct me if I’m wrong on the statistics here — it turns out that because
employers with 50 employees or less are not subject to any
penalty for not providing health insurance, about 96%
of small businesses, they don’t have any
requirement on them, but they can take
advantage of it. Now, it is true that if you’ve
got a business that has a thousand employees and you’re
not providing them any insurance whatsoever, what we’re
saying is, you know what, that’s not fair because all
the rest of us are going to be paying for those folks when they
go to the emergency room or they apply for Medicaid
or what have you. And so we’re going to say, look,
if you provide insurance we’ll provide you help. If you don’t, then we’re going
to charge you for the fact that somebody else is going to
have to cover those costs. But for the vast majority
of small businesses, this is a great deal. And we’ve got testimony
here to show it. Now, in terms of how
to get the word out, nobody is more
effective than you. So I hope that all the reporters
who are here will record what you just said and will
help get that word out. But it’s a challenge,
because, frankly, there was opposition from the
Chamber of Commerce and some other small — and some other large lobbying organizations in Washington that said they were speaking for small business, but when you looked at
the facts this was good for small business. In fact, probably nobody
benefited more, because nobody is getting hurt more by health
care costs than small business. So thanks for
sharing your story. The President:
Anyone else? I know it’s warm out here,
but I want to hear from as many people as I can. Go ahead. Audience Member:
Hi. Thank you so much,
Mr. President, for having us here. I want to thank you. I just have a comment. My son, Sammy, who was here,
is seven and he has neurofibromatosis. I don’t know, have
you ever heard of it? The President:
You know, I’ve heard of it. But you should describe
for us what that means. Audience Member:
It means that he had a spontaneous mutation on his chromosome. And he was diagnosed two
and a half years ago. And it just basically means your
tumor suppressor doesn’t work properly, so every nerve cell has the potential of
becoming a tumor. The President:
Which is pretty
nerve-wracking for mom. Audience Member:
Oh, it’s unbelievable. And there’s a wide spectrum, so
some people end up with minor complications but others
have serious problems. And he’s already had surgeries
and things of that nature. So I just want to thank you and
the Secretary and congressmen and senators, because it’s
life changing for a parent. The President:
Well, Sammy looks terrific. I saw him running around here. Audience Member:
He is terrific. The President:
And I’m just glad to give you peace of mind. Look, people ask me sort of
how do I stay calm in my job. The reason I stay calm in my
job is that every night at six-thirty, no matter how
busy I am, I go upstairs — I’ve got a very short commute — (laughter) — and I go upstairs and I have dinner with my wife and my daughters. And as long as
they’re doing good, as long as they’re healthy and
happy and running around and telling me stories about the
crazy things that happened at school today, then there’s a
certain baseline that just gives you that sense, well, I
can take anything, right? Now, the flipside is when
Malia or Sasha get a sniffle, or an ear infection, or
a scrape, or a bruise, I’m over there just miserable. And I still remember Sasha,
when she was three months old, one night she just
wasn’t crying right. As a parent, you
start recognizing, that’s not how she cries. She wasn’t hungry, it
wasn’t a diaper change. Something was going on. So we called our pediatrician,
and he said, “Well, why don’t you bring her down?” And this was in the
middle of the night. This is like one
o’clock in the morning. And he was willing to see her,
and he pressed on top of her head, and he said, “You know,
she may have meningitis; I want you to go to
the emergency room.” And it turned out
she had meningitis, and she had to get a spinal tap,
and they had to keep her there for three or four days. And the doctor was talking
about if this didn’t — if her temperature didn’t come
down and if we didn’t solve this, she could have permanent
damage to her hearing or other effects. But I still remember that
feeling of just desperation, watching the nurse take her away
to provide treatment for her. But I was thinking, what
if I hadn’t had insurance? What if I was looking at my bank
account and I didn’t have the money to cover her? How would I be able
to face my wife, and how would I be able to look
in the mirror if I didn’t feel like I could somehow
make sure they were okay? And that’s what this
is about, ultimately. I mean, we’ve got to make
sure that health care — our health care dollars
are used smartly. We’ve got to make the system
work better for consumers. We’ve got to make
it more responsive. But ultimately, the thing
that’s most important is, we’ve just got to give people
some basic peace of mind. And I’m just so glad that I’m
able to stand here before you and hear these stories, and
hopefully it gives you a little more peace of mind. (applause) So, all right, well,
thank you, everybody. Appreciate you. And if anybody else
has any questions, they can come up and we
can chat in the shade here. (laughter) Because I don’t have to go
right away, and maybe we can — these guys will
take some pictures. So thank you.

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