This piece first appeared at Popular Resistance.
My fellow Americans, tonight I want to apologize for the results of my efforts in reforming US healthcare. It is now evident from the roll-out and the technical problems that have been exposed that we have created a complex system in which these types of problems will exist, not just at the beginning in the setting up of a website to sell health insurance, but as the law takes full effect. Therefore, tonight I am announcing my intent to work for a major but simple change in direction.
First, I apologize because these problems should have been evident before we passed the Affordable Care Act. Prior to the ACA, the existence of the insurance industry created tremendous bureaucracy for consumers, doctors, health providers and hospitals as well as for business and the government. It also resulted in millions of Americans not being able to get the healthcare they needed, even if they had insurance. After the ACA we now see these problems persist. This is not surprising.
The ACA requires each state as well as Washington, DC and Puerto Rico to have an exchange to sell health insurance. Each exchange has four levels of insurance -- platinum, gold, silver and bronze. Within each level there are multiple insurance companies and each insurance company puts forward multiple insurance plans. Each state has its own regulatory system for health insurance and the federal government has thousands of pages of regulations as well. This is a very complex system not only for the purposes of selling insurance, but will remain complex throughout the system. Doctors, health providers and hospitals will continue to need to spend more time and money managing payments for healthcare; businesses will continue to need to spend a lot of overhead figuring out what kind of insurance to have and government will have to create bureaucracy to manage thousands of insurance policies.
Second, I want to apologize for stifling the debate we should have had in developing a national healthcare system. When we began this process we had the opportunity to look at three very distinct systems currently operating in the United States -- a market-based system dominated by the insurance industry with healthcare provided for-profit; a single-payer system, Medicare, where the government is the only funder of healthcare and private providers deliver healthcare services; and, a completely government-run healthcare system for Veterans (VA) where the doctors, hospitals and healthcare providers all work for the government.
This would have been a great debate that would have resulted in the United States putting in place the best national health plan based on our experience, and the empirical evidence, of what has worked and what has not, in US healthcare. I suspect if we had that debate the market-based system would have been shown to be the weakest of the three alternatives and a combination of Medicare and the VA would have been the most cost-effective way to provide healthcare for every person in the United States.
As a former advocate for single payer I knew this, but put aside the empirical evidence. Instead, I allowed those with the most money to decide what kind of healthcare we should have. Even though single-payer had the support of more than 60 percent of Americans, two-thirds of doctors as well as nurses, I ignored the desires of the people and instead worked with the insurance industry, pharmaceutical industry and for-profit hospitals. This was a terrible mistake and a missed opportunity that would have resulted in the United States getting on the path to becoming the most efficient and effective healthcare system in the world; instead we remain the most expensive system that produces mediocre results.
Today, I am announcing the "drop two words campaign." Rather than producing a law of more than one thousand pages and thousands of pages of regulations, I am going to work to drop "over 65" from the Medicare law so that Medicare will serve everyone. After we pass this law, future administrations can work to make the law better, as even the best health systems in the world constantly work to improve themselves. My hope is that Medicare covers more health services and ends out-of-pocket costs for healthcare, but for now we are merely seeking to drop two words and provide healthcare to all.
People will say this is a politically unrealistic goal, which is why I am calling this a campaign. Rather than counting votes in Congress, I will work to build the movement that is needed to force members of Congress to do the people's will. If Members refuse, I will work to remove them from office no matter whether they are Democrats or Republicans. Providing healthcare to every American is more important than either political party or any politician.
While I am apologizing for the healthcare law, I need to apologize for something else that became evident this week. A chapter of the Trans-Pacific Partnership was made public by Wikileaks. This chapter on intellectual property rights showed that my administration has been doing the bidding of transnational corporations throughout the nearly four years we have secretly negotiated this agreement. And, the documents leaked also show that my government has been the most aggressive in the world in pushing a corporate agenda even if it would undermine Internet Freedom, healthcare and other essential aspects of people's lives. The root cause of these actions by my administration are the same as the root cause of the problems with the ACA -- I have allowed Wall Street and other big money interests to dominate the direction of trade negotiation. I apologize for putting their profits ahead of the needs of the people and ahead of the necessity of protecting, and even enhancing the environment.
Tonight I am announcing that we are erasing what has been done so far and re-starting the TPP negotiations. For the last four years we have negotiated in secret with more than 600 corporate advisers helping to draft the text. This text cannot be saved and must be started anew. It is evident from the experience of the last 15 years that negotiating trade agreements that are rigged for big business interests does not work and is not supported by the people. We cannot continue to use trade negotiations as an end-around democracy. The World Trade Organization has been stopped from making progress since the 1990s and 14 trade agreements have been stopped over that time because people do not support rigged trade for transnational corporations. Obviously, the approach we are taking is not working and is not serving the people and planet.
The new approach to trade needs to be transparent and inclusive. We want the participation of civil society in all the countries that are part of the negotiations. I have learned that the public interest is best met when the views of the people are heard. And, we need to set a new framework going forward. Trade needs to build a new economy for the 21st Century. This needs to be the century we end poverty, meet basic necessities and lift the wealth of all people as well as develop economic relationships that help make diplomacy by war a thing of the past. The framework I am putting forward tonight begins with putting the necessities of the people and the protection of the planet before excessive profits by corporations.
Finally, while my administration has been at odds with Julian Assange and Wikileaks, as well as other whistleblowers, tonight I want to say thank you to them. Before becoming president I said that I believed in transparent government and that whistleblowers play an important role in getting out the truth. As president I have learned that sometimes these truths are ones of which I am not even fully aware. I am directing the Department of Justice and Department of Defense to review all prosecutions and convictions of whistleblowers. In addition, the issues they have exposed will now be reviewed by people independent of the government. We will not have the NSA and members of the intelligence establishment reviewing the spying on Americans. We will have critics of the NSA making such a review and recommendations. This is the model we will use on a host of issues that have been exposed.
I realize many Americans are already well-aware of the corruption of government by big business interests that has been created by the rule of money. And, I know that as the candidate who has set two records in campaign spending, that I have been part of that problem. I pledge in my remaining time in office that I will do all I can to end the rule of money and empower people -- not only in our electoral system but also in the running of government on a day-to-day basis. I cannot do this without the help and participation of the American people, so this will not be the last message to you on these important matters.
Thank you all for listening tonight.
President Barack Obama