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pd01no04 Remarks in Onalaska, Wisconsin...

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continue to expand Pell grants so low- and middle-income Americans can 
start their career with a college diploma. We're going to continue to 
expand access to community colleges so that people actually have the 
skills necessary to fill the jobs of the 21st century.
    I'm going to also remind you that to make sure our economy grows, 
we've got to keep your taxes low. And taxes are an issue in this 
campaign. They are a significant issue, and I'll tell you why. My 
opponent has proposed $2.2 trillion of new spending thus far. That's 
trillion with a ``T.'' [Laughter] That's a heck of a lot even for a 
Senator from Massachusetts. [Laughter]
    So they asked him, ``How are you going to pay for it?'' And he 
pulled out that same old line, that class warfare line, ``Don't worry, 
we'll pay for it by taxing the rich.'' You can't raise enough money to 
pay for $2.2 trillion of new spending by taxing the rich. He says he's 
going to raise the top two brackets. I'll tell you three things about 
    One, most small businesses are Subchapter S corporations or limited 
partnerships, which mean they pay tax at the individual income-tax 
level. And when you're running up the top two brackets, you're taxing 
about 900,000 to a million small businesses all across America. Guess 
what, 70 percent of new jobs in America are created by small businesses. 
It makes no sense to tax job creators.
    Secondly, there is a tax gap. There is a difference between what he 
has promised, 2.2 trillion, and what he can raise. Now, guess who 
usually gets to fill that gap? Yes, you do.
    Thirdly, the so-called rich hire lawyers and accountants for a 
reason when it comes to tax time: to slip the bill and pass it onto you. 
The good news is, we're not going to let him tax you. Taxes would be bad 
for our economy. If you want to make sure you keep jobs here in Ohio, 
you keep the taxes low. We're not going to let him tax the American 
people because we're going to win in November. He can run. He can run--
he can even run in camo--[laughter]--but he cannot hide.
    A couple of other things I want to share with you, and then we're 
going to talk about health care, as you can see. I want to talk about 
promoting an ownership society in America. You know, it's said that no 
one ever washes a rental car. [Laughter] There's some wisdom in that. 
[Laughter] When you own something, you care about it. If you own your 
own small business, you care about the future of America. Do you realize 
that the homeownership rate under my administration is at an alltime 
high in America. We're going to talk about health savings accounts in a 
minute, but this is a way for people to own their own health care and 
manage their own health care in a way that makes sense for American 
families and American small businesses.
    I want to talk about Social Security and ownership. The 2000 
campaign, I remember it clearly. During that campaign, people ran 
advertisements that said, ``If George W. gets elected, our seniors will 
not get their Social Security checks.'' You might remember those ads. 
It's kind of the old typical political scare tactic. Well, as you're out 
gathering up the vote, remind our senior citizens, I did get elected, 
and you got your checks. And I'm going to get elected again, and you're 
still going to get your checks.
    The reason I bring that up is because I'm willing to talk about how 
to make sure the Social Security system is available for our children 
and our grandchildren. It is necessary to do so. See, we're in good 
shape as a baby boomer. The money in the trust--there's enough people 
paying in that we'll be taken care of. We need to worry about the 
children and grandchildren. We need to worry about whether or not Social 
Security will be available for them.
    In order to make sure Social Security is available for our young, I 
believe younger workers ought to be allowed to take some of their 
payroll taxes and set up a personal savings account that will earn a 
greater rate of interest--rate of return on their money than it does in 
the current Social Security trust, a personal account they can call 
their own, a personal account they can pass on to

[[Page 2536]]

whomever they want, and a personal account the Government will never 
take away.
    And here we have another difference in this campaign. See, I believe 
a President ought to confront problems and not pass them on to future 
Presidents and future generations. And we have a problem in Social 
Security. You might remember one of our debates when my opponent said, 
``Well, the status quo was fine.'' Let me remind you of two things about 
that. One, he is the only person on that stage during the debate that 
voted to tax Social Security benefits, not once but eight times. And 
secondly, the status quo is not fine when it comes to our children. A 
President must be willing to confront problems. And in a new term, I'll 
bring Republicans and Democrats together to make sure Social Security is 
available for the younger generation.
    Now, let me talk about health care. We have a clear choice when it 
comes to health care in this campaign. I have a commonsense approach to 
make sure health care is available and affordable. Available through 
places like community health centers, where the poor and the indigent 
can get health care and relieve pressure off of the emergency rooms of 
the hospitals all across the country. Available by making sure our 
children of low-income families are fully subscribed in the Government 
health care program for them.
    Affordable by recognizing that most of the uninsured in America work 
for small businesses, and therefore, small businesses ought to be 
allowed to pool risk across jurisdictional boundaries so they can buy 
insurance at the same discounts that big companies are able to do. 
Affordable through health savings accounts, which we'll discuss. Health 
care more affordable by moving generic drugs quicker to the market so 
our seniors are able to better afford prescription drugs.
    Affordable because I'm the first President to have taken on 
Medicare--I shouldn't say that; other Presidents have talked about 
Medicare. It used to be called ``Mediscare'' because anytime you talked 
about it, somebody would club you over the head with it as an issue, 
political issue. But I went to Washington to solve problems. And we had 
a problem in Medicare. Medicine was changing. Medicine was modernizing; 
Medicare wasn't. We'd pay tens of thousands of dollars for a heart 
surgery for a Medicare patient but not a dime for the prescription drugs 
that could prevent the heart surgery from being needed in the first 
place. That didn't make any sense. So I brought Republicans and 
Democrats together. I signed a good Medicare bill that says, in 2006, 
our seniors will get prescription drug coverage.
    To make sure health care is available and affordable, we have got to 
do something about these frivolous and junk lawsuits that are running up 
the cost of medicine and running good doctors out of practice. We're 
going to talk about that issue in a minute.
    We're going to talk about that issue in a minute, but I do want to 
make it very clear there is a difference of opinion between me and my 
opponent on health care. In one of the debates he said--he looked right 
in the camera, he said, ``The Government doesn't have anything to do 
with it,'' referring to his health care program. Stared right in the 
camera and said it. I could barely contain myself. [Laughter]
    The Government has got a lot to do with it. Eight out of ten people 
that will be signed up for health insurance on his program will end up 
on a Government program. When you raise the limits of Medicaid, it 
provides an incentive for small-business owners to provide no insurance 
for their employees because the Government will pick it up. And 
therefore, millions of people will go from private insurance to the 
Government rolls. His is a plan that creates 225 new mandates for small 
businesses. Government-run health care does not work. We have got a 
great health care system in the world because it's innovative, because 
it's--private medicine is at the center of our health care system. And 
my opponent's plan would increase the scope and the size of the Federal 
Government when it comes to your health care decisions.
    In all we do to make sure health care works, we'll make sure the 
decisions are between patients and doctors, not by officials in 
Washington, DC.
    Up here with me is Michael Gordon. No, not Michael Gordon. He didn't 
make it. Michael Gordon was supposed to be here. He's a small-business 
owner. Let me talk about Michael Gordon right quick. He's stuck out

[[Page 2537]]

there, probably behind a barricade chanting, ``Four more years.'' 
    Audience member. Four more years!
    The President. Oh, Michael, you made it. [Laughter]
    Anyway, he's from Tendon Manufacturing. He's a small business. He's 
adding employees. He's optimistic--a small manufacturing company here in 
Ohio. He is a Subchapter S corporation. I wish Michael were sitting up 
here so you could see him. He's a Subchapter S. He's expanding his 
business. When you run up the top two brackets of the Tax Code, you're 
taxing Michael. You're taxing his company. It makes no sense to tax the 
small-business job creators, which is precisely what Senator Kerry will 
    Now, let me talk to you about Bruce, Bruce McDonnell. That's you.
    Bruce McDonnell. That's me.
    The President. Okay. [Laughter] What do you do, Bruce?
    Mr. McDonnell. I'm a CPA.
    The President. You are? Good. And he is here to discuss with us 
health savings accounts. Some of you have heard of health savings 
accounts; some of you haven't heard of health savings accounts. But it 
is an innovative way to make sure the health care costs are reasonable.
    Describe to us, if you don't mind, for this great crowd how it 

[Mr. McDonnell made brief remarks.]

    The President. Let me stop you. That's to pay for major medical 
bills. So anything above 1,000 for an individual will be taken care of 
by the insurance company. Go ahead.

[Mr. McDonnell made further remarks.]

    The President. Right. So here's the way it works. He says--what he 
just said is, a health savings account, one, is a combination of a tax-
free saving account plus a high deductible insurance policy. So say 
you've got a $1,000 deductible, from zero to 1,000, you're responsible 
for paying, or in his case, his company contributes from the zero to 
1,000 a portion of that. And then above 1,000, the insurance company 
pays for it.
    But think about the benefits of that kind of plan. First of all, if 
you don't use all 1,000, it's rolled over to the next year tax-free, so 
that you begin to accumulate savings for your own health care. Secondly, 
if he were to start a new firm, which I'm not suggesting you're going to 
do, but if you were, and you moved, the health care account would go 
with you. It's yours. You own the health care account. You make the 
decisions. Decisionmaking between patient and doctor is a part of how we 
introduce market forces into a health care industry. One way to control 
cost is to let consumers have more decisionmaking, which is precisely 
what a health savings account does.
    Isn't that right?
    Mr. McDonnell. Absolutely right.
    The President. Did we get it right?
    Mr. McDonnell. You got it right.
    The President. This is a very interesting way to help small 
businesses hold down-- [applause].
    Guess who else is a health savings account owner? Doc, you're a 
health savings account owner--Dr. Schwieterman. Where are you from, doc?
    Dr. Tom Schwieterman. I'm from Mercer County, which is on the other 
side of the State, Mr. President.
    The President. Welcome. Glad you're here. You are a doctor of?
    Dr. Schwieterman. Family practice, and I provided obstetrics up 
until a month ago.
    The President. Yes. We've got a problem. ``Provided up until a month 
ago''--helps define what we're here to talk about, which is good health 
care for people.
    Doc, tell me, you have been--you've told me something really 
interesting. I don't know if you know this, but my grandfather was 
raised in Columbus, Ohio. He ended up being a Senator from Connecticut--
Connecticut, yes. My dad, as you know, was in politics. I'm in politics. 
Anybody in your family ever been a doctor before?
    Dr. Schwieterman. I am the fourth generation family physician in the 
same town and actually in the same building in rural Mercer County.
    The President. Yes. Nothing wrong with following the old family 
footsteps. [Laughter]
    Dr. Schwieterman. Little easier, though.
    The President. Right, girls. [Laughter] Oops.

[[Page 2538]]

    So, we were backstage talking. I mean, this is, obviously, not the 
first time I met Tom, or the doc, I call him. We have a--he's a rural 
doc. Rural health care is really important for the quality of life in a 
State like Ohio. And so tell me, describe your problem.
    Dr. Schwieterman. We have a family practice that has a very long 
heritage, of course, 113 years of providing general medical care and 
obstetrics. Over those 113 years, we have delivered over or near 10,000 
children, and--[applause]. Thank you. See, my dad's right there. He 
delivered 5,000.
    The President. Is that Dad?
    Dr. Schwieterman. That's my dad.
    The President. Hey, Dad. You raised a good boy.
    Dr. Schwieterman. And during those 110-13 years, we have never had a 
claims made against our practice. We have retained a majority of those 
births within the practice. And unfortunately, last month, we were 
forced to do our last delivery, and this was a fourth generation 
patient. And she unfortunately ended the legacy that we have enjoyed for 
so long.
    The President. And why? Tell people why. They need to know the 
truth. The people of Ohio need to understand what's taking place as a 
result of all these lawsuits.
    Dr. Schwieterman. For the past 3 years, we've pretty much done ob at 
cost. What we took in is what we paid out in malpractice, and this year, 
we--our premiums went up 40 percent, and it became a point where we 
could not afford to maintain a small business with our employees, take 
care of our patients, with the premiums going from 25 to 80 thousand 
dollars in 48 months.
    The President. Yes. Let me tell--people need to hear this. This is 
an issue in this campaign. The quality of life in the State of Ohio 
depends on whether or not you've got good docs and good, strong 
hospitals and people being able to find health care in cities and in 
rural America.
    Let me talk to you about these lawsuits. First of all, docs practice 
what's called defensive medicine. If you've got a lawyer looming right 
behind you all the time, if you're worried about what happens in the 
court--in the--okay, fine. Everybody needs a good lawyer. I've got too 
many myself. Anyway --[laughter]--it's the difference between some 
lawyers and personal injury trial lawyers that are constantly out there 
trying to convert this legal system into what looks like a lottery. And 
guess who ends up paying for the ticket? The taxpayers and the people, 
because the quality of health care is going down.
    If you've got a lawsuit, if you think you're going to get sued, 
you're going to practice more medicine than is needed so you can defend 
yourself in a court of law. That's what happens, and guess what that 
does to the Federal budget, for example. The defensive practice of 
medicine costs our budget about $28 billion a year. I say ``our'' 
budget, because when I talk about the Government budget, you pay for it. 
It's your money, 28 billion a year in excess costs in Medicaid and 
Medicare and veterans' health benefits. This is a national issue.
    Secondly, because of the lawsuits, because many people just settle 
whether the suit has merit or not, premiums go up. And guess who pays 
the premiums? You do.
    And thirdly, as a result of a lot of these lawsuits, people just 
can't simply practice medicine anymore. And you just talk--you just 
heard the story that unfortunately is being repeated over and over and 
over again in America. This country needs medical liability reform--now.
    And this is an issue in this campaign. This is an issue in 
campaign--this campaign. Oh, I heard him in the debates, my opponent. I 
heard him talking about medical liability reform. But let me tell you 
something. We had a bill on the floor of the United States Senate to 
provide liability protection to ob-gyns, and my opponent voted ``no.'' 
He's voted against medical liability reform 10 times in the United 
States Senate. He can run, but he cannot hide from that record.
    Barb Coen is with us. Doc, thanks. Where do you work?
    Dr. Barb Coen. I work in Norton, Ohio, at a practice called 
Generations Women's Health Care, with my partner, Dr. Susan Clark, who's 
    The President. Where's the doc? Oh, there you go. Thanks for coming. 
I appreciate you. Very good. Dr. Clark?
    Dr. Coen. Dr. Clark.

[[Page 2539]]

    The President. Yes, Dr. Clark. Good to see you, doc. You must have 
drawn the short straw, so you're the one who had to actually get up here 
and talk in front of all the cameras. [Laughter] Tell us about your 
practice. Just give--tell people exactly what's happening.

[Dr. Coen made brief remarks, concluding as follows.]

    Dr. Coen. And as all of you know who've had a baby, the relationship 
between an ob-gyn and a pregnant patient is pretty special. They trust 
you with not only their life but the life of their unborn child. I can't 
tell you what an honor it is to be the first person to touch a new life 

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