George W. Bush photo

Remarks in a Discussion on Health Care in Muskegon, Michigan

September 13, 2004

The President. Listen, thank you all for coming. Thanks for coming. Please be seated. So Hoekstra said, "Get over here." He said, "Come to Muskegon." I said, "Okay. See if you can get some people to show up."

Listen, thanks for coming. I'm here asking for the vote. I'm here to tell you I have a reason to ask for the vote, and we're going to do it a little differently today. I'm going to talk to some of our fellow citizens about health care. That's what I really want to spend some time on. I'm also going to talk about making America a safer place, making the world a safer place.

Before we get started on issues that matter to the future of everybody in this country, there's an issue that matters to me, and that is, I hope I can also count on your help in order to win this election. That means registering people to vote. Step one is to remind your friends and neighbors that we have an obligation in a free society to participate. So anybody who is 18 years old here who hasn't registered—register. You have an obligation. And step two is once we register people to vote, is to get them to vote. And step three is when you get them headed into the polls, remind them America will be a safer place, a stronger place, and a better place when you put Dick Cheney and me back into office.

Audience members. Four more years! Four more years! Four more years!

The President. Okay. Thank you all. Perhaps the most—I'm ready for 4 more years, and perhaps the most important reason to give us 4 more years is so that Laura will be First Lady for 4 more years. So I said, "Will you marry me?" She said, "Fine." She was a public school librarian in Texas. She said, "Yes, I'll marry you, just so long as I don't have to give any political speeches." [Laughter] Well, fortunately, it's a promise she didn't hold me to. People got to see her in New York City. She gave a fabulous speech. And the reason why is because she's a genuine, kind, compassionate person who is a great mom, a great wife. I love her dearly. And she sends her very best. She's out campaigning today.

I want to thank my friend Peter Hoekstra. He is a solid citizen and a very fine Member of the United States Congress. He is—and Diane, thanks for coming—he is a highly respected Member of Congress. He is now going to be in charge of the House Select Committee on Intelligence. I look forward to working with him to strengthen our intelligence gathering capabilities so that we can do as good a job as possible about protecting our fellow citizens. Peter understands that the world changed on September the 11th. He understands we have a solemn duty in America to do everything we can to protect you. And I look forward to working with you, Pete. It's a great honor that you've been selected.

I want to thank all the grassroots activists. Those are the unsung heroes who put up the signs and make the phone calls and do all the hard work. I want to thank you for what you have done. I want to thank you for what you're going to do—[laughter]—over the next couple of weeks. You know, there's just no doubt in my mind that with your help, we're going to carry Michigan and win the country.

Listen, most people in America agree with my philosophy that the role of Government is to help people realize their dreams, not to try to run their lives. The role of Government is to say, "What can we do to help you," not tell you what to do. And that's the fundamental difference of opinion in this campaign.

One of the things that I'm going to spend a lot of time talking about in this race is that I understand the world we live in has changed. And the fundamental systems of Government must change with a changing world. People say, "What do you mean?" Well, think about the workforce. When our dads and granddads were in the workforce, they generally were working for one company, one career, had one pension plan, one health care plan. Today, the workforce has changed. A lot of people have more than one job and more than one career. In other words, people are changing. Life is moving quite quickly.

The other most massive change in the workforce has been women. Women who used to stay at home are now not only working inside the house, are working outside the house. And yet, the Government systems haven't reflected this change.

The pension plans were designed for yesterday. They need to be designed for tomorrow. If you're a senior citizen, you don't have to worry about Social Security. If you're a baby boomer, you don't have to worry about Social Security. And by the way, you'll hear the same rhetoric you hear every campaign, believe me, you know, "Oh, don't worry, they're going to take away your Social Security check." It is the most tired, pathetic way to campaign for the Presidency. So you don't have to worry about that. And baby boomers are fine. We're in good shape, you know.

The people who aren't in good shape are the children and grandchildren in this country, because there's a lot fewer payer-inners than there are recipients when it comes to Social Security checks. I think we need to think differently for young folks when it comes to pension plans, and by that I mean younger folks ought to be able to take some of their own taxes and set aside a personal savings account. When you hear me talk about changing systems to help people, this is a—this will help people when they have their own personal savings accounts which will enable them to actually receive Social Security benefits.

The worker training programs were designed for yesterday. They need to be designed for tomorrow. That's why I'm such a big backer in community colleges. That's why I believe we ought to promote a lifetime of learning for workers. The jobs change in America. Sometimes the skill sets don't change with them. In order to make sure people can work and realize their dreams, the job training programs must adjust to a changing economy.

We're going to talk about health care. It needs to be changed and modernized. It needs to reflect the world in which we live.

The Tax Code needs to be changed. It's complicated—it's a complicated mess, is what it is. Americans spend about 6 billion hours filling out the taxes. That's a lot of time and a lot of headache. The Tax Code is full of special interest loopholes. In a second term, I'm going to work with both Republicans and Democrats to simplify the Tax Code, to make it more fair. This will not only help our economy grow, it'll help the American worker; it'll help the American family. So we're going to simplify the Tax Code.

What I'm telling you is, I recognize the changing world in which we live, and the proper role of the Government is to change the systems of Government that were designed for yesterday so that they reflect tomorrow. In order to make sure—by the way, one of the biggest changes we have in America is the fact that our workers are more productive than ever. There have been high productivity increases, and that's great for the country. People say, "What do you mean by productivity increases?" It means you've gone from a shovel to a— you know, to a mechanized digger, or from a manual typewriter to a computer. That's what it means, when you come more productive.

And yet, a more productive workforce requires our economy to have sustained growth in order for people to find work. If the same worker can—if one worker can double the output of the past, it means the economy has to grow faster in order to make sure people can find work if they're not working. That's what that means. And, therefore, I put out a plan to make sure the economy that we have today is even stronger tomorrow.

Now, when you're out gathering the vote, remind people we've been through a lot. Think about what this economy has been through. When we got in there, the market had already been declining for about 5 months. In other words, there was something fragile about the economy. And then we had a recession. The first three-quarters of my Presidency were declared recession because economic growth was negative. In other words, we checked in to serve the American people, and the next thing we know is we've got a recession handed to us.

And then we had some corporate scandals, and that affected the psychology of the country. Make no mistake about it, when somebody doesn't tell the truth in the corporate world, it affects economic growth. There should be no question in anybody's mind today that we will not tolerate dishonesty in the boardrooms of America.

And then September the 11th came, and it hurt us. I'm going to talk a little bit later on what it meant in terms of working to secure the homeland. There's some interesting—not "interesting"—really important lessons from that day. But they estimate we lost a million jobs in the 3 months after September the 11th.

And yet, if you think about it, we've overcome those obstacles. This economy of ours is strong, and it's getting stronger. And the fundamental question—I mean, the national unemployment rate is 5.4 percent. That's lower than the average of the 1970s, 1980s, and 1990s. Now, there are pockets in your State where the recovery is lagging behind the national average. I understand that. But that means we ought to put good policies in place and keep them in place, as opposed to resorting to the old, tired, you know, Government approach.

So I want to talk to you about how we're going to keep the economy growing. And one of the key aspects is to make sure the health care system works. Before we get to the health care system, let me— here are some ideas that the American people need to hear.

In order to make sure the job base expands in America, we need an energy policy that makes us less dependent on foreign sources of energy. I mean, it's going to be hard to sustain economic growth if we stay hooked. And we need to modernize our electricity grid as well. I submitted a plan to the United States Congress over 2 years ago, and it's stuck. It's a plan that encourages conservation. It's a plan that recognizes technology is going to change much of the energy debate.

In other words, hopefully within a decade, people will be driving hydrogen-powered automobiles. That makes sense. You know, we've got great research being done on clean coal technology, so we can use an available resource. We want people— and one of—I think a great opportunity for America is that someday they're going to walk in and say, "Here's the crop report, Mr. President. We're growing more corn than ever, and now were less dependent on foreign sources of energy." We ought to be using ethanol and biodiesel as ways to diversify our energy supply.

I think we ought to be using technology to expand and advance nuclear power. We ought to be wise about how we diversify our energy supplies and encourage energy conservation. In order to keep this economy growing, we put forth a plan that Congress must pass in order to make us less dependent on foreign sources of energy.

In order to make sure the economy grows, we've got to continue to open up markets. There's a lot of farmers in this part of the world. The farm economy is strong here, strong in Michigan, and it's strong around the world. One of the reasons why is because we're selling U.S. product in other markets. That's one of the reasons why. Ask your corn growers, ask the people who are growing soybeans what it's like to be able to sell product, grown here in Michigan or elsewhere in America, overseas. And listen, we've opened up our markets, and it's good for you we have. Here's the way the economy works: If you've got more choices to choose from, you're likely to get the product you want at a better price and higher quality. That's how it works. My message to places like China is, "You treat us the way we treat you," because we can compete with anybody, anytime, anywhere, so long as the rules are fair.

One of the reasons we overcame the obstacles, one of the reasons this economy is growing, is because of well-timed tax cuts. I mean, when you've got more money in your pocket, it means that you're going to demand an additional good or a service. And when you demand an additional good or a service, somebody is going to have to produce it. And when somebody produces it, it means somebody is more likely to find work.

One of the central tenets of that tax relief was, we're helping our small-business owners. Do you realize 90 percent of the small-business owners in America pay individual income taxes?

Audience member. [Inaudible]

The President. Good, well, there you are. Then you understand what tax relief means. [Laughter] When you give—70 percent of the new jobs in America are created by small businesses, and when you provide tax relief for small businesses, it means our economy is growing. That's what's happening here in America.

And so here's the thing, we've got to do something about these frivolous lawsuits that are making it hard for small businesses to stay in business. We've got to reduce regulations on small businesses so they're able to hire. And we must not raise taxes. In order to keep this economy growing, in order to make sure that jobs are available not only this year but in the out-years, we've got to keep your taxes low, and that's an issue in this campaign. It's an issue.

I'm running against a fellow who has proposed over $2 trillion of new Federal spending. That's a lot. And so they said, "Well, how are you going to pay for it?" He said, "Oh, don't worry. I'm just going to tax the rich." Now, let me—a couple of things wrong with that. One is, you can't tax the rich enough to pay for over $2 trillion of new money. In other words, there's a tax gap. Guess who's going to get stuck? Yes. Don't worry, we're not going to let him stick you, because we're going to win. [Applause]

Hold on a second. A couple of other things. Thank you all. We've got a lot of work to do here, though. [Laughter] I appreciate the cheering.

Secondly, if you run up the top two brackets on the individual income taxes, you're taxing about a million small businesses, is what you're doing. Now, why in the heck would you want to tax small businesses just as this economy is beginning to grow? If 70 percent of the new jobs are—in America are created by small businesses, why would you want to tax the job creators? You wouldn't.

Thirdly, you've heard the rhetoric, right, "Tax the rich." We've heard that before. The rich hire accountants and lawyers for a reason. [Laughter] And you get stuck with the bill. Raising taxes is wrong right now for this economy, and we're not going to let him get away with it. We are going to win. Taxes is a big issue in this campaign. I intend to make it an issue all across the country.

Let me talk about health care. We're going to talk about health care now. And I've asked some folks to come and explain to you some of the reasons why our policy makes sense. You've probably already heard enough from me already for one day.

Audience members. No-o-o!

The President. Okay, well, that's good. I'm just looking for a little affirmation. [Laughter] If that's the case, I'm just getting wound up.

I have a practical, commonsense plan to make health care available and affordable, and that's important, a practical way to make sure health care is available and affordable and a way to make sure good doctors keep practicing medicine.

I believe health care decisions should be made by doctors and patients, not by bureaucrats in Washington, DC. We have a difference of opinion in this campaign. I'm running against a fellow who has got a massive, complicated blueprint to have our Government take over the decisionmaking in health care.

Audience members. Boo-o-o!

The President. His plan, if you listen carefully to what he says, would have bureaucrats become the decisionmakers, and that would be wrong for America. As well today, there's a independent study which has been released which says that his plan would cost the taxpayers $1.5 trillion in new Government spending. Not only is his plan going to increase the power of bureaucrats in your lives, but he can't pay for it unless he raises your taxes.

Today we're going to talk about a difference of opinion. It starts with—you know, what would you expect from a Senator from Massachusetts? [Laughter] That's what you would expect—a Government takeover of health care with an enormous price tag. We're going to talk about a way to make sure health care is available and affordable, and start with Medicare. You might remember the old Medicare debates. They were called "Medi-scare" because people wouldn't dare talk about changing them. I believe we have a duty to our seniors. I believe we have a moral obligation to make sure health care is available and affordable to our seniors.

Plus, I went up to Washington to fix problems. You know, I said, "If I'm fortunate enough to win"—this is what I said in 2000—"I'm going up to address problems, not pass them on to future generations and future Presidents." My style is to say, "Here's a problem. Let's come together to fix it." We had a problem in Medicare. And the problem was that medicine was modernizing and Medicare wasn't. People say, "What do you mean by that?" Well, Medicare would pay for, you know, $100,000, say, for heart surgery, but wouldn't pay for the prescription drugs to prevent the heart surgery from being needed in the first place. That didn't make any sense. It didn't make any sense for our seniors. It didn't make any sense for the taxpayers.

And so we modernized Medicare. Listen, seniors should get a prescription drug card today. It will help you with your cost of drugs. Starting in 2005, we'll have preventative care and screenings for our seniors as a part of Medicare. That makes sense. You hear me say I've got a commonsense, practical plan. It's practical to have seniors tested early so we can diagnose problems before it's too late. It's practical for seniors to be given preventative screenings in Medicare, and in 2006, prescription drugs will be available for senior citizens in Medicare. We have strengthened Medicare, and it's good for our seniors we have done so.

To make health care available and affordable, we've got to do something about the junk lawsuits that are running up the cost of medicine. And those junk lawsuits are running good docs out of practice. If the goal is an available and affordable health care, we've got to do something about lawsuits. Make no mistake about it, these lawsuits are running up your cost of medicine. You ask small-business owners, you ask docs what it's like to practice in a litigious society. That means there's a lot of lawsuits. [Laughter] I'm not even a lawyer, and I know the word "litigious." [Laughter] Yes.

And so—people say, "Well, that was a local issue." No, it's not a local issue when the cost of medicine is skyrocketing or the cost of health care is skyrocketing because of the defensive medicine being practiced by docs, so if they get sued, they're able to have a good case in the courthouse. And it costs the taxpayers about 28 billion a year for docs to practice medicine defensively.

And therefore, I went to Congress and said, "This is a national problem. It requires a national solution. We need medical liability reform." Of course, it's stuck in the United States Senate. It came out of the House, and I want to thank Pete for his support. It's stuck in the Senate because the trial lawyers are powerful. They are a powerful special interest. They stand in the way of good medical liability reform. This a big difference in this campaign. I like to remind people you can't be pro-doctor or pro-patient and pro-trial-lawyer at the same time. You have to choose. My opponent made his choice, and he put him on the ticket. I made my choice. I'm standing with the docs and patients. I am for medical liability reform—now.

There's more to do to make health care available and affordable. We've got to modernize the health care information. I believe that within the next 10 years, we can have electronic health records, with safeguards for your privacy, which will cut down on the administrative costs of health. We can save a lot of money by using technology to modernize health care.

In order to make sure that health care is available, we need to expand the Government health insurance program for children. In other words, it exists, but many children are not using it. We've got a billion dollars available in the budget to encourage families to take advantage of Government-sponsored health care for children, for low-income children. It makes sense to make sure that the programs are fully utilized in every aspect of our—in every corner of our country.

In order to make sure health care is available, we need to expand community health centers. Tom Lufkin is with us. We're about to talk about community health centers. I made a promise, by the way, when I was running. I said, "These things make sense for low-income Americans, to have a place to get preventative care. It's better that they get care in a community center rather than an emergency room in a hospital." I think it's good use of taxpayers' money to expand these, and we're doing it. We're fulfilling the promise I made in the 2000 campaign. I made a further pledge. I think every poor county in America ought to have a community health center.

Tell us what they are, Tom. Thanks for coming.

[At this point, Thomas Lufkin, executive director, Muskegon Family Care Center, made brief remarks.]

The President. Appreciate that. Thanks. See, I believe Government ought to help people who can't help themselves. And the idea is to help people so they can help themselves, but there are some who just can't, some who are stuck, some who are poor. In the land of plenty, there are pockets of poverty. We've got to understand that. And the idea is to make sure that preventative health care is available through community health centers.

I want to thank you for your compassion. An interesting point he said was these health centers spawn other acts of generosity in communities. People see that they're up and available, and other people who have got good hearts, who want to love their neighbor like they'd like to be loved themselves, step up and participate in helping those who hurt, in helping those who need help.

And so one way to make sure health care is available is to expand community health centers throughout the country. And that's what we're doing. I want to thank you for coming, Tom.

Another way to make sure health care is affordable and available is to help small businesses with health care. Now, here's the problem for small businesses: They go out and bid in the current system, and they don't have a significant pool of people to spread risk. That's the problem. They're in the midst of trying to provide health care in their businesses, and they go out and try to get a bid for health care, and they're kind of a little, stand-alone entity. Now, big companies are able to pool risk because of their size. We believe in order to make sure health care is available and affordable, that little companies ought to be able to bind—be bound together, share risk, so they can get the same discounts that big companies get.

David. David Pray. I was looking for you and finally found you. [Laughter] Tell us what you do.

[David J. Pray, president and chief executive officer, Decker Construction, Inc., made brief remarks.]

The President. Good, that's a good sign, isn't it? Upbeat guy. Small company, how many employees?

Mr. Pray. We have 10 employees.

The President. Ten, that's small. That's the definition of a small business. And so he was telling me aboard Air Force One there that he has some problems with health care.

Mr. Pray. Well, we've been—through Associated Builders and Contractors, we have been in a statewide pool for quite a long time. And for a lot of years, we enjoyed about a 10 to 15 percent cost advantage over being—over going out and finding single, affordable policies elsewhere.

The President. So they got a plan here in Michigan where you can pool together. It's a nice concept. However?

Mr. Pray. However, last year, the State of Michigan passed legislation called Small Group Health Care Reform which, instead of now being able to pool the risk over 400 member companies, premiums are now calculated based on claims history. So we don't have the advantage of pooling anymore. And the immediate effect for our company was a 29-percent increase in our premiums. And bear in mind that we, as a company, feel a duty to provide the medical and dental care not only for the employee, himself, but for his dependents. We fund 100 percent of that cost.

The President. So here's what we're talking about. Listen, this guy's a responsible guy, you know. He says, "I've got a duty as a employer of people to do the best I can do." The problem is the system is so designed that he can't really do his job because he is unable to pool risk. See, the more people you have in the risk pool, the lower the cost of health insurance. That's just how it works.

And so what we're suggesting is, is that David be able to combine with companies not only in Michigan but nationwide. I mean, why shouldn't a guy building commercial construction in Texas not be able to put his employees in the same pool as David? The reason why is because the health systems were designed for the past. The current health care system is stuck in the past, as far as I'm concerned.

A national plan—in other words, people being able to bind together nationally would mean that a lot of mandates that now affect the cost of health care would not be imposed upon these small businesses, and it means that more people could bind together. People resist this because they like the system the way it is. What we're interested in is, we don't like the way it is. We're interested in change. Government must be willing to change with the times. Association health plans mean we're willing to change with the times to help small employers be able to provide good health insurance for their workers.

Another way—as you can see, I've got a strategy to make sure health care is available and affordable without the Federal Government making the decisions for you. See, we've said, "We're going to take care of those who can't help themselves. We're going to make sure small businesses are able to afford insurance just like big businesses can do."

And now, I want to talk about a very interesting idea called health savings accounts. This is a different approach to health care, which will mean that the patient and doctor are central to the decision-making process and helps us hold down the cost of health care. Health savings accounts are an innovative idea that became the law of the land as a result of the Medicare bill I signed. And I want some people to describe. Matt, are you willing to describe what it means?

Matthew J. Venema. Yes.

The President. Okay, don't worry about all the cameras. [Laughter]

Mr. Venema. All right, all right. I'll try to forget about those.

The President. First, start with the name of the company and why you're even involved.

Mr. Venema. The name of our company is All-Flo Plumbing, LLC. We're a plumbing contractor in the Grand Rapids and West Michigan region. We were struggling under the burden of our health care.

The President. How many people, sorry?

Mr. Venema. Fourteen employees, twelve full-time.

The President. Small business, thousands of small businesses just like his all over the world, all over the country, all over America. The heart and soul of the American economy are these small-business owners. Sorry.

Mr. Venema. No problem.

The President. Giving you time to warm up. [Laughter]

[Mr. Venema, controller, All-Flo Plumbing, LLC, made brief remarks.]

The President. Hold on a minute. Sorry. We've got to make sure the people understand what we're talking about. A lot of times, you use initials in Government. [Laughter] HSA.

Okay, here it is. So you buy a high deductible——

Mr. Venema. High deductible health policy.

The President. ——health policy to cover for major medical costs, right?

Mr. Venema. Correct. Correct.

The President. So, for example, if you're a family—I've said, this company, he'll tell you what his is, I think it's a zero——

Mr. Venema. Pardon me?

The President. What is your deductible in your——

Mr. Venema. It's $3,500 for a family plan.

The President. So above $3,500, the insurance company will take care of the costs.

Mr. Venema. Absolutely.

The President. And then so what happens between zero and 3,500?

Mr. Venema. As the employer, we took most of the portion of our savings and funded the HSA plans for each individual employee.

The President. So the company is now putting in the money to cover routine medical expenses from zero to 3,500. They're able to put it in tax-free. They're able to rollover the money tax-free, and they're able to take the money out of the HSA tax-free.

Mr. Venema. Yes, it's a nice benefit for the individual employee. If they happen to have a good health situation, they get a tax-free savings account. If something goes wrong, they're still covered. And my wife and I gave this a good test run last year because we had a premature baby and $20,000 in health bills at the hospital, and it worked like a charm. So we're very happy with this plan.

The President. Let's make sure we understand here. This is—we're trying to simplify what sounds like a complex issue. And zero to $3,500, you pay—"you" being the company and the employee, depending upon the arrangement. Now, if you spend $2,000 in the year, 1,500 of that 3,500 that's in your account rolls over for the next year. And that's your money, and it's tax-free. It rolls over. So you build up a health savings account over time.

Now, think about a system, by the way, that provides an incentive for you to make good choices with your life. If you save that money by—because you're healthier, that may cause you to go out and walk 20 minutes a day. No fooling. In other words, the system all of a sudden says, "You're in charge. You, the employee, or, you, the patient, you're in charge of your decisions, as opposed to somebody far away making decisions whether or not you deserve this or not through your insurance plan. You're the person in charge." And there's a tax incentive for you to make right decisions.

All right, any savings?

Mr. Venema. Yes, actually when we switched over, the premium savings have been phenomenal. Our total group expenditure right now for health insurance, including what we contribute to everyone's HSAs, is $38,500 a year, approximately. If we were still under our previous conventional plan, it would be about $81,000 a year. So we're talking about a 52-percent savings for our group, and we've been very excited about that.

The President. These work. I'm telling you, they work. They make a lot of sense. Health care is more affordable under health savings accounts, and health care is more manageable because the decisionmaking is between the patient and the doc. And it's really important for people to understand that. This stands in contrast to a system where the Federal Government is going to say, "Oh, here's what's going to happen here. We're going to move people from private health insurance to expanded Medicaid," for example. You don't want the Government making decisions on your behalf when it comes to health care. And this is one of the fundamental philosophical differences in this campaign, is who do you trust? We trust the people. My opponent trusts the Government to make decisions when it comes to health care.

Now, we've got another man here who knows something about it. Jim, tell us what's—welcome.

[Jim Glupker, customer relations, All-Flo Plumbing, LLC, made brief remarks.]

The President. It's an interesting twist. [Laughter] You're not the first person in America that way, by the way. [Laughter] Go ahead. Would you care to clarify why you're mad at me? [Laughter]

Mr. Glupker. I can do that——

The President. ——a fellow like me, sitting here.

Mr. Glupker. I'm just a little disappointed that it wasn't available to me 30 and 35 years ago, when I was a young family, you know? Because then that account would have a lot more in it than it does today.

The President. Yes, see, explain to people—you've got an account up and running? And you've used it?

Mr. Glupker. I've used it, and the interesting thing is, when we changed over——

The President. They work for the same company, by the way.

Mr. Glupker. Yes. We were able to keep our same doctors, which was interesting. And the other thing is, because it's our money, when we go shopping for prescription drugs and stuff, we shop, because why pay $100 for that prescription when you can go down the street and only pay 80?

The President. Yes. See, that's a very interesting point, isn't it? There is a marketplace in America, if consumers are empowered to have choice. That's what we're talking about here. "We go shop." The old system, when the Government is involved, they don't shop. They dictate. Here, consumers shop. It's your money. You're in charge of your money. In this case, the company puts a lot of money in there that you call your own money. It's part of how they make sure the labor relations are good inside this little company, is they contribute to the health savings account, and he's out shopping.

People ask me about prescription drugs a lot. Let me—a couple of points I want to talk to you about. And one, one way to make sure that prescription drug costs are reasonable is to encourage people to go into the marketplace and to provide more information to people so that they're not necessarily buying a brand drug when the generic is available. Generics are a lot cheaper than brand drugs, but nevertheless, they do the same thing.

Secondly, we've got to move generic drugs quicker to the market. That's important for us to do, and we've got plans to do so. As a matter of fact, the Medicare bill helps do that. There's a lot of stalling tactics sometimes in the industry, where they say, "We've got a new add-on that needs to be—need to extend the protection period for our brand drug." Well, we're cutting through all that. We're saying, "Here's a reasonable period of time for you to recoup your investment," and generics are going to move quicker.

I'm asked a lot about importation of drugs. It's an interesting idea. But remember, my job is to protect you as best I can. That's the role of the Government. And what we don't want to do is have a system where it sounds like a pharmaceutical may be coming in from Canada, but, in fact, it is manufactured in another country. I suspect the consumers of this country, while it sounds good that these may be able to help us on price of drugs if they come in from Canada—before I'll allow that to happen, I'm going to make sure that you're safe. Because all you need to do is get a batch of drugs manufactured elsewhere that sounds like they're legitimate, and get sick, and then you're going to be wondering, where were the people, why weren't they doing their jobs of protecting consumer safety? And so I'm interested in knowing whether or not we can make sure you're safe. That's a duty we have in the Federal Government.

Seems like to me, the best way to make sure that drug costs are reasonable is encourage the consumer to be a pricer in the market and to speed up generics. They say we'll save $35 billion over 10 years by speeding up the generic drugs to the marketplace, is what we're doing.

Anyway, I hope you've got a better sense of where I intend to take health care. It's a practical way to make sure health care is available and affordable.

And it's a comprehensive plan. We've thought through this very carefully. It's commonsensical. In other words, it makes sense to do it this way, because the alternative is, in my solemn judgment, not right for the American people. Having the Federal Government run your business and health care is—would be costly, it would lead to rationing of health care. It would mean that you're not in charge of your decisions, which is the exact opposite philosophy we hold.

Now, let me talk to you about making America a safer place and the world a safer place. A couple of things I want to share with you. One, it's important never to forget the lessons of September the 11th, and I'm not going to forget them. I'm not going to forget them.

The first lesson is, the enemy we face is coldblooded, and they have no conscience, that you cannot negotiate with these people, in other words. You cannot hope for the best from them. You cannot hope they'll change their ways. See, these are people who profess, you know, Islam. No, they've hijacked Islam, and they've substituted the peaceful nature of Islam with an ideology of hate. And they use terrorism as a tool to shake our will, to shake the conscience of the free world. And so the only way to deal with them is to stay on the offense, is to chase them down overseas so we don't have to face them here at home, and we will. [Applause]

And it's important—okay, if you'll all hold on—thank you. I've got a little more work to do, though. Got some things on my mind——

Audience member. Four more years!

The President. Oh, we'll have a chance to do a little "4 more year" thing in a minute. [Laughter] I've got to tell you what's on my mind. I want you to know I have a reason for running again. I've got a plan to make this world a safer place and the country a more hopeful place. That's why I'm running.

See, we've done a lot in this administration, but the only reason to look backwards is to best determine who to lead us forward. And that's what I'm talking about here. I just want you to know I have a plan and a reason for running, so that you can go out and tell your friends and neighbors, "Let's put him back in there. He's got some good ideas. He understands what he's doing when it comes to making sure this economy continues to grow, making sure that families are strong, making sure that the institutions and systems are changed in order to help the American people, and he's got a plan and a vision to make this world a safer place." And that's what I'm here to tell you.

First, I know the nature of the enemy. It means we must be relentless and unyielding. Secondly—and we must use all tools at our disposal. That's why I'm looking forward to working with Peter, to make sure the intelligence system—see, we're chasing down people who hide in caves, people who kind of lurk in the dark corners of cities around the world. And therefore, we need good intelligence, and we're working with friends and allies in order to share intelligence. You know, people—we'll use law enforcement. We're darn sure going to use our United States military, too, to protect the American people. And that's why it's important for our military to be, you know, transformed to meet the threats of the 21st century.

Secondly, since it's a different kind of war, in order to make sure America is safer I laid out a new doctrine that said, "If you harbor a terrorist, you're just as guilty as the terrorist." Now, when the American President says something, he better mean it. When the American President says something, he's got to speak in a way that's easy for people to understand and mean what he says. I meant what I said when I said to the Taliban, "If you harbor a terrorist, like Al Qaida, you're just as guilty as they are." They ignored what we said, and that's why they're no longer in power. In other words, we said, "If you continue doing what you're doing, you're not going to be in power." And as a result of a great United States military and as a result of brave souls, Afghanistan has been liberated from a barbaric group of people. And we're safer for it. Al Qaida can no longer train because we upheld doctrine.

Remember, they were training thousands of people in Afghanistan so they could put these terrorist cells around the world. Way before September the 11th, they were training in Afghanistan, plotting and planning. You know, somebody said, "Well, they—by staying on the offense, you're creating more enemy." I strongly disagree with that sentiment—I strongly disagree. They were planning—they were plotting and planning way before September the 11th. No, by staying on the offense, we're reducing the enemy. By keeping the pressure on them, we're reducing the enemy and making America more secure. And by upholding doctrine, we're making America more secure as well.

Now, think about Afghanistan for a second. Not only is the Taliban out and Al Qaida has lost a safe haven, but people are free in that country, and that matters to America. It should because free societies promote peace. Free societies become allies when it comes to fighting off the ideologues of hate.

You know, it just wasn't all that long ago—it was 3 years ago that young girls weren't allowed to go to school—many young girls—most young girls weren't allowed to go to school in Afghanistan. That's backwards, see? When you've got people running a country that is so clouded in their vision that they wouldn't let young girls go to school, is a society that would breed, you can imagine, incredible resentment. It's a hopeless society. That's how terrorists are able to recruit, because there's no hope. Freedom—a free society is one that promotes hope. You know, their moms would be drug out in the public square and whipped. And that matters to America, because we believe in human dignity. We believe in the value of every human being. That's why we support a culture of life, because we believe in life.

Think about this, tell your friends and neighbors this amazing statistic when it comes to Afghanistan—at least I think it's amazing. Three years ago, these people lived in a dark world. Today, there's light, and freedom is moving rapidly to that country to the extent that 10 million citizens, 41 percent of whom are women, are registered to vote in the Presidential elections that will be taking place next month. Think about that. Amazing, isn't it?

I have—I can't remember all the people that wrote and opined about what it was like going into Afghanistan back then. I suspect some probably said that these people can't be free. You know, they really don't want to be free. Freedom is powerful. And I'm just guessing that there were some people that were pessimistic about the country's dream of having a democracy there in Afghanistan. But 10 million people—that wasn't all that long ago that women were pulled off a bus by the Taliban and murdered because they were involved in the election process.

Third lesson is, when we see a threat, we must deal with it before it fully materializes. In other words, one of the lessons of September the 11th is that oceans no longer protect us from harm's way. It used to be, prior to September the 11th, that if we saw a threat, we could deal with it or not deal with it because we never dreamt it would come home to hurt us if we saw something materializing overseas. Policymakers in the country could say, "Well, that makes sense to deal with that," or, "We can let that one go because it can't possibly hurt us." That's what we thought, and history had taught us that. I can understand why everybody felt that way, but September the 11th changed that equation.

And therefore, when we see a threat, this country must deal with that threat so it doesn't come home to harm us. And I saw a threat in Saddam Hussein. The reason I saw a threat in Saddam Hussein is because I was looking at intelligence that said he was a threat. But as importantly, I remembered his history. He was a sworn enemy of the United States of America. We had been to war with him once before. He was shooting at our pilots who were enforcing the world's sanctions. He had harbored terrorists. Remember Abu Nidal? He killed Leon Klinghoffer. Abu Nidal and his organization was in Iraq. Zarqawi, he's still lingering around. He had an organization. He's got ties to Al Qaida. He's the guy who beheads people to shake our conscience. He was in and out of Baghdad. Saddam Hussein paid the families of suiciders

Now, he was a threat. I went to the Congress, and I said, "The world has changed." And they looked at the—they agreed. They looked at the intelligence I looked at. They remembered his history. And they concluded—Members of the Congress from both political parties concluded that Saddam Hussein was a threat, and they authorized the use of force. My opponent, he looked at the very same intelligence my administration looked at. And he voted yes when it came time to authorize the use of force.

I went to the United Nations, and I'll tell you why I went to the U.N., because I believe before a Commander in Chief commits troops into harm's way, we must try all avenues, all avenues to solve a problem. I understand the grave decision of sending men and women into harm's way. It's a decision I wish I hadn't had to make as your President. It's a decision, however, that came to my desk because of the actions of an enemy.

And so I went to the United Nations in the hopes that we could solve this problem diplomatically. And so I gave a speech, I remember, there talking about the threat, reminding people of the world that we lived in after September the 11th. And the United Nations looked at the same intelligence I looked at and remembered the same history and voted 15 to nothing to send this message to Saddam Hussein: "You disarm"—or "Disclose, disarm, or face serious consequences." Now, I believe when you say something, you better mean it in order to make the world a more free and peaceful place. That's what I think. I think when you say something, in order to—if you're going to vote to authorize force, you better mean it. If you're going to say "serious consequences," you better mean it.

But Saddam Hussein ignored the demands of the free world once again. People say, "Well, you didn't try diplomacy." Diplomacy had been tried for a decade. This was a confirmation that he wasn't interested in complying with the demands of the free world. I think there was, what, 17 U.N. resolutions? Something like that—a lot, like, resolution after resolution after resolution. And he wasn't interested in complying. One reason we knew is because he systematically deceived the inspectors.

And so I have a choice to make at this point: Do I forget the lessons of September the 11th, take the word of a madman, or take action to defend this country? Given that choice, I will defend America every time. [Applause] Thank you.

A couple other points. It's hard work in Iraq and Afghanistan. I know that, and I want to thank the family members who are here who—if you've got a loved one in the military, I want to thank you for the sacrifices you've made and the sacrifices your son, daughter, husband, or wife have made on behalf of this country. It's not easy to help a country. There are people around this world that want to stop the march of freedom because they see it as the biggest threat to their ideology of hate. That's the fact.

A lesson I've learned, and a lesson that— it wasn't hard for me to learn it, either— was that anytime you put troops into harm's way, the Federal Government needs to support them so they can finish their mission. That's why a year ago, I went to the Congress and proposed $87 billion of supplemental funding to make sure marines, like this man right here, have got what it takes to do the job. And we got great support in Congress. You might remember that, Pete, about how members of both parties stood up and recognized the need for us to support troops in harm's way. As a matter of fact, the support was so strong that only 12 Members of the United States Senate voted against essential funding for our troops—only 12—2 of whom were my opponent and his runningmate, were part of those 12.

Interestingly enough, when you're out gathering the vote, you might remind people that there was only four Members of the United States Senate that voted to authorize the use of force and then didn't vote to fund the troops. And two of those four were my opponent and his runningmate. You might remember, when asked to explain why he made the vote he made, he said, "I actually did vote for the $87 billion, right before I voted against it." [Laughter] See, I think a President needs to speak clearly and mean what he says. So they kept pressing him. He finally said, "The whole thing is a complicated matter." There's nothing complicated about supporting our troops in combat.

A couple other things I want to share with you—a couple of other things then we've got to move on down the road in the bus. [Laughter] It's a bus tour. [Laughter] It's exciting to go on a bus tour, because a lot of people come out, and they want to wave, and it warms my heart to see many people lining the roads like— that's what happens on these trips.

Let me tell you a couple of other things. One, people say, "What's the mission?" The mission is, in Afghanistan and Iraq, to help those countries become free countries, is to help on the road to democracy, is to help the political process go forward.

Remember, Iraq is going to be having elections in January. They've got a tough Prime Minister. I like him, Allawi. He's a strong guy. He's the guy that, by the way, survived an assassination attempt by Saddam Hussein. The guy sent the people in to—he was living in London at the time—they sent a ax-wielding thug to try to chop him to pieces. And he survived it. Seriously. So he understands. He understands the tyrant. He believes in the aspirations of the people. He wants there to be elections. He knows that Iraq can handle democracy. It's what he believes in his soul. I believe we ought to help him get there.

When we give our word, we need to keep our word. In order to make the world a more peaceful place, when you say something, you better mean it. And we've told the people of Afghanistan, Iraq, we'll help them. We will stay the course so that they can develop an army and police force of their own so they can defend themselves. That's what we're doing. We're providing stability for a political process to go forward, and we're training troops so they can do the hard work, so they can step up, so they can help the reconstruction efforts go forward. It's precisely what we're doing. And we're going to get the job done as quickly as possible, and then our troops will come home with the honor they've earned. And the world will be better off.

I believe liberty can transform the world. Listen, we all want peace. And I believe it's going to happen, that our children and grandchildren will grow up in a peaceful world, that we will make America secure by staying on the offense. But in the long run, our security comes from spreading liberty.

You know, I tell people that one of my favorite leaders in the world is Prime Minister Koizumi of Japan. I want you to think about this here for a minute. You know, I sit down at a table with him and have dinner, and we have really interesting, meaningful discussions about peace. What's unusual about that conversation is that 60 years ago or so, my dad and your dads and husbands and grandfathers were at war with the Japanese. They were a sworn enemy of America. Thousands lost their life because of the Japanese.

Fortunately, Harry Truman believed in the power of liberty to transform societies, and so did a lot of other Americans. There was a lot of skeptics, and you can understand why there was skepticism after World War II. If your loved one had been over fighting and had lost a life, how could you possibly imagine that a sworn enemy could become a friend? But because our predecessors believed in the power of liberty— I mean, predecessors for citizens and elected officials—to transform an enemy into a friend, today, Japan is a friend.

We did the hard work after World War II of helping Japan go toward a democracy, not an American democracy but a Japanese democracy. And today, I sit down at a table with Prime Minister Koizumi talking about the peace, talking about how to deal with the tyrant in North Korea. By the way, it is now five voices reminding him that he needs to disarm, including China, as opposed to one voice reminding him.

I talked to Prime Minister Koizumi about how liberty can transform Iraq and Afghanistan to become allies in the war on terror. I talked to the head of a country that we were at war with about how free societies will serve as powerful examples for women who want to be free in the Middle East or for reformers who wonder whether or not the free world hears their calls for help. I talked to him about feeding the hungry.

I believe to whom much has been given, much is required. I believe this United States of America must use our great wealth and generosity to help those who are hungry in the world. I believe we ought to continue to lead the effort to help orphans whose lives have been changed because of the pandemic of HIV/AIDS on the continent of Africa. I believe we not only need to write checks; I believe we need to unleash the great faith-based programs of America to help those who suffer. I believe all these things. And of course, we'll continue to provide medicines and help and infrastructure to help save lives. I believe all this because the actions we take will mean that a generation of young Americans can grow up in a better world.

The enemy attacked us. We didn't ask for this attack. They attacked us, but out of this attack, because of U.S. leadership, because we've got great values, because of our resolve, because of a clear vision of a better world, out of that attack is going to come some incredible good, in my judgment, a safer America, a more peaceful world, a better life.

And that's why I'm asking for the vote for 4 more years. I know where I want to lead us. I have the energy and desire to do so. And I'm not afraid to ask for your help.

God bless. Thanks for coming.

NOTE: The President spoke at 10:58 a.m. at the Muskegon County Airport. In his remarks, he referred to Diane Hoekstra, wife of Representative Hoekstra; senior Al Qaida associate Abu Musab Al Zarqawi; Prime Minister Ayad Allawi of the Iraqi Interim Government; Prime Minister Junichiro Koizumi of Japan; and Chairman Kim Chong-il of North Korea.

George W. Bush, Remarks in a Discussion on Health Care in Muskegon, Michigan Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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