奥巴马演讲 俄亥俄州民宅谈经济3
And I am very proud that we’ve got somebody like a Sherrod Brown or a Mary Jo, who worked really tirelessly with us in Congress to make sure that we don’t have a situation where we’ve got to bail out banks that have taken reckless risks; that we are monitoring what’s happening in the financial system a lot more carefully, making sure people aren’t cheated when it comes to their mortgages, or that there are a bunch of hidden fees in their credit cards that helped to create some of the problems that we’ve seen in the financial systems.
We can’t go back to doing things the way we were doing them before. We’ve got to go forward. That’s what we’re trying to do. And hopefully as we continue over the next several months and the next several years, we’re going to see a Columbus and an Ohio and a United States of America that is going to be stronger than it was before this crisis struck. I am absolutely confident of that. But we’ve got more work to do.
All right. So, with that, what I want to do is I just want to open it up and you guys can ask me questions about anything — and just ignore all these cameras who are here. (Laughter.) Pretend they’re not there. The only thing I would ask is introduce yourselves so that I get a chance to know you. Or if you haven’t met one of your neighbors, this is a good chance for you to do so.
Why don’t we start with this gentleman right here. And we’ve got some mics — the only reason — the main reason we’re using mics is so that these folks behind us can hear you. This gentleman right here.
Q Hi, President Obama. I hope I don’t pass out（昏倒，分发） while I’m asking this question, so — my question is actually about health care. My brother is disabled. And he’s definitely what I would consider one of the working poor. He will not mature any more as far as mindset（心态，倾向） of a 12-year-old. Right now he works washing dishes at a local restaurant and, unfortunately, because the employer does not offer health care insurance, one whole check, which is two weeks’ worth of work, has to actually go towards him just paying for COBRA, which is obviously well out of his budget. But he has to, simply because of various illnesses that he suffers from.
My question is, unfortunately, I’m not able to sit down and read a 2,000-page bill or law that — with all the reform that happened with health care. With the present reforms that went into place, how will that help him? And if it doesn’t, then how will — I know that you’re not done with health care — how will your — the latest changes that you want to happen with health care, how will that help him?
And thank you for doing such a wonderful job.
THE PRESIDENT: Well, thank you. Here’s how specifically health reform should help your brother. Number one, it gives an incentive（动机，刺激） to his employer to provide health insurance — because one of the key components of health care reform was providing employers a 35 percent tax break（所得税宽减额） on the premiums they pay for their employees, all right? So basically it’s cutting his potential costs — the employer’s potential costs for providing your brother with health insurance, it’s cutting it by a third. That’s step number one.
And there are going to be companies out there that say, you know what, we want to provide health insurance, but we just couldn’t afford to do it, but now that it’s costing us up to a third less, saving us thousands of dollars, maybe we should go ahead and provide coverage for that. Okay, so that is step number one.
Step number two is if the employer still doesn’t provide coverage, over the next couple of years your brother is going to be able to join a pool — what we’re calling an exchange — where he can basically buy the same kind of insurance that these members of Congress are buying. And the advantage that he’s going to have is that now he’s part of a pool of millions of people who are buying it all at the same time, which means they’ve got leverage. The same way big companies are able to lower their costs per employee because the insurance company really wants their business, well, now your brother could be part of the same pool that these guys are and that’s going to give leverage, which will lower his rates.
And the final part of it is, if even with these lower rates, this better deal, he still can’t afford it, then we’re going to provide some subsidies（补贴，津贴） to help him. So all those things combined should help make sure that your brother is getting health insurance.
Now, one of the things that I think people may not be aware of is that although this exchange isn’t going to be set up until 2014 — because it takes a while, we’ve got to set it up right — there’s some immediate things that are helping right now. If your child has a preexisting（先前存在的） condition, insurance companies, starting this year, will not be able to deny those children coverage. And that’s a big deal for a lot of folks whose children may have diabetes（糖尿病） or some other illness and right now can’t get insurance. Insurance companies are going to have to provide them insurance. That’s number one.
Number two, how many people here have kids who are college-age, about to go to college? All right. Well, one of the things you’re going to be able to do is when those kids get out of college, if they don’t get insurance right away, they’re going to be able to stay on your insurance until they’re 26 years old. That’s a big deal because a lot of times that first job or those first couple of jobs out of college are the ones that don’t provide health insurance.
So there are a number of changes that are being made right now that will make those of you who have health insurance more secure with the insurance they have. We’re eliminating lifetime limits. There’s a bunch of fine print on the insurance forms that sometimes have ended up creating real problems for people. Your insurance company decides to drop you right when you get sick, just when you need it most. Those kinds of practices are over now.
And the final aspect of health reform that’s important is, is that by changing the incentives for how doctors get paid under Medicare and under Medicaid, we’re actually encouraging doctors to become more efficient so that over time health care costs actually start leveling out a little bit instead of skyrocketing each and every year. Because everybody here who’s got health insurance, what’s been happening? Your premiums have been going up; co-payments, deductibles（免税额） , all that stuff has been going up. So we’ve got to actually try to control the costs of it, and part of it is just a matter of making sure that we get a better bang for our health care dollar.
So, for example, when you go to a doctor, we’re still filling out forms in triplicate（一式三份） on paper. It’s the only business there is where you still have a whole bunch of paperwork. And what we’re trying to do is to encourage information technologies so that when you go into a doctor, they can already pull down your medical records electronically. If you take a test, then it’s sent to all the specialists who are involved so you don’t end up having to take four or five tests, and pay for four or five tests, when all you needed was just one.
Those are the kinds of things that will take a little bit longer to actually take into effect, but hopefully over time they’re actually going to lower cost.
All right. I’m going to go boy, girl here to make sure it’s fair. (Laughter.) Right here. Absolutely.