Loose Transcript of Barack Obama's Speech in Lancaster County on March 31, 2008

Q:
Woman: I work with drug addicted adolescents. I’m tired of having to beg insurance companies for approvals. They have way too much power in system. What’s your plan to deal with insurance companies? A:
I agree with you. Insurance companies are some of the biggest players in Washington. That’s why it’s so important not to have them finance your campaign. When they do, they get their hooks in ya. Insurance companies do have a role to play. They’ve just come to dominate the system so much, that it’s just broken.

If you've got insurance, you biggest probem is rising costs. That’s why I’m going to set up a program that works with employers to cap the rise in premiums so those savings get passed on to employees.

There will be nobody in America who wants health care and won't get it. My mother got sick with ovarian cancer. They told her they couldn’t cover it because it was a preexisting condition. They wouldn't pay her medical bills. It’s broken health care. This is personal for me.

Another thing I plan to do is emphasize prevention. Really that's what the health care system has to do more of. An insurance company may not cover someone who’s going join a group in an effort to lose weight, but they’ll cover a foot amputation because you got diabetes.

With prevention, it’s estimated we can save 150 billion every single year that’s with a b. That’s what we'll use to subsidize preventative plans.

There’s a reason I have not opposed the single payer plan. I would probably institute a single payer plan if I were starting from scratch, but more than half the American people get their health insurance through their employers.

I want to make the system more effective over time so people can opt into the plan I talked about. Over time we can make the transition.

Substance abuse, mental health services. I’m strongly in favor of mental health parity. Let’s treat it like other problems. That falls into the category of prevention. It’s good for society as whole. Police officers devote a huge amount of time devoted to homeless who can't take care of themselves. Police officers who should be fighting crime, not engaging in social services. They wouldn't have to if they had had health care in the first place.

Sen. Clinton has a good health care system proposal. It’s very similar to mine. She's not willing to fight against the way the system works in Washington.

She and Bill Clinton fought against the health care system in the 1990s. The problem was that it was too secretive. They didn't invite the American people into the debate.

We need to change how the process works and change the finance system. I’m going to have a big round table, and invite doctors, nurses, employers and labor unions. Insurance companies will have a seat at the table, too, they just won’t be able to buy every chair. I'll sit at the table, too. I'll have the biggest chair ‘cause I'll be president. (applause)

I’ll put my plan forward for reform. I don't assume I have all the ideas. I'm doing it all on C-SPAN so the American people will know what’s going on. That way if some member of Congress is carrying water for the insurance company, the American people will be able to see it. Well, I’ll be able to call in my health care expert...and ask him if that’s true.

Drug companies say they need money for research and development. What they call research and development is actually marketing for these ads with people running through fields looking all happy and you don't know what the drug is for...except for that one drug...you know what that's for. (laughter, applause)

We’re going to be enlisting the American people to be a part of the process. We’re going to be getting the American people to hold next president accountable. I want to be held accountable. That’s the big difference between my opponents and me.

Q:
Man: What about the Social Security system? What’s going to happen for people who are 20, 30 and 35?

A:
Great question. I’m glad you asked it.

Social security is the greatest social program we have created in this country. I want it to be in place yesterday, today and tomorrow. For all generations. I opposed the privatization of social security like what George Bush was promoting. The idea behind privatization was that every body would have to put a portion of their money into individual investment accounts. Problem was, if you invested into Enron, you’d be out of money, and we’d still have to take care of you. Not an individual Account. Social Security is an inter-generational system. It’s a guarantee we can count on. American people should invest in our great companies, but it should be separate and apart from Social Security.

There are only three or four ways to fix it. One, we could go ahead and let the benefits drop, two is to cut the benefits for everybody. Seniors are already having trouble getting by. So we don’t want to do that. Another way is to raise the retirement age, but I was visiting steel wire plant watching guys working in a plant who had been there for thirty-five, forty years. The idea that you would raise the retirement age after those guys had worked there all those years, just isn’t fair. It’s not right.

Another way is to implement a payroll tax raise. That’s not fair, either. Most Americans are paying taxes on 100 percent of income. My friend Warren Buffett … he’s only paying a fraction of one percent of his income. If we raise the payroll tax on everybody, it’s not fair. My idea is to raise the cap on the payroll tax to include the millionaires and the people who are wealthy.