We also have to provide Americans who can’t afford health insurance more affordable options. That’s a economic imperative but it’s also a moral imperative, because we know that when somebody doesn’t have health insurance, they’re forced to get treatment at the ER, and all of us end up paying for it. The average family pays a thousand dollars in extra premiums to pay for people going to the emergency room who don’t have health insurance. So you’re already subsidizing other folks; it’s just you’re subsidizing the most expensive care. You’d be better off subsidizing to make sure they were getting regular checkups. We’re already paying for it. It’s just it’s hidden in your premiums.
So what we’re working on is the creation of something called the Health Insurance Exchange, which would allow you to one-stop shop for a health care plan, compare benefits and prices, choose the plan that’s best for you. If you’re happy with your plan, you keep it. None of these plans, though, would be able to deny coverage on the basis of pre-existing conditions. (Applause.)
Every plan should include an affordable, basic benefits package. And if you can’t afford one of these plans, we should provide assistance to make sure that you can. (Applause.) I also strongly believe that one of the options in the Exchange should be a public insurance option. (Applause.) And the reason is not because we want a government takeover of health care — I’ve already said if you’ve got a private plan that works for you, that’s great. But we want some competition. If the private insurance companies have to compete with a public option, it’ll keep them honest and it’ll help keep their prices down. (Applause.)
Now, covering more Americans is obviously going to require some money up front. We’ll save money when they stop going to the emergency room and getting regular checkups, but it’s going to cost some money up front. Helping families lower their costs, there’s going to be a cost to this. And it comes at a time when we don’t have a lot of extra money to spend, let’s be honest. When I came in we had a $1.3 trillion deficit. And with the economic recession that we’re going through, tax revenues are down — I was talking to Governor Doyle — tax revenues are down, more people are seeking help from the state. So we’ve got a lot of pressure on our budget.
So that’s why I’ve already promised that reform cannot add to our deficit over the next 10 years. And to make that happen, we’ve already identified hundreds of billions of dollars worth of savings in our budget — savings that will come from steps like reducing Medicare overpayments to insurance companies and rooting out waste and fraud and abuse in both Medicare and Medicaid. And I’ll be outlining hundreds of billions of dollars more in savings in the days to come. And I’ll be honest, even with these savings, reform will require some additional up front resources. And that’s why I’ve proposed that we scale back how much the highest-income Americans can deduct on their taxes back — take it back to the rate that existed under the Reagan years, and we could use some of that money to help finance health care reform. (Applause.)