My Fellow Americans:

I speak to you tonight at a crucial moment in our nation’s history. When you elected me president almost one year ago, you voted in favor of hope, and in favor of change. You voted for the idea that we are all in it together, and that we share responsibility to uphold the public good. You rejected the old politics of special interests, of legislative gridlock, and the failed notion that you’re better off on your own than as part of one indivisible nation.

You called out—in veterans’ halls and in union halls, in congregations and from small businesses, in senior centers and on college campuses—that this is America and, in America, we can fix what’s broken, and we can do it together.

Tonight our nation faces a crucial test of that profoundly American resolve. Will we rise together and ensure the basic security for our people that comes from affordable, quality health insurance? Or will we allow the cynics and the fear mongers, and the entrenched interests to extinguish that hope? Can we transcend the partisan bickering and solve the biggest problems facing our nation? Can we be the country we were meant to be?

Tonight, my fellow Americans, I come to you with a clear answer to that question:  Yes We Can.
We will reform our health insurance system this year. And we will reform it with one core value at its center: that health care is a basic human right, as essential to leading a productive and fulfilling life as food and shelter. It is not a consumer good. It is not a luxury. It is a public good and a human right. No one in our great nation should have to go without that human right. And starting this year, 2009, no one will.

Protecting the human right to health care is not only about those who cannot afford health insurance, or those whose insurance does not cover their actual health needs. It is not only about the elderly among us, or the sick, or about our vulnerable children and youth. It is about all of us.

When workers cannot afford the care they need, our entire nation’s prosperity suffers. When businesses that do offer coverage are crippled by spiraling costs, our entire nation’s competitiveness is in jeopardy. When half of all personal bankruptcies are due to health care related debts, our entire nation’s economic security is enfeebled. When parents cannot afford to take their children to the doctor, our entire nation’s future is at risk. And when 22,000 Americans die, as they will again this year, solely because they lack health insurance, we are failing to be the country we were meant to be.

That will not happen on my watch. And so we will reform our nation’s health care system this year. We will uphold the human right to health care, and we will do it by ensuring that any legislation that I sign includes four non-negotiable elements:

First, it will cover everyone. All the time. No preexisting condition, no change or loss of job, no red tape or clerical error will stand in the way of your access to needed care. Where you live, what you look like, where you come from, will pose no barrier to your health care coverage.

Second, it will be affordable.  To everyone.  I’m going to say that again.  It will be affordable to everyone.

Third, it will be comprehensive. It’s both just and economically sound that the care Americans need for a healthy and productive life—preventive care, emergency care, reproductive and neonatal care, geriatric care, mental health care—must be covered.

Now if you want that Botox injection for cosmetic reasons, you may have to save up your pennies. But when it comes to basic care, you will be covered.

And fourth, it will insist upon high quality care, holding our health care system accountable to patients while supporting our nation’s committed health care professionals.

Let me be clear.  I will veto any plan that does not ensure these four essential elements.

But I am confident that I will not be called upon to veto a bill. Because it is clear that the American people want reform that includes these core elements. And I am confident that their elected representatives in Congress will respond to that demand.

So we will reform our health insurance system this year. We will reform it with Republican votes if possible, but we’ll reform it solely through with our Democratic majority if necessary. There are two ways of avoiding gridlock—one is through compromise and the other is through resolve. As you know, I prefer compromise. But if good faith negotiation is not forthcoming, we will use our party’s votes in Congress to achieve the change that’s needed. That’s what a majority means in our democracy.

Now, there’s been a lot of talk about public options, cooperatives, and other tools for getting this job done. It’s important to remember that they are only tools. I continue to believe that a public option—which means that the government will stand behind the guarantee of health care coverage if and when there are gaps in privately run insurance—is the most effective way to achieve our goals. I will not be inflexible in crafting reform, but I do insist that any attack on a public option or any other tool I’ve offered be accompanied by a concrete alternative that will achieve the core goals I’ve outlined: cover everyone, be affordable to everyone, be comprehensive for everyone, ensure the highest quality care for everyone.

We’ve also seen a lot of confusion and misinformation out there about this process—some of it in good faith and some of it the result of deliberate deception. For those Americans who are understandably confused about the elements of reform, we’ll be launching a new area of the whitehouse.gov website to provide clear information and to answer questions. We will also be setting up telephone hotlines in each region of the country to answer questions and provide information. And I am encouraging every member of Congress who supports commonsense health insurance reform to prepare their constituent service staff to do the same.

I also ask you, the American people, to ask of any proposal or counterproposal that’s out there, including mine: does it cover everyone? It is affordable to everyone? Is it comprehensive for everyone? Will it ensure the highest quality for everyone?

For the small group of organizations and politicians who are intentionally deceiving and scaring their fellow Americans with falsehoods about our vision of health insurance reform, you are on the wrong side of history. And you will fail. The American people want an insurance system that protects their fundamental human right to health care and, starting today, my administration and my allies in Congress will be relentless in communicating what reform will and will not mean.

We will not be jumping to counter every outrageous claim that you may make. That’s an old Washington game that we will no longer be playing. But we will be clear, plainspoken and rigorously honest about what our vision of reform will mean for all Americans. And I call upon our nation’s news media to fulfill their important responsibility to separate fact from fiction.

One clearly legitimate concern is the cost of this plan to the American people. Health insurance reform is an investment in America’s future that we cannot afford not to make. It is also true, however, that our nation must make sacrifices in the short term in order to finance that long-term investment. In addition to the savings we’ll accrue through economies of scale and reductions in waste and fraud, affluent Americans—those who’ve benefited most from our national prosperity—will have to pay somewhat more in taxes in the short term. This should be no surprise, as it was among the promises I made during my campaign. But, over time, this investment will pay off in dollars in cents, in economic security and prosperity, and in the innovation and opportunity that it will unleash in the American people. That dividend will benefit the most affluent Americans in at least the same proportions as it will benefit our nation as a whole.

So I say to you, my fellow Americans, that at this critical moment in our history, we will rise to the challenge. We will look back upon 2009 as the year that America fulfilled the human right to health care for all of its people, and year that we made a historic downpayment on our future.

Read more at The Opportunity Agenda website.

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