President Bush Visits Cleveland, Ohio

July 10, 2007,1:42 P.M. EDT,THE PRESIDENT: Thank you, Fred. Thanks for coming. Thanks for having me. It's a smart marketing¹ tool -- you know, all the cameras. (Laughter.) I thought for sure the largest Chamber² of Commerce was in Texas, but I guess not. (Laughter.),I'm thrilled to be back in Cleveland. I've had a fascinating day. I went to a small business that is on the cutting edge of changing the way we're going to consume energy. I just came from the Cleveland Clinic, which is one of the most fabulous³ hospitals in America., I do want to spend a little time talking about our economy, talking about health care and energy policy that will be an integral part of making sure the economy continues to grow. I'd like to spend a little time talking about the war against extremists and radicals⁵. And I'd like to answer some of your questions, if you have any.,Before I do I want to tell you Laura sends her best. She's arguably the most patient woman in America. (Laughter.) She's a fabulous First Lady and a great mom. I love her dearly, and she told me to say hi to you all -- so, hi. (Applause.),I appreciate Joe Roman, who works with Fred. Thanks for setting this deal up. Appreciate the chance to come and visit with fellow citizens here in Cleveland. I'm the Commander-in-Chief; I'm also the educator-in-chief. Part of my job is to explain the philosophy behind the decisions that I have made. I'm honored you'd give me a chance to do so.,I'm traveling with a good man, the Congressman⁶ from this area -- one of the Congressmen from this area, Steve LaTourette. Proud to be with you, Congressman. Thank you for your time. (Applause.) State Auditor⁷ Mary Taylor is here -- thanks for being here, Mary. (Applause.) I met the Mayor of Cleveland across the street at the hospital. I was proud to be with him. I tha nk him for his time, for taking time out of his day. I thank Toby Cosgrove of -- Doc, thank you for being here -- from the hospital there across the street. I thank the docs, by the way, for taking time to show me some amazing technology.,Let me first talk about our economy. It's -- our economy is changing and it's strong. I remember back to -- early on in my administration, when we were confronted with some very difficult times. There was a recession, the economy had gotten overheated and it was correcting. Then we got hit by an enemy that killed nearly 3,000 of our citizens, which such an attack obviously would have an effect on the economy. Then there were some corporate⁸ scandals that had a psychological effect on our economy. People were beginning to worry about the system where people were not upholding the law, taking advantage of the situation, taking advantage of shareholders⁹.,And yet, we acted and cut taxes -- and cut them hard -- (applause) -- because one of the philosophical¹⁰ drivers of this administration is, is that if you have more money in your pocket to spend, save, or invest, the economy is more likely to grow. In other words, there's always a conflict in Washington about how -- what's the proper amount of money in Washington and what is the proper amount of money in your pocket. I'm one of these fellows that err¹¹ on the side of trusting people to spend their money, more than trusting government. (Applause.),I'm not trying to elicit¹² applause -- thank you, but -- (laughter) -- and our plan has worked. I don't know if you noticed last month that we added another 132,000 new jobs. We've added over 8 million new jobs since August of 2003. Entrepreneurship flourishes when people have got more capital in their pocket.,One of the interesting things about the tax cuts that we proposed is that a lot of the tax cuts were aimed at small businesses. One of the statistics that makes our economy interesting and, I believe, robust¹⁴ is that 70 percent of new jobs are created by small business owners. And that's an important thing for our fellow citizens to remember, particularly those in Congress who are thinking about something to do with the tax code.,Most small businesses are Subchapter S corporations or limited partnerships¹⁵. In other words, they pay tax at the individual income tax rate. So, therefore, when you cut income taxes on everybody who pays taxes -- in other words, when you lower the rates, it affects the ability of small businesses to keep capital; in other words, keep more of what they earn. And when a small business keeps more of what they earn, it is more likely that business will expand. And, therefore, when you hear me say that 8 million new jobs have been created since August of 2003, I might as well have said, as well, the small business sector¹⁶ of America is strong, and the best way to keep it that way is to keep taxes low.,And now we're going to have a debate on that in Washington. And that's going to be the interesting, philosophical argument. You'll hear people say in Washington, well, we need to raise taxes in order to either pay for new programs or balance the budget. I happen to believe we can balance the budget without raising taxes if we're wise about how we spend your money. And we're proving it possible.,Tomorrow I'm going to talk about the size of the deficit¹⁷. I'm not going to guess what that will be, but I can predict it's going to be substantially lower than it was three years ago. And we didn't raise your taxes. We kept your taxes low, which caused the economy to grow, which yielded more tax revenues. And because we set priorities, the deficit is shrinking.,And the big fight in Washington is going to be whether or not the budgets that the Congress is trying to now pass is going to go through. It's not -- I'll veto them if they're excessive in spending. I'm not going to let them raise your taxes. I think it would be bad for the economy. I think it would be bad for entrepreneurship. (Applause.),Let me talk about health care, since it's fresh on my mind. The objective has got to be to make sure America is the best place in the world to get health care, that we're the most innovative¹⁸ country, that we encourage doctors to stay in practice, that we are robust in the funding of research, and that patients get good, quality care at a reasonable cost.,The immediate¹⁹ goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room. The question is, will we be wise about how we pay for health care. I believe the best way to do so is to enable more people to have private insurance. And the reason I emphasize private insurance, the best health care plan -- the best health care policy is one that emphasizes private health. In other words, the opposite of that would be government control of health care.,And there's a debate in Washington, D.C. over this. It's going to be manifested here shortly by whether or not we ought to expand what's called S-CHIP. S-CHIP is a program designed to help poor children get insurance. I'm for it. It came in when I was the governor of Texas; I supported that. But now there are plans to expand S-CHIP to include families -- some proposals are families making up to $80,000 a year. In other words, the program is going beyond the initial intent of helping²⁰ poor children. It's now aiming at encouraging more people to get on government health care. That's what that is. It's a way to encourage people to transfer from the private sector to government health care plans.,My position is, we ought to help the poor -- and we do, through Medicaid. My position is, we ought to have a modern medical system for the seniors -- and we do, through Medicare. But I strongly object to the government providing incentives²² for people to leave private medicine, private health care to the public sector. And I think it's wrong and I think it's a mistake. And therefore, I will resist Congress's attempt -- (applause) -- I'll resist Congress's attempt to federalize medicine.,I mean, think of it this way: They're going to increase the number of folks eligible²³ through S-CHIP; some want to lower the age for Medicare. And then all of a sudden, you begin to see a -- I wouldn't call it a plot, just a strategy -- (laughter) -- to get more people to be a part of a federalization of health care. In my judgment²⁴, that would be -- it would lead to not better medicine, but worse medicine. It would lead to not more innovation, but less innovation.,And so -- but you got to be for something in Washington. You can't be against federalization, you've got to be for a plan that enhances the relationship between doctor and patient, and that's what I'm for. Here's what I believe in: One, I believe in health savings²⁵ accounts as an alternative to the federalization of medicine. It gives people the opportunity to save, tax-free, for routine medical costs and, at the same time, have a catastrophic health care plan to back them up.,I like the idea of people making decisions that are -- that will, one, enhance their health, and two, save money. The doc told me that -- we were looking at one of these brilliant heart guys working for him. You're not going to believe the technology in this hospital, by the way. If you're a Cleveland resident, you ought to be proud of this hospital. It's unbelievable. (Applause.),He said something pretty wise, though. He said, you can have all the technology that man can conceivably create, but if you continue to smoke, we're going backwards²⁶. If you're not exercising, if you're not taking care of the body yourself, all the technology isn't going to save your life. In other words, there is a certain responsibility that we have as citizens to take care of ourselves. And a health savings account actually provides a financial incentive²¹ for you to do that.,I believe in plans that enable small businesses to congregate²⁷ across jurisdictional²⁸ lines so they can afford insurance, afford spreading risk just the way big corporations can do. In other words, one way to control costs is to enable small businesses, many of which are having trouble affording insurance, to pool -- pool risk.,I'm a strong believer in medical liability reform. We've got a legal system which is driving up the costs of medicine, because docs are practicing defensive²⁹ medicine and driving good doctors out of practice. And it makes no sense to have a legal system that punishes good medicine. And therefore, I strongly believe that the Congress ought to pass federal medical liability insurance for our doctors and our providers.,I believe in information technology. The first time I came to Cleveland Clinic, we were talking about how to modernize³⁰ our hospital systems and our doctors' offices into the 21st century. Perhaps the best way to describe the problem is we've got too many doctors still writing out prescriptions³¹ by hand. Most of them can't write to begin with. (Laughter.) And then they pass the file from one person to the next. That's inefficient³² in this new era. I mean, technology is changing the way we live; it ought to be changing the way medicine operates. And it is, at Cleveland Clinic. I envision the day, one day, when all of us will have our own medical electronic record that will be safe from snoopers, in other words, will be private, but will make health care more efficient.,Cleveland Clinic did something interesting. I went to four different stations, and after every station they gave me an outcomes book. In other words, we're willing to be measured, says the good doc. There ought to be transparency in medicine. How many of you have ever actually tried to price a medical service? Probably not many. How many of you have ever said, gosh, I wonder whether this health care quality is better than the neighbors? I doubt any of you -- many of you have done that. Why? Because the system is not geared toward that. Somebody else pays your bills. If you really think about it, and you're working, say, for a company in America, and they provide a health care plan for you, there's a third-party payer. Well, if somebody else pays the bills, why do you care what the cost is at the time of purchase?,In other words, the whole plan has got to be to bring more accountability into health care, to make the consumer more responsible for making proper and rational decisions. That's what accountability does. And I applaud you for that, Doc. That's what transparency in pricing means, that you should be able to shop for price.,But the system, by the way, the tax system does not enable the individual to be incented to buy insurance in the private sector. If you work for a company and you get insurance, you get a good -- you get a good tax benefit. If you're an individual and buy insurance, you don't get the same tax benefit. That doesn't make any sense. The tax code needs to be reformed. The tax code ought to treat everybody equally when it comes to health care. And therefore, one proposal, one way to deal with that is something I talked to the Congress about, and said, if you're a married person and you're working, you ought to get a $15,000 deduction³⁴, just like a mortgage deduction, from your income, whether you're working for corporate America, or you're working on your own; whether you're working for a small-business owner, or you're looking for a job.,And that way, you begin to make sure the tax code is a level playing field. And that way, an individual market begins to grow, because you have got an incentive at that point in time to go out and purchase health care. As a matter of fact, you won't get your deduction unless you purchase health care if you're in the individual market.,The whole point I'm trying to make is there's an alternative to federalization of health care. It doesn't make a nice, neat sound bite. It's not something that's easy to sell -- what do you care about making sure you expand S-CHIP? That sounds nice and cozy³⁵, but nevertheless, it is an alternative that will work, and it is working, right here in America today.,The technological³⁶ changes in the hospital across the street have been amazing. The quality of care has been fantastic. There's just more we can do to make sure we continue to be the leader, without wrecking³⁷ the health care system.,Energy: In order to keep this economy strong -- and we do have a strong economy -- not only have we added 8.2 million new jobs since August of 2003, interest is low, inflation is down. I mean, this thing is buzzing. There are some parts of the country that are hurting. The manufacturing sector up here isn't doing as well as other parts of the country. However, I would remind you that the unemployment rate in Ohio is 5.8 percent. Is that perfect? No. Is it better than it has been? You bet it is.