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Welcome to "Ask the White House" -- an online interactive forum where you can submit questions to Administration officials and friends of the White House. Visit the "Ask the White House" archives to read other discussions with White House officials.

Michael Leavitt
Secretary of Health and Human Services

February 21, 2007

Michael Leavitt
Good afternoon, this is Mike Leavitt. I am the Secretary of Health and Human Services. I'm pleased to be answering questions about the ways this Administration is working to provide all Americans with access to a basic health insurance policy at an affordable rate.

In his State of the Union, President Bush outlined his vision and I traveled with him to Chattanooga, Tennessee earlier today to discuss his plan.

Shehzad, from Saint Louis, Missouri writes:
Please explain in simple words your vision of improving Health and Dental care for all Americans irrespective of age and economic status?

Michael Leavitt
All Americans need access to a basic health insurance policy -- at an affordable rate. I'd like to lay out our basic strategy on how we can accomplish this goal.

In the State of the Union address, the President proposed that we eliminate taxes on the first fifteen thousand dollars earned by families who have insurance, and 7500 by individuals. To get that standard exclusion, you would have to have at least catastrophic insurance.

The President’s proposal would ensure that whether you buy health insurance through your workplace, or buy it on your own; you get the same tax break. It is indefensible that a person who buys insurance individually is treated differently than a person who buys it through an employer. The President’s proposal would level the playing field.

We are a compassionate nation and for those in need government will provide health insurance and pay for most of it through Medicare, Medicaid and the State Children’s Health Insurance Program. For everyone else who needs insurance: state government, with help from the federal government, will organize the marketplace so every person has a choice of plans they can afford – either though their employer or as an individual. Extra help will be provided for those who still can’t afford a basic plan. More than a dozen states are exploring significant efforts to expand access to health insurance.

ben, from pkwms writes:
Is there any way to make sure every citizen in the US has healthcare?

Michael Leavitt
Health care is obviously an important component in a prosperous society and a happy life. We need to have a system of health care where there's competition based on value and where every American has access to an affordable basic plan.

The President’s plan is the best way to meet this nation’s aspiration of every American having access to a basic insurance policy at an affordable price. It accomplishes two objectives. One is affordable basic insurance available in every state. The second is for every person in America to have a pathway to affording it.

That is an goal that we all hold but there is real tangible movement toward that objective right now for the first time. There is real momentum to see it done. In addition to the President’s plan, HHS is working with more than a dozen states on their own plans.

Rob, from Nashville writes:
How does providing tax breaks to poor people who can't afford health insurance benefit them if they are below the earnings level that is taxed? Do they use the savings on the tax they don't pay to purchase insurance they can't afford?

Michael Leavitt
The President’s proposal removes both income and payroll taxes on earnings up to the standard deduction amounts. Low-wage workers who may not pay income taxes would still benefit from the reduction in their payroll taxes.

The current tax system favors those with the most expensive, employer-provided plans.

Millions of others can’t get insurance through work are faced with buying it on their own. I am talking about a waitress, construction worker, student or self-employed worker. As things stand today, not only do they pay higher rates, they do not get a tax break. Most of the time – these are the people who need help the most. The President’s plan will level the playing field and make the tax system work for everyone.

boonwello, from phoenix, arizona writes:
what are the president's plans to reduce the costs of healthcare?

Michael Leavitt
By reforming the tax code, the President’s proposal would reduce the cost of buying health insurance for million of Americans.

To reduce the costs of healthcare overall, we need to create a health care system where there is competition based on value – the best quality at the lowest price. We don’t have that right now. In fact, most of us don’t know what our health care costs or if it is any good. But if we give consumers that information, they will be a force for driving quality up and costs down, just as they are in every other area.

The Medicare drug benefit is a clear demonstration. Instead of restricting choice to one government benefit, Congress allowed choices and competition. The market responded. The cost of the monthly premium dropped from an estimated $37 to $22 a month. Why the drop? Competition.

Pamela, from Riverdale, GA writes:
How do you expect people who where displaced by Hurricane Katrina in the state of Louisiana to stay in good health if they do not have stable housing, separated from family or a source of income?

Michael Leavitt
HHS has been working with the state of Louisiana to rebuild its health care system. Louisiana has a historic opportunity to replace one of the most expensive and least effective health care systems in this nation. Together, we can build a new, patient-centered system of care that provides better, more efficient care to the neediest populations.

HHS has been and continues to be a major contributor to the recovery of Louisiana’s health care system, having provided over $1 billion in federal resources. Based on the guiding principles developed by the Louisiana Health Care Redesign Collaborative, HHS has provided the state with three models which show affordable accessible insurance coverage is possible in Louisiana. Our plan would make a big difference in the lives of 319,000 Louisianans currently without health care insurance.

I remain committed to providing better health, at a lower cost for all the people of Louisiana. We have outlined three positive models for a healthier Louisiana but the decision on the next course of action must come from the state.

Lee, from Noble, OK writes:
Government health programs work great in Canada and the UK. Why can't it work here and why do we need to continually pay high prices for good health care? It seems that all the government is doing is making easier for the middle class family to disappear. This would leave us with two classes of people - those that have and those that don't. We need a better system and insurance, even basic insurance, is a farce that needs to be replaced by a social health program just like in Canada. When are we going to have a great social health program?

Michael Leavitt
There's a rigorous debate that will unfold over the next several months about how to provide affordable access to insurance.

There are two distinctly different approaches: There will be proposals for the federal government to insure everyone and to run the health care system. The result is predictable: Less choice, long waits, lower satisfaction, higher taxes. The other approach will be led by states in partnership with the federal government and with private insurers. Again, the results are predictable: more choices, high satisfaction, lower costs, competition based on value.

In the State of the Union address, the president made clear that he believes the federal government should not run health care. He wants to partner with the states in developing plans that provide access to basic and affordable plans.

Charles, from Fort Collins, CO writes:
Many people seem to think that health care is a right for all American's (and non-Americans for that matter). Health care costs are too high, but I don't think it is a right like free speech and property. What do you and the President think about the "right to health care"? And what are the plans for reducing costs of health care without more government regulation?

Michael Leavitt
Our fundamental principle is that all Americans need to have access to affordable health care coverage. Through the Affordable Choices initiative, the President has outlined ways to help all Americans have access to affordable health care coverage.

There are other ways we’re working to create more value and better choices in the health care system. Right now, we’re crusading to transition into a health care system from a sector. That’s a system connected electronically, a system that has competition based on value. A system that is transparent, where people are able to get independent assessments of the quality of what they’re receiving. We want consumers to be able to compare price and make an assessment in the value. The large land of agreement is that we have to have information in the hands of consumers and a system that will reward better quality and lower costs

I have been meeting with governors, leading companies and health care officials all over the country seeking their commitment to create a system of competition based on value. Such a system is built on four cornerstones: 1. Electronic health records; 2. Quality measures; 3. Comparable prices; and 4. Proper incentives. If you’re interested in the way we think incentives would work in a system of value-based competition, look on our website at

Finally, a great way to reduce costs is to stay healthy. We can all do a better job of taking care of ourselves. I’m talking about diet, exercise, and our personal behaviors. More than 75 percent of all medical costs come from chronic disease. Most chronic diseases can be prevented or managed.

Duke, from Corvallis, Oregon writes:
For young adults like myself between 18 to 25, how will President's Bush's health care proposals affect us. While many of us are uninsured with health care coverage, will President Bush's proposal provide better access to health for this age bracket? Last year, at the state of the union address, he emphasized health savings accounts, why wasn't this program mentioned this year?

Michael Leavitt
The President believes HSAs are an important tool for Americans to get better health care coverage. I believe this too – in fact, I have an HSA for my health care expenses.

Further, the health initiative that the President’s Affordable Choices initiative will help young adults and all Americans get better access to affordable coverage. It creates access to affordable basic insurance available in every state and a pathway to affording it.

Michael Leavitt
I appreciate your questions and I've enjoyed being with you today. Please keep an eye on for future updates about the President’s initiative to provide better health care at lower costs for all Americans.

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