Networking Support Groups for the unemployed in the Portland, Oregon area:

http://www.jobfinderssupport.com

Visitors are always welcome, and you will meet many great individuals who will help and support your transition back into the work force!

Purpose:
To utilize all the collective minds that attend the meeting each week to assist one another on how to be productive in finding your next opportunity. We'll help you end your work week on an upbeat note, putting you in a more positive mood for your next encounter. Remember it is your job to spot the many opportunities that you come in contact with everyday.

What Goes on in a typical meeting?
Generally we start with introductions of ourselves. That will lead to questions, suggestions, referrals, networking, idea exchanges, dates of upcoming meetings, and what the group wants to discuss each week.

If you wish to attend please phone or email Andrew Beach for the next meeting date

Prudential NW Properties
5 Centerpointe Drive, 1st Floor Conf Rm
Lake Oswego, OR 97035

DIRECTIONS:
Centerpointe is off of Kruse Way east of I-5. Exit I-5 at the Lake Oswego/217 intersection. Head East. You'll make the first left turn Kruse Oaks Drive (just past Chili's). Proceed to Centerpointe Drive (one block) and turn left. Five Centerpointe Drive will be clearly marked with a brick building sign by the main driveway entrance -- pass it and proceed to next driveway and turn left. Drive to the back side of the Five Centerpointe building and enter through the glass doors. The conference room is just past the elevators on the 1st floor. (Our Prudential host is me, Andrew Beach, 503-320-4410).

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The American Recovery and Reinvestment Act (ARRA) of 2009 was signed by President Obama on Feb. 17, 2009. This Act provides insurance payment relief for eligible individuals who were involuntarily terminated and who were otherwise eligible for continuation coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly called COBRA. Relief also will be available to eligible individuals on Oregon continuation coverage. However, Washington state does not have continuation coverage.

Eligible individuals pay only 35 percent of their COBRA premiums and the remaining 65 percent is reimbursed to the coverage provider (usually an employer) through a tax credit. The premium period affected began on March 1, 2009. There are many details to the new law and not all involved parties are ready to begin implementing the assistance program. The following is a high-level summary of the program.

COBRA payment assistance

Generally applies to companies with 20 or more employees

Eligibility

• COBRA-eligible individuals who were involuntarily terminated from employment between Sept. 1, 2008, and Dec. 31, 2009.
• COBRA-eligible dependents of individuals who were involuntarily terminated from employment between Sept. 1, 2008, and Dec. 31, 2009.
• Individuals who meet these criteria and who previously declined COBRA coverage on or after Sept. 1, 2008, will be given another chance to enroll.
• An individual ceases to be eligible for the subsidy when the individual becomes eligible for other group health plan coverage.

Timing

• The first premium period affected began on March 1, 2009.
• The subsidy is generally available for up to nine months for those who remain eligible.
• Maximum period of COBRA coverage (typically 18 months for terminations of employment) is not extended.
• No one is eligible for the subsidy before date of enactment, which was Feb. 17, 2009.
• Eligible individuals who pay the full monthly premium for their March or April coverage will be able to arrange a subsidy credit with the employer.

Income

• Individuals are ineligible for the subsidy if adjusted gross income exceeds $145,000, or $290,000 for joint filers.
• Subsidy is phased out if adjusted gross income is between $125,000 and $145,000 for individuals, or between $250,000 and $290,000 for joint filers.

What does this mean for you?

Affected individuals

Eligible individuals are obligated to pay only 35 percent of their COBRA premium beginning with the March 1, 2009, premium payment; however, the former employer may not yet be ready to administer the premium assistance. Most individuals whose coverage terminated on or after Sept. 1, 2008, will receive a notice regarding COBRA assistance in the mail within 60 days of Feb. 17, 2009. The notice will provide additional details on next steps. For more information, please review the information provided by the government by clicking on the links at the bottom of this page. If you have questions, then please call your former employer.

Employers

Eligible individuals are obligated to pay only 35 percent of their premiums as early as the period of coverage beginning March 1, 2009. You will be reimbursed the subsidized amount, 65 percent, by the government. Please review this helpful IRS question and answer regarding reimbursement. Employers are responsible for notifying affected individuals as required by law within 60 days of Feb. 17, 2009, and for paying 100 percent of all COBRA premiums to the insurer.

Producers

When communicating with employers, please discuss the fact that eligible individuals are only obligated to pay 35 percent of their premiums effective March 1, 2009. Also, it is important to alert them to the employers' responsibility of notifying affected individuals and paying 100 percent of all COBRA premiums to the insurer.

Regarding individual communication, please alert individuals to the March 1, 2009, effective date for reduced premiums and inform them that their former employer will provide them with a notice with additional information regarding next steps. Refer them to their former employers with questions.

Producers also may direct employers and individuals to the Department of Labor, Internal Revenue Service and the Oregon Insurance Division's Web sites for more information. Links to these Web sites are highlighted below.

Oregon continuation

Continuation coverage applies to companies whose insurance is based in Oregon and are not eligible for COBRA, such as those with 19 or fewer employees.

Individuals involuntarily terminated from employment between Sept. 1, 2008, and Dec. 31, 2009, and who were otherwise eligible for Oregon continuation coverage will have premium assistance available to them beginning with their March 1, 2009, premium payment. Affected individuals will receive a notice regarding premium assistance in the mail within 60 days of Feb. 17, 2009. While many of the details that apply to individuals eligible for COBRA coverage will apply to those eligible for Oregon continuation coverage, there are some important differences. For example, Oregon continuation coverage provides a maximum of six months of continuation coverage from the date that group coverage terminated. At this time, the process for providing assistance is being reviewed and refined. The written notices sent will explain the process to affected individuals and provide additional information.

Washington continuation

Washington state does not have continuation of coverage for employers who are not subject to Federal COBRA, such as those with fewer than 20 employees. Therefore, affected individuals are not able to access premium assistance.

Additional Resources

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BNI Networking for individuals in Oregon
Career Builder
CareerJet(Search)
Career Journal by Wall Street Journal
Career Makers-Market Yourself
Career Web Portfolios- A service by Career Makers
Careerful.Com-List of many links
Cascade Link (Mult.Cty.Lib. jobs)
Cascade Policy Institute - Think Tank
CHIFOO- Computer-Human Interaction Forum of Oregon
Circle of Experts-Resources
Community Nonprofit Resources Group (CNRG)
Company Search info
Connectworks- Links to network with
Contract Employment Weekly
Contract Staffing Firms
Craigs List
Cube Management (Sales & Mktg)
Dick Warn- Inspirational and motivational
DinnerGrrls -interesting, passionate women
Do It Now Careers (Aimed at over 50 crowd)
Dog Pile
Doug's List
Dunn and Bradstreet
Edgelink (Headhunter-Temp staffing)
Eight(8) Great Magazine Articles on Job Search
Elevator Speech
What do YOU do that can help ME? (The elevator speech)
Employment Dept. (Oregon)
FBI Jobs
Find a Job (Higher Education)
Flip Dog
Fortune 500
Freecycle
Freecycle Portland
GadBall
Gray Hair Management
Guy Kawasaki
Health Care Reps
Henry Gregor - Job seekers help
Hoovers
Hot Jobs
How to Change the World
HR EXtras (Temp.help)
IdeaList
Ideas on Job Search from the Universities
InDeed
International Association of
Administrative Professionals -IAAP
International Assc. of Business Communicators (Oregon/Columbia chapter )
Internet Professionals Northwest
Internet Searching
IT Solution Journal (Periodical)
I Take the Lead (Leads Group)
Job Animal
JobDango
Job Hunt
Job Reference Guide Links
Job Search Engine
The Ladder ($100K & up)
The Link-Connecting Women
Linked In-Networking via the web
Living the Potential
Lunch and Learn-Mult.Co.Lib.
Monster
National Notary Association
Networking for Busy People
Northwest Association of Book Publishers (NWABP)
OGI Events
OGI Scholarships
OGI Seminars
Oregon Career Solutions (Self Marketing)
Oregon Dept. of Employment
Oregon Graduate Institute
Oregon Convention Center Calendar
Oregon Employment Dept.
Oregon State Legislature
Oregon Watchdog -political help
Oregonian Events Calendar
OTBC-Oregon Technical Business Center
PDX Mindshare - Ideas
Paul's site - Too much
Payscale-Compares salaries
Personal Development for Smart People
Pledge of Allegiance by Red Skelton
Poindexter & Assc. (Executive Search)
Portland Business Journal Calendar
Portland Business Journal Free E-mail news
Portland LinkedIn Group
Professional Temporary Service
Professional Resource Consortium
[PRC]
Radiant Action- Coaching
RAINS- Reg. Alliances (Security)
Recruiting Services International
Regional Arts & Culture Council
Resume Words to Avoid
Retirement Jobs
Richardson & Farrell
Riley Guide
Roger Fulton-Former attendee
Secrets to Finding a Job When You’re Over 50
Share Technology (Old high tech equip)
Similar Minds (Personality Tests)
Simply Hired (Searches search engines)
Starve-Ups
Steve Pavlina
Take the Lead (Leads Group)
Technical Assisitance for Community
Service
TechLink NW Engineering Resources
The Big Job List - listing of Portland jobs
The Paradoxical Commandments - Thoughts
The US Group (Useful info)
Toastmasters
Toastmasters International
Useful Web Sites for Job Search
Volunteer Match
Wallmasters International Toastmasters
Web Search Strategies
Willamette Valley Development Officers (fundraising)
Wine and Hospitality Jobs
Wired Womens Web (Networking)
What Color is Your Parachute
Whole Foods Markets Events
Women Entrepreneurs of Oregon
Women in Technology-Portland
Women's Resources
Work
Workforce Network
Young Professionals of Portland (Everyone is welcome)
Young Professional of Vancouver, Wash.
Your Oregon State Legislature
Zoom-People,Company search engine

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In The News

Plan for a Healthy America  - Source http://www.barackobama.com/issues/healthcare/

Barack Obama and Joe Biden's Plan

On health care reform, the American people are too often offered two extremes - government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year.

If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

• Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
• Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
• Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
• Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
• Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care.
• Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
• Ensure everyone who needs it will receive a tax credit for their premiums.

• Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market
• Require hospitals to collect and report health care cost and quality data
• Reduce the costs of catastrophic illnesses for employers and their employees.
• Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.

The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.

A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.

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This information was obtained from: http://www.barackobama.com/pdf/issues/HealthCareFullPlan.pdf

Health care costs are skyrocketing. Health insurance premiums have doubled in the last 8 years, rising 3.7

times faster than wages in the past 8 years, and increasing co-pays and deductibles threaten access to care.1

unlimited financial liability. Over half of all personal bankruptcies today are caused by medical bills.2 Lack of

Americans die from medical errors in hospitals every year.3 One-quarter of all medical spending goes to

needlessly increases these costs.4

Tens of millions of Americans are uninsured because of rising costs. Over 45 million Americans5—

including over 8 million children6—lack health insurance. Eighty percent of the uninsured are in working

families.7 Even those with health coverage are struggling to cope with soaring medical costs. Skyrocketing

all of this less than 4 cents of every health care dollar is spent on prevention and public health.8 Our health care

Inefficient and poor quality care costs the nation at least $50 to $100 billion every year.9 Billions more are

wasted on administration and overhead because of inefficiencies in the health care system.10 And given current

trends, this problem will only get worse as health care spending is expected to double within the next decade.11

half the cost of other equally renowned academic medical centers in other parts of the country.12 The key is to

(1) INVEST IN ELECTRONIC HEALTH INFORMATION TECHNOLOGY SYSTEMS. Most medical records are still

Processing paper claims also costs twice as much as processing electronic claims.13 Barack Obama and Joe

testing, more appropriate drug utilization, and other efficiencies.14

(2) IMPROVE ACCESS TO PREVENTION AND PROVEN DISEASE MANAGEMENT PROGRAMS. Experts agree that

􀂾 Support disease management programs. Over seventy-five percent of total health care dollars are

pressure.15 Many patients with chronic diseases benefit greatly from disease management programs,

which help patients manage their condition and get the care they need.16 Barack Obama and Joe Biden

􀂾 Coordinate and integrate care. Rates of chronic diseases have skyrocketed in the last 2 decades.17

Over 133 million Americans have at least one chronic disease.18 With proper care, the onset and

early death they cause, these chronic conditions cost a staggering $1.7 trillion yearly.19 Barack Obama

􀂾 Require full transparency regarding quality and costs. Health care quality and costs can vary

information.20 Barack Obama and Joe Biden will require hospitals and providers to collect and publicly

􀂾 Promote patient safety. Barack Obama and Joe Biden will require providers to report preventable

􀂾 Align incentives for excellence. Both public and private insurers tend to pay providers based on the

volume of services provided, rather than the quality or effectiveness of care.21 Barack Obama and Joe

􀂾 Comparative effectiveness reviews and research. One of the keys to eliminating waste and missed

􀂾 Tackle disparities in health care. Although all Americans are affected by problems with our health

􀂾 Reform medical malpractice while preserving patient rights. Increasing medical malpractice

insurance rates are making it harder for doctors to practice medicine22 and raising the costs of health

care for everyone.23 Barack Obama and Joe Biden will strengthen antitrust laws to prevent insurers

(3) LOWER COSTS BY TAKING ON ANTICOMPETITIVE ACTIONS IN THE DRUG AND INSURANCE COMPANIES. It

􀂾 Increasing competition in the insurance industry. The insurance business today is dominated by a

care mergers in the last 10 years and just two companies dominate a full third of the national market.24

skyrocketed, increasing over 87 percent over the past six years.25 Over the same time period, insurance

expenditure growth of 8.6 percent.26

received multi-million dollar bonuses.27 Barack Obama and Joe Biden will prevent companies from

􀂾 Prevent private insurance waste and abuse in Medicare. Medicare’s private plan alternative, called

show that on average the government pays 12 percent more than it costs to treat comparable

beneficiaries through traditional Medicare.28 These excessive subsidies cost the government billions of

􀂾 Allow consumers to import safe drugs from other countries. The second-fastest growing type of

health expenses is prescription drugs.29 Pharmaceutical companies should profit when their research and

and Canada but charging Americans a 67 percent premium.30 Barack Obama and Joe Biden will allow

􀂾 Prevent drug companies from blocking generic drugs from consumers. Some drug manufacturers

and keep charging Americans exorbitant prices for brand name products.31 The Obama-Biden plan will

􀂾 Allow Medicare to negotiate for cheaper drug prices. The 2003 Medicare Prescription Drug

prices with drug companies has garnered significant savings for taxpayers.32 Barack Obama and Joe

could be as high as $30 billion,33 to further invest in improving health care coverage and quality.

(4) REDUCE COSTS OF CATASTROPHIC ILLNESSES FOR EMPLOYERS AND THEIR EMPLOYEES. Catastrophic

health expenditures account for a high percentage of medical expenses for private insurers.34 In fact, the most

account for 49 percent of the overall health care dollar.35 For small businesses, having a single employee with

their coverage due to rising costs.36 Rising costs are also a burden on employers, particularly small businesses,

to eight years ago,37 and this trend shows no sign of slowing down. It is simply too expensive for individuals

(1) GUARANTEED ELIGIBILITY. Obama and Biden will require insurance companies to cover pre-existing

(2) NEW AFFORDABLE, ACCESSIBLE HEALTH INSURANCE OPTIONS. The Obama-Biden plan will create a

􀂾 Comprehensive benefits. The benefit package will be similar to that offered through the Federal

􀂾 Affordable premiums, co-pays and deductibles. Participants will be charged fair premiums and

􀂾 Simplified paperwork. The plan will simplify paperwork for providers and will increase savings to the

􀂾 Easy enrollment. All Exchange health insurance plans will be simple to enroll in and provide ready

􀂾 Portability and choice. Participants will be able to move from job to job without changing or

􀂾 Quality and efficiency. Participating hospitals and providers that participate in the new public plan will

(3) TAX CREDITS FOR FAMILIES AND SMALL BUSINESSES. Barack Obama and Joe Biden understand that too

(4) EMPLOYER CONTRIBUTION. Large employers that do not offer meaningful coverage or make a meaningful

(5) REQUIRE COVERAGE OF CHILDREN. Barack Obama and Joe Biden will require that all children have health

(6) EXPANSION OF MEDICAID AND SCHIP. Barack Obama and Joe Biden will expand eligibility for the

(7) FLEXIBILITY FOR STATE PLANS. Due to federal inaction, some states have taken the lead in health care

condition, and children are increasingly being affected.38 Five chronic diseases—heart disease, cancer, stroke,

chronic obstructive pulmonary disease, and diabetes—cause over two-thirds of all deaths each year.39

resources. Care for patients with diabetes costs $130 billion each year alone, and this amount is growing.40

(1) EMPLOYERS. Reduced workforce productivity from illness and disability represents an additional drain on

(2) SCHOOL SYSTEMS. Childhood obesity is nearly epidemic,41 particularly among minority populations,42 and

adhere to nutritional standards for fat content in school lunches.43 Barack Obama and Joe Biden will work with

(3) WORKFORCE. Primary care providers and public health practitioners have and will continue to lead efforts

to protect and promote the nation’s health. Yet, the numbers of both are dwindling,44 and the existing

(4) INDIVIDUALS AND FAMILIES. Preventive care only works if Americans take personal responsibility for their

(5) FEDERAL, STATE, AND LOCAL GOVERNMENTS. The federal government and state and local governments

benefit from greater research to optimize organization of the 3,000 health departments in this nation,45

ensure a 21st century public health system and healthy America.

􀀁 Health IT investment, which will reduce unnecessary and wasteful

􀀁 Improving prevention and management of chronic conditions;

􀀁 Increasing insurance industry competition and reining in the abusive

􀀁 Providing reinsurance for catastrophic cases, which will reduce insurance

􀀁 Ensuring every American has health coverage, which will reduce spending

Cutting Costs and Covering America: A 21st Century Health Care System

University of Iowa | May 29, 2007  Source: http://www.barackobama.com/2007/05/29/cutting_costs_and_covering_ame.php

I want to thank the University of Iowa for having us here, and I want to give a special thanks to Amy and Lane for joining me today to tell their story.

A few hours north of here, Amy and Lane run a small business that offers internet service to their community. They were the very first company to provide broadband access in their remote corner of northeastern Iowa, and every day, hundreds of people count on the services they provide to do their jobs and live their lives.

But today they are on the brink of bankruptcy - a bankruptcy that has nothing to do with any poor business decision they made or slump in the economy they weren't prepared for.

Lane was diagnosed with cancer when he was twenty-one years old. He lost a lung, a leg bone and part of a hip. Seventeen years later, he is cancer-free, but the cost of health insurance for him, his wife and his three kids is now over $1,000 per month. Their family's premiums keep rising hundreds of dollars every year, and as hard as they look, they simply cannot find another provider that will insure them.

Amy and Lane are now paying forty percent of their annual income in health care premiums. They have no retirement plan and nothing saved. They can no longer afford to buy new clothes or fill up their cars with gas, they have racked up more credit card debt then they know what to do with, and Amy wrote to us and said that the day she heard the loan officer say the word "bankruptcy" was one of the worst in her life.

"My heart was in pain," she said. "This is not who we are. We have done everything right. We have done everything we were supposed to do. This is not who we are."

Amy is right. This is not who we are. We are not a country that rewards hard work and perseverance with bankruptcies and foreclosures. We are not a country that allows major challenges to go unsolved and unaddressed while our people suffer needlessly. In the richest nation on Earth, it is simply not right that the skyrocketing profits of the drug and insurance industries are paid for by the skyrocketing premiums that come from the pockets of the American people.

This is not who we are. And this is not who we have to be.

In the past few months, I've heard stories like Amy's at town halls we've held in New Hampshire, and here in Iowa, and all across the country. Stories from people who are hanging on by a thread because of the stack of medical bills they can't pay. People who don't know where else to turn for help, but who do know that when it comes to health care, we have talked, tinkered, and let this crisis fester for decades. People who watch as every year, candidates offer up detailed health care plans with great fanfare and promise, only to see them crushed under the weight of Washington politics and drug and insurance industry lobbying once the campaign is over.

Well this cannot be one of those years. We have reached a point in this country where the rising cost of health care has put too many families and businesses on a collision course with financial ruin and left too many without coverage at all; a course that Democrats and Republicans, small business owners and CEOs have all come to agree is not sustainable or acceptable any longer.

We often hear the statistic that there are 45 million uninsured Americans. But the biggest reason why they don't have insurance is the same reason why those who do have it are struggling to pay their medical bills - it's just too expensive.

Health care premiums have risen nearly 90% in the past six years. That's four times faster than wages have gone up. Like Ami and Lane's family, nearly half of all Iowans have said that they've had to cut back on food and heating expenses because of high health care costs. 11 million insured Americans spent more than a quarter of their salary on health care last year. And over half of all personal bankruptcies are now caused by medical bills.

Businesses aren't faring much better. Over half of all small businesses can no longer afford to insure their workers, and so many others have responded to rising costs by laying off workers or shutting their doors for good. Some of the biggest corporations in America, giants of industry like GM and Ford, are watching foreign competitors based in countries with universal health care run circles around them, with a GM car containing seven times as much health care cost as a Japanese car.

This cost crisis is trapping us in a vicious cycle. As premiums rise, more employers drop coverage, and more Americans become uninsured. Every time those uninsured walk into an emergency room and receive care that's more expensive because they have nowhere else to turn, there is a hidden tax for the rest of us as premiums go up by an extra $922 per family. And as premiums keep rising, more families and businesses drop their coverage and become uninsured.

It would be one thing if all this money we spend on premiums and co-payments and deductibles went directly towards making us healthier and improving the quality of our care.

But it doesn't. One out of every four dollars we spend on health care is swallowed up by administrative costs - on needless paperwork and antiquated record-keeping that belongs in the last century. This failure to update the way our doctors and hospitals store and share information also leads to costly errors. Each year, 100,000 Americans die due to medical errors and we lose $100 billion because of prescription drug errors alone.

We also spend far more on treating illnesses and conditions that could've been prevented or managed for far less. Our health care system is turning into a disease care system, where too many plans and providers don't offer or encourage check-ups and tests and screenings that could save thousands of lives and billions of dollars down the road.

Of course, the biggest obstacle in the way of reforming this skewed system of needless waste and spiraling costs are those who profit most from the status quo - the drug and insurance companies who pocket a growing chunk of the medical bills that people like Amy and Lane are going bankrupt trying to pay.

Since President Bush took office, the single fastest growing component of health care spending has been administrative costs and profits for insurance companies. Coming in a close second is the amount we spend on prescription drugs. In 2006, five of the biggest drug and insurance companies were among the fifty most profitable businesses in the nation. One insurance company CEO received a $125 million salary that same year, and has been given stock options worth over $1 billion. As an added perk, he and his wife get free private health care for as long as they live.

Now, making this kind of money costs money, which is why the drug and insurance industries have also spent more than $1 billion on lobbying and campaign contributions over the last ten years to block the kind of reform we need. They've been pretty good at it too, preventing the sale of cheaper prescription drugs and defeating attempts to make it harder for insurance companies to deny coverage on the basis of a preexisting condition.

Look, it's perfectly understandable for a business to try and make a profit, and every American has the right to make their case to the people who represent us in Washington.

But I also believe that every American has the right to affordable health care. I believe that the millions of Americans who can't take their children to a doctor when they get sick have that right. I believe that people like Amy and Lane who are on the brink of losing everything they own have that right. And I believe that no amount of industry profiteering and lobbying should stand in the way of that right any longer.

That's not who we are.

We now face an opportunity - and an obligation - to turn the page on the failed politics of yesterday's health care debates. It's time to bring together businesses, the medical community, and members of both parties around a comprehensive solution to this crisis, and it's time to let the drug and insurance industries know that while they'll get a seat at the table, they don't get to buy every chair.

We can do this. The climate is far different than it was the last time we tried this in the early nineties. Since then, rising costs have caused many more businesses to back reform, and in states from Massachusetts to California, Democratic and Republican governors and legislatures have been way ahead of Washington in passing increasingly bolder initiatives to cover the uninsured and cut costs.

We've had some success in Illinois as well. As a state senator, I brought Republicans and Democrats together to pass legislation insuring 20,000 more children and 65,000 more parents. I authored and passed a bill cracking down on hospital price gouging of uninsured patients, and helped expand coverage for routine mammograms for women on Medicaid. We created hospital report cards, so that every consumer could see things like the ratio of nurses to patients, the number of annual medical errors, and the quality of care they could expect at each hospital. And I passed a law that put Illinois on a path to universal coverage.

It's a goal I believe we can achieve on a national level with the health care plan I'm outlining today. The very first promise I made on this campaign was that as president, I will sign a universal health care plan into law by the end of my first term in office. Today I want to lay out the details of that plan - a plan that not only guarantees coverage for every American, but also brings down the cost of health care and reduces every family's premiums by as much as $2500. This second part is important because, in the end, coverage without cost containment will only shift our burdens, not relieve them. So we will take steps to remove the waste and inefficiency from the system so we can bring down costs and improve the quality of our care while we're at it.

My plan begins by covering every American.

If you already have health insurance, the only thing that will change for you under this plan is the amount of money you will spend on premiums. That will be less.

If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law. No one will be turned away because of a preexisting condition or illness. Everyone will be able buy into a new health insurance plan that's similar to the one that every federal employee - from a postal worker in Iowa to a Congressman in Washington - currently has for themselves. It will cover all essential medical services, including preventive, maternity, disease management, and mental health care. And it will also include high standards for quality and efficiency.

If you cannot afford this insurance, you will receive a subsidy to pay for it. If you have children, they will be covered. If you change jobs, your insurance will go with you. If you need to see a doctor, you will not have to wait in long lines for one. If you want more choices, you will also have the option of purchasing a number of affordable private plans that have similar benefits and standards for quality and efficiency.

To help pay for this, we will ask all but the smallest businesses who don't make a meaningful contribution today to the health coverage of their employees to do so by supporting this new plan. And we will allow the temporary Bush tax cut for the wealthiest Americans to expire.

But we also have to demand greater efficiencies from our health care system. Today, we pay almost twice as much for health care per person than other industrialized nations, and too much of it has nothing to do with patient care.

That's why the second part of my health care plan includes five, long-overdue steps we will take to bring down costs and bring our health care system into the 21st century - steps that will save each American family up to $2500 on their premiums.

First, we will reduce costs for business and their workers by picking up the tab for some of the most expensive illnesses and conditions.

Right now, two out of every ten patients account for more than eighty percent of all health care costs. These are patients with serious illnesses like cancer or heart disease who require the most expensive surgeries and treatments. Insurance companies end up spending a lion's share of their expenses on these patients, and not surprisingly, they pass those expenses on to the rest of us in the form of higher premiums. Under my proposal, the federal government will pay for part of these catastrophic cases, which means that your premiums will go down.

Second, we will finally begin focusing our health care system on preventing costly, debilitating conditions in the first place.

We all know the saying that an ounce of prevention is worth a pound of cure. But today we're nowhere close to that ounce. We spend less than four cents of every health care dollar on prevention and public health even though eighty percent of the risk factors involved in the leading causes of death are behavior-related and thus preventable.

The problem is, there's currently no financial incentive for health care providers to offer services that will encourage patients to eat right or exercise or go for annual check-ups and screenings that can help detect diseases early. The real profit today is made in treating diseases, not preventing them. That's wrong, which is why in our new national health care plan and other participating plans, we will require coverage of evidence-based, preventive care services, and make sure they are paid for.

But in the end, prevention only works if we take responsibility for our own health and make the right decisions in our own lives - if we eat the right foods, and stay active, and listen to our wives when they tell us to stop smoking.

Third, we will reduce the cost of our health care by improving the quality of our health care.

It's estimated that poor quality care currently costs us up to $100 billion a year. One study found that in Pennsylvania, Medicare spent $1 billion a year just on treating infections that patients contracted while at the hospital - infections that could have easily been prevented by hospitals. This study led hospitals across the state to take action, and today some have completely eliminated infections that used to take hundreds of lives and cost hundreds of thousands of dollars every year.

Much like the hospital report cards we passed in Illinois, my health care proposal will ask hospitals and providers to collect, track, and publicly report measures of health care quality. We'll provide the public with information about preventable medical errors, nurse-to-patient ratios, and hospital-acquired infections. We'll also start measuring what's effective and what's not when it comes to different drugs and procedures, so that patients can finally start making informed choices about the care that's best for them. And instead of rewarding providers and physicians only by the sheer quantity of services and procedures they prescribe, we'll start rewarding them for the quality of the outcomes for their patients.

Fourth, we will reduce waste and inefficiency by moving from a 20th century health care industry based on pen and paper to a 21st century industry based on the latest information technology.

Almost every other industry in the world has saved billions on administrative costs by computerizing all of their records and information. Every transaction you make at a bank now costs less than a dollar. Even at the Veterans Administration, where it used to cost nine dollars to pull up your medical record, new technology means you can call up the same record on the internet for next to nothing.

But because we haven't updated technology in the rest of the health care industry, a single transaction still costs up to twenty-five dollars.

This reform is long overdue. By moving to electronic medical records, we can give doctors and nurses easy access to all the necessary information about their patients, so if they type-in a certain prescription, a patient's allergies will pop right up on the screen. This will reduce deadly medical errors, and it will also shorten the length of hospital stays, ensure that nurses can spend less time on paperwork and more time with patients, and save billions and billions of dollars in the process.

Finally, we will break the stranglehold that a few big drug and insurance companies have on the health care market.

We all value the medical cures and innovations that the pharmaceutical industry has developed over the years, but it's become clear that some of these companies are dramatically overcharging Americans for what they offer. They'll sell the same exact drugs here in America for double the price of what they charge in Europe and Canada. They'll push expensive products on doctors by showering them with gifts, spend more to market and advertise their drugs than to research and develop them, and when a generic drug maker comes along and wants to sell the same product for cheaper, the brand-name manufacturers will actually payoff the generic ones so they can preserve their monopolies and keep charging the rest of us high prices.

We don't have to stand for that anymore. Under my plan, we will make generic drugs more available to consumers and we will tell the drug companies that their days of forcing affordable prescription drugs out of the market are over.

And it's not just the drug industry that's manipulating the market. In the last ten years, there have been over four hundred health insurance mergers. Right here in Iowa, just three companies control more than three-quarters of the health insurance market. These changes were supposed to increase efficiency in the industry. But what's really increased is the amount of money we're paying them.

This is wrong, and when I'm President, we're going to make drug and insurance companies compete for their customers just like every other business in America. We'll investigate and prosecute the monopolization of the insurance industry. And where we do find places where insurance companies aren't competitive, we will make them pay a reasonable share of their profits on the patients they should be caring for in the first place. Because that's what's right.

We are a country that looks at the thousands of stories just like Amy and Lane's - stories we have heard and told for decades - and realizes that our American story calls on us to write them a hopeful, happier ending. After all, that's what we've done before.

Half a century ago, America found itself in the midst of another health care crisis. For millions of elderly Americans, the single greatest cause of poverty and hardship was the crippling cost of their health care. A third of all elderly Americans lived in poverty, and nearly half had no health insurance.

As health care and hospital costs continued to rise, more and more private insurers simply refused to insure our elderly, believing they were too great of a risk to care for.

The resistance to action was fierce. Proponents of health care reform were opposed by well-financed, well-connected interest groups who spared no expense in telling the American people that these efforts were "dangerous" and "un-American," "revolutionary" and even "deadly."

And yet the reformers marched on. They testified before Congress and they took their case to the country and they introduced dozens of different proposals but always, always they stood firm on their goal to provide affordable health care for every American senior. And finally, after years of advocacy and negotiation and plenty of setbacks, President Lyndon Johnson signed the Medicare bill into law on July 30th of 1965.

The signing ceremony was held in Missouri, in a town called Independence, with the man who issued the call for universal health care during his own presidency - Harry Truman.

And as he stood with Truman by his side and signed what would become one of the most successful government programs in history - a program that had seemed impossible for so long - President Johnson looked out at the crowd and said, "History shapes men, but it is a necessary faith of leadership that men can help shape history."

Never forget that we have it within our power to shape history in this country. It is not in our character to sit idly by as victims of fate or circumstance, for we are a people of action and innovation, forever pushing the boundaries of what's possible.

Now is the time to push those boundaries once more. We have come so far in the debate on health care in this country, but now we must finally answer the call issued by Truman, advanced by Johnson, and pushed along by the simple power of stories like the one told by Amy and Lane. The time has come for affordable, universal health care in America. And I look forward to working with all of you to meet this challenge in the weeks and months to come. Thank you.

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