Essentially, my proposal would change three things about the current health care system.  First, it would end the worst practices of insurance companies.  No longer would they be able to deny your coverage because of a preexisting condition.  No longer would they be able to drop your coverage because you got sick.  No longer would they be able to force you to pay unlimited amounts of money out of your own pocket.  No longer would they be able to arbitrarily（武断地，专横地） and massively raise premiums like Anthem Blue Cross recently tried to do in California -- up to 39 percent increases in one year in the individual market.  Those practices would end.

Second, my proposal would give uninsured individuals and small business owners the same kind of choice of private health insurance that members of Congress get for themselves -- because if it’s good enough for members of Congress, it’s good enough for the people who pay their salaries.  (Applause.) 

The reason federal employees get a good deal on health insurance is that we all participate in an insurance market where insurance companies give better coverage and better rates, because they get more customers.  It's an idea that many Republicans have embraced in the past, before politics intruded. 

And my proposal says that if you still can’t afford the insurance in this new marketplace, even though it's going to provide better deals for people than they can get right now in the individual marketplace, then we'll offer you tax credits to do so -- tax credits that add up to the largest middle-class tax cut for health care in history.  After all, the wealthiest among us can already buy the best insurance there is, and the least well off are able to get coverage through Medicaid.  So it's the middle class that gets squeezed（挤，勒索）, and that’s who we have to help. 

Now, it is absolutely true that all of this will cost some money -- about $100 billion per year.  But most of this comes from the nearly $2 trillion a year that America already spends on health care -- but a lot of it is not spent wisely.  A lot of that money is being wasted or spent badly.  So within this plan, we’re going to make sure the dollars we spend go towards making insurance more affordable and more secure.  We’re going to eliminate wasteful taxpayer subsidies（津贴，补助金） that currently go to insurance and pharmaceutical（制药的） companies; set a new fee on insurance companies that stand to gain a lot of money and a lot of profits as millions of Americans are able to buy insurance; and we're going to make sure that the wealthiest Americans pay their fair share on Medicare.

The bottom line is our proposal is paid for.  And all the new money generated in this plan goes back to small businesses and middle-class families who can't afford health insurance.  It would also lower prescription drug prices for seniors.  And it would help train new doctors and nurses and physician assistants to provide care for American families.

Finally, my proposal would bring down the cost of health care for millions -- families, businesses, and the federal government.  We have now incorporated most of the serious ideas from across the political spectrum about how to contain the rising cost of health care --- ideas that go after the waste and abuse in our system, especially in programs like Medicare.  But we do this while protecting Medicare benefits, and extending the financial stability of the program by nearly a decade.   

Our cost-cutting measures mirror most of the proposals in the current Senate bill, which reduces most people's premiums and brings down our deficit by up to a trillion dollars over the next two decades -- brings down our deficit.  Those aren't my numbers; those are the savings determined by the Congressional Budget Office, which is the Washington acronym（首字母缩略词） for the nonpartisan（无党派的） , independent referee（裁判员，调解人） of Congress in terms of how much stuff costs. (Laughter.)

So that's our proposal.  This is where we've ended up.  It's an approach that has been debated and changed and I believe improved over the last year.  It incorporates the best ideas from Democrats and Republicans --- including some of the ideas that Republicans offered during the health care summit, like funding state grants on medical malpractice（玩忽职守，不法行为） reform, and curbing waste and fraud and abuse in the health care system.  My proposal also gets rid of many of the provisions that had no place in health care reform -- provisions that were more about winning individual votes in Congress than improving health care for all Americans.

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