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Obama's Health Care Address to Congress 844 words

Obama's Health Care Address to Congress, made on September 9th, 2009.


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  1. health care
    the preservation of mental and physical health by preventing or treating illness through services offered by the health profession
    So tonight, I return to speak to all of you about an issue that is central to that future - and that is the issue of health care.
  2. insurance
    protection against future loss
    Some can't get insurance on the job.
  3. insurance company
    a financial institution that sells insurance
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  4. affordable
    that you have the financial means for
    Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices.
  5. health insurance
    insurance against loss due to ill health
    More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too.
  6. coverage
    the extent to which something is covered
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  7. Medicare
    health care for the aged; a federally administered system of health insurance available to persons aged 65 and over
    When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid.
  8. Medicaid
    health care for the needy; a federally and state-funded program
    When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid.
  9. health
    the general condition of body and mind
    So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.
  10. uninsured
    not covered by insurance
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  11. pre-existing
    existing previously or before something
    Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition.
  12. rugged individualism
    individualism in social and economic affairs; belief not only in personal liberty and self-reliance but also in free competition
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  13. colonoscopy
    visual examination of the colon (with a colonoscope) from the cecum to the rectum; requires sedation
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  14. not-for-profit
    an organization chartered for other than profit-making activities
    But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.
  15. out-of-pocket
    calling for the spending of cash
    We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick.
  16. option
    one of a number of things from which only one can be chosen
    Now, even if we provide these affordable options, there may be those – particularly the young and healthy – who still want to take the risk and go without coverage.
  17. Secretary of Health and Human Services
    the position of the head of the Department of Health and Human Services
    It's a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.
  18. emergency room
    a room in a hospital or clinic staffed and equipped to provide emergency care to persons requiring immediate medical treatment
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  19. one percent
    one part in a hundred equal parts
    And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.
  20. reform
    make changes for improvement in order to remove abuse and injustices
    It has now been nearly a century since Theodore Roosevelt first called for health care reform.
  21. silver bullet
    a simple guaranteed solution for a difficult problem
    I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.
  22. care
    the work of providing treatment for or attending to someone or something
    So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.
  23. golden years
    the time of life after retirement from active work
    They joined together so that all of us could enter our golden years with some basic peace of mind.
  24. gallstone
    a calculus formed in the gall bladder or its ducts
    One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about.
  25. costs
    pecuniary reimbursement to the winning party for the expenses of litigation
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  26. leavening
    a substance used to produce fermentation in dough or a liquid
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  27. malpractice
    a wrongful act that the actor had no right to do; improper professional conduct
    Finally, many in this chamber – particularly on the Republican side of the aisle – have long insisted that reforming our medical malpractice laws can help bring down the cost of health care.
  28. self-employed
    working for yourself
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  29. plan
    a series of steps to be carried out or goals to be accomplished
    The plan I'm announcing tonight would meet three basic goals:

    It will provide more security and stability to those who have health insurance.
  30. tall tale
    an improbable (unusual or incredible or fanciful) story
    So don't pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget
  31. mammogram
    X-ray film of the soft tissue of the breast
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  32. healthcare
    the preservation of mental and physical health by preventing or treating illness through services offered by the health profession
    We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average.
  33. medical bill
    statement of charges for medical services
    More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years.
  34. mastectomy
    surgical removal of a breast to remove a malignant tumor
    Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.
  35. willing and able
    not reluctant
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  36. tonight
    during the night of the present day
    So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.
  37. unfinished business
    work that is left incomplete
    And he expressed confidence that this would be the year that health care reform – "that great unfinished business of our society," he called it – would finally pass.
  38. colon cancer
    a malignant tumor of the colon; early symptom is bloody stools
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer
  39. insurance premium
    payment for insurance
    This is one of the reasons that insurance premiums have gone up three times faster than wages.
  40. provide
    give something useful or necessary to
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  41. bureaucrat
    an official of a bureaucracy
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  42. company
    an institution created to conduct business
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  43. gridlock
    a traffic jam so bad that no movement is possible
    I still believe we can replace acrimony with civility, and gridlock with progress.
  44. insurer
    a financial institution that sells insurance
    One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about.
  45. cost
    be priced at
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  46. acne
    an inflammatory disease involving the sebaceous glands of the skin; characterized by papules or pustules or comedones
    Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.
  47. demagoguery
    impassioned appeals to the prejudices and emotions of the populace
    In fact, I want to speak directly to America's seniors for a moment, because Medicare is another issue that's been subjected to demagoguery and distortion during the course of this debate.
  48. breast cancer
    cancer of the breast; one of the most common malignancies in women in the US
    By the time she had her insurance reinstated, her breast cancer more than doubled in size.
  49. co-op
    a jointly owned commercial enterprise (usually organized by farmers or consumers) that produces and distributes goods and services and is run for the benefit of its owners
    Others propose a co-op or another non-profit entity to administer the plan.
  50. takeover
    a change by sale or merger in the controlling interest of a corporation
    My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system.
  51. deficit
    the property of being an amount by which something is less than expected or required
    Put simply, our health care problem is our deficit problem.
  52. misinformation
    information that is incorrect
    Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform.
  53. long-run
    relating to or extending over a relatively long time
    And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run.
  54. United States of America
    North American republic containing 50 states - 48 conterminous states in North America plus Alaska in northwest North America and the Hawaiian Islands in the Pacific Ocean; achieved independence in 1776
    That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.
  55. Health and Human Services
    the United States federal department that administers all federal programs dealing with health and welfare; created in 1979
    It's a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.
  56. healthier
    improved in health or physical condition
    We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it.
  57. pay for
    have as a guest
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  58. waiver
    a formal written statement of relinquishment
    There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  59. prescription drug
    a drug that is available only with written instructions from a doctor or dentist to a pharmacist
    And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs.
  60. leverage
    the mechanical advantage gained by being in a position to use a lever
    As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage.
  61. incorporate
    make into a whole or make part of a whole
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  62. will
    the capability of conscious choice and decision and intention
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  63. savings
    a fund of money put by as a reserve
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  64. vibrant
    vigorous and animated
    A full and vibrant recovery is many months away.
  65. jack up
    lift with a special device
    And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.
  66. iron out
    settle or put right
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  67. chemotherapy
    the use of chemical agents to treat or control disease (or mental illness)
    One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about.
  68. system
    a group of independent but interrelated elements comprising a unified whole
    And our financial system was on the verge of collapse.
  69. senior citizen
    an elderly person
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  70. marketplace
    an area in a town where a public mercantile establishment is set up
    We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.
  71. breaking point
    the degree of tension or stress at which something breaks
    Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
  72. checkup
    a thorough physical examination; includes a variety of tests depending on the age and sex and health of the person
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  73. spending cut
    the act of reducing spending
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  74. drug company
    a company that makes and sells pharmaceuticals
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  75. back down
    move backwards from a certain position
    But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice.
  76. senior
    advanced in years; (`aged' is pronounced as two syllables)
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  77. basic principle
    principles from which other truths can be derived
    But I will not back down on the basic principle that if Americans can't find affordable coverage, we will provide you with a choice.
  78. trillion
    the number that is represented as a one followed by 12 zeros
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  79. misrepresent
    represent falsely
    If you misrepresent what's in the plan, we will call you out.
  80. Great Depression
    the economic crisis beginning with the stock market crash in 1929 and continuing through the 1930s
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  81. from scratch
    from the beginning, especially without relying on resources or other advantages
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  82. premium
    a prize, bonus, or award given as an inducement to purchase products, enter competitions initiated by business interests, etc.
    More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care.
  83. profit margin
    the ratio gross profits divided by net sales
    There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  84. employer
    a person or firm that employs workers
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  85. sign up
    engage by written agreement
    If there are affordable options and people still don't sign up for health insurance, it means we pay for those people's expensive emergency room visits.
  86. acknowledgement
    the state or quality of being recognized or acknowledged
    A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise.
  87. business
    the principal activity in your life that you do to earn money
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  88. ideological
    of or pertaining to or characteristic of an orientation that characterizes the thinking of a group or nation
    Some have dug into unyielding ideological camps that offer no hope of compromise.
  89. acrimony
    a rough and bitter manner
    I still believe we can replace acrimony with civility, and gridlock with progress.
  90. one-sixth
    one part in six equal parts
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  91. tirelessly
    with indefatigable energy
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  92. un-American
    considered contrary to the best interests of the United States
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  93. materialize
    come into being; become reality
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  94. economic crisis
    a long-term economic state characterized by unemployment and low prices and low levels of trade and investment
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  95. payer
    a person who pays money for something
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  96. Bill of Rights
    a statement of fundamental rights and privileges (especially the first ten amendments to the United States Constitution)
    They worked together on a Patient's Bill of Rights.
  97. government
    (government) the system or form by which a community or other political unit is governed
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  98. trust fund
    a fund held in trust
    That is why not a dollar of the Medicare trust fund will be used to pay for this plan.
  99. stability
    the quality or attribute of being firm and steadfast
    Those who do have insurance have never had less security and stability than they do today.
  100. let up
    become less in amount or intensity
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  101. chip in
    contribute to some cause
    Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.
  102. walk of life
    careers in general
    And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole.
  103. compete
    compete for something; engage in a contest; measure oneself against others
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  104. tax break
    a tax deduction that is granted in order to encourage a particular type of commercial activity
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  105. stand fast
    refuse to abandon one's opinion or belief
    But the men and women of Congress stood fast, and we are all the better for it.
  106. individual
    being or characteristic of a single thing or person
    On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.
  107. ironed
    (of linens or clothes) smoothed with a hot iron
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  108. throw overboard
    throw from a boat
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  109. irresponsible
    showing lack of care for consequences
    The problem is, such irresponsible behavior costs all the rest of us money.
  110. kill off
    kill en masse; kill on a large scale; kill many
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  111. common ground
    a basis agreed to by all parties for reaching a mutual understanding
    And I will continue to seek common ground in the weeks ahead.
  112. existing
    having existence or being or actuality
    Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition.
  113. email
    (computer science) a system of world-wide electronic communication in which a computer user can compose a message at one terminal that can be regenerated at the recipient's terminal when the recipient logs in
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  114. pay
    give money, usually in exchange for goods or services
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  115. challenge
    a call to engage in a contest or fight
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  116. low-cost
    that you have the financial means for
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  117. cancer
    any malignant growth or tumor caused by abnormal and uncontrolled cell division; it may spread to other parts of the body through the lymphatic system or the blood stream
    By the time she had her insurance reinstated, her breast cancer more than doubled in size.
  118. currently
    at this time or period; now
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  119. basic
    reduced to the simplest and most significant form possible without loss of generality
    The plan I'm announcing tonight would meet three basic goals:

    It will provide more security and stability to those who have health insurance.
  120. internationally
    throughout the world
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  121. customer
    someone who pays for goods or services
    Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.
  122. skyrocket
    propels bright light high in the sky, or used to propel a lifesaving line or harpoon
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  123. solve
    find the solution to (a problem or question) or understand the meaning of
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  124. tax credit
    a direct reduction in tax liability (not dependent on the taxpayer's tax bracket)
    For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need.
  125. Ted
    a tough youth of 1950's and 1960's wearing Edwardian style clothes
    It was from our beloved friend and colleague, Ted Kennedy.
  126. talk show
    a program during which well-known people discuss a topic or answer questions telephoned in by the audience
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  127. decade
    the cardinal number that is the sum of nine and one; the base of the decimal system
    Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
  128. here and now
    at this time
    I still believe we can do great things, and that here and now we will meet history's test.
  129. exchange
    the act of changing one thing for another thing
    We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.
  130. coordination
    the regulation of diverse elements into an integrated and harmonious operation
    The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between te
  131. bogus
    fraudulent; having a misleading appearance
    Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost.
  132. unwarranted
    incapable of being justified or explained
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  133. More
    English statesman who opposed Henry VIII's divorce from Catherine of Aragon and was imprisoned and beheaded; recalled for his concept of Utopia, the ideal state
    More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too.
  134. dig into
    examine physically with or as if with a probe
    Some have dug into unyielding ideological camps that offer no hope of compromise.
  135. middle-class
    occupying a socioeconomic position intermediate between those of the lower classes and the wealthy
    These are middle-class Americans.
  136. medical
    relating to the study or practice of medicine
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  137. saving
    recovery or preservation from loss or danger
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  138. sick
    affected by an impairment of normal physical or mental function
    More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care.
  139. finance committee
    a committee appointed to consider financial issues
    Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week.
  140. self-sufficient
    able to provide for your own needs without help from others
    I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
  141. afford
    have the financial means to do something or buy something
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  142. taxpayer
    someone who pays taxes
    Finally, our health care system is placing an unsustainable burden on taxpayers.
  143. security
    the state of being free from danger or injury
    Those who do have insurance have never had less security and stability than they do today.
  144. hardship
    something hard to endure
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  145. homeowner
    someone who owns a home
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  146. consumer
    a person who uses goods or services
    And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned.
  147. helping hand
    physical assistance
    A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand.
  148. idea
    the content of cognition; the main thing you are thinking about
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  149. Congress
    the legislature of the United States government
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  150. laughable
    arousing or provoking laughter
    Such a charge would be laughable if it weren't so cynical and irresponsible.
  151. inhibit
    limit the range or extent of
    It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a
  152. voucher
    someone who vouches for another or for the correctness of a statement
    So don't pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget that wo
  153. competition
    the act of competing as for profit or a prize
    My guiding principle is, and always has been, that consumers do better when there is choice and competition.
  154. at any cost
    regardless of the cost involved
    Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost.
  155. status quo
    the existing state of affairs
    And I will not accept the status quo as a solution.
  156. self-reliance
    personal independence
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  157. one-tenth
    a tenth part; one part in ten equal parts
    And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.
  158. goal
    the state of affairs that a plan is intended to achieve and that (when achieved) terminates behavior intended to achieve it
    That is our ultimate goal.
  159. waste
    use inefficiently or inappropriately
    Second, we've estimated that most of this plan can be paid for by finding savings within the existing health care system – a system that is currently full of waste and abuse.
  160. job
    a specific piece of work required to be done as a duty or for a specific fee
    We were losing an average of 700,000 jobs per month.
  161. scary
    provoking fear terror
    So don't pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget
  162. Theodore Roosevelt
    26th President of the United States; hero of the Spanish-American War; Panama Canal was built during his administration
    It has now been nearly a century since Theodore Roosevelt first called for health care reform.
  163. can
    airtight sealed metal container for food or drink or paint etc.
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  164. subsidy
    a grant paid by a government to an enterprise that benefits the public
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  165. profit
    the advantageous quality of being beneficial
    There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  166. unyielding
    stubbornly unyielding
    Some have dug into unyielding ideological camps that offer no hope of compromise.
  167. wipe away
    remove by wiping
    In 1933, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism.
  168. inefficiency
    unskillfulness resulting from a lack of efficiency
    Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.
  169. percent
    a proportion in relation to a whole (which is usually the amount per hundred)
    And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.
  170. fundamental principle
    principles from which other truths can be derived
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  171. bickering
    a quarrel about petty points
    Well the time for bickering is over.
  172. issue
    some situation or event that is thought about
    So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.
  173. individualism
    the quality of being individual
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  174. reducing
    any process in which electrons are added to an atom or ion (as by removing oxygen or adding hydrogen); always occurs accompanied by oxidation of the reducing agent
    The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between te
  175. get worse
    deteriorate in health
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer befo
  176. debate
    a discussion in which reasons are advanced for and against some proposition or proposal
    Instead of honest debate, we have seen scare tactics.
  177. distortion
    a shape resulting from distortion
    In fact, I want to speak directly to America's seniors for a moment, because Medicare is another issue that's been subjected to demagoguery and distortion during the course of this debate.
  178. expensive
    high in price or charging high prices
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  179. exploited
    developed or used to greatest advantage
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  180. illegally
    in an illegal manner
    This, too, is false – the reforms I'm proposing would not apply to those who are here illegally.
  181. sixty-five
    being five more than sixty
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  182. ensure
    make certain of
    These steps will ensure that you – America's seniors – get the benefits you've been promised.
  183. accountable
    liable to account for one's actions
    I just want to hold them accountable.
  184. special interest
    an individual or group who are concerned with some particular part of the economy and who try to influence legislators or bureaucrats to act in their favor
    I will not stand by while the special interests use the same old tactics to keep things exactly the way they are.
  185. short-term
    relating to or extending over a limited period
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  186. problem
    a question raised for consideration or solution
    But the problem that plagues the health care system is not just a problem of the uninsured.
  187. tab
    a short strip of material attached to or projecting from something in order to facilitate opening or identifying or handling it
    If some businesses don't provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors.
  188. preventive
    tending to prevent or hinder
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  189. bicker
    argue over petty things
    Well the time for bickering is over.
  190. employee
    a worker who is hired to perform a job
    It's why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely.
  191. in this
    (formal) in or into that thing or place
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  192. doctor
    a person who holds Ph.D. degree (or the equivalent) from an academic institution
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  193. figuring
    problem solving that involves numbers or quantities
    And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.
  194. usher in
    be a precursor of
    Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody.
  195. wealthy
    having an abundant supply of money or possessions of value
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  196. make sense
    be reasonable or logical or comprehensible
    That makes sense, it saves money, and it saves lives.
  197. abide by
    show respect towards
    And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned.
  198. leaven
    a substance used to produce fermentation in dough or a liquid
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  199. per year
    by the year; every year (usually with reference to a sum of money paid or received)
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  200. skepticism
    doubt about the truth of something
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  201. town hall
    a government building that houses administrative offices of a town government
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  202. just
    and nothing more
    But we did not come here just to clean up crises.
  203. initiative
    readiness to embark on bold new ventures
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  204. peace of mind
    the absence of mental stress or anxiety
    They joined together so that all of us could enter our golden years with some basic peace of mind.
  205. hold down
    restrain
    And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run.
  206. stifle
    impair the respiration of or obstruct the air passage of
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  207. illness
    impairment of normal physiological function affecting part or all of an organism
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  208. tax
    charge against a citizen's person or property or activity for the support of government
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  209. American
    of or relating to the United States of America or its people or language or culture
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  210. need
    have need of
    And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.
  211. disrupt
    make a break in
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  212. dollar
    the basic monetary unit in many countries; equal to 100 cents
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  213. entrepreneur
    someone who organizes a business venture and assumes the risk for it
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  214. healthy
    having or indicating good health in body or mind; free from infirmity or disease
    Now, even if we provide these affordable options, there may be those – particularly the young and healthy – who still want to take the risk and go without coverage.
  215. worker
    a person who works at a specific occupation
    There may still be companies that refuse to do right by their workers.
  216. take effect
    go into effect or become effective or operative
    This exchange will take effect in four years, which will give us time to do it right.
  217. partisan
    a fervent and even militant proponent of something
    But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government.
  218. automaker
    a business engaged in the manufacture of automobiles
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  219. today
    on this day as distinct from yesterday or tomorrow
    Those who do have insurance have never had less security and stability than they do today.
  220. ideology
    an orientation that characterizes the thinking of a group or nation
    On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience.
  221. on the job
    actively engaged in paid work
    Some can't get insurance on the job.
  222. tactics
    a plan for attaining a particular goal
    Instead of honest debate, we have seen scare tactics.
  223. general election
    a national or state election; candidates are chosen in all constituencies
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  224. liberalism
    a political orientation that favors social progress by reform and by changing laws rather than by revolution
    For some of Ted Kennedy's critics, his brand of liberalism represented an affront to American liberty.
  225. deliver
    bring to a destination, make a delivery
    Now is the time to deliver on health care.
  226. bring down
    move something or somebody to a lower position
    Finally, many in this chamber – particularly on the Republican side of the aisle – have long insisted that reforming our medical malpractice laws can help bring down the cost of health care.
  227. policy
    a plan of action adopted by an individual or social group
    Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.
  228. impact
    the striking of one body against another
    No one would be forced to choose it, and it would not impact those of you who already have insurance.
  229. bill
    an itemized statement of money owed for goods shipped or services rendered
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  230. lifetime
    the period during which something is functional (as between birth and death)
    They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.
  231. exist
    have an existence, be extant
    Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition.
  232. dime
    a United States coin worth one tenth of a dollar
    First, I will not sign a plan that adds one dime to our deficits – either now or in the future.
  233. Republican
    a member of the Republican Party
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  234. eat up
    use up (resources or materials)
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  235. many
    a quantifier that can be used with count nouns and is often preceded by `as' or `too' or `so' or `that'; amounting to a large but indefinite number
    A full and vibrant recovery is many months away.
  236. tactic
    a plan for attaining a particular goal
    Instead of honest debate, we have seen scare tactics.
  237. blizzard
    a storm with widespread snowfall accompanied by strong winds
    And out of this blizzard of charges and counter-charges, confusion has reigned.
  238. private
    confined to particular persons or groups or providing privacy
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  239. aspiring
    desiring or striving for recognition or advancement
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  240. badly
    to a severe or serious degree
    And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.
  241. requirement
    required activity
    There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  242. not
    negation of a word or group of words
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  243. decisive
    characterized by decision and firmness
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  244. executive
    a person responsible for the administration of a business
    Insurance executives don't do this because they are bad people.
  245. legitimate
    based on known statements or events or conditions
    They provide a legitimate service, and employ a lot of our friends and neighbors.
  246. constraint
    the state of being physically constrained
    They understood that there are instances when the gains in security from government action are not worth the added constraints on our freedom.
  247. people
    (plural) any group of human beings (men or women or children) collectively
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  248. democrat
    an advocate of democratic principles
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  249. helplessness
    the state of needing help from something
    He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging p
  250. republican
    having the supreme power lying in the body of citizens entitled to vote for officers and representatives responsible to them or characteristic of such government
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  251. still
    not in physical motion
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  252. disability
    the condition of being unable to perform as a consequence of physical or mental unfitness
    They worked together to provide health care to children with disabilities.
  253. spend
    pass time in a specific way
    We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it.
  254. consensus
    agreement in the judgment or opinion reached by a group as a whole
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  255. America
    North America and South America and Central America
    That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.
  256. some
    quantifier; used with either mass nouns or plural count nouns to indicate an unspecified number or quantity
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  257. risky
    involving risk or danger
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  258. get
    come into the possession of something concrete or abstract
    Some can't get insurance on the job.
  259. future
    the time yet to come
    We came to build a future.
  260. benefit
    something that aids or promotes well-being
    And I have no doubt that these reforms would greatly benefit Americans from all walks of life, as well as the economy as a whole.
  261. tax cut
    the act of reducing taxation
    Add it all up, and the plan I'm proposing will cost around $900 billion over ten years – less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the begin
  262. entity
    that which is perceived or known or inferred to have its own distinct existence (living or nonliving)
    Others propose a co-op or another non-profit entity to administer the plan.
  263. colon
    the part of the large intestine between the cecum and the rectum; it extracts moisture from food residues before they are excreted
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  264. million
    the number that is represented as a one followed by 6 zeros
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  265. credits
    a list of acknowledgements of those who contributed to the creation of a film (usually run at the end of the film)
    For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need.
  266. require
    have need of
    Here are the details that every American needs to know about this plan:

    First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will requir
  267. skeptical
    marked by or given to doubt
    I know that many in this country are deeply skeptical that government is looking out for them.
  268. contributing
    tending to bring about; being partly responsible for
    I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.
  269. one
    the smallest whole number or a numeral representing this number
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  270. choice
    the act of choosing or selecting
    Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices.
  271. constructive
    constructing or tending to construct or improve or promote development
    These are all constructive ideas worth exploring.
  272. public
    not private; open to or concerning the people as a whole
    But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.
  273. timidity
    fear of the unknown or unfamiliar or fear of making decisions
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  274. lose
    fail to keep or to maintain; cease to have, either physically or in an abstract sense
    We were losing an average of 700,000 jobs per month.
  275. come close
    be close or similar
    Nothing else even comes close.
  276. Kennedy
    35th President of the United States; established the Peace Corps; assassinated in Dallas (1917-1963)
    It was from our beloved friend and colleague, Ted Kennedy.
  277. 1000
    the cardinal number that is the product of 10 and 100
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  278. rigorous
    rigidly accurate; allowing no deviation from a standard
    And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.
  279. more
    (comparative of `much' used with mass nouns) a quantifier meaning greater in size or amount or extent or degree
    There are now more than thirty million American citizens who cannot get coverage.
  280. able
    (usually followed by `to') having the necessary means or skill or know-how or authority to do something
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  281. recovery
    return to an original state
    A full and vibrant recovery is many months away.
  282. year
    the period of time that it takes for a planet (as, e.g., Earth or Mars) to make a complete revolution around the sun
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  283. clean up
    put (things or places) in order
    But we did not come here just to clean up crises.
  284. encourage
    inspire with confidence; give hope or courage to
    The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between te
  285. ultimate
    furthest or highest in degree or order; utmost or extreme
    That is our ultimate goal.
  286. responsibility
    the social force that binds you to the courses of action demanded by that force
    It's a plan that asks everyone to take responsibility for meeting this challenge – not just government and insurance companies, but employers and individuals.
  287. expert
    a person with special knowledge or ability who performs skillfully
    And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
  288. believe
    accept as true; take to be true
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  289. chamber
    a natural or artificial enclosed space
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  290. controlled
    restrained or managed or kept within certain bounds
    Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies.
  291. support
    the act of bearing the weight of or strengthening
    I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery.
  292. Social Security
    social welfare program in the U.S.; includes old-age and survivors insurance and some unemployment insurance and old-age assistance
    In 1933, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism.
  293. drug
    a substance that is used as a medicine or narcotic
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  294. agenda
    a list of matters to be taken up (as at a meeting)
    Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost.
  295. Depression
    a period during the 1930s when there was a worldwide economic depression and mass unemployment
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  296. finally
    as the end result of a succession or process
    Finally, our health care system is placing an unsustainable burden on taxpayers.
  297. program
    a series of steps to be carried out or goals to be accomplished
    When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid.
  298. details
    true confidential information
    Here are the details that every American needs to know about this plan:

    First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will re
  299. there
    in or at that place
    There are now more than thirty million American citizens who cannot get coverage.
  300. improve
    to make better
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing to i
  301. better
    (comparative of `good') superior to another (of the same class or set or kind) in excellence or quality or desirability or suitability; more highly skilled than another
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  302. terminal
    occurring at or forming an end or termination
    He had written it back in May, shortly after he was told that his illness was terminal.
  303. clear up
    become clear
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  304. size
    the physical magnitude of something (how big it is)
    By the time she had her insurance reinstated, her breast cancer more than doubled in size.
  305. bankrupt
    financially ruined
    More families will go bankrupt.
  306. relentless
    never-ceasing
    All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."
  307. help
    give help or assistance; be of service
    Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.
  308. outlined
    showing clearly the outline or profile or boundary
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  309. work
    activity directed toward making or doing something
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  310. emergency
    a sudden unforeseen crisis (usually involving danger) that requires immediate action
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  311. spread over
    form a cover over
    Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform.
  312. affront
    a deliberately offensive act or something producing the effect of deliberate disrespect
    For some of Ted Kennedy's critics, his brand of liberalism represented an affront to American liberty.
  313. thank
    express gratitude or show appreciation to
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  314. aging
    the organic process of growing older and showing the effects of increasing age
    He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging p
  315. three times
    by a factor of three
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  316. Iraq
    a republic in the Middle East in western Asia; the ancient civilization of Mesopotamia was in the area now known as Iraq
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  317. reduce
    make smaller
    Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody.
  318. charge
    assign a duty, responsibility or obligation to
    And out of this blizzard of charges and counter-charges, confusion has reigned.
  319. at stake
    to be won or lost; at risk
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  320. strike out
    set out on a course of action
    If you strike out on your own and start a small business, you will be able to get coverage.
  321. administer
    work in an administrative capacity; supervise or be in charge of
    Others propose a co-op or another non-profit entity to administer the plan.
  322. long-term
    relating to or extending over a relatively long time
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  323. quality
    an essential and distinguishing attribute of something or someone
    Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices.
  324. vulnerable
    capable of being wounded or hurt
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  325. guiding
    showing the way by conducting or leading; imposing direction on
    My guiding principle is, and always has been, that consumers do better when there is choice and competition.
  326. eliminate
    terminate, end, or take out
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  327. economy
    the system of production and distribution and consumption
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  328. based
    having a base
    On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.
  329. change
    become different in some particular way, without permanently losing one's or its former characteristics or essence
    More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too.
  330. together
    in contact with each other or in proximity
    Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do.
  331. small
    limited or below average in number or quantity or magnitude or extent
    It's why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely.
  332. teddy
    plaything consisting of a child's toy bear (usually plush and stuffed with soft materials)
    But those of us who knew Teddy and worked with him here – people of both parties – know that what drove him was something more.
  333. unfinished
    not brought to the desired final state
    And he expressed confidence that this would be the year that health care reform – "that great unfinished business of our society," he called it – would finally pass.
  334. abuse
    cruel or inhumane treatment
    To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it.
  335. know
    be cognizant or aware of a fact or a specific piece of information; possess knowledge or information about
    One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about.
  336. profits
    the excess of revenues over outlays in a given period of time (including depreciation and other non-cash expenses)
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  337. Utah
    a state in the western United States; settled in 1847 by Mormons led by Brigham Young
    We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average.
  338. civility
    the act of showing regard for others
    I still believe we can replace acrimony with civility, and gridlock with progress.
  339. matched
    going well together; possessing harmonizing qualities
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  340. rates
    a local tax on property (usually used in the plural)
    And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.
  341. argue
    have an argument about something
    On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.
  342. misunderstanding
    an understanding of something that is not correct
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  343. too
    to a degree exceeding normal or proper limits
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  344. concern
    something that interests you because it is important or affects you
    Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost.
  345. month
    one of the twelve divisions of the calendar year
    We were losing an average of 700,000 jobs per month.
  346. chuck
    throw carelessly
    His friend Chuck Grassley knows that.
  347. participate
    become a participant; be involved in
    Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.
  348. cynical
    believing the worst of human nature and motives; having a sneering disbelief in e.g. selflessness of others
    Such a charge would be laughable if it weren't so cynical and irresponsible.
  349. reliance
    the state of relying on something
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  350. offer
    present for acceptance or rejection
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  351. also
    in addition
    I also want to thank the American people for their patience and resolve during this trying time for our nation.
  352. here
    in or at this place; where the speaker or writer is
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  353. about
    (of quantities) imprecise but fairly close to correct
    So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.
  354. drop
    let fall to the ground
    More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care.
  355. incentive
    a positive motivational influence
    Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers.
  356. prescription
    directions prescribed beforehand; the action of prescribing authoritative rules or directions
    And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs.
  357. additional
    further or added
    But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.
  358. competitive
    involving competition or competitiveness
    We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.
  359. insure
    protect by insurance
    There are also those who claim that our reform effort will insure illegal immigrants.
  360. market
    a marketplace where groceries are sold
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  361. bankruptcy
    a legal process intended to insure equality among the creditors of a corporation declared to be insolvent
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  362. paid
    marked by the reception of pay
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  363. unfair
    not fair; marked by injustice or partiality or deception
    If some businesses don't provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors.
  364. only
    without any others being included or involved
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  365. beneficial
    promoting or enhancing well-being
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  366. slow
    not moving quickly; taking a comparatively long time
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  367. spending
    the act of spending or disbursing money
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  368. in some way
    in some unspecified way or manner; or by some unspecified means
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  369. handy
    skillful with the hands
    It is only one part of my plan, and should not be used as a handy excuse for the usual Washington ideological battles.
  370. credit
    an estimate, based on previous dealings, of a person's or an organization's ability to fulfill their financial commitments
    Credit was frozen.
  371. unprecedented
    having no precedent; novel
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  372. exempt
    (of persons) freed from or not subject to an obligation or liability (as e.g. taxes) to which others or other things are subject
    There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  373. collective
    done by or characteristic of individuals acting together
    Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
  374. brink
    the edge of a steep place
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  375. charitable
    relating to or characterized by charity
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  376. principle
    a basic generalization that is accepted as true and that can be used as a basis for reasoning or conduct
    My guiding principle is, and always has been, that consumers do better when there is choice and competition.
  377. more and more
    advancing in amount or intensity
    More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too.
  378. but
    and nothing more
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  379. focus on
    center upon
    So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.
  380. now
    at the present moment
    It has now been nearly a century since Theodore Roosevelt first called for health care reform.
  381. realize
    be fully aware or cognizant of
    Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform.
  382. build on
    be based on; of theories and claims, for example
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  383. greater
    greater in size or importance or degree
    When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid.
  384. same
    same in identity
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  385. friend
    a person you know well and regard with affection and trust
    They provide a legitimate service, and employ a lot of our friends and neighbors.
  386. available
    obtainable or accessible and ready for use or service
    For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need.
  387. understand
    know and comprehend the nature or meaning of
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  388. conditions
    the prevailing context that influences the performance or the outcome of a process
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  389. defer
    yield to another's wish or opinion
    I understand that the politically safe move would be to kick the can further down the road – to defer reform one more year, or one more election, or one more term.
  390. improving
    getting higher or more vigorous
    Improving our health care system only works if everybody does their part.
  391. especially
    to a distinctly greater extent or degree than is common
    I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery.
  392. understood
    implied by or inferred from actions or statements
    You see, our predecessors understood that government could not, and should not, solve every problem.
  393. required
    required by rule
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  394. budget
    a summary of intended expenditures along with proposals for how to meet them
    In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
  395. price
    the amount of money needed to purchase something
    We will do this by creating a new insurance exchange – a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices.
  396. like
    having the same or similar characteristics
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  397. happen
    come to pass
    In other words, it can happen to anyone.
  398. each year
    without missing a year
    And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.
  399. socialism
    a political theory advocating state ownership of industry
    In 1933, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism.
  400. federal
    characterized by or constituting a form of government in which power is divided between one central and several regional authorities
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  401. comprehensive
    including all or everything
    A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943.
  402. claim
    assert or affirm strongly; state to be true or existing
    Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost.
  403. arbitrary
    based on or subject to individual discretion or preference or sometimes impulse or caprice
    They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.
  404. professional
    of or relating to or suitable as a profession
    That's not my judgment – it's the judgment of medical professionals across this country.
  405. jack
    tool for exerting pressure or lifting
    And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.
  406. Afghanistan
    a mountainous landlocked country in central Asia; bordered by Iran to the west and Russia to the north and Pakistan to the east and south
    Add it all up, and the plan I'm proposing will cost around $900 billion over ten years – less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the begin
  407. politically
    with regard to government
    I understand that the politically safe move would be to kick the can further down the road – to defer reform one more year, or one more election, or one more term.
  408. rely on
    put trust in with confidence
    I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
  409. count on
    judge to be probable
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  410. plight
    a situation from which extrication is difficult especially an unpleasant or trying one
    That large-heartedness – that concern and regard for the plight of others – is not a partisan feeling.
  411. overboard
    to extremes
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  412. verge
    the limit beyond which something happens or changes
    And our financial system was on the verge of collapse.
  413. infection
    (medicine) the invasion of the body by pathogenic microorganisms and their multiplication which can lead to tissue damage and disease
    The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between te
  414. supported
    held up or having the weight borne especially from below
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  415. why
    the cause or intention underlying an action or situation, especially in the phrase `the whys and wherefores'
    It's why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely.
  416. cancel
    declare null and void; make ineffective
    Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.
  417. time
    the continuum of experience in which events pass from the future through the present to the past
    I also want to thank the American people for their patience and resolve during this trying time for our nation.
  418. effort
    use of physical or mental energy; hard work
    I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery.
  419. every
    (used of count nouns) each and all of the members of a group considered singly and without exception
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  420. seriously
    in a serious manner
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  421. directing
    showing the way by conducting or leading; imposing direction on
    It's a good idea, and I am directing my Secretary of Health and Human Services to move forward on this initiative today.
  422. adoption
    a legal proceeding that creates a parent-child relation between persons not related by blood; the adopted child is entitled to all privileges belonging to a natural child of the adoptive parents (including the right to inherit)
    The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between te
  423. financial
    involving financial matters
    And our financial system was on the verge of collapse.
  424. Speaker
    the presiding officer of a deliberative assembly
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  425. disadvantage
    the quality of having an inferior or less favorable position
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  426. primarily
    for the most part
    These are not primarily people on welfare.
  427. usher
    someone employed to conduct others
    Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody.
  428. add
    make an addition (to); join or combine or unite with others; increase the quality, quantity, size or scope of
    First, I will not sign a plan that adds one dime to our deficits – either now or in the future.
  429. Alabama
    a state in the southeastern United States on the Gulf of Mexico; one of the Confederate states during the American Civil War
    In Alabama, almost 90% is controlled by just one company.
  430. medicine
    the learned profession that is mastered by graduate training in a medical school and that is devoted to preventing or alleviating or curing diseases and injuries
    I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.
  431. pad
    a flat mass of soft material used for protection, stuffing, or comfort
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  432. detail
    a small part that can be considered separately from the whole
    Here are the details that every American needs to know about this plan:

    First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will re
  433. call for
    express the need or desire for; ask for
    It has now been nearly a century since Theodore Roosevelt first called for health care reform.
  434. crisis
    a crucial stage or turning point in the course of something
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  435. monopoly
    (economics) a market in which there are many buyers but only one seller
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  436. aisle
    a long narrow passage (as in a cave or woods)
    Finally, many in this chamber – particularly on the Republican side of the aisle – have long insisted that reforming our medical malpractice laws can help bring down the cost of health care.
  437. term
    a limited period of time
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  438. collapse
    break down, literally or metaphorically
    And our financial system was on the verge of collapse.
  439. passion
    a strong feeling or emotion
    In their mind, his passion for universal health care was nothing more than a passion for big government.
  440. proposal
    the act of making a proposal
    My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system.
  441. forward
    at or to or toward the front
    Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week.
  442. breaking
    the act of breaking something
    Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
  443. part
    one of the portions into which something is regarded as divided and which together constitute a whole
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  444. make
    perform or carry out
    I have to say that there are arguments to be made for both approaches.
  445. overall
    including everything
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  446. immigrant
    a person who comes to a country where they were not born in order to settle there
    There are also those who claim that our reform effort will insure illegal immigrants.
  447. cherry
    any of numerous trees and shrubs producing a small fleshy round fruit with a single hard stone; many also produce a valuable hardwood
    And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.
  448. abortion
    termination of pregnancy
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  449. spread
    distribute or disperse widely
    Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform.
  450. charged
    of a particle or body or system; having a net amount of positive or negative electric charge
    We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick.
  451. defensive
    an attitude of defensiveness (especially in the phrase `on the defensive')
    I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.
  452. exaggerated
    enlarged to an abnormal degree
    But its impact shouldn't be exaggerated – by the left, the right, or the media.
  453. spent
    depleted of energy, force, or strength
    Add it all up, and the plan I'm proposing will cost around $900 billion over ten years – less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the begin
  454. nothing
    in no respect; to no degree
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  455. administrative
    of or relating to or responsible for administration
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  456. thrive
    make steady progress; be at the high point in one's career or reach a high point in historical significance or importance
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  457. seek
    try to locate or discover, or try to establish the existence of
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  458. already
    prior to a specified or implied time
    Here are the details that every American needs to know about this plan:

    First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will re
  459. sign
    a perceptible indication of something not immediately apparent (as a visible clue that something has happened)
    As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most.
  460. country
    the territory occupied by a nation
    We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it.
  461. treat
    subject to a process or treatment, with the aim of readying for some purpose, improving, or remedying a condition
    That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.
  462. represented
    represented accurately or precisely
    For some of Ted Kennedy's critics, his brand of liberalism represented an affront to American liberty.
  463. condition
    a mode of being or form of existence of a person or thing
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  464. opportunity
    a possibility due to a favorable combination of circumstances
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  465. represent
    be a delegate or spokesperson for; represent somebody's interest or be a proxy or substitute for, as of politicians and office holders representing their constituents, or of a tenant representing other tenants in a housing dispute
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  466. disdain
    lack of respect accompanied by a feeling of intense dislike
    But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government.
  467. doubled
    twice as great or many
    By the time she had her insurance reinstated, her breast cancer more than doubled in size.
  468. United States
    North American republic containing 50 states - 48 conterminous states in North America plus Alaska in northwest North America and the Hawaiian Islands in the Pacific Ocean; achieved independence in 1776
    That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.
  469. illegal
    prohibited by law or by official or accepted rules
    There are also those who claim that our reform effort will insure illegal immigrants.
  470. hatch
    a movable barrier covering a hatchway
    His friend, Orrin Hatch, knows that.
  471. encouraging
    giving courage or confidence or hope
    The commission can help encourage the adoption of these common-sense best practices by doctors and medical professionals throughout the system – everything from reducing hospital infection rates to encouraging better coordination between te
  472. restrict
    place under restrictions; limit access to
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  473. critic
    a person who is professionally engaged in the analysis and interpretation of works of art
    As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.
  474. remind
    put in the mind of someone
    To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it.
  475. competitor
    the contestant you hope to defeat
    If some businesses don't provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors.
  476. rugged
    having long narrow shallow depressions (as grooves or wrinkles) in the surface
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  477. progressive
    favoring or promoting progress
    To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it.
  478. Democratic
    belong to or relating to the Democratic Party
    This reform will charge insurance companies a fee for their most expensive policies, which will encourage them to provide greater value for the money – an idea which has the support of Democratic and Republican experts.
  479. thanks
    an acknowledgment of appreciation
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  480. want
    the state of needing something that is absent or unavailable
    I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery.
  481. come forward
    make oneself visible; take action
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  482. move
    change location; move, travel, or proceed, also metaphorically
    More and more Americans worry that if you move, lose your job, or change your job, you'll lose your health insurance too.
  483. Wall Street
    a street in lower Manhattan where the New York Stock Exchange is located; symbol of American finance
    All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."
  484. go up
    move upward
    This is one of the reasons that insurance premiums have gone up three times faster than wages.
  485. misunderstand
    interpret in the wrong way
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  486. worth
    the quality that renders something desirable or valuable or useful
    It's worth noting that a strong majority of Americans still favor a public insurance option of the sort I've proposed tonight.
  487. coalition
    the union of diverse things into one body or form or group; the growing together of parts
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  488. cover
    provide with a covering or cause to be covered
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  489. reason
    a rational motive for a belief or action
    This is one of the reasons that insurance premiums have gone up three times faster than wages.
  490. in other words
    otherwise stated
    In other words, it can happen to anyone.
  491. meet
    come together
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  492. calculation
    the procedure of calculating; determining something by mathematical or logical methods
    But know this: I will not waste time with those who have made the calculation that it's better politics to kill this plan than improve it.
  493. member
    anything that belongs to a set or class
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  494. any
    one or some or every or all without specification
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  495. step in
    act as a substitute
    A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise.
  496. base
    lowest support of a structure
    On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.
  497. replace
    put something back where it belongs
    I still believe we can replace acrimony with civility, and gridlock with progress.
  498. chip
    a small fragment of something broken off from the whole
    Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.
  499. protection
    the activity of protecting someone or something
    And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned.
  500. remain
    continue in a place, position, or situation
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  501. pressure
    the act of pressing; the exertion of pressure
    When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid.
  502. fraud
    intentional deception resulting in injury to another person
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  503. right
    free from error; especially conforming to fact or truth
    On the right, there are those who argue that we should end the employer-based system and leave individuals to buy health insurance on their own.
  504. grow
    increase in size by natural process
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  505. previous
    just preceding something else in time or order
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  506. reward
    a recompense for worthy acts or retribution for wrongdoing
    As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it.
  507. past
    earlier than the present time; no longer current
    And that is precisely what those of you in Congress have tried to do over the past several months.
  508. provision
    the activity of supplying or providing something
    As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.
  509. counting
    the act of counting; reciting numbers in ascending order
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  510. things
    any movable possession (especially articles of clothing)
    I will not stand by while the special interests use the same old tactics to keep things exactly the way they are.
  511. delayed
    not as far along as normal in development
    They delayed his treatment, and he died because of it.
  512. excessive
    beyond normal limits
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  513. routine
    an unvarying or habitual method or procedure
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  514. profitable
    yielding material gain or profit
    They do it because it's profitable.
  515. overhead
    located or originating from above
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  516. out
    moving or appearing to move away from a place, especially one that is enclosed or hidden
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  517. average
    an intermediate scale value regarded as normal or usual
    We were losing an average of 700,000 jobs per month.
  518. middle
    an area that is approximately central within some larger region
    These are middle-class Americans.
  519. nation
    a politically organized body of people under a single government
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  520. all
    to a complete degree or to the full or entire extent (`whole' is often used informally for `wholly')
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  521. achieve
    to gain with effort
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  522. over
    beyond the top or upper surface or edge; forward from an upright position
    And that is precisely what those of you in Congress have tried to do over the past several months.
  523. pass
    go across or through
    The time for games has passed.
  524. be born
    come into existence through birth
    That is how Medicare was born.
  525. rigid
    incapable of or resistant to bending
    On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience.
  526. sponsor
    an advocate who presents a person (as for an award or a degree or an introduction etc.)
    As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.
  527. growth
    (biology) the process of an individual organism growing organically; a purely biological unfolding of events involved in an organism changing gradually from a simple to a more complex level
    And it will slow the growth of health care costs for our families, our businesses, and our government.
  528. more than
    (comparative of `much' used with mass nouns) a quantifier meaning greater in size or amount or extent or degree
    There are now more than thirty million American citizens who cannot get coverage.
  529. harden
    make hard or harder
    But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government.
  530. character
    a characteristic property that defines the apparent individual nature of something
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  531. add to
    have an increased effect
    The plan will not add to our deficit.
  532. worst
    the least favorable outcome
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  533. way
    how something is done or how it happens
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  534. in place
    in the original or natural place or site
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  535. putting
    hitting a golf ball that is on the green using a putter
    And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.
  536. make sure
    make a point of doing something; act purposefully and intentionally
    And I will make sure that no government bureaucrat or insurance company bureaucrat gets between you and the care that you need.
  537. picking
    the act of picking (crops or fruit or hops etc.)
    And it makes it easier for insurance companies to treat their customers badly – by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates.
  538. efficient
    being effective without wasting time or effort or expense
    Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody.
  539. thoughtful
    exhibiting or characterized by careful thought
    We have seen many in this chamber work tirelessly for the better part of this year to offer thoughtful ideas about how to achieve reform.
  540. needs
    in such a manner as could not be otherwise
    And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.
  541. fund
    a reserve of money set aside for some purpose
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  542. generation
    group of genetically related organisms constituting a single step in the line of descent
    And it remains a sacred trust that must be passed down from one generation to the next.
  543. plague
    any large scale calamity (especially when thought to be sent by God)
    But the problem that plagues the health care system is not just a problem of the uninsured.
  544. margin
    the boundary line or the area immediately inside the boundary
    There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements.
  545. meeting
    the social act of assembling for some common purpose
    It's a plan that asks everyone to take responsibility for meeting this challenge – not just government and insurance companies, but employers and individuals.
  546. commission
    the act of granting authority to undertake certain functions
    And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
  547. child
    a human offspring (son or daughter) of any age
    In it, he spoke about what a happy time his last months were, thanks to the love and support of family and friends, his wife, Vicki, and his children, who are here tonight .
  548. hard
    resisting weight or pressure
    Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier.
  549. hospital
    a medical institution where sick or injured people are given medical or surgical care
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  550. down
    spatially or metaphorically from a higher to a lower level or position
    As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most.
  551. rate
    a quantity or amount or measure considered as a proportion of another quantity or amount or measure
    When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid.
  552. rural
    living in or characteristic of farming or country life
    We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average.
  553. dug
    an udder or breast or teat
    Some have dug into unyielding ideological camps that offer no hope of compromise.
  554. honest
    marked by truth
    Instead of honest debate, we have seen scare tactics.
  555. stricken
    grievously affected especially by disease
    It was the experience of having two children stricken with cancer.
  556. exploit
    use or manipulate to one's advantage
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  557. most
    (superlative of `many' used with count nouns and often preceded by `the') quantifier meaning the greatest in number
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  558. ahead
    at or in the front
    And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
  559. breast
    either of two soft fleshy milk-secreting glandular organs on the chest of a woman
    By the time she had her insurance reinstated, her breast cancer more than doubled in size.
  560. unique
    the single one of its kind
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  561. put
    cause to be in a certain state; cause to be in a certain relation
    I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery.
  562. catching
    the act of detecting something; catching sight of something
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  563. fewer
    (comparative of `few' used with count nouns) quantifier meaning a smaller number of
    Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies.
  564. state
    the way something is with respect to its main attributes
    That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.
  565. behavior
    (behavioral attributes) the way a person behaves toward other people
    The problem is, such irresponsible behavior costs all the rest of us money.
  566. status
    a state at a particular time
    And I will not accept the status quo as a solution.
  567. congressman
    a member of the United States House of Representatives
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  568. unnecessary
    not necessary
    I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.
  569. congressional
    of or relating to congress
    In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
  570. essentially
    in essence; at bottom or by one's (or its) very nature
    So don't pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget that wo
  571. in the meantime
    during the intervening time
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  572. spreading
    act of extending over a wider scope or expanse of space or time
    So don't pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget
  573. predecessor
    one who precedes you in time (as in holding a position or office)
    You see, our predecessors understood that government could not, and should not, solve every problem.
  574. grown
    (of animals) fully developed
    Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform.
  575. engage
    consume all of one's attention or time
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes fo
  576. in the first place
    before now
    It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage.
  577. resolve
    find the solution
    I also want to thank the American people for their patience and resolve during this trying time for our nation.
  578. stand
    be standing; be upright
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  579. panel
    sheet that forms a distinct (usually flat and rectangular) section or component of something
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  580. deny
    declare untrue; contradict
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  581. auto
    a motor vehicle with four wheels; usually propelled by an internal combustion engine
    That's why under my plan, individuals will be required to carry basic health insurance – just as most states require you to carry auto insurance.
  582. big
    above average in size or number or quantity or magnitude or extent
    As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage.
  583. publicly
    in a manner accessible to or observable by the public; openly
    As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.
  584. remains
    the dead body of a human being
    And it remains a sacred trust that must be passed down from one generation to the next.
  585. walk in
    enter by walking
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  586. oppose
    be against; express opposition to
    My health care proposal has also been attacked by some who oppose reform as a "government takeover" of the entire health care system.
  587. tenth
    position ten in a countable series of things
    And if we are able to slow the growth of health care costs by just one-tenth of one percent each year, it will actually reduce the deficit by $4 trillion over the long term.
  588. dropping
    coming down freely under the influence of gravity
    It's why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely.
  589. frozen
    turned into ice; affected by freezing or by long and severe cold
    Credit was frozen.
  590. scratch
    cut the surface of; wear away the surface of
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  591. sheer
    so thin as to transmit light
    He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging p
  592. protect
    shield from danger, injury, destruction, or damage
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  593. testify
    give testimony in a court of law
    As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it.
  594. billion
    denoting a quantity consisting of one thousand million items or units in the United States
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  595. place
    a point located with respect to surface features of some region
    Everyone understands the extraordinary hardships that are placed on the uninsured, who live every day just one accident or illness away from bankruptcy.
  596. gap
    an open or empty space in or between things
    And we can use some of the savings to fill the gap in coverage that forces too many seniors to pay thousands of dollars a year out of their own pocket for prescription drugs.
  597. true
    consistent with fact or reality; not false
    And this is also true when it comes to Medicare and Medicaid.
  598. judgment
    the act of judging or assessing a person or situation or event
    That's not my judgment – it's the judgment of medical professionals across this country.
  599. Earth
    the 3rd planet from the sun; the planet we live on
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  600. appropriate
    suitable for a particular person or place or condition etc
    And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.
  601. thing
    a separate and self-contained entity
    The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies – subsidies that do everything to pad their profits and nothing
  602. united
    characterized by unity; being or joined into a single entity
    That is heart-breaking, it is wrong, and no one should be treated that way in the United States of America.
  603. used
    previously used or owned by another
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  604. controversy
    a contentious speech act; a dispute where there is strong disagreement
    So tonight I'd like to address some of the key controversies that are still out there.
  605. particularly
    to a distinctly greater extent or degree than is common
    Now, even if we provide these affordable options, there may be those – particularly the young and healthy – who still want to take the risk and go without coverage.
  606. point
    a distinguishing or individuating characteristic
    Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
  607. severely
    to a severe or serious degree
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  608. patient
    enduring trying circumstances with even temper or characterized by such endurance
    So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.
  609. insist
    be emphatic or resolute and refuse to budge
    I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
  610. always
    at all times; all the time and on every occasion
    My guiding principle is, and always has been, that consumers do better when there is choice and competition.
  611. senator
    a member of a senate
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  612. bad
    having undesirable or negative qualities
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  613. introduce
    bring something new to an environment
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  614. confidence
    freedom from doubt; belief in yourself and your abilities
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  615. pocket
    a small pouch inside a garment for carrying small articles
    We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick.
  616. self
    your consciousness of your own identity
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  617. access
    the right to enter
    And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned.
  618. too much
    more than necessary
    Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier.
  619. money
    the most common medium of exchange; functions as legal tender
    That makes sense, it saves money, and it saves lives.
  620. demonstration
    a show or display; the act of presenting something to sight or view
    I know that the Bush Administration considered authorizing demonstration projects in individual states to test these issues.
  621. fundamental
    any factor that could be considered important to the understanding of a particular business
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  622. Illinois
    a midwestern state in north-central United States
    One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about.
  623. avoid
    stay clear from; keep away from; keep out of the way of someone or something
    But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees.
  624. freedom
    the condition of being free; the power to act or speak or think without externally imposed restraints
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  625. faster
    more quickly
    This is one of the reasons that insurance premiums have gone up three times faster than wages.
  626. test
    any standardized procedure for measuring sensitivity or memory or intelligence or aptitude or personality etc
    I know that the Bush Administration considered authorizing demonstration projects in individual states to test these issues.
  627. rely
    have confidence or faith in
    I have insisted that like any private insurance company, the public insurance option would have to be self-sufficient and rely on the premiums it collects.
  628. silently
    without speaking
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  629. focus
    the concentration of attention or energy on something
    So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine.
  630. continue
    keep or maintain in unaltered condition; cause to remain or last
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  631. compromise
    an accommodation in which both sides make concessions
    Some have dug into unyielding ideological camps that offer no hope of compromise.
  632. action
    something done (usually as opposed to something said)
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  633. eighty
    the cardinal number that is the product of ten and eight
    And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.
  634. shared
    have in common; held or experienced in common
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  635. discus
    an athletic competition in which a disk-shaped object is thrown as far as possible
    Finally, let me discuss an issue that is a great concern to me, to members of this chamber, and to the public – and that is how we pay for this plan.
  636. years
    a prolonged period of time
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  637. progress
    the act of moving forward (as toward a goal)
    This has always been the history of our progress.
  638. buying
    the act of buying
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  639. election
    a vote to select the winner of a position or political office
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  640. helping
    an individual quantity of food or drink taken as part of a meal
    A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand.
  641. radical
    (used of opinions and actions) far beyond the norm
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  642. less
    (comparative of `little' usually used with mass nouns) a quantifier meaning not as great in amount or degree
    Those who do have insurance have never had less security and stability than they do today.
  643. earned
    gained or acquired; especially through merit or as a result of effort or action
    Right now, too much of the hard-earned savings and tax dollars we spend on health care doesn't make us healthier.
  644. embrace
    squeeze (someone) tightly in your arms, usually with fondness
    This was a good idea when Senator John McCain proposed it in the campaign, it's a good idea now, and we should embrace it.
  645. even
    being level or straight or regular and without variation as e.g. in shape or texture; or being in the same plane or at the same height as something else (i.e. even with)
    One man from Illinois lost his coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about.
  646. administration
    the act of governing; exercising authority
    I know that the Bush Administration considered authorizing demonstration projects in individual states to test these issues.
  647. scare
    cause fear in
    Instead of honest debate, we have seen scare tactics.
  648. kill
    cause to die; put to death, usually intentionally or knowingly
    Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost.
  649. break
    destroy the integrity of; usually by force; cause to separate into pieces or fragments
    Our collective failure to meet this challenge – year after year, decade after decade – has led us to a breaking point.
  650. looking for
    the act of searching visually
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  651. facing
    an ornamental coating to a building
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  652. allow
    make it possible through a specific action or lack of action for something to happen
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  653. in fact
    in reality or actuality
    In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
  654. out of
    motivated by
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  655. call
    utter a sudden loud cry
    It has now been nearly a century since Theodore Roosevelt first called for health care reform.
  656. parent
    a father or mother; one who begets or one who gives birth to or nurtures and raises a child; a relative who plays the role of guardian
    He never forgot the sheer terror and helplessness that any parent feels when a child is badly sick; and he was able to imagine what it must be like for those without insurance; what it would be like to have to say to a wife or a child or an aging p
  657. fact
    a piece of information about circumstances that exist or events that have occurred
    These are the facts.
  658. bless
    make the sign of the cross over someone in order to call on God for protection; consecrate
    Thank you, God Bless You, and may God Bless the United States of America.
  659. encouraged
    inspired with confidence
    As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it.
  660. best
    (superlative of `good') having the most positive qualities
    During that time, we have seen Washington at its best and its worst.
  661. serious
    of great consequence
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  662. law
    the collection of rules imposed by authority
    Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition.
  663. Pennsylvania
    a Mid-Atlantic state; one of the original 13 colonies
    We have long known that some places, like the Intermountain Healthcare in Utah or the Geisinger Health System in rural Pennsylvania, offer high-quality care at costs below average.
  664. employ
    put into service; make work or employ for a particular purpose or for its inherent or natural purpose
    They provide a legitimate service, and employ a lot of our friends and neighbors.
  665. cable
    a very strong thick rope made of twisted hemp or steel wire
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  666. significant
    rich in significance or implication
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  667. citizen
    a native or naturalized member of a state or other political community
    There are now more than thirty million American citizens who cannot get coverage.
  668. sixth
    position six in a countable series of things
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  669. prominent
    conspicuous in position or importance
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  670. primary
    of first rank or importance or value; direct and immediate rather than secondary
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  671. unfortunately
    by bad luck
    Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies.
  672. first
    preceding all others in time or space or degree
    I am not the first President to take up this cause, but I am determined to be the last.
  673. finance
    the commercial activity of providing funds and capital
    Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week.
  674. stand by
    be available or ready for a certain function or service
    I will not stand by while the special interests use the same old tactics to keep things exactly the way they are.
  675. wipe
    rub with a circular motion
    In 1933, when over half of our seniors could not support themselves and millions had seen their savings wiped away, there were those who argued that Social Security would lead to socialism.
  676. ten
    the cardinal number that is the sum of nine and one; the base of the decimal system
    Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices.
  677. recognition
    the process of recognizing something or someone by remembering
    A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand.
  678. modest
    marked by simplicity; having a humble opinion of yourself
    And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run.
  679. stand up
    rise to one's feet
    More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years.
  680. think about
    have on one's mind, think about actively
    I've thought about that phrase quite a bit in recent days – the character of our country.
  681. allies
    an alliance of nations joining together to fight a common enemy
    Despite all this, the insurance companies and their allies don't like this idea.
  682. salary
    something that remunerates
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  683. sense
    the faculty through which the external world is apprehended
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  684. come to
    cause to experience suddenly
    We came to build a future.
  685. colleague
    an associate that one works with
    It was from our beloved friend and colleague, Ted Kennedy.
  686. come
    move toward, travel toward something or somebody or approach something or somebody
    But we did not come here just to clean up crises.
  687. peril
    a state of danger involving risk
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  688. difficult
    not easy; requiring great physical or mental effort to accomplish or comprehend or endure
    I want to thank the members of this body for your efforts and your support in these last several months, and especially those who have taken the difficult votes that have put us on a path to recovery.
  689. service
    an act of help or assistance
    All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."
  690. college
    an institution of higher education created to educate and grant degrees; often a part of a university
    It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a
  691. entirely
    to a complete degree or to the full or entire extent (`whole' is often used informally for `wholly')
    It's why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely.
  692. vice president
    an executive officer ranking immediately below a president; may serve in the president's place under certain circumstances
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  693. counter
    a calculator that keeps a record of the number of times something happens
    And out of this blizzard of charges and counter-charges, confusion has reigned.
  694. scorn
    lack of respect accompanied by a feeling of intense dislike
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  695. own
    belonging to or on behalf of a specified person (especially yourself); preceded by a possessive
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  696. propose
    present for consideration, examination, criticism, etc.
    Others propose a co-op or another non-profit entity to administer the plan.
  697. abide
    dwell
    And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned.
  698. committee
    a special group delegated to consider some matter
    Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week.
  699. try
    make an effort or attempt
    I also want to thank the American people for their patience and resolve during this trying time for our nation.
  700. pick
    look for and gather
    If some businesses don't provide workers health care, it forces the rest of us to pick up the tab when their workers get sick, and gives those businesses an unfair advantage over their competitors.
  701. no longer
    not now
    They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.
  702. wages
    a recompense for worthy acts or retribution for wrongdoing
    This is one of the reasons that insurance premiums have gone up three times faster than wages.
  703. new
    not of long duration; having just (or relatively recently) come into being or been made or acquired or discovered
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  704. either
    after a negative statement used as an intensive meaning something like `likewise' or `also'
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  705. fix
    restore by replacing a part or putting together what is torn or broken
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  706. university
    a large and diverse institution of higher learning created to educate for life and for a profession and to grant degrees
    It would also keep pressure on private insurers to keep their policies affordable and treat their customers better, the same way public colleges and universities provide additional choice and competition to students without in any way inhibiting a
  707. step
    the act of changing location by raising the foot and setting it down
    But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.
  708. bargain
    an agreement between parties (usually arrived at after discussion) fixing obligations of each
    As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage.
  709. to that
    to that
    So tonight, I return to speak to all of you about an issue that is central to that future – and that is the issue of health care.
  710. precisely
    in a precise manner
    And that is precisely what those of you in Congress have tried to do over the past several months.
  711. prosperity
    the condition of prospering; having good fortune
    He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that "it concerns more than material things."
  712. welfare
    something that aids or promotes well-being
    These are not primarily people on welfare.
  713. cut
    separate with or as if with an instrument
    And to prove that I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize.
  714. spectacle
    something or someone seen (especially a notable or unusual sight)
    But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government.
  715. expectation
    belief about (or mental picture of) the future
    All of this is in service of meeting what this former executive called "Wall Street's relentless profit expectations."
  716. making
    the act that results in something coming to be
    But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.
  717. quite a
    of an unusually noticeable or exceptional or remarkable kind (not used with a negative)
    I've thought about that phrase quite a bit in recent days – the character of our country.
  718. stake
    a strong wooden or metal post with a point at one end so it can be driven into the ground
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  719. combined
    made or joined or united into one
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  720. no matter
    in spite of everything; without regard to drawbacks
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  721. extra
    more than is needed, desired, or required
    And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies – because there's no reason we shouldn't be catching diseases like breast cancer and colon canc
  722. democracy
    the political orientation of those who favor government by the people or by their elected representatives
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  723. social
    living together or enjoying life in communities or organized groups
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  724. repeat
    to say, state, or perform again
    Let me repeat this: nothing in our plan requires you to change what you have.
  725. in the way
    forming a hindrance, impediment, or obstruction
    Now, because Medicare is such a big part of the health care system, making the program more efficient can help usher in changes in the way we deliver health care that can reduce costs for everybody.
  726. means
    how a result is obtained or an end is achieved
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  727. trying
    hard to endure
    I also want to thank the American people for their patience and resolve during this trying time for our nation.
  728. freeze
    change from a liquid to a solid when cold
    Credit was frozen.
  729. other
    not the same one or ones already mentioned or implied
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  730. closer
    (comparative of `near' or `close') within a shorter distance
    And there is agreement in this chamber on about eighty percent of what needs to be done, putting us closer to the goal of reform than we have ever been.
  731. works
    performance of moral or religious acts
    Since health care represents one-sixth of our economy, I believe it makes more sense to build on what works and fix what doesn't, rather than try to build an entirely new system from scratch.
  732. last
    coming after all others in time or space or degree or being the only one remaining
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  733. opponent
    someone who offers opposition
    And it's a plan that incorporates ideas from Senators and Congressmen; from Democrats and Republicans – and yes, from some of my opponents in both the primary and general election.
  734. meantime
    the time between one event, process, or period and another
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  735. trust
    the trait of believing in the honesty and reliability of others
    And it remains a sacred trust that must be passed down from one generation to the next.
  736. measure
    determine the measurements of something or somebody, take measurements of
    A belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgement that sometimes government has to step in to help deliver on that promise.
  737. build
    make by combining materials and parts
    We came to build a future.
  738. room
    an area within a building enclosed by walls and floor and ceiling
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  739. crash
    break violently or noisily; smash;
    But they also understood that the danger of too much government is matched by the perils of too little; that without the leavening hand of wise policy, markets can crash, monopolies can stifle competition, and the vulnerable can be exploited.
  740. used to
    in the habit
    And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.
  741. estimate
    judge tentatively or form an estimate of (quantities or time)
    In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up.
  742. bullet
    a projectile that is fired from a gun
    I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs.
  743. eventually
    after an unspecified period of time or an especially long delay
    If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined.
  744. paying
    for which money is paid
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  745. example
    an item of information that is typical of a class or group
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  746. by no means
    definitely not
    As any American who is still looking for work or a way to pay their bills will tell you, we are by no means out of the woods.
  747. President
    the person who holds the office of head of state of the United States government
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  748. both
    (used with count nouns) two considered together; the two
    I have to say that there are arguments to be made for both approaches.
  749. above all
    above and beyond all other consideration
    "What we face," he wrote, "is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
  750. craft
    the skilled practice of a practical occupation
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity pa
  751. address
    the place where a person or organization can be found or communicated with
    So tonight I'd like to address some of the key controversies that are still out there.
  752. letters
    scholarly attainment
    Because there are too many Americans counting on us to succeed – the ones who suffer silently, and the ones who shared their stories with us at town hall meetings, in emails, and in letters.
  753. beginning
    the act of starting something
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  754. times
    a more or less definite period of time now or previously present
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  755. John
    youngest son of Henry II; King of England from 1199 to 1216; succeeded to the throne on the death of his brother Richard I; lost his French possessions; in 1215 John was compelled by the barons to sign the Magna Carta (1167-1216)
    A bill for comprehensive health reform was first introduced by John Dingell Sr. in 1943.
  756. experience
    the content of direct observation or participation in an event
    On issues like these, Ted Kennedy's passion was born not of some rigid ideology, but of his own experience.
  757. Roosevelt
    32nd President of the United States; elected four times; instituted New Deal to counter the Great Depression and led country during World War II (1882-1945)
    It has now been nearly a century since Theodore Roosevelt first called for health care reform.
  758. dispute
    coming into conflict with
    Nobody disputes them.
  759. brand
    a name given to a product or service
    For some of Ted Kennedy's critics, his brand of liberalism represented an affront to American liberty.
  760. revenue
    the entire amount of income before any deductions are made
    Much of the rest would be paid for with revenues from the very same drug and insurance companies that stand to benefit from tens of millions of new customers.
  761. rest
    take a short break from one's activities in order to relax
    The problem is, such irresponsible behavior costs all the rest of us money.
  762. ill
    affected by an impairment of normal physical or mental function
    In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill.
  763. politician
    a leader engaged in civil administration
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  764. purchase
    obtain by purchase; acquire by means of a financial transaction
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses to pu
  765. choose
    pick out, select, or choose from a number of alternatives
    As proof, critics point to a provision in our plan that allows the uninsured and small businesses to choose a publicly-sponsored insurance option, administered by the government just like Medicaid or Medicare.
  766. on earth
    used with question words to convey surprise
    We are the only advanced democracy on Earth – the only wealthy nation – that allows such hardships for millions of its people.
  767. completed
    successfully completed or brought to an end
    Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week.
  768. born
    brought into existence
    That is how Medicare was born.
  769. control
    power to direct or determine
    Unfortunately, in 34 states, 75% of the insurance market is controlled by five or fewer companies.
  770. patience
    good-natured tolerance of delay or incompetence
    I also want to thank the American people for their patience and resolve during this trying time for our nation.
  771. responsible
    worthy of or requiring responsibility or trust; or held accountable
    And I will not let up until those Americans who seek jobs can find them; until those businesses that seek capital and credit can thrive; until all responsible homeowners can stay in their homes.
  772. look out
    be vigilant, be on the lookout or be careful
    I know that many in this country are deeply skeptical that government is looking out for them.
  773. rob
    take something away by force or without the consent of the owner
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  774. period
    an amount of time
    In just a two year period, one in every three Americans goes without health care coverage at some point.
  775. kick
    drive or propel with the foot
    I understand that the politically safe move would be to kick the can further down the road – to defer reform one more year, or one more election, or one more term.
  776. make for
    cause to happen or to occur as a consequence
    I have to say that there are arguments to be made for both approaches.
  777. family
    primary social group; parents and children
    And it will slow the growth of health care costs for our families, our businesses, and our government.
  778. a good deal
    to a very great degree or extent
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  779. speak
    use language
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  780. game
    an amusement or pastime
    The time for games has passed.
  781. create
    bring into existence
    And we will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.
  782. good deal
    (often followed by `of') a large number or amount or extent
    But by avoiding some of the overhead that gets eaten up at private companies by profits, excessive administrative costs and executive salaries, it could provide a good deal for consumers.
  783. care for
    be fond of; be attached to
    And according to these same experts, this modest change could help hold down the cost of health care for all of us in the long-run.
  784. shoes
    a particular situation
    Our ability to stand in other people's shoes.
  785. attempted
    tried unsuccessfully
    And ever since, nearly every President and Congress, whether Democrat or Republican, has attempted to meet this challenge in some way.
  786. solution
    a homogeneous mixture of two or more substances; frequently (but not necessarily) a liquid solution
    And I will not accept the status quo as a solution.
  787. mention
    make reference to
    And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned.
  788. folks
    people in general (often used in the plural)
    So don't pay attention to those scary stories about how your benefits will be cut – especially since some of the same folks who are spreading these tall tales have fought against Medicare in the past, and just this year supported a budget
  789. long
    primarily spatial sense; of relatively great or greater than average spatial extension or extension as specified
    Too many have used this as an opportunity to score short-term political points, even if it robs the country of our opportunity to solve a long-term challenge.
  790. driving
    the act of controlling and steering the movement of a vehicle or animal
    To my progressive friends, I would remind you that for decades, the driving idea behind reform has been to end insurance company abuses and make coverage affordable for those without it.
  791. take
    get into one's hands, take physically
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  792. do it
    have sexual intercourse with
    This exchange will take effect in four years, which will give us time to do it right.
  793. full
    containing as much or as many as is possible or normal
    A full and vibrant recovery is many months away.
  794. session
    a meeting for execution of a group's functions
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  795. five
    the cardinal number that is the sum of four and one
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  796. opposed
    being in opposition or having an opponent
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  797. given
    acknowledged as a supposition
    They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.
  798. nervous
    of or relating to the nervous system
    Still, given all the misinformation that's been spread over the past few months, I realize that many Americans have grown nervous about reform.
  799. shortly
    in the near future
    He had written it back in May, shortly after he was told that his illness was terminal.
  800. beloved
    dearly loved
    It was from our beloved friend and colleague, Ted Kennedy.
  801. Texas
    the second largest state; located in southwestern United States on the Gulf of Mexico
    Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.
  802. decide
    reach, make, or come to a decision about something
    Many other Americans who are willing and able to pay are still denied insurance due to previous illnesses or conditions that insurance companies decide are too risky or expensive to cover.
  803. medium
    the surrounding environment
    But its impact shouldn't be exaggerated – by the left, the right, or the media.
  804. sixty
    the cardinal number that is the product of ten and six
    Sixty-five years later, his son continues to introduce that same bill at the beginning of each session.
  805. all in
    very tired
    A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand.
  806. keep
    continue a certain state, condition, or activity
    But an additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange.
  807. Washington
    1st President of the United States; commander-in-chief of the Continental Army during the American Revolution (1732-1799)
    During that time, we have seen Washington at its best and its worst.
  808. former
    the first of two or the first mentioned of two
    As one former insurance executive testified before Congress, insurance companies are not only encouraged to find reasons to drop the seriously ill; they are rewarded for it.
  809. somebody
    a human being
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  810. shift
    move very slightly
    But either one would represent a radical shift that would disrupt the health care most people currently have.
  811. give
    transfer possession of something concrete or abstract to somebody
    They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.
  812. likewise
    in like or similar manner
    Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers.
  813. role
    the actions and activities assigned to or required or expected of a person or group
    And figuring out the appropriate size and role of government has always been a source of rigorous and sometimes angry debate.
  814. spoke
    support consisting of a radial member of a wheel joining the hub to the rim
    Madame Speaker, Vice President Biden, Members of Congress, and the American people:

    When I spoke here last winter, this nation was facing the worst economic crisis since the Great Depression.
  815. dig
    turn up, loosen, or remove earth
    Some have dug into unyielding ideological camps that offer no hope of compromise.
  816. Here
    queen of the Olympian gods in ancient Greek mythology; sister and wife of Zeus remembered for her jealously of the many mortal women Zeus fell in love with; identified with Roman Juno
    Here are the details that every American needs to know about this plan:

    First, if you are among the hundreds of millions of Americans who already have health insurance through your job, Medicare, Medicaid, or the VA, nothing in this plan will re
  817. large
    above average in size or number or quantity or magnitude or extent
    This is how large companies and government employees get affordable insurance.
  818. capacity
    capability to perform or produce
    And they knew that when any government measure, no matter how carefully crafted or beneficial, is subject to scorn; when any efforts to help people in need are attacked as un-American; when facts and reason are thrown overboard and only timidity passes fo
  819. essential
    basic and fundamental
    We lose something essential about ourselves.
  820. declare
    state emphatically and authoritatively
    Another woman from Texas was about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne.
  821. group
    any number of entities (members) considered as a unit
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  822. confusion
    a mistake that results from taking one thing to be another
    And out of this blizzard of charges and counter-charges, confusion has reigned.
  823. aspect
    a characteristic to be considered
    While there remain some significant details to be ironed out, I believe a broad consensus exists for the aspects of the plan I just outlined: consumer protections for those with insurance, an exchange that allows individuals and small businesses t
  824. thank you
    a conversational expression of gratitude
    Thank you, God Bless You, and may God Bless the United States of America.
  825. Canada
    a nation in northern North America; the French were the first Europeans to settle in mainland Canada
    There are those on the left who believe that the only way to fix the system is through a single-payer system like Canada's, where we would severely restrict the private insurance market and have the government provide coverage for everyone.
  826. set up
    create by putting components or members together
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  827. much
    (quantifier used with mass nouns) great in quantity or degree or extent
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  828. lend
    give temporarily; let have for a limited time
    A recognition that we are all in this together; that when fortune turns against one of us, others are there to lend a helping hand.
  829. four
    the cardinal number that is the sum of three and one
    Of the five committees asked to develop bills, four have completed their work, and the Senate Finance Committee announced today that it will move forward next week.
  830. for example
    as an example
    For example, some have suggested that that the public option go into effect only in those markets where insurance companies are not providing affordable policies.
  831. class
    a collection of things sharing a common attribute
    These are middle-class Americans.
  832. phrase
    an expression consisting of one or more words forming a grammatical constituent of a sentence
    I've thought about that phrase quite a bit in recent days – the character of our country.
  833. fierce
    marked by extreme and violent energy
    One of the unique and wonderful things about America has always been our self-reliance, our rugged individualism, our fierce defense of freedom and our healthy skepticism of government.
  834. three
    the cardinal number that is the sum of one and one and one
    Others are self-employed, and can't afford it, since buying insurance on your own costs you three times as much as the coverage you get from your employer.
  835. burden
    weight to be borne or conveyed
    Finally, our health care system is placing an unsustainable burden on taxpayers.
  836. bold
    fearless and daring
    But thanks to the bold and decisive action we have taken since January, I can stand here with confidence and say that we have pulled this economy back from the brink.
  837. longer
    for more time
    They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime.
  838. discover
    discover or determine the existence, presence, or fact of
    More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care.
  839. radio
    medium for communication
    The best example is the claim, made not just by radio and cable talk show hosts, but prominent politicians, that we plan to set up panels of bureaucrats with the power to kill off senior citizens.
  840. nurse
    one skilled in caring for young children or the sick (usually under the supervision of a physician)
    Our overall efforts have been supported by an unprecedented coalition of doctors and nurses; hospitals, seniors' groups and even drug companies – many of whom opposed reform in the past.
  841. refuse
    show unwillingness towards
    There may still be companies that refuse to do right by their workers.
  842. hidden
    not accessible to view
    And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
  843. faced
    having a face or facing especially of a specified kind or number; often used in combination
    Part of the reason I faced a trillion dollar deficit when I walked in the door of the White House is because too many initiatives over the last decade were not paid for – from the Iraq War to tax breaks for the wealthy.
  844. pile
    a collection of objects laid on top of each other
    More than four decades ago, this nation stood up for the principle that after a lifetime of hard work, our seniors should not be left to struggle with a pile of medical bills in their later years.