I thought this had some good insight. It is worth the read.

Government Health Plans Always Ration Care
By Scott Gottlieb Wall Street Journal Thursday, June 25, 2009

Only by expanding government control of health care can we bring down its cost. That's the faulty premise of the various proposals for health reform now being batted around Washington. The claimed cost control depends on politically safe ideas such as preventive care or the adoption of electronic health records. And neither--even according to the Congressional Budget Office--will do much to reduce spending.

If these proposals are implemented and fail to produce savings, government will turn to a less appealing but more familiar tool to cut costs: the regulation of access to drugs and medical services. Medicare is already going down this path. What will be new about government-run health care is the instrument of regulatory control. There will be an omnipotent federal health board. Buried in current reform proposals, this board deserves closer scrutiny.

Our best look at this construct comes from a bill released by the Senate Health, Education, Labor and Pensions (HELP) Committee. The bill calls for a "Medical Advisory Council" to determine what medical products and services are "essential benefits" and those that shouldn't be covered by a public insurance plan.

Rationing is inevitable if we simply expand government control without fixing the way health care is reimbursed so that doctors and patients become sensitive to issues of price and quality.
The Senate Finance Committee turns to a "Federal Health Board" to compare similar medical treatments in order to steer reimbursement to lower-cost options. Senate Finance also proposes a "sustainability commission" charged with finding automatic cuts to Medicare spending that would then pass Congress by a simple up or down vote.

Meanwhile, a draft health-care reform proposal introduced last week in the House of Representatives by the three committees with jurisdiction over health policy set up an independent "advisory committee" that will "recommend a benefit package based on standards set in the law." It also proposes a new "commission" that may, among other things, help develop treatment protocols based on government-directed research.

Congress, of course, can authorize the creation of panels and commissions to provide expert advice to the executive branch. But such bodies are typically advisory, and their advice is free to be rejected or modified by the president. Under the HELP committee's plan, the health board's recommendations would be binding unless Congress acts within a brief period to pass a "joint resolution disapproving such report in its entirety."

President Obama objects when people use the word "rationing" in regards to government-run health care. But rationing is inevitable if we simply expand government control without fixing the way health care is reimbursed so that doctors and patients become sensitive to issues of price and quality.

Like Medicare's recent decisions to curtail the use of virtual colonoscopies, certain wound-healing devices, and even a branded asthma drug, the board's decisions will be one-size-fits-all restrictions. Such restrictions don't respect variation in preferences and disease, which make costly products suitable for some even if they are wasteful when prescribed to everyone.

Moreover, these health boards prove that policy makers know they'll need to ration care but want to absolve themselves of responsibility. Some in Congress and the Obama administration recently tipped their hand on this goal by proposing to make recommendations of the current Medicare Payment Advisory Committee (MedPAC) legally binding rather than mere advice to Congress. Any new health board's mission will also expand over time, just as MedPAC's mandate grew to encompass medical practice issues not envisioned when it was created.

The idea of an omnipotent board that makes unpopular decisions on access and price isn't a new construct. It's a European import. In countries such as France and Germany, layers of bureaucracy like health boards have been specifically engineered to delay the adoption of new medical products and services, thus lowering spending.

In France, assessment of medical products is done by the Committee for the Evaluation of Medicines. Reimbursement rates are set by the National Union of Sickness Insurance Funds, a group that also negotiates pay to doctors.

In Germany, the Federal Joint Committee regulates reimbursement and restrictions on prescribing, while the Institute for Quality and Efficiency in Healthcare does formal cost-effectiveness analysis. The Social Insurance Organization, technically a part of the Federal Joint Committee, is in charge of setting prices through a defined formula that monitors doctors' prescribing behavior and sets their practice budgets. In the past 12 months, the 15 medical products and services that cleared this process spent an average 35 months under review. (The shortest review was 19 months, the longest 51.)

In short, other countries where government plays a large role in health care aren't shy about rationing. Mr. Obama's budget director has acknowledged that rationing reduces costs. Peter Orszag told Congress last year when he headed the Congressional Budget Office that spending can be "moderated" if "diffusion of existing costly services were slowed."

Medicare can already be painstakingly slow. Appealing to it takes patients an average 21 months according to a 2003 Government Accountability Office report (17 months involve administrative processing). Layers of commissions and health boards would delay access still further.

When asked to judge the constitutionality of the Senate HELP committee proposal, there's a reason why the nonpartisan Congressional Research Service said that the proposed Medical Advisory Council "raises potentially significant constitutional concerns." Our Founders thought politicians should be accountable when it comes to citizens' right to life, liberty and the pursuit of heart surgery.

Scott Gottlieb, M.D., is a resident fellow at AEI.

This article was found at http://www.aei.org/article/100677 on June 25, 2009

Here is Representative Paul's most recent weekly address. I do no agree with 100% of his conclusions but do agree with many of them. The bottom line is, everything costs money, it has to come from somewhere and there isn't an endless amount of valuable money. We can't continue to deficit spend like we are. It is surely a long term recipe for a total economic disaster. It has to catch up with us some day. If we get it under control and keep it under control we can avoid it - but only by acting today. The video is worth the four minutes.





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Is health care a fundamental right? Isn't this the question that is at the root of the current debate?

What is a right? We often hear of civil rights, economic rights, social rights. etc. For me, all rights falls within two categories:

1. Natural Rights
2. Legal Rights

Natural Rights

When I personally speak of rights, and when I read the words of our founders, these are the kinds of Rights that I usually refer to and that resonate in my soul. In the words of Thomas Jefferson, and affirmed by the unanimous vote of Congress assembled,

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

These unalienable rights are those that cannot be conferred by any other person, priest, potentate, king or magistrate. These are rights that our Creator himself has conferred and endowed upon all mankind. Examples of these rights are:

1. The Right to worship God how, where, or what we may
2. The Right to free speech
3. The Right to Life
4. The Right to choose for one's self
5. The Right to pursue happiness

This list is certainly not all inclusive. The keys to determining a natural right from a legal right, privilege or entitlement are these:

1. It cannot be purchased or sold
2. It cannot be conferred by anyone or anything
3. It is something that is universal for all - in whatever country, climb or continent

These are the rights I fight for. These are the rights you and I would die for. These are the rights for which men and women of our country have pledged their most sacred honor.

Legal Rights

Now that I have defined Natural Rights, I will now address legal rights. The Stanford Encyclopedia of Philosophy defined legal rights as follows: "Legal rights are, clearly, rights which exist under the rules of legal systems."

Often times these rights codify into law natural rights such as in our own Bill of Rights. However, legal rights may include rights not conferred by the Creator. Some examples of legal rights are:

1. Under law, I have a right to draw on Social Security when I retire.
2. Under law, I have the right to drive a car on public roads if I have the proper license.
3. Under law, I have the right to be able to purchase toys that have passed the government's safety screening practices.
4. Under law, I have the right to draw on unemployment insurance if I am terminated from my employer.
5. Under law, I have the right to COBRA insurance.
6. Under law, Corporations have rights including tax advantages and protection for shareholders & directors.

All of these are excellent laws and I am grateful for the rights they confer upon me. However, legal rights can also be unjust. Some examples of that are:

1. The right to hold slaves
2. The right to segregate schools
3. The right to discriminate based on race & gender
4. The right to force whole peoples off of their land

Thankfully, these laws have been repealed. Nevertheless, legal rights may at times infringe on the natural rights of others and may be unjust.

The keys to determining a legal right from a Natural one are as follows:

1. A legal right is conferred by the legislature
2. A legal right can be taken away by the legislature
3. Because these rights are conferred by man, they may at times be unjust.
4. A legal right can often be divided up into two sub parts: entitlement or qualified.

I will briefly define an entitlement and qualified legal right. A qualified legal right is one that a person may have to qualify for and often requires money (i.e., I have the right to Social Security retirement if I pay into the system, I have a right to a drivers license when I pass the test and purchase it, etc.).

An entitlement legal right is one that a person is legally entitled to regardless of their abilities to pass a test, work or purchase something. Some legally authorized entitlements that law confers upon our citizens are as follows:

1. Medical care for the poor and needy
2. Food & housing for the poor and needy
3. Educational assistance for the poor and needy
4. Social Security Disability

In summary, a legal right is one that is conferred by a legislature that did not exist prior to its being conferred and may take the form of a qualified legal right or an entitlement.

The key differences between Natural & Legal Rights

Now that we have defined Natural & legal rights we can conduct our analysis. However, before that analysis, we must quickly summarize the differences between these two kinds of rights. The key differences between these two kinds of rights are that Natural Rights cannot be bought or sold. They also always Existed, Are now, and Ever will be without regard to government. They are independent of anything or anyone. Legal rights are rights that were not, might be now, but might go away based on circumstances, economics, politicians, court decisions, and aims of government. Legal rights can be taken away. Natural rights are eternal. Legal rights may, or may not, infringe on the rights of others.

Analysis

So, is health care a Natural or legal right? Let's apply the keys.

Can it be purchased or sold?

Health care is its own industry. However, whole industries exist around natural rights. For example, the Right to Free Speech is one that supports the press. Is the right of Health Care a similar right where an industry has grown up out of a right?

The key difference between Freedom of Speech and Health Care is that one can still speak freely - even when deprived of all material goods and wealth. In that entirely destitute state, a person can still voice their thoughts and opinions, their purposes and desires. Health Care on the other hand is one that can only be purchased. Why? Because it has to be provided by another Human Being. For them to provide their services, they must be somehow compensated.

Now, there is a certain level of health care that a person will gladly perform without remuneration. It is that service which, when pressed upon in an emergency and where they are free from material harm to themselves, they are moved by compassion upon their fellow man to save them from their plight. This is motivated out of a love for their fellow man and a desire to serve. It is a Natural Responsibility to confer that aid & support but not a Natural Right that requires it.

Can it be conferred by anyone or anything?

As already mentioned, Freedom of Religion is a Natural right. It is one that cannot be conferred. Kings and Priests may seek to oppress this Right, but mankind will always endeavor to exercise it. Whether it sends them to the furnaces in Babylon, the Cross in Rome, or to Plymouth Rock, mankind will endeavor to worship God according to the dictates of their own conscience or choose to not worship at all.

Health Care is something that must be conferred on an individual. They must receive it at the hands of another Human Being.

Is it something that is universal for all - in whatever country, climb or continent?

All mankind are endowed equally with life, their agency, and ability to worship or not worship. However, individuals are born into many different countries, homes and families where health care standards and practices vary.

Is it a legal right conferred by the legislature?

Health Care entitlement rights have been conferred upon the citizens of our country by the Federal & State governments at different times. There was not a legal right to health care before these laws were passed. Even the President stated that because the country was now so wealthy, it was now something that the Government could/should confer. That is, we can now afford this right and because of that we ought to confer it. Natural rights are free. Legal rights often time have some kind of precondition that has to be met for it to be conferred.

Is it a legal right that can be taken away by the legislature?

In the event that funding becomes scarce, this is a right that can be taken away by the federal & state legislatures.

Is Universal Health Care Unjust?

This can be argued either way. Those who declare that health care is a right say it is unjust to not provide it to all. Those who say it is unjust, do so on three principles:

1. It takes away the Right to Choose one's own care
2. It will lead to a rationing of care by the State
3. To force individuals to pay for the health care of others is an infringement on their Right to the fruits of their labors

Can it be classified into one of two sub parts: entitlement or qualified?

At the moment, it is only an entitlement legal right.

Before we make a final conclusion about whether or not health care is a Natural or Legal right, it is important to briefly discuss two additional points: Privileges and Government Power.

Difference Between Natural Rights & Privileges

Privileges are the benefits one receives by the worthy exercise of Natural Rights. Some of these benefits are:

1. Happiness
2. Peace
3. Health (inasmuch as it is in ones control)
4. Freedom
5. Prosperity

As my mother often said, "Privileges are earned." The opportunity for those privileges is the Natural Right - conferred without distinction. These rights might be conferred without distinction but our world and society is one full of distinction: children are born into families that are high & low, rich and poor, in lands of war & lands of peace. It is the duty of thinking men and women everywhere to bring an end to these distinctions. Many people look to their governments for this leveling.

Government's Power

This is a topic of which entire books and philosophies discuss. I will simply quote our own Declaration of Independence: "That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed." Governments are a social contract. We contract with each other through it and delegate to it certain powers we Naturally possess. Now there are both just and unjust governments. In my estimation, an unjust government is one whose powers infringe on the Natural Rights of its citizens. A just government is one that secures those Natural Rights.

You cannot give to anyone something that you do not have. Follow that logic through and you will see that it is a universal truth. In the sense of government, a citizen cannot give, endow, or bestow upon its government any Power that the citizen alone does not possess.

Governments at times exercise powers that their citizens do not have (the power to oppress, steal, plunder, murder, lie, etc.). In these situations, whether by consent or otherwise, the Government is unjust because it has usurped and exercised powers that it had no Right to possess. Consent alone does not qualify a government as Just. A Government that exercises unjust powers by consent is none other than mob rule of varying degrees.

If I don't have the Natural Right to require health care, then I cannot give to the government the right to confer it. If I have it, then I can confer that Right upon the government. Any other way is an infringement upon the Natural Rights of man - conferred by Creation. Infringing on the Natural Rights of others is essentially stealing from the Creator those rights He bestowed upon His creations.

Finally, whereas I don't have the right to force my neighbor to level themselves in Fraternal love for their fellowman, I cannot give to the government the power to level the high & low, the rich and the poor. This leveling is one that must come from within and never has, and never will, come from Government. People cannot be leveled by force. To be brought together as one is a choice each individual must make. This is something we must work to attain. They can urge it and persuade but they cannot force.

Conclusion

This argument is based on the premise that there are natural and legal rights. We have seen that health care is something that can be bought and sold. It is something that can be conferred and denied by legislatures. It is something that is not universal and is contingent upon other pre-conditions. Forcing others, even if by the consent of the majority, to pay for the health care of others is an infringement on another human being's Natural Rights. Because of this, we can see that Health Care is not a Natural Right but rather it has the makings of being a Legal Right.

Does that end the debate? As far as determining the Government's role it shows where its role is not. But it hardly ends the debate over the inequity and costs of health care. To continue that debate, we must recognize that Natural Rights are not the only thing conferred upon man by their Creator. Our Creator also conferred upon us Natural Responsibilities.

You might call these Natural Responsibilities under the names of Obligations, Duties or Ethics. These Natural Responsibilities include the responsibility to aid, support and protect one another. These are responsibilities that you and I cannot neglect without consequence. And although, as I have shown, we are not entitled to Health Care by Right, by the obligation of Natural Responsibilities laid upon us by our Creator, we should endeavor, no, we must endeavor, as far as our means allow us, to faithfully discharge these Responsibilities. As far as health care is concerned, that includes citizens everywhere working together to improve health care access and find solutions to ease the cost burden on our brothers and sisters by the willful donations of our money, time, energy and efforts. We furthermore should seek out the poor and needy and treat them as we ourselves would like to be treated.

America is about the opportunity to obtain the privileges. America is not about the entitlement to those privileges.

In sum, by the discharge of our Natural Responsibilities and the worthy exercise of Natural Rights - especially that of agency, we might earn and enjoy the Privilege of a Healthy, Happy, Secure and Peaceful society. This society would be one that had chosen, of their own free will and accord, to level themselves to each other and work for each others welfare and gain and not their own selfish endeavors. This society is something that cannot be conferred. This is something we are not entitled to. This is something that must be earned. Creating an entitlement society will only work against the ends that you and I seek to gain. Earning this society is what we must live for. Earning this society is what millions have fought & died for. Let us endeavor once again to take up our responsibility and earn that society.

I know that by respecting the Natural Rights of each other and by faithfully discharging our Natural Responsibilities to our fellowman we can create an America that truly does enjoy the privileges of Liberty and Justice for all.

The following link is to a video showing the growing threat of nuclear war from North Korea.

Whereas China holds a majority of US debt, and whereas the United States of America has more debt than 13 times the actual currency in circulation, and whereas our national debt offerings are becoming less attractive on the open market, and whereas the United States has no financial reserves, and whereas North Korea is an ally of China and therefore a war with North Korea is also a war with China, would China allow its biggest debtor to fight a war with its ally and in the event of war with North Korea, how would the US fund such a war?

That is the predicament we find ourselves in right now on any front - whether it be with China, North Korea, Iran, Russia or any other country. We are at the point where our credit card is nearly maxed out. There is still some space on it but it will soon be taken by health care reform. There will always be some way to fund our actions but at what cost? At what rate of return will our creditors require? What can we afford? And, because of our severe indebtedness, will we be able to make the hard choices required to preserve life, liberty and the pursuit of happiness?

It all comes back to this:

1. You need money to buy things
2. Money has to come from somewhere
3. There isn't an infinite amount of valuable money

We, the People, are the guardians of our credit. In order to fulfill that responsibility, we need to understand what public credit is for and why it was established. To do this, we must go back to our roots to understand the foundations for public credit.

Public credit for the United States was established by Alexander Hamilton, our most influential and revolutionary founding father. He was the only one of the founders who saw not just the political revolution, but also the economic one. In his 1790 "Report on Public Credit," Hamilton laid out the purposes, as well as the good and bad fruits, of public credit. He stated there were four reasons for public credit:

"That exigencies (emergencies) are to be expected to occur, in the affairs of nations, in which there will be a necessity for borrowing.

"That loans in times of public danger, especially from foreign war, are found an indispensable resource, even to the wealthiest of them.

"And that in a country, which, like this, is possessed of little active wealth, or in other words, little monied capital, the necessity for that resource, must, in such emergencies, be proportionably urgent.

"And as on the one hand, the necessity for borrowing in particular emergencies cannot be doubted, so on the other, it is equally evident, that to be able to borrow upon good terms, it is essential that the credit of a nation should be well established (footnote 1)."

This is critical to understanding why we ever had a national debt in the very first place. Essentially it is for emergencies, public danger, and foreign war. It was never intended for and should not be used for the day-to-day operations of government or the funding of entitlement programs. These things were certainly envisioned in his day and were warned against. It is also indispensable to know that it was for the time when the country had little wealth. Public debt was something that would be done away with except for in times of national emergency.

Hamilton fought hard to establish public credit to restore the good name of the United States and to place us in a situation whereby we could protect the public and ensure that the government was equal to any emergencies that arose. His efforts established the framework for our financial system which helped in creating the country we are today. However, with an official debt of nearly $12 trillion, and an unofficial debt of nearly $62 trillion, we are destroying our public credit and therefore the nation with it. This was evidenced a few weeks ago when our Treasury Secretary had to go on a personal tour to reassure the world of US commitments to pay its debts. Sadly, he was literally laughed at (footnote 2).

2008 saw $412 billion dollars go to interest payments alone (that's 25% of your taxes) on the national debt (footnote 3). That number is staggering. As the debt gets higher, the interest rates on that debt will climb. Therefore, those interest payments will also climb. As those payments climb, so do our taxes. Our taxes will climb at the same time we will be taxing more to pay for more and more entitlement programs - and perhaps even try and fund another war. Just like with an individual's finances, this kind of math doesn't add up. It will eventually strangle or cripple the Republic and its citizens.

David Hume, a British philosopher, wrote on the good and evils of public credit. He recognized that many good things can come from it. He also acknowledged that several ills can come from it. He wrote:

"If the abuses of treasures be dangerous, either by engaging the state in rash enterprizes, or making it neglect military discipline, in confidence of its riches; the abuses of mortgaging are more certain and inevitable; poverty, impotence, and subjection to foreign powers (footnote 4)."

I repeat, the consequences of abusing public credit are: poverty, impotence, and subjection to foreign powers. Anyone who has lived in a third world country can attest to this. Despite America's many rash enterprises, we have somehow survived. However, with a national debt closing in on $12 trillion, is now the time for more of them? I think not. Even so, what appears to be a limitless checking account in the hands of government seems to give them the illusion that any time is a good time for another rash enterprise. Hume continued:

"The practice, therefore, of contracting debt will almost infallibly be abused, in every government. It would scarcely be more imprudent to give a prodigal son a credit in every banker's shop in London, than to empower a statesman to draw bills, in this manner, upon posterity...(footnote 4)"

We sadly are not concerned enough with restricting the government's ability to draw bills on public credit. Certainly there has been some "good" wrought out of our current debts. However, it is hard to say that the good it brings outweighs the cost of it. Hume stated:

"More men, therefore, with large stocks and incomes, may naturally be supposed to continue in trade, where there are public debts; and this, it must be owned, is of some advantage to commerce, by diminishing its profits, promoting circulation, and encouraging industry. But, in opposition to these two favourable circumstances, perhaps of no very great importance, weigh the many disadvantages which attend our public debts, in the whole interior economy of the state: You will find no comparison between the ill and the good which result from them.

"...The taxes, which are levied to pay the interests of these debts, are apt either to heighten the price of labour, or be an oppression on the poorer sort.

"...As foreigners possess a great share of our national funds, they render the public, in a manner, tributary to them, and may in time occasion the transport of our people and our industry (footnote 4)."

This is a truth with debt of any kind. As foreign countries, oil companies and banks possess the greatest share of our debt (footnote 5), we have become tributes to them and are losing our own sovereign ability to steer and guide America. America is now an enterprise for them and their uses. Can you see how we can't continue to spend like we are? Can you see how we cannot continue on this reckless course? The consequences of poor public credit are even greater though. Hume stated,

"If the prince has become absolute, as may naturally be expected from this situation of affairs, it is so easy for him to encrease his exactions upon the annuitants, which amount only to the retaining money in his own hands, that this species of property would soon lose all its credit, and the whole income of every individual in the state must lie entirely at the mercy of the sovereign: A degree of despotism, which no oriental monarchy has ever yet attained (footnote 4)."

What that means is that the chief executive, being responsible for all of that debt, will become a greater despot than ever known to pay off the debts which the government had so foolishly contracted. The states will be subject to him. Congress will be subject to him. All of the citizenry will be subject unto him - the high and the low, the rich and the poor. Our liberties will be sacrificed for our short sighted behavior. Is this worth it to us?

We must restore our public credit. We must put a stop to this endless spending and restore the government to its proper role. I quote Alexander Hamilton, "To justify and preserve their confidence; to promote the encreasing respectability of the American name; to answer the calls of justice; to restore landed property to its due value; to furnish new resources both to agriculture and commerce; to cement more closely the union of the states; to add to their security against foreign attack; to establish public order on the basis of an upright and liberal policy. These are the great and invaluable ends to be secured, by a proper and adequate provision, at the present period, for the support of public credit (footnote 1)."

Our country and its citizens would be blessed in every possible way if we were to restore the government to fiscal responsibility and pay off our debts. These are an embarrassment to the very principles of SOUND GOVERNMENT, of LIBERTY, of FREEDOM, of NATIONAL DEFENSE. Debt is bondage and bondage is everything but what we believe in but yet is everything we are working for. This path is one of folly. Surely you must see this.

Please Click Here to Write Your Representatives to Get us on a Better Road

________________________________

Footnotes

1. http://press-pubs.uchicago.edu/founders/documents/a1_8_2s5.html

2. http://www.youtube.com/watch?v=CwM6OdbN2-w and http://www.youtube.com/watch?v=ZNNy_yz1f_E&NR=1

3. http://www.federalbudget.com/

4. http://socserv.mcmaster.ca/econ/ugcm/3ll3/hume/pubcred

5. http://www.treas.gov/tic/mfh.txt

This morning I found an article on Senator Kennedy's bill on health care reform. According to this article, "Americans would be able to buy long-term care insurance from the government for $65 a month under a provision tucked into sweeping health care legislation that senators will begin considering next week."

The frightening thing about this is that Long Term Care (LTC) insurance was not even included in the President's forecast of $1.6 trillion. I saw this and I said, "Does the good Senator truly want to put us on the fast track for bankrupting the United States?" An estimated 10 million Americans currently need LTC. That number is expected to double by 2030 (footnote 1).

The problem with the cost is that the average cost of daily personal care is $7,000 per month (footnote 2). Of course they are couching it as a modest benefit to start (not to be less than $1,500 per month but it doesn't state the maximum). However, these things grow and receive a life of their own. So you, through the government, are going to take on the cost burden (we will assume they negotiate down prices and have a limited monthly maximum benefit of $3,000) on average, $3,000 per month per enrollee or $36,000 annually per enrollee. Do the math. It's not pretty. Can you see how these things can mushroom cloud into something so much larger than they initially tell you?

My favorite was this part:

"Both plans omitted specifics on how to cover the costs, which could exceed $1 trillion over 10 years (see footnote 3)." Also, why didn't they say "which could exceed $1.6 trillion?" $600,000,000,000 is a lot of money to not include in their article.

They must think we are either stupid, not listening, or we won't get involved. Let's prove them wrong on all of the above.

_____________________________

Footnotes

1. Georgetown University, Long Term Care Financing Project, "National Spending for Long-term Care Fact Sheet," January 2007

2. Chicago-Sun Times, "The Savage Truth on Money" by Terry Savage, Monday, March 31, 2008

3. http://news.yahoo.com/s/ap/20090610/ap_on_bi_ge/us_health_overhaul;_ylt=AoA0E6i2EyEL4ndNzgwOzf6yFz4D;_ylu=X3oDMTJuOWk4YzlvBGFzc2V0A2FwLzIwMDkwNjEwL3VzX2hlYWx0aF9vdmVyaGF1bARwb3MDMQRzZWMDeW5fYXJ0aWNsZV9zdW1tYXJ5X2xpc3QEc2xrA2tlbm5lZHloZWFsdA--

Here is Senator Lieberman's response to my letter to him regarding health care reform. I personally interpret "ecreasing the costs of insurance" as eliminating the exemption from the Anti-trust laws. Let's hope we can create a true free market system for health care.




June 4, 2009

Dear Mr. Coman:

Thank you for contacting me to express your desire to improve our nation's health care system. I share your concern that this must be a top national priority, and I am committed to addressing this critical issue. I understand that Americans today are faced with greater uncertainty than ever before when it comes to their health needs. These concerns often focus around rising medical costs, aging, the risk of disease, and the multitude of treatments. In Connecticut, 325,000 residents - 50,000 of whom are children - are uninsured.

Throughout my career in public service, I have fought to make the nation's health care system work better for all Americans. I have concentrated on decreasing the costs of insurance, expanding access to treatment, assuring the best health care workforce has the newest medical technology, and protecting the rights of patients and consumers through their interactions with our cumbersome system.

It is especially important that we work to strengthen health care delivery systems for the uninsured, while also providing affordable, quality health care coverage for everyone.

Unfortunately, individuals and families without health coverage are more likely than those with coverage to forego needed health care, which often leads to worse health outcomes and the need for expensive medical treatment. Lack of insurance can lead to health care access problems affecting whole communities, such as overcrowding in emergency rooms. The nation as a whole is burdened through increased taxes to pay for the uncompensated care of uninsured persons.

On November 21, 2008, I sent a letter, along with several of my colleagues, to President-Elect Obama, in which we indicated our commitment to working with him in a bipartisan fashion to reform our health care system. Given our current economic challenges, and the fact that a growing number of Americans have lost their jobs and subsequently their health care benefits, we urged that the Congress and the White House immediately work together to tackle the challenges of health care costs and coverage. In the letter we outlined principles for reforming our nation's health care system. These include: ensuring that all Americans have health care coverage; making health care coverage both affordable and portable; implementing strong private insurance market reforms so that insurers can compete on price, benefits, and quality; modernizing federal tax rules for health coverage; promoting improved disease prevention and wellness activities, as well as better management of chronic illnesses; making health care prices and choices more transparent so that consumers and providers can make the best choices for their health needs and health care dollars; and improving the quality and value of health care services. I look forward to working with the new Administration to enact legislation that accomplishes these principles. I am pleased that President Obama conducted the first White House Forum on Health Reform on March 5, 2009, in which a broad group of doctors, patients, business owners, insurers, and lawmakers, among other interested stakeholders, met to discuss and advance ways to reduce costs, expand coverage, and improve quality.

On February 5, 2009, along with 12 cosponsors, I reintroduced sweeping bipartisan legislation that would guarantee every citizen affordable health insurance, regardless of income, and significantly improve access to quality medical treatments. The Healthy Americans Act (S. 391) would comprehensively reform the health care system by providing universal coverage through a centrally financed system of private health insurance. This fiscally responsible legislation reverses the current trend in health care costs and provides much-needed relief for families and businesses. Under the plan, comprehensive coverage policies would be available through regional markets, harnessing the power of competition and providing individuals with greater choice and better value. Insurance companies would be required to offer a generous benefits package, similar to what federal employees receive. Coverage could not be denied; and insurance companies could not charge higher premiums because of a person's health status, occupation, gender, genetic information, or age. It would also implement a standard health care tax deduction and a system of subsidies in order to guarantee that all Americans can afford quality health coverage.

Last Congress, I took a first step to expanding coverage by cosponsoring legislation to provide more affordable health care to the millions of Americans working for small businesses. Over 45 million people in the United States had no health insurance in 2007. Among the non-elderly uninsured, more than half of these individuals were in families with a full-time worker and employed by, or with family members employed by, a small business with fewer than 100 employees.

On September 24, 2008, I became the lead cosponsor of the Affordable Coverage for Small Employers Act. This bipartisan bill would increase access to high-quality and affordable health care for our nation's small business owners, their employees, and their families by removing barriers to health care coverage faced by small business owners. This legislation would partner the federal government with states and small businesses to create regional health care pools that would allow for more competition in the small group market. It would offer more health insurance options to small business owners so they can pick the health care coverage that best fits their needs. It would also provide a framework for extending coverage to all Americans. The benefit packages available through this plan mirror the health care benefits available to Members of Congress and other federal employees. In addition, the bill provides advanceable, refundable tax credits to working families to help offset the cost of health coverage, as well as tax credits to small employers who contribute to their employees' health insurance premiums.

Over my career, I have focused on making sure high-quality health care was available to those in the greatest need. In both the 108th and 109th Congresses, I introduced the FairCare Act to ensure that all Americans receive the same quality of medical care regardless of gender, race, or ethnicity. That measure would have set medical standards of care for diseases that doctors should follow for each and every patient, rewarding health professionals for practicing these standards, and increasing transparency of health care practices by creating the conditions for an electronic health record that can be analyzed for the quality of care received. By improving the quality of care in this country, we can save approximately $30 billion a year. More importantly, we can reduce suffering and save lives.

I support legislative initiatives to protect the rights and benefits of patients who are enrolled in managed care and other types of health care plans; and I have been involved in efforts to craft a bipartisan managed care reform bill that can be enacted by the Congress. We must ensure that all Americans have decent health care plans with essential patient protections, such as guaranteed access to needed health care specialists; access to emergency room services when and where the need arises; continuity of care protections to assure patient care if a patient's health care provider is dropped; access to a timely internal and independent external appeals process with a medical necessity standard; assurance that doctors and patients can openly discuss treatment options; and an enforcement mechanism that ensures appropriate recourse for patients who have been harmed as a result of health plan actions and that holds health plans accountable for decisions that result in patient injury or death.

We must also update our health care system's infrastructure by expanding the use of health information technology (IT) in our country. Widespread adoption of health IT would save the system money and increase the quality of care delivered. Improving the quality of care delivered to Americans is dependent on decreasing medical errors and limiting wasteful spending on clinical procedures that fail to improve health outcomes. I am paying close attention to legislative initiatives to expand pay-for-performance to Medicare, which would result in payments to physicians based on delivering high-quality care to their patients. These efforts must be comprehensive, well funded, and thoughtful to ensure that positive impacts are experienced by every American.

Expanding access to health care for Americans will involve safeguarding the successful Medicare and Medicaid programs and improving the quality of medical care in our country which can make our health care systems more effective and efficient. I will continue to fight against cuts to clinically proven programs and reimbursement reductions for our high-quality hospitals and providers serving those on Medicare and Medicaid.

Finally, in addition to providing greater access to life-saving treatments, we need to invest in the development of new treatments. During the 110th Congress, I reintroduced my Accelerating Cures Act legislation, which would accelerate the pace of biomedical research so that we can advance the study and development of therapies that can more effectively treat and even solve diseases, such as cancer, Parkinson's disease, heart failure, and diabetes. The sole mission of this legislation is to translate basic science discovery, such as that produced by the National Cancer Institute (NCI), into novel diagnostics, therapies, and life-altering cures. Some examples of what this proposal would do are to create new opportunities for: increasing collaboration between traditionally separate disciplines and between the public and private sectors; funding high-risk, high reward research that could result in new treatments for diseases quickly; and making funding available to small companies that are doing breakthrough medical work but often do not have the resources to bring their products to market. Many life-threatening and chronic diseases would undoubtedly benefit from passage of such legislation. I also support expanding stem cell research in the hope of realizing lifesaving treatments for many diseases, along with increased funding for more coordinated efforts to combat autism and other developmental disorders.

As the Senate focuses renewed attention on health care quality, affordability, accessibility, and related matters in this 111th Congress and beyond, you can be assured that I will keep in mind your specific thoughts and suggestions; and I will continue to be an advocate for strong patient protections, health care plan accountability, and affordability to benefit all of our nation's citizens.
Thank you again for sharing your views and concerns with me. I hope you will continue to visit my website at http://lieberman.senate.gov for updated news about my work on behalf of Connecticut and the nation. Please contact me if you have any additional questions or comments about our work in Congress.

Sincerely,

Joseph I. Lieberman
UNITED STATES SENATOR

JIL:vdh

I found this post, written by Mat Rodina, a Russian who lives in Russia, and thought it would be good to share. It is his perspective on the recent moves of our Government. I don't agree with all of it - including his piece about the Russians fighting for their freedom (when did that happen?) - nevertheless, sometimes an outside perspective is the one that really opens our eyes. Enjoy the read:

It must be said, that like the breaking of a great dam, the American decent into Marxism is happening with breath taking speed, against the back drop of a passive, hapless sheeple, excuse me dear reader, I meant people.

True, the situation has been well prepared on and off for the past century, especially the past twenty years. The initial testing grounds was conducted upon our Holy Russia and a bloody test it was. But we Russians would not just roll over and give up our freedoms and our souls, no matter how much money Wall Street poured into the fists of the Marxists.

Those lessons were taken and used to properly prepare the American populace for the surrender of their freedoms and souls, to the whims of their elites and betters.

First, the population was dumbed down through a politicized and substandard education system based on pop culture, rather then the classics. Americans know more about their favorite TV dramas then the drama in DC that directly affects their lives. They care more for their "right" to choke down a McDonalds burger or a BurgerKing burger than for their constitutional rights. Then they turn around and lecture us about our rights and about our "democracy". Pride blind the foolish.

Then their faith in God was destroyed, until their churches, all tens of thousands of different "branches and denominations" were for the most part little more then Sunday circuses and their televangelists and top protestant mega preachers were more then happy to sell out their souls and flocks to be on the "winning" side of one pseudo Marxist politician or another. Their flocks may complain, but when explained that they would be on the "winning" side, their flocks were ever so quick to reject Christ in hopes for earthly power. Even our Holy Orthodox churches are scandalously liberalized in America.

The final collapse has come with the election of Barack Obama. His speed in the past three months has been truly impressive. His spending and money printing has been a record setting, not just in America's short history but in the world. If this keeps up for more then another year, and there is no sign that it will not, America at best will resemble the Wiemar Republic and at worst Zimbabwe.

These past two weeks have been the most breath taking of all. First came the announcement of a planned redesign of the American Byzantine tax system, by the very thieves who used it to bankroll their thefts, loses and swindles of hundreds of billions of dollars. These make our Russian oligarchs look little more then ordinary street thugs, in comparison. Yes, the Americans have beat our own thieves in the shear volumes. Should we congratulate them?

These men, of course, are not an elected panel but made up of appointees picked from the very financial oligarchs and their henchmen who are now gorging themselves on trillions of American dollars, in one bailout after another. They are also usurping the rights, duties and powers of the American congress (parliament). Again, congress has put up little more then a whimper to their masters.

Then came Barack Obama's command that GM's (General Motor) president step down from leadership of his company. That is correct, dear reader, in the land of "pure" free markets, the American president now has the power, the self given power, to fire CEOs and we can assume other employees of private companies, at will. Come hither, go dither, the centurion commands his minions.

So it should be no surprise, that the American president has followed this up with a "bold" move of declaring that he and another group of unelected, chosen stooges will now redesign the entire automotive industry and will even be the guarantee of automobile policies. I am sure that if given the chance, they would happily try and redesign it for the whole of the world, too. Prime Minister Putin, less then two months ago, warned Obama and UK's Blair, not to follow the path to Marxism, it only leads to disaster. Apparently, even though we suffered 70 years of this Western sponsored horror show, we know nothing, as foolish, drunken Russians, so let our "wise" Anglo-Saxon fools find out the folly of their own pride.

Again, the American public has taken this with barely a whimper...but a "freeman" whimper.
So, should it be any surprise to discover that the Democratically controlled Congress of America is working on passing a new regulation that would give the American Treasury department the power to set "fair" maximum salaries, evaluate performance and control how private companies give out pay raises and bonuses? Senator Barney Franks, a social pervert basking in his homosexuality (of course, amongst the modern, enlightened American societal norm, as well as that of the general West, homosexuality is not only not a looked down upon life choice, but is often praised as a virtue) and his Marxist enlightenment, has led this effort. He stresses that this only affects companies that receive government monies, but it is retroactive and taken to a logical extreme, this would include any company or industry that has ever received a tax break or incentive.

The Russian owners of American companies and industries should look thoughtfully at this and the option of closing their facilities down and fleeing the land of the Red as fast as possible. In other words, divest while there is still value left.

The proud American will go down into his slavery with out a fight, beating his chest and proclaiming to the world, how free he really is. The world will only snicker. "


For purposes of copyright - this work is entirely that of Mat Rodina. You can read this post at http://mat-rodina.blogspot.com/2009/04/american-capitalism-gone-with-whimper.html. It was accessed on June 7, 2009. You can also read his blog for other very interesting perspectives on the west.

PRESIDENT OBAMA: Thank you very much. Good afternoon. I am honored to be in the timeless city of Cairo, and to be hosted by two remarkable institutions. For over a thousand years, Al-Azhar has stood as a beacon of Islamic learning; and for over a century, Cairo University has been a source of Egypt's advancement. And together, you represent the harmony between tradition and progress. I'm grateful for your hospitality, and the hospitality of the people of Egypt. And I'm also proud to carry with me the goodwill of the American people, and a greeting of peace from Muslim communities in my country: Assalaamu alaykum. (Applause.)

We meet at a time of great tension between the United States and Muslims around the world -- tension rooted in historical forces that go beyond any current policy debate. The relationship between Islam and the West includes centuries of coexistence and cooperation, but also conflict and religious wars. More recently, tension has been fed by colonialism that denied rights and opportunities to many Muslims, and a Cold War in which Muslim-majority countries were too often treated as proxies without regard to their own aspirations. Moreover, the sweeping change brought by modernity and globalization led many Muslims to view the West as hostile to the traditions of Islam.

Violent extremists have exploited these tensions in a small but potent minority of Muslims. The attacks of September 11, 2001 and the continued efforts of these extremists to engage in violence against civilians has led some in my country to view Islam as inevitably hostile not only to America and Western countries, but also to human rights. All this has bred more fear and more mistrust.

So long as our relationship is defined by our differences, we will empower those who sow hatred rather than peace, those who promote conflict rather than the cooperation that can help all of our people achieve justice and prosperity. And this cycle of suspicion and discord must end.
I've come here to Cairo to seek a new beginning between the United States and Muslims around the world, one based on mutual interest and mutual respect, and one based upon the truth that America and Islam are not exclusive and need not be in competition. Instead, they overlap, and share common principles -- principles of justice and progress; tolerance and the dignity of all human beings.

I do so recognizing that change cannot happen overnight. I know there's been a lot of publicity about this speech, but no single speech can eradicate years of mistrust, nor can I answer in the time that I have this afternoon all the complex questions that brought us to this point. But I am convinced that in order to move forward, we must say openly to each other the things we hold in our hearts and that too often are said only behind closed doors. There must be a sustained effort to listen to each other; to learn from each other; to respect one another; and to seek common ground. As the Holy Koran tells us, "Be conscious of God and speak always the truth." (Applause.) That is what I will try to do today -- to speak the truth as best I can, humbled by the task before us, and firm in my belief that the interests we share as human beings are far more powerful than the forces that drive us apart.

Now part of this conviction is rooted in my own experience. I'm a Christian, but my father came from a Kenyan family that includes generations of Muslims. As a boy, I spent several years in Indonesia and heard the call of the azaan at the break of dawn and at the fall of dusk. As a young man, I worked in Chicago communities where many found dignity and peace in their Muslim faith.

As a student of history, I also know civilization's debt to Islam. It was Islam -- at places like Al-Azhar -- that carried the light of learning through so many centuries, paving the way for Europe's Renaissance and Enlightenment. It was innovation in Muslim communities -- (applause) -- it was innovation in Muslim communities that developed the order of algebra; our magnetic compass and tools of navigation; our mastery of pens and printing; our understanding of how disease spreads and how it can be healed. Islamic culture has given us majestic arches and soaring spires; timeless poetry and cherished music; elegant calligraphy and places of peaceful contemplation. And throughout history, Islam has demonstrated through words and deeds the possibilities of religious tolerance and racial equality. (Applause.)

I also know that Islam has always been a part of America's story. The first nation to recognize my country was Morocco. In signing the Treaty of Tripoli in 1796, our second President, John Adams, wrote, "The United States has in itself no character of enmity against the laws, religion or tranquility of Muslims." And since our founding, American Muslims have enriched the United States. They have fought in our wars, they have served in our government, they have stood for civil rights, they have started businesses, they have taught at our universities, they've excelled in our sports arenas, they've won Nobel Prizes, built our tallest building, and lit the Olympic Torch. And when the first Muslim American was recently elected to Congress, he took the oath to defend our Constitution using the same Holy Koran that one of our Founding Fathers -- Thomas Jefferson -- kept in his personal library. (Applause.)

So I have known Islam on three continents before coming to the region where it was first revealed. That experience guides my conviction that partnership between America and Islam must be based on what Islam is, not what it isn't. And I consider it part of my responsibility as President of the United States to fight against negative stereotypes of Islam wherever they appear. (Applause.)

But that same principle must apply to Muslim perceptions of America. (Applause.) Just as Muslims do not fit a crude stereotype, America is not the crude stereotype of a self-interested empire. The United States has been one of the greatest sources of progress that the world has ever known. We were born out of revolution against an empire. We were founded upon the ideal that all are created equal, and we have shed blood and struggled for centuries to give meaning to those words -- within our borders, and around the world. We are shaped by every culture, drawn from every end of the Earth, and dedicated to a simple concept: E pluribus unum -- "Out of many, one."

Now, much has been made of the fact that an African American with the name Barack Hussein Obama could be elected President. (Applause.) But my personal story is not so unique. The dream of opportunity for all people has not come true for everyone in America, but its promise exists for all who come to our shores -- and that includes nearly 7 million American Muslims in our country today who, by the way, enjoy incomes and educational levels that are higher than the American average. (Applause.)

Moreover, freedom in America is indivisible from the freedom to practice one's religion. That is why there is a mosque in every state in our union, and over 1,200 mosques within our borders. That's why the United States government has gone to court to protect the right of women and girls to wear the hijab and to punish those who would deny it. (Applause.)

So let there be no doubt: Islam is a part of America. And I believe that America holds within her the truth that regardless of race, religion, or station in life, all of us share common aspirations -- to live in peace and security; to get an education and to work with dignity; to love our families, our communities, and our God. These things we share. This is the hope of all humanity.
Of course, recognizing our common humanity is only the beginning of our task. Words alone cannot meet the needs of our people. These needs will be met only if we act boldly in the years ahead; and if we understand that the challenges we face are shared, and our failure to meet them will hurt us all.

For we have learned from recent experience that when a financial system weakens in one country, prosperity is hurt everywhere. When a new flu infects one human being, all are at risk. When one nation pursues a nuclear weapon, the risk of nuclear attack rises for all nations. When violent extremists operate in one stretch of mountains, people are endangered across an ocean. When innocents in Bosnia and Darfur are slaughtered, that is a stain on our collective conscience. (Applause.) That is what it means to share this world in the 21st century. That is the responsibility we have to one another as human beings.

And this is a difficult responsibility to embrace. For human history has often been a record of nations and tribes -- and, yes, religions -- subjugating one another in pursuit of their own interests. Yet in this new age, such attitudes are self-defeating. Given our interdependence, any world order that elevates one nation or group of people over another will inevitably fail. So whatever we think of the past, we must not be prisoners to it. Our problems must be dealt with through partnership; our progress must be shared. (Applause.)

Now, that does not mean we should ignore sources of tension. Indeed, it suggests the opposite: We must face these tensions squarely. And so in that spirit, let me speak as clearly and as plainly as I can about some specific issues that I believe we must finally confront together.
The first issue that we have to confront is violent extremism in all of its forms.

In Ankara, I made clear that America is not -- and never will be -- at war with Islam. (Applause.) We will, however, relentlessly confront violent extremists who pose a grave threat to our security -- because we reject the same thing that people of all faiths reject: the killing of innocent men, women, and children. And it is my first duty as President to protect the American people.

The situation in Afghanistan demonstrates America's goals, and our need to work together. Over seven years ago, the United States pursued al Qaeda and the Taliban with broad international support. We did not go by choice; we went because of necessity. I'm aware that there's still some who would question or even justify the events of 9/11. But let us be clear: Al Qaeda killed nearly 3,000 people on that day. The victims were innocent men, women and children from America and many other nations who had done nothing to harm anybody. And yet al Qaeda chose to ruthlessly murder these people, claimed credit for the attack, and even now states their determination to kill on a massive scale. They have affiliates in many countries and are trying to expand their reach. These are not opinions to be debated; these are facts to be dealt with.

Now, make no mistake: We do not want to keep our troops in Afghanistan. We see no military -- we seek no military bases there. It is agonizing for America to lose our young men and women. It is costly and politically difficult to continue this conflict. We would gladly bring every single one of our troops home if we could be confident that there were not violent extremists in Afghanistan and now Pakistan determined to kill as many Americans as they possibly can. But that is not yet the case.

And that's why we're partnering with a coalition of 46 countries. And despite the costs involved, America's commitment will not weaken. Indeed, none of us should tolerate these extremists. They have killed in many countries. They have killed people of different faiths -- but more than any other, they have killed Muslims. Their actions are irreconcilable with the rights of human beings, the progress of nations, and with Islam. The Holy Koran teaches that whoever kills an innocent is as -- it is as if he has killed all mankind. (Applause.) And the Holy Koran also says whoever saves a person, it is as if he has saved all mankind. (Applause.) The enduring faith of over a billion people is so much bigger than the narrow hatred of a few. Islam is not part of the problem in combating violent extremism -- it is an important part of promoting peace.

Now, we also know that military power alone is not going to solve the problems in Afghanistan and Pakistan. That's why we plan to invest $1.5 billion each year over the next five years to partner with Pakistanis to build schools and hospitals, roads and businesses, and hundreds of millions to help those who've been displaced. That's why we are providing more than $2.8 billion to help Afghans develop their economy and deliver services that people depend on.

Let me also address the issue of Iraq. Unlike Afghanistan, Iraq was a war of choice that provoked strong differences in my country and around the world. Although I believe that the Iraqi people are ultimately better off without the tyranny of Saddam Hussein, I also believe that events in Iraq have reminded America of the need to use diplomacy and build international consensus to resolve our problems whenever possible. (Applause.) Indeed, we can recall the words of Thomas Jefferson, who said: "I hope that our wisdom will grow with our power, and teach us that the less we use our power the greater it will be."

Today, America has a dual responsibility: to help Iraq forge a better future -- and to leave Iraq to Iraqis. And I have made it clear to the Iraqi people -- (applause) -- I have made it clear to the Iraqi people that we pursue no bases, and no claim on their territory or resources. Iraq's sovereignty is its own. And that's why I ordered the removal of our combat brigades by next August. That is why we will honor our agreement with Iraq's democratically elected government to remove combat troops from Iraqi cities by July, and to remove all of our troops from Iraq by 2012. (Applause.) We will help Iraq train its security forces and develop its economy. But we will support a secure and united Iraq as a partner, and never as a patron.

And finally, just as America can never tolerate violence by extremists, we must never alter or forget our principles. Nine-eleven was an enormous trauma to our country. The fear and anger that it provoked was understandable, but in some cases, it led us to act contrary to our traditions and our ideals. We are taking concrete actions to change course. I have unequivocally prohibited the use of torture by the United States, and I have ordered the prison at Guantanamo Bay closed by early next year. (Applause.)

So America will defend itself, respectful of the sovereignty of nations and the rule of law. And we will do so in partnership with Muslim communities which are also threatened. The sooner the extremists are isolated and unwelcome in Muslim communities, the sooner we will all be safer.
The second major source of tension that we need to discuss is the situation between Israelis, Palestinians and the Arab world.

America's strong bonds with Israel are well known. This bond is unbreakable. It is based upon cultural and historical ties, and the recognition that the aspiration for a Jewish homeland is rooted in a tragic history that cannot be denied.

Around the world, the Jewish people were persecuted for centuries, and anti-Semitism in Europe culminated in an unprecedented Holocaust. Tomorrow, I will visit Buchenwald, which was part of a network of camps where Jews were enslaved, tortured, shot and gassed to death by the Third Reich. Six million Jews were killed -- more than the entire Jewish population of Israel today. Denying that fact is baseless, it is ignorant, and it is hateful. Threatening Israel with destruction -- or repeating vile stereotypes about Jews -- is deeply wrong, and only serves to evoke in the minds of Israelis this most painful of memories while preventing the peace that the people of this region deserve.

On the other hand, it is also undeniable that the Palestinian people -- Muslims and Christians -- have suffered in pursuit of a homeland. For more than 60 years they've endured the pain of dislocation. Many wait in refugee camps in the West Bank, Gaza, and neighboring lands for a life of peace and security that they have never been able to lead. They endure the daily humiliations -- large and small -- that come with occupation. So let there be no doubt: The situation for the Palestinian people is intolerable. And America will not turn our backs on the legitimate Palestinian aspiration for dignity, opportunity, and a state of their own. (Applause.)

For decades then, there has been a stalemate: two peoples with legitimate aspirations, each with a painful history that makes compromise elusive. It's easy to point fingers -- for Palestinians to point to the displacement brought about by Israel's founding, and for Israelis to point to the constant hostility and attacks throughout its history from within its borders as well as beyond. But if we see this conflict only from one side or the other, then we will be blind to the truth: The only resolution is for the aspirations of both sides to be met through two states, where Israelis and Palestinians each live in peace and security. (Applause.)

That is in Israel's interest, Palestine's interest, America's interest, and the world's interest. And that is why I intend to personally pursue this outcome with all the patience and dedication that the task requires. (Applause.) The obligations -- the obligations that the parties have agreed to under the road map are clear. For peace to come, it is time for them -- and all of us -- to live up to our responsibilities.

Palestinians must abandon violence. Resistance through violence and killing is wrong and it does not succeed. For centuries, black people in America suffered the lash of the whip as slaves and the humiliation of segregation. But it was not violence that won full and equal rights. It was a peaceful and determined insistence upon the ideals at the center of America's founding. This same story can be told by people from South Africa to South Asia; from Eastern Europe to Indonesia. It's a story with a simple truth: that violence is a dead end. It is a sign neither of courage nor power to shoot rockets at sleeping children, or to blow up old women on a bus. That's not how moral authority is claimed; that's how it is surrendered.

Now is the time for Palestinians to focus on what they can build. The Palestinian Authority must develop its capacity to govern, with institutions that serve the needs of its people. Hamas does have support among some Palestinians, but they also have to recognize they have responsibilities. To play a role in fulfilling Palestinian aspirations, to unify the Palestinian people, Hamas must put an end to violence, recognize past agreements, recognize Israel's right to exist.

At the same time, Israelis must acknowledge that just as Israel's right to exist cannot be denied, neither can Palestine's. The United States does not accept the legitimacy of continued Israeli settlements. (Applause.) This construction violates previous agreements and undermines efforts to achieve peace. It is time for these settlements to stop. (Applause.)

And Israel must also live up to its obligation to ensure that Palestinians can live and work and develop their society. Just as it devastates Palestinian families, the continuing humanitarian crisis in Gaza does not serve Israel's security; neither does the continuing lack of opportunity in the West Bank. Progress in the daily lives of the Palestinian people must be a critical part of a road to peace, and Israel must take concrete steps to enable such progress.

And finally, the Arab states must recognize that the Arab Peace Initiative was an important beginning, but not the end of their responsibilities. The Arab-Israeli conflict should no longer be used to distract the people of Arab nations from other problems. Instead, it must be a cause for action to help the Palestinian people develop the institutions that will sustain their state, to recognize Israel's legitimacy, and to choose progress over a self-defeating focus on the past.

America will align our policies with those who pursue peace, and we will say in public what we say in private to Israelis and Palestinians and Arabs. (Applause.) We cannot impose peace. But privately, many Muslims recognize that Israel will not go away. Likewise, many Israelis recognize the need for a Palestinian state. It is time for us to act on what everyone knows to be true.

Too many tears have been shed. Too much blood has been shed. All of us have a responsibility to work for the day when the mothers of Israelis and Palestinians can see their children grow up without fear; when the Holy Land of the three great faiths is the place of peace that God intended it to be; when Jerusalem is a secure and lasting home for Jews and Christians and Muslims, and a place for all of the children of Abraham to mingle peacefully together as in the story of Isra -- (applause) -- as in the story of Isra, when Moses, Jesus, and Mohammed, peace be upon them, joined in prayer. (Applause.)

The third source of tension is our shared interest in the rights and responsibilities of nations on nuclear weapons.

This issue has been a source of tension between the United States and the Islamic Republic of Iran. For many years, Iran has defined itself in part by its opposition to my country, and there is in fact a tumultuous history between us. In the middle of the Cold War, the United States played a role in the overthrow of a democratically elected Iranian government. Since the Islamic Revolution, Iran has played a role in acts of hostage-taking and violence against U.S. troops and civilians. This history is well known. Rather than remain trapped in the past, I've made it clear to Iran's leaders and people that my country is prepared to move forward. The question now is not what Iran is against, but rather what future it wants to build.

I recognize it will be hard to overcome decades of mistrust, but we will proceed with courage, rectitude, and resolve. There will be many issues to discuss between our two countries, and we are willing to move forward without preconditions on the basis of mutual respect. But it is clear to all concerned that when it comes to nuclear weapons, we have reached a decisive point. This is not simply about America's interests. It's about preventing a nuclear arms race in the Middle East that could lead this region and the world down a hugely dangerous path.

I understand those who protest that some countries have weapons that others do not. No single nation should pick and choose which nation holds nuclear weapons. And that's why I strongly reaffirmed America's commitment to seek a world in which no nations hold nuclear weapons. (Applause.) And any nation -- including Iran -- should have the right to access peaceful nuclear power if it complies with its responsibilities under the nuclear Non-Proliferation Treaty. That commitment is at the core of the treaty, and it must be kept for all who fully abide by it. And I'm hopeful that all countries in the region can share in this goal.

The fourth issue that I will address is democracy. (Applause.)

I know -- I know there has been controversy about the promotion of democracy in recent years, and much of this controversy is connected to the war in Iraq. So let me be clear: No system of government can or should be imposed by one nation by any other. That does not lessen my commitment, however, to governments that reflect the will of the people. Each nation gives life to this principle in its own way, grounded in the traditions of its own people. America does not presume to know what is best for everyone, just as we would not presume to pick the outcome of a peaceful election. But I do have an unyielding belief that all people yearn for certain things: the ability to speak your mind and have a say in how you are governed; confidence in the rule of law and the equal administration of justice; government that is transparent and doesn't steal from the people; the freedom to live as you choose. These are not just American ideas; they are human rights. And that is why we will support them everywhere. (Applause.)

Now, there is no straight line to realize this promise. But this much is clear: Governments that protect these rights are ultimately more stable, successful and secure. Suppressing ideas never succeeds in making them go away. America respects the right of all peaceful and law-abiding voices to be heard around the world, even if we disagree with them. And we will welcome all elected, peaceful governments -- provided they govern with respect for all their people.
This last point is important because there are some who advocate for democracy only when they're out of power; once in power, they are ruthless in suppressing the rights of others. (Applause.) So no matter where it takes hold, government of the people and by the people sets a single standard for all who would hold power: You must maintain your power through consent, not coercion; you must respect the rights of minorities, and participate with a spirit of tolerance and compromise; you must place the interests of your people and the legitimate workings of the political process above your party. Without these ingredients, elections alone do not make true democracy.

AUDIENCE MEMBER: Barack Obama, we love you!

PRESIDENT OBAMA: Thank you. (Applause.) The fifth issue that we must address together is religious freedom.

Islam has a proud tradition of tolerance. We see it in the history of Andalusia and Cordoba during the Inquisition. I saw it firsthand as a child in Indonesia, where devout Christians worshiped freely in an overwhelmingly Muslim country. That is the spirit we need today. People in every country should be free to choose and live their faith based upon the persuasion of the mind and the heart and the soul. This tolerance is essential for religion to thrive, but it's being challenged in many different ways.

Among some Muslims, there's a disturbing tendency to measure one's own faith by the rejection of somebody else's faith. The richness of religious diversity must be upheld -- whether it is for Maronites in Lebanon or the Copts in Egypt. (Applause.) And if we are being honest, fault lines must be closed among Muslims, as well, as the divisions between Sunni and Shia have led to tragic violence, particularly in Iraq.

Freedom of religion is central to the ability of peoples to live together. We must always examine the ways in which we protect it. For instance, in the United States, rules on charitable giving have made it harder for Muslims to fulfill their religious obligation. That's why I'm committed to working with American Muslims to ensure that they can fulfill zakat.

Likewise, it is important for Western countries to avoid impeding Muslim citizens from practicing religion as they see fit -- for instance, by dictating what clothes a Muslim woman should wear. We can't disguise hostility towards any religion behind the pretence of liberalism. In fact, faith should bring us together. And that's why we're forging service projects in America to bring together Christians, Muslims, and Jews. That's why we welcome efforts like Saudi Arabian King Abdullah's interfaith dialogue and Turkey's leadership in the Alliance of Civilizations. Around the world, we can turn dialogue into interfaith service, so bridges between peoples lead to action -- whether it is combating malaria in Africa, or providing relief after a natural disaster.

The sixth issue -- the sixth issue that I want to address is women's rights. (Applause.) I know –- I know -- and you can tell from this audience, that there is a healthy debate about this issue. I reject the view of some in the West that a woman who chooses to cover her hair is somehow less equal, but I do believe that a woman who is denied an education is denied equality. (Applause.) And it is no coincidence that countries where women are well educated are far more likely to be prosperous.

Now, let me be clear: Issues of women's equality are by no means simply an issue for Islam. In Turkey, Pakistan, Bangladesh, Indonesia, we've seen Muslim-majority countries elect a woman to lead. Meanwhile, the struggle for women's equality continues in many aspects of American life, and in countries around the world.

I am convinced that our daughters can contribute just as much to society as our sons. (Applause.) Our common prosperity will be advanced by allowing all humanity -- men and women -- to reach their full potential. I do not believe that women must make the same choices as men in order to be equal, and I respect those women who choose to live their lives in traditional roles. But it should be their choice. And that is why the United States will partner with any Muslim-majority country to support expanded literacy for girls, and to help young women pursue employment through micro-financing that helps people live their dreams. (Applause.)

Finally, I want to discuss economic development and opportunity.

I know that for many, the face of globalization is contradictory. The Internet and television can bring knowledge and information, but also offensive sexuality and mindless violence into the home. Trade can bring new wealth and opportunities, but also huge disruptions and change in communities. In all nations -- including America -- this change can bring fear. Fear that because of modernity we lose control over our economic choices, our politics, and most importantly our identities -- those things we most cherish about our communities, our families, our traditions, and our faith.

But I also know that human progress cannot be denied. There need not be contradictions between development and tradition. Countries like Japan and South Korea grew their economies enormously while maintaining distinct cultures. The same is true for the astonishing progress within Muslim-majority countries from Kuala Lumpur to Dubai. In ancient times and in our times, Muslim communities have been at the forefront of innovation and education.

And this is important because no development strategy can be based only upon what comes out of the ground, nor can it be sustained while young people are out of work. Many Gulf states have enjoyed great wealth as a consequence of oil, and some are beginning to focus it on broader development. But all of us must recognize that education and innovation will be the currency of the 21st century -- (applause) -- and in too many Muslim communities, there remains underinvestment in these areas. I'm emphasizing such investment within my own country. And while America in the past has focused on oil and gas when it comes to this part of the world, we now seek a broader engagement.

On education, we will expand exchange programs, and increase scholarships, like the one that brought my father to America. (Applause.) At the same time, we will encourage more Americans to study in Muslim communities. And we will match promising Muslim students with internships in America; invest in online learning for teachers and children around the world; and create a new online network, so a young person in Kansas can communicate instantly with a young person in Cairo.

On economic development, we will create a new corps of business volunteers to partner with counterparts in Muslim-majority countries. And I will host a Summit on Entrepreneurship this year to identify how we can deepen ties between business leaders, foundations and social entrepreneurs in the United States and Muslim communities around the world.

On science and technology, we will launch a new fund to support technological development in Muslim-majority countries, and to help transfer ideas to the marketplace so they can create more jobs. We'll open centers of scientific excellence in Africa, the Middle East and Southeast Asia, and appoint new science envoys to collaborate on programs that develop new sources of energy, create green jobs, digitize records, clean water, grow new crops. Today I'm announcing a new global effort with the Organization of the Islamic Conference to eradicate polio. And we will also expand partnerships with Muslim communities to promote child and maternal health.

All these things must be done in partnership. Americans are ready to join with citizens and governments; community organizations, religious leaders, and businesses in Muslim communities around the world to help our people pursue a better life.

The issues that I have described will not be easy to address. But we have a responsibility to join together on behalf of the world that we seek -- a world where extremists no longer threaten our people, and American troops have come home; a world where Israelis and Palestinians are each secure in a state of their own, and nuclear energy is used for peaceful purposes; a world where governments serve their citizens, and the rights of all God's children are respected. Those are mutual interests. That is the world we seek. But we can only achieve it together.

I know there are many -- Muslim and non-Muslim -- who question whether we can forge this new beginning. Some are eager to stoke the flames of division, and to stand in the way of progress. Some suggest that it isn't worth the effort -- that we are fated to disagree, and civilizations are doomed to clash. Many more are simply skeptical that real change can occur. There's so much fear, so much mistrust that has built up over the years. But if we choose to be bound by the past, we will never move forward. And I want to particularly say this to young people of every faith, in every country -- you, more than anyone, have the ability to reimagine the world, to remake this world.

All of us share this world for but a brief moment in time. The question is whether we spend that time focused on what pushes us apart, or whether we commit ourselves to an effort -- a sustained effort -- to find common ground, to focus on the future we seek for our children, and to respect the dignity of all human beings.

It's easier to start wars than to end them. It's easier to blame others than to look inward. It's easier to see what is different about someone than to find the things we share. But we should choose the right path, not just the easy path. There's one rule that lies at the heart of every religion -- that we do unto others as we would have them do unto us. (Applause.) This truth transcends nations and peoples -- a belief that isn't new; that isn't black or white or brown; that isn't Christian or Muslim or Jew. It's a belief that pulsed in the cradle of civilization, and that still beats in the hearts of billions around the world. It's a faith in other people, and it's what brought me here today.

We have the power to make the world we seek, but only if we have the courage to make a new beginning, keeping in mind what has been written.

The Holy Koran tells us: "O mankind! We have created you male and a female; and we have made you into nations and tribes so that you may know one another."

The Talmud tells us: "The whole of the Torah is for the purpose of promoting peace."

The Holy Bible tells us: "Blessed are the peacemakers, for they shall be called sons of God." (Applause.)

The people of the world can live together in peace. We know that is God's vision. Now that must be our work here on Earth.

Thank you. And may God's peace be upon you. Thank you very much. Thank you. (Applause.)