Transcript: President Bill Clinton at the Campus Progress National Conference, July 6, 2011
PRESIDENT BILL CLINTON: Thank you. Thank you very much. Thank you. Thank you. First, I want to thank Emily for the wonderful introduction and for sticking up for the progressive causes in our native state, which probably went farther from Democrat to Republican in the 2010 than any other state in America. I’m very grateful for her commitment.
I want to thank the wonderful head of the Center for American Progress, my former chief of staff, John Podesta, and David Halperin the director Campus Progress, who was a very able speechwriter for me on foreign policy when I was president. I sort of have to show up when they ask – (laughter) – but I’m very glad to be here.
I want to begin by something that was emphasized in the brief film. Most of the time when I was in politics people debated what are you going to do much money are you going to spend on it. And there wasn’t enough attention given to how are you going to do it so your good intentions actually turn into real changes. And if you don’t think about that, you get in trouble.
For example – and I’ll come back to this in a minute, but I just want to mention it – in the current budget debate there’s all this discussion about how much will come from spending cuts how much will come from tax increases. Almost nobody’s talking about one of the central wants that everyone who’s analyzed this situation makes, including the bipartisan Simpson-Bowles Commission, which said you shouldn’t do any of this until the economy is clearly recovering because if you do things that dampen economic growth – and the UK is finding this out now. They adopted this big austerity budget, and there’s a good chance that economic activity will go down so much that tax revenues will be reduced even more than spending is cut and their deficit will increase. So why are we talking more about the economy and less about this? Partly because the Republicans who control the House and have a lot of votes in the Senate have now decided, having quadrupled the debt in the 12 years before I took office and doubled it after I left, that it’s all of a sudden the biggest problem in the world. (Laughter.)
I’ll come back to that, but I want you to think about it because I hate these deficits. And I was appalled that that was doubled in the eight years after I left office. And I think the condition – the fiscal condition of the country did make us weaker in dealing with the financial crash. I’ll say more about that in a minute. But you have to know about what works and there’s almost no discussion this debate. I read the articles every day about the timing of whatever it is they do and whether it will work or not.
When I left the White House and I started this foundation, a decade ago, I decided to focus on that. I wanted to work on things that I’d cared about when I was president where I could still have an impact. And it seemed to me that I was in a position to try to involve people in answering these how questions.
So for example, the first thing I did was established at the University of Arkansas, but sighted at my presidential library, a school, graduate school which would offer America’s first degree not in public policy but in public service. The students there spend half their time in the field in America and all over the world trying to actually figure out how to solve a particular problem or seize a particular opportunity. And then I got involved in this AIDS work because when I left office, there was relatively small amount of money being spent in the global fight against AIDS.
The United States, the last budget I left I think was for $300 million a year and that was 25 percent of everything that was being spent in the world. But we organized a Global Fund on AIDS, TB, and Malaria. And it was established. Then President Bush came in and passed the PEPFAR program, which I think was his finest achievement, which allocated billions of dollars to the fight against Aids and later malaria.
But anyway, we didn’t have a lot of money, and when I started there were only 200,000 people in poor countries getting medicine necessary to live, something that we had come to take for granted in America. And two-thirds of those people were in Brazil which was a rising economy where the government basically paid for the medicine and they have their own pharmaceutical industry.
We were paying and dupe today about $10,000 a year for standard AIDS treatment to keep people alive. That’s what the medicine that’s given out at my neighborhood clinic Harlem costs.
The generic medicine was about $500 a year. Sounds cheap, but in countries with the per-capita income of less than a dollar a day and an infection rate of 10 percent or higher, it was prohibitively expensive. So basically, when I looked at it and I got some good people in to help me, the AIDS medicine business – and this reflects – I want you to think about this thing when you think about all the things you’re concerned about today – was even $500 a person a year was a high profit margin, low volume, uncertain payment business.
So I went to Canada, Ireland, and then a number of other donors and I said “I want you to promise to fund these programs. I don’t want you to give me the money. I just want you to give me the right to green light the money if I can get a lot of this medicine discount.” And then we went to the producers of the medicine. We said “okay we want you to change your business model from a low volume to a high volume, from a high margin to a low margin, from an uncertain payment to a certain payment business. We’ll help you review the manufacturing processes. We’ll work on your supply chain, and we’ll give you the money promptly. How much will you sell me the medicine for?” We cut from $500 to a $140.
Then – (applause ) – then, children’s medicine, we cut from $600 to $190, and then when we got some serious money in there, we cut the price down to about the old regime which some people still use – we can buy from $90 now in the children’s medicine for $60. Now there’s one pill which is much easier to use which we now have down under $200 from about $700.
The point I want to make is this wasn’t a Republican or Democratic deal, there was X amount of money and a wide number of people who needed the medicine stay alive. Now we’re not where we need to be yet, but now in 70 countries, there are four million people, about half of all the people in poor countries – which is a long way from 200,000 – about half of all people in poor countries on earth getting medicine off these contracts, including about 75 percent of children. And the money made a big difference.
UNITAID, funded primarily by the France Airline tax on overseas flights – it’s one or two Euros – funds the children’s medicine part. But I give you this only as an example. We apply the same theory to trying to lower the cost of new technologies when we got into the climate change business and we’re helping 40 cities around the world to try to reduce their greenhouse gas emissions by not only retrofitting buildings, but changing the street lights and – wherever possible in megacities in developing world, closing landfills, which are huge emitters of methane gas, and which really are gold mines if you think about it. All those urban landfills –you have recyclable glass and plastic and metal and all the rest, the organic material can be turned into fertilizer, and the rest can be turned into electricity.
So we we’re trying to do the same thing. We have doubled, tripled, sometimes even quadrupled income of African farmers in Malawi and Rwanda by lowering the cost of fertilizer and seed, and working out a distribution network, and saving them – half their income by taking their products to market.
But the point is I live in a world now which is very different from the world that I found in Washington, which was very different than the world are lived in when I was a governor.
I remember one day, I had a young man working for me in the White House. He’d been with me for 10 years before in my governorship. And I said – I mentioned some piece was in the paper that was highly critical of me and I asked this guy if he’s read it. He said, yes. I said, what do you think of that piece? He said they’re talking about somebody I’m not familiar with.
The problem with a national political environment is it’s so far removed from real people physically and both – all the players who are trying to get their bite on the evening news or their headline that you tend to lose what really matters, which is how’s all this going to affect us and your future, and people all around the world. So I think first I want to say, whether you like or dislike what’s going on in the government, it’s really important that you spent a lot of your time and attention trying to change the reality on the ground within whatever constraints public policy imposes.
That’s what we do with the Clinton Global Initiative. At the opening of the UN, every year, we bring in business people, philanthropists, government leaders, and NGOs. We fly people in from the poorest countries in the world who are active on the ground doing things, and who don’t have their own money, and we all get together. And instead of giving speeches, everybody just has a conversation and makes a commitment. And in the last six years, those commitments have already measurably improved the lives of 300 million people in 180 countries, just by asking people to do it.
We have one for university students every year. And university students, as you know, don’t have a lot of money – (laughter) – but very often they have the best ideas.
Last year’s to students at Berea College – anybody here from Berea? Fascinating. Berea College was established before the Civil War, in Kentucky, 1855, a university then open to women, which was a radical idea at the time and also available to African-Americans. And they have very low tuition. All the students work on campus. But two students decided that they would go out into their neighborhood in eastern Kentucky, which is hilly and it’s part of Appalachia, and do free energy audits. So they’re doing it, and we found out that they can actually save these poor people a lot of money for almost no investment.
Another student University of California, San Diego, realized that there were huge numbers of students who weren’t even aware of all the tax credits they were entitled to, some of which were passed when I was president, and so he decided – he calculated that if there was 100 percent knowledge – and I’m going to come back to this in a minute, remember this – if there was 100 percent knowledge of all the students at the University of California, San Diego, of every form of student aid they could access, they would save two and a half million dollars a year just on the campus.
So I believe in all this and I think you have to have – you can’t get discouraged when the politics are going in a direction you don’t like. You have to keep fighting against the things you don’t like, but also find something to do that you do like. It’s very important in life not just to be against a tad that you oppose, but also to make something good happen because every time you make something good happen, it gives weight to your position on these political issues. That’s why I think one of the most important bills I ever signed was the bill creating AmeriCorps – 700,000 plus young people now have done work all over America – (applause) – and they made a big difference.
So that brings me down to this current moment and your topic, which is neat twist on the old speak truth to power, turning truth to power. You cannot turn truth into power unless you have it in the first place, beginning with basic facts. So for example, we have this current political drama playing out in Washington over the budget. What do you want America to look like in the 21st century anyway? That’s – the decisions you make on the budget should be informed by the life you want to live.
When you’re 30, when you’re 40, when you’re 50, what do you want America to be like? When you have children who are in these chairs, what do you want to be like? President Obama has a vision of an economy that works for everybody, that is modern and sustainable, and offers shared opportunities, a vision of government and society that involves shared responsibilities, not specific benefits nearly as much as everybody pitching in and doing what they’re supposed to do to create the government we need to have for a structure of opportunity an empowerment to take hold in America. And he has a vision of community that makes the most of America’s greatest asset: our diversity. That’s why he and I passionately believe in the DREAM Act.
I can’t – I don’t understand – (applause) – think we’re better off with more immigrants not fewer, so I don’t understand all that, but anyway – (applause) – the main thing I want to say is – that’s why he believes in gay rights, that’s why I was proud of my – (applause) – I was immensely proud of my – another of my former administration members, my former HUD secretary, now the governor of New York, for passing the Gay Marriage Bill just because (applause) – I think – (applause) – if you look at the story of America, we had a lot of speeches –I bet on the Fourth of July – that politics is always taking hold of about what America means and what the (intent ?) of the framers was and all of that. The Declaration of Independence gave America a permanent mission. The framers pledged their lives, their fortunes, their sacred honor to form a more perfect union. That’s 18th century speak.
In 21st century slang what that means is hey we’re not perfect, we’re never going to be perfect, but we can always do better. And our job is to keep doing better, to keep stumbling in the right direction. Or in the words of Martin Luther King, “the arc of history is long, but it bends toward justice.” Our job is to make sure the arc bends in the right direction.
And when I was president, I used to tell people all the time, to me, forming a more perfect union means widening the circle of opportunity, deepening the meaning of freedom, and strengthening the bonds of community. And it requires all of us to keep growing and learning and embracing.
Several years ago, a man named Robert Wright, wrote a book called Nonzerothat had a big influence on me, also wrote a book called The Moral Animal, and what he meant by that was not moral in the traditional sense, he meant socially ethical, that people wanted to be cooperative and needed to work together.
Nonzero’s central argument is this that ever since the first people rose up on the African savannah, approximately 150,000 years ago, there has been a constant need to redefine who is us and who is the. And the definition of us has gotten bigger and bigger and bigger. That’s the only thing that’s kept humanity from destroying itself. And the only way you can make a bigger definition of us is to have competition and cooperation in a way that, in the words of – in game theory terms, allows nonzero sum games. A zero sum game is what we Americans lose – love. There has to be a winner. There has to be a loser.
So I love March madness every year and I love the Big East Basketball Tournament – (applause) – a couple years ago – (applause) – a couple years ago two of our teams played six overtimes. They were so exhausted they weren’t very competitive in the NCAA, but we insisted that they play till they dropped.
And my native state – the University of Arkansas was involved with Kentucky a few years ago in a football game that went to six overtimes, and the score was 71 to 63. It sounds like basketball. That’s a nonzero sum game. It’s fun to watch, but it’s not a good model for the way society has to work. We have to find a way to have enough competition to keep creativity alive, but we don’t require there to be a lot of losers.
Now, what does that mean for where we are now? In contrast to the vision the president has laid out of shared prosperity and shared responsibilities and a deeply widening community, the current governing philosophy of the Republicans in Congress it’s that America would be just fine if we could weaken the government more. The government is the source of all of our problems. There’s no such thing as a good tax, no such thing as a bad tax cut, no such thing as a good regulation, no such thing as a bad deregulation. And all these programs are a waste of money and time, beginning with the stimulus.
This idea that the government is the source of all America’s problems would strike the founding fathers as passing strange, but it has had a great hold on America’s since the election in 1980. So let’s look at this. Let’s just take a little walk down memory lane, and realize you can’t turn truth to power unless people know.
Let’s begin with something recent. In the 2010 election, the Democrats took a terrible whipping. We were always going to lose number of seats for two reasons. First, people only hired the Democrats in the last 30 years when things are messed up – (laughter) – so they hired me in ’92 – (laughter) – and they hired President Obama in 2008. And then – so they want us to fix them, and in 1994 and 2010, things didn’t feel fixed. It’s hard to fix things that were messed up over a longer period of time, but people didn’t feel fixed, and we had a lot of what you might call “soft seats,” that is seats we had picked up because of bad economic conditions in 2006 and 2008. But the election results were more adverse to the Democrats than they would have been, I believe, if voters had known basic facts.
And so before we blame them, those of us who did know have to blame ourselves because the American people make rational decisions based on what they know. If they don’t know – you can’t turn truth into power if the ultimate holders of power, the citizens themselves, don’t know the facts.
So for example, everybody knows the stimulus was a failure, except it wasn’t. The hole blown on the economy was about $3 trillion deep. The stimulus was $800 billion. Even Albert Einstein himself couldn’t fill a $3 trillion hole with $800 billion, first.
Second, this stimulus was designed to put a floor in that hole, and it worked. Thirty six percent of the stimulus money went to a tax cut to 95 percent of the American people. Most Americans voted on Election Day not knowing they had received that tax cut. Why? Because it was given out in the most economically effective way by cutting the payroll tax by about $800, I think, for family. And the Republicans didn’t consider tax cuts since the top 5 percent didn’t get theirs. (Laughter.) True. Now, wait a minute. I want you to laugh, but it’s serious. (Laughter.) The most important thing in the world for me, as someone who now makes money that’s – I never dreamed I’d make was I got my five tax cuts or whatever under President Bush. You know, I made out like a bandit. I should have changed parties. (Laughter.) But it didn’t seem to me to work.
But the American people didn’t know that. They didn’t know that another 30 percent of the money went to state and local governments to try to keep them having to lay off a million teachers and police officers and health care workers. Now that the stimulus has played out, you might be interested to know, since the economy is not fully recovered, that one of the things keeping unemployment high in America today is declining payrolls this year at the state and local government level of about a million, which will have, among other things, I think quite adverse impacts on our schools.
So only about a third of that money, even less, was spent to create jobs, a lot of it in green energy and manufacturing. Then there was the automobile restructuring, which was not a bailout. It says we’ll give you aid in return for restructuring.
So let’s just look at what happened that people didn’t know. As of last November, America’s automobile industry was coming back and we had 70,000 more people working in the automobile industry. And if they had all been allowed to fail, there’d be at least another million people out of work when you think of the parts suppliers, the people running the dealerships, and all those things.
More important – listen to this – when Barack Obama took office as president, the United States had exactly 2 percent of the market for these high-powered batteries that are necessary to run hybrid electric and all electric cars. Because the Democratic Congress had previously provided a tax credit, after they won in 2007 – when they took office in 2007 – for new green manufacturing jobs, and then, in 2009, it was turned into – for startups the cash equivalent of the tax credit. That is you don’t need a tax credit if you just started your business. You have no income against which to claim a credit. So they want to accelerate the growth of this new manufacturing. So they said, okay, you can get the cash equivalent of it.
On election day, America had 20 percent of the world market – from two to twenty in less than two years, with 30 new factories built or under construction, 18 in Michigan, with the second highest unemployment rate in the country and – (applause) – but it was a secret to most voters. If you knew it and you didn’t tell people, you’re part of the problem. Would it have reversed the aggregate results? No, but it would change a lot of particular elections? Absolutely.
Now, let’s go to something that everybody said that the Tea Party says they hated the bailout. They all say we got organized according to bailout, waste of government money. Well, there’s a reason that John McCain and Barack Obama, then both senators voted for the bailout, which was wildly unpopular and they didn’t want to do it. It is not because of Wall Street. It was because of Main Street. The biggest car dealership in the country, it stopped financing cars, was about to get to the point where you couldn’t go to Sears and buy any kind of appliance on credit. The financial system had to be saved. But we don’t want to go there again.
So most people didn’t know this. They said we hate these bailouts. So Democrats passed a financial reform bill, which gave the government power, that over some transactions it did not have, to stop excessive leverage, that is to stop companies from making too many investments if they didn’t have the cash to cover. Traditional banks, for example, would own $10 for every dollar in cash they had.
When Bear Stearns failed, that was leveraged at $34 to one, Lehman Brothers about $30 one. Now, the government can stop that and has instructed to stop that. That’s what’s really in the finance reform bill. And it says and by the way, if somehow they get around us and they fail again, no more bailouts. Here’s an orderly procedure for bankruptcy, so the management and the shareholders have to eat the loss. In other words, the Democrats have passed a bill which was designed to prevent future meltdowns and future bailouts, and people were going in voting against them thinking they were the bailout party.
Then there was – they cut Medicare, remember that one? That’s the most interesting thing of all. The Republicans ran to the left of the Democrats on Medicare till I got in. They didn’t – what they did was to reduce the amount of increase given to certain Medicare services – particularly, the Medicare Advantage Program, which is a private company insurance managed program – and use the money to close the donut hole in the senior citizens drug program, and to add years to the life of the Medicare Trust Fund, but nobody knew it.
And now to your business, one of most important bills the president signed and he supported and Secretary of Education Arne Duncan supported was a bill that radically reformed the Student Loan Program, by making a national system out of what I was able only to make voluntary for schools when I was president and then the Bush administration didn’t like it, so nothing happened to it.
The Student Loan Program used to work like this. Students would qualify for loans. They’d get the loans from banks. The government would guarantee 95 percent of the loan. The new program works like this. The government sets aside a reserve, loans the money direct to the schools, and then to the students, so that the interest rates are lower, first. Secondly, every student in America will now have the option of repaying their student loan as a small fixed percentage of their income for up to 20 years. This is huge. This means nobody ever has to drop out of college again because of the cost. Nobody ever has to be afraid to take out another loan, and when you get out of school, if you want to take a couple years to do a public service related job, if you want to be a teacher or go into some other kind of community service, your loan obligation will be determined by your job not the other way around.
This is a massive thing and (tabooed ?). It saved $60 billion dollars in government subsidies to banks, $40 billion of which are put into guaranteeing for the next decade, the Pell grants, and work-study programs, and everything else keeps up with inflation, the other $20 reduces the deficit by $20 billion dollars.
The Republicans proposed to repeal that. They were really honest about it, you know, bank reform their money back. But at a time when America already, in the last decade, for the first time since World War II, dropped from first to ninth in the percentage of young adults with four-year college degrees, a calamitous development, even though we’re still first in the percentage of young people going to college, what does that tell you about the impact of cost? They actually won seats in Congress saying, hey, vote for us. I’m going to make the student loans more expensive and harder to repay, and by the way, I’m going to increase the deficit. (Laughter.) Why? Because nobody knew. You cannot turn truth into power if you do not know. So you got to do more to connect the dots.
I remember in the election all things are said about the health care reform, they called it ObamaCare. They said oh, this is terrible. It’s going to cause private employers to drop coverage, even though most private employers would be much better off under this law and small businesses get substantial subsidies to offer coverage. And in 2010, in the election, the insurance companies – in the election year – raised – the private insurance companies, for-profits – raised the premiums through the roof, and they said “oh, we hate to do this. We’re so sorry. We know the economy is in bad shape, but this ObamaCare, it’s so uncertain. We have to build up a big reserve here.
And no one pointed out, even though it came out at the end of the election. Finally they filed the financials for 2009, when there was ObamaCare, when the recession was at its depth. You know what happened, 2009? The for-profit insurance companies, health insurance companies’ profits increased in that horrible year 26 percent. They raised rates through the roof, causing five million Americans under the old system to lose their health care, three million of them went on the state Medicaid program, which ballooned the deficits of both the federal and state governments, but nobody knew.
You cannot turn truth into power if you don’t have the facts and people don’t connect the dots. Now, I didn’t think that health care reform bill was perfect and some changes need to be made. Already bipartisan votes have cleaned up some of the small business reporting requirements. But the real reason that there was such a passionate desire to repeal that 1,100 page bill is one line, which said that from now on, if you’re in a big insurance company plan, 85 five cents of every dollar you pay has to go to your health care and not profits or promotion. If you’re in a small pool, give them a bigger margin – 80 percent.
Now, ask yourself whether you saw this. About three weeks ago, I saw a small article in the paper which said America’s largest insurance company and one of its best, Aetna, had filed a petition in Connecticut where it’s headquartered, with the commissioner of insurance to lower health insurance rates 10 percent across the board because of the 85 percent requirement. In other words, it is going to work, and still nobody knows it.
So we spend too much time majoring in the minors. I want you to serve. I want you to answer the how questions. I want you to a lobby for the things you clap for like the DREAM Act. But this economy is fragile. We cannot go another decade continuing to fall in the percentage of our young people with college degrees. We have to implement this student loan program, and then 100 percent of the people have to know about it. You have to know.
And here’s what I want to say about this whole budget debate and the government would mess up a two-car parade and all taxes are bad. There is not a single example today of a really successful wealthy country that does not have both a vibrant economy and a strong effective government. Not one, not anywhere.
This political and economic theory – I saw one columnist called it faith-based – that the Republicans have caused, it means I just believe this way and the evidence is irrelevant. It must be wrong. (Laughter.) But just – (applause) – let’s just look at the evidence.
In 1980, we embraced this theory – the government would mess up a two-car parade. And President Reagan was good at – you know – he could make you laugh, and he also was more ideological rhetorically than practically. Otherwise the debt being bigger than it is. They restored about – he signed bills restoring about 6 – 40 percent of the money that was given out in tax cuts, in 1981.
But we began to do something we’d never done before as a country, ever. We began to run large structural deficits in good times and bad. And you can say, oh well, President Reagan had a Democratic Congress. That’s true, but – and there were Democrats who voted for all the spending and the tax cuts, but it’s also true that the Congress actually appropriated slightly less money than the administration asked for in those eight years.
And it worked pretty well to generate a lot of jobs in beginning because it was like – unlike President Obama’s program; it wasn’t eight-year long stimulus. But it started to play out and then it produced almost no new jobs in President Bush’s term, which is how I got elected. (Laughter.) And I don’t mean that – funny, you know, I – I like, admire, and love him. He’s a good man. And when he said it was voodoo economics, in 1980, he was right and he had to pay the price.
You can’t run a structural deficit without paying the price. Eventually interest rates got so high, cratered the economy, and I could come in and begin to balance the budget right away and cut that deficit because I knew it would lower interest rates and investment would pick up, and we’d be off to the races.
Then I left off and – of one of the things that was really helpful in all this was a rule called pay as you go which the Democratic Congress adopted and President Bush signed, to his credit, right before I got elected, which said if you want to start a new program, you got to stop something you’re doing or come up with the money to pay for it. So after I left office, a lot of these same people who don’t want to raise the debt ceiling now, what’s the first thing they did? They let the pay as you go rule expire. And they voted for eight years to raise the debt ceiling and double the debt of the country. So how’s it working? Well, there were – 12 years before and eight years after the time I served, how’s it working? More jobs in those eight years and in the 20 years combined, 100 times as many people moved out of poverty in those eight years than in the 20 years combined, more new business formation, every other indicator. And the only four surpluses we’ve had since 1969 and the first time we had four in a row in more than 70 years.
So this is not about whether you’re fiscally conservative or not. This is about what works. This theory won’t work, and that’s why the president has been resisting it.
From World War II to 1980, constantly, the bottom 90 percent of us took home 65 percent of national income. The top 10 percent of us took home 35 percent, the top 1 percent 9 percent. That was enough inequality to reward hard work creativity and good ideas. Look how it’s changed since 1980 under the alternative theory. The bottom 90 percent share of national income has dropped from 65 to 52 percent. The top 10 percent has gone from 65 to 48 percent. The top 1 percent has gone to 22 percent.
Now, that happened for two reasons. One is the government is the problem reason. The other is something had happened outside government. I guess – I’m so old, I can’t believe it. I get my Medicare card this year. (Laughter.) But – I’m about the last generation of people who could have gotten an MBA, and I saw you were discussing the Citizens United case before – when I was in law school, and if I had been in business school, we were taught that corporations were creations of the state and that in return for their privileges, they had certain responsibilities, and they had responsibilities to all their stakeholders, their shareholders, their employees, their customers, and the communities of which they were a part. For about 30 years coincident with “the government is the problem” theory in government, we’ve been told that corporations’ only responsibilities are to their shareholders. Those two ideas together have produced a combustible and unsustainable amount of inequality in America. And if you want to live in a country where people like Emily middle class kids, and people like you, have a fair shot of the American dream, we have to re-examine them both.
Professor Michael Porter at Harvard Business School, a distinguished Republican I’ve known for many years, who’s done great work to promote development in the inner cities, has a cover story, he (followed up ?) on the internet and two editions back I think of the Harvard Business Journal, saying that we have to change our notion of corporations exist for shareholder values to corporations exist to advance shared values. We have to – there has to be a mission which involves sharing, another nonzero sum game.
So that’s what I want to say. It’s not true the government will mess up a two-car parade. I’ll give you just one example. Medicare is the biggest driver of the federal deficit – Medicare and Medicaid – but that’s because health care costs tripled in the 12 years from 1981 and 1993 and we kept – tripled over the rate of inflation – we kept them or less in line with inflation. And then they tripled again.
In that context, here’s the problem with just cutting Medicare and giving everybody a voucher. Medicare is actually a better value than the rest of health care. Since 1970, Medicare costs per recipient have gone up 400 percent. Private insurance premiums have gone up 700 percent. The health care system is not competitive. We spend 17.2 percent of our income on health care. No other wealthy country spends more than 10.5 of any size as Canada. Everybody else is between 9 and 10.5. And it’s because of the way we deliver and pay for health care, paying for procedure instead of care, and because of the way we administer it through our health insurance system, which means 30 cents on the dollar goes to paperwork. That’s 11 cents more than any other system in the world. That’s $200 and some billion a year right there.
It’s $1 trillion a year that could be invested in education, in green technology, in paying down the debt, and all this other stuff. We cannot continue this.
But I’ll just give you an example of why the government has to play a role in that somehow Medicare costs can be brought in line with inflation only as health care costs are. We have known now for a few years that thousands of people die every year at the cost of tens of billions of dollars from hospital acquired infections. And many thousands of others have to come back to the hospital to get fixed again. And the primary purpose is – the primary cause of this is the lack of adequate, rigorous sterilization procedures at every step along the hospital stay.
Atul Gawande, who was the White House fellow under me, and it’s a – literally a brain surgeon who writes a lot on health care – has written a book on this called The Checklist Manifesto. You can read it in an hour, an hour and a half. You ought to read it. And he points out that if you just – if you put a nurse in charge of the doctors and everybody else, it’s four, five critical junctures in this – the journey to a hospital. You can take this infection, the death rate, and the tens of millions of dollars out of the system. Guess which hospital network was the very first in America to rigorously implement this? The VA hospital system. It’s not true. That’s a government system. The government would mess up a two-car parade. But nobody knows it.
So I say this to encourage your activism but to say your activism has to include sharing what you know with your generation. I can’t help thinking, since we just celebrated the 4th of July, and we’re supposed to be a country dedicated to liberty, that one of the most pervasive political movements going on outside Washington today is the disciplined, passionate, determined effort of Republican governors and legislators to keep most of you from voting next time.
There has never been in my lifetime, since we got rid of the poll tax and all the other Jim Crow burdens on voting, the determined effort to limit the franchise that we see today. Getting rid of same day registration, some states getting rid of all advance voting. The governor of Florida proposed to reverse his Republican predecessors signing of a bill that gave people the right to vote when they’d gotten out of prison and they’d finish their probation period, even if they didn’t have a pardon. That’s one of the most important things we can do. Why should we disenfranchise people forever once they paid their price? Because most of them in Florida were African-Americans and Hispanics and would tend to vote for Democrats. That’s why.
Why do we want to get rid of self – same day registration? Why has New Hampshire made it almost impossible for college students who live in other states – come from other states, but live in New Hampshire most of the year, to vote there? Why is all this going on? This is not rocket science. They are trying to make the two 2012 electorate look more like the two 2010 electorate then the 2008 electorate.
Constitutional right to vote, the need to empower, the need to widen the circle of opportunity – sounds good, but if you lose a right to vote, it doesn’t amount to much. Are you fighting? You should be fighting.
I think there’s a good chance the New Hampshire is unconstitutional because of the case in the ’70 involving Vanderbilt, which gave students the constitutional right to vote where they reside most of the year. But the larger point I want to make is this. Most of my life has nothing to do with any of this.
My life is my foundation and the Global Initiative and trying to get people involved in doing affirmative things. But in every place I work – and I don’t go in any country unless the government welcomes our foundation – I see what a difference a government makes, a good one or a bad one, a competent one or one lacking in capacity. In our country, you have to both serve and be a good citizen. In fact, I think being a good citizen requires service, but it also requires knowledge. If you’re serious about turning truth to power, remember this. It begins with knowing. It begins with knowing.
There is too much we don’t know and too much we know we don’t share. You cannot blame citizens for mistakes they make for what they don’t know. Most people do not have the time or the space, the emotional or financial or practical space that you have at this moment in your lives to know. So make sure you know and make sure you share.
Thank you and good luck. God bless you. (Applause.) Thank you. Thank you.
(END)
Transcript provided by DC Transcription.
