John McCain Health Care Agenda VIDEO

Remarks By John McCain On Health Care On Day Two Of The "Call To Action Tour" FULL STREAMING VIDEO ARLINGTON, VA -- U.S. Senator John McCain delivered the following remarks as prepared for delivery at the University of South Florida -- Lee Moffitt Cancer Center & Research Institute, in Tampa, FL, April 29, 2008 at 10:00 a.m. EDT:

Thank you. I appreciate the hospitality of the University of South Florida, and this opportunity to meet with you at the Moffitt Cancer Center and Research Institute. Speaker Moffitt, Dr. Dalton, Dean Klasko, thank you for the invitation, and for your years of dedication that have made this campus a center of hope for cancer victims everywhere. It's good to see some other friends here, including your board member and my friend and former colleague Connie Mack. And my thanks especially to the physicians, administrators, and staff of this wonderful place.

Sometimes in our political debates, America's health-care system is criticized as if it were just one more thing to argue about. Those of you involved in running a research center like this, or managing the children's hospital that I visited yesterday in Miami, might grow a little discouraged at times listening to campaigns debate health care. But I know you never lose sight of the fact that you are each involved in one of the great vocations, doing some of the greatest work there is to be done in this world. Some of the patients you meet here are in the worst hours of their lives, filled with fear and heartache. And the confident presence of a doctor, the kind and skillful attentions of a nurse, or the knowledge that researchers like you are on the case, can be all they have to hold onto. That is a gift only you can give, and you deserve our country's gratitude.

I've had a tour here this morning, and though I can't say I absorbed every detail of the research I certainly understand that you are making dramatic progress in the fight against cancer. With skill, ingenuity, and perseverance, you are turning new technologies against one of the oldest enemies of humanity. In the lives of cancer patients, you are adding decades where once there were only years, and years where once there were only months. You are closing in on the enemy, in all its forms, and one day you and others like you are going to save uncounted lives with a cure for cancer. In all of this, you are showing the medical profession at its most heroic.

In any serious discussion of health care in our nation, this should always be our starting point -- because the goal, after all, is to make the best care available to everyone. We want a system of health care in which everyone can afford and acquire the treatment and preventative care they need, and the peace of mind that comes with knowing they are covered. Health care in America should be affordable by all, not just the wealthy. It should be available to all, and not limited by where you work or how much you make. It should be fair to all; providing help where the need is greatest, and protecting Americans from corporate abuses. And for all the strengths of our health-care system, we know that right now it falls short of this ideal.

Some 47 million individuals, nearly a quarter of them children, have no health insurance at all. Roughly half of these families will receive coverage again with a mother or father's next job, but that doesn't help the other half who will remain uninsured. And it only draws attention to the basic problem that at any given moment there are tens of millions of Americans who lost their health insurance because they lost or left a job.

Another group is known to statisticians as the chronically uninsured. A better description would be that they have been locked out of our health insurance system. Some were simply denied coverage, regardless of need. Some were never offered coverage by their employer, or couldn't afford it. Some make too little on the job to pay for coverage, but too much to qualify for Medicaid or other public programs. There are many different reasons for their situation. But what they all have in common is that if they become ill, or if their condition gets worse, they will be on their own -- something that no one wants to see in this country.

Underlying the many things that trouble our health care system are the fundamental problems of cost and access. Rising costs hurt those who have insurance by making it more expensive to keep. They hurt those who don't have insurance by making it even harder to obtain. Rising health care costs hurt employers and the self-employed alike. And in the end they threaten serious and lasting harm to the entire American economy.

These rising costs are by no means always accompanied by better quality in care or coverage. In many respects the system has remained less reliable, less efficient, more disorganized and prone to error even as it becomes more expensive. It has also become less transparent, in ways we would find unacceptable in any other industry. Most physicians groups and medical providers don't publish their prices, leaving Americans to guess about the cost of care, or else to find out later when they try to make sense of an endless series of "Explanation of Benefits" forms.

There are those who are convinced that the solution is to move closer to a nationalized health care system. They urge universal coverage, with all the tax increases, new mandates, and government regulation that come along with that idea. But in the end this will accomplish one thing only. We will replace the inefficiency, irrationality, and uncontrolled costs of the current system with the inefficiency, irrationality, and uncontrolled costs of a government monopoly. We'll have all the problems, and more, of private health care -- rigid rules, long waits and lack of choices, and risk degrading its great strengths and advantages including the innovation and life-saving technology that make American medicine the most advanced in the world.

The key to real reform is to restore control over our health-care system to the patients themselves. Right now, even those with access to health care often have no assurance that it is appropriate care. Too much of the system is built on getting paid just for providing services, regardless of whether those services are necessary or produce quality care and outcomes. American families should only pay for getting the right care: care that is intended to improve and safeguard their health.

When families are informed about medical choices, they are more capable of making their own decisions, less likely to choose the most expensive and often unnecessary options, and are more satisfied with their choices. We took an important step in this direction with the creation of Health Savings Accounts, tax-preferred accounts that are used to pay insurance premiums and other health costs. These accounts put the family in charge of what they pay for. And, as president, I would seek to encourage and expand the benefits of these accounts to more American families.

Americans need new choices beyond those offered in employment-based coverage. Americans want a system built so that wherever you go and wherever you work, your health plan is goes with you. And there is a very straightforward way to achieve this.

Under current law, the federal government gives a tax benefit when employers provide health-insurance coverage to American workers and their families. This benefit doesn't cover the total cost of the health plan, and in reality each worker and family absorbs the rest of the cost in lower wages and diminished benefits. But it provides essential support for insurance coverage. Many workers are perfectly content with this arrangement, and under my reform plan they would be able to keep that coverage. Their employer-provided health plans would be largely untouched and unchanged.

But for every American who wanted it, another option would be available: Every year, they would receive a tax credit directly, with the same cash value of the credits for employees in big companies, in a small business, or self-employed. You simply choose the insurance provider that suits you best. By mail or online, you would then inform the government of your selection. And the money to help pay for your health care would be sent straight to that insurance provider. The health plan you chose would be as good as any that an employer could choose for you. It would be yours and your family's health-care plan, and yours to keep.

The value of that credit -- 2,500 dollars for individuals, 5,000 dollars for families -- would also be enhanced by the greater competition this reform would help create among insurance companies. Millions of Americans would be making their own health-care choices again. Insurance companies could no longer take your business for granted, offering narrow plans with escalating costs. It would help change the whole dynamic of the current system, putting individuals and families back in charge, and forcing companies to respond with better service at lower cost.

It would help extend the advantages of staying with doctors and providers of your choice. When Americans speak of "our doctor," it will mean something again, because they won't have to change from one doctor or one network to the next every time they change employers. They'll have a medical "home" again, dealing with doctors who know and care about them.

These reforms will take time, and critics argue that when my proposed tax credit becomes available it would encourage people to purchase health insurance on the current individual market, while significant weaknesses in the market remain. They worry that Americans with pre-existing conditions could still be denied insurance. Congress took the important step of providing some protection against the exclusion of pre-existing conditions in the Health Insurance Portability and Accountability Act in 1996. I supported that legislation, and nothing in my reforms will change the fact that if you remain employed and insured you will build protection against the cost of treating any pre-existing condition.

Even so, those without prior group coverage and those with pre-existing conditions do have the most difficulty on the individual market, and we need to make sure they get the high-quality coverage they need. I will work tirelessly to address the problem. But I won't create another entitlement program that Washington will let get out of control. Nor will I saddle states with another unfunded mandate. The states have been very active in experimenting with ways to cover the "uninsurables." The State of North Carolina, for example, has an agreement with Blue Cross to act as insurer of "last resort." Over thirty states have some form of "high-risk" pool, and over twenty states have plans that limit premiums charged to people suffering an illness and who have been denied insurance.

As President, I will meet with the governors to solicit their ideas about a best practice model that states can follow -- a Guaranteed Access Plan or GAP that would reflect the best experience of the states. I will work with Congress, the governors, and industry to make sure that it is funded adequately and has the right incentives to reduce costs such as disease management, individual case management, and health and wellness programs. These programs reach out to people who are at risk for different diseases and chronic conditions and provide them with nurse care managers to make sure they receive the proper care and avoid unnecessary treatments and emergency room visits. The details of a Guaranteed Access Plan will be worked out with the collaboration and consent of the states. But, conceptually, federal assistance could be provided to a nonprofit GAP that operated under the direction of a board that i ncluded all stakeholders groups -- legislators, insurers, business and medical community representatives, and, most importantly, patients. The board would contract with insurers to cover patients who have been denied insurance and could join with other state plans to enlarge pools and lower overhead costs. There would be reasonable limits on premiums, and assistance would be available for Americans below a certain income level.

This cooperation among states in the purchase of insurance would also be a crucial step in ridding the market of both needless and costly regulations, and the dominance in the market of only a few insurance companies. Right now, there is a different health insurance market for every state. Each one has its own rules and restrictions, and often guarantees inadequate competition among insurance companies. Often these circumstances prevent the best companies, with the best plans and lowest prices, from making their product available to any American who wants it. We need to break down these barriers to competition, innovation and excellence, with the goal of establishing a national market to make the best practices and lowest prices available to every person in every state.

Another source of needless cost and trouble in the health care system comes from the trial bar. Every patient in America must have access to legal remedies in cases of bad medical practice. But this vital principle of law and medicine is not an invitation to endless, frivolous lawsuits from trial lawyers who exploit both patients and physicians alike. We must pass medical liability reform, and those reforms should eliminate lawsuits directed at doctors who follow clinical guidelines and adhere to patient safety protocols. If Senator Obama and Senator Clinton are sincere in their conviction that health care coverage and quality is their first priority, then they will put the needs of patients before the demands of trial lawyers. They can't have it both ways.

We also know from experience that coordinated care -- providers collaborating to produce the best health outcome -- offers better quality and can cost less. We should pay a single bill for high-quality disease care, not an endless series of bills for pre-surgical tests and visits, hospitalization and surgery, and follow-up tests, drugs and office visits. Paying for coordinated care means that every single provider is now united on being responsive to the needs of a single person: the patient. Health information technology will flourish because the market will demand it.

In the same way, clinics, hospitals, doctors, medical technology producers, drug companies and every other provider of health care must be accountable to their patients and their transactions transparent. Americans should have access to information about the performance and safety records of doctors and other health care providers and the quality measures they use. Families, insurance companies, the government -- whoever is paying the bill -- must understand exactly what their care costs and the outcome they received.

Families also place a high value on quickly getting simple care, and have shown a willingness to pay cash to get it. If walk-in clinics in retail outlets are the most convenient, cost-effective way for families to safely meet simple needs, then no policies of government should stand in their way. And if the cheapest way to get high quality care is to use advances in Web technology to allow a doctor to practice across state lines, then let them.

As you know better than I do, the best treatment is early treatment. The best care is preventative care. And by far the best prescription for good health is to steer clear of high-risk behaviors. The most obvious case of all is smoking cigarettes, which still accounts for so much avoidable disease. People make their own choices in this country, but we in government have responsibilities and choices of our own. Most smokers would love to quit but find it hard to do so. We can improve lives and reduce chronic disease through smoking cessation programs. I will work with business and insurance companies to promote the availability and use of these programs.

Smoking is just one cause of chronic diseases that could be avoided or better managed, and the national resources that could be saved by a greater emphasis on preventative care. Chronic conditions -- such as cancer, heart disease, high blood pressure, diabetes and asthma -- account for three-quarters of the nation's annual health-care bill. In so many cases this suffering could be averted by early testing and screening, as in the case of colon and breast cancers. Diabetes and heart disease rates are also increasing today with rise of obesity in the United States, even among children and teenagers. We need to create a "next generation" of chronic disease prevention, early intervention, new treatment models and public health infrastructure. We need to use technology to share information on "best practices" in health care so every physician is up-to-date. We need to adopt new treatment programs and fi nancial incentives to adopt "health habits" for those with the most common conditions such as diabetes and obesity that will improve their quality of life and reduce the costs of their treatment.

Watch your diet, walk thirty or so minutes a day, and take a few other simple precautions, and you won't have to worry about these afflictions. But many of us never quite get around to it, and the wake-up call doesn't come until the ambulance arrives or we're facing a tough diagnosis.

We can make tremendous improvements in the cost of treating chronic disease by using modern information technology to collect information on the practice patterns, costs and effectiveness of physicians. By simply documenting and disseminating information on best practices we can eliminate those costly practices that don't yield corresponding value. By reforming payment systems to focus on payments for best practice and quality outcomes, we will accelerate this important change.

Government programs such as Medicare and Medicaid should lead the way in health care reforms that improve quality and lower costs. Medicare reimbursement now rewards institutions and clinicians who provide more and more complex services. We need to change the way providers are paid to focus their attention more on chronic disease and managing their treatment. This is the most important care for an aging population.

There have been a variety of state-based experiments such as Cash and Counseling or The Program of All-Inclusive Care for the Elderly (PACE) that are different from the inflexible approaches for delivering care to people in the home setting. Seniors are given a monthly allowance that they can use to hire workers and purchase care-related services and goods. They can get help managing their care by designating representatives, such as relatives or friends, to help make decisions. It also offers counseling and bookkeeping services to assist consumers in handling their programmatic responsibilities.

In these approaches, participants were much more likely to have their needs met and be satisfied with their care. Moreover, any concerns about consumers' safety appear misplaced. For every age group in every state, participants were no more likely to suffer care-related health problems.

Government can provide leadership to solve problems, of course. So often it comes down to personal responsibility -- the duty of every adult in America to look after themselves and to safeguard the gift of life. But wise government policy can make preventative care the standard. It can put the best practices of preventative care in action all across our health-care system. Over time that one standard alone, consistently applied in every doctor's office, hospital, and insurance company in America, will save more lives than we could ever count. And every year, it will save many billions of dollars in the health-care economy, making medical care better and medical coverage more affordable for every citizen in this country.

Good health is incentive enough to live well and avoid risks, as we're all reminded now and then when good health is lost. But if anyone ever requires further motivation, they need only visit a place like the Moffitt Center, where all the brilliance and resourcefulness of humanity are focused on the task of saving lives and relieving suffering. You're an inspiration, and not only to your patients. You're a reminder of all that's good in American health care, and we need that reminder sometimes in Washington. I thank you for your kind attention this morning, I thank you for the heroic work you have done here, and I wish you success in the even greater work that lies ahead.

Tags: John McCain and Health Care Agenda

Press Conference by the President 04/29/08 VIDEO PODCAST

President George W. Bush laughs as he takes a question from a journalist Tuesday, April 29, 2008, during a news conference in the Rose Garden of the White House. White House photo by Shealah Craighead

Press Conference by the President FULL STREAMING VIDEO Rose Garden 10:31 A.M. EDT. PODCAST OF THIS ARTICLE THE PRESIDENT: Thank you. Good morning. This is a tough time for our economy. Across our country many Americans are understandably anxious about issues affecting their pocketbook, from gas and food prices to mortgage and tuition bills. They're looking to their elected leaders in Congress for action. Unfortunately, on many of these issues all they're getting is delay.

Americans are concerned about energy prices, and I can understand why. I think the last time I visited with you it was like -- I said it was like a tax increase on the working people. The past 18 months, gas prices have gone up by $1.40 per gallon. Electricity prices for small business and families are rising, as well.

I've repeatedly submitted proposals to help address these problems. Yet time after time, Congress chose to block them. One of the main reasons for high gas prices is that global oil production is not keeping up with growing demand. Members of Congress have been vocal about foreign governments increasing their oil production; yet Congress has been just as vocal in opposition to efforts to expand our production here at home.

They repeatedly blocked environmentally safe exploration in ANWR. The Department of Energy estimates that ANWR could allow America to produce about a million additional barrels of oil every day, which translates to about 27 millions of gallons of gasoline and diesel every day. That would be about a 20-percent increase of oil -- crude oil production over U.S. levels, and it would likely mean lower gas prices. And yet such efforts to explore in ANWR have been consistently blocked.

Another reason for high gas prices is the lack of refining capacity. It's been more than 30 years since America built its last new refinery. Yet in this area, too, Congress has repeatedly blocked efforts to expand capacity and build more refineries.

As electricity prices rise, Congress continues to block provisions needed to increase domestic electricity production by expanding the use of clean, safe nuclear power. Instead, many of the same people in Congress who complain about high energy costs support legislation that would make energy even more expensive for our consumers and small businesses.

Congress is considering bills to raise taxes on domestic energy production, impose new and costly mandates on producers, and demand dramatic emissions cuts that would shut down coal plants, and increase reliance on expensive natural gas. That would drive up prices even further. The cost of these actions would be passed on to consumers in the form of even higher prices at the pump and even bigger electric bills.

Instead of increasing costs and increasing new roadblocks to domestic energy production, Congress needs to clear away obstacles to more affordable, more reliable energy here at home.

Americans are concerned about rising food prices. Unfortunately, Congress is considering a massive, bloated farm bill that would do little to solve the problem. The bill Congress is now considering would fail to eliminate subsidy payments to multi-millionaire farmers. America's farm economy is thriving, the value of farmland is skyrocketing, and this is the right time to reform our nation's farm policies by reducing unnecessary subsidies. It's not the time to ask American families who are already paying more in the check-out line to pay more in subsidies for wealthy farmers. Congress can reform our farm programs, and should, by passing a fiscally responsible bill that treats our farmers fairly, and does not impose new burdens on American taxpayers.

Americans are concerned about making their mortgage payments and keeping their homes, and I don't blame them. Last year I called on Congress to pass legislation that would help address problems in the housing market. This includes critical legislation that would modernize the Federal Housing Administration, reform Fannie Mae and Freddie Mac, and allow state housing agencies to issue tax-free bonds to refinance sub-prime loans. Yet they failed to send a single one of these proposals to my desk. Americans should not have to wait any longer for their elected officials to pass legislation to help more families stay in their homes.

Americans are concerned about the availability of student loans. The recent credit crunch makes it uncertain that some students will be able to get the loans they need. My administration is taking action through the Department of Education's "lender of last resort" program, which works to arrange loans for students who are unable to secure one from a lender on their own. In other words, we're helping. Congress needs to do more by passing a bill that would temporarily give the federal government greater authority to buy federal student loans. This authority would safeguard student loans without permanently expanding the government's role in their financing.

In all these issues, the American people are looking to their leaders to come together and act responsibly. I don't think this is too much to ask even in an election year. My administration will reach out to Congress. We will work to find areas of agreement so that we can deal with the economic pressures that our American taxpayers and American families are feeling. I ask Congress to do its part by sending me sensible and effective bills that I can sign, instead of issuing or sending bills that simply look like political statements. We can work together. We can help Americans weather this difficult period. We can keep our country moving forward.

Now I'll be glad to take some of your questions. Jennifer.

Q Thank you, sir. You have said that we need to wait until the first stimulus has taken effect to act again. But since it was passed, gas prices have gone up, foreclosures have gone up, there have been layoffs, news just this morning that consumer confidence is down yet again. Isn't it time to think about doing more?

And on another issue, would you support a summer moratorium on the federal gas tax?

THE PRESIDENT: First of all, the money is just now making it into people's bank accounts. And I applaud the Speaker and the Leader of the Senate and minority leaders there for working together to get this done. And now, after a period of time, the money is beginning to arrive, and we'll see what the effects are.

And we'll look at any idea in terms of energy, except I will tell you this, that if Congress is truly interested in solving the problem, they can send the right signal by saying we're going to explore for oil and gas in the U.S. territories, starting with ANWR. We can do so in an environmentally friendly way. They ought to say, why don't we -- I proposed, you might remember, taking some abandoned military bases and providing regulatory relief so we can build new refineries. I mean, if we're generally interested in moving forward with an energy policy that sends a signal to the world that we're not -- we're going to try to become less reliant upon foreign oil, we can explore at home, as well as continue on with an alternative fuels program.

Yes, sir.

Q Was that a "yes" on the moratorium?

THE PRESIDENT: No, I'm going to look at everything they propose. We'll take a look.

Q Thank you, Mr. President. Were you premature in saying that the U.S. economy is not in a recession, when food and energy prices are soaring so high? And what more can you do to persuade Saudi Arabia during your upcoming visit to reconsider output levels and cut prices?

THE PRESIDENT: I mean, you know, the words on how to define the economy don't reflect the anxiety the American people feel. The average person doesn't really care what we call it; the average person wants to know whether or not we know that they're paying higher gasoline prices and that they're worried about staying in their homes. And I do understand that. That's why we've been aggressively helping people refinance their homes. That's why I continue to call upon Congress to pass legislation that will enable people to stay in their homes.

These are tough times. People -- economists can argue over the terminology. And these are difficult times. And the American people know it, and they want to know whether or not Congress knows it. I think an important signal to send on energy, just like I said, is to say, okay, we're going to go find oil here at home.

We're transitioning to a new era, by the way -- a new era where we're going to have batteries in our cars that will power -- enable people to drive 40 miles on electricity. There's going to be more ethanol on the market, more alternative fuels. It would be -- our driving habits will change. But in the meantime, we need to be sending a signal to the world markets that we intend to explore here in America. We can also send a clear signal that we understand supply and demand, and then when you don't build a refinery for 30 years, it's going to be a part of restricting supply. And therefore, we ought to expand our refining capacity by permitting new refineries and getting after it quickly.

On the electricity front, as you know, I'm a big believer in nuclear power, except we keep getting mixed signals out of Congress. And the regulatory system sends mixed signals.

And so -- and then, to your question on the Saudis, look, I have made the case that the high price of oil injures economies. But I think we better understand that there's not a lot of excess capacity in this world right now. Hopefully high prices will spur more exploration to bring excess capacity on, but demand is rising faster than supply. And that's why you're seeing global energy prices rise. And that's why it's important for us to try to take the pressure off by saying we're going to start exploring here at home.

John.

Q Thank you, Mr. President. I'd like to ask you about an area --

THE PRESIDENT: You're welcome.

Q -- where food prices and energy come together; that's biofuels.

THE PRESIDENT: Yes.

Q The World Bank says about 85 percent of the increase in corn price since 2002 is due to biofuel -- increased demand for biofuels. And your Secretary of State said that -- indicated yesterday that she thought that might be part of the problem. Do you agree with that? And what can the United States do -- what more can the United States do to help make food more affordable around the world?

THE PRESIDENT: Actually, I have a little different take: I thought it was 85 percent of the world's food prices are caused by weather, increased demand and energy prices -- just the cost of growing product -- and that 15 percent has been caused by ethanol, the arrival of ethanol.

By the way, the high price of gasoline is going to spur more investment in ethanol as an alternative to gasoline. And the truth of the matter is it's in our national interests that our farmers grow energy, as opposed to us purchasing energy from parts of the world that are unstable or may not like us.

In terms of the international situation, we are deeply concerned about food prices here at home and we're deeply concerned about people who don't have food abroad. In other words, scarcity is of concern to us. Last year we were very generous in our food donations, and this year we'll be generous as well. As a matter of fact, we just released about $200 million out of the Emerson Trust as part of a ongoing effort to address scarcity.

One thing I think that would be -- I know would be very creative policy is if we -- is if we would buy food from local farmers as a way to help deal with scarcity, but also as a way to put in place an infrastructure so that nations can be self-sustaining and self-supporting. It's a proposal I put forth that Congress hasn't responded to yet, and I sincerely hope they do.

Jim.

Q Good morning, Mr. President. Thank you. I just want to follow up on the idea of the gas tax moratorium if I may, because you're indicating that perhaps you'd be open to it. You mentioned in your opening remarks that --

THE PRESIDENT: I'm open to any ideas and we'll analyze everything that comes our way, but go ahead.

Q Well, we're talking about perhaps the most immediate relief to people who are buying gasoline every day, because it would be an 18.4 cents a gallon tax cut. Senator Clinton and Senator McCain are in favor of it; Senator Obama is not. But Americans are hearing about this every day. So could you flesh out perhaps some of your thinking about why this would be a good idea, or not; why you would agree with Senator McCain or Senator Obama?

THE PRESIDENT: I appreciate you trying to drag me in the '08 race. And this is the first attempt to do so, and I can understand why you would want to do that. I will tell you that, first of all, the American people have got to understand that here in the White House we are concerned about high gasoline prices, we're concerned about high food prices, we're concerned about people staying in their homes, and we're concerned about student loans -- just like I described. And Congress can be helpful. Congress -- they can show leadership by dealing with these issues.

And we'll consider interesting ideas. But, Jim, what I'm not going to do is jump right in the middle of a presidential campaign. We'll let the candidates argue out their ideas.

Q Well, would --

THE PRESIDENT: I just told you I'll consider the ideas. If it's a good idea, we embrace it; if not, we're analyzing the different ideas coming forward.

Wendell.

Q Mr. President, you just said there's not a lot of excess supply out there. Some energy experts think we may have already passed or be within a couple of years of passing the maximum oil-pumping capability. In other words, we may be close to tapping all we've got. Do you think that's the case? And if you do, why haven't you put more resources into renewable energy research, sir?

THE PRESIDENT: Wendell, we've put a lot into ethanol. As a matter of fact, the solution to the issue of corn-fed ethanol is cellulosic ethanol, which is a fancy word for saying we're going to make ethanol out of switchgrasses, or wood chips. And we're spending a lot of money along those lines.

But energy policy needs to be comprehensive. And we got to understand we're in a transition period. The problem is there's been a lot of focus by the Congress in the intermediate steps and in the long-term steps -- the long-term steps being hydrogen; the intermediate steps being biofuels, for example, and researching the biofuels, and battery technology -- but not enough emphasis on the here and now.

And so you ask -- you say that people think we can't -- there's not any more reserves to be found. Well, there are reserves to be found in ANWR; that's a given. I just told you that there's about 27 million gallons of diesel and gasoline that could be -- from domestically produced crude oil that's not being utilized. And not only that, we can explore in environmentally friendly ways. New technologies enables for -- to be able to drill like we've never been able to do so before -- slant hole technologies and the capacity to use a drill site, a single drill site, to be able to explore a field in a way that doesn't damage the environment. And yet this is a litmus test issue for many in Congress. Somehow if you mention ANWR it means you don't care about the environment. Well, I'm hoping now people, when they say "ANWR," means you don't care about the gasoline prices that people are paying.

Yes, sir. Rog.

Q Thank you, Mr. President, and good morning.

THE PRESIDENT: Good morning. (Laughter.) I like a friendly guy here in the Rose Garden.

Q Sir, 14 --

THE PRESIDENT: Would that be you, Rog, a friendly guy here in the Rose Garden? (Laughter.)

Q Thank you. Yes.

THE PRESIDENT: Mr. Sunshine, they call you. (Laughter.)

Q Fourteen senators, including your own Senator, Kay Bailey Hutchison from Texas, are calling on you to stop filling the Strategic Petroleum Reserve. You've been asked that several times over the past few years. I know what your answer has been. But do you think now, with the rising prices, the record high oil prices, it's time to change course?

THE PRESIDENT: In this case, I have analyzed the issue, and I don't think it would affect price, for this reason: We're buying, at the moment, about 67,000 to 68,000 barrels of oil per day, fulfilling statutory obligations to fill up the SPR. World demand is 85 million barrels a day. So the purchases for SPR account for one-tenth of one percent of global demand. And I don't think that's going to affect price when you affect one-tenth of one percent, and I do believe it is in our national interests to get the SPR filled in case there's a major disruption of crude oil around the world.

And one of the -- for example, one of the things the -- al Qaeda would like to do is blow up oil facilities, understanding we're in a global market, a attack on an oil facility in a major oil-exporting country would affect the economies of their enemy -- that would be us, and other people who can't stand what al Qaeda stands for. And therefore, the SPR is necessary, if that's the case, to be able to deal with that kind of contingency. And if I thought it would affect the price of oil positively, I'd seriously consider it. But when you're talking about one-tenth of one percent of global demand, I think the -- if you -- on a cost-benefit analysis, I don't think you get any benefits from making the decision. I do think it costs you oil in the case of a national security risk.

Martha.

Q Thank you, Mr. President. I'd like to switch to Afghanistan. There was another attempt on President Karzai's life. There are operations going on there right now. Is the strategy succeeding? Are we winning in Afghanistan?

THE PRESIDENT: I think we're making progress in Afghanistan, but there's a very resilient enemy that obviously wants to kill people that stand in the way of their reimposition of a state that is -- which vision is incredibly dark. I mean, it's very important for the American people to remember what life was like in Afghanistan prior to the liberation of the country. We had a government in place that abused people's human rights, they didn't believe in women's rights, they didn't let little girls go to school, and they provided safe haven to al Qaeda. In the liberation of this country, we've achieved some very important strategic objectives: denying al Qaeda safe haven from which to plot and plan attacks, and replacing this repressive group with a young democracy.

And it's difficult in Afghanistan. If you know the history of the country, you understand it's hard to go from the kind of society in which they had been living to one in which people are now responsible for their own behavior. But I am pleased with a lot of things. One, I'm pleased with the number of roads that have been built. I'm pleased with the number of schools that have opened up. I'm pleased a lot of girls, young girls are going to school. I'm pleased health clinics are now being distributed around the country. I'm pleased with the Afghan army, that when they're in the fight they're good.

I wish we had completely eliminated the radicals who kill innocent people to achieve objectives, but that hasn't happened yet. And so I think it's very much in our interests to continue helping the young democracy. And we will.

Yes. Obviously you've got a follow-up.

Q But do you think we're winning? Do you think we're winning?

THE PRESIDENT: I do, I think we're making good progress. I do, yes.

Q Can I just add to that, a couple weeks ago --

THE PRESIDENT: No, you can't. This is the second follow-up. You usually get one follow-up, and I was nice enough to give you one. I didn't give anybody on this side a follow-up, and now you are trying to take a second follow-up.

Q They didn't try.

THE PRESIDENT: I know you try.

Yes.

Q Can I just say --

THE PRESIDENT: They just cut off your mic. You can't, no.

Q A couple weeks ago you said --

THE PRESIDENT: Now she's going to go without the mic. This is awesome. (Laughter.)

Q A couple weeks ago you said that in Iraq, in 2006, you said we were winning and the strategy was working to keep up troop morale.

THE PRESIDENT: Yes.

Q How can we believe that you're not doing the same thing here?

THE PRESIDENT: You tried to ask me that question before. It's a repeat. Look, I said --

Q No, I'm talking --

THE PRESIDENT: Can I finish, please? The question you asked me before at the exclusive I gave you on the ranch was: You said that we were winning in the past. I also said that there was tough fighting. Make sure you put the comments in place.

So what I'm going to tell you now is, we're making progress in Afghanistan, but there's tough fighting. I'm under no illusions that this isn't tough. I know full well we're dealing with a determined enemy. I believe it's in our interest that we defeat that enemy. And so, yes, we're making progress. But it's also a tough battle. We're facing people who are willing to strap bombs on themselves and walk into places where the innocent dwell, or the innocent shop, and kill them.

Is it in our interest to confront these people now, whether it be in Afghanistan, or Iraq, or Europe, or anywhere else? And the answer is, absolutely, it's in our interest. And the notion that somehow we can let these people just kind of have their way or, you know, let's don't stir them up, is naive or disingenuous, and it's not in our nation's interests. We are in a global struggle against thugs and killers. And the United States of America has got to continue to take the lead.

And so in Afghanistan, yes, we're making progress. Does that mean that it's over? No, it doesn't mean it's over. We're in a long struggle, as I've told you many a time, against these jihadists. You defeat them ultimately by the advance of democracy. See, this is an ideological struggle. These aren't isolated, law-enforcement moments. We're dealing with a group of ideologues who use asymmetrical warfare -- that means killing innocent people -- to try to achieve their objectives. And one objective is to drive us out of Afghanistan, Iraq, the Middle East, or anywhere else where we try to confront them.

And so, yes, I mean, look -- is it tough? Yes, it's tough. Is it difficult? Absolutely. Is it worth the fight? In my judgment, yes, it is.

Yes, ma'am.

Q Mr. President --

THE PRESIDENT: I can't hear you too well. Sorry, got a flawed mic. Martha, what did you do to the mic? (Laughter.) She wanted an exclusive again. Anyway. (Laughter.)

Q Mr. President, thank you, sir. Previously when asked about Israel's September bombing of the Syrian facility, you refused aggressively to discuss it. Then suddenly last week, your administration released classified photos and details of that bombing, intelligence officials claiming that it showed that this facility was a North Korean-designed nuclear facility being actually built with the help of Pyongyang. Why the turnaround, sir? What did you hope that that would accomplish? And what do you say to lawmakers of both parties on Capitol Hill who are quite concerned that indeed if this was what this facility was, that it took some eight months for you to inform them, sir?

THE PRESIDENT: Thank you. Let me correct the record. We briefed 22 members of Congress on what I'm about to tell you. First, we were concerned that an early disclosure would increase the risk of a confrontation in the Middle East or retaliation in the Middle East. As I mentioned to you early on, we did notify 22 members of Congress, key committee chairmen. And I was -- I'm mindful that there was going to be this kind of reaction, and of course, we wanted to include more members of Congress at a time when we felt the risk of retaliation or confrontation in the Middle East was reduced, and so that moment came upon us, and then extended the briefings.

We also wanted to advance certain policy objectives through the disclosures, and one would be to the North Koreans, to make it abundantly clear that we may know more about you than you think, and therefore, it's essential that you have a complete disclosure on not only your plutonium activities, but proliferation, as well as enrichment activities.

And then we have an interest in sending a message to Iran, and the world for that matter, about just how destabilizing a -- nuclear proliferation would be in the Middle East, and that it's essential that we work together to enforce U.N. Security Council resolutions aimed at getting Iran to stop their enrichment programs. In other words, one of the things that this example shows is that these programs can exist and people don't know about them -- because the Syrians simply didn't declare the program; they had a hidden program.

And finally, we wanted to make it clear to Syria -- and the world -- that their intransigence in dealing with helping us in Iraq, or destabilizing Lebanon, or dealing with Hamas -- which is a destablizing force in our efforts to have a Palestinian state coexist peacefully with Israel -- that those efforts are -- gives us a chance to remind the world that we need to work together to deal with those issues. So that's why we made the decision we made.

Yes, sir.

Q Mr. President, you've expressed frustration with Congress, obviously, over the economic -- wanting them to do more on the economy. They've blocked you on Colombia. They've blocked you on the FISA issue. Are you frustrated? Are you angry? And do you have any real hope of being able to work with this Congress this year?

THE PRESIDENT: I am -- I believe that they're letting the American people down, is what I believe. On the FISA issue, it is hard to believe that it's okay to pass the Protect America Act in August of 2007, and that act -- people in Congress can't -- don't believe that act is relevant in 2008. I mean, the act was set to expire; it did; and yet this threat hasn't gone away. And I can only -- it's either lack of leadership or a lack of understanding of the issue, and either way, it's not good for the country. We need to make sure our professionals have the tools to protect the American people from attack.

The Colombia free trade agreement, this economy is -- as I mentioned to you, it's a sour time. It's tough for the American people. And yet the Colombia free trade agreement would benefit our economy. And the reason why is, is that many goods from Colombia come into our country duty-free. And yet our goods going to Colombia are taxed through tariff. And the American people expect the President and the Congress to at least insist that a foreign country treat us the way we treat them. And in this case, the benefits will be more exports, more mid-sized and small businesses exporting into Colombia. About 9,000 exporters into Colombia today; 8,000 are mid-sized and small businesses. And when you can export more, it helps the economy. And one of the bright lights of the economy has been the amount of exports going overseas.

So rather than playing politics or whatever rationale that they have made for Colombia, they ought to be saying, this is good for our economy, it's good for workers, it's good for small businesses.

And so I'm perplexed, I guess is the best way to describe it, about why there's no action, inactivity on big issues. And -- because the two issues you mentioned -- FISA, protecting America, and Colombia, protecting America's economy by encouraging growth -- are important to people whether they be Republicans, Democrats or independents.

Sheryl.

Q Thank you, Mr. President.

THE PRESIDENT: You're welcome.

Q I'm still waiting for my exclusive at the ranch.

THE PRESIDENT: Yes. (Laughter.)

Q Mr. President, today I'm -- (laughter.)

THE PRESIDENT: I'm at a loss for words. If only you'd have been at the White House Correspondents' Dinner, I would have invited you. (Laughter.) Anyway, please, go ahead.

Q Well said.

THE PRESIDENT: An inside joke for everybody listening. (Laughter.)

Q Mr. President, you have spoken today about opening ANWR for drilling and also refineries. But these are clearly long-term solutions to the problem of rising gas prices. What can you tell Americans about what your administration is doing in the short term? And secondly, have you been briefed on tomorrow's GDP numbers, and are you concerned --

THE PRESIDENT: No, I haven't been.

Q Okay -- and are you concerned that they will show us to officially be in a recession?

THE PRESIDENT: I think they'll show that we're -- it's a very slow economy. I can't guess what the number will be, and I haven't been shown, truly.

And by the way, opening up ANWR is not long term, it's intermediate term. But it sends a clear signal, is what it does. It sends a clear signal to the markets that the United States is not going to restrict exploration; the United States is going to encourage exploration.

And in the meantime we have done, increasing CAFTA, for example. But the market is going to do as much for encouraging conservation as anything else is now. And so I firmly believe that -- you know, if there was a magic wand to wave, I'd be waving it, of course. I strongly believe it's in our interest that we reduce gas prices, gasoline prices. I mean, it would be like a major tax cut for people. And --

Q But what --

THE PRESIDENT: Let me finish, please, Sheryl. Strike one on the exclusive. (Laughter.) Excuse me, strike two. (Laughter.)

That -- you made me lose my train of thought, of course -- maybe that's what you were attempting to do. No, I think that if there was a magic wand, and say, okay, drop price, I'd do that. And so part of this is to make -- set the psychology right that says to the world, we're not going to become more beholden on your oil, we're going to open up and be aggressive and have an aggressive energy policy. Secondly, we're going to send the signal we're going to be building new refineries.

But there is no magic wand to wave right now. It took us a while to get to this fix. That's why I told you that if Congress had responded -- matter of fact, Congress did pass ANWR in the late 1900s -- 1990s -- and the 1900s -- (laughter) -- 1990s. But it didn't go forward. And it's my considered judgment, given the technological advances, to say this is -- we'll destroy the environment is just -- I don't think it's an accurate statement.

And so I think it's very important, Sheryl, for Congress. The other thing Congress can do, if you want to send a good signal during these uncertain times, is make the tax cuts permanent, is to let people -- send the signal that people are going to be able to keep their money. And I think that will help the psychology of the country.

Yes, Mark.

Q Mr. President, do you feel --

THE PRESIDENT: Yes, you can use a mic.

Q Do you feel your foreign policy in the Middle East has been undermined by Jimmy Carter's meeting with Hamas leaders? What harm does it do for him to have met with Hamas leaders?

THE PRESIDENT: Foreign policy and peace is undermined by Hamas in the Middle East. They're the ones who are undermining peace. They're the ones whose foreign policy objective is the destruction of Israel. They're the ones who are trying to create enough violence to stop the advance of the two-party state solution. They are a significant problem to world peace -- or Middle Eastern peace.

And that's the reason I'm not talking to them. And that's the reason why -- it's just important for people to understand that this is a -- we're in a -- we're witnessing a struggle between those who understand liberty and believe in the advance of liberty, and those who want to stop the advance of liberty. And Hamas has made their position very clear.

Unfortunately, they're getting help; in Syria, they get help. There's rumors about Iranian help. And these countries that I just named are -- take, for example, Lebanon. I talked to Prime Minister Siniora today. Here's a struggling democracy in the heart of the Middle East that is -- whose internal politics are being influenced by Syria, Hezbollah -- as a result of Iranian influence with Hezbollah -- all aiming to destabilize the country, which should be a clear signal about the intents of -- the intentions of groups like Hezbollah and Hamas.

So when you want to talk about peace being difficult in the Middle East -- it's going to be difficult, but it's even made more difficult by entities like Hamas, who insist upon lobbing rockets into Israel, trying to provoke response and trying to destabilize -- even destabilize the region more.

And anybody can talk to who they want, but I just want the people to understand that the problem is Hamas. And until Hamas changes, or until there's a competing vision in the Middle East for President Abbas, Prime Minister Fayyad to offer to the Palestinian people, that's all the more reason to try to define a state, and that's why I'm going to the Middle East, besides going to the 60th anniversary of Israel.

Yes, Ann.

Q Thank you, sir. Did any good come out of President Carter's talks with Hamas? And did anyone in your administration ask him not to do it? And will it have any impact on your trip to the Middle East?

THE PRESIDENT: I didn't talk to him, and I don't know, I don't know what the conversations were. And I don't see Hamas changing. It's up to Hamas to change. You get these meetings with these people, and they say one thing and do another. And this is the way it's been now for seven and a half years in this administration, watching Hamas be a destabilizing influence.

And I supported the elections, by the way. And curiously enough, they won the elections against Fatah because they ran on a non-corruption campaign. The sad situation is now they've been given power, they haven't delivered for the people in Gaza.

And my mission is to, when I go to the Middle East, is to continue to work with both Israelis and President Abbas and his government on a variety of fronts: one, coming up with a vision, helping them find a common ground on the vision; but also working with the Israelis to empower the Palestinians in the West Bank to be more in charge of security, to have less obstacles with which to deal with, to help the Palestinians with economic vitality and growth. There's some very interesting initiatives that are being developed there.

I'm still hopeful we'll get an agreement by the end of my presidency. Condi is heading back out there. I've been in touch with President Abbas here in the Oval Office, and I talk to Prime Minister Olmert, and the attitude is good. People do understand the importance of getting a state defined.

But Hamas is -- look, when you're Israel and you've got people lobbing rockets into your country, you're going to take care of business. But you got to ask, why is Hamas lobbing rockets? And one reason why is because they're trying to destabilize and create chaos and confusion. And to answer whether or not people's conversation -- whether they're more effective, all we got to do is watch to see how Hamas behaves.

Richard.

Q Thank you, Mr. President. Congress is preparing to add a couple of things to your supplemental spending request for Iraq, and I'm wondering if some of these seem like things you could support -- extending unemployment benefits and, particularly, additional help for Iraq and Afghanistan war veterans in terms of educational benefits. Are these things you might agree to, even though you have set a $108 billion ceiling on the package?

THE PRESIDENT: Richard, $108 is $108. And I made my position very clear to Congress and I will not accept a supplemental over $108 billion or a supplemental that micro-manages the war, ties the hands of our commanders.

We will work with Congress on these veterans' benefits. I'm a firm believer that we ought to treat our veterans with respect. In the State of the Union I talked about the idea of transferring -- a soldier being able to transfer educational benefits to a spouse or children. We've sent legislation to that effect up to Congress; we would like for them to move on it quickly. But the $108 billion is $108 billion.

Michael.

Q Thank you, Mr. President. I wonder if there's a big, urgent problem facing the country, coming down the road, that you worry your successor will neglect or postpone. That is, when the politics are done, after the war on terror, what do you think should be at the top of the list of the person who moves into that office?

THE PRESIDENT: I don't think John McCain is going to neglect the war on terror. And I do think he'll be the President. Here I am interjecting myself in the '08 campaign, just like I told you I wouldn't. That's unfair, isn't it?

He -- it's very important for the President to understand that America is still in danger of attack, and that we're dealing with an ideological struggle that can only be solved with the spread of liberty. And a concern of mine, as you've heard me say, is that the nation has had the tendency in the past to become isolationist and correspondingly protectionist. And I would hope whoever the President is, and I do believe it will be John, will be willing to resist the impulse, the temptation, to say, well, it's not worth it anymore to confront an enemy, it's not worth it to try to do the hard work of helping democracies thrive and succeed -- because not only is it worth it, we will succeed in laying the foundation for peace if we have faith in the capacity of liberty to be transformative.

I'm also concerned about protectionism. This lad right here asked me about Congress's intransigence on Colombia. I think it reflects the fact that there is a strong protectionist sentiment in the United States. People -- good people -- believe it is not in our interest to be opening up markets. You might remember the CAFTA trade vote; we won by one vote, and it was a tough vote to get. And now the Speaker pulled a unique maneuver to stop the Colombia from moving forward. And it's a sign of -- that the country is losing its confidence, to a certain extent; that protectionist policy is better than confidently trading and treating unfairness in the marketplace.

And so my worry -- not worry -- my hope is, is that whoever the President is understands that America is a force for good in the world; that in the spread of liberty we're adhering to a universal value -- not an American value, it's a universal value, the notion of liberty. You've heard me say it a lot: I do believe it's a gift from the Almighty to every man, woman and child. If you believe in that and act on that, you're really acting on a platform of peace, because ultimately liberty yields the peace you want. It's transformative and powerful. And I believe that people will be making a mistake if they say we can't compete economically, and therefore, let's throw up walls. And yet the tendencies here in America are pretty strong right now.

There's a lot of concern around the world, by the way, about America's retreat -- they're wondering whether or not America is going to remain a leader. They're wondering whether or not -- for example, will capital be welcomed back into our country. And so it's the "isms" that bother me -- isolationism and protectionism.

April.

Q Thank you, Mr. President.

THE PRESIDENT: You're looking good in yellow.

Q Thank you.

THE PRESIDENT: How's the baby?

Q She's good, thank you. You're trying to get me off, but it's okay.

THE PRESIDENT: No. Is it true you named her "Georgia"?

Q No. Is that okay with you?

THE PRESIDENT: It's your baby. (Laughter.)

Q Anyway, moving on to the subject of the day. I talked to James Clyburn before this press conference. He said, "As a man thinketh, so are we." And Americans believe we are in a recession. What will it take for you to say those words, that we are in a recession?

And also on Zimbabwe, what's the next step? And does South Africa play a part in that?

THE PRESIDENT: Yes, thank you. I've answered the question on the words and terminologies. I will tell you that these are very difficult economic times -- very difficult. And we'll let the economists define it for what it is. I would hope that those who worry about recession, slowdown, whatever you want to call it, make the tax cuts permanent as a way of helping to address this issue -- because if you're somebody out there trying to plan your future and you're worried about the future and you think your taxes are going to go up, it's going to cause different behavioral patterns.

Secondly, I do want to thank the members of Congress -- and the man you talked to is a leader and did a very good job of helping shepherd through this billions of dollar package that is now beginning to hit America's pocketbooks. And we'll see how that goes. I hope it's as stimulative as we think it will be. But you can tell the good man you talked to, who is a good guy, that I fully understand that people are concerned. And they're concerned about high gasoline prices; they're worried about high food prices; worried about staying in their homes.

The new issue, of course, is student loans. The House of Representatives passed a bill, sponsored by Mr. Miller, George Miller, that is a -- that we think can do the job. I hope the Senate moves a version of it very quickly so that we can help address this issue. I mean, one of the things that government can do is either create more anxiety or less. And if you think your taxes are going to go up, that's going to make you anxious. If you think the government is going to step in with a good policy that will help your child get a student loan, that will make you less anxious.

One of the things we've done on home ownership is the HOPE NOW Alliance, which hopefully makes people less anxious; hopefully it helps -- has kind of brought some sense of not only concern, but action into the marketplace. And I was told this morning that HOPE NOW has affected about 1.4 million homeowners and helped a lot of them refinance, get refinancing, or helped a lot of them get different interest payment schedules -- all aiming for creditworthy people to be able to stay in their homes during this difficult period.

Zimbabwe. First of all, the will of the people needed to be respected in Zimbabwe. And it is clear that they voted for change, as they should have, because the -- Mr. Mugabe has failed the country. It's a country that used to be an exporter of food; it's now got terrible human conditions there.

Secondly, the violence and the intimidation is simply unacceptable. The government is intent upon -- and is -- intimidating the people there.

We support the U.N. Security Council discussions that are going on. But the truth of the matter is, April -- and you mentioned this -- it's really incumbent upon the nations in the neighborhood to step up and lead, and recognize that the will of the people must be respected, and recognize that that will came about because they're tired of failed leadership.

Thank you all for your interest. Enjoyed it.

END 11:20 A.M. EDT For Immediate Release Office of the Press Secretary April 29, 2008

Tags: President Bush and ANWR or nuclear power