“‘Patient-centered care’: as I’m sure you know, that is one of the biggest buzz-phrases in our healthcare debate. And no one is in a better position than pharmacists to understand what patient-centered care really means. It means a chance to talk, and to listen. It means care that responds first and foremost to the needs of the sick, not to the needs of a bureaucracy. It is what happens across your counters in every town in America, every day of the year.

“Sadly, though, patient-centered care is truly missing from so much of our healthcare system. Americans feel its lack whenever they spend time fighting with insurance companies instead of helping their loved ones recover; whenever they spend hours on end in ER waiting rooms; whenever they have to start from scratch in explaining their condition to doctor after doctor.

“And that is just one of the problems plaguing American healthcare. There is also the problem of cost: Since 2000, the health care premiums of American families have more than doubled, while wages have stood still. Last year alone, employees’ out-of-pocket healthcare costs jumped by more than 10%. Every day, healthcare costs bankrupt American families. And every day, they put a straitjacket around our businesses—which spend more than twice as much on healthcare as their foreign counterparts. Did you know that Starbucks spends more on healthcare than on coffee? Did you know that every car you buy from the Big Three automakers has about an extra 1,500 healthcare dollars tacked on to the price tag? Think of how much more effectively our businesses, from large to small, could compete if they didn’t have to pay those costs—think of all the American jobs they could create.

“Last but not least is the problem of access—the problem of 45 million uninsured Americans, who live sicker and shorter lives because they cannot afford a doctor’s care. And in this recession, their ranks are growing. With 61% of Americans getting coverage through their employers, lost jobs mean lost healthcare. Every time the unemployment rate ticks up one percent, it means that 2.4 million more people lose their employer-sponsored insurance.

“America is home to the best practitioners in the world, the greatest technology in the world, the most advanced research and development in the world—but it is also saddled with a system in desperate need of reform. But here’s the good news: We are working to pass healthcare reform this year.

“Let me tell you what I think that reform will look like. For one, Democrats want to build upon the current system of employer-sponsored care. We are telling every American: if you like the policy you have now, you can keep it. And we want to protect the vital principle of patient choice: we want to guarantee every American his or her choice of coverage and of doctor, a choice that, under the status quo, is all too often constrained by insurance companies.

“But we also recognize that, without the ability to pay for it, all the healthcare choice in the world is meaningless. So Democrats also support policies that will strengthen private and public coverage and make affordable healthcare available to all. One of the central debates is over the possibility of a public option and how it might be structured. Senator Schumer recently put forward a proposal that would allow for a public plan but subject it to the same standards as private insurance. The House Progressives and Tri-Caucus support a public option that is similar to Medicare. As far as I’m concerned, a public option needs to be a part of the healthcare debate; but it’s also clear that, in order to succeed, it needs to win a broad consensus.

“Finally, let me say something about the effect of healthcare on our budget. It is clear that the central fiscal challenge our country faces is controlling the cost of healthcare—and if we don’t get a handle on those costs, they will eat up more and more of budget every year, preventing us from paying for other things we need. If we do nothing, by 2025, the interest on our debt, plus the ‘big three’ entitlements of Social Security, Medicare, and Medicaid, will consume virtually all of our revenues. That would be a fiscal catastrophe, and healthcare reform is one of the most important ways to stave it off.

“So we must design a reform that is deficit-neutral. I want to expand access, but we must pay for it. Paying for healthcare reform, though, is not enough. We must slow the growth of healthcare spending over the long term—and as we do so, we must remember that the American healthcare system, which does not buy us better health than the rest of the developed world, is the world’s most expensive per capita. Our goal must not simply be expanded access to high-quality care, but a more efficient use of our healthcare dollars.

“By bringing more patients into the risk pool and by encouraging preventive care, expanded access will help us get costs down. But it isn’t a magic bullet. Better health information technology will let doctors store and access patient records at any hospital in America. Funding long-term research on health outcomes will help doctors ground their treatment choices in the best empirical data. Both of those steps will also bring down costs. In the end, though, we are going to face some difficult long-term choices, and we must make them. We should remember that cost-control is both good policy and smart politics.

“That is my case for why health reform is so vital, and that is the form I think it will take. But none of this will happen without your support, and the hard work of people across America who are like you. There are powerful forces with an interest in preserving the status quo, and they will use distortion and demagoguery to get their way. It is essential that you and I answer them with the facts—especially the facts you see from watching a broken system up close. I want to thank you for your dedication to the patients you serve every day—and I hope you will use that same dedication to help give every American a healthcare system that is worthy of this great Nation and is fiscally-sustainable for future generations.”