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Our previous coverage:

Senator Al Franken (D) at the 2009 Harkin Steak Fry – part 1

Senators Harkin (D) and Franken (D) in Indianola, Iowa – there will be a strong public option

The 2009 Harkin Steak Fry in Indianola, Iowa – photos

Before anyone gets a shovel and digs a grave for the Public Option, read this

The second and final part of Al Franken’s remarks:

….The truth is, if we don’t fix the system most of us are gonna lose the health care because we’re simply not gonna be able to afford the health care. [applause] And at the Minnesota state fair that’s the question everybody was asking, Democrats and Republicans. But right now in Congress Democrats seem to be the only ones asking it. Republicans are busy asking Washington questions. They’re asking, “How do we break President Obama?  How do we make sure he fails?” That’s what they’re asking.

Tom referred to Jim DeMint of South Carolina, our esteemed colleague who is, is close friends with, well, both of us. [laughter] Good, good friend. [laughter] And Senator DeMint said this, I’m gonna quote what he said, “If we’re able to stop Obama on this it will be his Waterloo.” Well I don’t think this debate should be about President Obama. [applause] [cheers] It should be, it should be about the people who are going bankrupt because of the cost of health care, [applause] even when they have insurance. [applause] The number one cause, the number one cause of bankruptcy, of personal bankruptcy in this country are health care crises. More than half of the personal bankruptcies in this country are caused by health care crisis. And more than two thirds of those people who go bankrupt because of a health care crisis have health insurance….

….This debate should be about that woman in Fergus Falls, the one I mentioned, the one with diabetes. See, her adult son has diabetes, too, but he can’t afford health insurance so she shares her insulin with her son. In America. [pause]

This debate should be about the older woman who came up to me at the booth. She said to me, “You know when you’re my age, everything is pre-existing.” [laughter] This debate is about the American people. And if this debate is about what’s gonna help the American people well then there’s really no debate. We’ve gotta change the system. And that’s what we’re going to do. [applause]

So the question is, the question is, if you get sick, how do you get health care? And how do we keep people healthy in the first place? And the answer to the question also happens to be the answer to keeping costs down. Tom knows that. In Minnesota we know that. In Minnesota we do pretty well. Ninety-one cents of every health insurance dollar goes to actual health care in Minnesota as compared to seventy to eighty cents in the rest of the country. In one health care roundtable a, a health care economist said to me, “You know, in Minnesota we get an ‘A’.” But then, then he continued saying, “But that’s only because we grade on a curve.” [laughter] Now here in Iowa you’re also in the top quintile in, in health care. But the way our system works we don’t really pay our doctors to keep people healthy. A doctor won’t get paid for helping a diabetic control his diabetes. But we do pay doctors a lot for removing a diabetic’s foot.

Now let’s take for example McAllen, Texas – the most expensive medical market in the country. In McAllen they spend three times as much on health care for Medicare patients as they do in Mayo Clinic. Even though at Mayo the get better outcomes. Well that’s because in McAllen doctors own the hospitals and they own the imaging clinics. So they perform more tests and procedures and Medicare pays for the tests and the procedures, but they don’t pay for the outcome. At Mayo it’s patient centered. The doctors who flock to Mayo are paid salaries. They don’t get paid more money for [inaudible] procedure, they get paid to keep people healthy. [applause]

See, right now we’re paying for sick care we’re not paying health care. [applause] And when doctors, and when doctors look at a patient as a dollar sign we get a far different outcome. Then when doctors look at a patient as someone you want to keep, get healthy and then keep ’em healthy. So we’re gonna change the system so that we emphasize preventive care on front end and reward doctors for good outcomes on the back end. [applause] And we’re gonna make it so insurance companies can’t deny you, your claim because of pre-existing condition. [applause] We’re gonna make sure that insurance companies face real competition with [emphasis] a public option. [applause] [cheers] we’re going to improve electronic health records [applause] so that doctors don’t do duplicative tests that are unnecessary. These changes are gonna keep us healthier, save families money, and bring down the cost of health care. And call me crazy but it just seems like a pretty damn good idea. [applause]

Now even though these are good ideas some people are gonna fight ’em with everything they got. And it’s pure, it’s pure politics. These people rail against government health care but they’re sure happy that their parents have Medicare. President Obama could propose just about anything and some of our Republican friends would still oppose it. They don’t even think the President should be allowed to tell kids to stay in school and work hard. [applause] [cheers] That’s how ridiculous this is. Their goal isn’t to see how much we can do, it’s to see much we can undo, or they can undo.

The last time the Republicans were in power they undid a lot. [laughter] Under Republicans we couldn’t get vaccines to kids during flu season. Under Republicans we couldn’t get clean water to New Orleans when the levees broke. Under Republicans we couldn’t tell the difference Saddam Hussein and Osama Bin Ladin. [applause] [cheers] And the last Republican President, I, I forget his name [laughter], left us, left us on the brink of a great depression. It’s that old Republican tactic. They run for office saying that government doesn’t work, then they get elected and they prove it. [laughter] [applause]

But what our friends across the aisle don’t get is this, this is a Democracy. It’s not the government versus the people. The government is the people. We’re on the same team [applause], we work together. And when government reflects the will of the people and responds to the people we make a lot of progress as individuals and as a country. I think President Obama said it best last Wednesday night in that great speech. He said this, “Our predecessors understood that government could not and should not solve every problem. They understood that there are instances when the gains and security from government action are not worth the added constraints on our freedom. But they also understood that the danger of too much government is matched by the perils of too little. That without the leavening hand of wise policy markets can crash, monopolies can stifle competition, the vulnerable can be exploited.”

This is something we know in, in my family. When my wife Frannie was about seventeen years old her father, a World War II decorated vet, died in a car accident on the way home from doing two straight shifts at the paper mill in Portland Maine, leaving Frannie’s mom widowed at age twenty-nine with five kids. Now, Frannie’s mo
m had a high school education, that’s it, and they had a tough time, but they made it. And they made it because of Social Security survivor benefits. [applause] Sometimes there wasn’t enough food on the table, sometimes they turned the heat off, and this is Portland, Maine, it was kind of cold. But they made it. My brother-in-law, middle kid, went into the Coast Guard. Became an electrical engineer, he still works with the Coast Guard. My three sisters-in-law and Frannie all went to college on combinations of Pell Grants and scholarships. [applause] And Frannie’s younger sister, there’s one younger than Frannie, Bootsie. And Bootsie went to high school, my mother-in-law got a four hundred dollar GI loan to fix a hole in the roof, instead of using it to fix a hole in the roof, she used it to go to college at the University of Maine at Gorham. And she got three more loans and graduated. And got another loan, then got a masters in teach, in, in teaching kids to read and she became a teacher. And she had a career teaching Title I kids to read and because she taught Title I kids all her loans were forgiven. [applause] Every member of my wife’s family, every member of my wife’s family became a productive member of society. And they did it because of Social Security. [applause] They did it because of Pell Grants. [applause] They did it because of the GI Bill. [applause] They did it because of Title I. [applause]  Now, they tell you in this country pull yourself up by your bootstraps. And that’s something that everyone of us here believes. But first you gotta have the boots. [voice: “Yeah.”] [applause] The government Frannie’s family the boots. And that’s what we’re about, that’s what we’re about. [applause] [cheers] I ran for the senate because I know that Frannie’s story isn’t unique. It’s Tom Harkin’s story. It’s the politics that he practices. It’s America’s story.

The health care bill we’re fighting for right now, it isn’t just about health care. It isn’t just about bringing down the costs, bringing down the debt. It’s about opportunity. It’s about giving people the boots. If you go in to debt because a family member gets sick or hurt you’re gonna spend years just keeping your head above water. If your child has a pre-existing condition you can’t change your job to start a small business which creates seventy percent of the new jobs in this country. You can’t do it because you won’t get health care. Think about what this means for families and then what it means for our economy.

You hear Democrats talk a lot about opportunity. That’s because we really do believe in opportunity. And everything we’ve done [applause] in the last nine months reflects that. We inherited an economy on the brink of a depression and we passed a major recovery act that pulled us from the brink. Cut taxes for families, a third of it was tax cuts for people under two hundred fifty thousand dollars. [applause] It kept states, it kept states from having to cut even more than they’ve had to cut, saving jobs and police and nurses and firefighters and social workers. People who are needed at a time of financial crisis. And we invested in today’s infrastructure and tomorrow’s infrastructure. We passed a law in the last nine months to keep the credit card companies from taking advantage of consumers. [applause] [cheers] A law, a law to protect equal pay for women. [voce: “Yeah!”] [applause] We covered seven million uninsured children through SCHIP. [applause] We gave the FDA the power to regulate tobacco, to regulate it like the health risk that it is. [applause]

In any other year that would be enough. But this year we have the chance to confront the single biggest threat to America’s future and the greatest unmet moral obligation in our history, all rolled into one. That’s what health care is. [applause] [voice: “Obama’s (inaudible), he’s our President!”] This is, this is our moment of opportunity. This need, needs to be the moment where the debate changes, when the heat of an angry summer breaks. So, we need you. We don’t want to look back and say we squandered this opportunity because we allowed ourselves to be shouted down. Or that we voted for change and got scared of actual change. [laughter] [applause] [cheers] We want to look back on this day from an America in which everyone has health care and say, it wasn’t the easiest thing, but it was the right thing. [applause] And together we got it done. [applause] Thank you. [applause] [cheers] Now, now. [applause] [cheers]