Prevention Matters

At Partnership we focus much on issues and policies affecting prevention which, happily, are significant components of the recently passed health reform legislation. But beyond the details of specific provisions we must pause to give credit to the work of the House Speaker, Nancy Pelosi of California, who made possible -- comprehensive health reform – when many “political experts” thought the task was impossible.

There will be many commentators who will dissect the Speaker’s leadership style and seek to explain the nature of her success. But I am interested and impressed more by the substance of what she has achieved and the philosophy that guided her efforts.

Before the final vote last night on passage of HR 3590, the “Patient Protection and Affordable Care Act” the Speaker entered the well of the House and delivered a final call to action on behalf of the American people. Her words, powerfully delivered, came at the conclusion of seemingly bitter and contentious legislative process.

The Speaker spoke of the legislation’s passage as an “historic moment” that would lead to healthier lives.

She said “we have the opportunity to complete the great unfinished business of our society and pass health insurance reform for all Americans that is a right and not a privilege.”

She spoke of a letter sent to President Obama from the late Edward Kennedy who wrote ‘At stake are not just the details of policy but…the character of our country.’

The Speaker’s words evoked the best of American values. They captured, better than any Committee report or legislative history, why passage of the legislation was a duty, and important, not just to individual families but to moving us closer to the Founding Father’s goal of a more perfect union.

I commend the reading of the full text of the Speaker’s Remarks.

Ripley Forbes
Director, Government Affairs
Partnership for Prevention


Statement on the floor of the US House of Representatives by Speaker Nancy Pelosi, on passage of HR 3590, the “Patient Protection and Affordable Care Act.” (March 21, 2010):


“Thank you, my colleagues. Thank you, Mr. Speaker. I thank the gentleman for yielding. I thank all of you for bringing us to this moment.

“It is with great humility and with great pride that we tonight will make history for our country and progress for the American people. [Applause] Just think—we will be joining those who established Social Security, Medicare, and now tonight health care for all Americans. [Applause]

“In doing so, we will honor the vows of our founders, who in the Declaration of Independence said that we are ‘endowed by our Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.’ This legislation will lead to healthier lives, more liberty to pursue hopes and dreams and happiness for the American people. This is an American proposal that honors the traditions of our country. [Applause]

“We would not be here tonight, for sure, without the extraordinary leadership and vision of President Barack Obama. [Applause] We thank him for his unwavering commitment to health care for all Americans.

“And this began over a year ago under his leadership in the American Recovery and Reinvestment Act, where we had very significant investments in science, technology, and innovation for health care reform. It continued in the President’s budget a few months later, a budget which was a statement of our national values, which allocated resources that were part of our value system. And in a way that stabilized our economy, created jobs, lowered taxes for the middle class and did so, and reduced the deficit, and did so in a way that had pillars of investment, including education and health care reform—health care reform and education, equal opportunity for the American people. [Applause]

“And this legislation tonight, if I had one word to describe it would be ‘opportunity,’ with its investments in education and health care as a continuation of the President’s budget. We all know, and it has been said over and over again, that our economy needs something new, a jolt. And I believe that this legislation will unleash tremendous entrepreneurial power into our economy. Imagine a society and an economy where a person could change jobs without losing health insurance, where they could be self-employed or start a small business. Imagine an economy where people could follow their passions and their talent without having to worry that their children would not have health insurance, that if they had a child with diabetes who was bipolar or pre-existing medical condition in their family, that they would be job-locked. Under this bill, their entrepreneurial spirit will be unleashed. [Applause]

“We all know, we all know that the present health care system and insurance system, health insurance system in our country is unsustainable. We simply cannot afford it. It simply does not work for enough people in terms of delivery of service and it is bankrupting the country with the upward spiral of increasing medical costs.

“The best action that we can take on behalf of America’s family budgets and on behalf of the federal budget, is to pass health care reform. [Applause]


“The best action we can take to strengthen Medicare and improve care and benefits for our seniors is to pass this legislation tonight, pass health care reform. [Applause]

“The best action we can do to create jobs and strengthen our economic security is pass health care reform. [Applause]

“The best action we can take to keep America competitive, ignite innovation, again unleash entrepreneurial spirit is to pass health care reform. [Applause]

“With this action tonight, with this health care reform, 32 million more Americans will have health care insurance. And those who have insurance now will be spared being at the mercy of the health insurance industry with their obscene increases in premiums, their rescinding of policies at the time of illness, their cutting off of policies even if you have been fully paying but become sick, the list goes on and on about the health care reforms that are in this legislation: insure 32 million more people, make it more affordable for the middle class, end insurance company discrimination based on pre-existing conditions, improve care and benefits under Medicare, and extending Medicare’s solvency for almost a decade, creating a healthier America through prevention, through wellness and innovation, create 4 million jobs in the life of the bill and doing all of that by saving the taxpayer $1.3 trillion dollars. [Applause.]

“Another Speaker, Tip O’Neill once said: ‘All politics is local.’ And I say to you tonight that when it comes to health care for all Americans, ‘All politics is personal.’

“It’s personal for the family that wrote to me who had to choose between buying groceries and seeing a doctor. It’s personal to the family who was refused coverage because their child had a pre-existing condition — no coverage, the child got worse, sicker. It’s personal for women — after we pass this bill, being a woman will no longer be a pre-existing medical condition. [Applause.]

“It’s personal for a senior gentleman whom I met in Michigan, who told me about his wife who had been bed-ridden for 16 years. He told me he didn’t know how he was going to be able to pay his medical bills. As I said to you before, I saw a grown man cry. He was worried that he might lose his home — that they might lose their home because of his medical bills and he didn’t know how he was going to pay them. And most of all, he was too embarrassed to tell his children and ask them for help. How many times have you heard a story like that?

“And it’s personal for millions of families who’ve gone into bankruptcy under the weight of rising health care costs. In fact, many, many, many — a high percentage of bankruptcies in our country are caused by medical bills that people cannot pay. And it’s personal for 45,000 Americans and their — families who have lost a loved one each year because they didn’t and couldn’t get health insurance.

"That is why we’re proud and also humbled today to act with the support of millions of Americans who recognize the urgency of passing health care reform. And more than 350 organizations, representing Americans of every age, every background, every part of the country, who have endorsed this legislation. Our coalition ranges from the AARP, who said that our legislation ‘improves efforts to crack down on fraud and waste in Medicare, strengthening Medicare for today’s seniors and future generations.’ I repeat: ‘Improves efforts to crack down on fraud and waste in Medicare, strengthening the program for today’s and future generations of seniors.’ To the American Medical Association, the Catholic Health Association, the United Medical — the United Methodist Church, and Voices of America’s Children. From A to Z — they are sending a clear message to Members of Congress: Say yes to health care reform. [Applause.]

“We have also reached this historic moment because of the extraordinary leadership and hard work and dedication of all the Members of Congress, but I want to especially recognize our esteemed Chairs — Mr. Waxman, Mr. Rangel, Mr. Levin, Mr. Miller, Mr. Spratt, Ms. Slaughter — for bringing this bill to the floor today. Let us acknowledge them. [Applause.]

“And I want to acknowledge the staff of the committees and of the leadership — they have done a remarkable job — dazzling us with their knowledge and their know-how. [Applause.] I would like to thank on my own staff: Amy Rosenbaum, Wendell Primus, and Arshi Siddiqui.

“And now, I want to just close by saying this. It would not be possible to talk about health care without acknowledging the great leadership of Senator Edward Kennedy, who made health care his life’s work. [Applause.]

“In a letter to President Obama before he passed away — he left the letter to be read after he died. Senator Kennedy wrote that: ‘Access to health care is the great unfinished business of our society.’ That is until today. [Applause.]

“After more than a year of debate, and by the way, the legislation that will go forth from here has over 200 Republican amendments, and while it may not get Republican votes and be bipartisan in that respect, it is bipartisan in having over 200 Republican amendments. [Applause.]

“After a year of debate and hearing the calls of millions of Americans, we have come to this historic moment. Today, we have the opportunity to complete the great unfinished business of our society and pass health insurance reform for all Americans that is a right and not a privilege. [Applause.]

“In that same letter to the President, Senator Kennedy wrote, what is ‘at stake’ he said, ‘At stake are not just the details of policy but…the character of our country.’

“Americans will look back on this day as one which we honored the character of our country and honored our commitment to our nation’s founders for a commitment to ‘life, liberty, and the pursuit of happiness.’

“As our colleague John Lewis has said, ‘We may not have chosen the time, but the time has chosen us.’ We have been given this opportunity. I urge our — an opportunity — stay right up there with again, Social Security, Medicare, health care for all Americans. I urge my colleagues in joining together in passing health insurance reform — making history, making progress, and restoring the American dream.

“I urge an aye vote. Thank you.”