The First Lady Visits Caroline Family Practice

3:24 P.M. EDT

     MRS. OBAMA:  Well, thank you.  Yes, it is a little warm.  (Laughter.)  But it was cool in there -- there's some cool air coming out. 

But I want to thank you so much for having me here today.  It's a pleasure to be with all of you to cut the ribbon and declare Caroline Family Practice Community Health Center officially open for business.  That's a good thing.  (Applause.)  

     So you've been open for a little bit, but this is the official opening. 

I want to thank Rod for that wonderful introduction and for everything that he's done and the Central Virginia Health Services are doing to keep families and communities healthy across this nation. 

     I want to do a few more thank you's.  I want to thank and acknowledge Bettina Reed, who you just saw, the Site Director here at Caroline Family Practice, for her tireless hard work in getting this center up and running in such a short period of time.  It's a miraculous endeavor even when you do have the money.  So this is a wonderful thing. 

     I also want to recognize Mary Wakefield, who I saw earlier.  I think she's in the air-conditioned room, but don't be mad.  (Laughter.)  She's the Administrator of the Health Resources and Services Administration, and some of her colleagues are here with us today, and I want to recognize them for their work to promote centers like this all throughout the country. 

     And we also have the First Lady of Virginia here, a good friend of mine, and her lovely daughter, Anne and Annella, who are joining us here.  We're thrilled that they could come.  I've gotten to know this lady over the course of the last couple of years, and I just love her to death, and I am grateful for everything that she and her husband and her family are doing to support places like this.  And it means so much that you're here, because I know this is your thing just as much as anyone's.

     I also want to thank the Vice Chair of the Caroline County Board of Supervisors, Max Rozell; the Mayor of Bowling Green who's here, David Storke; Town Manager, Steve Manster, for all their dedication and leadership -- because none of this stuff happens without the right leadership.  So, thank you.

     And finally, I have to thank all the health care providers who are here and all the health care providers who are listening -– the doctors and the nurses and all the others who've chosen to work in underserved communities like this one.  When you know that many of these folks could have gone to fancy practices and made a lot more money, it's just important to know that there are people who are making commitments to places like Bowling Green, and they're making these communities a primary focus of their practice.  And we have to commend those folks and encourage others to join them in what is a fulfilling and important endeavor.  So we have to acknowledge all of them for their hard work.  (Applause.)  

     And that's sort of one of the things I'd like to talk a little bit about -- oh, no, one more person -- Ms. Maggie James, who -- I don't know if you know, but I know she is the oldest living person in Caroline County.  And she came here to see me.  (Applause.)  She is 109 years young, and looking great in that fuchsia.  (Laughter.)  It's pink, but it's fabulous.  (Laughter.)  And I'm grateful, Ms. James, that you came to see me.

But I wanted to talk a bit about why the work that everyone is doing here is so critical, not just in this community, but all across the nation –- and not just for the health of our families, but for the future of our entire health care system.

     So I know many of you have been following the debate that's going on out there in Washington where I live now.  And I know that with all the numbers, and the ads, and the back-and-forth on TV news shows, it gets easy to lose sight about what it's all about -- all that discussion.  But as I've traveled the country over the past couple years, campaigning for my husband, and even working in health administration, no matter where I've gone, no matter who I've been talking to, they always want to talk about health care.  I don't care if you're lucky enough to have a good health care system or not, you either know someone who has struggled under the current system, and it has been the number-one issue on the minds of the majority of Americans that I've talked to.

     And I think that there's one fact –- one statistic –- that should remind us all exactly what's at stake here, and that is that we spend more money on health care than any other nation on Earth.  We do, already today.  Yet we are nowhere near the healthiest.  And that says something.  We're nowhere near the healthiest.  In fact, people in some of the countries that spend less than we do are actually living longer than we do here in this nation.  And one of the main -- that's other than Ms. James, of course.  (Laughter.)

     And one of the main reasons for this is the reason why we're all here today –- and it's because that right now, today here in America, 60 million people in this country don't have adequate access to primary care.  They don't have any access at all.  Many of them are uninsured and can't afford any kind of health care at all.  That's a good chunk of them.  Many actually have insurance, but live in underserved areas, like this one –- inner cities or small rural towns where there aren't any primary care providers to speak of.  They have to drive hours.

     So what happens to folks in America in this situation is that they don't get check-ups.  They don't get regular, routine screenings that keep us healthy.  When they get sick, their only option is to wait until it gets so bad that they have to visit the emergency room.  And then they wind up lurching from illness to illness, and crisis to crisis, getting emergency care instead of health care.  And we wind up spending billions of dollars each year to treat diseases that –- for far less money –- we could prevent in the first place. 

     We will spend thousands of dollars for an emergency room visit and hospital stay for a child, for example, having an acute asthma attack that could have been prevented by a $100 doctor's visit and a $50 inhaler.  We'll spend tens of thousands to treat complications from diabetes that could have been prevented by a couple hundred dollars worth of counseling on nutrition and blood sugar monitoring.  And today, chronic -– and preventable -- illnesses like diabetes and obesity, heart disease and high blood pressure consume 85 percent of all health care spending in this country.  That's what we're spending our money on here.   

     And if you think that's bad, just wait a few years.  Because right now, if we think about our children, nearly a third of them in this country are overweight or obese, and a third will suffer from diabetes at some point in their lifetimes.  In the African American and Hispanic communities, that number goes up to half -- half of all those kids will be in that situation.  It's gotten so bad that this week, experts from across the country are meeting in Washington for what they're calling a "Weight of the Nation" conference sponsored by the CDC to discuss how we can address the rising threat of obesity, particularly in our children.

     So we know that something is not quite right with the current system.  We sort of know that.  Our experiences tell us that.  We know we need to start focusing on primary care and preventative care –- on promoting wellness, and not just treating sickness.

     That's the mission of this community center and health centers like it across the country that serve 17 million of our fellow citizens -– not just to make diagnoses and hand out prescriptions, but to understand why people are getting sick in the first place, and how they can get healthy and stay healthy in the future. 

     See, when someone goes to the emergency room with a fever or a sore throat, chances are they'll get a quick exam, they'll get some antibiotics, and they’ll get a pretty hefty bill.  But when they come to a place like this, the providers here may very well ask them when they had their last blood pressure checked.  Or they'll delve a little deeper -- they might ask whether they're getting regular mammograms, and how often they exercise, and if they've gotten that mole on their arm checked out.  They just dig a little bit deeper in places like this.  It's an approach to care that's about curing illness and preventing it at the same time.

     And it's an approach that's about making sure that people can actually take advantage of the care that's provided.  There's a whole 'nother level to care, making sure that people actually can access what's available.  In community health centers across the country, they don't just give people appointments; they help folks find transportation to actually get to those appointments. 

Right here, folks don't just write prescriptions; they make sure that people can actually fill them out, that they can connect with programs to ensure that they do.  And folks here don't just tell someone that they need a specialist, but they actually get on the phone and find that specialist, even if it means making dozens of calls until they find someone that the patient can afford. 

In places like this, care is provided in languages that patients can understand, in a way that's respectful of their various cultures, and that takes into account the challenges they face in their everyday life. 

     Ultimately, practice here isn't just about diagnosing problems –- it's about caring for people.  It's about educating people so that they can better educate themselves.  And it's about giving people the security of knowing that health care will be there for them and their families whenever they need it.

     And when you get right down to it, that's what the debate in Washington is all about.  And if you really think about it, that's why my husband and so many folks in Congress are fighting so hard for reform that lowers people's costs and ensures that all families have good coverage that they can actually afford. 

     What they're doing is critical not just for the work this center is doing here in Bowling Green, but for all people across this country.  It's critical to all of us.  And that's one of the key points that I want to make:  that health insurance reform isn't just about the nearly 46 million Americans who don't have insurance; it's also about all those folks who do.

     If you think about it for a minute, right now, for example, you might have a good plan that you really like and think our health system is great just the way it is.  Show of hands?  (Laughter.)  

     But the question becomes, even if you're in that situation, what happens if you lose your job, and then your coverage goes away, and then you can't find a new job right away?  Those are some of the stories I've heard.  Or if you want to change jobs, but your new employer doesn't offer any insurance at all because more and more employers are finding it difficult to keep up with the cost of health care?  Or what if you decide you want to change insurance plans, but your new insurer decides that you have a preexisting condition, or your age or your gender or your health status means that they need to charge you a fortune for that insurance?  What if you get sick, and they decide you're too expensive to insure?  That happens.  And then they drop your coverage completely.  See, these are the things that happen to hardworking, responsible people who've done exactly what they thought they should do.  It's happening every single day across this country. 

     And of course, there are plenty of folks who won't experience any of these misfortunes.  There really are.    They're blessed.  And despite rising costs and declining coverage, some of them are convinced that things are just fine right now.  But even if that were true, even if the status quo were acceptable to us, then the question becomes, what about 10 years from now?  

     If we don't pass reform, within a decade we'll actually be spending one out of every five dollars we earn on health insurance.  In 30 years, when my kids are ready to come into the world, it will be one in every three dollars spent on health care.  So think about that -- one in every three dollars by the time our kids get to be where we are.  And without reform, what we spend on Medicaid and Medicare -- government programs -- will eventually be more than what our government spends on anything else -- anything else -- that we spend today. 

    
     Right now, premiums are rising three times faster than wages -- right now, today.  And if we don't pass reform, they're going to keep on rising in this way.  So think about how much we'll be paying 10 years from now without reform.  That's what we have to project.  Folks who have insurance they like now could find themselves overwhelmed with sky-high premiums and much higher out-of-pocket costs. 

     Think about all the businesses that will have to drop their coverage or lay people off, if we don't pass reform, because they can't afford the cost.  Think about the millions of people who will lose their coverage, and many whom will wind up using the emergency room as their primary care provider, which will mean higher costs for all of us. 

     And then let's go back to the statistics on the childhood obesity and diabetes for a minute.  If a third of our kids are overweight or obese now, what's that going to mean 10 years from now?  How much will we be spending on obesity-related conditions like heart disease and cancer and high blood pressure in 10, 20, 30 years?  How much money will our economy lose in missed days of work and decreased productivity?  And how much will all of this diminish our quality of life here in this nation? 

     And what does it mean that for the first time in the history of our nation, medical experts today warn that this generation -- my children, our grandchildren -- may be on track to have a shorter lifespan than their parents?

     You know, this isn't who we are as Americans.  If there's one thing that defines what it means to be an American, is that we always do better for our kids.  We always do better for our kids.  We sacrifice so that we can give them opportunities and advantages that we never had.  That's what I was taught.  That is our obligation to the next generation.

     That's why my husband and I think about -- that's what we think about at night when we tuck our kids in.  We don't think about the life they have today, we think about the life we're going to provide for them when they're older.  And that's why he ran for President in the first place.  It's not about us, it's not about now; he's running because of the world he wants to leave them.  That's why he's fighting so hard to fix our health care system.  Not just to make it more affordable today; not just to ensure that it covers more people; but to make sure that it provides better, higher-quality care that makes us all healthier.  All of us.

     That's why his plan makes historic investments in prevention and wellness –- investments to help people quit smoking, and to lose weight, and get immunizations and screenings. 

     That's why he included $2 billion in the American Recovery and Reinvestment Act to upgrade and expand community health centers, including the $1.3 million to fund the one that we're here to open today.  This money is going to allow for the expansion of desperately-needed primary care services to more than 2.8 million more people, and it's going to create jobs in places that desperately need them, as well.

     And that's why he's investing $300 million in the Recovery Act for the National Health Service Corps -- something we talked about in our earlier meeting.  It's an outstanding program that helps doctors, dentists, nurses and other health care providers repay their student loans in exchange for practicing in places like this.  It’s a great idea.  And I want to take a moment to recognize all the current and former Corps members who are here with us today, who shared their stories –- because we're so proud of you and so grateful for your contributions to these communities all over the nation -- because you could be doing something else.

     The new investments in this program will more than double its capacity.  Right now there are 38* Corps members serving four million Americans; with the new money there will be 8,000 providers serving 8.5 million Americans by the end of next year if we get this passed.  And many of them will be working in community health centers just like this one, doing the kind of work that means so much to so many Americans. 

     And that's what Dr. Regina Benjamin –- who is my husband's nominee for our next Surgeon General –- this is what she did after graduating from medical school.  She joined the Corps, and was sent down to Alabama.  And what does she do?  She stayed there, eventually running the clinic herself.  And those were stories that we heard here today.  And what she said she was doing was so meaningful that, as she put it, she said, "I don't feel like I'm giving to the community.  I think they're giving to me."  And I heard those same sentiments echoed by the National Health Corps members who are here. 

     In the end, that's what the work in this community center is all about.  It's about the human connections that people make with the people and the communities that they serve.  It's about the steps you take above and beyond what's required, because you really care about your patients.  It's about the peace of mind that you give to people with nowhere else to turn.  And that is the story of community health centers in America.

     It's the story of a man named Ed who was diagnosed with acute myeloid leukemia at a community health center in Oklahoma.  The center not only got him to the oncology services he needed, they came to his house to draw blood when his immune system was too weak for him to go outside.  That's the kind of work you do.

    
     It's the story of a man named Randy, all the way in Indiana, who went to a community health center because of an allergic reaction to his blood pressure medication.  The doctor there noticed the lump on his neck and did some tests, and diagnosed him with cancer.  Randy had no insurance and no way to pay for treatment, but that didn't stop the clinic's Medical Director and CEO.  They spent hours making calls until they found a surgeon who would treat him at a reduced fee.  And today, Randy is cancer free.

     And then there's the story of a nine-year-old boy named Michael who was brought to a community health center in Kansas with a high fever and an abscessed tooth -- something that you will see here on a regular basis.  After having been in severe pain for weeks, he finally got the treatment that he needed.   And then when the staff of the center later came to his school to screen the other kids, they said Randy took their hands and walked into his classroom, and announced to his classmates, "These are my friends and they will help you."

     These are the stories you'll soon be telling here at this center.  Wonderful stories.  I've heard some of them already.  And that's why so many folks in Washington are putting in these long hours to pass health insurance reform -- because all our families deserve this kind of care, and all our kids deserve the chance to have a healthy future. 

     And I think it's fitting that the town of Bowling Green used to be called "New Hope Village" -- that's what I was told  -- because that's exactly what this center will be giving to so many folks in this community.  And we look forward to supporting you in this work in the months and years ahead. 

     Thank you so much for your work, and God bless you all.  Now let's get this opened.  (Applause.)  Thank you. 

                               END              3:56 P.M. EDT

* 3,800