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To revitalize the American dream, we also need to renew the battle to make health care affordable and available to all our people.
In this new century of the life sciences, breakthrough treatments and miracle cures are steadily revolutionizing the practice of medicine and the quality of life. The mapping of the human genome enables us to understand far more about the molecular basis of disease and to plan far-reaching cures that were inconceivable only a few years ago.
Sadly, in America today, the miracles of modern medicine are too often the province only of the wealthy. We need a new guarantee for the years ahead that the cost of these life-saving treatments and cures will not be beyond the reach of the vast majority of the American people.
An essential part of our progressive vision is an America where no citizen of any age fears the cost of health care and no employer refuses to create new jobs or cuts back on current jobs because of the high cost of providing health insurance.
The answer is Medicare, whose 40th birthday we will celebrate in July.
I propose that, as a 40th birthday gift to the American people, we expand Medicare over the next decade to cover every citizen from birth to the end of life.
It's no secret that America is still dearly in love with Medicare. Administrative costs are low, patient satisfaction is high, unlike with many private insurers, they can still choose their doctor and their hospital.
For those who prefer the private insurance, we will offer comparable coverage under the same range of private insurance plans already available to Congress.
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I call this approach Medicare for all, because it will free all Americans from the fear of crippling medical expenses and enable them to seek the best possible care when illness strikes.
The battle to achieve Medicare for all will not be easy. Powerful interests will strongly oppose it, because they profit immensely from the status quo.
Right-wing forces will unleash false attack ads, ranting against socialized medicine and government-run health care. But those attacks are a generation out of date, retreads of the failed campaign that delayed Medicare in the 1950s and '60s.
Today we are immunized against such attacks by the obvious success of Medicare. It is long past time to extend that success to all.
The Democratic Party's proudest moments and greatest victories have always come when we would stand up against powerful interests and fight for the common good. And this coming battle can be another of our finest achievements.
To make the transition from the current splintered system, I propose to phase in Medicare for all age group-by-age group, starting with those closest to retirement, between 55 and 65. Aside from senior citizens themselves, they have the greatest health needs and the highest health costs and need our help the most.
The first stage of the phase-in should also guarantee good health care to every young child. We made a start with the Children's Health Insurance Program in 1997. It does a major part of the job. But it's time to complete the job now.
As we implement this reform, financing must be a shared responsibility. All will benefit; all should contribute.
Payroll taxes should be part of the financing, but so should general revenues, to make the financing as progressive as possible.
By moving to electronic medical records for all Americans when they go to the hospital or doctor, we can save hundreds of billions of dollars a year in administrative cost while improving the quality of care.
Equally important, we should pay for health care based on value and results, not just the number of procedures performed or days in a hospital bed.
We must also expand our investments in medical research so that we can realize even more of its extraordinary promise.
We must confront and defeat the misguided ideology that in the name of life denies lifesaving cures by blocking stem cell research.
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Above all, as we face the forces of globalization, we must inspire a stronger sense of national purpose among our citizens in a wide variety of areas that serve the public interest.
We must affirm anew what it means to be an American. Citizenship is far more than just voting every two years or every four years. The strengthen and genius of our democracy depends on the caring and involvement of our people, and we cannot truly secure our freedom without appealing to the character of our citizens.
If we fail, we open the way for abuses of power in the hands of the few, for neglect of poverty and bigotry and for arrogant foreign policies that shatter our alliances and make enemies of our friends.
Our founders made the values of justice, equality and civic responsibility the cornerstones of America's strength and its future.
If we are serious about reducing the number of abortions, we must be serious about reducing unwanted pregnancy. We must accept policies with a proven track record of reducing abortion.
History teaches that abortions do not stop because they are made illegal. Indeed half of all abortions in the world are performed in places where abortions are illegal.
We do know, however, that the number of abortions is reduced when women and parents have education and economic opportunity. Our progressive vision is of an America where parents have the opportunity and the resources, including good prenatal care, to bring healthy children into the world.
We want every child to be welcomed into a loving home and to be part of the American dream. This fundamental vision is at the heart of who we are as Democrats and we must do everything in our power to make it a reality.
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On the issue of gay rights, I continue strongly to support civil marriage. We cannot and should not require any religion or any church to accept gay marriage.
But it is wrong for our civil laws to deny an American the basic right to be a part of a family, to have loved ones with whom to build a future and share life's joys and tears and to be free from the stain of bigotry and discrimination.
The true American spirit and the basic generosity of the American people here never been more in evidence than in the spontaneous outpouring of support by millions of our fellow citizens for the victims of the deadly tsunami that caused such tragedy and devastation across South Asia.
We are a compassionate and caring people, and in times like this we are never separated by borders or oceans or politics or faith. The people of Indonesia, Sri Lanka and India and Thailand, and other suffering nations are our brothers and sisters.
Sustained action by America and other nations will be essential in the ongoing mission of reconstruction and rehabilitation. The people of South Asia need our help now and they need our long-term support, and so do other peoples struggling desperately to deal with the overwhelming poverty and disease. Their nations can be our friends or be the breeding ground of our enemies.
As President Kennedy said in his inaugural address, If a free society cannot help the many who are poor, it cannot save the few how are rich.
America is strongest in the world when we use our superpower status to join with other nations to achieve great goals.
