Faire savoir la vérité et être à sa recherche tel est le but de mon blogue.
Je vous invite donc à faire jaillir la vérité par chacune de vos interventions sur ce blogue que vous rendrez plus éclairant.
Soyez les bienvenu(e)s.
La visite du président Biya à Paris a occasionné des achats d'espace dans Le Monde et l'Express qui révoltent les journalistes camerounais. L'un d'entre eux explique pourquoi. En France, seule la société des journalistes de l'Express a protesté.
Mardi dernier, sur le plateau de l’émission «Cartes sur table» diffusée par la chaîne Stv, les invités de Thierry Ngogang ont débattu de la dernière visite du président Paul Biya en France. Me Emmanuel Pensy, Henriette Ekwe directeur de publication de Bebela, Hervé Emmanuel Nkom du Rdpc et Kah Wala du Social democratic front ont en effet abordé la question des publicités parues dans certains journaux français avec le cas particulier de l’hebdomadaire français L’Express. La Société des journalistes (Sdj) de l’Express n’a pas apprécié que le magazine publie, sur une demi-page, un message de la présidence de la République du Cameroun, publicité vantant le site Internet du palais de l’Unité. La Sdj a même publié un communiqué le 24 juillet dans lequel elle estimait qu’une telle réclame «qui paraît opportunément à l’occasion de la visite officielle en France [de Paul Biya] nuit à l’image de L’Express en induisant le doute sur la caution qu’apporterait le journal à un homme régulièrement dénoncé pour ses manquements démocratiques ». Au-delà de ces considérations éditoriales qui n’ont été relevées que par les journalistes de L’Express, les autorités camerounaises ont également payé des pages de publicité dans d’autres journaux français dont le prestigieux quotidien Le Monde. On a ainsi vu une double page centrale consacrée au Cameroun dans l’édition du quotidien fondé par Hubert Beuve Méry du 24 juillet dernier.
Une pub dans Le Monde = un an d'aide à la presse au Cameroun! Les tarifs de publicité y sont connus. Une double page ici coûte 190 000 euros soit 124 640 000 francs Cfa! De la même manière, une page en quadrichromie à l’Express est facturée 25 200 euros soit 16 531 200 francs. Un montant qui permet de se faire une idée du prix de la demi page. La presse camerounaise, toujours en proie à de cruelles difficultés financières, salive à la vue du pactole que la presse française a empoché à la faveur de la visite du chef de l’Etat en France. Pour un peu elle trouverait une telle générosité illégitime. Il faut en effet savoir que l’aide publique à la presse privée s’élève chaque année à 150 millions de francs Cfa. Le Monde, à lui tout seul, a donc reçu 124 640 000 francs Cfa. Mieux encore, le montant total de la publicité dans un quotidien privé au Cameroun s’élève à environ 125 millions sur une période de dix mois à un an.
La liste complète des ministres, des hommes et des sociétés qui se partagent 202 417 hectares au détriment des paysans - Des ministres, des hommes d’hommes, des sociétés ont fait main basse sur les terres de Mbane. Depuis le 19 mars des surfaces totales de terres de 202 417 hectares ont été bradées. La révélation a été faite par la Conférence des leaders de Benno Siggil Senegaal en conférence de presse hier, mardi 28 juillet, dans un hôtel de la place.
Depuis l’Alternance du 19 mars en 2000, des surfaces totales de terres de Deux cent deux mille quatre cent dix sept (202.417,20) hectares ont été bradées dans la communauté rurale de Mbane. Ainsi, en l’espace de trois(3) années seulement de GOANA et REVA, ce furent Cent quatre vingt neuf mille cent quatre vingt dix (189.190) hectares qui ont été spoliés correspondant exactement à la surface totale de la Communauté Rurale (190.600 ha) ! C’est ce qu’a soutenu la Conférence des leaders de Benno Siggil Senegaal en conférence de presse hier, mardi 28 juillet, sur la situation de Mbane. Mieux, si l’on en croit l’opposition, en tenant compte des 30.791 ha distribués entre 1980 et 2002, toutes les surfaces confondues attribuées s’élèvent à Deux cent trente trois mille deux cent huit (233.208,32) hectares depuis la création de la communauté rurale en 1980. « Si la logique boulimique libérale et suicidaire s’éclipse face à une réflexion lucide, on constate qu’en réalité il n’existe plus ni pâturages, ni zones d’habitations, encore moins de forêts classées dans cette Communauté Rurale. En effet, la surface de la communauté rurale de Mbane s’élève à 190.600 hectares seulement alors que 233.208 hectares de terres ont été distribués, soit quarante deux mille six cent huit (42.608,32) hectares de plus », affirme la Conférence des leaders de Benno Siggil Senegaal. Des autorités de la République font main basse….
Pour l’opposition, le scandale foncier est d’autant plus inacceptable, qu’il implique de grandes personnalités de la République, qui manifestement, dit-elle, piétinent la loi N° 64-46 du 17 juin 1964 relative au Domaine National. Ces autorités de la République « se sont fait attribuer des milliers d’hectares, n’ont payé ni des frais de bornage, encore moins entamé une quelconque exploitation de ces terres ». Et « ayant pris les meilleures terres aux abords immédiats du Lac de Guiers, elles ont par voie de conséquence pris toutes les dispositions de pouvoir, pour confiner les paysans et éleveurs dans les zones arides du Diéri ».
Comme des vautours autour du butin
La Conférence des leaders de Benno Siggil Senegaal donne la liste des bénéficiaires, il s’agit de :
* Dakaria Diaw, le Directeur de Cabinet du Président de la République, 1.000 hectares, * Souleymane Ndéné Ndiaye, Premier Ministre, 50 hectares, * Djibo Kâ, Ministre, 100 hectares, * Papa Diop, Président Sénat, Ancien maire de Dakar, 800 hectares, * Assane Bâ, Ministre Conseiller du Président de la République, 500 hectares, - *Maître Madické Niang, Ministre d’Etat, Ministre de la justice, 100 hectatres, - *Samuel Hameth Sarr, Ministre, 100 hectares, * Oumar Sarr, Ministre d’état, 300 hectatres, * Hamath Sall, Ministre 100 hectares, * Thierno Lô, Ministre, 1.000 hectares, * Cheikh Lô, Frère du Ministre Thierno Lô, 1.500 hectares, * Bacar Dia, Ancien Ministre du Sport, 300 hectares, * Général de division Boubacar Wane, 300 hectares, * Général Abdoulaye Fall, 100 hectares, * Madické Diop, Magistrat, 50 hectares, * Ministère de l’Agriculture et de l’élevage, 1.000 hectares, * Me Cheikh Bamba Niang, Magistrat, 210 hectares, * Mme Rokhaya Agathe, 30.000 hectares (trente mille), * Babacar Ndiaye « Keur Khadim », 2.150 hectares, * Rabi Fakih, 3.000 hectatres, * Ibrahima Ndiaye, 1.500 hectares, * Serigne Mboup CCBM, 500 hectares, * Oumar Guèye, fils du Président de la Chambre de Commerce de Kaolack, 6.000 hectatres, * Al Housseynou Dème, Sous-préfet de Mbane, 40 hectares, * l’Union des Jeunes Travailliste Libérales (UJTL), 10 hectares
A cette liste, il faut ajouter les sociétés attributaires :
* Société « Plantation verte », 20.000 hectares, * SEDIMA S.A., 1.000 hectares, * Société MTM, 30.000 hectares (trente mille), * Société SENEGINDIA, 5.000 hectares, * Sté Hispano-Sénégalaise, 1.000 hectatres, * SEPROCA SA, 5.000 hectares, * TOUBA INSER, 2500 ha, * PROMODEV SA, 50.000 hectares (cinquante mille), * AFRINVEST, 5.000 Hectares, * Henno Sann, 800 hectares, * John Roberts, DG Bomfords, Angleterre, 500 hectares, * Société Agro Pastorale SANOSSI, 1.500 hectares
Penser aux conséquences d’une boulimie foncière
A en croire le Benno Siggil Senegaal , si les 233.208 hectares distribués devaient être irrigués, on devrait faire face à une opposition immédiate de la Mauritanie et du Mali. Il soutient que pour « le programme de l’après barrage, seuls 240.000 hectares peuvent être aménagés sur la rive gauche du Fleuve Sénégal au profit du Sénégal, sur lesquels seuls 140.000 sont destinés à l’agriculture (voir le Programme de Développement Intégré de la Rive Gauche (PDRH) élaboré par la SONED et l’état du Sénégal) ». Avant de s’interroger : « Comment peu-t-on alors envisager d’exploiter 233.208 hectares à Mbane sans provoquer une crise dans la sous-région ? Pour beaucoup moins que cela, l’excellent Programme des Vallées Fossiles pour le Sénégal, initié sous le régime socialiste, a été sacrifié, pour éviter un conflit avec la Mauritanie ! ».
En plus, au plan de l’environnement et de l’approvisionnement en eau potable, souligne l’opposition, « il faut savoir que le hydrogéologues ont prouvé que le lac de GUIERS perdait 75% de son volume par évapotranspiration chaque année. Si on veut en plus irriguer 233.208 hectares avec ses mêmes ressources hydriques, on l’assécherait et on priverait Dakar d’eau potable de manière irréversible ».
Pourquoi ils veulent changer le Pcr issu des rangs de Benno
La Conférence des leaders de tirer la conclusion « qu’au vu de ce qui précède, on comprend mieux les enjeux des élections rurales dans la Communauté Rurale de Mbane. Une nouvelle équipe est arrivée au pouvoir, suite à une éclatante victoire de la coalition « BENNOO SIGGIL SENEGAAL » au lendemain des élections municipales et Rurales du 22 mars 2009 ». Cette dernière avait, selon l’opposition, commencé à mettre en œuvre ses promesses électorales suivantes, en l’occurrence : « un audit citoyen des attributions des terres en zones de terroir ;La désaffectation des terres attribuées illégalement ; Une redistributions des terres aux paysans, éleveurs et ayant droits ; Le refus systématique de déplacements de villages Peulhs au profit de l’agriculture ». Et d’ajouter : « Les déprédateurs de la République sachant que leurs terres seront nécessairement désaffectées, font tout ce qui est en leur pouvoir, pour éviter que l’équipe de « BENNOO SIGGIL SENEGAL » victorieuse ne s’installe durablement aux commandes »
La résistance s’organise
Pour les populations de Mbane, il n’est pas question qu’une nouvelle équipe vienne prendre les rênes de leur Communauté Rurale. « Elles ne veulent ni d’une équipe SOPI ni d’une Délégation spéciale, qui ne serait rien d’autre qu’un bras armé du SOPI et des déprédateurs de la République », souligne l’opposition, avant d’ajouter : « Si les tenants du pouvoir essayent d’imposer Mamadou Ciré Diallo et son équipe à la tête de la Communauté Rurale ou d’y installer une Délégation Spéciale, les populations leurs opposeraient une désobéissance civile sans précédent dans l’histoire de notre pays, jusqu’à l’avènement d’un nouveau régime, en l’occurrence : refus de payer les impôts, refus de payer les taxes dans les loumas, déclaration de tous les membres du « nouveau Conseil Rural » persona non grata dans la Communauté Rurale, Refus de déférer à toute convocation de ce « Conseil » ou de son « Président », Interdiction de tenue de réunions dans la maison Communautaire de Mbane, Refus de travailler avec le nouveau sous-préfet, etc.. »
En tout état de cause, le Front « BENNOO SIGGIL SENEGAAL » « avertit solennellement, qu’il se réserve, une fois au pouvoir, le droit de remettre en cause toute acquisition de terres dans des conditions non transparentes à Mbane, surtout par des Ministres de la République, qui ont manifestement abusé de leur situation de pouvoir et de proximité avec le Président Abdoulaye Wade, pour spolier les pauvres populations. Aucune indemnisation ou dédommagements ne leur seront payés ».
Speaking to North Carolinians at a town hall in Raleigh, the President made clear why health reform will benefit all American: "if you’ve got health insurance, then the reform we’re proposing will also help you because it will provide you more stability and more security. Because the truth is we have a system today that works well for the insurance industry, but it doesn’t work well for you." We all know the horror stories, which is why the health insurance consumer protections that are part of reform are so important.
At the town hall, the President outlined these core principles:
Let me be specific. We will stop insurance companies from denying you coverage because of your medical history. (Applause.) I've told this story before -- I will never forget watching my own mother, as she fought cancer in her final days, worrying about whether her insurer would claim her illness was a preexisting condition so they could wiggle out of paying for her coverage. How many of you have worried about the same thing? (Applause.) A lot of people have gone through this. Many of you have been denied insurance or heard of someone who was denied insurance because they got -- had a preexisting condition. That will no longer be allowed with reform. (Applause.) We won't allow that. (Applause.) We won't allow that.
With reform, insurance companies will have to abide by a yearly cap on how much you can be charged for your out-of-pocket expenses. No one in America should go broke because of an illness. (Applause.)
We will require insurance companies to cover routine checkups and preventive care, like mammograms and colonoscopies -- (applause) -- eye and foot exams for diabetics, so we can avoid chronic illnesses that cost not only lives, but money. (Applause.)
No longer will insurance companies be allowed to drop or water down coverage for someone who's become seriously ill. That's not right, it's not fair. (Applause.) We will stop insurance companies from placing arbitrary caps on the coverage you can receive in a given year or in a lifetime. (Applause.)
So my point is, whether or not you have health insurance right now, the reforms we seek will bring stability and security that you don't have today -- reforms that will become more urgent and more urgent with each passing year.
So, in the end, the debate about reform boils down to a choice between two approaches. The first is projected to double your health care costs over the next decade, make millions more Americans uninsured, bankrupt state and federal governments, and allow insurance companies to run roughshod over consumers. That's one option. That's called the status quo. That's what we have right now.
I want everybody to understand this. If we do nothing, I can almost guarantee you your premiums will double over the next 10 years because that's what they did over the last 10 years. It will go up three times faster than your wages, so a bigger and bigger chunk of your paycheck will be going into health insurance. It will eat into the possibility of you getting a raise on your job because your employer is going to be looking and saying, I can't afford to give you a raise because my health care costs just went up 10, 20, 30 percent. And Medicare, which seniors rely on, is going to become more and more vulnerable. On current projections, Medicare will be in the red in less than 10 years.
So that's the status quo. When everybody goes around saying, why is Obama taking on health care -- that's the answer. That's one option. I don't like that option. You shouldn't either. (Applause.) That plan doesn't sound too good. That's the health care system we have right now.
You can read more about the President’s eight health insurance consumer protections here, and figure out how reform will directly affect you and your family.
Speaking to tens of thousands of AARP members today, the President told them that "We’ve made a lot of progress over the last few months... I know it's not easy. I know there are folks who will oppose any kind of reform because they profit from the way the system is right now." Forty-four years to the day after Medicare was passed, he pointed out that opponents used the same sort of scare tactics back then: "They'll run all sorts of ads that will make people scared. This is nothing that we haven't heard before.," He noted that at the time opponents called Medicare "socialized medicine," but over the past four decades it has helped seniors live longer, healthier, and more productive lives.
(President Barack Obama, center, with AARP Chief Executive Officer A. Barry Rand, left, and AARP President Jennie Chin Hansen, right, participates in an AARP tele-town hall on health care Tuesday, July 28, 2009. Official White House Photo by Pete Souza.)
And as consensus builds for comprehensive health insurance reform, we are closer than ever before to passage thanks to groups like AARP, an organization which has been at the forefront of the fight for reform. The President held a tele-town hall today at AARP headquarters to answer questions from seniors about how reform will affect them. In his opening remarks, the President outlined the main pillars in his plan for health insurance reform:
And that's why I want to start by taking a new approach that emphasizes prevention and wellness, so that instead of just spending billions of dollars on costly treatments when people get sick, we're spending some of those dollars on the care they need to stay well: things like mammograms and cancer screenings and immunizations -- common-sense measures that will save us billions of dollars in future medical costs.
We're also working to computerize medical records, because right now, too many folks wind up taking the same tests over and over and over again because their providers can't access previous results. Or they have to relay their entire medical history -- every medication they've taken, every surgery they've gotten -- every time they see a new provider. Electronic medical records will help to put an end to all that.
We also want to start rewarding doctors for quality, not just the quantity, of care that they provide. Instead of rewarding them for how many procedures they perform or how many tests they order, we'll bundle payments so providers aren't paid for every treatment they offer with a chronic -- to a patient with a chronic condition like diabetes, but instead are paid for how are they managing that disease overall. And we'll create incentives for physicians to team up and treat a patient better together, because we know that produces better outcomes.
And we certainly won't cut corners to try to cut costs, because we know that doesn't work. And that's something that we hear from doctors all across the country. For example, we know that when we discharge people from the hospital a day early without any kind of coordinated follow-up care, too often they wind up right back in the hospital a few weeks later. If we had just provided the right care in the first place, we'd save a whole lot of money and a lot of human suffering, as well.
Finally, we'll eliminate billions in unwarranted subsidies to insurance companies in the Medicare Advantage program --giveaways that boost insurance company profits but don't make you any healthier. And we'll work to close that doughnut hole in Medicare Part D that's costing so many folks so much money. Drug companies, as a consequence of our reform efforts, have already agreed to provide deeply discounted drugs, which will mean thousands of dollars in savings for the millions of seniors paying full price when they can least afford it.
The President then took questions via email, phone, and from the audience. One question was about whether insurance companies will be required to cover people with pre-existing conditions, which the President answered with a resounding yes:
Number one, if you've got a preexisting condition, insurance companies will still have to insure you. This is something very personal for me. My mother, when she contracted cancer, the insurance companies started suggesting that, well, maybe this was a preexisting condition; maybe you could have diagnosed it before you actually purchased your insurance. Ultimately, they gave in, but she had to spend weeks fighting with insurance companies while she's in the hospital bed, writing letters back and forth just to get coverage for insurance that she had already paid premiums on. And that happens all across the country. We are going to put a stop to that. That's point number one.
Point number two: We're going to reform the insurance system so that they can't just drop you if you get too sick. They won't be able to drop you if you change jobs or lose your job, as long as you're willing to pay your premiums. They are -- we're going to make sure that we eliminate sort of the lifetime cap that creates a situation -- a lot of times people get sick, then they find out the fine print says that at a certain point they just stop paying, or they'll pay for your hospitalization but they don't pay for your doctor, or they pay for your doctor but not your hospitalization.
We want clear, easy-to-understand, straightforward insurance that people can purchase. So that's point number one.
Point number two is, in addition to those reforms, we want to make sure that we set up what's called a health insurance exchange so that anybody who wants insurance but can't get it on their job right now, they can go to this exchange; they can select a plan that works for them or their families -- these are private-option plans, but we also want to have a public option that's in there -- but whatever you select, you will get high-quality care for a reasonable cost, the same way Congress, members of Congress, are able to select from a menu of plans that they have available. And if you're very -- if the plan that you select is still too expensive for your income, then we would provide you a little bit of help so that you could actually afford the coverage.
So the idea behind reform is: Number one, we reform the insurance companies so they can't take advantage of you. Number two, that we provide you a place to go to purchase insurance that is secure, that isn't full of fine print, that is actually going to deliver on what you pay for. Number three, we want to make sure that you're getting a good bargain for your health care by reducing some of the unnecessary tests and costs that have raised rates.
Even if you have health insurance, your premiums have gone up faster than wages over the last 10 years. Your out-of-pocket costs have gone up about 62 percent, which means that for people who aren't on Medicare right now, people let's say 54 to -- or 50-64, a lot of those folks are paying much higher premiums than they should be -- hundreds or thousands of additional dollars that could be saved if we had a system that was more sensible than it is right now.
As a perfect example of the scare tactics spread by those looking to protect the status quo, one questioner from North Carolina repeated a myth spread by her home state Member of Congress recently. The audience had a laugh as the President dispelled it:
Q I have heard lots of rumors going around about this new plan, and I hope that the people that are going to vote on this is going to read every single page there. I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die. This bothers me greatly and I'd like for you to promise me that this is not in this bill.
THE PRESIDENT: You know, I guarantee you, first of all, we just don't have enough government workers to send to talk to everybody, to find out how they want to die.
I think that the only thing that may have been proposed in some of the bills -- and I actually think this is a good thing -- is that it makes it easier for people to fill out a living will.
Read the transcript for his full explanation of how this provision actually works, as well as his full answers to a whole range of questions seniors have been asking.
THE WHITE HOUSE
Office of the Press Secretary __________________________________________________________________________ For Immediate Release July 28, 2009
REMARKS BY THE PRESIDENT IN AN AARP TELE-TOWN HALL ON HEALTH CARE REFORM
AARP Headquarters Washington, D.C.
1:40 P.M. EDT
THE PRESIDENT: Thank you. Thank you so much. (Applause.) I am just going to provide some brief remarks, and then I want to hear from you.
It is wonderful to be here today. I want to thank Mike for moderating this discussion. I want to thank Jennie and Barry for their extraordinary leadership here at AARP.
Some of you may know that 44 years ago today, when I was almost four years old, after years of effort, Congress finally passed Medicare, our promise as a nation that none of our senior citizens would ever again go without basic health care. It was a singular achievement -- one that has helped seniors live longer, healthier and more productive lives; it's enhanced their financial security; and it's given us all the peace of mind to know that there will be health care available for us when we're in our golden years.
Today, we've got so many dedicated doctors and nurses and other providers across America providing excellent care, and we want to make sure our seniors, and all our people, can access that care.
But we all know that right now, we've got a problem that threatens Medicare and our entire health care system, and that is the spiraling cost of health care in America today. As costs balloon, so does Medicare's budget. And unless we act, within a decade -- within a decade -- the Medicare trust fund will be in the red.
Now, I want to be clear: I don't want to do anything that will stop you from getting the care you need -- and I won't. But you know and I know that right now we spend a lot of money in our health care system that doesn't do a thing to improve people's health. And that has to stop. We've got to get a better bang for health care dollar.
And that's why I want to start by taking a new approach that emphasizes prevention and wellness, so that instead of just spending billions of dollars on costly treatments when people get sick, we're spending some of those dollars on the care they need to stay well: things like mammograms and cancer screenings and immunizations -- common-sense measures that will save us billions of dollars in future medical costs.
We're also working to computerize medical records, because right now, too many folks wind up taking the same tests over and over and over again because their providers can't access previous results. Or they have to relay their entire medical history -- every medication they've taken, every surgery they've gotten -- every time they see a new provider. Electronic medical records will help to put an end to all that.
We also want to start rewarding doctors for quality, not just the quantity, of care that they provide. Instead of rewarding them for how many procedures they perform or how many tests they order, we'll bundle payments so providers aren't paid for every treatment they offer with a chronic -- to a patient with a chronic condition like diabetes, but instead are paid for how are they managing that disease overall. And we'll create incentives for physicians to team up and treat a patient better together, because we know that produces better outcomes.
And we certainly won't cut corners to try to cut costs, because we know that doesn't work. And that's something that we hear from doctors all across the country. For example, we know that when we discharge people from the hospital a day early without any kind of coordinated follow-up care, too often they wind up right back in the hospital a few weeks later. If we had just provided the right care in the first place, we'd save a whole lot of money and a lot of human suffering, as well.
Finally, we'll eliminate billions in unwarranted subsidies to insurance companies in the Medicare Advantage program --giveaways that boost insurance company profits but don't make you any healthier. And we'll work to close that doughnut hole in Medicare Part D that's costing so many folks so much money. Drug companies, as a consequence of our reform efforts, have already agreed to provide deeply discounted drugs, which will mean thousands of dollars in savings for the millions of seniors paying full price when they can least afford it.
All of this is what health insurance reform is all about: protecting your choice of doctor; keeping your premiums fair; holding down your health care and your prescription drug costs; improving the care that you receive -- and that's what health care reform will mean to folks on Medicare.
We've made a lot of progress over the last few months. We're now closer to health care reform than we ever have been before. And that's due in no small part to the outstanding team that you have here at AARP, because you've been doing what you do best, which is organize and mobilize, and inform and educate people all across the country about the choices that are out there; pushing members of Congress to put aside politics and partisanship; and finding solutions to our health care challenges.
I know it's not easy. I know there are folks who will oppose any kind of reform because they profit from the way the system is right now. They'll run all sorts of ads that will make people scared. This is nothing that we haven't heard before. Back when President Kennedy, and then President Johnson, were trying to pass Medicare, opponents claimed it was "socialized medicine." They said it was too much government involvement in health care; that it would cost too much; that it would undermine health care as we know it.
But the American people and members of Congress understood better. They ultimately did the right thing. And more than four decades later, Medicare is still giving our senior citizens the care and security they need and deserve.
With the AARP standing on the side of the American people, I'm confident that we can do the right thing once again, and pass health insurance reform and ensure that Medicare stays strong for generations to come.
So I'm hoping that I can answer any questions that you have here today. I'm absolutely positive that we can make the health care system work better for you, work better for your children, work better for your parents, work better for your families, work better for your businesses; work better for America. That's our job.
So thank you very much. (Applause.)
MR. CUTHBERT: Much as it would be every broadcaster's dream to share the podium with the President of the United States, he has to get wired up for sound. So I'll start with a question that was e-mailed in before the program, which combines a couple of factors you spoke about, Mr. President.
He says: My brother is 56 and uninsurable. He could afford to buy insurance, but he can't get it because he has a preexisting condition and in his state there is not a high-risk pool. When the President's program starts, will insurance companies be required to cover people with preexisting conditions? Will he be able to get insurance in the first phase of the plan, even if he's willing to pay the full amount?
THE PRESIDENT: The answer is yes. And so let me talk just a little bit about the kind of insurance reform that we're proposing as part of the broader reform package.
Number one, if you've got a preexisting condition, insurance companies will still have to insure you. This is something very personal for me. My mother, when she contracted cancer, the insurance companies started suggesting that, well, maybe this was a preexisting condition; maybe you could have diagnosed it before you actually purchased your insurance. Ultimately, they gave in, but she had to spend weeks fighting with insurance companies while she's in the hospital bed, writing letters back and forth just to get coverage for insurance that she had already paid premiums on. And that happens all across the country. We are going to put a stop to that. That's point number one.
Point number two: We're going to reform the insurance system so that they can't just drop you if you get too sick. They won't be able to drop you if you change jobs or lose your job, as long as you're willing to pay your premiums. They are -- we're going to make sure that we eliminate sort of the lifetime cap that creates a situation -- a lot of times people get sick, then they find out the fine print says that at a certain point they just stop paying, or they'll pay for your hospitalization but they don't pay for your doctor, or they pay for your doctor but not your hospitalization.
We want clear, easy-to-understand, straightforward insurance that people can purchase. So that's point number one.
Point number two is, in addition to those reforms, we want to make sure that we set up what's called a health insurance exchange so that anybody who wants insurance but can't get it on their job right now, they can go to this exchange; they can select a plan that works for them or their families -- these are private-option plans, but we also want to have a public option that's in there -- but whatever you select, you will get high-quality care for a reasonable cost, the same way Congress, members of Congress, are able to select from a menu of plans that they have available. And if you're very -- if the plan that you select is still too expensive for your income, then we would provide you a little bit of help so that you could actually afford the coverage.
So the idea behind reform is: Number one, we reform the insurance companies so they can't take advantage of you. Number two, that we provide you a place to go to purchase insurance that is secure, that isn't full of fine print, that is actually going to deliver on what you pay for. Number three, we want to make sure that you're getting a good bargain for your health care by reducing some of the unnecessary tests and costs that have raised rates.
Even if you have health insurance, your premiums have gone up faster than wages over the last 10 years. Your out-of-pocket costs have gone up about 62 percent, which means that for people who aren't on Medicare right now, people let's say 54 to -- or 50-64, a lot of those folks are paying much higher premiums than they should be -- hundreds or thousands of additional dollars that could be saved if we had a system that was more sensible than it is right now.
MR. CUTHBERT: We go to Margaret, in Greeley, Colorado, for our first tele-town call. Go ahead, Margaret. Margaret, are you there? Let me ask Margaret's question for her. She wants to keep her good coverage. Will it continue with the new plan?
THE PRESIDENT: Here's a guarantee that I've made: If you have insurance that you like, then you will be able to keep that insurance. If you've got a doctor that you like, you will be able to keep your doctor. Nobody is trying to change what works in the system. We are trying to change what doesn't work in the system.
And this -- let me also address I think a misperception that's been out there that somehow there is any discussion on Capitol Hill about reducing Medicare benefits. Nobody is talking about reducing Medicare benefits. Medicare benefits are there because people contributed into a system. It works. We don't want to change it. What we do want is to eliminate some of the waste that is being paid for out of the Medicare trust fund that could be used more effectively to cover more people and to strengthen the system.
So, for example, right now we're paying about $177 billion over 10 years to insurance companies to subsidize them for participating in Medicare Advantage. Now, insurance companies are already really profitable. So what we've said is let's at least have some sort of competitive bidding process where these insurance companies who are participating, they're not being subsidized on the taxpayer dime; if they got better services -- they have better services that they can provide to seniors rather than through the traditional Medicare program, they're free to participate, but we shouldn't be giving them billions of dollars worth of subsidies.
That's the kind of change that we want to see. That will strengthen Medicare. But nobody is talking about cutting Medicare benefits. And I just want to make that absolutely clear because we've received some e-mails and some letters where people are concerned that that may happen.
MR. CUTHBERT: Our operators, by the way, are telling us that we have literally tons of questions from people worried about keeping the care they have. On the other hand, Ollie, in Texas, you've got a concern on the other end.
Hi, Ollie.
Q Hello. May I start now?
THE PRESIDENT: Yes.
Q Well, I am an AARP volunteer, an AARP member. I support AARP's position on health care reform and I want to thank President Obama for making this a priority issue on his agenda also.
My question is there are so many negative ads and so many negative articles about the tremendous cost for health care reform that is being proposed by different congressional committees. What we don't hear is what the dollar amount would be if we do nothing. And I think this is very important because people are scared by the trillions of dollars, and I know that if we do nothing for the next 10 years, health care will still keep on rising. And I want to know if the President has any way of putting out some information as to what it would cost if we do nothing. Thank you.
THE PRESIDENT: Well, look, I think this is a great question, Ollie, and so let me try to be as specific as I can about the cost of doing nothing.
I've already mentioned that health care costs are going up much faster than inflation. So your wages, your income, if you're lucky, right now, maybe they're going up 2 percent a year, maybe 3 percent a year; for a lot of people, they're not going up at all because the economy is in tough shape. But your health care costs are still going up 6 percent a year, 7 percent a year. Some people are getting notices in the mail their premium just went up 20 percent.
On that trajectory, health care costs will probably double again -- your premiums will probably double again over the next 10 years. They may even go up faster than that. The costs of Medicare are going to keep on rising a lot faster than tax revenues coming in, which means that the trust fund -- you've got more money going out than is coming in, which makes that more unstable. And we know that if we do nothing we will probably end up seeing more people uninsured.
We're already seeing 14,000 people lose their health insurance every day -- 14,000 people. So the costs of doing nothing are trillions of dollars in costs over the next couple of decades -- trillions -- not billions, but trillions of dollars in costs, without anybody getting any better care.
So what we've said is if we can control health care inflation, how fast costs are going up, then not only can we stabilize the Medicare trust fund, not only can we help save families money on their premiums, but we can actually afford to provide coverage to the people who currently don't have health care.
Now, here's the problem, that in order for us to save money, in some cases, we've got to spend some money up front. Let me give you some very specific examples. Health care IT: Health care is the only area where you still have to fill out five different forms -- when you go into a bank you don't have to do that. You've got an ATM. If you use your credit card, they'll find you real quick and the billing is real easy -- (laughter) -- right? But if for some reason you want health care, you fill out pencil and paper -- I guess they Xerox it -- they give it to somebody else. Sometimes you see their files and it's all stuffed with papers, and nurses can't read the doctor's handwriting.
So for us to set up a system like they have at the Cleveland Clinic that I just visited in Ohio, where every medical record -- your privacy is protected, but everything is digitalized; everything -- the minute you take a test, it goes to all the doctors and all the specialists that you might end up dealing with. So you end up just having that one test instead of having to then go back to the doctor again and again and again and have a bunch of different tests. Well, that saves money, but you've got to get the computer equipment in the first place to do it. So in some cases we've got to spend some money on the front-end.
I also think that if we provide coverage for people who don't have health insurance right now, then they are going to be getting preventive care, they're going to be getting screenings, and so they don't end up in the emergency room with really expensive care that all of us are paying for, even though we don't know it.
The average family is spending about $900 a year in higher health care premiums, because they are paying indirectly for uncompensated care. Essentially, the insurance companies charge you a little more, and hospitals and doctors, they're all charging you a little bit more, because they're not getting reimbursed for people who don't have any care whatsoever.
So what we've done is we've said, look, over 10 years, the health care reform proposals, to cover everybody, would cost about a trillion dollars over 10 years. So that's about $100 billion a year. Keep in mind we spend $2 trillion every year on health care, so this is just a fraction of what we spend. But we're talking about a trillion dollars over 10 years -- that's $100 billion a year.
About 60 percent of that can be paid for by taking money that's already in the system but isn't working to make you healthier -- that can pay for about 60 percent of it. So really what we're talking about is another $30 billion to $40 billion every year to cover everybody, and we're going to get most of that money back if we're providing more prevention, more wellness, doctors and hospitals are being reimbursed more intelligently. Over time that money will -- that investment will more than pay for itself.
But Ollie is exactly right -- you get these stories where, oh, there's a trillion dollars here, a trillion dollars there; after a while it starts being real money, even here in Washington. And so I understand people being scared that this is going to be way too costly. It's not that costly if we start making changes right now.
Last point I would make, just to give you a sense of why I know that we can get savings in the system without over the long term spending more money. We spend about $6,000 per person more than any other industrialized nation on Earth -- $6,000 more than the people do in Denmark, or France, or Germany, or -- every one of these other countries spend at least 50 percent less than we do, and you know what, they're just as healthy.
And I just had a doctor in the Oval Office today who told me it's not because they're healthier; it turns out they actually are generally older and they smoke at a higher rate. And so, in fact, their costs should be higher than ours. And yet they are spending $6,000 per person less than we are.
Now, that's money out of your pocket. If you're already retired, it's money that is out of your pocket because some of that money could have been going into your retirement fund instead of going to pay for your health care. If you're working right now, some of that money could be going into your paycheck instead of going into your health benefits right now. It's money that is being given away, and we need to save it. That's why health reform is so important.
MR. CUTHBERT: Let's go next to Illinois and talk with Caroline with her question. Caroline, you're on the tele-town hall.
Q Thank you. Hello, Mr. President, from Joliet.
THE PRESIDENT: Good to -- tell everybody in Joliet I said hi. (Laughter.)
Q I will, thank you. I came from our AARP chapter meeting this morning and I asked for questions. There were two big fears that came out of the discussion. One had to do with the fear of losing a preferred insurance plan, which I think you've addressed to some extent this morning.
THE PRESIDENT: Right.
Q The other has to do with the knowledge that there will be millions of dollars of cuts in Medicare over the years to accommodate baby boomers. So the question is, does this translate into dictation of what can and cannot be given to a senior as service? For example, will there be fewer hip and knee replacements? Even if I decide when I'm 80 that I want a hip replacement, am I going to be able to get that? Am I going to be able to see a cardiologist if I have a heart condition, or other specialist? Or is that going to all be primary care?
I'm calling it rationing of care, I'm coining it that.
THE PRESIDENT: Yes -- no, I think it's an excellent question, Caroline, and I appreciate it because I do think this is a concern that people have generally.
My interest is not in getting between you and your doctor, although keep in mind right now, insurance companies are often getting between you and your doctor. So it's not as if these choices aren't already being made; it's just they're being made by private insurance companies, without any real guidance as to whether the decisions that are being made are good decisions to make people healthier or not. So what we've said is we just want to provide some guidelines to Medicare, and by extension, the private sector, about what works and what doesn't.
Some of you may have heard we wanted to set up what we're a IMAC -- an independent medical advisory committee -- that would, on an annual basis, provide recommendations about what treatments work best and what gives you the best value for your health care dollar. And this is modeled on something called MedPAC, which, by the way, Jennie, who is sitting right next to me, is currently on, and gives terrific recommendations every year about how we could improve care -- to reduce the number of tests, or to make sure that we're getting more generic drugs in the system if those work and are cheaper -- all kinds of recommendations like that. Unfortunately, right now they're just sitting on a shelf.
So we don't want to ration by dictating to somebody, okay, you know what, we don't think that this senior should get a hip replacement. What we do want to be able to do is to provide information to that senior and to her doctor about this is the thing that is going to be most helpful to you in dealing with your condition.
So let's say that person is diabetic. It turns out that if hospitals and doctors are providing reimbursements for a nurse practitioner or a social worker to work with that diabetic to control their diets and their medications, then they may avoid having to get a foot amputation. That's a good outcome. And by the way, that will save money. That saves Medicare money. And if we save money on Medicare, that means that it's going to be more stable and more solvent over the long term.
So the thing that I'm -- if I were -- look, I think I'm scheduled to get my AARP card in a couple years, is that right? (Laughter.)
MR. CUTHBERT: Anytime you want one. (Laughter.)
THE PRESIDENT: I know I'm automatically getting -- associate member, right? Okay. (Laughter.)
So if I was thinking about Medicare and making sure that I was secure, the thing that I would be most worried about right now is health care inflation keeps on going up and the trust fund in 10 years is suddenly in the red. And now Congress has to make some decisions: Are they going to put more money into Medicare, especially given the deficits and the debt that we already have? Or are they, at that point, going to start making decisions about cutting benefits, but not based on any science or what's making people healthier -- they're just going to start making it based on politics?
And what we're saying is we can avoid that scenario by starting to make some good decisions now about how do we improve care, make the system more rational, make it work better. That will actually stabilize and save Medicare over the long term.
One last point, because I think Caroline also raised the issue of we're taking some money out of Medicare. The only things that we're talking about have nothing to do with benefits. It has to do with things like subsidizing insurance companies or, for example, right now we reimburse hospitals for the amount of time that you're there without checking to see if they're doing a good job in the first place. So they have no penalty. If you go into the hospital, they're supposed to fix you; suddenly you have to go back three weeks later. That hospital gets paid all over again, even though they didn't get it right the first time.
Now, if you got your car fixed at a mechanic, and three weeks later you had to go back, and you had to pay again to get your car fixed all over again, you'd be pretty mad, wouldn't you?
A
nd yet when it comes to health care, that happens all the time. That happens all the time. And the hospital gets reimbursed for the second time or the third time, even though they didn't get it right the first time.
And so what we're saying is, let's incentivize the hospitals; we'll pay you a little bonus if the person is not readmitted because you got it right the first time. That will save money over the long term. Those are the kinds of changes we're talking about.
MR. CUTHBERT: We have been very geographically in-specific in our conversation so far, so let's get geographically specific, like going to Jeanine in our audience. She's from Fairmont, Nebraska, and has a very relevant question.
Jeanine, welcome to the tele-town hall.
Q Hi, Mr. President.
THE PRESIDENT: Hi, Jeanine.
Q I'm concerned about affordability and preexisting conditions, and I'm glad to hear you say what you have. My family and I live in rural Nebraska and my husband and I are both -- are self-employed, and we're paying -- and he was originally denied because of a preexisting condition, and he's in a CHIPS pool. We're paying $900 a month, and we have a $8,000 deductible.
THE PRESIDENT: Yes, that's tough.
Q Yes, and it's, you know, and we've done this for about a year and a half. And we're not alone. There are a lot of people who do this.
THE PRESIDENT: Well, Jeanine, you are a prime candidate for the health care exchange that I just described, because essentially what you would be able to do is you could just go online, you would be able to see a list of participating insurers -- which by the way, is very important, because in most states right now insurance companies are dominated by -- or the insurance market is dominated by just one or two insurers, so you don't have a lot of choices. And this way, you would have a lot of choices. They would all have to compete on the basis of price, but they'd be abiding by a certain set of rules, like you can't exclude somebody for a preexisting condition.
And so you could then select the plan that was best for you, do your own comparison shopping; and if you qualified, then we would provide you a little bit of help on your premiums to reduce your costs. So that's what essentially we could pay for if we take some of these inefficiencies and the waste out of the system right now. That will pay for you getting the kind of help you need, and we'd have insurance regulations in place that would protect you from being scammed in the insurance market, which unfortunately, a lot of people suffer from.
The other reason we can drive your costs down is you'd be part of a huge pool, right? Part of the reason why large companies are typically able to offer lower insurance premiums for their employees than small companies is they've got a big pool. The federal government is a classic example. The Federal Health Employees Program is a pretty good deal, because you've got several million people who are part of it. So that gives you a lot of bargaining power with the insurers. Well, the exchange will provide that same market power to help negotiate with the insurers to drive prices down.
And the other thing that we do want to do -- now, this is controversial, and I understand some people are worried about this -- we do think that it makes sense to have a public option alongside the private option. So you could still choose a private insurer, but we'd also have a public plan that you could choose from that would be non-for-profit, wouldn't have, hopefully, some of the same high administrative costs, and would be potentially more responsive to your needs at a lower cost. I think that helps keep the insurance companies honest because now they have somebody to compete with.
And I have to say, the reason this has been controversial is a lot of people have heard this phrase "socialized medicine" and they say, we don't want government-run health care; we don't want a Canadian-style plan. Nobody is talking about that. We're saying, let's give you a choice. You can choose the private marketplace, or this other approach.
And I got a letter the other day from a woman; she said, I don't want government-run health care, I don't want socialized medicine, and don't touch my Medicare. (Laughter.) And I wanted to say, well, I mean, that's what Medicare is, is it's a government-run health care plan that people are very happy with. But I think that we've been so accustomed to hearing those phrases that sometimes we can't sort out the myth from the reality.
MR. CUTHBERT: In our tele-town hall, we go next to Lawrence, Kansas, and talk with Mitzi. Mitzi, you're on the tele-town hall.
Q Mr. President, thank you so much for doing the hard work of health care reform.
THE PRESIDENT: Thank you, Mitzi.
Q My question is, historically, older Americans, along with women of child-bearing age and persons with preexisting conditions, have paid more for health care coverage. And I want to know if reform will eliminate the disparity for older Americans.
THE PRESIDENT: Well, one thing that we strongly believe in is you can't discriminate in the insurance market. And that's actually what's happening right now. You're not seeing it in Medicare if you're already in Medicare, but if you're in the private marketplace right now, essentially insurance companies are cherry-picking. They want young, healthy people because they can collect premiums and don't have to pay out a lot. And then as people get older, then they start suddenly making it harder for those folks to get coverage. And if they do get coverage, it's wildly expensive.
And so part of the insurance reforms we want to institute is to make sure that there's what's called a community rating principle that keeps every insurer operating fairly so that they can't just select the healthy, young people. If they want to participate in, for example, this health care exchange, they've got to take everybody. And that will help I think reduce costs or level out costs for older Americans. And we also want to enshrine a principle in there that says no discrimination against women, because there is still oftentimes a gender bias in terms of some of the coverage that people receive.
MR. CUTHBERT: We go next to North Carolina for a question we had all week last week. I think every town hall had this one. It's from Colin. And, Colin, go ahead and ask this question. Go ahead, Colin.
Q This is his wife, Mary.
THE PRESIDENT: Hi, Mary.
Q Hi.
THE PRESIDENT: What happened to Colin? (Laughter.)
Q Well, I'm the one they talked to.
THE PRESIDENT: I got you. That's how it is in my house, too. (Laughter.)
Q I have heard lots of rumors going around about this new plan, and I hope that the people that are going to vote on this is going to read every single page there. I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die. This bothers me greatly and I'd like for you to promise me that this is not in this bill.
THE PRESIDENT: You know, I guarantee you, first of all, we just don't have enough government workers to send to talk to everybody, to find out how they want to die.
I think that the only thing that may have been proposed in some of the bills -- and I actually think this is a good thing -- is that it makes it easier for people to fill out a living will.
Now, Mary, you may be familiar with the principle behind a living will, but it basically is something that my grandmother -- who, you may have heard, recently passed away -- it gave her some control ahead of time, so that she could say, for example, if she had a terminal illness, did she want extraordinary measures even if, for example, her brain waves were no longer functioning; or did she want just to be left alone. That gives her some decision-making power over the process.
The problem is right now most of us don't give direction to our family members and so when we get really badly sick, sadly enough, nobody is there to make the decisions. And then the doctor, who doesn't know what you might have preferred, they're making decisions, in consultation with your kids or your grandkids, and nobody knows what you would have preferred.
So I think the idea there is to simply make sure that a living will process is easier for people -- it doesn't require you to hire a lawyer or to take up a lot of time. But everything is going to be up to you. And if you don't want to fill out a living will, you don't have to. But it's actually a useful tool I think for a lot of families to make sure that if, heaven forbid, you contract a terminal illness, that you are somebody who is able to control this process in a dignified way that is true to your faith and true to how you think that end-of-life process should proceed.
You don't want somebody else making those decisions for you. So I actually think it's a good idea to have a living will. I'd encourage everybody to get one. I have one. Michelle has one. And we hope we don't have to use it for a long time, but I think it's something that is sensible.
But, Mary, I just want to be clear: Nobody is going to be knocking on your door; nobody is going to be telling you you've got to fill one out. And certainly nobody is going to be forcing you to make a set of decisions on end-of-life care based on some bureaucratic law in Washington.
MR. CUTHBERT: Mr. President, she mentioned, not in her question, but in her preview, that she's talking about Section 1232, the infamous page 425, which is being read as mandatory end-of-life care advice and counseling for Medicare. As I read the bill, it's saying that Medicare will, for the first time, cover consultation about end-of-life care, and that they will not pay for such a consultation more than once every five years. This is being read as saying every five years you'll be told how you can die.
THE PRESIDENT: Well, that would be kind of morbid. (Laughter.) I think that the idea in that provision, which may be in the House bill -- keep in mind that we're still having a whole series of negotiations, and if this is something that really bothers people, I suspect that members of Congress might take a second look at it. But understand what the intent is. The intent here is to simply make sure that you've got more information, and that Medicare will pay for it.
So, for example, there are some people who -- they get a terminal illness, and they decide at a certain point they want to get hospice care. But they might not know how to go about talking to a hospice, what does it mean, how does it work. And they don't want to -- we don't want them to have to pay for that out of pocket. So if Medicare is saying you have the option of consulting with somebody about hospice care, and we will reimburse it, that's putting more power, more choice in the hands of the American people, and it strikes me that that's a sensible thing to do.
MR. CUTHBERT: We go to Denver, Colorado, next, and Sarah, another doughnut hole question. Go ahead, Sarah.
Q Hi, this is my first year in the doughnut hole, and it's quite a frightening thing to go through. I have Parkison's so I will be going through it year after year, and it looks like I could last about two years, and then all of my savings will be gone to the doughnut hole. So what do you intend to replace the doughnut hole with?
THE PRESIDENT: Well, we want to replace it with prescription drugs that won't force you to use up all your retirement.
When the original Medicare Part D was put forward -- first of all, it wasn't paid for, so it automatically was unstable financially. Then there was an agreement that you couldn't negotiate with the drug companies for the cheapest available price on drugs. The American people pay about 77 percent more for drugs than any other country -- 77 percent. Almost twice as much as other countries do.
So what we've said is, as part of reform, let's negotiate with the pharmaceutical companies; we'll cover more people -- that means potentially the pharmaceuticals will have more coverage -- or more customers -- but as part of the deal, they've got to start providing much better discounts on their drugs. They've already committed that if the health care reforms pass, they would provide $80 billion worth of discounts. That would be enough to cover about half of the doughnut hole.
So, right off the bat, right now, without further negotiations, the drug companies have already committed that they would reduce -- they would cut in half the costs that folks have to go through when they're in the doughnut hole right now. That's money directly in their pocket that could be in their retirement savings.
I think we can get potentially an even better deal than that, because we're overpaying 77 percent.
But the problem is if we don't get health care reform, the pharmaceutical industry is going to fight for every dime of profits that they're currently making -- and filling that doughnut hole is going to be very expensive because when the Medicare Part D was originally passed nobody put in provisions to pay for -- and so putting even more money into it at a time when Medicare may go bankrupt -- not "go bankrupt," but go into the red 10 years from now, that's a big problem. That's part of the reason why reform is so important.
And I think for AARP members especially there are hundreds of thousands of people out there who would directly benefit from reduced prescription drug costs if we're able to pass this bill.
MR. CUTHBERT: As you know, you may have heard, the cost of the program is a concern. Jane here in our audience has a question about that, from Alexandria, Virginia. Jane.
Q Hello, Mr. President. My question is some concern we have about the possibility of a cost containment commission. If you could comment on that.
THE PRESIDENT: The idea is not the cost -- it's not a cost containment commission that's been proposed. It's been what I just described -- an independent medical advisory committee modeled on the kind of committee that is called MedPAC right now. It's got people who are health care experts, nurses, doctors, hospital administrators. The idea is how do you get the most value for your health care dollar.
Now, the objective is to control costs. But it's not cost containment by just denying people care that they need. Instead it's reducing costs by changing the incentives and the delivery system in health care so that people are not paying for care that they don't need. The more we can reduce those unnecessary costs in health care, the more money we have to provide people with the necessary costs -- the things that really pay high dividends in terms of people becoming healthier.
And this is pretty straightforward. I mean, it's pretty logical. If you think about your own family budget -- if you could figure out a way to reduce your heating bill by insulating your windows, then that money that you saved -- you're still warm inside; you're just as comfortable as you were -- it's just you're not wasting all that energy and sending it in the form of higher bills to the electric company or the gas company. And that's then money that you can use to save for your retirement or help your kid go to college.
Well, it's the same principle within the health care system. If we can do the equivalent of insulating some windows and making the house more efficient, you're still going to be warm; you're just going to be able to save some money. In this case, you're still going to be healthy; you will just have saved some money and that money then we can use to lower your prescription drug costs, for example.
MR. CUTHBERT: We have an Internet question next from Alpharetta, Georgia. Robert asks, if the new health care reform bill is so great for all Americans, why are members of Congress and other arms of government excluded from having to participate?
THE PRESIDENT: Well, I actually think that the health care exchange that people like Jeanine would be able to participate in would be very similar to the kind of program that we have for the federal health care employees.
But keep in mind -- I mean, this is something that I can't emphasize enough: You don't have to participate. You don't -- if you are happy with the health care that you've got, then keep it. If you like your doctor, keep it. Nobody is going to go out there and say, you've got to change your health care plan.
So this is not like Canada where suddenly we are dismantling the system and everybody's signed up under some government program. All we're doing is we're saying, if you've already got health care, the only thing we're going to do for you is we're going to reform the insurance companies so that they can't cheat you, and we are -- if you don't have health insurance, we're going to make it a little bit easier for you to be able to obtain health care. And hopefully, overall, we are going to change the delivery systems so that we are saving money as a society over the long term.
So nobody is being forced to go into this system, and frankly the -- if we do this right, then all we're actually doing is giving the American people the same option that members of Congress have, because they've got a pretty good deal right now. And the fact of the matter is, is that they don't have to worry about losing their health insurance. They have a bunch of different options and different plans to select from. So if they've got a good deal, why shouldn't you? (Applause.)
MR. CUTHBERT: We hope that you've found this tele-town hall with President Obama, AARP CEO A. Barry Rand, and AARP President Jennie Chin Hansen to be informative, interesting, helpful, and stimulating of further discussion. If you have a personal story you'd like to share with us about the impact the high cost of health care has had on your family, please stay on the line to leave us a message. Be sure to leave your contact information so we can get back to you.
Now for some closing remarks, let's get back to Barry Rand. Barry.
MR. RAND: Well, I want to thank you again, Mr. President, for joining us, listening to our members, whether they're here in person or on the phone or on the Web, and for hearing their stories, and getting a chance to talk directly and answer their questions. So we thank you very much for that. (Applause.)
THE PRESIDENT: Well, I just want to say thank you to all of you for taking the time to get informed on this issue. And I want to thank AARP for all the good that it has done to provide greater security and stability in the lives of people who are older.
You know, this week celebrates the anniversary of Medicare, and when you look at the Medicare debate it is almost exactly the same as the debate we're having right now. Everybody who was in favor of the status quo was trying to scare the American people saying somehow that government is going to take over your health care, you won't be able to choose your own doctor, they're going to ration care, they're going to tell you you can't get this or that or the other. And you know what? Medicare has been extraordinarily popular, it has worked, it has made people a lot healthier, given them security. And we can do the same this time.
Sometimes I get a little frustrated because this is one of those situations where it's so obvious that the system we have isn't working well for too many people and that we could just be doing better. We're not going to have a perfect health care system; it's a complicated system, there are always going to be some problems out there. But we could be doing a lot better than we're doing right now. We shouldn't be paying 50 percent more, 75 percent more than other countries that are just as healthy as we are. We shouldn't have prescription drugs 77 percent higher in costs than ours. And we shouldn't have people who are working really hard every day without health care or with $8,000 deductibles -- which means they basically don't have health insurance unless they get in an accident or they get really sick.
That just doesn't make sense. And the stories I get are heartbreaking, all across the country, from people who are just having a really tough time and it's going to get tougher. So we've got to have the courage to be willing to change things. I know that sometimes people have lost confidence in the country's ability to bring about changes, but I think this is one of those times where we've really got to step up to the plate, and it will ultimately make Medicare stronger, as well as the whole health care system stronger.
So thank you very much, everybody. (Applause.)
MR. CUTHBERT: One of the most difficult parts of working on an effort like health care reform is to keep in touch and keep up to date. May we suggest a Web site: healthactionnow.org, that's healthactionnow -- all one word -- dot org. It will tell you how to get in touch with your congressman and the people who are debating this whole issue, and tell you how to keep involved until the very end, which we hope is soon.
Mr. President, Mr. CEO, Madam President, and everybody here and at home on the tele-town hall, we thank you all for participating. Keep up the good work, and we'll talk with you again. I'm Mike Cuthbert in Washington. Have a good day.
Durant cinq numéros, J.A. revient sur les enjeux identitaires, politiques et raciaux qui traversent la culture noire américaine. Après la littérature et avant la danse : la musique.
Michael Jackson, décédé le 25 juin dernier, Miles Davis, Ray Charles, Jimi Hendrix, John Lee Hooker, Tina Turner ou encore James Brown… Les États-Unis ont livré au monde les plus grandes stars de la musique. Rien d’étonnant à cela. Du gospel au hip-hop en passant par le jazz, le funk, la soul, le disco, voire le rock’n’roll né sous les doigts de guitaristes comme Chuck Berry, ces courants émanent peu ou prou des communautés noires.
Est-ce parce qu’elles sont intimement liées à l’Histoire que ces musiques ont marqué leur empreinte dans ce pays ? Toujours est-il que la conjonction entre la naissance des États-Unis et la traite négrière est à l’origine d’une sono mondiale que le génie de Jackson portera à son paroxysme trois siècles plus tard.
Arraché à l’Afrique pour le Nouveau Monde, le peuple noir s’est inventé aux États-Unis une nouvelle culture sur un territoire en friche. En plus des champs de coton, c’est dans les églises méthodistes et baptistes qu’il trouve les espaces de sa réinvention. À partir du chant et de la danse, considérés comme des « apports africains », selon l’universitaire Lucien Malson, les esclaves créent les spirituals puis les gospels avec pour thèmes la rédemption et une vie meilleure au paradis. Ces chants typiques de la ferveur religieuse évoquent aussi la souffrance (« I Want to Go Home ») ou l’imploration (« Let My People Go »). Véritable diffuseur de la culture africaine-américaine, ils forment la trame d’un message que le jazz, le funk ou la soul reprennent tout au long du XXe siècle.
« I’m Black, I’m Proud »
Parallèlement à l’apparition de sectes ou d’Églises noires, la fin de la guerre de Sécession accentue la généralisation des musiques typiques de cette communauté. Partout, fanfares et orchestres fleurissent. Au même moment, un grand nombre d’anciens esclaves sans travail à la suite de la faillite des grandes plantations s’installent dans les villes du Sud. Poussés par la ségrégation des lois Jim Crow, qui restreignent leurs droits, d’autres choisissent d’émigrer plus au nord, vers les centres industriels. Dans les deux cas, les Noirs vivent dans une totale promiscuité. Citoyens de seconde zone, sans avenir, victimes de la crise de 1929, beaucoup se noient dans le chant mélancolique. Plaintif et populaire par excellence, ce blues, qu’il vienne des campagnes sudistes ou des villes, est la première manifestation musicale qui ne doit rien au Vieux Continent.
Au contact des villes, le blues se modifie harmoniquement pour donner naissance, à Chicago ou à New York, au ragtime (Scott Joplin) ou au boogie-woogie (Willie Smith, Fats Waller…). Mais c’est le jazz, né durant la Première Guerre mondiale, qui marque la plus grande révolution. Puisant dans le blues, ce style abandonne les pratiques vocales au profit d’un traitement particulier du son par les instruments qui restituent les effets (shouting, growling…) des chants entendus dans les plantations et les églises.
Des grands orchestres de Duke Ellington aux formations réduites du bop, le jazz devient le mode d’expression des Noirs. Festive et dansée, cette musique, soutenue par une solide industrie discographique, n’effraie pas la communauté blanche et développe même des modes vestimentaires, architecturales ou picturales. Qualifié de « musique classique des États-Unis », allant jusqu’à influencer des compositeurs comme Maurice Ravel, il s’exporte dans le monde tout en montrant la puissance de la créativité africaine-américaine avec Charlie Parker, Dizzy Gillespie ou Thelonious Monk.
Mais s’ils sont plus célèbres que leurs aînés bluesmen, les jazzmen n’en sont pas moins révoltés par leurs conditions. Souvent adhérents à la National Association for the Advancement of Colored People (NAACP), à l’instar de Max Roach, Charles Mingus ou Miles Davis, ils militent sans relâche au travers d’innombrables compositions engagées. Propulsées par Horace Silver, Art Blakey, John Coltrane ou Ornette Coleman, les revendications s’intensifient entre 1955 et 1969 avec le hard-bop, le funky-jazz ou le free-jazz, créés en réaction au style cool joué par les Blancs.
Dans les années 1960, les artistes de soul ou de rhythm & blues (Aretha Franklin, Ray Charles, Otis Redding…) se retrouvent avec les jazzmen autour du concept d’« Amérique fraternelle » prônée par Martin Luther King. Ce combat pacifique débouche sur le Civil Rights Act (1964) et le Voting Rights Act (1965). Mais ces lois qui interdisent la discrimination se traduisent difficilement sur le terrain. Les musiciens sont à nouveau en première ligne pour mobiliser ou calmer leur communauté, notamment après l’assassinat de leur mentor. Certains tubes empêchent même une révolte généralisée. James Brown, par exemple, conjure cette situation en axant son message sur la fierté de sa couleur de peau (« Say It Loud ! I’m Black, I’m Proud »).
Quelques années plus tard, le « parrain de la soul » met ses slogans au service d’un genre cru qu’il contribue à inventer : le funk. L’arrivée de nouveaux instruments, dont la basse électrique, précipite cette révolution. Sans abandonner les chapelles du blues ou du jazz, les Africains-Américains empruntent cette voie épurée, voire agressive. Plus que jamais leur musique s’érige contre les répressions policières, le pouvoir blanc ou les inégalités.
Sans concession
C’est dire si le disco, propagé comme une traînée de poudre à partir de 1977, joueun rôle de décompresseur. D’inspiration noire, ce style tourné vers la danse veut fédérer. Alors que le fondateur du célèbre label Motown, Berry Gordy, avait permis à Ray Charles, Stevie Wonder ou Michael Jackson de conquérir le public blanc, le disco généré par Kool & The Gang, Chic, Donna Summer ou encore Barry White réussit à son tour à établir ce « crossover » entre Blancs et Noirs. Mais le phénomène ne dure pas. Le disco des Bee Gees dans Saturday Night Fever est si sirupeux que les Noirs, sentant le style leur échapper, vont en créer d’autres. Ce sera le rap et le hip-hop.
Cette culture, en grande partie contestataire, née dans le Bronx, réveille l’Amérique conservatrice de Ronald Reagan, là où le disco l’avait endormie. Le rap (« Rhythm and Poetry » ou « Rock Against Police ») s’organise autour de la figure du disc-jockey et de groupes sans concession (Gangstarr, NWA, Public Enemy…). Anticonformiste au beat minimal enrichi de scratchs et de textes au vitriol, le rap inonde la jeunesse américaine. Mieux, en même temps que les dérivés de la soul tels le R’nB, le drum & bass ou la nu soul portée par Erykah Badu, il a étendu son influence à la jeunesse mondiale.
Identité de toute une communauté, les musiques africaines-américaines ont grandement œuvré à l’émancipation des Noirs jusqu’au point d’orgue qu’est l’élection de Barack Obama. Ce n’est pas un hasard si ce dernier a invité Stevie Wonder à la Maison Blanche, en février dernier, rendant ainsi hommage à plusieurs siècles de lutte et de créativité.
Le nombre de saisies de drogue en provenance de la sous-région et à destination de l’Europe est en forte baisse.
La crise fait-elle baisser la consommation de cocaïne des Européens, ou les douaniers se montrent-ils très dissuasifs ? Selon le dernier rapport publié par l’Office des Nations unies contre la drogue et le crime (ONUDC) le 7 juillet et intitulé « Trafics transnationaux et État de droit en Afrique de l’Ouest : une évaluation de la menace », le nombre de saisies de drogue en provenance d’Afrique de l’Ouest et à destination de l’Europe baisse sensiblement depuis deux ans. Interpol indique que, dans les aéroports européens, ce nombre est passé de 476 en 2007 à 330 en 2008, pour s’établir finalement à 56 au premier trimestre de 2009. De même, 11 saisies d’envergure ont été effectuées en 2007 dans la région, mais seulement 4 en 2008, et aucune depuis le début de 2009. Sur les 1 000 tonnes de poudre blanche annuellement produites dans le monde – dont 250 tonnes sont commercialisées en Europe –, seules 20 continueraient à transiter par l’Afrique de l’Ouest, soit une baisse du trafic d’environ 50 % depuis 2007.
Pour Antonio Mazzitelli, responsable de l’ONUDC pour l’Afrique de l’Ouest, plusieurs facteurs expliquent cette diminution du nombre des saisies. « Il y a d’abord des causes extérieures, explique-t-il, comme la baisse de la production, notamment en Colombie, et la multiplication des saisies, ainsi qu’une stagnation de la demande européenne. Et puis il y a des facteurs propres à l’Afrique de l’Ouest, comme les changements politiques en Guinée et en Guinée-Bissau, mais aussi au Ghana, où le nouveau président, John Atta Mills, a pris des mesures énergiques pour lutter contre les trafiquants et leurs éventuelles complicités gouvernementales. »
Les réseaux se réorganisent
L’embellie sera-t-elle durable ? Rien n’est moins sûr. Déjà les réseaux se réorganisent et cherchent de nouveaux points de transbordement pour leurs marchandises. En septembre-octobre 2008, au Togo, une filière projetant l’importation par avion de 2 tonnes de cocaïne a été démantelée. En mai 2009, au Pérou, un navire contenant une « grosse cargaison » a été arraisonné alors qu’il faisait route pour le Bénin. Enfin, la vente au détail de la drogue passant au travers des mailles du filet reste une activité particulièrement rentable : plus de 1 milliard de dollars…
« Si le problème de la drogue était résolu à un endroit, il pourrait se reproduire un peu plus loin, ou être simplement remplacé par d’autres activités illégales », analyse Antonio Maria Costa, directeur exécutif de l’ONUDC. Parmi ces dernières, certaines sont moins déstabilisatrices pour les États que le narcotrafic, comme la contrebande de cigarettes en provenance d’Asie (775 millions de dollars), le trafic de médicaments venant d’Europe et d’Asie (438 millions), ou encore le trafic de femmes du Nigeria vers l’Europe (300 millions). En revanche, le détournement de la rente pétrolière nigériane reste très coûteux : on l’estime à près de 1 milliard de dollars.
Many people were arrested after Sunday's violence in Bauchi
Dozens of people have been killed after Islamist militants staged three attacks in northern Nigeria, taking the total killed in two days of violence to 150.
A BBC reporter has counted 100 bodies, mostly of militants, near the police headquarters in Maiduguri, Borno State, where hundreds are fleeing their homes.
Witnesses told the BBC a gun battle raged for hours in Potiskum, Yobe State and a police station was set on fire.
Some of the militants follow a preacher who campaigns against Western schools.
ANALYSIS
By Caroline Duffield, BBC News, Nigeria
Tensions are never far from the surface in northern Nigeria. Poverty and competition for scarce resources, along with ethnic, cultural and religious differences have all fuelled sudden violence.
But the latest violence is not between communities, it involves young men from religious groups, arming themselves and attacking local police.
Fringe religious groups in Nigeria have claimed links to the Taliban before - individuals have also been accused of links to al-Qaeda. But Nigeria is very different to countries like Mali or Algeria, where groups such as al-Qaeda in the Islamic Maghreb operate.
The idea of radical Islamist militants gaining a serious foothold in Nigeria is usually dismissed, because of the strength of local identities and traditions.
The preacher, Mohammed Yusuf, says Western education is against Islamic teaching.
There has also been an attack in Wudil, some 20km (12 miles) from Kano, the largest city in northern Nigeria.
A curfew is in force in Bauchi, the scene of Sunday's violence.
Sharia law is in place across northern Nigeria, but there is no history of al-Qaeda-linked violence in the country.
Nigeria's 150 million people are split almost equally between Muslims and Christians and the two groups generally live peacefully side by side, despite occasional outbreaks of communal violence.
Militants chanting "God is great" attacked the Potiskum police station at about 0215 local time (0115 GMT) - the same time as the raid was launched in Maiduguri.
The police station and neighbouring buildings in Potiskum have been razed to the ground, eyewitnesses say.
Two people have been confirmed dead and the police have made 23 arrests.
Fringe group
The corpses of civilians are scattered around the streets of Maiduguri, after being pulled from their cars and shot, eyewitnesses say.
The police and army are patrolling, firing into the air, apparently trying to clear civilians from the area.
There are unconfirmed reports of a jailbreak in the town.
In Wudil, three people have been killed and more than 33 arrested. The senior police officer in Wudil has been wounded.
Security is said to have been beefed up in Plateau State, to the south of Bauchi, where hundreds were killed in clashes between Muslims and Christians last year.
Mr Yusuf's followers in Bauchi are known as Boko Haram, which means "Education is prohibited".
They attacked a police station on Sunday after some of their leaders were arrested.
Correspondents say the group is seen locally as a fringe group and has aroused suspicion for its recruitment of young men, and its belief that Western education, Western culture and science are sinful.
Malaak Compton-Rock: Some critical of "Black in America" focus on problems
She says community has serious challenges to overcome, particularly for children
Compton-Rock: "Black in America 2" will show solutions
She says naysayers must join the fight to improve conditions
By Malaak Compton-Rock Special to CNN
Editor's note: Malaak Compton-Rock is founder and director of The Angelrock Project, "an online e-village promoting volunteerism, social responsibility, and sustainable change." One of her initiatives, "Journey for Change: Empowering Youth Through Global Service," will be seen as part of CNN's "Black in America 2." Her first book is being published by Broadway Books in May, 2010, titled, "If It Takes a Village, Build One: How I Found Meaning Through a Life of Service to Others and 100+ Ways You Can Too."
(CNN) -- In the words of my mentor and America's foremost child advocate Marian Wright Edelman, founder and president of The Children's Defense Fund, it's time to "raise a ruckus people, it is time to raise a ruckus!"
CNN's "Black in America" raised many critical issues facing African-American people in this great country of ours. It was not pretty, it was not flattering, but it was very, very frank. The show delved into the negative issues that have plagued the African-American community for generations, i.e., crime, education, single parent families, drug abuse and the like.
People got mad. People sent many e-mails and letters to Soledad O'Brien and CNN and cried foul. People said "Black in America" was not consistent with the lives of many African-American people and was one-sided. Blogs and Web sites popped up all over the place where people "raised a ruckus" about the content of the show.
I read a lot of these comments. As a matter of fact, I was obsessed with people's views for many weeks after the documentary aired. And the more I read, the more I got angry. The more I read, the more I wanted to "raise my own ruckus." But I was frustrated and upset for a very different reason than most.
I was almost apoplectic with the amount of criticism for "Black in America" without critical, thought provoking commentary about how each person can do their part to make a difference to change the very startling and distressing issues facing most African-American children and adults in America.
On a typical day in the lives of black American children:
Three children or teens are killed by firearms
24 babies die before their first birthday
102 children are arrested for violent crimes
119 children are arrested for drug crimes
292 babies are born to teen mothers
348 babies are born without health insurance
497 children are confirmed abused or neglected
794 babies are born into poverty
1,202 babies are born to unmarried mothers
1,385 children are arrested
And on a typical school day for black children in America:
417 high school students drop out
442 public school students are corporally punished
6,916 public school children are suspended
And consider that in America,
One in three black children live in poverty
More than eight of every 10 black fourth graders in our public schools cannot read at grade level
A black boy born in 2001 has a one in three chance of going to prison in his lifetime
[Statistics are from the Children's Defense Fund's Child Research Data.]
This is serious stuff people. And it is the cold-hearted truth. So, it is okay to comment that the documentary did not represent your life. It is okay to comment that it was upsetting to see images of black men in jail, children dropping out of school, and unwed mothers.
It is okay because the truth hurts, especially when it is seen by 16 million people. In fact, most of the images shown in "Black in America" do not represent my personal life or the lives of my children. But because these issues face my brothers and sisters in my collective African-American family, they concern me, they hurt me, they belong to me, and I will own them.
We know that as African-Americans we have come a long way. We know that we are doctors, lawyers, CEOs, philanthropists, politicians, and even the president of the United States of America. And yes, it would do our children a lot of good if these images were portrayed more frequently in the media. But this does not change the very real issues facing African-American people portrayed in "Black in America."
And frankly, with so many of our people struggling, we can't just celebrate our achievements -- we must make it a priority to work on the most critical and urgent matters in our community. As I always say, "The blessed and the best of us, must take care of the rest of us."
So why did the criticism make me so mad? Because so much of it was unaccompanied by real ideas, thought-provoking suggestions, plans of action, or inspiring initiatives or solutions. How can you complain if you are unwilling to join the fight?
How can you get mad, if you are disinclined to make a difference in someone else's life? And why would you take the time to write an accusatory e-mail to Soledad O'Brien instead of writing a letter to your representative in Congress demanding health care for all children and pregnant women, increased funding for schools, or new initiatives to increase black-owned businesses in black neighborhoods?
"Black in America 2" will offer many solutions to the ills facing African-American people. I think it will make the naysayers happy. But it will only make me happy if the naysayers "raise a ruckus" by joining the fight to better the lives of all black folks.
The opinions expressed in this commentary are solely those of Malaak Compton-Rock.
The 40-Workout Strength Challenge
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by Dan John | 11/13/15
Here's what you need to know...
1. Pick one exercise from five categories: a press, a pull, a hinge
movement, a squat, a...
La liste complète des ministres, des hommes et des sociétés qui se partagent 202 417 hectares au détriment des paysans - Des ministres, des hommes d’hommes, des sociétés ont fait main basse sur les terres de Mbane. Depuis le 19 mars des surfaces totales de terres de 202 417 hectares ont été bradées. La révélation a été faite par la Conférence des leaders de Benno Siggil Senegaal en conférence de presse hier, mardi 28 juillet, dans un hôtel de la place. 
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