Transcript: President Trump on Investment in Rural Health Roundtable

And we’re not going to have that. We’re taking great care of them.

With the Rural Health Transformation Program, we are getting rural communities the health support they need, and we’re getting it immediately. These funds will go to empowering rural hospitals, strengthening their workforce, modernizing facilities and technology, and ensuring that rural Americans get world-class healthcare in their own community — right smack in their own community, like they’ve never had it before. And they’ve been hurt very badly by the Unaffordable Care Act.

Partisan Divide on Rural Healthcare

Every single Democrat in Congress voted against the Lifeline for Rural Communities. And I hope everyone knows this. And this is not about elections, but I hope you remember this in the midterms, because the Democrats are just so horrible toward the rural community.

But I want to take a moment to thank the incredible House and Senate Republicans who worked so hard on making this historic investment possible. That’s what they did. And they did work hard. We — I don’t think — got a Democrat vote, did we? Did we get one Democrat vote? We got all Republican votes. It was an amazing feat. And I want to thank Mike, our Speaker of the House, Mike Johnson, and John Thune, for really doing a great job. You know, we have small majorities. And I want to thank the congressmen that are here for doing — in particular, for working so hard and getting this done.

Introducing the Great Healthcare Plan

Yesterday, I also announced our framework to lower healthcare prices for all Americans, including those in rural America. And we’re calling it the Great Healthcare Plan. You know, we had to come up with a name. And everybody wanted to say, oh, well, can we put something about lowering costs? Because we’re lowering costs very substantially.

So I had Bobby and I had Oz. We had everybody in there. We had a whole group of people, and we’re trying to come up with — so we’re saying, the cost-reduction plan that gives you good healthcare. And I said, it’s too long. It’s not going to sell. I said — we had more plans. And they wanted to get the words cost reduction in there, Laurel, especially you. They wanted cost reduction in, and then they wanted great healthcare in. I said, look, you can have one or the other, but it gets too long. We’re talking about the name of a plan. So we got it down to seven or eight words, which is far too long. Nobody can remember that much. And I said, how about just call it — because this is the Great Healthcare Plan. Now, a great plan has to be cost-effective, otherwise it can’t be a great plan. That’s the way I looked at it. So we have a very glamorous name.

It’s called the Great Healthcare Plan, not the Unaffordable Care Act. I don’t like that name. This is called, officially, the Great Healthcare Plan. That means low price and great healthcare. So you’re going to have, at a lower price, great healthcare.

First, our proposal codifies the massive discounts on prescription drugs that my administration is achieving through our most favored nation provisions. Okay. We can go into this for hours, but the bottom line is, we’ll be paying the lowest price of any nation in the world. Whoever is paying the lowest, we match it. This could have been done years ago. I was going to do it in my first administration, but when COVID came toward the end, I said, I can’t believe — it wasn’t exactly a good time to be doing it. But I said, why isn’t somebody doing it?

Why Drug Prices Were So High

And the reason they’re not doing it is that no other nation would agree. France, as an example, paid 10 percent of what we paid. Germany was paying 13 or 14 percent of what we paid. In other words, we paid many times more, not a little bit more, not 10 percent more, 10 times more. A pill would cost 10 times more in New York than it would cost in London, as an example, than it would cost in Munich. And this went on for many decades. This was right from the beginning.

And the reason it went on was a little bit of the healthcare companies, but it was other nations. And I understand that. If I were heading Germany, I’m not going to double and triple and quadruple my healthcare. They got the healthcare companies to pay. It just took place over a long period of time. It got worse and worse. And it just hit numbers that were just absolutely unsaleable.

And if you remember, the doctors in the audience remember this. They said, “Well, we have to do research and development.” I said, “Well, what about research and development for Germany?” “Well, we’ve decided to put up the —” so the pill would cost five times more because of research and development, and five times more for other reasons. They had all these phony reasons. And finally, I said to the healthcare companies, we can’t do it anymore. We can’t do it.

The Story That Started It All

And it started, really. I tell the story. It wasn’t meant to be funny. People find it funny. But a friend of mine who’s a very smart guy — very, very rich, very powerful man, actually — but he’s very fat. And he took the fat drug. I won’t give you which one. It was Ozempic. I won’t tell you that.

And he went to London on one of his many business trips. It’s all he does is business. He can’t walk across the street, but he’s a great businessman. And he said, “President, President.” I said, “What?” He used to call me Donnie. Now he calls me President. So I said, “You’ve come a long way.” He goes, “But I have a problem.” “What’s your problem?” “In New York, I pay $1,300 for this drug.” Now, this means nothing to him. This is like a penny out of your wallet. The guy’s worth hundreds of millions, billions of dollars.

He said, “And in London, sir, I pay just a fraction of that.” I said, “Well, is it the same drug?” I knew exactly what he was getting at because it had bothered me for a long time. He said, “It’s the exact same drug.” And because of his wealth and his business smarts, he had it checked. It was made in the same plant by the same company. It’s identical. And here I pay $87, and in New York, I pay $1,300.

So it was too much to bear. Because after I told him that the drug does not work on him because I saw him recently, he’s actually fatter than ever. I said, “The drug is not working on you.”

You’re going to have to go to something else. But it does work on a lot of people. And he said, “Thanks. You make me feel good.” I said, “Well, I got to be truthful. You always tell the truth, right, Mr. Congressman?” Oh, look, one of the great, one of the great congressmen. Two of the great congressmen.

The Drug Pricing Problem

PRESIDENT TRUMP: But the drug, we have to do something about it because that’s the same with every, I would say, Bobby, every drug, essentially. It doesn’t have to be in that proportion. In some cases, it’s much worse. Because what happened, I might as well get off this crap because it doesn’t explain it properly. Because what happened is, these countries are very smart, and the drug companies would go to them, and they’d say, “Look, we’re paying $10 for the pill. We’re not paying more. Charge America.” And this happened one time, then the next year, the next year. This is over 40 years. All of a sudden, they’re paying $10 for a pill, and we’re paying, like, $130 for the same pill. It just happened over years, slowly. And it got to a point, over the last 10, 12, 15 years, where it just was unbearable.

And I went to a great executive at Eli Lilly, the top man. He’s a very smart guy. And I confronted him, and he had the same line that they always had: “bah, bah, bah, research and develop.” I said, “Look, look, we got to stop this nonsense. We’re paying 10 times more for things in Europe. It’s not research and development. And if it is research and development, they should pay their fair share of that, too.”

And he said to me, and he’s a great guy, he said, “Look, you’re right. We can’t defend it anymore.” I said, “You’re admitting?” Because these guys had a, all of them. They must have taken a class together. It must have been, it’s probably illegal what they did, Lola. You’ll check it, right? They must have gone to school together and said, “This is the way we’re going to fight this crazy thing where the United States pays 10, 12, 13 times more for a drug. Same drug. Same drug made in the same plant.”

How Foreign Nations Dictate Drug Prices

PRESIDENT TRUMP: And he said, “Here’s the problem we have. The nations are brutal. When we go in and say, ‘We have to give you an increase,’ they say, ‘No, put it on America. We’re not paying you anything.’ And they say it with such power. And they actually shut us off from selling the drug.” And it just happened over and over again. It got a little worse, a little worse, a little worse. All of a sudden, we’re paying many times more for the same.

And so it’s not going to happen anymore. He said, “The problem is, sir, you’ll never get the nations to agree. It’s impossible. They’re very tough, and they are. And they’d have to agree to a doubling or tripling of their drug prices in order to get you down because the world is a bigger place than us.” So it’s not like you cut it in half. Actually, if they raised it a little bit, we’d go down a lot. You understand that. I think people understand that.

So you raise it like from $10 to $20 or $10 to $30, but we’d go from $130 down to $30 or down to $20. So because the numbers are much bigger, the numbers on their side are much bigger. So they’d need a doubling or tripling or quadrupling. Now, if you’re the head of France, the last thing you want to do is say, “I’m going to quadruple the cost of a drug.” And that’s the way it is.

But I said, “I know, but it’s not fair.” And this has taken place. And the head of Eli Lilly, and I really mean it, an unbelievable executive, an unbelievable guy, one of the most successful companies, and who is, by the way, spending hundreds of billions of dollars right now.

He’s building, he told me the other day, he’s building six major plants in the United States. You know why he’s doing that? Because of tariffs. He’s doing that because of tariffs. Without tariffs, he wouldn’t be doing it. Nobody understood tariffs until I came along. Other than President McKinley, he understood them a long time ago. And because of him, we were the richest nation that we ever were at that period of time.

And then, when he died, he was assassinated. Teddy Roosevelt came over, and he inherited a war chest, and he built the Panama Canal, which is the single most expensive thing ever built in the history of the United States, relatively. We spent what would be the equivalent of $5 trillion building the Panama Canal. It was also the most successful thing probably we’ve ever built, and to this day.

The Panama Canal Giveaway

And then Jimmy Carter gave it away for $1. This is the same theory we have on favored nations. The great Jimmy Carter, President Jimmy Carter, gave it away for $1. We lost 38,000 men. In those days, it was men. I hate to say this, but mostly men. They didn’t have a lot of women workers on the Panama Canal. But we lost 38,000 people. They died from malaria and snakebites. It was a combination of that. A vicious snake, one of the most vicious. You get hit, you’re dead. They died from snakebites.

So, 38,000. They paid workers from the United States three times more than they made to come over to Panama and dig. For many of them, that was not a good deal. They died. Thirty-eight thousand, we gave it away for that. But that same stupidity having to do with the Panama Canal, and I could tell you about a hundred other stories, too. You don’t have time. But that’s what went into this whole thing with favored nations.

Drug Pricing Disparities

So, Europe and other nations all over the world were getting drugs from the same plant, same factory, same everything, same location, everything. Same company for a tiny fraction of what we’re paying. So, our people were paying a tremendous amount. So, the gentleman from Eli Lilly and others, we had a meeting, and they all finally put up their hands, “you got us. We give up.” And they were great from that time.

But we had a problem. The other nations weren’t going for it. France turned it down. Germany turned it down. UK turned it down. European Union turned it down. The whole group. And they said, “there’s nothing you can do about it, sir.” I said, “yes, there is.” “No, there isn’t. You’ll never be able to get them up. Never. I mean, the whole industry is going to be torn apart.” I said, “we’ll get them up easily. Are you crazy? Of course, we’ll get them up. That’s what I do for a living. I get people up.”

Negotiating with President Macron

So, I called. I started with President Macron of France. And a very nice person. I like him a lot. I hope he’s listening because he doesn’t believe that, but I do. He’s a nice man. And I said, “Emmanuel.” “Yes, don’t know, don’t know. Thank you so much for calling.” “Oh,” I said, “you’re not going to like this call. You’re going to have to get your drug prices up.” “No, no, no, no, no. I will not do that.”

I said, “Emmanuel, we’re paying 13 times more than 13 times, not 13 percent. Thirteen times more than you offer this pill.” I rattled off some numbers that are crazy. You know, the numbers I’m talking about, Oz. Oz would give me some numbers. I’d say, “this is crazy. We’re paying 10 times, 12 times, 13 times.” “No, no, no.” I said, “No, no, I will not do that.”

I said, “Look, you’ve got to do it. A hundred percent you’re going to do it.” “No, no, Donald, I told you I will not do that.” I said, “Here’s the story, Emmanuel.”

If you don’t do it, I’m going to put a 25 percent tariff on all goods, wine, champagnes, and everything else coming into the United States of America. He said, “Donald, I would love to do this for you. It would be a great honor to do it.” And that’s where it began. And I went through country after country.

Susie was responsible for getting every one of those leaders on the thing. Susie, by the way, stand up, Susie. She is doing such a good job. She’s the first. She’s the first female chief of staff, and she might be the best chief of staff, too. But she’s doing a great job. Thank you, Susie.

So Susie got him on. And I just went one after another. I called Germany. No, no, no, we will not do that. I said, “No, we’re going to put a 25 percent tariff,” which is, by the way, about seven times more than they would have to pay by raising their drug. Like, seven times. This wasn’t a little bit more. Seven times more.

And I may do that for Greenland, too. I may put a tariff on countries if they don’t go along with Greenland, because we need Greenland for national security. So I may do that. I’ll give you a little—I’ll talk about—I’ll take you out of the—in fact, that will end up being the story. But actually, this is a much bigger story because we’re reducing healthcare by numbers that you haven’t seen.

Most Favored Nations Policy

So I spoke to the top 10 countries. They all said no. And within about two minutes, they all agreed. And we were off to the races. And now we have favored nations. It’s called Most Favored Nations. So if France is paying, let’s say, $20 or $30 instead of $10, we are going to pay that $20 or $30. We pay the lowest price, whatever the lowest price is.

So if France is paying $100, but Germany is paying $20, we pay what Germany pays. So we go from a horrible situation on drugs—prescription drugs—to the lowest price anywhere in the world. Is that a correct statement, Oz? Because they’re going to blame you. If you want to correct me, you can. But, you know, you won’t be here for long if you do. So, Oz has left employment.

No, but is that a correct statement?

DR. MEHMET OZ: That’s an absolutely correct statement. And that’s what we want to codify in the great healthcare plan. That’s why it’s so important. Because if the President is not here, there’s a flight risk with these companies not obliging us anymore, because I think it’s the strength of your personality, but also they know they will follow through with the threats if we don’t act.

So we believe other countries will change their opinions, and so will drug companies. So we’ve got to get it into legislation.

Foreign Influence and Tariff Policy

PRESIDENT TRUMP: Well, if you have the wrong President, the countries have tremendous influence over us. You know, they—look, why are—why did we go to an income tax system instead of a tariff system? We had the wealthiest nation. If you go back to the 1800s, 1887, we had money, so much money, we didn’t know what to do with it.

But the countries at that time seemed no different. They have a tremendous influence over this country. For whatever reason, I don’t know, but they do. So if you have the wrong President, they’ll change the system in two minutes. I mean, they’ll change it.

And the drug companies are very powerful, too. You have to deal with them. In this case, it was both. I mean, you had a problem with the drug companies, but you had a tougher problem, in theory, other than the fact that I understood how to deal with them, and I’m the tariff king, and the tariff king has done a great job.

And I hope we win the Supreme Court case, because if we don’t, be a shame for our country. Be a shame. We have a great, safe, beautiful country now.

We’re doing better than we’ve ever done. We hit 42 stock market highs during the 11-month period that I’ve been here. It’s never been anything like it. Stock market’s hitting a new high again today. So it’s, you know, it’s been incredible.

So, just to end it on this, because it’s such a big subject and it can’t be explained by reading as good as my speechwriter is. He’s fantastic, but he can’t write it in one sentence, what we’re talking about. So we’re going to get most favored nations. We will be taking prescription drugs down to the highest medical levels. Never even contemplated. And that’s all great for healthcare. Because when you’re paying a tiny fraction of what you had anticipated paying prior to today, prior to this month, this all took place over the last month and a half.

And the sad part is that when we first announced it, and we did it in a little bit less, more general form, when we first announced it, the Times did a story on page 22 or something, way back in the little story in the back of the newspaper. This is the biggest revolution in the history of medicine in this country, because it’s price. You’re going to buy the drugs for a small fraction of what you were paying for them last month.

Historic Drug Price Reduction Achievement

And I tell the story of my first term. I was the one, after 28 years, that got drug prices down. It was either one-quarter or one-eighth of 1 percent. I got them down for the year. First time in 28 years. I was so proud of myself, I called a news conference, I said, “Ladies and gentlemen, for the first time in 28 years, drug prices have gone down for the year.” One-eighth of a point.

In fact, I had a chart. It was the worst chart I’ve ever seen. It was a line that went from January to December, and it was dead straight. You had to get a little, you know, like a carpenter here, just to see. I said, “Does it look good?” It’s not the greatest line, but I was proud of it because it did. It went down either a quarter of a point or an eighth of a point. Tiny.

And now, think of what we’re doing. We’re bringing medicine down by many times. By many times. Nobody’s ever seen. And there are two ways of calculating. You could say 1,000 percent, 2,000, or you could say 90 percent or 80 percent. The Democrats want you to say 90 or 80, but there are two ways of calculating it. You understand that, Dan? And we’ll take either way. It doesn’t matter. But we’ll be paying a tiny fraction.

Codifying the Healthcare Plan

So that’s going to go into our plan. And what I said is very important. It’s very important that whoever is in this office is, you know, strong and intelligent. And if they’re not, they could, you know, it could be ended. But what we want to do is we want to have it codified. So it’s very hard to change. And that’s all part of the process.

I think it’s the greatest revolution because its financial is, you know, a big part of the drugs. And all of the doctors sitting there know exactly what I’m talking about. They have their patients in Europe, and they say, “I can’t believe it. I’m buying the same thing for, you know, 15 percent of what I pay in New York or in Chicago.” And they’re all nodding their heads. That’s right. That’s not going to happen anymore.

We pay now, just to end it, the lowest price in the world, whatever that is, that’s what the United States of America will be paying. Isn’t that an amazing, long story? I was going to say long, boring. It’s not boring. To me, it’s long and exciting. It’s the biggest thing to happen to healthcare. I don’t think there’s anything we can do. We can do all of our different methods, but there’s nothing we can do that can ever top what we do.

And the press should treat it fairly instead of not writing about it because they don’t write about it because it’s me, primarily because it’s me, but also because it’s Republican. And they don’t write about it, and they should be ashamed. Fortunately, the public understands it, and that’s why we won the election in a landslide.

So it’s a great thing. Instead of Americans paying the highest drug prices anywhere in the world, by far, by 10 times sometimes, we’ll now pay the lowest cost paid by the lowest nation. So the lowest nation, whatever that is, I hope they negotiate a great deal. I hope somebody out there of all those nations is going to be a better negotiator than everybody else. And whatever they get, we get, Mike. Is that pretty good? Look at Mike. Even though it’s the first time I’ve ever seen him smile.

Reducing Insurance Premiums

And next, our plan would reduce your insurance premiums by stopping government payoffs to big insurance companies and sending the money directly to the people. So instead of — and this started — and I’m not really a healthcare maven, but I was always a good businessman. It started — I’m reading the paper, and I see the money that the insurance companies were making from us on Obamacare, and they’re up by 1,000 percent, 1,600 — I think one was up 1,723 percent. 1,700 percent. And it’s because of the massive amount of money that’s sent to them by the United States government.

And I said, “Why don’t we just send it directly to the people instead?” And I made that statement. It was a common-sense statement. I didn’t check with anybody. I didn’t even call Oz or anybody. It just made sense. I made a statement, and it went viral. Can you believe it? It was so popular. In other words, we cut out the insurance companies. They’re making a fortune. And, you know, they’re good people. They’re business people. I don’t blame them. But we cut them out. We pay the money directly to the people.

The people love it. I said it — you know, I said it as a nonprofessional in that business. And I made the statement like — all of a sudden, it’s like — the biggest story. That was the biggest story. And I get a call from Caroline, who’s around here someplace. She said, “Sir, we’re getting inundated.” Margo called me, too. Margo, you called me, too. Margo. Everyone knows Margo. She’s been here from the beginning, right from the beginning. But she said, “Sir” — both of them. They said, “Sir, we’re being inundated.” By what? “You made a statement about healthcare being paid directly to the people into health savings accounts or whatever you want, health care accounts.” And I said I did. What’s the story? “I said, it’s crazy. It’s blown up. People loved it.” And so that’s where we started.

Obamacare and Insurance Companies

So Obamacare was designed to make insurance companies rich. It really was. I mean, maybe not knowingly at the time by Obama, because he didn’t know much about this stuff. Obamacare was designed by other people in Congress that are total pros that are bought off by the insurance companies. And the problem we’ll have with this is we’ll get no Democrat votes, even though it should be very bad, very bad for them if they don’t. But maybe you’ll get some. You’ll call some of your friends, fellas. And Bob, you’ll call some of your friends over on the other side. I don’t know how they can reject it. It’s just so popular, so compelling.

So Obamacare was designed to make insurance companies rich with taxpayer subsidies. And I want that extra money straight to the health savings accounts for you. And you can choose your own health care. You go out and negotiate your own health care. It makes people entrepreneurs, many entrepreneurs. They’ll pick the health care that’s best for them because it’s so different. A young person, they need health care for different reasons, and an old person doesn’t need certain things that a young person needs, and vice versa.

To further reduce insurance premiums, my plan ends the giant kickbacks to insurance brokers and corporate middlemen. We’re getting rid of the middlemen. How long have you heard doctors? All these doctors over there, they look so smart. They’re all brilliant people. I assume you’re brilliant, otherwise you wouldn’t be here, right? I assume we have the best. Do we have the best of the doctors, I would imagine, right?

Hey, how cool is the White House, okay? They’re always in operating rooms. I wouldn’t want to be in an operating room. I don’t like operating rooms, but they do. But how cool is the White House, right? The coolest place on Earth. And this is where it all begins.

This is where we came up with a little concept about a place called Venezuela. How did that work out? And this is going to be the same thing in terms of its precision, its importance is so big. It’s going to work just like that. Venezuela was so amazing, but I equate that to other things because we can do other things like that.

It doesn’t always have to be a Minnesota where everything is corrupt, where they have health care centers that nobody shows up and somebody’s making millions of dollars, where they have daycare centers where there are no kids. It’s a scam. It’s a big scam. It’s a horrible thing.

We have a country that was great. We have a country that’s now great again. It’s really come a long way. Make America Great Again is almost going to be obsolete because our country is very close to, you know, we originally were going to keep America great. We have to switch to keep America great. But I don’t know. There’s something about MAGA we should never change. But Susie said, “Don’t change. We like MAGA. Everybody likes MAGA.”

Precision and Transparency in Healthcare

So we want to make this precision just like Venezuela, just like the attack on the Iran nuclear weapons, which wiped that out, just like all of the other things we do. Their precision. We want to make it the opposite of Minnesota, California and all these places that are so badly run.

So to further reduce insurance premiums, my plan ends the giant kickbacks to those insurance brokers and corporate middlemen that you’ve been hearing about for so long. It also funds the so-called cost sharing reduction program to bring down the cost of the most common plans on the exchanges by more than 15 percent.

And next, the great health care plan mandates unprecedented accountability and transparency from insurance companies and all health care providers. We want transparency. You’re not allowed to ask a doctor how much is it going to cost. You’re going to have your heart ripped out and you’re not allowed to negotiate. This is a giant scam.

It’s in certain ways. Look, nothing can compare to most favored nations. But when you give yourself the right to negotiate, you’re not allowed to even ask how much it costs. You’re supposed to go into a hospital and get operated on. Then they send you a bill and you have to file for bankruptcy. Not going to let that happen.

So we’re going to have insurance companies and health care providers going to have to have great and hospitals. Great transparency. The word transparency is a very important word. So they can’t get away with ripping you off any longer.

Comparing Plans and Reducing Costs

It requires insurance companies to make it easy for you to compare plans. You’ve got to be able to compare plans. You can’t do that now. You’re not allowed to do that. It’s not even believable. I’ll tell you what. I used to sit before I was a politician home and I used to say, how is that possible?

Things happen that I guess it’s just the forces of nature, the forces of power. And you end up with very, very badly treated people and they won’t stand for it. But these forces are going to release an earthquake of reduced price health care. You’re going to have massively reduced costs.

This is no longer we’re going to cut it by the famous one eighth of a point. You’re going to have massively reduced health care and it’s going to be massively better. You’re going to have great health care at a much lower price, which is the two things we want. Great health care. And we want low price. You’re going to have great health care at low price. Now you have terrible health care at a high price. You have horrible, horrible Obamacare health care. Like everything else he did, it was crap. It was a horrible plan was from day one and should have never been approved. It was a very sad night that night when there was a thumb raise.

Price Transparency Requirements

PRESIDENT TRUMP: Most importantly, we’ll require any hospital or insurer who accepts Medicare, Medicaid to prominently post all prices. You’re going to post your prices at their place of business. Something they don’t have to do, something they’re not even allowed to do. We’ll have the maximum price transparency and the cost will come down just by that. Not even talking about favored nations. The price will come down.

So just in conclusion, I’m calling on Congress to pass this framework into law so that we can get immediate relief to the American people, including rural America. And I hope to get Democrat votes. They know. They saw it. I know a lot of Democrats. And they say our plan is unbelievable. Are you going to vote? Well, I’m going to try. They have tremendous pressure on them. Vote no. Vote no.

Comments on Congressional Opposition

PRESIDENT TRUMP: We have a couple of Republicans, Massey, Thomas Massey, always votes no. He’s like something wrong with the guy. If you have any clinical psychiatrists in there, maybe go check out his mind. But he always votes no. He’s a very bad person. He’s a very bad Republican, bad American. When you always vote no. Just vote no. Do you approve? No. You know, there’s not a thing you can say to him either, Lola. Look, Lola wants to be nice. He likes to get along with everybody. I don’t. I don’t. But they vote no.

But so, I don’t know. You know, you have some people. They’re very — I call them Rand Paul Jr. Rand Paul always votes — I don’t know why he votes no, but he just — I guess he thinks it’s good politics. I got him elected twice. If I didn’t endorse him, he wouldn’t have been elected. But he doesn’t reciprocate, and I guess that’s okay.

Significance of the Healthcare Plan

PRESIDENT TRUMP: But I want to hear now, if I could, from Dr. Oz, and then we’re going to have Dan Sullivan say a few words, and Rob and Mike. And Governor, you’re going to say a few words, and we appreciate you being here very much. You’re doing a fantastic job.

I just want to leave by saying that this is the biggest thing to ever happen to healthcare in our country. It will not be covered that way by the fake news, and that’s a sad thing. It will probably not be voted positively by the Democrats, and that’s a sad thing. They all know how good it is. I think we can make healthcare into a Republican issue, because the Republicans are going to be close to unanimous on this. It should be unanimous. Maybe we will be unanimous, but it will be close.

But we have a small majority. We probably need a little bit of help from the Democrats. So whatever we can do, we’re going to do it. It’s the biggest thing to happen to healthcare, maybe from the beginning. So Oz, would you take it away, please? Thank you very much. Mr. President.

DR. MEHMET OZ: Mr. President, thank you for standing up for American healthcare. And I just want to underline this fundamentally important issue. We need Congress to help craft the great America healthcare plan, and the great healthcare plan will work.

It’s a brilliantly conceived framework, and as it comes to the American people, they understand that they’ll want it, and it should represent the analogous situation, similar to what you did so brilliantly last spring with the Working Families Tax Cut legislation that the President mentioned has created the Rural Health Transformation Fund, which is why we’re here today.

I want to put a little bit of texture around why this is such an important issue, because the Rural Health Transformation Fund is the largest investment ever in American history in our rural communities. Fifty percent increase in the amount of money that Medicaid, which Secretary Kennedy and I regulate, into our rural communities, $50 billion. You can do the math, it’s $1 billion per state, and that’s an important factor because it got them competing.

There’s 60 million rural Americans, and these folks do not have access to the same care that’s available in urban and suburban America. Their life expectancy, if they’re in a vulnerable situation, is nine years shorter, because your zip code actually is your destiny. It determines how long you’re going to live, and we can make a dent in this, because the high rates of chronic disease and other ailments that plague our rural areas are often driven because they don’t have access to care.

That’s going to change because of the Sentinel legislation. And again, it’s similar teams, the same leadership, same president, same Congress that passed the Working Families Tax Cut legislation, which is incredibly popular around the country and will make the great health care plan successful as well.

CMS Team Mobilizes to Deploy $50 Billion Fund

From the day the legislation was signed to create this wonderful fund, this transformational fund, the team at CMS, which is under Secretary Kennedy, began working. And they’re here today, Steph Carlton, Outstanding Chief of Staff, Alina Chekhi, and Emily Chan. That day started working. It was July the 4th, by the way, on the specific vision for the program.

How do you actually get the money out the door in six months? The president was insistent. He did not want the money in Washington. So we began working closely to make sure that we’d use the money not as a Band-Aid, but to empower those closest to the challenges that rural patients face. And who are those people? The 50 people who know rural health care the best? The governors.

They wanted the money out of Washington into the governor’s hands. And that was done in a remarkable way. The governors thought big. We have one here from Nebraska, who was actually the first to start working on community engagement, which is part of that legislation as well. But we have to right-size health care in rural America. And that’s an important phrase.

All 50 states submitted amazing ideas to transform rural health care in ways that should have been done decades ago. The CMS team awarded each team their portion of the $50 billion investment precisely with the same precision that we took Venezuela leadership, convicted individual, and with Iran as well, the same precision on time before the end of the year, and got it out of Washington into the states.

Butler, Pennsylvania: A Case Study in Rural Health Care Gaps

Now I want to take a step back and do a little thought experiment, Mr. President, if you want to do this. If you, and God forbid this happened, had turned your head the other way in Butler, Pennsylvania, it wouldn’t have been an ear injury. Now I’ve been to Butler. I’m from Pennsylvania. Butler General Hospital is a good hospital. They don’t have neurosurgery there.

If you have an injury to the head, you have a golden hour to get cared for. You were taken to Butler General Hospital. Because the injury, thankfully, was not as lethal as it was designed to be, it wasn’t a problem. But if you’d had a head injury, you could have had your life saved. But with not a neurosurgeon, and there is no neurosurgeon at Butler General Hospital, unfortunately, you wouldn’t have an option. Because Pittsburgh is a far, far ride away. That’s the closest metropolitan area where there are lots of neurosurgeons.

But with this bill, this legislation, rather, this funding of $50 billion, Pennsylvania got its share. And they’re going to be able to build telemedicine hookups, even tele-robotic surgery, that would allow an injured individual in a car accident or any other reason that is a head injury in Butler General and rural hospitals across the country to access the best care our nation has to offer so rural America will not suffer.

That’s the promise of what this money offers to our nation. It’s not just paying the bills, not just picking up the pieces. It’s actually transforming, using technology we have widely available in urban America, the way we save lives in rural America.

Each state competed aggressively. Because for a billion dollars, Mr. President, you’ll fight pretty hard. And they gave us brilliant ideas that they’re talking with each other about. So we’re actually creating teams that now across state lines will connect, because they’re all Americans.

Key Pillars of State Healthcare Plans

And they base their advances on several pillars. Secretary Kennedy can talk about MAHA, because there’s MAHA elements to this as well. But very precisely, sustainable access. We asked states, how can we bring top care closer, like in the thought experiment I gave you for Butler General?

In Pennsylvania and North Carolina, their regional spoke models, which at hub and spoke means you’ve got a big hospital in the city, and they adopt or work closely with some rural hospitals to solve the challenges of fragmented care. And that actually works. You share administrative back office work. You group purchase your stuff. You save money. You exchange medical records.

Alabama has no OB-GYNs in many of their counties. So they’re doing something pretty cool. They’re actually having robots do ultrasounds on these pregnant moms. So we can actually get those images back to the big center, so we know if the child has a problem, and we know if that mother’s at risk.

We have one of the highest maternal mortality rates in the world, in the country with the best medicine in the world. It’s often stated, people ask, does healthcare stink in America? Well, they don’t like it. Would you leave America to get healthcare elsewhere? Nobody leaves. We have the best healthcare, if you can get to it. We don’t want rural America left behind anymore.

Most Favored Nation Drug Pricing and Fertility Drugs

As an aside, by the way, we’ve talked about the most favored nation drug pricing. One of the first companies and areas we use most favored nation drug pricing is fertility drugs. That’s why we’re going to have so many Trump babies, because we’ve dropped dramatically the most expensive part of the fertility space. And so America no longer will pay so many times more, in that case it was 10 times more, for the same fertility drugs that they’re available for moms who want to get pregnant in Europe.

Addressing the Rural Healthcare Workforce Shortage

I want to thank Terry, who’s here as a nurse practitioner. Andrew is a doctor, West Virginia, New Mexico. They’re representatives of the workforce in rural America. But there are only two of them here representative, because we don’t have enough people working in rural America. It’s a big challenge.

So Delaware is creating its own medical school, their first ever medical school, in a rural part of the state. So that can get more local talent that will stay local in those parts of Delaware.

Michigan is launching the High School to Healthcare Pipeline Grant Program. They want to take kids out of high school in Michigan, local rural communities, and get them into the system. Get them trained as nurses, because they’ll stay home, because they’re from those communities. And they’ll save lives for decades there.

These are the types of programs that can get our rural communities and economies up to high gear, and keep it that way long after this five-year funding is done.

Technology Innovation in Rural Healthcare

And finally, tech innovation. Rural communities would benefit the most from high-tech advances, like we just discussed, as possibly if there was a head trauma case. Many states want to partner with our CMS Data Interoperability Network.

It was created by Amy Gleason, who spearheaded so much of the technology transformation in our government. It’s going to support the president’s pledge to provide transparency that he mentioned as part of the Great Health Care Plan. And Congress can ensure these are all available for decades to come if we can get this legislation through.

As the tech innovation forefront, just to give you a couple examples, Texas and Hawaii are making targeted investments in statewide telehealth. So everybody has telehealth. The best doctors for the best knowledge available where you are will meet you where you are. If you’re a vet and depressed and you’re thinking of taking your life, we’ll be there. Just let us know you’re in trouble and we’ll help.

Alaska wants to deploy, and I’m going to hand it to Senator Sullivan in a second, wants to deploy unmanned pharmaceutical distribution kiosks and drones that will deliver medications. Because in the North Slope of Alaska, you can’t get there this time of year. So these technologies, they exist. Why we use them in midtown Manhattan, we should use them in rural Alaska.

This administration is committed to collaborating with all 50 states. All 50, red and blue. All 50 states to carry out bold plans to tackle the challenges that local communities face. We’re not pouring funds blindly, however, into a broken system. We’re going to carefully, precisely, as the president said, target this investment with health care fraud running rampant. And I was in Minnesota this week, Mr. President. It’s worse than we’ve heard. But Minnesota, pardon the pun, is just the tip of the iceberg. California is the varsity team when it comes to fraud, waste, and abuse. We’re not going to let that happen.

We want transparency for this $50 billion investment. We owe it to Capitol Hill. We owe it to this president. And we want accountability to be a top priority. For that reason, we’ve created an Office of Rural Health Transformation at CMS for long-term oversight. The office is led by Alina Czekaj. Alina, again, was one of the people who helped create this program in the forefront. She was in the first administration, Mr. President. She’s going to guide states in implementing their rural health transformation plans. Coordinate all the federal and state partnerships, making sure there’s appropriate oversight.

In addition, every single state is going to have a dedicated project officer. We will be there with you. We’re going to help you. Please engage us. You’ve got lots of lives at risk. It’s a true state-federal partnership, unbelievable, extraordinary milestone for health care. Your zip code will no longer dictate whether you have excellent health care. Your zip code will no longer be your destiny. It’s not going to dictate your life expectancy.

Mr. President, I cannot thank you enough for the leadership that it took to get this $50 billion investment in rural health care. They don’t make a lot of noise. They just want to get the job done. You stood up for them. And Congress, God bless you for making this possible. Please do it again. Please do it again for the great health care plan.

Let me hand it to Dan Sullivan, who’s a spectacular member of the Senate. And obviously, Alaska, they’re pretty rural. Thank you.

Senator Dan Sullivan on Alaska’s Rural Health Needs

SENATOR DAN SULLIVAN: Thank you, Dr. Oz. And Mr. President, I am very honored to be here. This is a really exciting day. I want to thank you, sir, and your team. Worked really closely with Dr. Oz, Secretary Kennedy, many others. You know, this is a great example of how Congress, working closely with your administration, can achieve historic things. This is historic for our rural health care, certainly in the Working Families Tax Cuts Act. You combine it with what you were talking about, sir, in terms of drug price reductions for all Americans. So these are two things that are happening right now and are historic. And I agree 100% with you, Mr. President. Has got a lot of press, even though it is historic. It’s going to really impact people in rural America.

America, especially my state, this fund that I want to talk about. But what you’ve done on the drug pricing is even when you get Lisa Murkowski to vote for it. She voted for it. Now, are you going to get her to vote for the great, big, beautiful health care bill that when we get that, I think MFN drug pricing. I bet every member of Congress, are you going to get her to vote for it?

We’ll work on it, sir. We’ll work.

Alaska’s Resource Development and Infrastructure Boom

So let me actually talk a little bit about the context of what’s going on in Alaska and how this relates to it. You know, after four years of being locked up and shut down by the previous administration, we are on the cusp of achieving some huge goals in my state that we’ve been working on for decades. We have this huge resource development boom going on on the North Slope of Alaska. I was with a bunch of the Inupiat, Alaska native people who live up there. They are so excited about what’s happening there.

We are, as you know, Mr. President, building icebreakers. We’re home porting some of those in Alaska. We have huge historic infrastructure in economic and national security investments happening. In particular, the gas line that you have championed so much, the big LNG project. All of these things are happening. It’s really exciting. By the way, all of these issues I just talked about, all of those were in the Working Families Tax Cuts Act, so there’s a lot of excitement.

Alaska’s Historic $1.4 Billion Health Care Investment

But Mr. President, in addition to a strong economy, the thousands of jobs that these projects are going to have, we have to have a strong health care system in every state. In rural Alaska, as you mentioned, as Dr. Oz mentioned, has often, almost always been an afterthought when it comes to investing in health care in America. And that’s not happening anymore after the Working Families Tax Cuts Act.

As you said, Mr. President, as Dr. Oz said, this is the biggest investment in rural health care in American history, $50 billion. The award the great state of Alaska was able to get working with Dr. Oz and the parameters of the bill was about $1.4 billion over five years to transform our health care system. So that’s really exciting, but here’s the big deal. This is not just about money. This bill isn’t just about money.

State-Driven Solutions Over One-Size-Fits-All Mandates

The reason it’s so impactful is that it’s focused on letting states and governors design the system that they need. Alaska has many unique health care challenges, Mr. President, as you know, but for decades the mentality in Washington, D.C., is this approach to one size fits all. D.C. tells every state, “here’s how you have to do it,” and it never works. It never works. It certainly doesn’t work in my state.

I’ll just give you one example, the federal match on Medicaid. Our state typically has the lowest match in the country, even though we have the highest health care costs and highest delivery costs in the country. The one size fits all doesn’t work. This bill is different. This bill that we wrote with your administration is all about allowing states to design a system that works for them with CMS guidance, and this will be a generational opportunity for every state to bring health care closer to home, to make it more responsive to the people who live in that state, and make it more affordable.

I’ll just end with this, Mr. President. Like I said, a lot of excitement. We got Governor Dunleavy, who sends his greetings, was hosting the stakeholders in Alaska who are going to be applying for these funds, working with CMS in our state. Over the last couple of days, we have over 300 people come in these meetings on how to use this transformation fund to better health care in Alaska, and this is going to help my constituents. It’s going to help every American, and it is really exciting, and I want to thank again you, Mr. President, and your team.

Thank you, Dan. Thank you very much. Thank you very much. We’re going to have to go very fast. We’re going to have to go very — we are way behind schedule, and I have a couple of meetings that are very important. Nothing more important than this, but let’s go. Come on, Bob. Rob? Fire around. Please.

SPEAKER: Mr. President, thank you very much for having me here today, and I represent Northeastern Pennsylvania. Your governor from Scranton, Pennsylvania, so never had the opportunity to meet, but I inherited a very similar problem, but before I was even sworn into office, I had two hospitals, Moses Taylor and Regional in Scranton, that were eminently facing closure, and it’s been — and working with Dr. Oz, Administrator Oz, and the CMS team has been absolutely incredible on so many levels, and thank you again for intervening and shepherding us through that process.

But when you’re looking at Pennsylvania, we’re going to receive over $193 million. In five years, it will be over a billion dollars for the Commonwealth of Pennsylvania. And when you think about Northeastern Pennsylvania, clinics and regional hospitals, rural hospitals are the backbones of our communities. So making a targeted investment that is not just going to band-aid over poor operational procedures, it’s going to actually transform rural healthcare. That’s what we are so excited about.

Pike County in my district is the largest-growing county in the Commonwealth of Pennsylvania, where there’s not a hospital. The nearest commute to a hospital is over 55 minutes away. So these are going to be funds that will be so imperative. The unprecedented investment is going to be incredible, and thank you for having me up here and being a part of this journey.

PRESIDENT TRUMP: Thank you, Rob. Appreciate it.

New York State’s Investment in Rural Health

SPEAKER: Thank you, Mr. President. This is a great opportunity to be here with you and your team. Dr. Oz has been a tremendous asset. The $50 billion commitment to rural health transformation is critical. New York State is going to see about $212 million in the first year, which is vital for workforce development, access to care, primary, behavioral, maternal, emergency, telemedicine, et cetera.

How did we – how were we able to do it? Because we rooted out waste, fraud, and abuse in the system. Democrats will just say we cut a trillion dollars in Medicaid. That’s not what we did. We said you need to be eligible. You need to be a citizen. You need to work if you are able-bodied without dependent children. We reined in the provider tax and state-directed payments, which have exploded over years. And we are taking this money, not only preserving Medicaid for the IDD community, our seniors, our children, our single mothers, but we’re investing it in rural health.

The Problem with Obamacare and Insurance Companies

When you look at Obamacare, health insurance premiums have risen 96 percent since Obamacare took effect, insurance revenues up 2,000 percent. Mr. President, you are 1,000 percent correct that the insurance companies are the problem. They wrote Obamacare. It’s to their benefit, and the American people are being screwed. And so we can get a bipartisan agreement on what you are trying to do.

Lowering Drug Prices Through Price Control Reform

When it comes to lowering drug prices, I will tell you, one of the largest pharmaceutical companies is in my district in Westchester County. I met with them in 2024, and I said, what would you do to lower drug prices? And the response was, go after the European price controls. You are spot on on taking on the price controls that have been put in place. Most favored nation is the single best thing we can do to lower prescription drug prices here in America. The pharmaceutical companies will tell you that privately. And that is the fundamental fact.

We need to go after PBM reform, associated health care plans. We put that on the floor. Every Democrat voted against it. Every Republican for it. Those would reduce costs by 11 percent because businesses, small businesses, would be able to pool together and purchase health care plans at a lower rate.

We need to go after the PBMs and make sure that insurance companies are not owning providers and owning PBMs. That is what is driving up the cost of health care in this country. You’ve talked about IVF. I’ve been a big champion on this. We need to make sure the insurance companies cover it. I also have a tax bill to provide tax incentives to Americans. And what you have done to lower IVF costs on the drugs is critical. And you are a thousand percent correct on expanding HSAs. I fundamentally believe that we can address the issues with Obamacare, make sure that the American people have access to care at a lower rate. We can get a bipartisan agreement to address the EPTC with expansion of HSAs so that the money goes to the people and not the insurance companies. We are committed to working to get this done and I thank you for your leadership. Thank you.

UNIDENTIFIED SPEAKER: Thank you. Mr. President, a gigantic thank you and thank you for your incredible leadership. Your courage gives me more courage to say it the way it is. We’re working very hard in Nebraska to run government like a business. This investment into rural America, which by the way, in all of Nebraska, you poll 85 percent. I don’t know what the hell is wrong with the other 15, but 85 is a pretty good number.

I think, to be very, very brief, this plan will allow us to do common sense, pragmatic investments in rural Nebraska and they will be sustainable. We will make sure that we don’t need another dollar after five years. We’re working on simple things like food. Real food is good medicine. We’re working on making sure that all of our veterans, Nebraska is 500 miles long, 250 miles wide, no longer are veterans going to have to drive to Omaha to get care. We’re going to take care of our veterans at home.

Investments in technology so we can educate our children in rural Nebraska to provide health care are really, really important issues. And I think that the other is we’ve developed what we call six regions, one Nebraska, and that will focus and take advantage of those. So we’re working on what we have and then being able to use these resources to also help us with mental health and drug care as well. So we’re incredibly grateful. Nebraska, we work hard. We’re about faith, family, hard work, the American dream, and we don’t ask for much help in rural Nebraska. So we’re really grateful for this investment. Thank you.

PRESIDENT TRUMP: Thank you. Thank you. Thank you for being here.

UNIDENTIFIED SPEAKER: One minute. How about 30 seconds? How about 30 seconds, sir?

As a small town kid from Glen Rose, Texas, 1200 where I grew up, what you are doing today changes everything. And on behalf of our farmers and our ranchers in rural America, it is a new day and we’re so grateful.

Historic Presidential Leadership

The final thing I’ll say is I think about Abraham Lincoln, who also sat in this room, and I think about other presidents throughout American history. And you think about how the fundamental course of American history has changed in certain pivot points throughout history. I think about you as the peace president. Eight wars solved, more coming. I think about you as the security president, a border that is secure for the first time and more than any time in American history. I think about you as the prosperity president. We talk about Kevin wages going up.

PRESIDENT TRUMP: We’ll give her more than one minute. Oh, no. She can. No, she can speak as long as you want.

UNIDENTIFIED SPEAKER: Prosperity president and what’s happening. Think about you as the affordability president. Everything is coming down. Inflation is coming down. The cost of groceries is coming down. Fuel, housing, et cetera. And, sir, today in the last two weeks, you will go down in history as the greatest president for the health of this country in history. Think about our new dietary guidelines from Bobby Kennedy and I.

But with your leadership, putting real food back in the middle of our health care conversation, whole milk for healthy kids with those dairy farmers two days ago. We were in Pennsylvania talking about it yesterday and today, putting the patient and the doctor back in charge of health care with great leaders like Governor Pillan. God bless you, your leadership and all of our leaders. Thank you so much.

PRESIDENT TRUMP: Thank you very much. And Terry and Andrew, thank you. Thank you very much for being here. I hear you’re just outstanding people and have really helped. We appreciate it. You want to say something?

TERRY: Thank you, President Trump. And I would just echo everything that’s been said here. Thank you very much for what you’re doing. I’m from the northwest corner of New Mexico. We also work with the Navajo Nation. And so we have a lot of rural areas in our state and in our county. I’m also a county commissioner. So I take as being a nurse practitioner, a county commissioner with a heavy weight in order to see this happen.

And it will help produce accessibility, which is a huge thing. People have to drive for miles in order to see a health care provider, workforce, quality care, and sustainability for our hospitals. That’s what we’re looking at. We meet next week in Santa Fe with our legislators. And so that is we’re going to be addressing the licensure compact as well.

PRESIDENT TRUMP: And they’ve got to clean up their elections in New Mexico. We’re working. Because those elections are so corrupt. It’s incredible. If they cleaned it up, we wouldn’t buy a lot. But they are really corrupt elections. So I think if you want to do this, you have to tell them to start working on that. It’s one of the more corrupt states in terms of that. But you uncorrupted. So I appreciate you being here. The northwest corner loves you. I know we have great love in New Mexico, but the elections are so corrupt. Not much you can do about it. We have that with numerous states. Thank you very much.

Andrew, thank you very much. You have anything to say?

Andrew’s Remarks on Quality Care Access

ANDREW: Mr. President, thank you for having me here today. It’s an honor to be here to represent my community. I’m from northwest Georgia. I grew up in West Virginia to represent my colleagues in my profession. It’s truly an honor. This is so important to our patients to put the physician and the patient back together and take everything else out of the middle.

I practice in cardiology. You know, having efficient, effective, high quality care is so important. And time is of the essence. And patients need to be able to have close proximity to their doctors to get the care that they deserve. Quality of care shouldn’t matter about the zip code. We should be able to do what we are best at and take care of our patients on an equal playing field. And this certainly helps that.

I greatly appreciate all that you’ve done for the American people. You are an inspiration to us. You make us believe no problem is too big to solve. I mean, you are a representative of that. And I thank you for your leadership. Thank you for this opportunity to be here. And thank you for putting health care at the forefront. It’s so important to every patient and every family that we take care of.

Closing Remarks

PRESIDENT TRUMP: Thank you very much, Andrew. Great job. Great job, you both do. Amazing. I’ve heard unbelievable things. And doctors in particular, thank you very much for being here. We very much appreciate it. Thank you, everybody. It’s a big story. Thank you. Thank you very much. Thank you, Bob.

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