four long years of endless work, sleepless nights, and constant
stress, you can finally look forward to three years of even more
work, less sleep, and stress that may tempt you to self-prescribe.
But hey, at least there's
Of course, you knew all
of this coming in. You understood the sacrifices involved and the
commitment necessary to become a doctor. You were aware that it
would take years of your life and leave you with significant debt.
And yet, you signed up
You chose this profession
because you heard a calling; and in answering that call revealed
that you don't just see this as a profession. From now on, doctor
won't just be a title you'll hold, it will be a part of who you
are - a healer, a saver of life. And no matter where you may be
or what situation you may find yourself, you will forever come forward
at the first sound of the question, "Is there a doctor in the
This is a good thing. I
mention it not to add to the burdens that must already weigh heavily
on your shoulders, but to point out that your distinct commitment
and compassion for the lives of your fellow human beings is a quality
that has intrinsic value far outside the doctor's office or the
And it is because of this
quality that I want to ask something of you.
Life often happens in a
way that makes it easy for us to miss the larger obligations we
have toward one another. The demands of work and time and money
tend to narrow our focus and cause us to turn inward. You might
flip on the news or pick up the paper and feel moved by a story
about genocide in Darfur or the AIDS epidemic or the fifteen-year-old
who was gunned down in front of his house. You may even feel compelled
to do something about it. But inevitably, it becomes time to study,
or go to work, or cook dinner, or put the kids to bed - and so we
often turn away from the big stuff and concentrate on simply surviving
This is perfectly human.
It is perfectly understandable. And yet, the survival of our country
has always required more. It has required ordinary men and women
to look beyond their own lives; to think about the larger challenges
we face as a people - and then rise to meet them.
This is what I'd like to
ask you to do today.
In a few months, your residencies
will begin. And on a daily basis, you will encounter patients with
every disease and ailment imaginable. There will be heart problems
and lung problems; common colds and deadly flus; broken bones and
But after being there for
awhile, you will encounter another, more pervasive affliction that
affects more than just individual patients. Perhaps you will first
notice it when a doctor tells a woman that her husband will need
a life-saving procedure that their insurance will not cover and
their family cannot afford. Perhaps it will be the late-stage diagnosis
of a cancer that could have been prevented with a routine screening
that the patient's health care plan just doesn't cover. Perhaps
it will be the endless stream of people who wait and wait in an
Emergency Room which is the only place that will treat the uninsured.
At some point in your residency,
you'll see firsthand that there is something fundamentally broken
about our health care system. You'll realize that for millions upon
millions of Americans, the care you provide is becoming far too
costly for them to afford. And you'll have to decide what, if anything,
you're going to do about it.
You've all heard the statistics
- 46 million Americans uninsured. 5 million more in just the last
four years. Family premiums up 65%. Deductibles up 50%.
It's a cost crisis that
traps us all in a vicious cycle. Because the uninsured can't afford
health care, they put off seeing a doctor or end up in the ER when
they get sick. Then their care is more expensive, and so premiums
for all Americans go up. Because everyone's premiums go up, more
Americans lose their health care.
From the smallest mom and
pop stores to major corporations like GM, businesses who can't afford
these rising costs are cutting back on insurance, workers, or both.
States with bigger Medicaid bills and smaller budgets are being
forced to choose whether they want their citizens to be unhealthy
or uneducated. And over half of all family bankruptcies today are
caused by medical bills.
This is affecting your
profession too. Whether it's Medicaid reimbursements, the rising
price of medical malpractice insurance, or having HMOs look over
your shoulder, all the hard work and sacrifice you've put in during
medical school is becoming less rewarding than it once was.
And so today I ask you
to be more than just practitioners of medicine; I ask you to be
advocates for medicine. I ask you to be advocates for a health care
system that is fair, that is just, and that provides every single
American with the best your profession has to offer.
Just like generations before,
you must dare to believe - not only as tomorrow's physicians, but
as tomorrow's parents, workers, business owners, and citizens. You
must choose: Will the medical miracles you perform over the next
generation reach only the luckiest few? Or will history look back
at this moment as the time when we finally made care available at
a cost that we can afford?
There isn't one person
sitting here today who wants to turn a sick patient away because
they can't pay. Not one person who wants the care they deliver denied
to those whose lives depend on it. Each of you has dedicated yourselves
to this calling because where there is a sick person, you want to
heal them. Where there is a life in jeopardy, you want to save it.
And so today, when you
leave here, it will not only be with great knowledge, but with even
greater responsibility. Because if we do nothing about the rising
cost of health care, it will keep climbing, and in ten years, the
number of uninsured could grow to 54 million.
We can solve this problem.
Challenging as it may seem, all over America there are already business
owners and political leaders and labor representatives and members
of the medical profession who are coming up with new and different
ways to cut costs and improve quality in our health care system.
In Massachusetts, they just signed into law a groundbreaking plan
that would cover most all of its citizens.
This can be our future,
but everyone needs to stay involved, and everyone needs to put the
pressure on Washington, because they sure won't do it on their own.
Just a little while ago, we were told that it was "Health Care
Week" in the U.S. Senate. Five days later, we had failed to
debate even a single bill that would have fundamentally improved
access for the 46 million Americans without health insurance.
This is why we need you.
We need you to dream, we need you to speak out, and we need you
to act. And together, we can build a health care system in this
country that finally works for every American.
We can have a system where
no matter how many times you switch jobs or how large or small your
employer is, you have a health care plan that stays with you forever.
We can have a system that
reduces medical error and cuts costs by using 21st century technology
to put all of our medical information online. A system where every
doctor and nurse can sit by a patient's bedside with a laptop and
pull up their entire medical history with the click of a mouse.
Where every patient has an electronic bracelet that you could scan
to find out the exact type and amount of medication they needed
so there are no mistakes made. Where you could go online and monitor
a patient's breathing and heart rate while they were home to track
We can have a system of
evidence-based health care that shares information about what works
and what doesn't, so we can actually provide patients with the care
they need when they need it.
And we can have a health
care system where we focus on preventing deadly and costly illnesses
before they occur - where we ensure that every American has routine
check-ups and screenings and information about how to live a healthy
We can do all of this -
but we need your help to get it done.
Of course, no one's forcing
you to meet these challenges. Each of you has been blessed with
extraordinary gifts and talent. And so if you want, you can leave
here and focus on your own medical career and your own success,
not giving another thought to the plight of the growing millions
who can't afford the care you will provide. After all, there is
no community service requirement in the real world; and no one's
forcing you to care.
But I hope that you do.
Not because you have a debt to all of those who helped you get to
where you are, although you do have that debt. Not because you have
an obligation to those who are less fortunate, although you do have
that obligation. You need to take on the challenges that your country
is facing because you have an obligation to yourself. Because our
individual salvation depends on collective salvation. Because it's
only when you hitch your wagon to something larger than yourself
that you will realize your true potential.
Looking out at this class
of 2006, I think my hope is well-placed. With the field you have
chosen, you've already shown how much you care about the lives of
others; how strongly you have heard the calling to be healers in
this world. Today, I ask you to remember that call always, and to
remember how it could include more than the patient sitting in your
office. It could also include the patients who can't afford to get
there, the ones who aren't being provided the best care, and the
general health of all Americans.
When you think about these
challenges, I also ask you to remember that in this country, our
history of overcoming the seemingly impossible always comes about
because individuals who care really can make a difference.
A century ago, who would
have dared to believe that in just one hundred years, we would add
thirty years to the average lifespan and witness a 90% drop in the
rate of infant death? Who would have dared to believe that with
a simple vaccine, we could eliminate a disease that left millions
without the ability to walk? That we could transplant a heart or
resuscitate one that stopped? That we could unlock the greatest
mysteries of life from the most basic building blocks of our existence?
In a time where you were
lucky to live past fifty and doomed if you came down with the flu,
who would have dared to believe these things?
The people who once sat
in your position - they did. The doctors and nurses, researchers
and scientists who came before. Who grew up believing that in America,
the most improbable of all experiments, the place where we continue
to defy the odds and write our own history, that they could be the
ones to improve, extend, and save human life. That they could be
And as you go forth from
here in your own life, you can keep this history alive if you only
find the courage to try. Good luck with this journey, and congratulations
on all of your achievements. Thank you.