Our work must begin [n]by making some basic decisions about our budget - decisions that will have a huge impact on the strength of our recovery.
Over the last few years, both parties have worked together to reduce the deficit by more than $2.5 trillion - mostly through spending cuts, but also by raising tax rates on the wealthiest 1 percent of Americans. As a result, we are more than halfway[o] towards the goal of $4 trillion in deficit reduction that economists say we need to stabilize our finances.
Now we need to finish the job. And the question is, how?
In 2011, Congress passed a law saying that if both parties couldn't agree on a plan to reach our deficit goal, about a trillion dollars' worth of budget cuts would automatically go into effect this year. These sudden, harsh, arbitrary cuts would jeopardize our military readiness. They'd devastate priorities like education, energy, and medical research. They would certainly slow our recovery, and cost us hundreds of thousands of jobs. That's why Democrats, Republicans, business leaders, and economists have already said that these cuts, known here in Washington as "the sequester,"[p] are a really bad idea.
Now, some in this Congress have proposed preventing only the defense cuts by making even bigger cuts to things like education and job training; Medicare and Social Security benefits.
That idea is even worse[q]. Yes, the biggest driver of our long-term debt is the rising cost of health care for an aging population. And those of us who care deeply about programs like Medicare must embrace the need for modest reforms [r]- otherwise, our retirement programs will crowd out the investments we need for our children, and jeopardize the promise of a secure retirement for future generations.
But we can't ask senior citizens and working families to shoulder the entire burden of deficit reduction while asking nothing more from the wealthiest and most powerful. We won't grow the middle class [s]simply by shifting the cost of health care or college onto families that are already struggling, or by forcing communities to lay off more teachers, cops, and firefighters. Most Americans - Democrats, Republicans, and Independents - understand that we can't just cut our way to prosperity[t]. They know that broad-based economic growth requires a balanced approach to deficit reduction, with spending cuts and revenue, and with everybody doing their fair share[u]. And that's the approach I offer tonight.
On Medicare, I'm prepared to enact reforms that will achieve the same amount of health care savings[v] by the beginning of the next decade as the reforms proposed by the bipartisan Simpson-Bowles commission. Already, the Affordable Care Act is helping to slow the growth of health care costs. The reforms I'm proposing go even further. We'll reduce taxpayer subsidies to prescription drug companies and ask more from the wealthiest seniors[w]. We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital - they should be based on the quality of care that our seniors receive. And I am open to additional reforms from both parties, so long as they don't violate the guarantee of a secure retirement. Our government shouldn't make promises we cannot keep - but we must keep the promises we've already made[x].