Hello, everybody! All right, everybody have a seat. I got a lot to say here. First of all, I want to just thank Becky Patton for the extraordinary work that she has done on behalf of nurses, on behalf of patients, on behalf of the country. Thank you so much. We are proud of everything that she's done. And her mom is in the house -- so, thanks, Mom. Good job. Good job with Becky. 大家好！好了，大家请坐。我有很多话要说。首先，我想感谢贝琪·帕顿为护士、为患者、为国家所做出的卓越工作。非常感谢。我们为她所做的一切感到骄傲。她的妈妈也来了——所以，谢谢妈妈。干得好。把贝琪培养得很好。
I want to thank Marla Weston, the CEO of the American Nurses Association. And I also want to acknowledge the presence here of Dr. Mary Wakefield, who is our -- for those of you who are not familiar, she is the administrator of HRSA and our highest-ranking nurse in the administration -- and does absolutely great work. 我想感谢美国护士协会的首席执行官玛拉·韦斯顿。我也要向在场的玛丽·韦克菲尔德博士致意——可能有些人不太熟悉，她是卫生资源和服务管理局的局长，也是我们政府中级别最高的护士——她的工作非常出色。
Now, I want to tell you, it is an honor to speak to the ANA, representing more than 3 million registered nurses across the country. Part of the reason I'm here is because I promised I was going to come, and I told to Becky that I don't break promises to nurses because you never know when I'm going to need a shot. And I don't want them working that needle all kind of -- "I can't find a vein." So I'm keeping my promises. 现在，我想告诉大家，能在美国护士协会演讲是我的荣幸，这里代表着全国超过300万名注册护士。我之所以来到这里，部分原因是我承诺过会来，我告诉过贝琪，我不会对护士食言，因为你永远不知道我什么时候需要打针。我可不想他们拿着针头到处戳——"我找不到血管啊。"所以，我信守承诺。
But it's not just out of fear. It's also because I love nurses. I love nurses. Now, I'm not just saying that because I'm talking to a roomful of nurses. There are representatives from Illinois here in the house -- and they will testify I loved nurses before I got to Washington. And I don't think I'm alone in that, because virtually all of us, at one time or another in our lives, have known the care and the skill that you offer. In hours of need, in moments where people are most vulnerable, most worried, nurses are there, doing difficult and lifesaving work. 但这不仅仅是出于恐惧，也是因为我热爱护士。我热爱护士。我现在不只是因为面对满屋子的护士才这么说。这里就有来自伊利诺伊州的代表——他们会作证，在我来华盛顿之前我就热爱护士了。我觉得不只我一个人这样想，因为我们几乎所有人，在生命的某个时刻，都感受过你们给予的关怀和专业技能。在最需要帮助的时刻，在人们最脆弱、最担忧的时刻，护士们始终在那里，做着艰难而救命的工作。
And you don't just provide clean bandages or an intravenous line. A nurse will hold your hand sometime, or offer a voice of calm, or that knowing glance that says things are going to be okay. 你们不仅仅提供洁净的绷带或静脉输液。护士有时会握住你的手，或带来平静的声音，或用一个了然的目光告诉你：一切都会好起来的。
And when Malia was born, I remember vividly the nurses who took care of Michelle and our new baby. The doctor who delivered is actually one of our best friends, but she was there about 10 minutes. And the nurse was there the whole time tending to this new family of ours. That was a happy day. 玛利亚出生的时候，我清楚地记得照顾米歇尔和我们刚出生宝宝的护士们。接生的医生其实是我们最好的朋友之一，但她只待了大约10分钟。而护士全程都在那里，照料着我们这个新组建的家庭。那是一个幸福的日子。
Now, there was another day when our youngest daughter, Sasha -- she was three months old -- was diagnosed with meningitis. And it was nurses who walked us through what was happening, and who, along with the doctors, helped make sure that Sasha was all right and that her father did not have a breakdown. 还有另外一天，我们的小女儿萨莎——当时才三个月大——被诊断出脑膜炎。是护士们一步步向我们解释发生了什么，是她们和医生们一起确保萨莎安然无恙，也确保她的父亲没有崩溃。
So, as a father, as a husband, I will forever be in debt to the women and men of your profession. And I know that millions of others feel the same way. America's nurses are the beating heart of our medical system. You're on the front lines -- You are on the front lines of health care in small clinics and in large hospitals, in rural towns and in big cities, all across America. 所以，作为一名父亲、一名丈夫，我将永远感激你们这个行业中的女性和男性。我知道数以百万计的人也有同感。美国的护士是我们医疗系统跳动的核心。你们站在第一线——你们站在医疗保健的第一线，在小诊所和大型医院，在乡村小镇和大城市，遍布美国各地。
And it's because you know our health care system so well that you've been such a fierce advocate for its reform. Because after all, you care for patients who end up in the emergency room, or in surgery, because they couldn't afford the preventive care that would have made more invasive and costly treatment unnecessary. You are asked not only to take care of patients -- you've got to navigate a tangle of rules and forms and paperwork that drive up costs and prevent you from doing the best job possible. 正是因为你们如此了解我们的医疗系统，你们才会成为其改革的坚定倡导者。毕竟，你们照顾的那些病人之所以最终进入急诊室或手术室，正是因为他们负担不起原本可以让更具侵入性、更昂贵的治疗变得不必要的预防性护理。你们不仅要照顾病人——还要在错综复杂的规则、表格和文书中周旋，这些文书推高了成本，也阻碍了你们把工作做到最好。
You're the ones who see the terror in a parent's eyes when an insurance company bureaucrat has denied coverage for a child's treatment. And you're the ones who have to comfort people who are wracked with worry not only about getting better, but also about paying for health care because they've hit a cap on benefits or their insurance doesn't cover a preexisting condition. 你们亲眼目睹过当保险公司的官僚拒绝为孩子支付治疗费用时，父母眼中的恐惧。你们也不得不安慰那些不仅为康复忧心忡忡，也为医疗费用焦虑不堪的人，因为他们已经触及了福利上限，或者他们的保险不涵盖既往病史。
So nurses have seen the consequences of our decades-old failure to reform our health care system -- the rising costs, the increased uninsured, the mixed up incentives, the overburdened providers, and a complex system that has been working a lot better for insurance companies than it's working for the American people -- or for providers. 所以，护士们看到了我们几十年来未能改革医疗系统的后果——不断上涨的成本、越来越多的未投保者、错乱的激励机制、负担过重的医疗服务提供者，以及一个对保险公司而言远比对美国人民——或对医疗服务提供者——运作得好得多的复杂体系。
And that's why, almost a year ago, nurses from across the country came to the White House to help make the case for reform -- for making coverage more affordable, and extending coverage to millions without it; for giving doctors and nurses more freedom to help their patients; for providing families and small businesses with more control over their health insurance; and for ending the worst and most abusive practices of the insurance industry. 正因如此，大约一年前，来自全国各地的护士来到白宫，帮助为改革奔走呼吁——为了让医保更可负担，并将覆盖范围扩展到数百万没有医保的人；为了让医生和护士有更多自由去帮助他们的患者；为了让家庭和小企业在医疗保险上有更多自主权；以及终结保险业最恶劣、最滥用的做法。
And after a long and tough fight, we succeeded -- yes, we did -- in passing health care reform. Thanks to you. And that reform will make a positive difference in the lives of the American people. 经过漫长而艰难的斗争，我们成功了——是的，我们做到了——通过了医疗改革。这要感谢你们。这项改革将给美国人民的生活带来积极的改变。
Now, this fight wasn't new for the ANA. I understand you were one of the only major health care organizations that supported the creation of Medicare from the start. And I want to recognize one of your leaders -- Jo Eleanor Elliott of Colorado, who is here today and was your president back then -- for the courage and leadership she showed. Where is she? There you are right there. Give her a big round of applause. 这场斗争对ANA来说并不新鲜。我了解到，你们是从一开始就支持建立医疗保险的少数主要医疗组织之一。我想在这里向你们的一位领袖致敬——来自科罗拉多州的乔·埃莉诺·埃利奥特，她今天也在这里，当年正是你们的主席——感谢她所展现的勇气和领导力。她在哪里？你就在那里。给她热烈的掌声。
So you've been there before and you were here this time. And I want to thank the ANA for advocating for health care reform -- for ensuring that the voices of nurses and of patients were heard. 所以你们过去就曾站在那里，这次也不例外。我要感谢ANA为医疗改革奔走呼吁——感谢你们确保护士和患者的声音被听到。
Now, already, we're seeing the start of a profound shift as reforms begin to take effect. We're giving ordinary consumers and small businesses more power and protection in the health care system -- and we're knocking down barriers that stand between you and the people who you care for. 现在，随着改革开始生效，我们已经看到了一场深刻变革的开端。我们正在让普通消费者和小企业在医疗系统中拥有更多的力量和保护——我们也在拆除横亘在你们和你们所照护的人之间的障碍。
A few weeks ago, 4 million small business owners and organizations got a postcard in their mailbox from the IRS. Now, usually that's not good news. But this time it was because it told them that they could be eligible for a health care tax cut this year -- a tax cut worth potentially tens of thousands of dollars for those small businesses; a tax cut that will help millions to provide coverage to their employees. That's happening now. 几周前，400万小企业主和组织收到了国税局寄来的明信片。通常，这不是什么好消息。但这次不一样，因为明信片告诉他们，今年他们可能有资格获得一项医疗税收减免——对那些小企业来说，这项减税可能价值数万美元；这项减税将帮助数以百万计的人为员工提供医疗保险。这一切正在发生。
In many cases, young adults without health insurance are now able to stay on their parents' plan until they're 26 years old. Even though insurance companies had until September to comply with this rule, we asked them to do so immediately to avoid coverage gaps for young adults, and most have agreed. 在很多情况下，没有医疗保险的年轻人现在可以继续留在父母的保险计划中，直到26岁。尽管保险公司本可以等到9月再遵守这一规定，我们仍要求他们立即执行，以避免年轻人出现保险覆盖空白，多数公司已经同意。
Starting this month, relief is also available to businesses for providing coverage to retirees who are not yet eligible for Medicare. And as of last week, senior citizens who fall into the doughnut hole have started receiving a $250 rebate to help them afford their medication -- and we're going to keep on going until we close that doughnut hole completely. 从本月开始，为尚未符合医保条件的退休人员提供保险的企业也可以获得税收减免。截至上周，落入"甜甜圈洞"的老年人已开始收到250美元的退款，帮助他们负担药费——我们将继续努力，直到完全填平这个"甜甜圈洞"。
In the meantime, we're strengthening Medicare by going after the billions of dollars in waste and fraud and abuse in the system. And states like Maine and Connecticut are beginning to predict budget savings as pieces of reform come online. 与此同时，我们正在通过追查系统中数十亿美元的浪费、欺诈和滥用行为来加强医疗保险。缅因州和康涅狄格州等州已开始预测，随着各项改革陆续落地，预算将出现节省。
So we've begun making coverage more affordable. In addition, the new health care law has also started to end the worst insurance industry practices. You know them. For too long, we've been held hostage to an industry that jacks up premiums and drops coverage whenever they please. Those days are coming to an end. 我们已经让医保变得更可负担。此外，新医疗法也开始终结保险业最恶劣的做法。你们都了解。长期以来，我们一直被一个随心所欲提高保费、随时取消保险的行业所绑架。那些日子正在走向终结。
So after my administration demanded that a large insurance company justify a massive premium increase on Californians, the company backed off its plan. My Secretary of Health and Human Services, Kathleen Sebelius, has urged states to investigate other rate hikes. We've set up a new Office of Consumer Information and Insurance Oversight. And we'll provide grants to states running the best oversight programs to root out bad practices when it comes to premiums. 所以我政府要求一家大型保险公司就大幅上调加利福尼亚人保费一事作出解释后，该公司放弃了原计划。我的卫生与公众服务部部长凯瑟琳·西贝利乌斯敦促各州调查其他保费上涨事件。我们设立了一个新的消费者信息与保险监督办公室。我们将向那些拥有最佳监督项目的州提供拨款，以根除保费方面的不良行为。
Now, as of September, the new health care law prohibits insurance companies from dropping people's coverage when they get sick, which is critical to giving people some peace of mind. 从9月起，新的医疗法禁止保险公司在投保人患病时取消其保险，这对于让人们安心至关重要。
But when news reports indicated that an insurance company was dropping the coverage of women diagnosed with breast cancer, my administration called on them to end the practice immediately -- don't wait till September. And soon after, the entire industry announced that it would comply with the new law early and stop this perverse practice of dropping people's insurance when they fall ill and when they need coverage the most. 但当有新闻报道指出，一家保险公司正在取消被诊断为乳腺癌的女性的保险时，我政府立即要求他们结束这种做法——不要等到9月。不久之后，整个行业宣布将提前遵守新法，停止这种在人们生病、最需要保险时取消保险的恶劣做法。
Some were also questioning whether insurance companies could find a loophole in the new law and continue to discriminate against children with preexisting conditions. So we called on insurance companies to step up, provide coverage to our most vulnerable Americans. And the insurance industry has agreed. 也有人质疑保险公司是否会钻新法的空子，继续歧视有既往病史的儿童。所以我们呼吁保险公司站出来，为我们最脆弱的美国同胞提供保险。保险业已经同意了。
In just two weeks, Americans denied coverage because of preexisting conditions will be able to enroll in a new national insurance pool. And for states that opt to run their own pools -- using funds from the new law -- we're urging them to begin enrolling people as soon as possible. 就在两周内，因既往病史被拒保的美国人将能够加入一个新的全国保险池。对于选择自行运营保险池的州——使用新法提供的资金——我们敦促他们尽快开始登记。
And these pools are going to provide some short-term relief, but they're temporary. They're going to ensure that folks who have been shut out of the market because they've been sick can access more affordable insurance starting right away. 这些保险池将提供一些短期缓解，但它们是临时性的。它们将确保那些因生病而被市场拒之门外的人从现在开始就能获得更可负担的保险。
But what we want is these health insurance exchanges up and running in a few years, so that, at that point, this kind of discrimination will finally be banned forever. And that's when those -- that's when the millions without coverage, including people with preexisting conditions, will have the access to the same types of insurance plans that members of Congress get. And you know those must be pretty good. 但我们希望的是几年内这些医疗保险交易所能够建立并运转起来，这样到那时，这种歧视将被永远禁止。到那时——到那时，数以百万计没有保险的人，包括有既往病史的人，将能够获得与国会议员相同类型的保险计划。你们都知道那些计划肯定相当不错。
We're also going to be putting in place a patient's bill of rights that will tell insurance companies that they can't put a restrictive limit on the amount of coverage you get in your lifetime, or in a given year. It will prevent insurance companies from rescinding your coverage when you get sick because of an administrative error. It will provide simple and clear information to consumers about their choices and their rights. 我们还将建立一份患者权利法案，告诉保险公司，他们不能对你一生中或某一年内获得的保险金额设定限制性上限。它将防止保险公司因行政错误而在你生病时撤销你的保险。它将为消费者提供关于其选择和权利的简单清晰的信息。
And beyond making insurance more affordable and more secure, reform also will mean changes that make it easier for you -- the backbone of the health care system -- to do your jobs. Already, over the past year, we've made one of the largest investments in the nursing and health workforce in recent history. We passed landmark reforms to make college more affordable, which can help more people gain a nursing degree -- even as we provide grants and aid for more than 15,000 nurses seeking graduate degrees and other training. 除了让保险更可负担、更安全之外，改革还将意味着一些变化，让你们——医疗系统的支柱——更容易开展工作。在过去一年中，我们已经对护理和医疗人力资源进行了近年来最大规模的投资之一。我们通过了一项具有里程碑意义的改革，让大学更可负担，这能帮助更多人获得护理学位——同时我们为超过15000名寻求研究生学位和其他培训的护士提供了资助和援助。
And we've begun the transition to private and secure computerized health records, because this will not only reduce errors and costs -- I know you can't read those doctors' handwriting -- it will mean you can spend more time with patients and less time with paperwork. And that's why you got into the profession. 我们还开始了向私密、安全的电子病历的过渡，因为这不仅能减少错误和成本——我知道你们看不懂那些医生的笔迹——还意味着你们可以把更多时间花在病人身上，而不是文书工作上。这才是你们从事这个职业的初衷。
Now, there is more work to do. And that's why today my administration is announcing a number of investments to expand the primary care workforce. This includes funding to allow students training part-time to become nurse practitioners to start training full-time. We want to speed up the process where folks go from the classroom into the exam room. And we're going to provide resources for clinics run by registered nurses and nurse practitioners. 现在，还有更多工作要做。正因如此，今天我政府宣布了一系列投资，以扩大初级护理劳动力。这包括提供资金，让那些兼职学习成为执业护士的学生可以转为全职学习。我们希望加快人们从教室走向诊室的进程。我们还将为注册护士和执业护士运营的诊所提供资源。
Without these nurses, many people in cities and rural areas would have no access to care at all. Now, all of these steps are part of a larger effort to make our system work better for nurses and for doctors, and to improve the quality of care for patients. And by focusing on primary medicine, we will finally recognize the role of all talented and skilled health care providers -- including nurses. 没有这些护士，许多城市和农村地区的人将完全无法获得医疗保健。所有这些步骤都是一个更大努力的一部分，旨在让我们的系统对护士和医生都运作得更好，并提高对患者的护理质量。通过聚焦初级医学，我们终将承认所有才华横溢、技艺精湛的医疗保健提供者——包括护士——的作用。
I don't have to tell you that nurses all too often have been given short shrift. Even amidst a nursing shortage, when there are cutbacks, you feel the squeeze in salaries or the reduction in shifts -- despite being overworked and underpaid. And, as you know, this disregard goes beyond numbers on a ledger. There have been a bunch of times, I'm sure, when the service you rendered is thought to be less consequential or valuable than that of other professions. That's what has to change. 不用我说你们也知道，护士往往受到忽视。即使正值护士短缺，一旦有裁员，你们就会在工资或排班上承受挤压——尽管你们已经过度劳累、薪水微薄。而且，如你们所知，这种轻视远不止账面上的数字。我确信有很多次，你们提供的服务被认为比其他职业的服务更无足轻重或更无价值。这是必须改变的。
It's important that we not only ensure that you have the support to do your jobs -- we're seeking to elevate and value the work that you do, because -- throughout our history, nurses have done more than provide care and comfort to those in need. 重要的是，我们不仅要确保你们有开展工作的支持——我们还要努力提升并珍视你们所做的工作，因为——纵观我们的历史，护士所做的远不止为需要帮助的人提供关怀与慰藉。
Often with little power or sway on their own, nurses -- mostly women, historically -- have been a force of will and a sense of common decency, and paved the way towards better care and a more compassionate society -- from Clara Barton's treatment of wounded soldiers at Antietam, to the advocacy of Dorothea Dix on behalf of people with mental disabilities, to the countless nurses whose names we'll never know. 尽管自身往往没什么权力或影响力，护士——历史上以女性为主——一直是意志的化身和共同体面感的代表，为更好的护理和更富有同情心的社会铺平了道路——从克拉拉·巴顿在安蒂坦救治伤兵，到多萝西娅·迪克斯为精神残疾人的倡导，再到无数我们永远不知道名字的护士。
One of America's greatest poets, Walt Whitman, also served as a nurse during the Civil War. And the experience changed him forever. Later, he would reflect on that time, on both the heartbreak and the fulfillment he found during those years. And he wrote: 美国最伟大的诗人之一沃尔特·惠特曼在南北战争期间也曾担任护士。这段经历永远地改变了他。后来，他会反思那段时光，反思那些年间他所经历的悲伤与满足。他写道：
I thread my way through the hospitals, The hurt and wounded I pacify with soothing hand, I sit by the restless all the dark night, Some are so young, some suffer so much, I recall the experience sweet and sad 我在医院中穿行， 用温柔的双手抚慰受伤的人， 我在黑暗的夜晚坐在焦躁者身旁， 有人如此年轻，有人如此痛苦， 我回忆起那段经历，甜蜜而悲伤
Sweet and sad. Your jobs are tough. Your days can be stressful and exhausting and sometimes thankless. But through long shifts and late nights -- in the hectic scrum of the emergency room, or in those quiet acts of humanity -- you are saving lives, you are offering solace, you're helping to make us a better nation. And my task as President -- our task as a people -- is to ensure that our health care system is worthy of your efforts. Our mission must be to live up to the values you uphold each and every day. 甜蜜而悲伤。你们的工作很艰苦。你们的日子可能充满压力、令人筋疲力尽，有时还得不到感谢。但通过漫长的轮班和深夜——在急诊室忙碌的喧嚣中，或是在那些静静的人性之举中——你们正在拯救生命，给予慰藉，帮助我们成为一个更好的国家。作为总统，我的使命——作为人民，我们的使命——是确保我们的医疗体系配得上你们的努力。我们的使命必须是践行你们每一天所坚守的价值观。
So, thank you. God bless you. And God bless the United States of America. Thank you, everybody. Thank you. 所以，谢谢你们。上帝保佑你们。上帝保佑美利坚合众国。谢谢大家。谢谢。