November 4, 1993

MRS. CLINTON: -- being here, with your Senator.
There is no stronger advocate, nor anyone more knowledgeable
about health care in America, than the Senator from West
Virginia, Senator Jay Rockefeller. And I think we all owe
him a debt of gratitude. (Applause)

I'm also delighted to be here with Congressman and
Mrs. Wise, who did come down with us. And we had a great
opportunity to have a discussion about a lot of the important
issues facing West Virginia and the country. And I want to
thank both of you for being here with me.

And I am just delighted to be back at Marshall. I
was able to give President Gilley (phonetic) the first copy
to come to West Virginia of this book. (Applause) I hope
that everyone in this crowd and everyone you can talk to will
take the time to read it.

It explains how we got to where we are. How did we
end up with the most expensive health care system in the
world without covering everybody? Without giving security to
everybody? Without making sure every American -- no matter
who they were, where they lived, where they worked, whether
or not they'd ever been sick -- had adequate comprehensive
health care.

And then it lays out what we believe needs to be
done in order to make it absolutely clear from this point
forward in America that every American citizen, no matter who
you are, you will have comprehensive health care guaranteed.
You will be secure for the rest of your life. (Applause)

You know, when I was here last year, before the
election, I told the wonderful crowd of residents and
students and faculty who had come out to greet me that we
needed a thundering herd for the Clinton/Gore ticket.
(Applause) And you heard that, and you responded.

And I'm back again because we need your help again.
We need your thundering herd to help us pass health care.
(Applause) And I hope we're as successful in the health care
arena as you have been in the football arena. (Applause)

Last year, one of my great moments was when I was
given a jacket from Marshall University. And I got out of
the car today and a couple of the folks standing around said,
"Well, why didn't you wear your jacket?" And I said, "Well,
to tell you the truth, I was afraid that, as good as the
football team is doing, I'd be accused of being an imposter."
(Laughter). So I decided that I'd better leave that at home.

But I do need the spirit and the commitment and the
courage that so many of you show day in and day out. Not
just with respect to great, fun events like football, but to
the daily business of trying to work, trying to go to school,
trying to take care of your families. That's really what is
at stake here.

Last year, we had a dream that we could begin to
tackle the problems that America had neglected. And we are.
It isn't easy. It certainly is controversial. But it is far
better to wake up every morning and go to bed every night
knowing that we're trying to help the American people deal
with their real problems, day in and day out. (Applause)

And when the President, last week, presented the
Health Security Act to Congress, he invited the entire
country to become involved in this great national discussion.
We want you to read this book. We want you to ask questions.
I was thrilled when I got here and saw the newspaper carrying
the questions and answers that so many citizens had called in
-- right here on two big pages.

This is what we need to be doing as a country.
This is exactly the kind of discussion we need to have.
Because when we do, we will be able to compare not only what
the President has proposed with what we have today, but also
with all the other proposals.

We invite anyone else with any other approach. Put
out your book. Put out your specifics. Tell the American
people how much they will benefit from what you propose.
(Applause) Because our plan is the result of literally
thousands, and tens of thousands, of conversations, and of
letters. We received over 800,000 letters from people all
over this country.

And I've had the extraordinary opportunity not only
to visit in person, but also to read those letters, hear
those stories.

On May 11th, I spoke with health care professionals
and citizens from all over West Virginia at a forum,
organized by Senator Rockefeller, about what West Virginia
wanted to see happen with health care reform.

I remember, very well, the woman whose family lost
insurance after her husband was disabled in a mine fall in
1988. She told me, and I quote, "I would like to be able to
take the kids for well check-ups, and not wait until they're

Well, I want that woman to know that under the
President's plan we will have these kinds of benefits. Every
single one of them will be provided for every American,
unlike today, where you have health insurance policies with
fine print. And oftentimes you don't know what they don't
cover and what they do cover.

You're going to be able to know what is covered
because every American will have the same coverage. You will
not have to worry about the fine print in insurance policies
anymore. (Applause) And what I want to tell that woman is
that preventive care is going to be available, finally, for
every American.

I have to tell you, I was surprised when my
daughter was born and I looked at my insurance policy and
learned it didn't pay when I took her for the well-child
check-up. But it sure would pay if I kept her at home until
she got real sick and then took her to the emergency room.

Now, what kind of system is that? We want to pay
for primary and preventive health care. We want to take care
of children and their immunizations. We want to pay for that
well-child care. And in this plan, it's going to be free,
because we believe that strongly in preventive health care,
and we want to be able to provide it for every single
American. (Applause)

And I want to say a special word of thanks to the
Marshall Medical School because of what you have done in
primary and preventive health care. I want to add my word of
congratulations for your having received the Silver Award of
the American Academy of Family Physicians, because of the
consistently high percentage of graduates entering family
practice from this medical school. (Applause)

If every medical school had produced the number of
family practice physicians, had produced the number of
physicians going into generalist practices, had been able to
even compete for the Outstanding Rural Health Program Award
that this medical school won, had entered into partnerships
like the one this medical school has with the Lincoln Primary
Care Center, we would not have some of the problems we have

Right now, we have too many specialists and not
enough family physicians and pediatricians and others who
tend to primary and preventive health care needs. (Applause)

I also remember the small business employee from
Martinsburg, who told me, "I don't think health insurance
should be higher than my mortgage. I don't think it should
run small companies out of business." And we agree 100
percent. (Applause)

The most discriminating part of the health
insurance market today is that part which services small and
medium-sized businesses, and individuals who are self-
employed. They're the ones who are paying far more than they
should. Oftentimes, 40 percent of the premium for a small
business goes to overhead and administration and profit. Not
to health care.

We are going to level that playing field. Small
businesses are going to have the same opportunity to get
cheap, good, high-quality insurance as the largest big
business does. And it's about time we did that to help all
businesses in West Virginia. (Applause)

(Interruption to tape) -- told me that it costs
paying hospital patients -- that's you and me, if we are
insured -- an extra $500 a day to cover the cost of those who
are treated for free.

Now, who is treated for free in our current system?
Well, they are working people, by and large. And they are
people who don't qualify for Medicaid because they get up
every day and they go to work. But they do not work for, or
are able to afford insurance in today's current market.

Think of the message we have sent to literally
millions and millions of working Americans. We have told
them very clearly, "If you are lucky enough to work for
someone who will help you with your insurance, or if you are
poor enough and down on your luck enough to qualify for
government assistance, then your bills will be paid.

But, if you're in the middle and you get up every
day and work for a living and you cannot afford it yourself,
you're out of luck. Since when should a hard-working
American citizen have to go on welfare to take care of
children with medical problems, because if they don't, they
are out of luck?

And it costs us money to take care of them when
they finally get their care, because that's what happens
every day. Our emergency rooms are filled with people who
postpone getting care, have an accident, something happens,
they end up in the hospital, and we want them to be taken
care of.

I want everybody with a health care problem to be
taken care of. I just want everybody to be paying something,
so that all of us know that we will always be able to get
good medical care because every American will be able to be
secure, and no American will be left out.

And let's start by making sure we give universal
health care coverage to all Americans as soon as possible, so
that everybody who works actually gets rewarded instead of
penalized for getting up every day. (Applause)

Some people have said to me, "Well, you know, isn't
this Health Security Act just for people who don't have
insurance?" And I've asked everybody who's asked me that to
ask themselves this question. Go home and look in the
mirror, and ask yourself this question: Do I know, for sure,
that this time next year I will have the same insurance I
have now at the same price?

I have yet to meet any American who can answer that
question "Yes." There is no way to answer that question
"Yes." What kind of insurance you have, and how much it
costs depends upon your employer -- if your employer is
helping to buy it, or offering it to you. It depends upon
whether you ever get sick. It depends upon whether you have
something called a "pre-existing condition." It depends upon
whether you're laid off.

And we know that in today's economy, even good jobs
with the best high-quality health insurance can be here today
and gone tomorrow. There is not one single American who in
good conscious can say, "I will have health insurance,
exactly what I need, next year, at a price that I can

What this plan will do is eliminate that question
from our worries. We will never have to ask it again. If
you're an American citizen, you will have health care that is
always there with comprehensive benefits. And you will be
secure now through the end of your life. (Applause)

Now, why have we not done this before? Well, there
are several reasons. Franklin Roosevelt tried to do it when
he introduced Social Security. He wanted Social Security to
be one half of his proposal, Health Security be the other.
He ran into terrible opposition from people who said, "Oh,
you can't do that. We don't want to make sure everybody has
health insurance." It didn't get done.

Harry Truman went to the Congress in 1945 and said,
"We have to have universal health care coverage." That was
when we were only spending 4 percent of our incomes on health
care. Harry Truman saw, in 1945, exactly what was going to
happen if we didn't change. He fought like -- crazy. He
gave everything he had. (Laughter)

You know what he fought like. But you know what?
Even Harry Truman, as good and tough and strong-minded as he
was, couldn't get through the opposition from people who
said, "Oh, my goodness, that's socialized medicine. Oh, my
goodness, you can't do that in America."

Well, then we rolled along for a while. We finally
got Medicare and Medicaid. I don't hear many people saying
Medicare is socialized medicine. Do you? Because every
person over 65 whom we know relies on Medicare. And thank
goodness we have it for our parents. And thank goodness we
have it to look forward to. So we took care of the needs of
our older citizens. We began to take care of the needs of
our poorer citizens.

But we left this great, big, open middle that any
one of us can fall into at any time. And every month, 2.25
million Americans lose their health insurance. Some lose it
for a day. Some lose it for a week. But 100,000 never get
it back, which is one of the reasons why more and more of us
are increasingly insecure.

Then along came President Nixon, who the last time
I looked was a Republican. And he -- I just want to tell
this to all the young Republicans who are here. (Applause)

I want them to hear this: President Nixon introduced a bill,
in 1970, to extend universal health care coverage financed by
employers and employees, paying just like the Health Security
Act introduced by President Clinton.

President Nixon actually did have a good idea. He
couldn't get it done because of Watergate. But at least he
had a good idea. (Applause)

So, here we are. It's 1993. We've had presidents
of both parties, we've had leaders of Congress, we've had
deans of medical schools, we've had physicians and nurses and
hospital administrators and business leaders, labor leaders,
all come forward and say, "We have to reform the health care

This time, we are still going to have opposition.
We're still going to have people who don't think it's right
that every American have the same kinds of rights that they
enjoy, because they were born wealthy and born lucky and born

But this time we're going to beat the opposition,
because it is a historic opportunity for America to make good
on health care for all of its citizens. (Applause)

As we move forward in this discussion, listen
carefully. Know what the arguments are. Know who is making
which argument, and why they are. Seek out information.

Read this book. Talk about it with your friends and
neighbors. Because when we come to vote on health care
reform next year, the members of Congress will need to hear
from you.

And ask yourself, "What will happen if we do
nothing?" Because that is the scariest possibility of all.
Because what will happen is -- I can guarantee you -- your
costs will continue to go up. You will not be secure. You
will pay higher and higher deductibles. You will have less
and less choice, as employers desperately try to limit costs
by pushing you into systems that they are told will keep the
costs down.

We will have to worry about quality, because
quality can only flourish in a system that is well funded,
where we can have good accountability, where medical schools
and research institutions get the money they need to help us
make this a quality system.

The worst alternative facing America is to do
nothing. But there are lots of folks who profit from the
current system. They like it just the way it is. If they
can eliminate people from health care coverage, then they can
only ensure the healthiest and the youngest, then they make
more money.

We have to stand up and say, "We want a health care
system that works for all of us." And if we do that, we will
put together the kind of majority in this country, and in the
Congress, that will once and for all speak with a loud voice.
Enough is enough. Let's make all Americans secure. Let's
take the unnecessary costs and waste and fraud and abuse out
of this system. And let's spend our money where it counts --
taking care of people who need it.

And I believe that if we are part of this kind of
national debate, we will not only have a health care bill we
can be proud of -- that will save us money, give us security,
provide comprehensive benefits -- but we will, as a country,
have taken a step forward, because we would have met one of
our primary challenges.

We would have shown that gridlock is over, that
partisan wrangling is over, that the debates about
irrelevancies have disappeared because we're finally focusing
on what counts.

The only way that can happen is if you speak up.
And if Congress, all the way in Washington, hears the
footprints and the footbeats and the sounds coming from
people all over West Virginia and this country. So, yes, we
need a thundering herd for health care reform.

Thank you all very much. (Applause)

(End of speech.)

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