June 14, 1994

MRS. CLINTON: Thank you very much. I have been in
this room to give many speeches. I don't think I've ever seen
a more enthusiastic, vocal crowd. And I wouldn't expect
anything less from members of the League who have been leading
the way for now nearly 75 years and have, in the past, taken
on difficult and controversial stands in a nonpartisan way,
putting the public's interest first, and this country owes all
of you a great debt.

I want to thank Becky for that introduction and,
more than that, for her leadership. She has been a superb
representative of the League. But I know that many of you
have been speaking out and working for positive change on
behalf of our country for many years. I don't know that there
is anyone here who's been doing it for nearly 75 years, but I
bet there are some here who have been doing it for half a
century or so, right?

And just look at some of the issues that you have
championed and worked for: collective bargaining; child labor
laws; minimum wage legislation; federal aid for maternal and
child care programs; Social Security; civil rights; school
desegregation; the Voting Rights Act; the Equal Rights
Amendment; natural resources preservation; pro-choice
legislation; campaign finance reform; and, most recently, the
Motor Voter Act. Just listen to that list.

And for every one of those there was controversy.
For every one of those there were special interests that were
opposed to the passage of such legislation. For every one of
those, there was a long, long effort behind the final
successful outcome of the legislation.

But there isn't any issue that we have all worked on
as a country for as long as we have worked on health care
reform, because it really began in earnest when Franklin
Roosevelt was President. He believed that health care
security would become the second part of Social Security, and
he was unable to get that accomplished.

President Truman, when he became President after the
death of President Roosevelt, understood intuitively that
health care reform was necessary, and twice as President, once
following his accession and second after his own election, he
pushed for health care reform. You should go back and read
some of President Truman's speeches, because you could make
that today. He saw the problem. He understood the solution.
And he saw what the obstacles to achievement were.

You could look at nearly any President. They have
all tried to do something about health care. It was finally
the combination of President Kennedy and President Johnson
that got us Medicare and Medicaid, but against the same
arguments that we are facing today with health care reform.
Go back and read some of the debates. You can see it almost
verbatim. And yet now here we are 60 years after Social
Security, 30 years after Medicare, finally at the brink of
being able to do what we should have done all along, and that
is to achieve comprehensive health care reform this year for
our country.

You know, it was 1911 when Carry Chapman Capp, the
founder of the League, offered some wisdom about change in
America. She said, "When a just cause reaches its flood tide,
whatever stands in the way must fall before its overwhelming
power." She was talking about women's suffrage, but she could
have been talking about any of the number of movements and
causes the League has supported since its founding. She
certainly could have been talking about health care reform,
because we are at a flood tide.

We are at a historic moment in our country's passage
from the kind of society that understands the importance of
individual responsibility but also the absolutely significant
role that community responsibility plays in coming together
with legislation that will assure what the League has been
promoting, universal coverage, cost containment, quality
benefits for every American. And yet we know that there are
many obstacles to overcome before we will gather on the White
House lawn, as we did for Motor Voter, and sign the health
care legislation together.

Last week for the first time Congress took several
significant steps toward enacting legislation. That
legislation will provide guaranteed private insurance for
every American. Senator Kennedy's bill was a very important
start in putting together the pieces for comprehensive
reforms. Chairman Moynihan in the Finance Committee is
engaged in intensive negotiations. In the next weeks, the
committees on the House side will begin to roll out their
legislation as well.

Let's remember what this debate is all about,
because in the midst of the controversy surrounding health
care reform we sometimes lose track of why the League took
this on as an issue, why other nonpartisan study groups have
been looking at this particular cause for a number of years,
why the President, when he was a Governor, said that health
care reform was absolutely essential for the well-being of our

First of all, no American has health security. That
is the basic bottom line fact of our system. And, yes, there
are 40 million now of Americans, the vast majority over 80
percent work but do not have health insurance, but none of us
in this room, no matter how well insured, can be guaranteed we
will have the same insurance this year at the same cost next
year if we do nothing to change our system. So health
security remains the primary objective, and universal coverage
must be the bottom line of any legislation.

But we also know that parts of the problem with
America's health care system is that costs have been permitted
to escalate to the point where we are not getting our money's
worth for our health care, and this is one of the difficult
arguments to make in America, where people seem to believe
that the bigger and more expensive the policy you have, the
better insured you are, when there is absolutely no
relationship, and the kinds of costs that we have been
expending year after year, which are now approaching nearly 15
percent of every dollar produced in America, have not
guaranteed us better health outcome, have not enabled us to
have a secure health care system. So cost containment must go
hand in hand with universal coverage. The League recognized
that (inaudible).

You know, there are some who always in the face of
controversy look for some way out. It would be as though when
they were debating Social Security people started saying,
"Well, that's a good idea but we really ought to phase it in.
We really ought to try to make sure that the private sector
first provides pensions for everybody, and only after we've
waited to see whether every company does provide pensions
should we do anything to make sure we provide Social

That is not only a very short-term approach, it is
one guaranteed to fail. We have tried to make sure people
have access to good health care in our country, and we have
produced the finest health care system in terms of the doctors
and nurses and facilities in the world, but we have failed at
making it affordable and accessible to every American. So,
just as with Social Security, we cannot wait very much longer
for some miracle to occur that will enable everyone to have
guaranteed insurance without any intervention in terms of

The League recognized that, as did other nonpartisan
groups. If you go back and look at the studies that were done
up to 1992 and early 1993 by groups such as the League, by
other leadership groups, of coalitions of business and labor
and academics, if you look at the report of the Catholic
Health Association -- pick any of the nonpartisan studies that
were out there before this issue got into the political arena
-- they all basically say the very same thing, that in the
absence of universal coverage you cannot have a system that
controls costs, you cannot guarantee insurance, and you cannot
be sure that every one of our systems of care, from Medicare
and Medicaid in the pubic sectors to private insurance, will
sustain such a very fragile financial footing into the future.

But what happens when we get into the political
arena? Under pressure, many of those groups, many of those
advocates begin to waiver. There are groups which, for
example, have supported the employer mandate for decades,
every year voted for it in their assemblies and their
conventions, and then, in the face of the pressure of a
minority, begin to back off from what they used to believe and
what they knew was a very sensible approach to financing
health care.

I am proud that the League does not give in to such
pressure and continues to take the position of study which it
knows is right, which it knows goes beyond partisanship or
ideology. You have stood firm, and we need you now to speak
even more about why you reached the conclusions you did and
take on all comers, because they cannot withstand the scrutiny
of the kind of analysis you can give their proposals.

This debate needs to be seen in its broadest
context. Yes, it is a debate about economics, because we can
do better. We can save more money. We can invest in our
businesses, our families if we are not spending as much money
as we now are and are projected to spend more on health care
alone. It is about the federal budget. For the first time
ever we finally have a responsible budget, put together by a
responsible President that will enable us to have declining
deficits for three years in a row, the first time that has
happened since President Truman sat in the Oval Office.

That is the good news, that we do have a very much
improved financial and budgetary system. The bad news is that
health care costs are just waiting to explode again: the
increasing costs in Medicare and Medicaid, the cost shifting,
the numbers of workers who are being dropped from employer-
based insurance into those who are eligible for government
assistance. So if we do not control health care costs, then
all the work we have done to get our budgetary house in order
will not work for us. So it is a question of economics.

It is also a question of social justice, and that is
something we should talk about in our country. It is not
right that some people are denied health care because of their
financial condition. I don't believe we should go another
year and have to continue to hear the kinds of stories I have
heard nearly every day now for 16 months.

I don't think I ever want to meet another family
which tells me the story of two families living together,
siblings raising their children in a big old house, the little
cousins playing together. One cousin gets a high fever, gets
taken to the hospital. That child's parents work. They have
insurance through the work place. The child is admitted with
a diagnosis of meningitis.

The other cousin, high fever, taken to one hospital
by the child's mother, who works, single mother, divorced,
raising her child. No insurance. Is sent from one hospital
to another hospital. Waits in the emergency room, filling out
forms, trying to answer questions about her eligibility
possibly for medical assistance since she has no insurance.
When it's determined she has no financial backing, she is
given Baby Tylenol, takes her child home, and the child dies.

That child has a younger sibling who also contracts
meningitis, and now the hospital that turned away the sibling
admits the child as a charity case. I don't want to hear any
more stories like that. I don't want to meet any more women
who work hard every single day, like the one I met who had had
the same job for more than 15 years as a bookkeeper, had
raised her child, had sent him off to adulthood, was still
working, no insurance, but tried to take care of herself.

Went every year for a checkup, and went in for her
checkup, and was told by her doctor -- he found a lump. He
referred her to a surgeon. The surgeon said, after finding
out she had no insurance, "Well, if you had insurance, we
would biopsy it, but since you don't, we'll just watch it."

I don't want to meet any more families with
catastrophic health care problems who did have insurance but
because of the extraordinary expense associated with a
premature birth with medical complications, a traumatic
accident with head injuries, a diagnosis of childhood cancer,
the other problems that could affect any one of us -- I don't
want to hear any more stories about how the lifetime limit is
hit and there's no more insurance, and, unless there's a way
to finagle onto government assistance, the families literally
spend day after day looking for ways to try to finance the
health care their children need.

And I will never forget the mother who looked at me
and asked if I knew what it felt like to have a child with a
congenital illness after the insurance had run out and who
knew therefore what quality health care was like because she
could afford it, and all of a sudden finds herself on the
other side, unable to afford it, and being told one time by an
insurance agent who she had gone to in a desperate effort to
piece something together which her family could afford -- her
husband was a lawyer; they were well paid, but they could not
afford what they were being asked to pay -- and finally having
this agent look at her and say, "You don't understand. We
don't insure burning houses."

I don't want to hear any more stories like that in
America. It is a simple issue of social justice that we are
addressing. It is also a question of whether or not our
political system will work, and that may be one of the hardest
issues to address, but it is very difficult as I travel around
the country to explain to people why this has been so debated
and so ignored for so long where the need is increasing. And
it's because our political system has for too long been mired
in gridlock and increasing partisanship. We need to get
beyond that. We need to understand that this country is the
oldest surviving democracy in the world because when we were
challenged, we were always able to respond.

My husband and I were in Europe last week. It was
such an emotional and moving time for us, because we
recognized, as many of you in this audience do, that we owe a
great debt to the generation of our parents and grandparents,
some of whom have died to save democracy and our country and
our way of life; others of whom have given many years of
service to see that accomplished, and that our best honoring
of them would come from continuing their work and solving our
problems and making our political system respond.

And it strikes me that we have a clear example of
the disconnect that sometimes exists. Every member of
Congress, every member of the Administration, every federal
employee is guaranteed health care coverage and is paid for by
an employer contribution matched by an employee contribution.
I believe that in politics your highest objective should be to
make sure you take care of the people who entrusted you with
their vote. And in this instance, if it is good enough for
our political system and our Congress to have universal health
care coverage, it is good.

And finally, I want to end with something that Becky
Cane told Congress on your behalf last year when she said
"Access to health care universal coverage will determine the
humanity of our system, because in the end this is also a
moral issue. It is an issue that strikes very deep into who
we are as people."

We are a diverse, wonderful collection of points of
view and attitudes and backgrounds and experience. But we
need to understand we are also very much connected by our
shared humanity, and that it is time once again in America to
care for each other, to reach out and help one another. There
is nothing more basic than health care, making sure every
child, every person has access to the kind of health care that
you and I always seek for our own families, knowing very well
as we look and hear about medical disasters that there, but
for the grace of God, go any of us. So, at the end of the day
it is about our humanity, about our country, and about our
future, and that's why what you are doing in fighting for
health care reform is so profoundly important. Thank you all
very much.

Q Thank you. Thank you so much. I believe there
might -- the First Lady has agreed to take a few questions.
And I believe there just might accidentally be someone from
Arkansas at microphone 1.

Q Good morning, Mrs. Clinton.


Q I am Saundra Ollange (phonetic) from
Fayetteville, Arkansas.

MRS. CLINTON: Good to see you.

Q I represent the Washington County League, and I
bring greetings from Arkansas and from the whole League. The
Clinton Administration and the League of Women Voters will
support a women's right to reproductive choice. Would you
give us your thoughts on whether we should ever consider
compromise on reproductive health coverage in order to achieve
comprehensive health reform?

MRS. CLINTON: Well, I think that's one of those
questions that we just cannot even answer right now, because
we have to get to the forest of universal coverage first, and
I think that part of our real challenge is to get a system
that secures guaranteed health coverage for every American.
Now, we believe that should include reproductive health
services. We believe that should include mental health
services. We believe that should include preventive health
services, including free preventive health services for groups
of the population who are at risk.

But the way this whole debate is developing, it is
very difficult to tell exactly where we are going to have to
make whatever compromise or where it's going to be taken out
of our hands and the Congress will basically argue it out, as
will happen on a number of these issues. So I don't think
anybody is ready to talk about compromise on any aspect. We
first have to develop the will and the support to get a
financing mechanism for universal coverage, or else everything
else we want to do becomes moot. So let's focus on getting
everything possibly done to make sure we get a system for
universal coverage, and then I think we can really begin to
fight out some of the issues that will come. Thank you.

Q Thank you.

Q Microphone 3.

Q Ms. Clinton, I am Margaret Colony (phonetic) from
Washington State. As you may be aware, the League favors a
national insurance plan financed by general (inaudible), the
single payer plan. We also support the Clinton plan as one
able to provide universal coverage and cost containment. As
people learn more about the various health care plans, they
seem to like the straightforward simplicity of single payer.
Do you feel that as the public discussion moves forward,
members of Congress and others inside the Beltway will begin
to see single payer as politically feasible?

MRS. CLINTON: Not for the foreseeable future. And
the reason I say that is for two reasons. There is a
tremendous amount of education that needs to go on, which you
all are engaged in, about health care reform, and particularly
with respect to single payer, because the negative image of
singe payer has been so effectively portrayed in so many parts
of our country that it will take an intensive national effort
if we were even to consider being able to get a single payer
system passed through the Congress.

Secondly, there are very distinct regional
differences in support and understanding of single payer.
There are great parts of our country that are extremely
hostile to doing anything with respect to health care reform,
but particularly with respect to single payer, in large
measure because there's no experience, there are huge numbers
of uninsured, there is no experience even with organized care
of any kind, whereas if you look at the states along the
Canadian border, if you look at California, which has a lot of
organized care and now has a referendum on the ballot, there
are pockets of understanding and support for single payer,
which is why in the President's bill we have an option for
states to become single payers. We really believe that

But I think that is the way it would have to go, so
there would be some real practical experience that overcomes
the concerns people have. I mean, this is just a little
aside, but, you know, we've had an employer mandate financing
system working in Hawaii for 20 years, and it's very effective
on not only reaching near universal coverage but also in
controlling costs.

Hawaii spends much less of its income on health care
than the rest of us do. It is so hard to get other states
even to pay attention to the Hawaii example. People are
really locked into stereotypes about health care that have
been fed by very effective information campaigns by interests
that don't want change, and so that's why I think we need to
go on a state-by-state basis with single payer.

Q Thank you. Microphone 4.

Q I'm Resa Neiman (phonetic) from the League of
Women Voters of Massachusetts. Your volunteer work to shape
health care reform and to advocate for it is unparalleled.
The League of Women Voters applauds and respects public
service, whether elected or appointed, volunteer or not. But
it seems to be getting nastier out there each day. Will radio
talk show hosts, ill-conceived movements like term limits, and
the media's penchant for sensationalism over substance
discourage and impede those who want to serve and make a

MRS. CLINTON: That is a very important question,
because it really goes to the heart of democratic
participation and willingness to take a public stand as well
as public leadership, and I think that the jury is out. I
mean, it is clear that we are in a particular phase in
American history where the penchant for sensationalism, where
the desire on the part of some to tear down instead of build
up is being fed, I mean, a greater and greater fire of
destructiveness from my perspective.

And I think that all we can do, those of us in this
room who believe deeply in democracy, who believe deeply in
issues and causes, is to keep going forward, and not be
deterred and not be diverted by what are clearly ideologically
and politically motivated attacks for the large measure.

And I think if you see them that way -- in a funny
sort of way, it's perversely flattering to be the subject of
such intensive hostile attack. And the only parallel I have
found in history is Eleanor Roosevelt, who I don't even
pretend to compare myself with, because I think she was doubly
remarkable for what she did at the time she did it, but she
was subjected to just incredible, just relentless attacks.

But they were confined largely to newspaper. They
weren't all-pervasive. They were not on TV 24 hours a day.
You know, they were not well organized by sort of hit squads
of people who are in this for a living. So the intensity and
pervasiveness of it seems greater, but the meanness of it,
unfortunately, has been with us for some time, and we just
can't let it get to us. We just have to believe that in the
end the truth and effort and hard work and faith pay off, and
I think that's a better way to get up in the morning and live
your life anyway.

Q This will be our last question. We only have
time for one more question, one quick one. Microphone 5.

Q Good morning. I'm Marliss Robertson (phonetic),
president of the League of Women Voters of California.
(Inaudible) adopted early intervention for children at risk as
a high priority. As a respected advocate for children, what
advice can you give us to ensure the needs of children,
particularly health care needs, be given a higher priority on
the public policy agenda?

MRS. CLINTON: Well, I really commend you for taking
that on. I hope that those of you who are interested in this
issue have read the recent Carnegie report that outlines the
extraordinary risks that our youngest children are facing
these days. I think that health care reform is absolutely
essential, and the kind of benefits package that we all
support, which starts with good prenatal care and well child
care and immunization, is absolutely the first step to make
sure we've got good intervention and that we have good support
for families.

And the President's work on the immunization policy
which many of you helped support, the work on extending and
expanding Head Start, many of those pieces are now falling
into place, and I hope that what we can do is begin to talk
about the responsibilities of parents, and we are going to
begin that debate today. The President is going to Kansas
City to talk about welfare reform. We need to start making it
very clear that there is a mutually reinforcing system.

You know, children are the products of both their
families and their society, and too often in the past we have
separated those. And the political debate has been polarized
between people who preached at families and told families to
straighten up despite changes in the economy, despite living
in neighborhoods that were dominated by gangs and drugs and
all the rest that we know, and there were those who ignored
the family and basically said the government should come in
with all of these programs and all of that.

Both of those as single solutions are inadequate.
What we need are good, positive government programs, like
health care reform, and Head Start, and other programs like
that, and responsible families. And so what we are trying to
do in this Administration is what you and I would do in a
common sense way in our own families, begin to meld those
responsibilities. And so, any work you can do talking about
the need for supportive programs for families is absolutely
critical, but then also in your public and private capacities
talking about family responsibility is critical.

As my husband says over and over again, governments
don't raise children, families do, parents do, but parents who
are under a lot of stress today could get some more support
for doing that job, so that's how we need to present this to
the American public, and I think we would begin to get more
support for what we have long advocated if we were to do that.
I'd like to help you.

Q Thank you. Please join me in thanking Mrs.

(End of speech.)

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