October 18, 1994


Thank you so much. Thank you so much Dr. Koop. He has been
an inspiration and wise counselor during these past twenty months
and I am so grateful to him. He has more good ideas every day
than most of us have in a year and it takes a lot of energy to
keep up with him. What we are doing here today is celebrating
another of his very good and important ideas that has taken shape
as the C. Everett Koop National Health Awards. I also want to
thank Carson Beadle, President of the Health Project and Dr. Mary
Jane England, the chair of the Work Side Programs for the Health
Project and President of the Washington Business Group on Health,
which was one of the groups that was helpful to us as we tried to
shape the direction of health care reform. I also want to
acknowledge Dr. Jim Freeze, and Dr. Reed Tuckson, and others of
you that have been involved in this movement for health
awareness, for prevention, for wellness, and then for all of you
who are involved in the day to day way with the management of
disabilities in the work place and the kind of practical problems
that you encounter in the work that you must do in order to
assist your employees and also try to do the best that you can
with your employers challenges in the health care field.

I think that it is so important that groups such as this and
groups that are represented here continue to recognize that
changing and improving the health care system is a shared
responsibility at all levels of our society. There are obviously
things that we as individuals can and should do to take better
care of ourselves. And things that we can and should do together
collectively to improve our health and well being. Also, to
continue efforts to reform our health care system. Many of the
companies honored here today and represented here have been
leading the way in attempting both to encourage individual
responsibility and to work out ways collectively to manage many
of the health care challenges that we know so well. And they
have proven that there are ways that costs can be cut and peoples
health can be improved. They are not mutually exclusive goals.
One of the hardest issues that I felt that we confronted in
the last twenty months in our efforts to educate the public about
health care was presenting what intuitively too many people
seemed like an inherent contradiction. And that is that we can
make better, more efficient use of our health care dollars not
only without sacrificing the quality of health care but in many
instances actually improving the quality of health care. I know
Dr. Koop and others said that at least a million times, and I
felt like I said it at least a trillion times, but it was still
very difficult for people to grasp.

In our system we have spent so much money and we have spent
it in so many ways that have not enhanced the quality of health
care, but have instead fed the paper work hospital, the
bureaucracy of our financing system, and many people could not
recognize what it would mean to more efficiently deliver the
health care dollar. But that's why the President and I are so
grateful to groups like the Health Care Project, and the
companies that are represented and honored today. They do in
many important ways stand not only for bringing together what
appeared to be mutually inconsistent goals in our efforts for
health care reform, but they also greater cooperation and
understanding between the public and private sectors and
emphasize the importance of preventive health care. We have
tried very hard and will continue to do so to make the point that
the government is already involved in the health care system.
You all know that, you are on the front lines. I must confess
that I was continuously amazed that so many of our fellow
citizens did not know that.

I would be asked often and occasionally with Dr Koop at my
side why the President wanted the government to run the health
care system. And I would say that is not at all what he is
recommending. He wants there to be better incentives in the
private sector and a more efficient market place so that health
care can be delivered better at higher quality to all Americans.
And someone would usually follow up and say well that's not what
I heard and that is not what I read and we do not want the
government in health care. And I would say let me ask you this
do you know anything about Medicare? And they would say what
does that have to do with anything. Well Medicare is a
government financed health care system but the government does
not tell you what doctor to go to. And that was just one of the
many examples of how there is this confusion about what the
government already does and what the possibilities for better
cooperation and more efficient of allocation of resources might

We are particularly pleased that companies such as the ones
that were honored here today are making it clear there are many
things we can do within this system even absent reform that will
make a difference in peoples lives and will make a difference in
the cost of health care. So I hope that as you continue this
conference and as you learn more about what you need to be able
to do in the work place and how you can contend with the
challenges that you are facing. You will also continue to focus
some part of your energy on what we can do to improve this system
and solve the problems that are not going away. Individual
companies will be able to obtain and sustain for some period of
time perhaps some kind of competitive edge within the existing
system. The underlying problems of the way we finance health
care, the underlying problems of cost shifting, and the
underlying misallocation of literally billions of dollars that do
not go directly to health care but instead to the paper work
health care system will continue to plague us and undermine your
best efforts and the rest of our country's best efforts to have a
health care system that provides high quality health care at an
affordable cost to every American. I believe this should
continue to be our goal, and it ought to be what will work for
both the individual and the business and government levels.

I hope that you will bring your ideas and suggestions to the
fore front, and your place of employment, your place of practice,
and with those who will make decisions in the future about how we
can actually achieve the kind of health care reform that will be
good for all of us. Thank you very much.