Office of the Press Secretary

For Immediate Release July 16, 1998


Dirksen Senate
Washington, D. C.

12:45 P.M. EDT

THE PRESIDENT: Thank you very much, all of you, for your obvious passion and concern for this issue. I thank Senator Daschle and Congressman Gephardt. I thank Congressman Ganske for his very moving and highly illustrative argument. I don't think any of will ever forget it. I thank Barbara Blakeney and Dr. Smoak for their strong representation of health care providers throughout our country. I thank all the health care advocates who are here today, all the members of Congress, especially I thank also Senator Kennedy and Congressman Dingell, and Secretary Shalala and Secretary Herman who co-chaired our quality health care commission that produced our recommendation for a health care bill of rights for patients.

Let me say, first of all, I hope that the presence of Congressman Ganske and Congressman Forbes will be appreciated not just by Democrats on Capitol Hill, but buy Republicans out in America. I don't believe this is a partisan issue anyplace but Washington, D.C. (Applause.) I've tried for years to talk them out of it, but I think most doctors are still Republican. (Laughter.) I've tried for years to turn them around, but most voters in most parts of my country still vote Republican. But when you show up at a hospital in an emergency room, or you test positive on a biopsy, nobody asks you what political party you belong to. (Applause.)

You know, this period and the period in which we're about to enter in the 21st century will be looked at 100-200 years from now, the last 50 years and the next 50 years, as one of the most remarkable times in human history for advances in health -- average life expectancy going up; the quality of our lives improving, not only because we're learning to manage our own lives better, but because of immunizations against dreaded childhood diseases, organ transplants, bioengineered drugs, promising new therapies for repairing human genes.

And it is, indeed, ironic that at this moment when medicine is becoming more and more successful, and, I might add -- we talk about the work of nurses and other medical professionals -- when we're more and more knowledgeable about how to get the benefits of medicine to people everywhere and technology is making it possible to bring them to rural areas, for example -- that this aspect of the medical system is so desperately in need of repair.

Now, I have always tried to say at every one of these events, that managed care has not been an unmixed curse for America. There was a reason that we developed managed care systems. Health inflation was going up at three times the rate of inflation in our economy. It was simply unsustainable. And there were management economies which could be achieved just by running the system better. But what's happened is that the imperatives of managed care have overtaken the objective of the health system so often that often doctors are hamstrung, patients are alienated, and as you've heard, lives are endangered.

Our job, representing all the American people, is not to abolish managed care. Our job is to restore managed care to its proper role in American life, which is to give us the most efficient and cost-effective system possible consistent with our first goal, which is -- managed care or regular care, the first goal is quality health care for the American people. That is our job. (Applause.)

And I just want to -- the previous speakers have talked very movingly about examples and about the specific provisions of the bill. There's no need in my repeating all that, but I would like to make two points very briefly. Number one, the panel of people from whom we heard yesterday -- Dr. Smoak referred to them -- are not atypical. The woman who told me that she and her husband were celebrating their 25th anniversary and she realized he had a terrible heart problem, and the doctor recommended a certain procedure and it was delayed and delayed and delayed until finally it was too late, and so when he was 45 years old he collapsed in his own yard and died in her arms -- at 45. The man who talked about his wife having a serious medical condition; she had a difficulty when they were in Hawaii on vacation; the doctor pleaded to perform the necessary procedure in Hawaii, the HMO said, no, put her on a plane, make her fly 4,000 miles or however many miles it is back to the United States, and so she died on the way, because her system couldn't stand the pressure of the transatlantic plane flight. The man who talked about how he lost his sister to cancer because the only thing that had a chance to save her life was denied until finally it was too late to do and, oh, then it got approved.

I think in a way, the most moving witness we had yesterday was a woman who works in a doctor's office and handles the insurance claims and has to get the approval from the insurance companies for the procedures. She just broke down and started crying because she said, you can't imagine how awful it is -- I'm the one who has to look into the eyes of all those patients and tell them "no" or "not yet" or "maybe" when my doctor is saying "now, yes, immediately."

So the first point I want to make is these stories are not examples that we've all seen in other areas -- and everyone who's elected is guilty of using them -- these are not isolated anecdotes. These are representative examples of systematic abuse. That's the first point. Don't let anybody tell you -- (applause.)

Now, second point I want to make is, we have to have comprehensive, national legislation. That is one of the biggest problems with the bill offered by the Republican leadership -- it covers too few people. It is not true that you can leave this issue up to the states. We have to have comprehensive, national legislation.

I've already signed an executive memorandum to extend the protection of the patients' bill of rights to the 85 million Americans who are enrolled in federal health plans or covered by federally funded plans. But as all the doctors, the nurses, the benefit managers -- 25 progressive HMOs have endorsed this legislation. Why? Because they know we have to have national, comprehensive legislation.

Today, we are going to have some more evidence of it. Families USA will release a report showing that most states that have acted have enacted only a few of the basic protections for patients, and not a single state in America has passed all the protections contained in the patients' bill of rights. Americans deserve a bill that provides all the protections for all the people. It requires a national solution. (Applause.)

Now, the bill sponsored by Representatives Dingell and Ganske and Senators Kennedy and Daschle do that, and you've already heard what their provisions are. I want to make one last point

because I expect, as we see the debate unfold in the few next weeks, this will be one of the major sticking points. Some people will come to us, and they say, okay, we'll be for all the substantive positions in your bill, or most of them, as long as you don't give the patients a right to sue or some other enforceable legal right. And that will be appealing when a lot of people hear it, because people say, gosh, I don't want -- I can't imagine -- I don't want any more lawyers, I don't want any more lawsuits, I don't want any more problems like that.

But let me say again, the thing that struck me yesterday at this hearing that we had at the AMA building was in three cases where people died, in all three cases, what the doctor told the patient the patient needed was ultimately approved. And in all three cases, it was approved so late that it was too late to do the procedure, so they died anyway. So you can write all the guarantees you want into the law here in Washington, and if nobody can enforce them, the delay in the system will still cause people to die. We have to do something about this. (Applause.)

Again I say to you, we need to do this for America. We need to do everything we can to stop this from being a partisan political issue, because it isn't anywhere but Washington. It's a people issue. It's about the integrity of the health care system. It's about how people feel about our country.

We've got a lot of young people here, working here, probably some of them just for the summer in Washington. I hope when they leave here and they go back to whatever else they're doing, they'll feel better about America than they did when they came here. And I hope they'll communicate that to other people all around their communities or their universities or wherever they are.

How do you think the people yesterday who were telling me their stories feel about America? This is not even about just health care; this is about how American citizens feel about our country. Are we a fair place? Are we a decent place? Are we a place where everybody counts? This is a huge issue. And we must do everything we can to make it a bipartisan issue or a non-partisan issue, to put progress ahead of partisanship. That's how we achieved a balanced budget. That's how we achieved the Kennedy-Kassebaum bill. That's how we got the Senate to pass the Chemical Weapons Convention and the expansion of NATO.

In the end, all the really big, important things we do around here are when we behave here the way the American people behave every day wherever they live, doing whatever they're doing. And that's what we have to do on this issue. This is a huge thing for millions and millions and millions of Americans. But for all of us -- for all of us -- even if we live our entire lives and never get sick, we should always remember the picture that Dr. Ganske showed us and the story he told, because if you love America and you believe in the promise of America, everyone of you, without regard to your party or your philosophy, has a personal, deep, vested interest in seeing every child like that treated with the dignity that we say in our Constitution and Bill of Rights is the God-given inherent right of every person on Earth.

Thank you and God bless you. (Applause.)

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