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REMARKS BY THE FIRST LADY
TO THE COMMUNICATIONS
WORKERS OF AMERICA
April 20, 1994
MRS. CLINTON: Do you all think you could come
back like once a week? You know, it's been a great week for us, as Morty
said. The President started his week by going to Milwaukee and having an
opportunity to spend time with Morty and meeting many of your members. The
real secret, I have to go ahead and confess, was that Air Force One has
been having communications problems, so we thought we'd get some really
firsthand advice. I also am pleased to be here with all of the
leadership that you are and the members you represent. I want to
particularly thank Barbara and Loretta for meeting me and greeting me as I
came in this morning. But I really am here to say thank you to all of
you. It is true, as Morty said, that we finally look like we're on
the verge of the historic change that health care reform will bring to our
country. And we could not have gotten there without a President whom you
helped elect, who cared about the health care of the people of this
country. But we also would not be on the verge of this change if
you at CWA had not worked year in and year out on behalf, not only of your
membership, but of millions of Americans who may never know what CWA stands
for. Because you tried in every way you knew how to make health care a
priority for this country. They will be better off because of it, and I am
personally grateful for your support. But you know it's not going to
be easy. It is going to be a real struggle in the next couple of months
to do what all of us in this room know needs to be done. We've been in
a situation for the last decade or so where a lot of our problems have been
denied. There's been a lot of political rhetoric, you know, politicians,
radio talk show hosts, all kinds of people ranting and raving, but until
last year, very little action. Now we've got a year behind us in
this administration. I think most of us, if two years ago had been in a
meeting like this, we would have thought we were dreaming if we had said,
you know, I would just like a president who would be responsible about the
budget and go ahead and take on the problems that this country has, and
go ahead and reduce the deficit by half, and while he was at it, give
tax breaks to millions of working Americans who deserve them because
they're working every day but they can't get themselves out of poverty.
Leave everybody else alone, and only tax the top 1.2 percent of the
wealthiest of Americans. Wasn't it interesting last week when
you finally got down to filling out those tax returns? I know. Probably
my favorite time of year. You know, there has been this year-long
blast about how, you know, everybody's taxes were being raised, and
then a lot of the Republicans and a lot of their allies ran all these
ads last week, you know, saying, look what happened. Lo and behold, it
happened to the people it should have happened to. I mean, that's what this
is all about. But think back, you know, two years ago, and again
let's dream a little. Suppose we had said, wouldn't it have been wonderful
to have a president who really was going to try to do something about
violence in America, not just talk about it, not just hold press
conferences about it? Wouldn't it be wonderful to have a president who
would finally have the guts to sign the Brady Bill and start getting guns
out of the hands of teenagers? You know, as unrealistic as it
might have seemed two years ago, wouldn't it have been wonderful to have
a president who really believed that we needed more police on the
streets? Because you know in the 1950s when I was growing up, and maybe
some of you as well, as I look around this room, we had three police
officers for every serious felony committed. Now we've got three serious
felonies for every police officer. So two years ago we would have
been here saying, oh, I mean, it's a pipe dream. But wouldn't it have
been great if we could get maybe another 100,000 police officers on the
street, and get us safe again in our homes and our neighborhoods? That's
what we're on the brink of doing with the crime bill that's in the Congress
right now because of the presidential leadership. There are so
many other things like that, I mean everything from waking up two years ago
knowing that, despite all of the confusion in the world and the Soviet
Union crumbling, there were still hundreds and thousands of missiles
pointed at our country. Now we've got, through peaceful means and through
leadership, the effort to dismantle that. We've got a national
service program that next year is going to start paying young people to do
service in their communities. We've got a new college loan program
that's going to start rewarding the children of people who work for a
living and can't afford college. We've done all of these things in just one
year that two years ago would have seemed unimaginable, because we were
living in a kind of drift, a denial, and gridlock. But leadership
does make a difference, and what we now are on the brink of facing is one
of the most important issues: health care reform. And it's an issue that's
been around for at least 60 years. You know, Franklin Roosevelt thought
that health care security would be the other half of social security. He
had to fight to get social security. He got that, thank goodness, and yet
he couldn't get health security through. Harry Truman made health
care reform one of his major issues. He worked as hard as he knew how --
and I've gone back and read some of his speeches. I mean, he called it
like he saw it. He called names, he pointed fingers. He knew exactly what
he was up against, because he was trying to change a system that is
entrenched, and a lot of people make a lot of money out of. Dwight
Eisenhower even came into his presidency trying to do something about
health care reform. Finally, in the 1960s, Presidents Kennedy and Johnson
got Medicare. And we ought to be so grateful for that, because at least
we provided basic health care services for our older Americans.
Even President Nixon had a health care reform bill that he fought for, that
was employer-based. And Jimmy Carter came to the Congress with ideas about
health care reform. Oh, we've tinkered on the edges. We've gotten
some good things like Medicare. We put a safety net under the poorest
of Americans, those on Medicaid. But every year that went by, as Morty
referred to earlier, all of you have seen wages held steady or even decline
in many sectors of the economy, when the only thing you could bargain for,
the only thing you could get, were health care benefits. And many
other workers without the kind of leadership that you have, they've seen
not only their wages stagnate and decline, but they've seen their benefits
slowly eroded, and many of them have ended up without health care
benefits at all. You and I all know people who went to work for
corporations 20 and 30 years ago and thought they would always be there.
They aren't there anymore, and the health care benefits have gone out with
them. So what we are facing now, as we look at health care reform,
is the possibility of making good on the promises and the hopes of the
leadership of this union of presidents, both democrat and republican, over
60 years, and making good on the fundamental promise that health care
should be a right, not a privilege of a select few. Now look at what
we have before us. We have the President's approach, which will do the
following things. And we have alternatives that are being debated in
the Congress. And we have, I hope, a national consensus that the time
has come, assuming we keep the momentum going. Let me just briefly outline
the principles that the President believes have to be part of his health
care reform effort. Number one, every American must be guaranteed
private insurance, and that must carry with it a package of benefits that
are comprehensive and emphasize primary and preventive health care. For too
long, insurance has been penny-wise and pound-foolish. It won't pay for
pre-natal care, it won't pay for the immunization, it won't pay for the
well-child care. It often won't pay for the mammogram or the Pap smear or
the cholesterol screening, but it sure will pay when you get real sick and
go to the emergency room. We want to start paying for and encouraging
people to use preventive health care. We want to keep people healthy,
we don't just want to take care of them when they are real sick and need
the kind of care that only is expensive and available in hospitals. So
let's begin by committing ourselves to guaranteed insurance with a
comprehensive set of benefits. The second thing we want to do is, we
want to outlaw insurance practices that discriminate against any person
on the basis of preexisting conditions. Nobody should be denied health care
insurance or told, yes, you can have it, but at a price that is so out of
sight that in effect it's unaffordable, because they or a member of their
family has been sick. You know, during the last year I have
traveled all over the country, and I have talked with so many people
about what has happened in their lives. And I've got this movie that
runs in my head. I see the faces, I see the settings, I hear the stories.
But probably nothing, nothing, summed up the tragedy of preexisting
conditions quite the way a woman did in Cleveland, at the Children's
Hospital there. While I was talking with a group of families whose
children were seriously ill -- they had leukemia, cerebral palsy, cystic
fibrosis -- very serious illnesses which require not only a lot of health
care, but require a lot of emotional and psychological care as well. And
this woman, whose husband was a lawyer -- they made a good income --
told me about how their first child, their son, had been born
healthy. Then they had two little girls, both of whom had cystic
fibrosis. And she recited for me what it had meant for this family to try
to find insurance for those little girls, because of course, once the first
one was born, the insurance company began pricing it out in such a way
that basically they were told, you can have insurance for yourselves
and your son, but not your daughter. And then, unbelievably, a second
daughter with the same problem. This woman said to me that after going
from place to place -- they've never asked for a handout, they've never
wanted their child to be on welfare and to get Medicaid -- she remembered
talking to an insurance agent and begging him to help her get some kind of
insurance. He finally looked at her and said, what you don't understand
is, we don't insure burning houses. Now, you know, I could not
even imagine what that mother felt like. And I could not even imagine that
if that were to happen to Bill and me with our daughter, how I would
react. I was so stunned. So if we do one thing in this whole year that
will mean more to me than anything, it will be to eliminate preexisting
conditions. It will also be to eliminate lifetime limits, because what
lifetime limits do is cruelly say to a family, when you are really sick,
when you need insurance health care the most, you may run out.
Some policies, when you read the fine print, have a lifetime limit as low
as $50,000. Others go to a million. But you know in today's high-tech
medical world that often doesn't last very long, especially if you have a
really sick member of your family. So we're going to outlaw -- make it
absolutely illegal -- for insurance companies to do anything that will in
any way restrict your coverage on the basis of preexisting conditions or
lifetime limits. That is what we are trying to do. The third
principle is one that is very important to me personally and I would
imagine to many of you. And that is, we want to give every American the
choice of doctors and choice of health plan. Now there has probably been
more misinformation about this than any other aspect of the President's
plan, and I think I've kind of figured out why. In addition to the
advertising campaigns run by interests that don't want you to have choices,
what's happening right now is that many, many of us are losing our
choice. Employers are picking plans and then telling you what doctors and
hospitals you can use. I hear that everywhere I go in the country.
I was in Baltimore on Monday, and I met a family who had a child with a
chronic condition. They were very pleased with their doctor. The husband's
employer changed insurance policies, and all of a sudden they were told
they can't take their child to the same doctor they've been taking him
to ever since he was born. They had to go to somebody else. What
we want to do is to stop the trend that is taking choice away from people,
because if we do nothing, if we do not reform the system, I can guarantee
you that most of us will not have any choice in the next 10 years. It
won't matter how hard you bargain, it won't matter how hard you shop,
there will be big conglomerates that will decide what doctors can belong
and what doctors cannot. They will offer the lowest prices to the
employers. That's what will be taken, and the rest of us will be left with
no choice. What I want for the American people is what the members
of Congress and federal employees have today. They have an employer-based
benefit. They have the federal government -- which pays their salary, then
pays 75 percent of their health care benefits -- going into the
marketplace and finding health plans that want to bid on my health
business. That's what a co-op, or an alliance, or a buyer's club
would do. It doesn't deliver health services. It does what the federal
government does for my husband and me, and for members of Congress. Every
year we get a whole bunch of brochures and information, and can attend a
meeting, so that we're told about all the different health plans that
are available in the Washington area. This goes on all across the
country for federal employees. What I want is for Americans to have
that choice. It's not my husband's employer, it's not the federal
government telling us what health care plan to choose, it is our choice. If
it's good enough for Congress, it's good enough for the American people.
And the fourth principle is, we want to preserve and improve
Medicare. Medicare has worked for older Americans, but it has two big gaps
we need to fill. It does not cover prescription drugs, and it does not
provide alternatives for long-term care to older Americans and people
with disabilities. Why are prescription drugs important? Well, we
want them to be a part of the benefits package for all of us under 65, and
we want it to be available for the people who use the most prescription
drugs, people over 65. So we have to change the Medicare system in order to
be able to do that and provide that benefit. But you know, it's
not only the right thing to do -- because I have met people all over this
country who every month make a choice at the end of the month, based on
their fixed income, between prescription drugs and food. I have met them, I
have talked with them. I have gone down rope lines on streets and in
big rallies, and people have grabbed my hands -- older men and women --
and thrust into them their prescription drug bills. And I had a man in New
Jersey say to me, here's how much my wife and I live on. We live on social
security, a very small pension, and here is what we make every year. I'm
spending half of my income on prescription drugs for myself and my
wife. Now it's not only the right thing to do because we need to
help these people, but it is the economical thing to do as well. Do you
know most older Americans, when confronted with costs like prescription
drugs -- they hesitate. You know, you've seen them. I've seen them.
I've talked to doctors and pharmacists. They don't know whether to
get the prescription filled. They leave their doctor's office with a bunch
of prescriptions, but they may only get one of them filled, not knowing
that you need to take all three for it to work. Or they may get the vial
and it says, take four pills a day for 10 days, and they say, if I only
take one a day, it will last longer. What happens? They end up
back in the doctor's office. About 23 percent of the admissions of older
people to hospitals are because the medication wasn't done right or
taken right, or administered right. So it's not only the right thing to do,
it will save us money. It is more economical to help people with their
prescription drugs than to readmit them to the hospital, or to pay the
doctor when they didn't do the drugs right. So that's the first thing.
And the second is, let's begin to provide some alternatives -- to
older Americans and Americans with disabilities -- besides nursing homes. I
have met -- (Applause.) -- I have met hundreds of Americans, and I have
gotten a million letters, and many of those letters are about the struggle
families have trying to take care of their loved one. Families
struggling with Alzheimer's -- you know, that's not just a disease of an
individual. That affects an entire family. Struggling with the effects of
stroke or serious diabetes, or heart conditions, all of those that not
only affect older people but also younger people, very often lead to the
person needing nearly full-time help during the day. And yet for
those families that want to take care of their loved ones, we don't give
them the help they need. We don't pay for the visiting nurse. We don't
help pay for the equipment they need in the home to be able to take
care of the physical needs. We don't provide reimbursement for adult
day care so that you can keep, like, an Alzheimer's patient at home, but
drop them off on the way to work, pick them up at night, so that the family
can keep working and stay together. No, what we do is say, well,
too bad, you're either on your own taking care of that relative all by
yourself, or go ahead, spend yourself into poverty, and then you can go
into a nursing home that costs thousands and thousands of dollars. That is
not a very fair thing to do, and it is also not very cost effective.
If we say to families, we want families to get together -- you know,
I'm tired of people saying they're pro- family and not lifting a finger to
help working -- (Applause.). Why don't we begin to put our policies
where our mouths are, and say, let's help families stay together?
And that's what we would do in the President's plan. He would enable
Medicare to provide options at home, in adult community centers and
congregate housing, so that people would slowly move toward levels of
needing this, that might eventually enter the nursing home, but not
necessarily. And the fifth point is that we want to provide health
care benefits through the work place. That's where most of us, the 100
million of us who are insured, get our benefits. We want to be able to say
to every employer and employee, everyone must share the responsibility of
paying for health care. Many of your employers have not only
contributed to your health care, they have subsidized their
competitors, they have subsidized other businesses in the community,
because those businesses took advantage of the health care system you and
your employer paid for without contributing themselves. We need a level
playing field where every employer and every employee makes a fair
contribution. (Applause.) What the President has proposed will be fair
to small business, it will help give discounts to them, it will help
support low-wage workers. But the bottom line is the principle: we have to
provide that opportunity. Now there are a couple of other things that
I wanted to say just quickly to this group. One thing that the
President's approach will not do is, it will not tax health care benefits.
(Applause.) It didn't seem right to us to turn around and penalize the
people who gave us wage increases over the last decade or two, increase
their compensation, largely through the addition of benefits, primarily
health care, and then say, we're going to tax that. We don't think that's
right, and the President has not proposed that. The President's plan will
protect early retirees, and it will provide a single payer option for
states that wish to pursue a single payer (inaudible). (Applause.)
You know, I was thinking this morning as I was coming over here that
it seems so self-evident to those of us in this room that we need to reform
our health care system, because you've seen the effects of eroding wages,
you've seen increasing costs, as Morty said, no matter what you and
your employers try to do. You kept running up against cost increases
that were coming because the entire system was out of control, even though
you were doing your best to be responsible. And yet you know as
well as I that the same arguments, and even some of the same people who
were against social security and against Medicare, are against health
care reform. And I don't want anyone in this room to at all feel that
this is going to be as self-evident to the congress and the rest of the
country. (Laughter.) You know, when I first started working in
public policy -- it seems like 100 years ago, it's probably about 25 or
-- 20 or 25 -- and I was primarily concerned about children's issues. I was
always amazed when I would go and talk to somebody, and I would say, but
the need is so obvious. And you know, fill in the blanks, you know.
These children are not getting immunized. These children are not
getting, you know, good nutrition. These children are being abused.
And I would make what I thought was certainly a winning argument, and
would be met with a blank stare, or met with a kind of brush-off, or met
with an ideological argument about how, well, that was the way it was meant
to be. So I know that this is a challenge for all of us. But I cannot
think of anything more important for us to be engaged in right now, because
this is not just a debate about economics, although it is. The
economy will be stronger when we stop spotting our competitors five cents
on every dollar because we spend so much more on health care. It is not
only an issue of social justice, although it is that, because how much
longer can we live not only with the nearly 40 million uninsured but
the 25 million underinsured? And the insecurity that any of us face is
because there is not one of us in this room, not one, who can say with
any certainty you will have the same health care benefit at the same cost
this time next year. And it's not only a political issue to see how well
our system can respond, and whether it can actually rise to the occasion as
it did 60 years ago and 30 years ago. It is also a question of what
kind of country we want to (inaudible). We are starting to take on
such problems. It's not easy. It's controversial, but at least we're facing
up to them. We're starting to get some results. We're beginning to see
that there is some hopefulness. The economy is back. Consumer confidence
is up. We're starting to do what the President said he wanted to see when
he ran for the Presidency. But really, it's not up to him, and
it's not really even up to members of congress, is it? It's up to all of
us, the way we are every day, how we treat each other, our
responsibilities for our families, our responsibilities at work. Those are
the things that make a great nation. We have always been great. But
now we need to rise to this occasion and make it absolutely clear that we
will not tolerate a two-class medical system, that we will not tolerate
insecurity that afflicts every one of us, and that we can deal with and
solve our problems and move toward creating a more caring, compassionate,
and yet practical country. That's what my hope is, and that's why
I'm going to do everything I can to make health care reform happen this
year. Thank you all. (Applause.) * * * * * | 
