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President Clinton Calls On Congress To Pass A Patients' Bill of Rights

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The Briefing Room

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, foryour obvious passion and concern for this issue. I thank SenatorDaschle and Congressman Gephardt. I thank Congressman Ganske for hisvery moving and highly illustrative argument. I don't think any ofwill ever forget it. I thank Barbara Blakeney and Dr. Smoak fortheir strong representation of health care providers throughout ourcountry. I thank all the health care advocates who are here today,all the members of Congress, especially I thank also Senator Kennedyand Congressman Dingell, and Secretary Shalala and Secretary Hermanwho co-chaired our quality health care commission that produced ourrecommendation for a health care bill of rights for patients.

Let me say, first of all, I hope that the presence ofCongressman Ganske and Congressman Forbes will be appreciated notjust by Democrats on Capitol Hill, but buy Republicans out inAmerica. I don't believe this is a partisan issue anyplace butWashington, D.C. (Applause.) I've tried for years to talk them outof it, but I think most doctors are still Republican. (Laughter.)I've tried for years to turn them around, but most voters in mostparts of my country still vote Republican. But when you show up at ahospital 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'reabout to enter in the 21st century will be looked at 100-200 yearsfrom now, the last 50 years and the next 50 years, as one of the mostremarkable times in human history for advances in health -- averagelife expectancy going up; the quality of our lives improving, notonly because we're learning to manage our own lives better, butbecause of immunizations against dreaded childhood diseases, organtransplants, bioengineered drugs, promising new therapies forrepairing human genes.

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

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

Our job, representing all the American people, is not toabolish managed care. Our job is to restore managed care to itsproper role in American life, which is to give us the most efficientand cost-effective system possible consistent with our first goal,which is -- managed care or regular care, the first goal is qualityhealth care for the American people. That is our job. (Applause.)

And I just want to -- the previous speakers have talkedvery movingly about examples and about the specificprovisions of the bill. There's no need in my repeating all that,but I would like to make two points very briefly. Number one, thepanel of people from whom we heard yesterday -- Dr. Smoak referred tothem -- are not atypical. The woman who told me that she and herhusband were celebrating their 25th anniversary and she realized hehad a terrible heart problem, and the doctor recommended a certainprocedure and it was delayed and delayed and delayed until finally itwas too late, and so when he was 45 years old he collapsed in his ownyard and died in her arms -- at 45. The man who talked about hiswife having a serious medical condition; she had a difficulty whenthey were in Hawaii on vacation; the doctor pleaded to perform thenecessary 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 theUnited States, and so she died on the way, because her systemcouldn't stand the pressure of the transatlantic plane flight. Theman who talked about how he lost his sister to cancer because theonly thing that had a chance to save her life was denied untilfinally it was too late to do and, oh, then it got approved.

I think in a way, the most moving witness we hadyesterday was a woman who works in a doctor's office and handles theinsurance claims and has to get the approval from the insurancecompanies for the procedures. She just broke down and started cryingbecause she said, you can't imagine how awful it is -- I'm the onewho 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 arenot examples that we've all seen in other areas -- and everyone who'selected is guilty of using them -- these are not isolated anecdotes.These are representative examples of systematic abuse. That's thefirst point. Don't let anybody tell you -- (applause.)

Now, second point I want to make is, we have to havecomprehensive, national legislation. That is one of the biggestproblems with the bill offered by the Republican leadership -- itcovers too few people. It is not true that you can leave this issueup to the states. We have to have comprehensive, nationallegislation.

I've already signed an executive memorandum to extendthe protection of the patients' bill of rights to the 85 millionAmericans who are enrolled in federal health plans or covered byfederally funded plans. But as all the doctors, the nurses, thebenefit managers -- 25 progressive HMOs have endorsed thislegislation. 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 haveacted have enacted only a few of the basic protections for patients,and not a single state in America has passed all the protectionscontained in the patients' bill of rights. Americans deserve a billthat provides all the protections for all the people. It requires anational solution. (Applause.)

Now, the bill sponsored by Representatives Dingell andGanske and Senators Kennedy and Daschle do that, and you've alreadyheard 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 cometo us, and they say, okay, we'll be for all the substantive positionsin your bill, or most of them, as long as you don't give the patientsa right to sue or some other enforceable legal right. And that willbe 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, Idon't want any more lawsuits, I don't want any more problems likethat.

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

Again I say to you, we need to do this for America. Weneed to do everything we can to stop this from being a partisanpolitical issue, because it isn't anywhere but Washington. It's apeople 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 whenthey 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 theircommunities or their universities or wherever they are.

How do you think the people yesterday who were tellingme their stories feel about America? This is not even about justhealth care; this is about how American citizens feel about ourcountry. Are we a fair place? Are we a decent place? Are we aplace where everybody counts? This is a huge issue. And we must doeverything we can to make it a bipartisan issue or anon-partisan issue, to put progress ahead of partisanship. That'show we achieved a balanced budget. That's how we achieved theKennedy-Kassebaum bill. That's how we got the Senate to pass theChemical Weapons Convention and the expansion of NATO.

In the end, all the really big, important things we doaround here are when we behave here the way the American peoplebehave 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 thingfor millions and millions and millions of Americans. But for all ofus -- for all of us -- even if we live our entire lives and never getsick, we should always remember the picture that Dr. Ganske showed usand the story he told, because if you love America and you believe inthe promise of America, everyone of you, without regard to your partyor your philosophy, has a personal, deep, vested interest in seeingevery child like that treated with the dignity that we say in ourConstitution and Bill of Rights is the God-given inherent right ofevery person on Earth.

Thank you and God bless you. (Applause.)

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