Association of Retarted Citizens

October 8, 1993

MRS. CLINTON: Thank you very much for that very warm welcome. It is such a pleasure to be here with David Dunn and the other officers and the board of the ARC and all of those in this audience and around the country who support the work of the ARC. And I'm also pleased to be here with the governor of Rhode Island, Governor Sundlun, and both Senator and Mrs. Pell, who came to be with us today.

And I am particularly pleased to have been introduced by someone you have known a long time and I've only been able to claim an acquaintanceship of less than a year, but whom I admire so greatly, Senator Chafee.

From the very first time that the President asked me to work on this very important task, he has been such a constructive and helpful counselor and advisor. And I think it's only fair to say that we now do have a president who is committed to health care reform.

And we have leaders like Senator Chafee who have worked on health care reform for many years who will help create the climate of cooperation that will lead to a bipartisan, nationally accepted health care reform in 1994. And I am very grateful. (Applause)

This is an issue that we know will be very discussed all over the country in all kinds of forums like this but even more importantly, in living rooms, in coffee shops, around the water coolers. People are going to be talking about health care reform. And I think it is a conversation that is long overdue and very welcome.

And those of you in the ARC have experience in knowing what is needed to make systems respond to human needs. And we are so grateful that the ARC has taken such a strong stand of support in favor of health care reform.

I want personally to thank the ARC for the very positive response that you issued in response to the President's health care speech. And I want to thank David and others for being with us at the White House when we kicked off this campaign for health care reform because you have been working with us through your officers and representatives now for a number of months.

And your help and your constructive advice has enabled the administration to come forward with the plan that has and will continue to make a contribution as we work through the Congress to the final resolution.

You know, often better than most Americans, how easy it is to be victimized by a health care system that discriminates against preexisting conditions, that does not offer adequate, long-term care choices, such as personal assistance and other support that people with mental retardation and their families need to rely on to fulfill their lives and to be productive citizens.

We are trying in our health care reform approach to deal with several of the problems that are most important to the ARC. We want to expand home- and community-based services to persons with disabilities. (Applause)

You know so well that we have to have the capacity to support people while they live in their home or in alternative living arrangements. And that you know so well that it is the right thing to do, both in terms of the human connection and in terms of the economic.

For too long we have looked to institutionalized care. And, as the wonderful introduction of Senator Chafee pointed out, we're beginning to understand the human and economic costs that that has made on our society. But we still have not recognized how much better it would be if we could provide more support for home- and community-based arrangements.

The health care reform plan will move beyond even the legislation that was mentioned and will finally make it clear that, regardless of income or age, individuals with severe disabilities should have the option to choose home- based care or community-based care. (Applause)

Also, as part of the overall plan, we are leaving in place these programs that have provided help and assistance. In fact, really, the theme of health care reform, as far as the President is concerned, is let's preserve what is right about --

(End tape 1, side 1.)

-- Medicaid home- and community-based waiver programs. (Applause) In fact, we would like to be able, assuming we can afford to do so, to increase the living allowances for residents of ICFMR from the $30 to higher than that, maybe as high as $100 per month if we're able to do that. (Applause)

You know, when the President in his speech held up that health security card -- I hope you saw that on television. He didn't hold it up and he didn't say, "Well, you'll only be able to get this if you're a certain age or if you've never been sick or if you do not have any mental retardation." He held it up, and he said, "Every American will be entitled to this card and the services that it will represent." (Applause) And we want to make that a right that every American can have. (Applause)

There are so many features of health care reform that will enshrine this basic principle about every American being entitled to receive health security and at an affordable cost that preserves and enhances quality. But particularly for people with mental retardation and their families, we see it as a way to end the discrimination that has for too long existed in our health care system.

I was talking with some friends of mine about their small business. They employ four people. So there are four families plus their own on their policy. Several years ago one of their employees had a child who was born with Down's Syndrome. And all of a sudden they were faced with what so many people are faced with everyday in our country.

Do you want to continue to insure this family with this child? Do you want to have to pay more? Because if you continue to insure this family, the costs for all your families will go up. And my friend, whom I have known ever since high school who is a small businessman, said, "You know, what a choice for me to be asked to make, to turn my back on an employee and his family that were part of my family and my small business, or to reach down even deeper out of the wages of my employees, out of our profits, and provide health care insurance."

He continued to do so. And he called me the other day to say, "You know, I made what I know was the right choice. It was the right choice for my business. It was the right choice for my employee and his family. But no American should have to make that choice. All Americans should be entitled to health care coverage no matter who they are or what happens to them during the course of their life." (Applause) And that is the bedrock principle (inaudible).

In the coming months, as the Senator referred to in his comments, you will be asked to judge health care reform by a number of questions. And I hope that you will keep them in mind as we go forward during this very important conversation.

In the news release that the ARC issued supporting health care reform and the President, it said that the ARC wants to measure any reform against a set of five principles from a disability perspective, and these are nondiscrimination, comprehensiveness, appropriateness, equity, and efficiency.

Everyone of those fits into the principles that the President outlined and that are also embodied in the alternative that Senator Chafee has worked so hard on. It has to be comprehensive. And that means it has to provide a comprehensive set of benefits.

It cannot discriminate against any American. It must be appropriate in the sense that we should build on what works. It should provide access to adequate quality, affordable health care in appropriate settings based upon the choices that individuals make that are best for them and their families.

It must -- it must have equity. And if it is comprehensive and does not discriminate, it should have equity. But it needs to have safeguards built in so that all of us feel that we are not being taken advantage of or discriminated against.

And it must have efficiency, efficiency in the better delivery of health care services and a more cost- effective (inaudible). This will be one of the greatest debates that we will be having, how much efficiency we are able to achieve.

But the ARC, for many of the programs that you are involved with, you have seen models that work. You know more efficient ways of delivering health care services to people with mental retardation. That is true across the country. And what we need is to build in incentives so that efficiency is rewarded and that those who are inefficient, who don't deliver high quality care at a cost-effective, affordable rate, will learn how to do better because there will be incentives in the system for them to become more efficient.

And we will need your voice and your experiences speaking loudly to people all over America about how we can do the job better. I share the confidence and optimism that Senator Chafee just said in his introduction. I know, I know we're going to have health care reform in 1994.

We are going to have it because it is the right thing to do, because we know that to stay with the status quo is no longer an option, and because so many people, including those in the ARC, have worked too long and too hard to try to make things better for us to give up now on what is a historic opportunity.

So I came today mostly to say thank you -- thank you not only for the support you have given in the last months to this health care reform effort, but thank you for the support and the advocacy and the caring and the examples you have given to this country for decades.

Our time has finally arrived. If we work together, we will see the fruits of your labor. And we will all be proud to be Americans and to live in a country that gives us the best opportunities in the world, if we are only willing to take responsibility (inaudible). Thank you all very much.


* * * * *

1993 Speeches

Congressional Black Caucus

American Medical Association

Health Care Roundtable Hawaii

Association of Retarted Citizens

Institute of Medicine

Marshall University, West Virginia

University of Pennsylvania Commencement

University of Michigan Commencement

Liz Carpenter Lecture Series on Civil Society

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