Marshall University, West Virginia

November 4, 1993

MRS. CLINTON: -- being here, with your Senator. There is no stronger advocate, nor anyone more knowledgeable about health care in America, than the Senator from West Virginia, Senator Jay Rockefeller. And I think we all owe him a debt of gratitude. (Applause)

I'm also delighted to be here with Congressman and Mrs. Wise, who did come down with us. And we had a great opportunity to have a discussion about a lot of the important issues facing West Virginia and the country. And I want to thank both of you for being here with me.

And I am just delighted to be back at Marshall. I was able to give President Gilley (phonetic) the first copy to come to West Virginia of this book. (Applause) I hope that everyone in this crowd and everyone you can talk to will take the time to read it.

It explains how we got to where we are. How did we end up with the most expensive health care system in the world without covering everybody? Without giving security to everybody? Without making sure every American -- no matter who they were, where they lived, where they worked, whether or not they'd ever been sick -- had adequate comprehensive health care.

And then it lays out what we believe needs to be done in order to make it absolutely clear from this point forward in America that every American citizen, no matter who you are, you will have comprehensive health care guaranteed. You will be secure for the rest of your life. (Applause)

You know, when I was here last year, before the election, I told the wonderful crowd of residents and students and faculty who had come out to greet me that we needed a thundering herd for the Clinton/Gore ticket. (Applause) And you heard that, and you responded.

And I'm back again because we need your help again. We need your thundering herd to help us pass health care. (Applause) And I hope we're as successful in the health care arena as you have been in the football arena. (Applause)

Last year, one of my great moments was when I was given a jacket from Marshall University. And I got out of the car today and a couple of the folks standing around said, "Well, why didn't you wear your jacket?" And I said, "Well, to tell you the truth, I was afraid that, as good as the football team is doing, I'd be accused of being an imposter." (Laughter). So I decided that I'd better leave that at home.

But I do need the spirit and the commitment and the courage that so many of you show day in and day out. Not just with respect to great, fun events like football, but to the daily business of trying to work, trying to go to school, trying to take care of your families. That's really what is at stake here.

Last year, we had a dream that we could begin to tackle the problems that America had neglected. And we are. It isn't easy. It certainly is controversial. But it is far better to wake up every morning and go to bed every night knowing that we're trying to help the American people deal with their real problems, day in and day out. (Applause)

And when the President, last week, presented the Health Security Act to Congress, he invited the entire country to become involved in this great national discussion. We want you to read this book. We want you to ask questions. I was thrilled when I got here and saw the newspaper carrying the questions and answers that so many citizens had called in -- right here on two big pages.

This is what we need to be doing as a country. This is exactly the kind of discussion we need to have. Because when we do, we will be able to compare not only what the President has proposed with what we have today, but also with all the other proposals.

We invite anyone else with any other approach. Put out your book. Put out your specifics. Tell the American people how much they will benefit from what you propose. (Applause) Because our plan is the result of literally thousands, and tens of thousands, of conversations, and of letters. We received over 800,000 letters from people all over this country.

And I've had the extraordinary opportunity not only to visit in person, but also to read those letters, hear those stories.

On May 11th, I spoke with health care professionals and citizens from all over West Virginia at a forum, organized by Senator Rockefeller, about what West Virginia wanted to see happen with health care reform.

I remember, very well, the woman whose family lost insurance after her husband was disabled in a mine fall in 1988. She told me, and I quote, "I would like to be able to take the kids for well check-ups, and not wait until they're sick."

Well, I want that woman to know that under the President's plan we will have these kinds of benefits. Every single one of them will be provided for every American, unlike today, where you have health insurance policies with fine print. And oftentimes you don't know what they don't cover and what they do cover.

You're going to be able to know what is covered because every American will have the same coverage. You will not have to worry about the fine print in insurance policies anymore. (Applause) And what I want to tell that woman is that preventive care is going to be available, finally, for every American.

I have to tell you, I was surprised when my daughter was born and I looked at my insurance policy and learned it didn't pay when I took her for the well-child check-up. But it sure would pay if I kept her at home until she got real sick and then took her to the emergency room.

Now, what kind of system is that? We want to pay for primary and preventive health care. We want to take care of children and their immunizations. We want to pay for that well-child care. And in this plan, it's going to be free, because we believe that strongly in preventive health care, and we want to be able to provide it for every single American. (Applause)

And I want to say a special word of thanks to the Marshall Medical School because of what you have done in primary and preventive health care. I want to add my word of congratulations for your having received the Silver Award of the American Academy of Family Physicians, because of the consistently high percentage of graduates entering family practice from this medical school. (Applause)

If every medical school had produced the number of family practice physicians, had produced the number of physicians going into generalist practices, had been able to even compete for the Outstanding Rural Health Program Award that this medical school won, had entered into partnerships like the one this medical school has with the Lincoln Primary Care Center, we would not have some of the problems we have today.

Right now, we have too many specialists and not enough family physicians and pediatricians and others who tend to primary and preventive health care needs. (Applause)

I also remember the small business employee from Martinsburg, who told me, "I don't think health insurance should be higher than my mortgage. I don't think it should run small companies out of business." And we agree 100 percent. (Applause)

The most discriminating part of the health insurance market today is that part which services small and medium-sized businesses, and individuals who are self- employed. They're the ones who are paying far more than they should. Oftentimes, 40 percent of the premium for a small business goes to overhead and administration and profit. Not to health care.

We are going to level that playing field. Small businesses are going to have the same opportunity to get cheap, good, high-quality insurance as the largest big business does. And it's about time we did that to help all businesses in West Virginia. (Applause) (Interruption to tape) -- told me that it costs paying hospital patients -- that's you and me, if we are insured -- an extra $500 a day to cover the cost of those who are treated for free.

Now, who is treated for free in our current system? Well, they are working people, by and large. And they are people who don't qualify for Medicaid because they get up every day and they go to work. But they do not work for, or are able to afford insurance in today's current market.

Think of the message we have sent to literally millions and millions of working Americans. We have told them very clearly, "If you are lucky enough to work for someone who will help you with your insurance, or if you are poor enough and down on your luck enough to qualify for government assistance, then your bills will be paid.

But, if you're in the middle and you get up every day and work for a living and you cannot afford it yourself, you're out of luck. Since when should a hard-working American citizen have to go on welfare to take care of children with medical problems, because if they don't, they are out of luck?

And it costs us money to take care of them when they finally get their care, because that's what happens every day. Our emergency rooms are filled with people who postpone getting care, have an accident, something happens, they end up in the hospital, and we want them to be taken care of.

I want everybody with a health care problem to be taken care of. I just want everybody to be paying something, so that all of us know that we will always be able to get good medical care because every American will be able to be secure, and no American will be left out.

And let's start by making sure we give universal health care coverage to all Americans as soon as possible, so that everybody who works actually gets rewarded instead of penalized for getting up every day. (Applause)

Some people have said to me, "Well, you know, isn't this Health Security Act just for people who don't have insurance?" And I've asked everybody who's asked me that to ask themselves this question. Go home and look in the mirror, and ask yourself this question: Do I know, for sure, that this time next year I will have the same insurance I have now at the same price?

I have yet to meet any American who can answer that question "Yes." There is no way to answer that question "Yes." What kind of insurance you have, and how much it costs depends upon your employer -- if your employer is helping to buy it, or offering it to you. It depends upon whether you ever get sick. It depends upon whether you have something called a "pre-existing condition." It depends upon whether you're laid off.

And we know that in today's economy, even good jobs with the best high-quality health insurance can be here today and gone tomorrow. There is not one single American who in good conscious can say, "I will have health insurance, exactly what I need, next year, at a price that I can afford."

What this plan will do is eliminate that question from our worries. We will never have to ask it again. If you're an American citizen, you will have health care that is always there with comprehensive benefits. And you will be secure now through the end of your life. (Applause)

Now, why have we not done this before? Well, there are several reasons. Franklin Roosevelt tried to do it when he introduced Social Security. He wanted Social Security to be one half of his proposal, Health Security be the other. He ran into terrible opposition from people who said, "Oh, you can't do that. We don't want to make sure everybody has health insurance." It didn't get done.

Harry Truman went to the Congress in 1945 and said, "We have to have universal health care coverage." That was when we were only spending 4 percent of our incomes on health care. Harry Truman saw, in 1945, exactly what was going to happen if we didn't change. He fought like -- crazy. He gave everything he had. (Laughter)

You know what he fought like. But you know what? Even Harry Truman, as good and tough and strong-minded as he was, couldn't get through the opposition from people who said, "Oh, my goodness, that's socialized medicine. Oh, my goodness, you can't do that in America."

Well, then we rolled along for a while. We finally got Medicare and Medicaid. I don't hear many people saying Medicare is socialized medicine. Do you? Because every person over 65 whom we know relies on Medicare. And thank goodness we have it for our parents. And thank goodness we have it to look forward to. So we took care of the needs of our older citizens. We began to take care of the needs of our poorer citizens.

But we left this great, big, open middle that any one of us can fall into at any time. And every month, 2.25 million Americans lose their health insurance. Some lose it for a day. Some lose it for a week. But 100,000 never get it back, which is one of the reasons why more and more of us are increasingly insecure.

Then along came President Nixon, who the last time I looked was a Republican. And he -- I just want to tell this to all the young Republicans who are here. (Applause)

I want them to hear this: President Nixon introduced a bill, in 1970, to extend universal health care coverage financed by employers and employees, paying just like the Health Security Act introduced by President Clinton.

President Nixon actually did have a good idea. He couldn't get it done because of Watergate. But at least he had a good idea. (Applause)

So, here we are. It's 1993. We've had presidents of both parties, we've had leaders of Congress, we've had deans of medical schools, we've had physicians and nurses and hospital administrators and business leaders, labor leaders, all come forward and say, "We have to reform the health care system."

This time, we are still going to have opposition. We're still going to have people who don't think it's right that every American have the same kinds of rights that they enjoy, because they were born wealthy and born lucky and born healthy.

But this time we're going to beat the opposition, because it is a historic opportunity for America to make good on health care for all of its citizens. (Applause)

As we move forward in this discussion, listen carefully. Know what the arguments are. Know who is making which argument, and why they are. Seek out information.

Read this book. Talk about it with your friends and neighbors. Because when we come to vote on health care reform next year, the members of Congress will need to hear from you.

And ask yourself, "What will happen if we do nothing?" Because that is the scariest possibility of all. Because what will happen is -- I can guarantee you -- your costs will continue to go up. You will not be secure. You will pay higher and higher deductibles. You will have less and less choice, as employers desperately try to limit costs by pushing you into systems that they are told will keep the costs down.

We will have to worry about quality, because quality can only flourish in a system that is well funded, where we can have good accountability, where medical schools and research institutions get the money they need to help us make this a quality system.

The worst alternative facing America is to do nothing. But there are lots of folks who profit from the current system. They like it just the way it is. If they can eliminate people from health care coverage, then they can only ensure the healthiest and the youngest, then they make more money.

We have to stand up and say, "We want a health care system that works for all of us." And if we do that, we will put together the kind of majority in this country, and in the Congress, that will once and for all speak with a loud voice. Enough is enough. Let's make all Americans secure. Let's take the unnecessary costs and waste and fraud and abuse out of this system. And let's spend our money where it counts -- taking care of people who need it.

And I believe that if we are part of this kind of national debate, we will not only have a health care bill we can be proud of -- that will save us money, give us security, provide comprehensive benefits -- but we will, as a country, have taken a step forward, because we would have met one of our primary challenges.

We would have shown that gridlock is over, that partisan wrangling is over, that the debates about irrelevancies have disappeared because we're finally focusing on what counts.

The only way that can happen is if you speak up. And if Congress, all the way in Washington, hears the footprints and the footbeats and the sounds coming from people all over West Virginia and this country. So, yes, we need a thundering herd for health care reform.

Thank you all very much. (Applause)

(End of speech.)

* * * * *

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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