President Clinton's Remarks on the Patients' Bill of Rights

Office of the Press Secretary

For Immediate ReleaseJuly 13, 1999


The White House
Washington, D.C.

9:45 A.M. EDT

THE PRESIDENT: Thank you very much, Senator Daschle and other members of the Senate who are here. I would also like to thank the health professionals who have joined us -- Beverly Malone, the President of the American Nurses Association; Dr. Michael Rapp, the President-elect of the American College of Emergency Physicians; Dr. Omega Silva, a board member of the American Medical Women's Association; Dr. Gary Dennis, the President of the National Medical Association. They represent over 200 medical, consumer and citizen groups who endorse our legislation.

You heard Senator Daschle say that it has been almost two years since we started the call for the Patients' Bill of Rights. Ever since, we have been gratified by the enormous outpouring of support from professional as well as consumer groups. Now, after months and months of delay, the Republican leadership in the Senate finally has agreed to allow an open debate on the Patients' Bill of Rights. And I must say, it has been very enlightening.

The American people have waited a long time for this day and we must not let this opportunity slip away. All Americans in all plans must have these basic rights; that's what this is about. Are you for or against all Americans and all plans having these basic rights: the right to see a specialist, the right to go to the closest emergency room, the right to remain with your health care provider throughout a medical treatment -- whether it's a pregnancy, chemotherapy, or some other course of treatment -- the right to hold a health plan accountable for its decisions if they are harmful.

Senator Daschle's bill would make each of these rights the law of the land. It is strong, meaningful, effective, and if you talk to people who have been affected adversely by the way HMOs too often operate in this country, it is long, long overdue.

Now as you know, there are some who will try to substitute the Republican leadership's own bill. As Senator Daschle has explained, it is watered down, it is nowhere near what the American people deserve or need. Not only does it offer merely toothless and half-hearted protections, it fails to protect all Americans in managed care. We estimate now that there are 110 million Americans who would not be covered at all by this bill.

Already the opponents are resorting to this $100 million scare campaign. They allege that a strong Patients' Bill of Rights would cause premiums to rise beyond the reach of average Americans. They are wrong. As Senator Daschle said, the Congressional Budget Office -- now we all remember going back to 1995, from the day the Republicans assumed the majority in Congress -- how they have said we must always rely on the studies of the Congressional Budget Office. We always have to rely on the CBO's figures. But now when the health insurance companies say, we don't want you to rely on the figures any more and we're spending $100 million to discredit the HMO figures that the same Republican leaders have held up as the gospel truth for four years now. They say it would cost no more than two dollars a month, and I would remind you that we have some evidence here.

I put in place by Executive Order the protections of the Patients' Bill of Rights for all those covered by the Federal Employees Health Insurance Plan, and it costs less than one dollar a month to implement. So we have evidence and we have the study of the group that Congress says we should rely on for all of our figures; that is, unless the health insurance companies decide differently.

Now this is not about dollars, this is about people. It's about whether the people of this country come first in the votes of the Congress of the United States.

The people deserve a bill that protects them, not the insurance companies. That is why every single doctors' organization, every major nurses' organization, every major consumer group stands with us today. Now we're going to have an honest debate. It should be open and it should be complete. No cynical, parliamentary maneuver should bypass the need of the American people to know exactly where and why every member of Congress stands on every issue.

The American people deserve to know whether the senator they elected is for or against the right of people to see a specialist. They need to know whether every senator is for or against the right of a doctor to decide; and stopping the right of an HMO accountant to delay -- sometimes indefinitely, often until it is too late -- the right of a patient to see that specialist. They need to know whether every senator is for or against the right of somebody who is hurt in an accident to go to the nearest emergency room and not have to bypass one or two or, in the case Senator Dorgan cited yesterday, three emergency rooms before getting emergency treatment. They need to know whether you are for or against maintaining the same doctor during a pregnancy or a chemotherapy treatment if your employer happens to change insurance providers during the course of that treatment. And they need to know whether they are for or against the right to correct and to get remedies when you are hurt by harmful decisions.

This is not complicated. This is not rocket science. And it is very real for the American people out there who feel they have lost control of their ability to have a secure relationship with their health care providers. This is about the way people live. And we now know that it would not be prohibitive in cost, but it could save a lot of lives and untold misery.

So let's have a clear decision. We've waited a long time for this day and the American people are entitled to know where their members stand and why.

Now let me say again, this is not a partisan issue anywhere in the United States of America outside Washington D.C. Democrats, Republicans, and Independents all get sick. They all have accidents. They all need doctors. And they all have pretty much the same opinion of whether this bill should pass in the form that Senator Daschle has presented it.

This is only a partisan issue in Washington, D.C. We have found common ground on health care before. We did provide the right to keep your health insurance when you change doctors -- excuse me -- when you change employment. We did provide the right of up to five million children to get health insurance. It is unconscionable that we would say -- here we are in the last year of the 20th Century -- that we would say, with all the miracles of modern medicine, I am sorry, we have found it necessary to allow health care to be organized in such a way that doctors can no longer tell you when you need a specialist -- that I'm sorry, no matter how badly hurt you are, you may not be able to go to the nearest emergency room -- that I'm sorry, no matter how difficult a chemotherapy or pregnancy treatment is, you may just have to change doctors in the middle of the stream. And I'm sorry, no matter how badly hurt you are, your insurance company should decide whether you get remedies or not. We don't need to say that.

The Congressional Budget Office, held up as the sacred authority on financial matters by the Republican majority, says this wouldn't cost more than two dollars a month a policy. And I'm telling you, there is no excuse for not passing it. I hope the Congress will pass this. The Senate has got to lead the way, and I thank those members who are here with us today for fighting for all the American people. This is an American issue, not a partisan issue, and it ought to be that way when the votes are counted.

Thank you very much. (Applause.)

Q What's your prediction? What's your prediction on the Daschle bill? Will it pass? You don't know?

Q Will you veto the Republican bill? Would you veto the Republican bill?

THE PRESIDENT: I don't know what my prediction is. You know, you would think that it would be a no-brainer. You would think -- 70 percent of the Republicans in America -- in America -- support this Patients' Bill of Rights. So, 200 medical and health-care organizations and consumer organizations support it. Senator Daschle says that health insurers are spending $100 million to beat it, and we're having all these scare tactics, and people are saying, oh, the states can take care of this.

Let me tell you something, I used to be a governor. And if I were still one, we'd have the strongest bill of rights I could possibly pass through my legislature. But the states cannot cover everybody, number one; and number two, what they have done is a total patchwork that does not provide any uniformity or protection. Now, I was a governor for 12 years, I know what these states have done. That is a hollow argument; it is not true. This is one of those things that can only be taken care of this way.

Now you have all these scare tactics. Every time we try to do something we have this kind if tactic. This is what we heard when we passed family and medical leave. Every piece of social advance we've had, you have these kind of scare tactics. But these folks have $100 million to spend on this, and lots of other money as well. So you know, it's just not right.

And I figured when the CBO came out with their study, as much as all of us heard about the CBO for the last four years, that would close the door. But this is not about the evidence. This is about political power in Washington trying to shut off something that is manifestly in the best interests of the average citizen of this country -- and not just the average citizen -- every single person covered by an HMO. And I feel that I have some standing to say this, since I have consistently said that good HMOs can manage health care better. Ever since I got here -- but this is wrong. It is just wrong.

And all of these stories that our side on this issue are recounting -- all these human stories -- to hear the others sort of dismiss this as sort of anecdotes and accidents, and odd-man-out stories is ridiculous. This is the way the world works for people out there who feel they have lost control of their most basic needs in life.

And I would just ask every person in America who watches this, who has ever had a child to think: how you would feel is your child was riding on a bicycle one day and got hit by a car and had to pass two emergency rooms before he or she could get care? How would you feel if your husband was at work being treated in his 30s or 40s for cancer with your whole life still before you, and the employer changes treatment -- and then they tell you in the middle of the treatment you've got to change doctors? Or if your wife was six months pregnant and had a difficult pregnancy and was told the same thing -- just ask yourself how you would feel. And there is nothing on the other side of this.

We have the study now from the CBO and we have the evidence of the Federal Health Employment Plan which led to increases in premiums of less than a dollar a month -- that's what our costs were. How would you feel? And I want to ask all of you who are reporting this -- you can't be biased, you have to give their side and ours. But just ask yourself -- how would you feel? That's what's happening in America today and we're here to try to do something about it. And God willing, and the creek don't rise, we'll do it. Thank you.

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