THE WHITE HOUSE
Office of the Press Secretary
For Immediate Release
June 22, 1998
REMARKS BY THE PRESIDENT,
THE VICE PRESIDENT, MRS. GORE, AND MRS. CLINTON
AT OPENING OF FAMILY REUNION 7: FAMILIES AND HEALTH
12:45 P.M. CDT
THE VICE PRESIDENT: Thank you very much, ladies and gentlemen,
and thank you, Bill, and thank you for the cosponsorship of the Child
and Family Policy Center and for the very hard work of the past year
that's made today possible.
Thank you, Chancellor Wyatt, for the wonderful hospitality of
Vanderbilt in hosting this important event. And we, Tipper and I,
earlier thanked Dr. and Mrs. Hefner for Tennessee State's role in
hosting the Experts Forum again.
Many thanks also to Marty Erickson and the Consortium for
Children, Youth and Families of the University of Minnesota. Your
energy and wisdom are crucial to this conference, and I know there are
many distinguished delegates from Minnesota who are with us here
Thanks also to our wonderful conference chair, Jill Iscol. Your
tireless energy and vision for the future of Family Reunion is
contagious and has won us many new friends for this initiative. And I
will thank all of the others who have been a part of this year's
conference and necessary to making it happen at the conclusion of our
session tomorrow, but I want to thank Nancy Hoyt, our conference
director, and all of those who have worked with her.
And among the many distinguished guests here, I hesitate to even
start mentioning people and I will miss a lot of people, but I do want
to acknowledge our wonderful Surgeon General, David Satcher, a kind of
a homecoming to Nashville. (Applause.) We're proud of you, Dr.
Satcher, thank you so much. (Applause.)
Tennessee's Chief Justice Riley Anderson is here and our former
Governor, Ned McWhorter, and our Speaker Pro Tem, Louise DeBarry is
here. All three of them are wonderfully welcome. (Applause.) There
are many other state officials, members of the state legislature, both
from Tennessee and from other states, and local elected officials,
Democrats and Republicans. Welcome all.
Now, Tipper and I would like to briefly welcome everyone here to
our Family Reunion. This is a tradition that we're proud to continue,
and initiative that is helping shape policy for children and families.
And we also welcome the thousands who are linked to our site here
today by satellite. There are lots and lots of downlinks around the country -- we'll be interacting with some of them this afternoon. We
appreciate your presence here.
We're looking forward to two days filled with ideas and
strategies that will move us toward improving family-centered health care for all generations. We'll hear stories that will remind us how
family-centered health care changes the lives of both patients and health care professionals. We'll hear how hospitals and communities are changing to be more responsive to the needs of families, how these changes are affecting medical training and education, and how information drives the health care system.
This afternoon, you'll meet some of the best minds in this field
who will be leading workshops around the campus. And then tomorrow,
we will hear a summary of those discussions and then move forward in our concluding sessions tomorrow.
Before I begin the session today, I just want to tell you what a
special honor and privilege it is for Tipper and me to be able to be
joined by two very good and close friends who have in recent years
made it a practice to come and attend these sessions. And, of course, as many of you know, our ability -- everybody in these Family Reunion
conferences to get the right kinds of policy outcomes based on the
learning experience that takes place here would be very much less --
except for the fact that we have a President and a First Lady who are
so committed to these issues and to the progress that we all want to see in our country.
And Tipper and I are so touched that once again this year they
have come to be a part of this Family Reunion conference. Ladies and
gentlemen, it is an honor to be able to welcome to our conference the
President of the United States and the First Lady, Bill Clinton and
Hillary Rodham Clinton. (Applause.) Welcome, Mr. President, Mrs.
Clinton. We're so honored that you're here.
Traditionally, we open up these Family Reunion conferences with
just a brief film presentation. Because just as each of us lives our
lives primarily in the venue of our families, whenever we have an
effort to try to advance understanding of a particular issue -- like families and health care -- it's always useful to remind ourselves how we talk to one another about this issue in our culture, in movies and in
Jeffrey Cole, Director of the Center for Communication Policy at
UCLA, along with his staff, have once again this year enabled us to
begin with a brief collage, this time a collage of media scenes
designed to show the images of families and health that we have absorbed from television and film. This video will show us many truths. We'll see dramatic family moments seen in the midst of health and sickness, life and death and birth. We will also see the impact of our culture on families and health care, including the glamorizing of tobacco and we'll see how the media educate us about health care, including educating us about the ugly truth concerning tobacco and the other aspects of families and health care.
This is the first time I've had to issue a rating for our media
clips. If one of the scenes in this collage is from a movie that's
rated "R" for language, and if you are going to be offended by it, now
is a good time to leave. (Laughter.) You'll recognize it when it
But as almost everyone will see, in at least one scene or two,
an emotional episode from our own past will remind us of something about what it means to be caring for a family member, or to be cared for by a family member at a time of weakness, uncertainty or need.
And so at that point, let's just watch this video.
(A video is shown.)
THE VICE PRESIDENT: We're very grateful to Jeff Cole and his
team. I know that you worked right up until the last minute, Jeff, to
include some scenes that were hard to locate. And you've succeeded,
once again, in producing a very power piece. I'd like to ask Jeff
Cole, who produced that film to please stand up and accept our thanks.
(Applause.) Thank you very much. (Applause.)
The power of that video we just saw comes from the fact that, in
this case, art does indeed imitate life. It provides a window into
our own lives. A health problem facing a loved one may be contained in
the body of that one person, but it affects the entire family's soul. Yet far too often, modern medical practices sees a patient's family as
another problem to be managed and not as a critical part of any
solution. They often see the family as a roadblock to proper
treatment rather than a building block for a health future.
For seven years now, Tipper and I have convened these Family
Reunion conferences for the express purpose of shining the spotlight
of public attention on the often overlooked role of the family in the
life of this nation and its people. The initiatives coming out of these conferences have been numerous, whether they've been from government, the private sector, community groups, or partnerships among all of the above. And in recent years, the regular attendance of the President and the First Lady has guaranteed that the meaningful solutions developed at each conference become a part of our nation's agenda.
Just to cite a couple of examples from previous Family Reunion
conferences, our Conference on Family and Media led to the V-chip that
will soon allow parents to block television programming that they feel
is inappropriate for their own children to watch. Our conference on
the role of fathers in children's lives has led to Father To Father, a
national network for fathers assisting fathers; a web site known as
Fathernet; and a presidential memorandum issued by the President
directing agencies to promote fatherhood through their programs,
policies, and personnel decisions. And that is working extremely
Our Conference on Family and Work contributed to a national
dialogue on balancing these two roles, and led to, among other things,
proposals for comp time and the expansion of Family and Medical Leave.
And last year's Conference on Families and Learning launched
efforts to expand quality after-school programs, develop new
techniques to encourage parent-teacher communication, and involve parents and communities in designing new public schools.
This year, we're exploring family-centered health care, because
our system of medical care, while scientifically ingenious, has not
made proper use of the crucial healing power of the family. It has too
often left family members confused and abandoned in the waiting room.
We will hear about fresh, new approaches, like redesigning
spaces in children's hospitals to encourage family involvement, allowing family perspectives to shape the medical education of the next generation of doctors and nurses; creating partnerships among organizations in a community to offer families in one place a full range of medical treatment and health advice. We will hear from people who know that health care information is often the world's most effective medicine, and who find ways of passing that information to families.
Family-centered care is an approach that relies on partnerships
between providers, patients and families to help promote health and
healing. You know, even though the phrase "primary health care
provider" is used in a specialized way by the medical community,
usually the true primary health care provider in America today is the family.
How many of us have been, as family members, the person who said or
heard the phrase, "did you take your medicine," "put this thermometer
under your tongue," "open wide."
This conference is designed to help us all find ways to more
effectively unleash the healing power of the family. Family-centered
health care recognizes the family's expertise, encourages
collaboration and shares information.
After working to get parents better information about prenatal
care and nutrition, one hospital in Ohio saw a more than 30-percent
reduction in the length of hospitalization for babies.
Family-centered support for children infected with HIV and for children with asthma has decreased hospital stays. Family involvement during a mother's hospital stay has reduced depression. Today, 21 million Americans provide health care to members of their own family. That is a threefold increase in just the last 10 years.
Of course, one of the reasons that families are now more
involved in health care is that our population is growing older and living longer. Those of us in the baby boom generation are the first
generation to have more parents than children, and many of us care for
both parents and children. More than 90 percent of
chronically-disabled elderly people receive informal care from family members and loved ones.
In fact, according to a study from the National Nursing Home survey,
so many people are involved in informal care-giving for the elderly that if the cost of that care had to be provided by professionals it would add as much as $94 billion to our health care bills.
For five years, with the courageous and tireless leadership of
President and Mrs. Clinton, our administration has been fighting to
improve health care for families. We passed legislation to let all
families keep their health care coverage when they changed jobs. We
passed a new law so that new mothers can stay in the hospital for at
least 48 hours after the delivery of a child. We passed a Mental
Health Parity Act, with the leadership of Tipper, to fight discrimination against family members with mental illnesses. The President signed into law the new children's health insurance program, which helps provide coverage for children who would otherwise not get it.
Last year, we passed a bipartisan balanced budget agreement with
reforms that gave older Americans new choices and expanded benefits in
Medicare. That's a step in the right direction, but language and
choice can often be confusing. So we need to make sure that Americans can understand their choices and that their families understand their
choices and learn how to make use of the new preventive care options
available to them. We can use our newest technology to help ensure
that older Americans and their families have access to the most up-to-date available information about their medical benefits.
Today, I'm pleased to announce a new nationwide Internet site,
www.medicare.gov, that will help families understand the new options and services that Medicare provides. It's up and running as of now. And from now on people will be able to type in their ZIP codes and see the specific health plan options available in their own communities for their older family members.
At the same time, to ensure that no family falls through the
cracks, I'm pleased to announce today the creation of a nationwide
public/private Medicare alliance including over 80 national
organizations. Members of the alliance, including the AFL-CIO, the
American Association of Retired Persons, the National Rural Health
Association and Health Care Financing Administration and others, will
reach out to communities large and small, urban and rural, all over
this nation, so that families understand the new options available to them, know about the new preventive benefits and are aware of the consumer protections available under Medicare.
Today, I'm pleased to announce that starting July 1st for the
very first time, Medicare will cover tests and education for Americans with diabetes. With this announcement today, the 20 percent of older
Americans with diabetes will be able to take preventive steps to help
them and their families avoid the pain and loss that can come when
this disease is undetected and untreated. One of the scenes in the video collage that dealt with this problem. That could have been prevented.
Also starting on July 1st, for the very first time Medicare will
cover the bone mass measurement test that can identify osteoporosis,
the silent killer. For the one out of two American women over the age of 50 who have an osteoporosis-related fracture, this new benefit does more than offer hope for stronger bones, it offers hope for a stronger
future for them and their families.
These new steps will make Medicare more responsive to the needs
of families, helping them find information, encourage prevention, and get the care they need for their eldest and often most vulnerable members.
But there is still so much to do to improve the health and health care
of Americans. I want to issue a challenge to all of us gathered at
this conference to understand and expand the practice of family-centered care. And here are five steps to help us meet that challenge -- you could call it a SMART plan for family centered health care: support,
measure, ask, respect and train.
Number one, support. Around the nation, communities have
developed support systems that can offer family care-givers the
emotional and psychological respite they need. We know that many
families are more than willing to be giving care to a family member,
but they are often exhausted by it. They need respite.
President Clinton has taken the lead by giving states new
flexibility to support home- and community-based options, adult day
care and respite care, so that families have the options they need to
supplement -- not supplant -- family care-giving.
Number two, measure. We have to measure the performance of our
health care programs and clinics and hospitals, and do it in language
that families can understand. Not only will this help patients choose
better health care options, it will reward the better health care
plans and providers and increase competition that could improve health care quality overall.
Just last week, I had the opportunity to announce that private
businesses, health consumer groups, professional organizations, labor
unions, and employers, are coming together to plan America's very
first health care quality forum, designing a comprehensive plan to ensure the widespread availability of comparative information to improve the quality of health care.
Number three, ask. Ask families for their knowledge and for
their participation. We must encourage our health care system to ask
families to play a role, to make them a vital part of our care-giving system. And we must ask the medical community to help design new ways to
involve the family, and after they ask, they have to listen. We all must listen to the answers that families provide. We're taking an important step in Washington right now to listen to families. The President is asking the Congress to pass a Patient's Bill of Rights that provides families with new protections in the changing health care system.
Number four, respect. We must make sure each health care
professional respects the power of families as health care providers
and offers families the information, guidance, assistance, and
encouragement that they need to keep their members healthy.
Number five, train. Doctors and other health care professionals
must be trained to be more sensitive to the needs and roles of
We will hear a new announcement from medical schools and nursing
schools about historic changes in how we train the next generation of health care providers to be more responsive to the needs of families. And we will hear ideas on how we can train families in how to use new
technologies available for home care-giving. We saw a scene in the
collage where a nurse was teaching the family member how to handle the
particular technology that was important for the patient.
So these five steps -- support, measure, ask, respect, and train
-- spell more than "SMART", they spell our a vision for maximizing the
healing power of families in our health care system.
We have an extraordinary opportunity at this Family Reunion
conference, because there are people gathered here from all over the
country, representing every aspect of our health care system --
patients, families, doctors, heads of medical schools, nurses,
insurers, professors, hospital administrators, and others. Let's learn
everything that we can from each other, today and tomorrow so we can change the nature and the culture of our health care system and unleash the healing and loving power of families.
Thank you and thank you for coming to this conference.
Now, it is my great pleasure to introduce my partner who
co-hosts these conferences with me every single year, and has since the time when I was back in the Senate, the love of my life, Tipper Gore. (Applause.)
MRS. GORE: Thank you. Thank you very much. (Applause.) Well,
thank you, this is -- it's wonderful, we're very excited that all of
you are here.
And Al, let me add my voice to yours by welcoming everyone, all
our distinguished guests, the people that are going to share their
expertise, everyone here that's listening, the media that's reporting.
We really appreciate all of you in helping us help others to keep
their families healthy and to share ideas about how we can best do that.
I know that a lot of you here today know Al very well, and if
you do, you probably know that he undertakes everything with great
enthusiasm. When he takes on an issue, he devotes a lot of time and
energy to researching that and to discussing it and to trying to get
all the very best opinions that he can on the issue.
When he was still in the Senate many years ago, he looked at
policies that impeded families helping themselves to become strong and
to stay strong, and he wanted to take a look at how you could change
those policies so that families can really support one another and can
become stronger the in process. So, together, we've taken a look at a
way to create policy, to build policy, to encourage policy, that will
help to strengthen families, which in turn, strengthens communities.
And that's the point that we are here to discuss today.
He has looked at issues that impact families, from education to
fatherhood and to health care. All of us have looked at the issue of
health care, and everyone in this room, I know, has a huge, huge stake
in how we can best deliver health care in our own families and in our
We've reached the same conclusion, and that is that families
truly are at the heart of each and every solution to health problems, and that policies and programs that support and strengthen families will
ultimately strengthen our nation. That's just common sense.
I'm really proud and honored to be a part of this event. I'm
happy that we're taking a look at the family center approach to health
care. As many of you know, we're very interested in how mental health
care fits into health care as a whole. Of course, it does, but we
need to continue to talk about that and to destigmatize mental or
behavioral health care. And I think that this conference is going to go a long way toward that end.
One of the topics that I'll be discussing tomorrow and later
today we'll be addressing mental health care for children, and also children that are facing chronic health problems of their parents and how we can best support them.
But now it is a great privilege and honor for me to be able to
introduce to you a very special woman who has been a lifelong advocate
on issues ranging from health care to women's rights to strengthening
families, back in her home state of Arkansas as well as our nation's
First Lady. And she's also a tremendous voice in addressing the needs
of women and children.
She has a very compassionate spirit. She has the courage to
out and always has, and she has a great determination to fight on
of women -- not just for women here in this country, but for women
across the world. And she represents our nation, and I know all of us
appreciate and respect her voice as it is our voice around the world.
She has demonstrated a lifelong commitment to improving health
care for all of our families. And as the administration's leading
voice on health care, she fought tirelessly for the passage of the landmark Children's Health Initiative, giving hundreds of thousands of
previously uninsured children the opportunity to have health insurance and come under health care coverage.
Her efforts have helped to shed light, to educate people about
the national need for more comprehensive health care services and benefits for all American families. And she has talked long and hard about a family centered approach to health care, the very issue that we are here to talk about in further detail today.
So I know all of you will join me in giving a very warm welcome
to a very special woman, a very special leader, and our nation's First
Lady, Hillary Rodham Clinton. (Applause.)
MRS. CLINTON: Thank you all. Thank you so much, and it
is great to be back here to join Tipper and Al for this seventh Family
Reunion conference. I know that many of you in the audience have
followed with great interest the Family Reunion conferences of the
past years, have been part of the deliberations and the follow-up. Others of you are new to this experience, but I can guarantee you that this is one of the most meaningful public policy discussions that you will be part of because it is aimed at really changing the way we look at a problem and coming up with practical solutions.
The Vice President made reference to some of what has already
flowed from previous Reunion conferences, and I expect the same from
this one, because certainly the issue is an important one in the lives
of our families and is a timely one, as we know, as we look at the
impact of a changing health care system on all of us.
The people who have planned this conference have been very
thoughtful in bringing all of us together and setting an agenda that
will lead to the kind of thoughtful reflection and results that are
the hallmark of what Al and Tipper have been doing for the last years.
Their vision to launch this series of Family Reunions seven years ago
was really in line with their lifetime of work and commitment to
seeking to bring people together, not drive them apart; looking for ways to build consensus, not flame conflict; and making it possible for people of different points of view and experiences to find common ground. We need that more than ever in our nation because we are at a point in our history where we should be, with all the blessings that we're enjoying, be able to address some of the problems that underlie the stresses and strains that tear at the fabric of family life.
So I am personally very grateful to my friends, Al and Tipper,
but I am even more grateful as a citizen to the Vice President and Tipper for making it possible for all of us to take some time out and think about these difficult problems that they have addressed through the Family Reunion conferences.
I want to thank everyone who has worked on this, particularly
the two co-hosts of the conference, Dr. Martha Erickson and Bill Purcell.
I want to thank the chair of the conference, Jill Iscol; and Nancy Hoyt, who doesn't seem to be slowed down at all by her crutches and is a
walking example of family-centered health care, since both her
daughter and her husband are here as part of her support system. But that's what these Family Reunion conferences are all about -- bringing us together.
And today we are surely talking about a subject that affects all
of us -- how do we get the health care system to be more responsive to
the needs of families. Every one of us has a personal experience like
the ones we just saw on the screen. We know the pain and anguish of
having a family member who is sick or injured or in need of long-term
care. I think every one of us has sat in a hospital waiting room
worrying about a chronically-ill relative or close friend. We have
faced the frustration of trying to understand the mind-numbing rules
and regulations of medical insurance forms.
And we know how difficult it is to deal with the emotional
stress that comes upon us at such a time. Now, we certainly have made a lot of progress in the last 30 years, 40 years, in moving toward being much more sensitive.
I well recall the anguish of my family when one of my brother
came down with rheumatic fever, and in those days, in the 1960s, there were no special considerations given to parents or family members, and
there was a very strict set of rules about what governed visiting, even for a young boy of the age of 8, alone in the hospital. So my mother and father were permitted only see him an hour a day, and certainly my brother and I were not permitted to see him at all.
What a difference that was from time that when Chelsea had her
tonsils out and had to spend the night in the hospital both Bill and I
were able to be there with her. So we've make a lot of progress in
the hospital system, the entire health care system appreciating the role that families play in the healing of a member of a family and how we now have to look at how we move that further in the face of new
Now, the administration, under the leadership of the President
and the Vice President, have been looking for ways to deal with the
changing nature of the health care system. We'll be hearing in a few minutes from the forum panelists up here on the stage before you. And what you will hear from them is good news about how hospitals and health care providers are working with families and communities to make sure that families are participants in important medical decisions, that they
get the information they need and the support they need and the respect they deserve.
But we know that there are still a lot of obstacles and
difficulties. And one of the reasons this conference is so timely is
that we have to be sure that as the way we organize and pay for health
care changes we don't lose the advances we've made since my brother
was in a hospital, and lose the extraordinary work that is being done by the panelists and many of you to make the health care system more family responsive.
You all know that we face an entirely different situation than
we had just a few years ago: 160 million people are enrolled in managed care plans today. Now, that's an increase of 75 percent just since 1990. And as with any sweeping change, it has the potential for both harm and benefit. We are learning, as we work our way through this
new system, that more people are feeling like numbers instead of patients.
I remember before my father died in 1993, he went to see a
doctor that had taken over the practice of his longtime physician. And he got into the waiting room and there was no person there. And he had to punch a button and an automatic voice came on and asked him who he
And my father said, "None of your business, I'm leaving," and walked
out the door. (Laughter.) Well, I think that a lot of people had that
feeling and have that feeling, that we don't want to be treated like
numbers and we especially don't want our children and our parents and
our loved ones treated like numbers. So how do we take the benefits
of a changing health care system and put them to work on behalf of all of us?
Now, this administration has worked very hard to improve the
health and well-being of our families and children, and to make sure,
particularly, that children and elderly relatives and citizens with
special needs are given the support and protections that they deserve.
One of the battles that the President and the Vice President
have taken on is against the tobacco lobby and they've taken up the
challenge of helping parents protect their kids from the deadly habit of smoking.
Now, while that initiative took a beating last week in Congress, I
know you can count on the President and Vice President never to walk away from fight when the fight is on behalf of the children of America.
(Applause.) And as the President has said, if the members of the
Senate had voted more like parents, instead of partisans, the outcome would have been different. And it still can be. (Applause.)
One of the important steps that the President and Vice President
are also working to achieve is to pass the Patient's Bill of Rights,
which would give Americans much needed protection.
Now, what does that mean to all of us? Well, I imagine, like
me, you've heard of or you've seen with your own eyes some of the stories that are coming back from what's happening in the health care system -- people denied emergency care because somebody, hundreds or even thousands of miles away, decides they don't need it; someone denied
access to a specialist because someone looking at paper, not looking
at the patient, decides they don't need a specialist.
So the Patient's Bill of Rights would once again enshrine what
we should never lose sight of: that the most important goal of any
health care system is the well-being of the patient. And we should once again protect the physician-patient relationship and put it above any other consideration. (Applause.) The bottom line of profits cannot ever be permitted to interfere with the bottom line of patient care.
So this Patient's Bill of Rights would do things such as
access to health care specialists and emergency services. It would
create a strong grievance and appeals process so that consumers can
resolve their differences with health plans and health care providers.
We must work to make sure that the Congress passes protections such as
that this year.
Yet, all of us who have followed what goes on -- whether it's in
state capital or our Nation's Capital -- knows that passing
doesn't guarantee change. There is a lot of hard work to implement a
law, and that is certainly the case with the historic children's
insurance program that extended health insurance for up to 5 million
our uninsured children. The administration has been working with
and communities to get the word out about the expanded coverage.
And I wanted to just show you a report that is being issued
a report to the President of an interagency task force of government
officials in Washington that have really looked hard about how we will
implement this. And all of you who are from all over our country, in
many different settings, I hope will really help us make sure that the
word gets out to parents and others that their children are now
for health care coverage. And the President will talk further about
steps that are going to be taken to reach as many children as
The Vice President also referenced this administration's
commitment to improving the quality and effectiveness of health care
our elderly citizens. And Tipper and I will be working together to
the word out about one of the new benefits that Medicare is covering
tests to detect osteoporosis. And many of you are equally concerned
about the new benefit on diabetes education. So we will do our best
get the word out in every way possible about osteoporosis, about
diabetes, so that we can reach Americans so that they can help take
of themselves and family members can help take care of each other by
spreading the word.
This conference today and tomorrow has such tremendous
But just like a piece of legislation that is passed standing alone it
won't do anything other than perhaps educate those who are here and
provide more opportunities for continuing to learn from each other.
In and of themselves, those are very worthy outcomes. But we want to be
sure that all of us take what we learn from this conference back to
the hospitals, the community centers, the neighborhood health clinics, the
advocacy groups -- everyone who is represented here -- and make sure
that all of us know that fighting for health care, making sure it is
family-centered, is not a luxury, it's not something that we can wait
to do, but it is critical to how we define health care going into the
Because of all the changes that we're coping with, we have a
chance to really make some important decisions that will determine
whether people are treated like numbers or whether people continue to
be given the respect they deserve at a moment in their lives when all of
us feel vulnerable and alone. And one of the ways of doing that is for
each of us to be sure to get the word out that taking care of health
care means taking care of families and giving families more of a voice
and an opportunity to be part of everything that happens to one of
their loved ones when the worst occurs.
So all of you are making it possible to fight for greater
protections and services for Americans. And for that, I am very
grateful and very pleased to be part of this important effort.
Thank you. (Applause.)
THE VICE PRESIDENT: Thank you so much. That was a wonderful
presentation. And now ladies and gentlemen, I'm honored to introduce
to you an individual who has been leading our country's efforts on health
care. And let me say right at the outset, no President has ever
worked harder to improve health care for all Americans.
President Bill Clinton has increased access to health insurance
for people who are self-employed, for people who have preexisting
conditions, for people who are changing jobs, for children of
families. He's now working to expand health insurance for Americans
aged 55 to 65. No one in history has cared more or done more to bring
health care to a poor child, a working parent, or an ailing
But President Clinton also understands that we must work to
maintain the quality of American health care, to ensure that the
dramatic changes in today's health care system work for, and not
against, American families. That's why he's pushing so hard for
of the Patient's Bill of Rights, so that every American gets quality
I'm honored to introduce to you a President who has the
the stamina, and the commitment to help us build, step-by-step, a new
nationwide commitment to health care access and excellence.
Ladies and gentlemen, the President of the United States, Bill
THE PRESIDENT: Thank you very much. Thank you. (Applause.)
Thank you very much. Mr. Vice President, Tipper, to all the leader of
the conference, Surgeon General Satcher, Governor McWhorter, ladies
gentlemen, first of all, let me say that I look forward to coming here
every year so much. I always learn something and I always see people
who are full of energy and idealism and a sense of purpose who remind
of what, at bottom, my efforts as President should be all about. So I
always get a lot more out of being here than I can possibly give back,
and I thank you for that.
All these issues have been very important to our family for a
time. I grew up in a family where my mother was a nurse and where she
served people before Medicare and Medicaid. I never will forget one
time when a fruit picker that she had put to sleep for surgery brought
us four bushels of peaches. I was really disappointed when
reimbursement came in. (Laughter.) I thought the previous system was
far superior. (Laughter.)
When Hillary and I met, she was taking an extra year in law
to work at the Yale University Hospital in the Child Studies Center to
learn more about children and health and the law and how they
interfaced. And when we went home to Arkansas she started the
Advocates for Families and Children -- a long time before she ever
her now famous book, "It Takes a Village."
The Vice President and Mrs. Gore have plainly been the most
influential, in a profoundly positive sense, family ever to occupy
present position -- whether it was in mental health or the V-chip in
television ratings or telecommunications policy or technology policy
environmental policy or reinventing government or our relations with
Russia and South Africa and a whole raft of other places -- history
record both the Vice President and Mrs. Gore as an enormous force for
good in America. And I am very grateful to them.
This Family Conference is one of their most remarkable
achievements. And as they said, it predates by a year our partnership
and what happened since 1993. But I will always be very grateful to
them for this as well.
I'd like to begin with just a remark or two about the tobacco
issue, since it's been raised and it was a big part of the movies that
we saw. We know that it's the number one public health problem
face in America. We know that more people die every year from
tobacco-related illnesses than from murders and fires and accidents
cancer -- not cancer, but AIDS and many other conditions combined. We
know that 3,000 children start to smoke every day -- even though it's
illegal to sell cigarettes to kids in every state in the country --
1,000 die early because of it. We know all these things.
We also know that in order to reduce teen smoking you have to do
something about price, you have to do something about access, you have
to do something about marketing -- both direct marketing, I would
by the tobacco companies, and their indirect marketing by placing
cigarettes strategically in movies, as we saw in this very compelling
set of film clips. Now, we know all that.
And what I had hoped was a remarkable and surprising example of
bipartisanship in spite of enormous political pressure to the
the United States Senate voted out of committee 19-1, almost
unanimously, a bill that would raise the price of cigarettes; stop
advertising, restrict access, put penalties on companies that violated
the requirements and use the money for medical research -- especially
cancer research -- for reimbursements to the states for the health
related to smoking they had incurred, which money the states would use
on health care, child care and education. And, for good measure, we
accepted amendments sponsored by Republicans in the Senate to spend
of the money fighting drug usage among our children and to give a tax
cut to low and moderate income working families to offset the
Then the bill came to a vote in the Senate. The American people
are now learning that, except for the budget, a minority in the Senate
can require every bill to pass with 60 votes, not 51. We had 57 votes
to pass that bill. But 43 senators followed the bidding of the
Republican leadership and the tobacco companies and at least
derailed that bill. It was a brazen act of putting politics over
and partisanship over progress.
I say this to you so that you understand the importance of
gatherings like this in grass-roots networks. No one doubts that this
came about in part because of an unanswered $40 million advertising
campaign by the tobacco companies which could not be matched by the
Cancer Society, the Heart Association, the Lung Association or most of
you in this room. What you should know is, I'll bet my bottom dollar
the night the news of the bill dying broke on the evening news, public
opinion switched back to our side, just like it always will as long as
people know the facts of what's in the bill and who's behind the
opposition to it.
So I say to you this is the intersection of politics, public
health and family. And the cutting-edge issues up there right now are
this bill and the Patient's Bill of Rights, about which the First Lady
spoke. I don't think you should let this Congress go home, if you can
stop it, without acting on these measures and taking care of our
families and our future. (Applause.)
Let me say, on a more positive note, this time in our history --
on the edge of a new century, in a new millennium, with our economy
strong, many of our social problems declining, a great deal of
self-confidence in the country -- is a real time of decision for us.
Usually free societies in good times like this take longer summer
vacations, spend more time in the sun -- that may be good, at least
vacation part -- wear your sunscreen if you do the other. (Laughter.)
Dr. Satcher will send me a gold star. (Laughter.) Or you can say,
we can do things now we couldn't do in normal times. We have
confidence. We have emotional space. We have the opportunity to
dreams about the future. We can take on the big challenges of the
country. I think that's what we ought to be doing. Because we know
that no set of circumstances stays the same forever, and because we
that things are really changing fast and because we need to be looking
to the future.
What are these big challenges? Well, a couple related directly
the concerns of the conference -- we need to make sure that Social
Security and Medicare will be reformed so that they can accommodate
baby boom generation without bankrupting our children and our
grandchildren. And we shouldn't be spending the surplus that finally
about to emerge after three decades of deficit spending, we shouldn't
be squandering that surplus until we have saved Social Security and we
know what we're going to do with Medicare. (Applause.)
We have to figure out how to grow the economy and do more to
preserve the environment -- not just to avoid making it worse, we've
to actually recover many of our essential environmental things.
(Applause.) And that's a health care issue.
We're here at Vanderbilt -- we've got the finest system of
education in the world. We have to develop the best system of
elementary and secondary education in the world. (Applause.)
We've got the lowest unemployment rate in 28 years, but we still
have double-digit unemployment in some urban neighborhoods, on some
Native American reservations, and in some poor rural communities. We
have to bring the spark of enterprise to every place in America to
that what we're doing really works. (Applause.) These are the things
that we have to do. And we have to prove that we can all get along
together across all the racial and religious and other lines that
us, because in the world today, which is supposed to be so modern and
wonderfully revolutionized by the Internet, old-fashioned racial and
religious and ethnic hatred seems to be dominating a lot of the
in the world. If we want to do good beyond our borders, we have to be
good at home. (Applause.)
But on that list should be health care. Why? Because we have
finest health care in the world, but we still can't figure out how to
give everybody access to it in a quality, affordable way. And in some
form or fashion, every family in America just about, sooner or later,
runs up against that fact.
Shirley McLaine was in there griping about her daughter getting
the shot on the movie, you know? Now, why do you suppose -- never
the movie -- why do you suppose something like that would happen in
life? Could it have something to do with the fact that not just HMOs,
but the government, tried to take steps to stop medical expenses from
going up at three times the rate of inflation, but, like everything
else, if you overdo it, and the hospitals have to cut down on service
personnel, that people will be late getting their pain shots? I mean,
we have to come to grips with the fact that we still are alone among
the advanced societies in the world in not figuring out how to deal
And I personally think we also -- we ought to be honest -- you
know, it's easy to -- we could all get laughs with HMO jokes, but the
truth is there was a reason for managed care, and that is that it was
unsustainable for the United States, with the smallest percentage of
people with health insurance of any advanced country, to keep spending
higher and higher percentage of its income and increasing that
expenditure at three times the rate of inflation. Pretty soon it
have consumed everything else. That was an unsustainable situation.
And a lot of good has come out of better management. I don't
think anyone would deny that. The problem is, if that kind -- if
techniques like that are not anchored to fundamental bedrock
then in the end, the process overcomes the substance. And you have
kind of abuses and frustrations that have been talked about. That's
the Patient's Bill of Rights is important.
Now, the second thing I want to say is, we have to figure out
to do a better job of turning laws into reality. One of the things
Vice President I hope will get his just desserts -- we may have to
for 20 years of history books to be written -- but the work that we
done in reinventing government is not sexy, it doesn't rate the
headlines every day, people don't scream and yell when you mention the
phrase, it doesn't sort of ring on the tip of the tongue. But we've
the smallest government we've had in 35 years, and it's doing more and
doing it better than we were doing before in our core important
And we've gotten rid of hundreds of programs and thousands and
thousands of pages of regulation -- but the government, on balance, is
performing better. And it's because of our commitment to change the
things work. The biggest challenge we've got right now is to fulfill
the promise we made to the American people when we persuaded the
Congress to put in the Balanced Budget Act of 1997 sufficient funds --
the biggest increase in Medicare funding since 1965, to provide health
insurance to at least 5 million more children. There are 10 million
or more children in America without any health insurance.
We had -- the latest numbers indicate that 4.5 million of those
kids are actually eligible for Medicaid. Now, most of you here know
that when we passed this program we provided for the establishment
state-by-state of things that are called CHIPS, child health insurance
programs, to provide health insurance mostly to the children of lower
and moderate income working families that don't have health insurance
But if you want to get the maximum number of people insured for
the money that's bean allocated, obviously the first thing we need to
is to sign every child up for Medicaid who's eligible for it. And,
again, most of these children live in lower income working families.
They've been rendered eligible by action of the federal government or
action of the state legislature in Tennessee and the other 49 states
Recent studies have shown that uninsured children are more
to be sick as newborns, less likely to be immunized, less likely to
receive treatment for even recurring illnesses like ear infections or
asthma -- which without treatment can have lifelong adverse
and ultimately impose greater cost on the health care system as they
undermine the quality of life.
Now, we're working with the states to do more, but I want the
federal government to do more as well. Four months ago I asked eight
federal agencies to find new ways to help provide health care for
Today, at the end of this panel, I will sign an executive memorandum
which directs those agencies to implement more than 150 separate
initiatives, to involve hundreds of thousands of people getting
information that they can use to enroll people in schools, in child
centers and elsewhere --involve partnerships with job centers and Head
This is what reinventing government is all about. The America
Academy of Pediatrics says that these initiatives are "representing
best of creative government and absolutely critical to achieving our
common goal of providing health insurance for all eligible children."
So that's what we're going to try to do coming out of this conference
do our part.
Let me again say that those of you who are here, if you believe
that families are at the center of every society, if you believe they
are the bedrock of our present and the hope of our future, if you
the most important job of any parent is raising a successful child,
surely -- surely -- we have to deal with the health care challenges,
of which have been discussed -- caring for our parents and
caring for our children. Surely we have to provide our families the
tools to do that if we expect America to be what it ought to be in the
new century. We'll do our part and I'm proud of you for doing yours.
Thank you and God bless you. (Applause.)
END 2:00 P.M. CDT