Bill Clinton: “Thank you very much. Thank you, Dr. Holley, for that kind introduction and for your good work and the good work of all…”

“Thank you very much. Thank you, Dr. Holley, for that kind introduction and for your good work and the good work of all the physicians whom you represent now in dealing with these very difficult and complex and profoundly important issues. I regret not being able to join you in person today, but I am glad that Ira Magaziner is able to be there with you. I'm glad I had a chance to visit with you, Dr. Holley, and your past president, Dr. Richard Corlin, in Washington recently, following another health care forum. And I'm grateful for many reasons for your continued good counsel and for this invitation to address you. Each of you has, in the most personal way, been part of the excellence in American medicine simply by caring for the families in your communities. And I'm grateful that you understand that our health care system needs dramatic reform. You know costs are rising too fast, that paperwork is mounting too much, that every day more constraints are placed on your patients and your ability to practice medicine the way you know it should be practiced. But unlike so many others in the debate who will only tell us what they don't want to change, long ago you left the sidelines and became advocates for responsible, comprehensive reforms. I appreciate the early and continued support you have shown for the objectives we are trying to achieve: providing Americans guaranteed private insurance, preserving the right of everyone to choose his or her own doctor and their own health care plans, outlawing unfair insurance practices, protecting and strengthening Medicare, and linking these health benefits to the workplace, where most people get their insurance today. These reforms are entirely consistent with many of the things that you have tried to do in California. Your health care providers have been innovators in improving quality and controlling costs. And judging from today's headlines, the new California purchasing pool is certainly a step in the right direction, offering consumers a wide choice of plans, a comprehensive benefit package, and lower rates. That kind of competition between insurers, combined with more choices for consumers, is what my plan is all about. At a national level, I think the first step we must take is clear. The best way to preserve what's right about our health care system is to guarantee private insurance to every American. That's the foundation of our health reform plan. We'll provide every American with a health security card that will guarantee them a comprehensive package of benefits that can never be taken away. The benefits will include for the first time for many Americans prescription drugs and preventive care. All of you know that the best way to keep people healthy is to promote wellness in addition to treating sickness. Retaining choice of doctors and health plans is also critically important to Americans and to American medicine. And this, too, is central to our approach. Today, only about half of American employers offer their employees more than two choices of insurance plans; 90 percent of the businesses that have 25 workers or less offer no choice at all. And even for those who have some choice today, there's no guarantee they'll have it tomorrow if they change jobs or lose their job or if their employer has difficulty meeting the costs. This is a tremendous restraint on most Americans. My proposal will guarantee the great majority of Americans far more choice of both doctors and insurance plans than they have now. Under this approach, people will be able to join a traditional fee-for-service plan, a network plan, or a plan sponsored by a health maintenance organization. But in all cases it will be families, not employers or insurance companies, that make the health care choices. The people who are telling you we don't offer enough choice, which is clearly not so on its face, are the same who for decades have been pushing you out of the way and limiting your choices. You don't believe their arguments and neither do we. That's why, among other things, we're going to insist upon different insurance practices: no more preexisting conditions, no more lifetime limits, no more higher rates for those who have had someone in their family sick or those who are older, no more overcharging of small employers or dropping them because one person in the workplace has a medical problem, no more avoiding people who might cost some money. The fact is, increasingly insurance companies set your fees. They second-guess your clinical decisions. More and more they make you get prior approval from someone who's thousands of miles away who's never seen your patient and doesn't have a clue about what really ought to be done. They all pay according to their own fee schedules, requiring different forms for different people under different circumstances. The forms are drowning the health care system in paper. I have a doctor friend who calls me about every 3 months to tell me another horror story. Recently he told me, ``We've got all these people doing paperwork. Now we've hired somebody who doesn't even fill out forms, just spends all day on the telephone beating up on the insurance companies about the forms we've already sent in.'' He's told me, he said, ``I went to medical school to practice medicine, but I'm getting lost in the funhouse instead.'' Well, he's right, and I know a lot of you agree with him and identify with that story. But this year we can escape that funhouse. The fourth element of our approach is to preserve and protect Medicare. Older Americans will continue to choose their doctor and their plan. And in addition, we want to cover prescription drugs under Medicare and provide new options for long-term care in the home and community, which most people prefer and which will become increasingly important as our population continues to age rapidly. Finally, let me say again, we should guarantee these health benefits at work; that's how most people are insured now. And 8 of 10 uninsured Americans have a family member who works. This is the fairest and most efficient approach to covering everyone. And so no one gets hurt by the needed reforms, we'll provide discounts for small businesses and breaks for self- employed people and their families. This is the proposal; it's pretty straightforward. All Americans will get a card that guarantees with it the security of private insurance and comprehensive benefits; then they can pick the doctor they want. They'll know that they're always covered by what is said to be covered, and it won't be subject to change by anyone. Before taking your questions now, let me again just express my deep thanks for your continued support and encouragement. After 60 years, I think this is the year we're going to provide every American health security that can't be taken away. I'm optimistic because of what's already been done. This Congress has been willing to act and to work with me to pass an economic plan that's helped to produce low interest rates and high [low] \1\ inflation and more than 2 million new jobs. After 7 years, this Congress passed and I signed the Brady bill and the family and medical leave bill, things that people had given up on getting done. The point is not that we have been able to do so much but that that is evidence that we can still do what we have to do. --------------------------------------------------------------------------- \1\ White House correction. --------------------------------------------------------------------------- The American people have demanded that we make a great deal happen. They want their dreams back, and they want this problem fixed. A big part of the American dream has always been knowing that you can care for your children or your family if they become sick. That's what you do. You're a part of every American family's dream. I've seen the magic you perform all over the country. You care, and the American people know it. And our challenge now is to do everything possible to keep and protect the bond that you've worked a lifetime to establish. Our challenge is to provide every American health care that's always there. With your help, we can do that and we can make history. I thank you for the leadership you've already shown. And if you have questions, I'll be glad to try to answer them. Thank you very much.”