Bill Clinton: “Thank you very much. He did a good job, didn't he? For a fellow that's not used to doing this, he did a great job. Well…”

“Thank you very much. He did a good job, didn't he? For a fellow that's not used to doing this, he did a great job. Well, first of all, Doctor, I want to thank you and all your colleagues for welcoming me into the clinic today. I enjoyed the tour. I enjoyed listening to you talk about what you've done. And I have to tell you that I saw something in that clinic today that no law can ever compensate for or require, and that is a level of constant commitment to the people of this area. That must be a priceless treasure, just the idea that you've committed your life here. And I thank you for that. I'd also like to thank Mayor Aguilar and Mrs. Aguilar for welcoming me here and--with their grandson back there. I enjoyed it, meeting them. And I appreciate the little--I'm about to fall in the hole here. This would make millions of people happy if I fell over--[laughter] I think I'm pretty well set now. They gave me a wonderful little proclamation declaring this day Bill Clinton Day in Bernalillo, which I am grateful for, and this wonderful piece of art. Thank you. I brought a number of people out here with me. But I want to recognize some of them because they will have a major say in what we ultimately do as a nation on the health care issue. First, members of your congressional delegation: Senator Bingaman and his wife, Anne, who's in our administration in the Justice Department. Senator Domenici, thank you for coming, sir. My good friend Congressman Richardson, who fought so hard for NAFTA, and his wife, Barbara, thank you for being here. Congressman Steve Schiff and Congressman Joe Skeen are here. Thank you for coming. We have a lot of State officials, but I do want to introduce my good friend Governor Bruce King here and his wife, Alice. Thank you, Bruce. Alice, are you there? Thank you, Alice. And your Lieutenant Governor, Casey Luna, flew back with me. Is he here in the audience somewhere? He wrote me a good letter endorsing our efforts in health care, which I really appreciated, as a Lieutenant Governor and as a small business person. I want to talk just a few moments today about what we're trying to do with this health reform effort, how the plan that I have presented to Congress would, in my view, help things for this doctor and this clinic and all of you who are served here and, perhaps more importantly, how it would help to provide these kind of services to other people in New Mexico and throughout the United States. Let me begin by saying that I think most of you know that before I became President, I was for 12 years the Governor of Arkansas, and there are thousands of people from my State now living in New Mexico. I see them every time I come out here. It is also a very rural State. I spent a lot of time as a boy in communities that make this place look like a thriving large metropolis, in little small towns in country crossroads. All my mother's people come from a place that now only has about 50 people in it. I spent a lot of time as Governor trying to keep open rural health clinics, keep open rural hospitals, develop clinic services or primary care or emergency services for people who live in isolated rural areas. So I have a certain familiarity with a lot of the kinds of problems that you have. I've also seen a lot of those problems get worse and some get better over the last 15 years. And Doctor, I think you've been here 17 years, is that right? So about the same timeframe of your service, I have been involved in public service dealing with health care in another way. I came here today to listen, to learn, and to try to explain what we're trying to do. Let me just briefly summarize how this health care plan would affect you and your families and your community. First of all, it would provide for the first time in our history a system of universal coverage. Every family and every person in every family would have a comprehensive package of benefits which would include primary care, the kind of care you get here, and preventive care services that you would always have even if you changed jobs, even if you lost a job, even if someone in your family got sick so you had what the insurance companies now call a preexisting condition. In addition to that, it would recognize that in rural areas there are 21 million Americans today who don't have access to primary care physicians or have inadequate access to primary care physicians. So that even if you gave an American family a health insurance card and there was no doctor to see, you would have coverage that would be meaningless. So this plan makes a real effort to increase people's access to health care in rural areas by doing two or three things: first of all, by guaranteeing funding to rural health clinics that are publicly funded; by increasing the funding stream to clinics like this one--rural doctors are the most likely to have to do uncompensated care--to make sure there will be some payment coming in for all the people who get care within any clinic; by taking steps to remedy the doctor shortage. You heard the doctor say that he didn't leave here in part because there was no national health corps facility or physician to come in behind him. Today, we're only providing funds for about 1,100 doctors a year in the National Health Service Corps. Under our plan, we go from 1,100 to 3,000 doctors a year by just after the turn of the decade and the century. So we would be, in other words, every year providing enough extra doctors to serve another couple of million patients in America at a reasonable ratio of doctors to patients. So that would make a huge difference in the quality of rural health care. Now, there are a lot of things we do to try to get doctors to come to rural areas. But the National Health Service Corps is one, providing more scholarship funds; providing more access to partnerships with people in health care centers like the ones that you mentioned is another. The other thing I want to emphasize is that a lot of people who have health insurance policies, in rural areas especially, tend to be underinsured. And one of the things that we've learned is: As Americans, we spend a huge amount of money on health care that we wouldn't spend if people had primary and preventive health care and if people had access to adequate medication. There are a lot of people who have all kinds of physical problems that could be adequately treated and their conditions could be maintained if they had adequate medication. A lot of people who have mental health problems that could be better managed and treated if they had access to a steady amount of appropriate medication. So one of the good things about our health care plan is that under the bill we presented, in the comprehensive benefit coverage, all families, whether they get care from the Medicare or Medicaid programs or through private health care programs, would have access to prescription drugs. There would be a copay, you'd have to put some money up front in it, but everybody would have access to those drugs. We believe that will lower the incidence of hospitalization and, over the long run, really lower the cost of health care by helping people to stay healthy and to maintain their own health conditions. How do we pay for this? The program would be paid for by a combination of sources. First of all we would require employers who don't cover their employees at all to cover their employees. And if their employees are not covered at all now, the employees would have to pay up to 20 percent of the premium themselves. The employer's contribution would be capped at 7.9 percent of payroll. But small businesses, which dominate rural areas, would be eligible for discounts on their guaranteed private insurance plan, which would dramatically lower in many cases the percent of payroll they would have to pay. Is this fair? I think it is. In every other country with which we compete, everybody makes a contribution directly or indirectly to the health care system. Today, everybody gets health care, but often when it's emergency care, when it's too late, and then their costs are paid by somebody else. They're either shifted back to the taxpayers or shifted onto other employers through higher insurance premiums. But by giving discounts to people who are smaller employers, we think that's a fair thing to do. How will the discounts be paid for, and how will the extra services be paid for that the Government's going to provide? By lowering the rate at which we're seeing medical inflation explode Medicare and Medicaid programs. Today the Government programs are increasing at 3 times the rate of inflation. Under our system, which would put more people on Medicare and Medicaid in the larger competitive bidding blocks with self-employed people and small businesses and others, we think we can cut the rate of increase in these costs at least to twice the rate of inflation and take the difference that we've already budgeted to pay for some of these other programs. There are no general taxes in this program. We do seek to raise the cigarette tax. And we ask the biggest companies, that can opt out of our system to provide their own health care plan-- they will get a huge drop in their premiums as a result of our system-- we ask them to make a modest contribution, trying to help pay for those that are uninsured and may need subsidies. That's how we pay for it. And we think it will work. There will also be a lot more competition in the system than there is now. That will drive costs down. But we don't take that into account in figuring out what it costs. So we think the system will not cost even as much as we say it will, once you take account of the increased competition. If you're a small business person or a self-employed person, the best thing about this program is that you'll be able to have access to a better health insurance policy at a lower price because for the first time, small business people and self-employed people will be able to have access to less costly premiums and will have the same sort of bargaining power in health care, particularly those who live in the bigger areas, that only big businesses and governments do today. Small business and individuals are at a terrible disadvantage today. So that's how the system works briefly. There are a lot of other specific questions I'm sure you'll want to ask me. I'm here, and I also brought a couple of my staff folks here who helped to work on putting this program together and especially spent a lot of time on rural health care. I personally spent one full day in the White House talking about rural health care to make sure that before we sent this plan up to Congress we would have a program that was very sensitive to the needs of rural health care, to the needs of Native Americans, to the needs of people that are underinsured as well as those that are uninsured. So, we'll try to answer your questions, but now I'd like to hear from the folks you brought here, Doctor, and to thank you very much for that. [At this point, clinic physician Alan Firestone read a list of participating community members, patients, and clinic employees. He then introduced participant Miranda Sapien.]”