    [Public Papers of the Presidents of the United States: William J. Clinton (1993, Book I)]
    [May 5, 1993]
    [Pages 567-569]
    [From the U.S. Government Publishing Office www.gpo.gov]

    [[Page 567]]

    Remarks on the Observance of National Nurses Week and an Exchange With
    Reporters
    May 5, 1993

        The President. Thank you very much, Ginny, for that wonderful
    statement and the introduction. And thank you, Secretary Shalala, for
    everything you said. I noticed a few groans in the audience when you
    pointed out that Dorothea Dix worked for nothing. I don't think she was
    suggesting that you do that, I think she was volunteering to do that,
    don't you think? [Laughter]
        I want to say, you know, I knew nurses were miracle workers, having
    been raised by one. But I don't see how you staved off the rain today.
    When I first heard 100 nurses were going to be here I thought to myself,
    what else can I do? I've given up junk food. I run every day. What more
    do you want of me? [Laughter] I'm doing my part.
        I want to say a special word of acknowledgement, too, to the nurses
    who are in this audience who work here at the White House, who care for
    me and my family and are available to the other people who work here.
    They do a wonderful job, and I'm very grateful to them. And they're here
    and there and around, and I thank them for their presence here.
        I'd also like to pay a special word of tribute to your president,
    Ginny Trotter Betts, for hanging it out there with us in the election
    and bringing the support for the American Nurses Association and also
    for being such a forceful advocate of sweeping reforms in our health
    care system. Hillary and I very much appreciate the work that she and
    the Nurses Association have done. And I know that she's also an old
    friend of Al and Tipper Gore's, and they're grateful, too, for her
    contributions.
        I'd also like to recognize some of the other people who are here
    today, including a remarkable nurse whose presence in the Congress is a
    symbol of your political strength, Congresswoman Eddie Bernice Johnson
    from Dallas and my dear friend. She's really a tribute to the practice
    of good health. I've known her for 20 years, and I look much older, and
    she looks younger than she did the first time we met.
        I also want to thank all the nurses who have advised our Health Care
    Reform Task Force and brought such a valuable perspective to that
    effort. You've really made a difference, and we're grateful to you.
        We're here today to mark the beginning of National Nurses Week, a
    time for our country to recognize the services that you and your
    colleagues provide 24 hours a day, 7 days a week, 365 days a year. From
    inner city hospitals to rural clinics, from the Red Cross to the armed
    services, America's nurses always answer the call.
        Today we're reminded that our Nation's 1.8 million working nurses
    are the backbone of a health care system, the largest single group of
    health care providers in America, and I might add, a group that will
    have to do more and should do more in primary and preventive care if
    we're going to bring the cost of medical care down.
        You know better than anyone else what is wrong with this system. You
    see all the people who show up at the emergency room to get the most
    expensive care too late because they didn't have a basic primary and
    preventive health care package. You see the enormous burden of paperwork
    squandering more and more hours of nurses and doctors, requiring more
    and more precious health care dollars to be diverted to clerical
    expenses instead of to investing in the health of our people. Every day
    you see these kinds of problems as the Nation continues to wait for
    action on a health care front. I'm here today on this beginning of your
    week to reaffirm to you my commitment that now is the time to do
    something about health care and to do it right.
        One of the most challenging things we have to do in this city at
    this time is to break a mindset that we have one problem at a time, and
    we'll get on it, and we'll only think about that. I believe that this
    country has at least three huge problems that relate one to the other.
    One is, there are too many people who are unemployed and too many people
    who are working harder with no gains in their incomes. And it's been
    that way for a long, long time. Two is, the cost of health care is
    exploding at an unacceptable rate, and yet, too few people have
    coverage, or their coverage is too limited.

    [[Page 568]]

    Third is, we're absolutely being consumed by a massive national debt and
    a growing deficit. And these things are all related one to the other.
        Now, people say to me, ``Well, we just do one thing at a time.''
    Well, look back over time where that's gotten us. People just say,
    ``Well, we ought to just spend money and give it to people, and maybe
    that will work.'' That hasn't worked. Then for 12 years we heard the
    worst thing in the world is taxes; we'll just cut taxes, especially on
    wealthy people, and that will make everything wonderful. Well, that
    hasn't worked out very well either. So the guy said to me yesterday, ``I
    know a bunch of people who got tax cuts last year, because they used to
    be making $40,000 a year, and now they're making $10,000. They all got a
    tax cut.''
        And what I say to you is that we don't want to just keep trying to
    give people things in a system that is broken. You can't give people
    Government money. You can't give people tax cuts if the system is
    broken. What we have to do is to attack all these problems at once and
    not keep giving people things but give them the means to take care of
    themselves and to create lives that are productive and good and strong
    for themselves and their families, their children. That's what we have
    to do.
        That's why, yes, we have to reduce spending and increase taxes,
    mostly on wealthy people who got their taxes cut in the 1980's, to bring
    the deficit down. But we also have to invest carefully in programs that
    will create jobs and raise incomes, new technologies for the 21st
    century, and the kind of education and training that will give people
    work. If everybody in this country who wanted a good job had one, we
    wouldn't have half the problems we've got.
        And then the third thing we have to do is to attack the health care
    crisis, because if we don't we will never get the Government deficit
    under control. We will never balance this budget, and more importantly,
    we will never provide the security that most families need and deserve
    in a rapidly changing and increasingly insecure world.
        There are millions of Americans today who cannot change jobs,
    because somebody in their family has been sick. There are millions of
    others who have no health insurance. There are millions of others who
    have some health insurance but very little, because they work for small
    businesses who cannot afford a basic package of health care because of
    the insurance system that we have in this country. There are untold
    billions of dollars being spent that should not be spent by the people
    who pay the full price and more for health care because they have to pay
    for somebody else's health care who's not covered when it's too late and
    too expensive or because they're paying an unbelievable bureaucratic
    burden for the paperwork burdens of this system.
        So I say to you, these are false choices. People cannot say to us
    you must choose between having a healthy country, an employed country, a
    country bringing its deficit down. We must do all three of those things
    because that's the only way we can--instead of trying to give people
    something that's not there to give, empower people to seize control of
    their destiny and bring this country back. That's what we've got to do.
        There will always be defenders of the status quo. It is easy to say,
    ``Well, let's just write somebody a check.'' Even easier to say, ``Taxes
    are evil. They're out to get you.''
        Right now, you know as well as I do, the lobbyists are lining up
    strategizing about how they're going to pick this health care proposal
    to death. But I'll tell you something, the worst thing we could do, in
    my opinion, after 400-and-something people have worked their hearts out
    for months and months and months, is to take a dive on the health care
    thing, to turn away from it, to deal with the inconveniences of it.
        People say, ``Well, it may cost somebody else some money.'' Let me
    tell you something, all those people who don't have health insurance
    today, they're being paid for by everybody else who's paying the bill.
    What about fairness to them? Who's thinking about them? I'll tell you
    something else, we've been reducing defense spending quite steeply and
    about all we can for the last 5 years. And all the savings we hope to
    have in the peace dividend have been exploded away by rising health care
    costs and interest payments on this deficit.
        So it is all related. You've got to have a job strategy. You've got
    to have a deficit reduction strategy. And you've got to have a health
    care strategy. Because if you don't have a health care strategy, the
    American people can't stay well, the American economy can't get well,
    and you cannot reduce the deficit to zero in this decade. Those things
    must be done together. We cannot be forced to make that false choice.
        And so I ask you--you represent 1.8 million

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    people who know the heartache, the heartbreak, and the problems of this
    system, and who also know that that which is right about our system
    makes it the best in the world for those who can access it. We are
    determined to come forward to the Congress with a plan that keeps the
    best of America's health care system, keeps the private provider system,
    keeps a lot of choice in the system, but deals with the awful problems
    that you know better than anybody. And I ask you to commit today not to
    let the special interests tell us that we can't deal with health care,
    not to let the special interests spook and scare the Members of Congress
    away from doing what is our manifest duty to the people of this country
    who are working hard and playing by the rules and falling further
    behind, and instead, to give us all a chance to do the work of a
    generation.
        And that is really what's being given us in this time, in this
    Congress: the opportunity to do something that comes along once in a
    generation to change the whole course of America's future. By dealing
    with these things together, providing security and quality and control
    of cost in this health care system, bringing this deficit down and
    pursuing a long-term strategy for a high-wage, high-growth, low-
    unemployment economy. And they're all together. If you'll help me take
    that message to the Congress, this will be one of the best years the
    American people ever had.
        Thank you very much.

    Bosnia

        Q. Have you heard anything from Bosnia, sir?
        The President. No.
        Q. How quickly are you prepared to move once you do?
        The President. Well, let's wait and see what they do first.
        Q. Mr. President, there is word that the parliament has agreed to
    the peace agreement. Mr. President, there is----
        The President. I hope they--I'm waiting for a call from Secretary
    Christopher right now. Let me go take the call, and I'll give you----
        Q. And then what, sir?

    Child Immunization

        Q. Sir, what happened to your immunization program on the Hill? Why
    did you have to dog back on that?
        The President. Well, Secretary Shalala says we're going to get a
    program that can immunize a lot more people. We did the best we could
    with the money we had. You know, a lot of these things are going to be a
    function of how much money we have. But I feel pretty good about it. I
    talked to her about it. She feels good about it. We think it's a big
    advance over where we are.
        Thank you.

    Note: The President spoke at 4:27 p.m. in the Rose Garden at the White
    House. A portion of the remarks could not be verified because the tape
    was incomplete.