[Public Papers of the Presidents of the United States: William J. Clinton (1993, Book I)]
[January 25, 1993]
[Pages 13-15]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks and an Exchange With Reporters on Health Care Reform
January 25, 1993

    I want to say good afternoon to members of the press. We have just 
finished a very lively discussion about the massive task before us in 
health care. Vice President Gore and I made a strong commitment to the 
American people during the last election that we would present to the 
United States Congress, within 100 days, a plan that would take strong 
action to control health care costs in America and to begin to provide 
for the health care needs of all Americans.
    As I traveled across the country last year, no stories moved me more 
than the health care stories. As I think all of you know, many of the 
people in our Faces of Hope luncheon last week during the Inaugural were 
people who were struggling to overcome incredible adversity occasioned 
by their health care problems. We've met elderly people choosing every 
week between medicine and food; we've met people forced to leave their 
jobs to get on public assistance to deal with children with terrific 
problems; we've met countless people who can't change their jobs because 
they or someone in their family have had health care problems.
    You will all remember, at the economic conference that we sponsored 
in Little Rock, perhaps the overwhelming concern of the business people 
there, of all sizes, was doing something about the cost and the 
availability of health care. When the Vice President and I met with the 
big three auto makers and the president of the United Auto Workers, once 
again they said, if you want to do something to help rebuild the

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auto industry, do something to control health care costs. And as Mr. 
Panetta just said again in a rather plaintive way before you came in, 
there is no way we will ever get control of the Federal budget deficit 
unless we do something about health care.
    The message is pretty simple. It's time to make sense of America's 
health care system. It's time to bring costs under control and to make 
our families and businesses secure. It's time to make good on the 
American promise that too many people have talked about for too long, 
while we have continued to spend more than 30 percent more of our income 
on health care than any other nation in the world, get less for it, and 
see 100,000 Americans a month losing their health insurance.
    As a first step in responding to the demands of literally millions 
of Americans, today I am announcing the formation of the President's 
Task Force on National Health Reform. Although the issue is complex, the 
task force's mission is simple: Build on the work of the campaign and 
the transition, listen to all parties, and prepare health care reform 
legislation to be submitted to Congress within 100 days of our taking 
office.
    This task force will be chaired by the First Lady, Hillary Rodham 
Clinton, and will include the Secretaries of Health and Human Services, 
Treasury, Defense, Veterans Affairs, Commerce, Labor, as well as the 
Director of the Office of Management and Budget and senior White House 
staff members.
    I am grateful that Hillary has agreed to chair this task force and 
not only because it means she'll be sharing some of the heat I expect to 
generate. As many of you know, while I was Governor of my State, Hillary 
chaired the Arkansas Education Standards Committee, which created public 
school accreditation standards that have since become a model for 
national reform. She served as my designee on the Southern Regional Task 
Force on Infant Mortality, was also chair of our State's rural health 
committee in 1979 and 1980, a time in which we initiated a number of 
health care reforms that benefit the people of my State to the present 
day. And on the board of the Arkansas Children's Hospital, she helped to 
establish our State's first neonatal unit.
    I think that in the coming months the American people will learn, as 
the people of our State did, that we have a First Lady of many talents, 
who most of all can bring people together around complex and difficult 
issues to hammer out consensus and get things done.
    Here in the White House, Hillary will work with my Domestic Policy 
Adviser, Carol Rasco; my Senior Policy Adviser, Ira Magaziner; and the 
head of our health care transition team, Judy Feder. I've asked all of 
them to be as inclusive as possible. And as a part of that, we are 
inviting the American public to write us here at the White House with 
their suggestions. All of them should be sent to the Task Force on 
National Health Care Reform at the White House in Washington, DC 20500.
    We will no doubt be criticized by some for undertaking something 
very, very ambitious. But as I said in my Inaugural Address, we're going 
to have to make some tough choices in order to control health care 
costs, to bring them down within inflation, and to provide health care 
for all. In order to preserve the vitality of the American private 
sector, in order to keep the American people's budget here at this 
national level from going totally bankrupt, we are going to have to make 
some tough choices. Powerful lobbies and special interests may seek to 
derail our efforts, and we may make some people angry. But we are 
determined to come up with the best possible solution.
    And in my lifetime, at least, there has never been so much consensus 
that something has to be done. We have a plan from the American Nurses 
Association, from the American Academy of Physicians, from the American 
Academy of Family Practice, from the health insurance industry itself. 
We have a plan uniting business and labor. There is an overwhelming 
knowledge that we have to move and move now. We are going to do our best 
to reform our system. We are going to do our best to meet the human 
needs of the people of this country.
    There are all kinds of problems that have to be dealt with that we 
haven't even discussed yet: access to care in inner cities and rural 
areas, coverage for little children, dealing with the AIDS crisis 
adequately, still unmet needs in the area of women's health care, the 
problem of the veterans in this country who don't have access to care, 
even as their own network goes broke. All these issues will be dealt 
with in this task force. This is going to be an unprecedented effort. 
And let me just say, in general, we're going to set up a workroom, kind 
of like the war room we had in the campaign, over

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in the Executive Office Building. And all of the departments you see 
here represented and leaders you see represented around this table will 
be represented in that room. And we are going to work constantly, day 
and night, until we have a health care plan ready to submit to the 
Congress that we believe we can pass.
    Finally, let me say I am committed to doing this in a partnership 
with the Congress. I will ask the leadership of the Congress to work 
with me on a bipartisan basis and to do whatever we can to make sure 
that as we present the plan, we have also maximized its chances of early 
passage in the Congress.
    I thank all these people for their willingness to serve and to work 
together. I hope the American people will see just how passionately I 
personally am committed to doing something about health care reform. 
We've talked about it long enough. The time has come to act, and I have 
chosen the course that I think is most likely to lead to action that 
will improve the lives of millions of Americans.
    Q. Mr. President, can you provide universal coverage without driving 
up the deficit?
    The President. I think you can do it if you control the cost of 
health care. You have to really--let me just--I don't want to get into 
one of these things that provoke a lot of cartoons about my policy wonk 
weakness, but we're at 14 percent of our income on health care now. The 
next most expensive health care system in the world is Canada's. It's at 
about 9.2 percent of income. That is a huge difference, massive. And 
yet, every other major country with which we compete provides some basic 
health care to everybody, something we don't do. So the answer to your 
question is, in my judgment, if we do this right over the next 8 years, 
you're going to see huge savings in tax dollars and even bigger savings, 
more than twice the savings, in private dollars that will free up 
hundreds of billions of dollars literally between now and the end of the 
decade to reinvest in economic growth and opportunity.
    In the short run, our tough call will be, how do you take the 
savings and phase in universal coverage, or should there be some other 
way to pay for that? We've got some short-term calls to make. But 
there's no question that in the medium term, 5 to 8 years, you're 
looking at massive savings with universal coverage, in both tax dollars 
and private sector dollars, if we do it right.
    Q. Mr. President, do you intend to pay the First Lady for her 
efforts?
    The President. No. No. I never have paid her for her public service 
efforts. I don't want to start now.
    Q. Is 100 days hard and fast, or are you willing to be flexible on 
that if it's not quite ready?
    The President. If it were 101 days I wouldn't have a heart attack, 
but I don't want to--I want it done now. I think we know what the major 
alternatives are. What we have to do now is something nobody's done, and 
that is to meld them into the best possible legislation, taking account 
of some of the problems that exist with every course.
    And let me make one acknowledgment on the front end about this. 
Legitimate objections can be raised to any course of action in this 
area. That is, there is no such thing as a perfect solution. So whatever 
course we choose to take, somebody can say, ``Well, it's not perfect for 
these reasons.'' To that, I have two answers, and I'm going to say this 
until I'm blue in the face for this entire year until we get action. 
Number one, the worst thing we can do is keep on doing what we're doing 
now, because more and more people are falling out of the system and the 
cost is becoming more and more burdensome to those who are still bearing 
it. So whatever course we take, we will preserve what is best about 
American health care, some consumer choice and the quality of care. So 
whatever problems we have, they won't be as bad as the ones we've got 
now. Number two, this is not going to be the end of the line. Whatever 
problems are there can be fixed later. But we will never, never get 
anywhere if we stand paralyzed, because there's no such thing as a 
perfect alternative.
    Q. What factors did you consider in giving this high-profile 
position to Mrs. Clinton?
    The President. Of all the people I've ever worked with in my life, 
she's better at organizing and leading people from a complex beginning 
to a certain end than anybody I've ever worked with in my life. And 
that's what I want done here.

Note: The President spoke at 2:02 p.m. in the Roosevelt Room at the 
White House at a meeting of the Health Care Working Group.