    [Public Papers of the Presidents of the United States: William J. Clinton (1993, Book II)]
    [September 21, 1993]
    [Pages 1546-1548]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Interview With Tabitha Soren of MTV
    September 21, 1993

    National Service Program

        Q. Obviously, this is a huge success, getting national service
    passed so quickly. One of the goals of national service is to have kids
    have a multicultural experience. But yet, in the pilot program, Summer
    of Service, within a couple of days, the black kids were in black
    caucuses, there were Hispanic caucuses and gang groups. How are you
    going to make sure during national service, when it gets going, that
    they serve side by side?
        The President. Well, those are the kinds of projects we'll favor.
    But I think if you look all across the world today, there's always going
    to be some ethnic cohesion. People are going to pull together, talk
    together, feel a greater initial comfort level. That's just true
    worldwide.
        But what we also saw in the Summer of Service is that people really
    were working together across racial and ethnic groups to an extent
    greater than they had before. I think what we have to do is let people
    be themselves but favor those programs that have multiracial makeup, and
    we will do that.

    Health Care Reform

        Q. Okay. As far as health care is concerned, isn't it true that
    because your health care plan is community based that many young people,
    because they're young and healthy and they get discounts on insurance
    now, may end up paying more with your plan?
        The President. Yes, in the first year, those who have insurance may
    pay more, depending on whether they work for small or big businesses.
    Very young people who are basically in plans that have big businesses
    insuring them may pay some more in the first year. Even they, however,
    within 5 years should be paying less, because we slow the rate of growth
    in these premiums.
        Young people who work for small businesses probably won't pay more
    because they're paying too much already, all small businesses. And
    they'll be in great big groups. But I would also point out that an awful
    lot of young people who don't have health insurance--and some young
    people do have access; some young people do get sick; some young people
    even have serious illnesses--so it will help them. And I would say,
    also, to all these young people, if we change it in this way so that
    we're all rated as a community, what it means is, is that some family
    gets a sick child, it means that they won't lose their health insurance
    if they change jobs, or they won't be locked into the job they're in.
    And all of the young people--I can certify because I was one once--will
    someday be middle-aged, will someday be older, and they will then
    benefit from that.
        So the fair thing for America to do is to do what Hawaii has already
    done, what a couple of other States have already done, and what other
    nations do, which is to have the nation in big pools of people so that
    we can keep overall costs down.

    Abortion

        Q. In terms of the health care plan, last time I spoke with you, you
    said you wanted abortion to be covered under the health care plan. And
    now I understand the language says ``medically necessary, pregnancy-
    related services'' are covered.
        The President. That's what it says----
        Q. Does that mean that anyone who wants an abortion can get one and
    have it covered under the plan?
        The President. It means that it will be just like it is today in
    most private plans. Most private plans absolutely cover it. But no
    insurance

    [[Page 1547]]

    plan specifically mentioned any surgical procedure. The surest way to
    eliminate any kind of abortion coverage from this act would be to
    mention it specifically, because no other surgical procedure, none, are
    mentioned specifically. And all private insurance plans which cover
    abortion may cover pregnancy-related services, and the doctor and the
    woman make the decision. So what we propose to do is to put low-income
    people who are covered by the Government today into these big pools with
    people who are privately insured, give everybody a private plan.
        Q. I'm sorry, I don't--is it more than the Hyde amendment in terms
    of----
        The President. Oh, yes, absolutely.
        Q. How so? I don't----
        The President. Because the Hyde amendment prohibits any public
    funding for abortions, except when the life of the mother is at risk.
        Q. But I thought the Hyde amendment was self-certifying now, and you
    could say, I have a heart condition, therefore----
        The President. Well, I don't know about that, but you have to prove
    that your life is at risk.
        Q. Or rape and incest.
        The President. Not in the Hyde amendment.
        Q. No? Okay.
        The President. No. We tried to expand it and broaden it, but this
    would simply put people who get Government funds into big private
    insurance pools, and they would then be treated like other people in
    private insurance pools. It's just what we did for the public employees
    this year; we got rid of the Hyde amendment for public employees this
    year.
        Q. You couldn't have just put ``abortion'' instead of ``pregnancy-
    related''?
        The President. Absolutely not. And it would have been wrong to do
    that. Then people would say, ``Well, why don't you put brain surgery in
    there; why don't you put appendectomies in there; why don't you put
    other surgeries in there?'' And that would have sparked a whole
    reaction. They would say, ``Why are we giving special preference to one
    kind of procedure over all others?'' This will guarantee that most plans
    will cover abortions.
        Now, there will be religious exemptions, which there are today.
    Catholic churches or other religious groups that have health plans don't
    have to cover it; doctors who have religious--don't have to do it. But
    if a doctor and a woman decide that that is an appropriate pregnancy-
    related service under this plan, then it can be provided.

    Health Care Cost Estimates

        Q. In terms of paying for universal health care, why are you trying
    to sugar-coat it? Why not just give us the bitter medicine of how much
    it's going to cost us in taxes?
        The President. I'm not trying to sugar-coat it. I have worked harder
    to get better cost estimates on this than anybody ever has. Moynihan--in
    all respect to Senator Moynihan, he's a very brilliant man, but he and
    his committee staff have not done anything like the work that I've done
    on this. Now, they may not want to pass Medicare cuts; they should say
    that. It doesn't mean the numbers aren't right. We have had----
        Q. ----some people say----
        The President. No. We have had four different Government Agencies,
    for the first time, working together to verify these numbers. We have
    had outside actuaries from people who work for private business working
    to verify these numbers. It may be difficult to pass because the
    Congress will not want to make the administrative changes necessary to
    lower the rate of increase. But I want to tell--first of all, there are
    no Medicaid cuts in this. The inflation rate in this country today is
    about 3 percent. Medicaid's going up this year at 16 percent. We're
    talking about, over an 8-year period, bringing down the rate of
    inflation in health care costs to the rate of inflation in the economy
    plus the number of people who are increased into the program. That's all
    we're talking about doing.
        For the next 5 years, health care costs will still go up more than
    prices as a whole in this economy. I don't think that is fantasyland, if
    you have a systematic change. Other countries do it. The Mayo Clinic,
    which is normally thought of as having some of the finest care in the
    world, is now charging less for many basic services than an awful lot of
    ordinary health care plans all across America today because they manage
    their business better.
        So it is not fantasy to say that the numbers are right and they can
    be achieved. Will it be politically difficult to do? You bet. Why?
    Because there are a lot of people who make a lot of money out of the
    inefficiencies of the system today. And because there are a lot of
    people who honestly don't believe you can ever

    [[Page 1548]]

    do more with less. But I do, and I think there's a lot of evidence of
    that.
        So, Senator Moynihan is right, it's going to be tough to pass. I
    don't think that the numbers are wrong. And let me also say something
    nobody else has noticed. There are 85 Members of the House of
    Representatives who want the Government to basically eliminate the
    private health insurance companies, get out of it altogether, have a
    huge tax increase to pay for health care but eliminate the premiums.
    They propose bigger cuts in Medicare and Medicaid than I do. So I just
    think that the numbers are entirely defensible, and I think we'll be
    able to persuade the Congress.

    Entertainment at Signing Ceremony

        Q. I forgot to ask you about--why Soul Asylum?
        The President. They were supportive in the campaign, and they made
    that wonderful song about runaway children, which had a big impact on
    young people throughout the country. We just thought they'd be a good
    group to be here.
        Q. Does Chelsea like them?
        The President. Yes. I do, too. I heard them play last night, you
    know. So I sort of got caught up on my music last night, listening to
    them practice.
        Q. Have people that looked like that ever walked into your Oval
    Office before?
        The President. Oh, sure. [Laughter] This is everybody's Oval Office.
    I'm just a tenant here.
        Q. I see.
        The President. Thanks.
        Q. Most people here tend to bathe, however. [Laughter] Thanks.
        The President. Thanks. Bye.

    Note: The interview began at 12:02 p.m. in the Colonnade at the White
    House. The band Soul Asylum played at the beginning of the signing
    ceremony for the National and Community Service Trust Act of 1993. A
    tape was not available for verification of the content of this
    interview.