[Public Papers of the Presidents of the United States: William J. Clinton (1994, Book I)]
[February 8, 1994]
[Pages 202-208]
[From the U.S. Government Publishing Office www.gpo.gov]



[[Page 202]]


Remarks to General Motors Employees in Shreveport, Louisiana
February 8, 1994

    The President. Thank you very much. Jack, thank you for the 
introduction, even from such a distance. You look good on this movie 
screen, although it's cut up in 16 parts. It looks like a lot of the 
bills I have to deal with in Congress. [Laughter] But you still look 
like a whole person. I want to thank Jack Smith and my good friend Owen 
Bieber. I want to thank Guy Briggs and Steve Yokich for being here with 
me today. And I want to thank all of you for welcoming me to this plant 
and to the world of General Motors.
    I was delighted that people all over the country will be able to 
watch this in other plants. I want to say a special word of thanks to 
the people at the GM plant in Baltimore, Maryland. I was supposed to 
visit them last week, and I lost my voice after the State of the Union. 
So if I had come, they might have loved it. I couldn't have said a word, 
I just would have had to listen to them. [Laughter] But anyway, I 
didn't. I also want to thank the Grambling band for the music today. 
That was great, and I thank you. What? What high school?
    Audience members. Airline.
    The President. Airline High School.
    I'd also like to say that I've been trying to think of a diplomatic 
way to ask for one of these pickups behind me. [Laughter] I owned, when 
I was a younger man and had a life, I owned an El Camino pickup in the 
seventies. It was a real sort of southern deal. I had Astroturf in the 
back. [Laughter] You don't want to know why, but I did. And I drove it 
literally until the blocks broke. I drove it until it just wouldn't go 
anymore. And you know, when I retire maybe I can have another pickup.
    I want to say a special word of thanks for the presence here with me 
of some people that are going to have to help make these health care 
decisions and other decisions we're making this year: Senator Breaux and 
Senator Johnston from Louisiana, Congressman Jimmy Hayes, Congressman 
Cleo Fields, Congressman Bill Jefferson, and Mrs. Johnette McCrery, the 
wife of Congressman McCrery; they're all here. And I also want to thank 
Lieutenant Governor Melinda Schwegmann for joining us today. All of them 
have come to be with me, and I thank them for that.
    I want to begin by talking about a few things besides health care 
just real quickly. I listened to what was said up here on this platform 
before I got here, the way that people talked about the teamwork that 
you have here at this plant, the product that you produce, the fact that 
you're going to be able to sell them not only in America but beyond 
America's borders.
    You know, when I was the Governor of your neighboring State to the 
north, that's what I thought public life was about. I thought my job was 
to get people together and to get things done. I thought it was pretty 
simple, and I was supposed to get people together and get things done. 
And I ran for President because I looked at Washington and I saw 12 
years in which we were coming apart when we ought to be coming together, 
when I didn't think anything was getting done, when we quadrupled the 
deficit, had low job growth, nobody's income was going up, and the 
middle class was getting socked. That's what I thought was going on, and 
I still believe that was what was going on. And I ran for President 
because I wanted to try to help bring the economy back, bring the 
country together, and make the Government work for ordinary people 
again, because I have always believed that if you give ordinary 
Americans the ability to succeed, they'll do extraordinary things. I 
don't think this is very complicated. I think if you give people a fair 
shot at the American dream, they will do extraordinary things.
    Thanks to the UAW and others, we made a good beginning on that. Last 
year we passed the family and medical leave law, so that workers all 
over America could be successful workers and good parents. They could 
take a little time off if a baby was born or a parent was sick without 
losing their job. In the economic plan, we rewrote the student loan bill 
so that the children of working class people can borrow money to go to 
college at lower interest rates and have longer repayment terms tied to 
the jobs they have, so they won't ever be discouraged from going to 
college for fear they won't be able to repay their loans. And we passed

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the national service bill to give 100,000 young people, year after next, 
the chance to pay off their college education by working for their 
communities to solve problems here at home, things that help ordinary 
people to deal with their lives.
    We passed a bill that begins to reduce the deficit. Next year the 
deficit is going to be 40 percent less than it was projected to be when 
I came into office. I heard all this talk from others about it; we did 
something about it. We did it by cutting spending and by asking only the 
top 1.2 percent of American earners to pay an increase in their income 
tax to bring the debt down. But look what we got for it: low interest 
rates, low inflation, high investment, car sales up, home sales up. 
Millions of Americans, including people in this room, I bet, have 
refinanced their homes in the last year. We had 1.9 million new jobs, 90 
percent of them in the private sector, not in the government, which had 
provided a lot of the job growth in the eighties--State and local 
government. We have begun to turn this thing around. Now, I know a lot 
of people still haven't felt it, but we are moving in the right 
direction basically by putting the people of this country first.
    Yesterday I offered another budget. It eliminates over 100 
Government programs entirely, cuts over 300 Government programs so we 
can save the money to bring the deficit down and to spend more on the 
things that count.
    What are we going to spend more on? Redoing the unemployment system 
to make it a reemployment system, so people can be trained for the jobs 
of the 21st century. We're going to spend more helping States set up 
systems to move young people who don't go to college into jobs with 1 or 
2 years of further training, so they will be well-trained and they can 
get good jobs, not dead-end jobs. That's worth more money.
    We're going to spend more to help our schools meet world-class 
standards and support local reforms, to meet the standards that will 
guarantee that when young people get out of high school they'll actually 
know enough to learn the skills they need to know to work in places like 
this. These are things that it is worth spending some more money on.
    This year we're also going to move forward on a crime bill. Most 
Americans, I think, have finally become aroused at the level of violence 
in this country, and they're ready to do something about it. Last year, 
after 7 years of fooling around, we finally passed the Brady bill, which 
at least gives us a chance to check into the criminal records of people 
who seek to buy guns.
    Let me tell you what this crime bill does. This crime bill will say, 
number one, if you commit three violent crimes, you shouldn't be paroled 
ever; ``three strikes and you're out''. Number two, this crime bill 
acknowledges the fact that we actually know how to reduce the crime 
rate. I came from Houston yesterday. The crime rate in Houston today is 
22 percent lower than it was a year and a half ago; the murder rate is 
27 percent lower than it was a year and a half ago. You know why? They 
put another 655 police officers on the street, in the high crime areas, 
working with the law-abiding citizens who live there. They know their 
neighbors; they know the kids. They help get the kids out of trouble; 
they help get them out of gangs and into good, productive activities. 
And they are working not only to catch criminals but to lower the crime 
rate. This bill would put another 100,000 police officers on the street, 
and I hope you will support it.
    The last thing we're going to do in addition to health care this 
year, I hope, is to continue the work of reforming the welfare system. 
There are millions of Americans trapped in welfare who want to go to 
work, who want to be good parents and good workers. Most of them are 
young women with little children. Most of them have almost no education. 
Most of them are part of a 30-year decline in the American family and in 
the communities they live in and the loss of jobs. You know it as well 
as I do. And many of them live and raise these children in neighborhoods 
where, because the families are weak, the communities are weak, and 
there aren't any jobs, gangs and guns and drugs and violence have moved 
into the vacuum. We have got to help them turn their lives around.
    We took a big step this year. This April 15th, when the taxes come 
due, 15 million working Americans with children, who are hovering right 
around the poverty line even though they work full-time, will get a tax 
cut so that they will never be encouraged to choose welfare over work. 
They will choose work over welfare. The welfare reform bill will say: 
We're going to give you education and training and child support and 
health care. But after 2 years, if you don't have a job, you've got to 
go to work once you

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get these services. You do it, and others should, too.
    But so many of these things we want to do--bringing back the 
economy, bringing down the deficit, reforming the health care system--
require reforming the welfare system, require addressing the health care 
problem. And I want to explain to you how all these things are related.
    First of all, you know you've got great health care benefits and 
good security, but do you know most working people in the last several 
years who have good health care benefits have had to give up wages to 
keep the health care benefits? And one reason is that General Motors and 
people like you all over the country are paying too much for your health 
care because other people don't pay anything for their health care. So 
when they get it, they get it when it's too late, too expensive, at the 
emergency room. They pass the cost on to you. You know that.
    One reason people don't leave welfare is, if you're really poor, 
your children get health care through the Medicaid program. If you take 
work at an entry-level job with no health care, you've got to stick it 
to your kids. You've got to give up the health care to go to work. So 
you've got this crazy system in America where you've got working people 
paying income taxes who don't have health care for their children, and 
they're paying income taxes to pay for health care for people who don't 
work. It's a crazy system.
    We're working to bring this deficit down. You've got a base here in 
this area. I'm telling you, we have cut defense a lot, but we can't cut 
defense any more and take care of this country. We are cutting it a lot. 
We shouldn't cut it any more. We have frozen domestic spending, which 
means I have to cut things in order to increase the job training 
programs I talked to you about. The only thing that is increasing in 
this budget is the cost of health care.
    Why is it going up so much? Because we don't have a system in 
America in which everybody is covered, in which people get primary and 
preventive health care, and in which there is some limit on how much the 
insurance companies can do to decide who's got insurance and who 
doesn't. It's a terrible, terrible problem.
    So all of these things we want to do. Seventy percent of the small 
businesses--you will hear a lot of talk about how my health care plan is 
unfair to small business--70 percent of the small businesses in this 
country do offer health care to their employees. And you know what? 
Their premiums are 35 to 40 percent higher than people in big business 
and the Government pay because they are so small. And more of them every 
month either go bankrupt or have to give up covering their employees. 
One hundred thousand people a month lose their health insurance for 
good. Thirty-nine million Americans every month now have no health care. 
And sometime during every year, 58 million Americans, out of a country 
of 250 million, 58 million have no health care.
    So all of these things are related. And I say to you, it is time for 
us to listen to the enlightened business leaders like Jack Smith and the 
enlightened labor leaders like Owen Bieber who say that the time has 
come for everybody to take some responsibility for health care. Everyone 
should have health care security that can never be taken away, so we can 
control the costs, people pay their fair share, and every family and 
every child in this country has got health care.
    Let me tell you, I'm going to do something today that violates every 
political poll you ever take. Politicians in both parties have been 
taking polls for years. And you know what one thing we always find out 
when we take a poll is that most Americans don't give a riff what they 
are doing in other countries. They don't want to hear what's going on in 
other countries; they don't believe it. But I think General Motors does, 
because you have to compete in a global economy. It matters to you 
whether Japan has a fair trade policy. It matters to you how much health 
care goes in every car in Germany or Japan, doesn't it? So you know we 
have to think about this.
    Now, let me tell you something. In America, we spent 14.5 percent of 
our income on health care. In Canada they spend 10 percent. In Germany 
and Japan, they spend under 9. There is no evidence that we get better 
health outcomes. Now, I think all of us would say, if all that money was 
going to the health care of our families and our children, to have 
access to our doctors and our health care system, we would all gladly 
pay it, if that's what it was going to. But it isn't.
    We're paying more than anybody else, and most of the difference is 
going to pay for paperwork, bureaucracy, and rulemaking, because this

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is the only country in the world with an advanced economy that doesn't 
provide some health care for everybody and permits itself to spend 
another dime on the dollar for paperwork, bureaucracy, and rulemaking; 
because we've got 1,500 separate health insurance companies writing 
thousands and thousands of different policies, charging old people more 
than young people, and saying who cannot get health insurance. We ought 
to stop it.
    Let me tell you something. If you work here and you've got a kid 
with asthma, you've still got a health insurance policy because your 
company gives you a health insurance policy that doesn't eliminate you 
for what's called preexisting conditions. But I got a letter from 
Jeanette Windham of Shreveport, and I had her come to the airport to 
meet me last night, a woman who works for an insurance company, who had 
a brain aneurism. Her doctor said she was totally healed, she was just 
fine, everything was all right, and she works for a company that 
allegedly has no preexisting conditions, and they still won't give her 
health insurance. There are people like that all over the country.
    What if you had a dream of starting a small business and you were 
willing to risk giving up working here with all the security that it 
has? If you had a sick kid and you did that, you couldn't insure your 
family. There are millions of Americans today--listen to this--there are 
81 million Americans, in a country of 250 million, who either have the 
worker or somebody in the family has once been sick. And as a result of 
that, they're either paying higher insurance premiums, or they don't 
have health insurance, or they can never change the job they have. They 
can't hope to move up because if they move up, they'll lose their health 
insurance. I'm telling you, we can do better than that. All these other 
countries we compete with, that put less money in health care in a car 
than we have to, are still solving those problems. I'm tired of hearing 
we can't solve those problems. I believe we can, and the time has come 
to do it.
    On Monday I was in Houston, and I went to a party of children with 
cancer and their parents, little kids fighting for their lives. And I 
looked out there in that sea of parents, so grateful to be in Houston, 
which is the largest medical center in America, having access to 
wonderful care. But a bunch of them were scared to death because they 
were part of the three out of four of American families that have 
lifetime limits on their policies. You don't have that, thank goodness. 
But what if you did? They're sitting there thinking, ``My kid's got care 
today, but what's going to happen when I hit the lifetime limits? Will I 
go bankrupt? Will something happen to the care?'' Other countries don't 
do that. I think we can do better.
    I could give you so many examples of this. And most of the 
propaganda you're going to hear--I had a doctor in my office Saturday 
who said to me, he said, ``Mr. President,'' he said, ``I'm a Republican. 
I have organized hundreds of doctors in a group to practice medicine. I 
have made more money than I ever dreamed. And I showed up here to tell 
you, I want to try to pass health care reform. I hear all these attacks 
on your program. Why, the people who are saying it don't have any idea 
what they're talking about, what medicine's really like out there in 
America. Most workers don't have a choice of doctors anymore.''
    You know, you've got three choices in your health care plan. My plan 
gives people three choices. You know, more than half the Americans don't 
have those choices anymore in their health care plan. I'm telling you, 
folks, when we go back to work in the Congress, I want you to help us 
pass this health care reform plan. I want you to urge the Members of 
Congress to debate all the tough issues. There are some hard questions, 
and I'll tell you what they are in a minute. There are some hard 
questions. But we have got to stop making excuses for ourselves and why 
we can't do it. If we don't do something to control health care costs, 
it's going to cost every American working family another $600 a year by 
the end of this decade. We cannot continue to do what we are doing.
    I got a letter from a woman from Louisiana that came to see me 
yesterday at the airport whose husband came down with lung cancer, and 
they wouldn't even treat him because he didn't have health insurance. 
They wouldn't even treat him. And he died in 5 weeks. How would you feel 
if that was one of your family? How would you feel?
    You know, I got a letter from a man from Shreveport who came out to 
meet me named Don Marks. He's a sales representative. He pays for his 
own health insurance. His wife got sick. His deductible went from $250 
to $2,500, $2,500. He had a $120 a month drug bill that wasn't covered.

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    Other countries cover prescription medicine for everybody. And if 
you have it, you know that a lot of people stay out of the hospital and 
cost the system less if they can get proper medication, especially true 
for older people. If our seniors had access to properly prescribed 
prescription drugs, their hospital bills would be lower. It would cost 
you less in maintaining the health system. But people don't want to put 
up the up-front cost because the way it works now, it doesn't come out 
of insurance premiums. The Government picks up the tab, or somebody else 
picks up the tab. It gets bumped along. We can do better than this. We 
can do better than this.
    You know, here I am at this plant, a world-class plant, the world's 
biggest company. Do you believe for a minute that you would be as 
productive as you are if you had a lousy health care policy and you had 
to worry about your kids every day on the job?
    Audience members. No-o-o!
    The President. You wouldn't, would you? Yes, it costs some money, 
but you wouldn't do as good a job as you do.
    All over America, we are paying today for the fact that we can't 
figure out what every other advanced country's figured out how to do: 
how to provide basic health care security that can never be taken away. 
And I think it's time to do it.
    Our plan does it by building on what works now. One of the things 
that you'll be hearing about--I get tickled; I read these ads of these 
folks that are so desperate to keep the system we have now, and they 
say, ``Oh, the President wants to have the Government take over the 
health care system.'' It isn't true. What the President wants to do is 
to keep the system we've got now and give it to everybody: guaranteed 
private health insurance, private doctors, private providers, a private 
system. That's what I want, and that's what our bill would require. Our 
approach guarantees people the right to choose their health care plan. 
Like I said, you've got three choices in your plan. That's what our plan 
does. Most American workers don't have three choices anymore, and you 
know it as well as I do.
    So what is this big myth that we're doing? And a lot of the plans 
competing with us would drive workers down to one choice, the least 
expensive HMO. That may be a good plan. A lot of these HMO's give great 
care at low cost, but one of the reasons is they have some competition, 
they have an incentive to do it. So if you have a choice, you will be 
more likely to choose that and have good quality health care. Our 
approach protects the early retirees and finds a way to help companies 
pay for it to spread the cost of that, to make General Motors, our steel 
companies, a lot of our other companies far more competitive.
    Our approach reinvests savings from the Medicare program into drug 
benefits and long-term care benefits for elderly people. It doesn't just 
take them away the way some others do. And our approach completely 
outlaws insurance company discrimination. Others say, ``Well, we make 
insurance companies cover everybody.'' Yes, well, you can get insurance 
now; we have universal access now if you've got $10,000 or $15,000. 
There's universal access to this truck, but only people with the money 
can pay it, right? There's universal access to the truck right now, 
right? So don't fall for all this rhetoric about universal access. 
Everybody in America has access to this truck right here. But they can't 
make it.
    Our approach says it is wrong to charge old people more than young 
people for health care just because they're older. Look, the number of 
young people is going down; the number of old people is going up. People 
are going to want to work longer. The fastest growing group of Americans 
are people over 80--[inaudible]. We cannot afford to set up a system 
where people can't afford to hire older workers. We can't do it. We need 
it for America's productivity. We have got to have that.
    So this is really not about whether we're going to put the 
Government in charge of health care. The Government is involved in 
health care. That's what the Medicare program is all about, and most of 
you would hang me from the highest tree if you thought we were going to 
repeal it, wouldn't you? I mean, right? It's not about that. The 
Government is involved in health care. Our plan does not put the 
Government in control of health care. What it does is to reduce the 
control of the insurance companies and give more influence to workers 
and businesses. That's what our plan does. And that's what I think we 
ought to do.
    Now, let's face facts. There are some tough choices. If you have 39 
million people without any health insurance and you're going to require 
people who are working who have no health

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insurance and their businesses to pay, well, they're going to be paying 
something they weren't paying. And then if you have to find a way to 
cover the people who aren't working but who aren't poor enough to be on 
Medicaid, we have to find some money for that. So it's not easy.
    How do we propose to pay for it? We believe the fairest way is to 
ask every employer and every employee without health insurance to make 
some contribution. We think that's fair. We know that small businesses 
have a tougher time, and there are limits on how much small businesses 
can pay under our plan. We understand that. That is the most 
controversial issue. But I don't see how you can possibly cover everyone 
unless you are going to tax people who are already paying too much for 
their health care to pay for people who ought to be paying something, or 
unless you require them to cover themselves.
    Now, I think that's the fairest way to do it. And if you don't cover 
everybody--you heard Mr. Smith say it--if you don't find a way to cover 
everybody, General Motors will repeatedly be paying too much because the 
people that don't have health insurance will get health care when it's 
too late and too expensive. They'll show up at the emergency room, 
they'll show up at the hospital, and then the cost will be passed on to 
you. And meanwhile, untold misery will be reaped in the lives of people 
all across the country. But now, that is a tough issue. And that is the 
toughest issue.
    What should the benefits be? Our bill prescribes the benefits. And 
they are similar to the ones you have. We emphasize preventive care so 
people can get annual checkups and things like that. Other approaches 
say, well, let somebody else decide the benefits. I don't believe the 
only choice in this country for workers who have no health care should 
be the least expensive HMO because if that's true, they won't have the 
competition necessary to maintain high-quality care. So I think we 
should have choices in the benefit package.
    I don't think that we can do it without limiting the payroll 
contributions that some small businesses have to pay and that others 
should pay. And I don't believe we can do it without giving small 
business the power to band together so they can buy insurance on terms 
as good as General Motors or the Federal Government can buy it. They've 
got a legitimate gripe there. And we're trying to address that.
    But what I want you to know most of all is, most of what you hear in 
this debate is about a world that doesn't exist. They say, ``Oh, Bill 
Clinton is going to take choices away.'' That's not true. We're going to 
guarantee more choices to most workers. You've got three choices today. 
Most workers don't, and you know it. So don't let people put that kind 
of smoke out there. They are saying we are getting the Government into 
health care. That's not true. We're moving the insurance companies out 
of the driver's seat and letting the people and the businesses have more 
influence. And that's what we ought to do.
    Look, I know there's a lot of money in this. And there are a lot of 
good people who work for those companies. But you just have to ask 
yourself whether we can afford to continue to spend 40 percent more than 
everybody else and not cover everybody. You're going to hear how, well, 
inflation in health care costs has gone way down because of the 
competition. It has; it goes down every time there's a serious threat to 
reform the health care system. And you let them kill my bill and you 
watch what happens to medical inflation for the rest of this century. It 
will go right back up again, just like it has every time in the last 50 
years as soon as the interest groups could kill a serious plan at health 
care reform.
    Folks, we have involved hundreds and hundreds and hundreds of 
doctors and nurses and business people and even folks from the insurance 
industry in trying to put this plan together. Is it perfect? Of course 
not. Is it complicated? It has to be; this is 14 percent of our income. 
How many of you have complicated health care circumstances? This is a 
complicated issue. But the basic issue is simple: Should every family 
have health insurance that can never be taken away? Should we keep the 
great American system of private health care providers and even private 
insurance? Should we make sure that we do what we can to emphasize 
primary and preventive care? And should we pay for it by asking people 
who don't pay anything to pay something for their own health care?
    You know how other plans pay for covering people without insurance? 
They want to tax the benefits of people with good health care plans and 
their companies. You're already paying too much for health care. Why 
should you pay more

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in taxes to pay for people who haven't paid anything for their own 
health care? I don't get that, and I don't think it makes sense.
    Now, we're going to go back to Washington, and we're going to have a 
debate on this. We're going to pass the crime bill. But don't forget, 
crime is also a health care issue. That's what's filling the emergency 
rooms on the weekends. We're going to work on welfare reform. But don't 
forget, if you want people to stay off welfare, they've got to be able 
to have health care for their children. We're going to keep bringing the 
deficit down. But don't forget, someday we'll be spending money we ought 
to be spending on education and training on health care because 
inflation is destroying the Federal budget all in health care costs.
    I am telling you, if you want us to do what you do here, if you want 
us to get together and get things done, if you want partnership not 
partisanship, if you want progress not petty politics, if you want us 
oriented on the future and not the past, we have got to deal with the 
health care crisis in America. And we're going to have to have your help 
to do it.
    Thank you, and God bless you all.

Note: The President spoke at 10 a.m. at the General Motors plant. In his 
remarks, he referred to Jack Smith, chief executive officer, and Guy 
Briggs, vice president, General Motors Co.; and Owen Bieber, president, 
and Steve Yokich, vice president, United Auto Workers.