[Public Papers of the Presidents of the United States: William J. Clinton (1994, Book II)]
[August 10, 1994]
[Pages 1455-1458]
[From the U.S. Government Publishing Office www.gpo.gov]



[[Page 1455]]


Remarks on Health Care Legislation and an Exchange With Reporters
August 10, 1994

    The President. I'd like to make a brief statement and then ask 
Governor Waihee and Mr. Bowles to say a thing or two.
    This is a very important week for our country. You know, it's the 
first time in our history that we've ever had a debate on the floor of 
either House of the Congress on the question of health care coverage for 
all Americans. Something that in other advanced nations people take for 
granted, we've never even been able to debate on the floor of our 
Congress. And I'm very hopeful that in both Houses they'll be able to 
work out enough of a consensus to pass a bill that will enable us to go 
to conference and come out and ultimately have legislation that does 
provide universal coverage.
    We wanted to ask you here today to talk about Hawaii for a couple of 
reasons, first of all because so much of this debate--I think way too 
much--has turned on the question of the requirement that employers share 
the cost of buying private insurance with their employees. And a lot of 
very dramatic claims, dire claims have been made about that. Hawaii has 
been doing it for 20 years. It works. Businesses have thrived. Jobs have 
not been lost. And the most important thing is that you can see that in 
addition to having lower costs for small business premiums, the closer 
you get to full coverage, the closer you get to the other goals of 
health care: cost control, better health care outcomes. These are the 
things, it seems to me, that cannot be refuted by the people on the 
other side of this argument.
    What it ultimately boils down to is they're saying, ``Well, we have 
this evidence in Hawaii,'' or ``We have evidence in Germany, but we 
don't want to deal with it. We still don't want to pay.'' And it just 
seems to me that--there's another issue I want to bring up that I keep 
talking about that's very important. Health coverage for people under 65 
has dropped from 88 to 83 percent in the last 10 years. There are 5 
million Americans today who had coverage 5 years ago who don't have it 
today. Almost all of them are working people and their children. I do 
not think that Congress ought to send a message to the country that it 
is fine with us if this deplorable development continues, if we just see 
a continuing erosion of the health care system in America, more and more 
people without coverage.
    So I'm looking forward to the week and next week and the months 
ahead in the hopes that we can really get something done. And I think 
that this example of Hawaii is important because it is not refutable; it 
actually happened. And it's not like Germany; they can't say, ``Well, it 
didn't happen here.'' It actually happened in the United States.

[At this point, the President called on Gov. John Waihee of Hawaii and 
Small Business Administrator Erskine Bowles, and each made brief 
remarks.]

Health Care Legislation

    Q. Mr. President, the employer mandate aside, there seems to be an 
increasing frustration among some members of the business community 
about the way the health care reform bills are shaping up on Capitol 
Hill. Specifically, there are concerns that employers may lose control 
of ability to negotiate with insurance companies and, therefore, control 
their costs. This is directed specifically at the Mitchell bill, 
although they have problems with the Gephardt bill as well. Are there 
some changes that you would be willing to accept to meet some of the 
concerns being expressed now by the business community?
    The President. I hope they'll get in there and make these concerns 
known in the whole debate.
    My bottom line is what it has always been. I think we have to have a 
system that, over a period of time, will lead to universal coverage, 
because I do not believe, number one, that you can do right by the 
American people without it, and number two, that you can achieve the 
other goals we have, which are cost control--cost containment, maybe, is 
a better word--and better health care. Those are my principal goals.
    There are a lot of members of the business community that I would 
urge to get into this debate with both feet. One of the reasons that the 
bills are in the position that they're in today is that the people who 
were against this from the beginning and wanted to wreck it over the

[[Page 1456]]

mandate were out there focused like a laser beam on beating it. I think 
one of them was quoted in the press today talking about how great they 
were getting votes against things. Whereas all the people who were for 
it and knew it had to be done took a more wait-and-see attitude, hoping 
that this little change or that little change might make it a better 
bill. Now that it's actually on the floor, I think it's incumbent on 
everybody to get in there and participate in the debate.
    I do believe that the more you move to universal coverage, the more 
all the objectives of these employers who do cover their employees will 
be met, because it will stop cost shifting; they won't have to bear the 
burden of anybody else's cost. And it will have more employers, even the 
small business groups, in there negotiating to keep health care costs 
down, which I think will help them very much.
    Q. Mr. President, how do you feel the debate is going so far? And do 
you have any feeling on when you think it will come to a vote in the 
Senate?
    The President. I think it's going pretty well. It may take a few 
more days to start having critical votes, depending on what happens in 
the House on the crime bill. I just don't know enough about the timing 
of the bodies to be sure, but we're going to try to resolve the crime 
bill in the House this week and move it over there, and so they may take 
a little longer. I think they still want to go on their August break at 
the end of the following week. So I hope we'll have some action before 
then.
    Q. Are you disappointed that more members of the business community 
who you feel favor your ideas and proposals have not gotten involved in 
this debate and come to your defense, because as you know, the 
Washington Post reported this morning that several large business groups 
are now coming together to jointly oppose the Mitchell bill, the 
Gephardt bill? Are you disappointed that these people haven't spoken 
out?
    The President. I met yesterday with a dozen or more business leaders 
who went outside the White House and once again reaffirmed their support 
for universal coverage. And if you read between the lines in the--at 
least my reading, to go back to Donna's [Donna Smith, Reuters] question, 
my reading of the Washington Post story today is that a lot of those 
people disagree with the NFIB, think they're dead wrong, want a 
requirement that employers and employees provide for health care through 
private insurance. And they're worried that the necessary changes that 
Senator Mitchell has made to try to get the bill through the Senate may 
not meet their needs.
    Well, the answer for them is to come in and try to fix the bill and 
stay with universal coverage. That would be my counsel. The business 
leaders--I met with several yesterday--told me they were terribly 
worried that if we passed up this opportunity to have universal 
coverage, we would continue to see what has happened so dramatically in 
the last 5 years where you've lost--you know, 5 million people don't 
have coverage who had it 5 years ago. More and more businesses are 
dropping their coverage. All those costs are being shifted on to the 
employers who are taking care of their employees, which makes the small 
businesses even more vulnerable and the big businesses even less 
competitive in the global economy, which will mean further aggravation.
    That's one thing that I think that Congress has got to come to grips 
with. We just can't allow the kind of disinformation that Mr. Bowles 
talked about and the intense, almost hysterical fear that's been bred in 
some of the small business community, and has been therefore felt by the 
Congress, to ignore the fact that we have a system that is breaking up. 
We're losing ground on the coverage. We've got millions more people 
without coverage and millions more at risk of losing it than we had just 
a few years ago. So, we're going in reverse.
    That, it seems to me, is a great argument for the Hawaii system. 
You've got something you know will work, you know won't hurt business, 
and you know won't go in reverse. And we can build on it and move to 
full coverage.
    Q. Have you been disappointed with the lack of support in the 
business community to date----
    Q. But you're asking them now to come forward at this critical time. 
Where were they before, and aren't you disappointed?
    The President. First of all, we had a press conference here and 
announced 600,000 small businesses had joined our coalition. That's more 
members than NFIB has. We put this coalition together around health 
care. Therefore, unlike the NFIB, they don't have the mailing lists, the 
political action committees, the way of put-


[[Page 1457]]

ting pressure on people at the local level. But we've shown business 
strength.
    We've also had very large numbers of large businesses supporting our 
position. Do I wish they had come out stronger earlier? Of course I do. 
But this is nothing new. The AARP has now come out strongly in favor of 
what we're doing, but they ran ads for a long time which said, ``Don't 
support a health care plan that doesn't have prescription drugs and 
long-term care.'' Our plan did, but somebody--not we but somebody else 
did research which showed that people thought, ``Well, why didn't Bill 
Clinton's plan have prescription drugs and long-term care?''
    So this is what always happens. Some of you may have heard me quote 
this before. Machiavelli said 500 years ago that there is nothing so 
difficult in all of human affairs than to change the established order 
of things, because people who are afraid they're going to lose fight you 
like crazy and people who will win are always uncertain of the result 
until the very end. And in that vacuum the antis, even if they're less 
numerous than the pros, can acquire a strategic advantage. That's 
plainly what happened in the last 4 months, 5 months in the House and in 
the Senate where there was just this ``kill it, kill it, kill it, kill 
it, kill it'' drumbeat coming out of the ones who were negative. But 
there are more American citizens, more American businesses who know we 
ought to have universal coverage and who support it. It's not too late 
to rescue that. That's why we have a debate.
    And I would remind you, in spite of all that, this is the first time 
in history we ever even got bills to the floor of both Houses of 
Congress. Truman couldn't do it. President Nixon couldn't do it. Nobody 
who's tried to do it has ever been able to do it. So I feel good about 
where we are, and I think now the public voices of reason from the 
business community and elsewhere have a chance to be heard.
    Administrator Bowles. The Governor and I will stay for questions. 
The President is going to have one more question and then he has to 
leave.
    Q. We're getting very close to a vote on a bill that would 
restructure 15 percent of the national economy, yet Wall Street seems to 
be completely ignoring the debate right now. Why do you think that is?
    The President. You would have to ask them. I think partly because 
they know it wouldn't fully restructure 15 percent of the economy. It 
would simply build on what we have. The things the Government's doing 
wouldn't change, except we would be more efficient in the management of 
the Medicare and Medicaid programs. But that would stay there. We would 
still fund Medicare. We would still fund Medicaid. Almost all the people 
in the country today who are providing health insurance would have the 
decision, the freedom just to keep doing what they're doing now.
    Only the most limited and inadequate plans would have to be 
substantially changed, so they could go into a different plan or stay in 
the one they've got. That's why this plan shouldn't bother Wall Street 
very much because under all the scenarios we've been discussing, what 
we're basically trying to do is to close that gap of people who work but 
don't have coverage and people who don't work but are above the poverty 
line and don't have coverage. That's basically what we're trying to do. 
The whole rest of the system will stay intact. And a lot of the 
structural changes which are occurring for the better, enabling a better 
cost control for some, will now be available for all.
    I think it's important to point out--Erskine pointed out that the 
small business rates went up 14 percent last year; health care costs 
went up 4.8 percent last year. So what we're trying to do is to make 
this available for all, the cost containment as well as the coverage.
    Q. Your wife yesterday seemed to suggest that she thought the 
Gephardt bill might have a better chance of producing the results you 
want. Do you have a similar feeling of that?
    The President. I don't know. I haven't talked to her about it. And I 
read a couple of stories, and one seemed to suggest that, and one 
didn't. I can't comment on it. All I can tell you is the device for 
achieving universal coverage in both bills meets the criteria that I 
have. And I think it's quite interesting that the CBO thinks that 
Senator Mitchell could get to 95 percent by 1997, which is a very rapid 
uptake and would indicate that we could go on then and cover everybody.

Whitewater Independent Counsel

    Q. Mr. President, what do you think of about the Starr nomination--
--
    The President. Everybody else has talked about that. I'll cooperate 
with whoever's picked. I just want to get it done.

[[Page 1458]]

Health Care Legislation

    Q. Mr. President, which of the two plans, the Mitchell or the 
Gephardt plan, most closely resembles the Hawaiian model?
    The President. Ask Governor Waihee, he's an expert on that.
    Q. Thank you, Mr. President.
    The President. They both resemble it in different ways, that's my 
read. They're both different, and they both have things in common.

Note: The President spoke at 10:45 a.m. in the Roosevelt Room at the 
White House.