    [Public Papers of the Presidents of the United States: William J. Clinton (1995, Book II)]
    [September 15, 1995]
    [Pages 1361-1364]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks to Representatives of Senior Citizens Organizations
    September 15, 1995

        Thank you very much. I'm delighted to see all of you. I'm glad to
    see you with your buttons and your--apparently, with your spirits
    intact. That's good. [Laughter]
        As all of you know, we're having this huge debate in Washington
    today about the future of this country. I want to try to put this
    struggle over Medicare and Medicaid into some kind of proper context so
    that you can take it not only to the Members of Congress and to your own
    members but out to the American people at large.
        There is an enormous consensus in our country, with which I agree,
    that we ought to pass a budget this time that will bring our books into
    balance by a date certain. I agree with that. We got into a bad habit,
    this country did, before I showed up here, in the eighties and the early
    nineties, of running a permanent deficit, not to invest, to grow the
    economy, to create jobs, but just because every year we preferred to
    spend more money than we were taking in. And it wasn't good for the
    country. We're on the verge of paying more in interest next year

    [[Page 1362]]

    than we pay for defense, for example. And every year we keep doing that,
    we spend more and more on interest, and we have less and less to spend
    on everything else.
        But why do we wish to do that? What are the values implicit in that
    choice? We do it because we want to free our children and our
    grandchildren from the burden of unnecessary debt. We do it because we
    don't want to have a country where the Government is taking all the
    money and the money will be free to be borrowed by private businesses to
    create jobs and to grow the economy. We do it because we think morally
    we'll be a stronger country if we don't just borrow money for the sake
    of borrowing it.
        But our objectives will be undermined if we forget about the other
    obligations we have. That's why I've said, you know, we ought to balance
    the budget, but why would we cut education and thereby hurt the economy
    and hurt the future of the very children we're trying to help? Why would
    we undermine our ability to protect the environment and public health
    and thereby erode the very quality of life we say we're strengthening by
    balancing the budget?
        And the same thing is true here. We have historically recognized
    significant obligations to the health care of people who are entitled to
    be taken care of through the Medicare program or, through no fault of
    their own, have to be given some assistance. It's a part of who we are;
    it's a part of what kind of country we are.
        And that's what this fight over Medicare and Medicaid is all about.
    What are our obligations to each other? How are we going to fulfill
    them? This is a compact between the generations, a compact we have
    honored now for three decades. It has made America a stronger, better,
    more humane place. It has made family life more secure not only for
    seniors, not only for Americans with disabilities but for their family
    members, their hard-working family members who knew that they got a
    little help so that they could all fulfill their responsibilities. These
    are the values I would argue that we want to advance as we try to
    balance the budget. We don't want to undermine them. We want to do this
    in a way that will bring the American people together, not tear the
    American people apart. That is what I am working to do here.
        It is truly ironic that this whole Medicare fight is being played
    out against the background of the trouble that the Trust Fund is in.
    Where did you hear that first? From me, right? And in 1993 and 1994,
    when I said the Medicare Trust Fund is in trouble, we have to do
    something to lengthen its life, we have to do the responsible thing and
    keep it strong, and I proposed solutions to keep it strong, some of
    those who are for cutting Medicare $270,000 billion today said that I
    was raising a red herring, that it wasn't really in trouble, and why
    were we even worried about this. How quickly they forget.
        But thanks to the responsible people in the Congress in the last 2
    years, we extended the life of the Medicare Trust Fund by 3 years. And
    in my balanced budget proposal, we extend the life of the Medicare Trust
    Fund by more than a decade from this day forward, making it in better
    shape than it's been in 9 of the last 15 years. That is what we have
    proposed to do and to do it without imposing new costs on seniors.
        Now, the congressional Republicans have outlined their plan to
    balance the budget, which includes a $270 billion Medicare cut, 3 times
    the size of any previous cut, and a $180 billion Medicaid cut. Together
    that's nearly half a trillion dollars taken out of the health care
    system over the next 7 years. I doubt seriously that the health care
    system can afford that. And that again affects all of us, not just
    people on Medicare, not just people on Medicaid. Almost half a trillion
    dollars.
        Their plan would increase premiums and other costs for senior
    citizens. It would reduce doctor choice. It would force many doctors to
    stop serving seniors altogether. It threatens to put rural hospitals and
    urban hospitals out of business. Brick by brick, it would dismantle
    Medicare as we know it.
        Now, here's the point. If all this were necessary, really necessary
    to save Medicare, maybe we'd all be willing to do it. But it isn't. And
    that is the point that has been missing from all this public debate, the
    point I tried so hard to make yesterday, the point you know but, I have
    to tell you, most of your fellow Americans, even members of your various
    groups who are on Medicare, do not know: The proposed reductions in the
    congressional or Republican congressional plan in Medicare spending on
    providers do go into the Trust Fund; the proposed increased costs on
    seniors do not go into the Trust Fund as a matter of law.

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        So all this conversation we have heard about saving the Trust Fund--
    give them their due, when they're talking about holding back money from
    Part A to the hospitals and the doctors, they're telling the truth; that
    will go into the Trust Fund. But the extra cost to seniors, by law, will
    not go into the Trust Fund. You know it and I know it and everyone in
    America should know it. Every nickel that will be taken from the seniors
    will go into the General Fund where it will be used to carry out this 7-
    year plan, which includes a very large tax cut. So this is a plan to
    take more from people on Medicare, three-quarters of whom live on less
    than $24,000 a year, and put it into a tax cut, more than half of which
    will go to Americans who plainly don't need it.
        Now that has to be driven home. That is a fact. And it is a fact I
    almost never hear discussed. This is not about saving the Trust Fund. If
    we were really about to see the Trust Fund go broke and there were no
    other options, we would all be saying, ``Let's get in a room and roll up
    our sleeves and figure out what it is we have to do to save the best of
    this program,'' wouldn't we? Every one of us would be; none of you would
    be here raising sand about that. And you'd also want to say to the
    hospitals, ``We want to keep you open,'' to the doctors, ``We want to
    keep you going. We don't want to bankrupt anybody. Let's see how we can
    have a fair plan of shared sacrifice.''
        But by law, the money coming out of the seniors does not go to that
    Trust Fund. And it is a grave disservice to the American people not to
    just tell everybody that, not to say, ``Hey, we'd like to fix the Trust
    Fund, and here's what the providers are going to have to sacrifice.''
    Then you could look at the President's plan and their plan and you could
    compare. I think my plan asks about all of the providers they can come
    up with, and it adds 10 years to the life of the Trust Fund. Unless we
    can dramatically lower medical inflation, I think it asks about all we
    can right now. But it's good that it adds a long time to the Trust Fund.
        But the money we're asking for from seniors--not us, but the
    congressional Republican plan--the money they ask for from the seniors
    won't go into that Trust Fund. And no one must be allowed to believe
    that it does. This is going into the balanced budget plan to pay for the
    tax cut.
        I am also for a tax cut. I believe we ought to help working families
    raise their children and educate themselves and their children and give
    tax reductions for those purposes. But I do not favor funding them by
    raising the price of Medicare on the poorest elderly people when, as all
    of you know, the average senior citizen today is paying the same
    percentage of his or her income for health care in 1995 that they were
    paying in 1965 before Medicare came in. So it isn't true to say the
    seniors of this country haven't done their part to try to keep Medicare
    going. We've seen increased costs with inflation.
        So I ask you to hammer this point home. This should not be a debate
    between things that the seniors and the disabled people of this country
    can't afford to pay and a system we can't afford to let go broke. That
    is not the choice. You know it; I know it; America must know it before
    these decisions are made. Fine, let's save the Trust Fund. We're going
    to do it. I've been working on it for 2\1/2\ years. We've made it
    better. But let us not pretend for a moment that it is necessary to do
    what is being done either to balance the budget or to save the Trust
    Fund. These fees on seniors are going up to meet that particular plan
    with that very large tax cut. And everyone must know that.
        A lot of these most painful cuts have been hidden altogether. In
    this congressional plan, deep within the fine print of the Medicare plan
    are cuts to be revealed later. What is it called--automatic look-back.
    [Laughter] We've all done that once or twice in one or two ways.
        Now, think about this: What about the Medicaid program? You hardly
    hear anything about Medicaid. People say, ``Oh, that's that welfare
    program.'' One-third of Medicaid does go to help poor women and their
    poor children on Medicaid. Over two-thirds of it goes to the elderly and
    the disabled. All of you know that as well. America must know that. If
    we reduce projected Medicaid spending by $180 billion and if States were
    to follow through with across-the-board cuts, our best estimates are
    that by the year 2000, there would be 300,000 people who would be either
    removed from or not be able to get into nursing homes and 4 million poor
    children who would not have access to medical care. Hundreds of
    thousands of families would have a much harder time caring for a member
    of their family in their home or helping their family members in some
    other way.

    [[Page 1364]]

        This is very important. If you don't do it across the board--you
    say, oh, we're going to take care of the people in nursing homes, the
    seniors--that's even more disabled people who are cut off. That's even
    more seniors in their homes who aren't helped. That's even more children
    who are in the streets without any health care. This is not a free ride.
        Do we need to lower the rate of inflation in Medicaid? You bet we
    do. I proposed a plan to do that. It doesn't reduce spending by near as
    much as theirs does because I don't know that we can do that. I honestly
    believe these things are going to happen. And we need to consider the
    consequences of them. I don't want to do something that could close our
    rural and urban hospitals, that could make the lives of poor children
    even more difficult, that could be terrible for not only the disabled
    and the elderly who would be affected by it but for all their family
    members. You think about how many middle class working people are not
    going to be able to save to send their kids to college because now
    they'll have to be taking care of their parents who would have been
    eligible for public assistance.
        I am not saying that we shouldn't balance the budget and that we
    don't have to slow the rate of increase. But look at the proposals we
    made in this administration. We made sensible, disciplined proposals
    that won't be easy to meet, but can be met and are directly related to
    saving the Medicare Trust Fund and to bringing the cost inflation down
    in health care and to balancing the budget, without asking the seniors
    of this country to pay for a tax cut for people who don't need it or
    where the size of it is too big.
        And I'm telling you, you can have the right kind of tax cut, you can
    have a healthy Medicare Trust Fund, you can have reductions in cost
    inflation in Medicare and Medicaid without these draconian consequences.
    That's what you have to tell the American people. If these were the only
    choices, it'd be tough enough. But this is an easy choice once you know
    the alternatives. If these health care cuts come to my desk, of this
    size, I would have no choice but to veto it.
        But let me say this. What always, always becomes the news every day
    is what the new fight is, what the new conflict is. We ought to be here
    to build a bridge. I can't believe anyone would willingly, willingly
    damage the seniors of this country, the Americans with disabilities, the
    children of this country as much as I believe this proposal will damage
    them, especially to pay for a tax cut that is too large, when we can
    have a targeted tax cut for education and childrearing for middle class
    families without doing any of this, when we can balance the budget
    without doing any of this, when we can save the Medicare Trust Fund
    without doing any of this. [Applause]
        I'm glad you cheered and I'm glad you clapped, but there is a bridge
    to be built here. We can get all Americans on the solution side of this
    problem. We can get Republicans and Democrats on the solution side of
    this problem. It is not too late. We have a few weeks here. But first,
    the American people must know the facts. So I implore you--most of you
    know so much about this you just assume other people do, too. And it is
    a very powerful thing to tell an average American working family that
    deeply believes in this country that we've got to do what it takes to
    save Medicare. That's a powerful thing. Well, we do. But this is not
    what it takes to save Medicare, this proposal that we're opposed to.
        So I ask you, stand up for what you believe. Fight for what you
    believe. Know that I'll be there for you if it comes to crunch time. And
    if I have to use the veto pen, I will. But go out there and build a
    bridge. Start it with the facts, the evidence, the truth. Ask people to
    come to grips with the truth. And ask them what our obligations are to
    one another. Ask them why we're balancing the budget and don't we have
    to balance the budget consistent with our desire for strong families,
    for honoring the people who have made this country what it is today, and
    for building a better future for our children, whether they're rich or
    poor.
        That, I think, ought to be the message. If so, we'll wind up
    building that bridge and making this country stronger.
        Thank you, and God bless you all.

    Note. The President spoke at 3:41 p.m. in Room 450 of the Old Executive
    Office Building.