[Public Papers of the Presidents of the United States: William J. Clinton (1995, Book II)]
[July 25, 1995]
[Pages 1140-1143]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks on the 30th Anniversary of the Passage of Medicare
July 25, 1995

    Thank you very much, Mr. Vice President, for your introduction and 
your leadership. Senator Kennedy and Congressman Dingell, thank you for 
your incredible inspiration to the country and to me. Mr. Glover, thank 
you, and thank you for your speech. To Congressman Gephardt and Senator 
Daschle, I want all of you to know that they lead well and they are 
doing well for our country. To my friend Arthur Flemming and his family 
and Mother Johnson and her family and to all of you seniors who are 
here, I am honored to be here, and I have loved listening to these 
stories and these speeches and hearing this commitment.
    I am honored to stand in the tradition of the Presidents who fought 
for Medicare. I believe that President Roosevelt and President Truman 
and President Kennedy and President Johnson were right. And I think 
those who opposed them were wrong.
    If you really think about Medicare and Medicaid, which was also 
passed at the same time, they've given all of us stories. I loved 
hearing the Vice President talk about his wonderful mother.
    All of you know that since I've been President I have lost my mother 
and my fine stepfather, but what you may not know is that my stepfather 
had a heart attack 10 years before he died, in the middle of one of my 
inaugural speeches for Governor. And when he woke up from his surgery, 
his quadruple bypass, I told him it was not that good a speech. 
[Laughter] But because he was a senior citizen covered by health care, 
he had 10 more good years. And my mother had a very difficult fight with 
cancer, which she lost. But because she was a senior citizen covered by 
good health care, she lived to see her son become President of the 
United States.
    I ran for President because I wanted to broaden that sense of 
security and opportunity for our people. I wanted middle class Americans 
to have family-wage jobs and be able to educate their children and have 
the same health security we had given to senior citizens, as Congressman 
Dingell said.
    And the same crowd that killed Harry Truman's plan for health care, 
the same crowd that fought against Medicare, were successful in 
derailing what we tried to do last year. But they did it in a brilliant 
way, because by last year Medicare had become so much of our common 
ground as Americans, so much a part of the fabric of our daily lives, 
that no one anymore thought about these Members of Congress having 
anything to do with it. It was just a part of our daily lives, just like 
getting up in the morning and seeing the Sun shine. And so these people, 
the same crowd that fought it tooth and nail 30 years ago, came up with 
this brilliant argument that because I said, when they denied it, the 
Medicare Trust Fund was in trouble and we had to reform health care, 
that I wanted to see the Government mess with their Medicare.
    And we had people all over America coming up to me or the First Lady 
or to Senator Kennedy, saying, ``Don't let the Government mess with my 
Medicare.'' People had actually forgotten where it came from, as if it 
sort of dropped out of the sky. Well, I got the message of the 1994 
election, and I'm not going to let the Government mess with your 
Medicare.
    I really thought Medicare had passed beyond the partisan and 
political divide into the generational life of our country. The people 
who passed it did it for their parents' generation and knew that they 
would have it when they came along and knew that, in so doing, they 
would relieve a burden from their children, who could then focus on 
building good lives for themselves and their children. It was sort of a 
part of the social compact of the American family.
    Now the Vice President's father, who's been mentioned several times 
and is a particular fa-


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vorite of mine, said that the absence of health care for the elderly 
was, I quote, ``a disgrace in a country such as ours.'' We got rid of 
the disgrace, and along with Social Security, as Secretary Shalala has 
said, we at least have finished that part of our country's work.
    We still have a lot of work to do. But the answer to the problems of 
the great American middle class, the answer to the problem of curing the 
American deficit, the answer to the problem of dealing with the 
challenge of educating a new generation of Americans for a new, highly 
competitive economy--surely the answer to those problems is not break 
down the one thing we have done right completely, which is to keep faith 
with our elderly people.
    I want to talk just a little bit about what this could mean to you. 
As I said, in 1965, the legislation which created Medicare also created 
Medicaid. A lot of Americans think it's just a program for poor people. 
Well, it did provide desperately needed care for poor children and their 
mothers, but it also provided more care for older and disabled 
Americans, especially long-term care. Two-thirds of the Medicaid budget 
goes for older Americans and disabled citizens. Without Medicaid, middle 
class families struggling to pay their own bills and raise and educate 
their children could face nursing home bills for their parents averaging 
$38,000 a year. I remember what those nursing homes looked like before 
Medicaid. Some of you do, too.
    We need to celebrate and recommit ourselves to this. And we need to 
ask ourselves, what is the future? We are at an historic moment. For the 
first time in a long time there is a willingness to try to bring the 
budget into balance, a willingness to try to secure the Medicare Trust 
Fund. But I know we can do both while maintaining our generational 
commitment. I know we can do both without returning Medicare to the area 
of American partisan politics and to nightmares for the elderly people 
and their children in this country. We can do it.
    As Mr. Gephardt said, the congressional majority appears to be 
choosing for the first time ever to use the benefits we provide under 
Medicare, paid for by a dedicated payroll tax, as a piggybank to fund 
huge tax cuts for people who don't really need them. But we showed that 
you could have a balanced budget plan, with no new Medicare costs for 
older Americans, that stabilized the Medicare Trust Fund. We know that. 
They instead would cut $270 billion from Medicare and raise Medicare 
premiums and out-of-pocket costs an average of $5,600 per couple over 7 
years, even for people who don't have enough money to get by as it is. 
They want to use this to pay for a $245 billion tax cut.
    If they would just reduce the size of the tax cut, target the middle 
class families and their basic needs, string out the time which we take 
to balance the budget, we would not need one penny, not a red cent of 
the Medicare beneficiary cuts they've proposed. Don't you let anybody 
tell you that we have to do that to stabilize the trust fund or to 
balance the budget. We do have to stabilize the trust fund. We should 
balance the budget. But we don't have to raise the roof on the 
beneficiaries to do it. We do not have to break our generational 
commitment to do it. Do not let anybody tell you that. It is simply not 
true.
    This plan kind of sounds good in the rabid antigovernment atmosphere 
in which we live today--their plan does. The majority's plan in Congress 
would provide older Americans with a voucher for a set amount each year. 
They almost make it sound like you can make a profit out of it. It 
supposedly would cover enough to buy medical insurance. The problem is 
that private health care costs are projected to increase 40 percent more 
than the value of the voucher. So if you're over 65 and you're healthy 
as a horse, this might be a good deal for you. But what if you get 
sicker as you get older? If the vouchers are inadequate, the elderly 
must make up the difference out of their own pockets.
    There's no clear provision that would give a larger voucher for a 
patient like my mother, who developed cancer, as opposed to one the same 
age who was healthy, not even a clear provision to give a larger one to 
seniors who are fortunate enough to live into their eighties. That's the 
fastest growing group of elderly people in America, in percentage terms, 
people in their eighties. But to be healthy in your eighties you just 
naturally use the health care system more. There's no clear provision to 
take care of that, no clear provision to stop companies from simply 
turning seniors down because of their medical condition or cutting them 
off when they get sick.
    In the past, various experts have suggested that Medicare budget 
cuts will inflict harm and

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financial suffering on the elderly, but as the grisly details of the 
plan become known, it becomes clearer and clearer that we could actually 
see a denial of medical care to those who need it. That was the very 
thing Medicare was designed to do away with.
    You know, my mother was a nurse-anesthetist. I can remember what it 
was like before there was any Medicare or Medicaid. I remember people 
that would actually come to our house with a bushel basket full of 
peaches, for example, trying to pay in kind for the medical service my 
mother had rendered. And I remember that the old folks weren't healthy 
enough to go pick peaches. I remember these things, and we should not 
forget. We can change without wrecking, and we need to be awfully 
careful before we buy a pig in a poke.
    It is easy to see how, in all but the direst of emergencies, 
millions of older Americans would actually just give up the medical 
attention to which they are entitled and which they need. Let me just 
give you some examples of what could happen. These are real examples of 
what could happen.
    Suppose a 75-year-old woman has exhausted her savings and is too 
sick to work, but her voucher isn't enough to permit her to afford any 
health insurance plan anymore. She'd have to reach into her own pocket, 
but she doesn't have any money there. She can't get to the hospital 
unless it's a dire emergency because she's got to pay a $750 deductible 
for that. So she can't get to the doctor's office because she can't pay 
the extra premium there. So the woman is stuck, and no care.
    Or suppose you have a 75-year-old man who gets a voucher that just 
about covers the cost of his health insurance, and in 3 years his 
voucher only goes up 5 percent a year, but the health insurance premium 
goes up 10 percent a year. So after 3 years, the gap is so wide he can't 
afford to pay. He doesn't have the money. He dropped his Medigap 
coverage because he was persuaded this voucher system would work. So 
he's stuck, no care.
    A 70-year-old man with open-heart surgery recovered enough to go 
home and be treated by a visiting nurse, but under the plan of the 
congressional majority, he must now pay $1,400 in copayments for that 
visiting nurse. He can't afford that, so he stays in the hospital at 3 
or 4 times the cost to the taxpayers. But after a while, Medicare stops 
paying for that, too. So he's stuck.
    Now, these are things that can happen. Those who want to keep what 
they have now will have to pay significantly more. Every person on 
Medicare will pay $1,650 more over 7 years. The average person who 
receives care in home--something we need more of, not less of--will pay 
$1,700 more in the year 2002 alone for the same health care. Remember, 
these are people who already pay over 20 percent of their income for 
health care.
    So I ask you, can the elderly really afford $1,650 more for premiums 
to cover their doctor bills? Can the elderly really afford $1,700 more 
for the same home health care in one year alone? Will vouchers cover 
them against sudden premium increases if they get sick? That's what 
health insurance is supposed to do, you know, cover you when you get 
sick, not when you're healthy. Will the medical costs stay sufficiently 
under control to permit these vouchers to cover the full cost of care? 
No expert thinks so.
    Is it fair to make older Americans give up their doctors and be 
forced into managed care, instead of giving the option to them to go 
into a managed care network? Is it really necessary, to balance the 
budget and to stabilize the Medicare Trust Fund, to do what the 
congressional majority proposes? The answer to every single one of these 
questions is no. No.
    Those who want to gamble with Medicare are asking Americans to bet 
their lives. And why should they bet their lives? Not to balance the 
budget, not to strengthen the Medicare Trust Fund, but simply to pay for 
a big tax cut for people who don't need it. It's a bad deal. We ought 
not to do it. It will break up America's common ground. And you can help 
to stop it.
    If the Congress and the majority really wants to balance the budget 
and reform the Medicare Trust Fund, let me ask them to join with me in a 
real commitment to health care reform that can be achievable, even by 
their standards. Senator Kennedy has already introduced a bill with 
Senator Kassebaum that goes part of the way. Let us require insurance 
plans to cover those with preexisting conditions. Let us make a 
commitment to preventive and long-term care. Let us encourage home care 
as an alternative to nursing homes and give folks a little help to have 
their parents there. Let us let workers take their insurance coverage 
with them when

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they change jobs and crack down on fraud and abuse and give people the 
option to choose a managed care option if they want it; don't force 
people to take something they don't want.
    If we really want to work together, there ought to be four basic 
principles that everybody, without regard to party, signs off on. We 
have to make sure that good, affordable health care is available to all 
older Americans. That's what we do now; let's don't stop it. We must not 
cut Medicare to pay for a bigger tax cut than can be justified, that 
goes to people who don't really need it, a lot of whom don't even want 
it. We ought not to do that. We must be committed to reducing medical 
cost inflation and stabilizing the Medicare Trust Fund through genuine 
reforms, not by destroying Medicare and hurting the people who are on 
it. We must not balance the budget by cutting Medicare to older 
Americans. We do not have to do any of these things.
    This is a time of great and exciting change, I know that. But you 
know, the conservatives are supposed to be in charge around here, and 
conservatism means--if nothing else--if it ain't broke, don't fix it. 
And do no harm. That's the first principle.
    My fellow Americans, this is a big fight, but it's not just for the 
seniors in this audience and in this country. It's for all their 
children. Most senior citizens have children that are working harder for 
the same or lower pay they were making 5 or 10 years ago. They have 
their own insecurities and their own problems. They need their jobs and 
their incomes and their children's education and their own health care 
stabilized. We don't need to do something that makes their lives worse, 
either. And it's for all their children, the people on Medicare's 
grandchildren. They deserve a chance to have a good education, to be 
sent to college. Their parents should not wake up in the middle of the 
night torn between their own parent's health care and their children's 
education.
    This is not just a senior citizens issue. We need to increase 
opportunity and security for all Americans. And the worst thing we could 
do is to tear down Medicare. That would increase insecurity, not just 
for the elderly but for all Americans. It would cloud the future of this 
country.
    We have come a very long way by pulling together. Do not let this 
budget debate tear this country apart. Do not turn back on Medicare. 
Stand up and say, if you want to do something to balance the budget and 
stabilize the Medicare Trust Fund in a way that helps the elderly people 
of this country, we will stand with you. But if you want the Government 
to mess with my Medicare, the answer is, no.
    Thank you, and God bless you.

Note: The President spoke at 11:06 a.m. in the Caucus Room of the Cannon 
House Office Building. In his remarks, he referred to Eugene Glover, 
national president, and Genevieve Johnson, DC chapter president, 
National Council of Senior Citizens; and Arthur Flemming, chair, Save 
Our Security. He also referred to his mother, Virginia Kelley; and his 
father-in-law, Hugh Rodham.