[Public Papers of the Presidents of the United States: William J. Clinton (1995, Book II)]
[September 19, 1995]
[Pages 1389-1392]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks to Senior Citizens in North Miami Beach
September 19, 1995

    The President. Thank you. Wow. Thank you so very much, Governor 
Chiles and Lieutenant Governor MacKay and Attorney General Butterworth 
and members of the legislature and Mayor, other local leaders, and 
especially Ginger, thank you for that wonderful introduction and that 
wonderful comment about the joys of old age. [Laughter] The last year 
has brought me prematurely closer to those joys--[laughter]--as I have 
worked along in Washington.
    I did come here today to talk about Medicare and Medicaid, but I'd 
like to put them, if I might, into a little bit of context about what's 
going on in our country today for all the American people. We are, all 
of us, privileged to be living through one of the most interesting 
periods in our country's history, where the way we work and the way we 
live is changing very, very rapidly.
    I think that you could argue that since we got started as a country, 
we've had about four periods of really profound change: obviously, 
leading up to and then after the Civil War and then when we changed our 
economy from a rural to an industrial economy between about 1895 and 
about 1916 and then the Great Depression and World War II and the cold 
war and now, coming out of that.
    I believe this is the most profound period of change we have faced 
in 100 years in the way we live and the way we work. And whenever those 
kinds of things happen, we have to think anew about what our basic 
values are, what kind of people we are, what our obligations to one 
another are across the generations and across incomes and in different 
ways of making a living, and we have to chart a course for our country's 
future.
    For me, that means that we have to have a period that is governed by 
new ideas rooted in old-fashioned values. This is still a country, 
fundamentally, that's about individual liberty and individual 
responsibility, devotion to family and devotion to community, rooted in 
the idea that we all ought to work if we can and we all have 
responsibilities, not only to ourselves but to each other, and that we 
also have a responsibility to be a beacon of hope to the rest of the 
world. And that is what we have tried to do.
    We've tried to change the economic policy of the country in a way 
that would bring the deficit down but invest more in education and 
technology, and it seems to be working. We've got 7.3 million new jobs. 
Florida is growing jobs at 3 times the rate it was growing them before 
our administration came in. And we've reduced the deficit from $290 
billion a year to $160 billion a year in only 3 years. So we need new 
ideas and a new direction.
    We have found a way to do this while increasing our investment in 
the education of our children, something I know all of you care deeply 
about and something that is more important than ever before. We know 
we've got to cut some things. Your Government is much smaller than it 
was the day I became President. We've reduced the size of the Federal 
Government by 160,000, and by the time I finish this term, we'll have 
the smallest Federal Government we've had since President Kennedy was 
the President of the United States, trying to give you a more 
entrepreneurial, less bureaucratic, less cumbersome Government, but 
still one that could fulfill our fundamental values.
    Today, even as we speak, the Congress, in the Senate at least, is 
debating the very important subject of welfare reform, something I've 
worked on for 15 years, almost as long as I've worked on issues 
affecting senior citizens in America. What we all want, I think, is for 
people on welfare to be able to live the way the rest of America lives. 
We want people to be able to succeed as workers and as parents. We want 
the values of family and work and responsibility to triumph. We don't 
want anybody to be trapped, generation after generation, on welfare. And 
we know it would be good for the rest

[[Page 1390]]

of us as well if they were liberated and became taxpayers instead of tax 
drawers. We know that.
    Since I've been President, waiting for the Congress to act, I've 
done what I thought I could to move people from welfare to work and help 
them succeed as parents. Florida is one of 34 States now that have 
received permission to get out from under old-fashioned Federal rules to 
put people to work. And in just one of Governor Chiles's experiments in 
the last year, the Florida Family Transition Program, they've moved over 
800 people from welfare to work. It's one thing to talk about it, quite 
another thing to do it. And so, congratulations, Governor, for doing it.
    Now, this bill that they're debating in the Senate today has broad 
bipartisan support because it will help to move people from welfare to 
work, and it will help families to stick together. And I want to say 
more about that in the context of Medicare and Medicaid in a moment.
    So if welfare reform remains a bipartisan effort to promote work, 
protect children, and collect child support from people who ought to pay 
it, we will have welfare reform this year, and it will be a very great 
thing. But if the Congress gives into extremist pressure and walks away 
from this bipartisan American common ground, they will kill welfare 
reform. So I ask you to do what you can without regard to your party to 
encourage your Senators and your Members of Congress to give this 
country a welfare reform bill that is pro-family, pro-work, pro-
responsibility and pro-child. We can do that, and we ought to do it.
    Now, what's all that got to do with Medicare and Medicaid? 
Everything. Why? Because now we have also a bipartisan consensus in 
Washington for balancing the Federal budget, something that hasn't been 
done since 1969, although the deficits in the seventies were pretty 
small and basically related to economic slowdowns. So there is a broad 
bipartisan agreement that we ought to do it. I believe we ought to do 
it. And I'm glad to help supporters in the Congress from both parties 
who want to do that. We had to have a one-party effort to take the 
deficit from $290 to $160, and we need everybody's help to go all the 
way. And I'm for that.
    But how we decide to balance the budget will tell us a lot about 
what kind of people we are, what our values are, what we're going to 
take into the next century, what we're going to say to our young people 
about what they can look forward to as they grow up into productive 
adults and then they grow into old age. It will say a lot about what we 
think our obligations are across generational and income lines.
    One of the things that has dismayed me about this discussion of 
Medicare and Medicaid has been the suggestion that anybody that doesn't 
support the congressional plan is somehow a wealthy older person who is 
insufficiently sensitive to the needs of the younger generation. That is 
a load of bull. I can tell you that in all my experience in public life, 
and I have been working on these issues for 20 years now, the thing that 
has always humbled me--and my State, Arkansas, had, when I was serving, 
in every year the second or the third highest percentage of people over 
65 in the country--the thing that always amazed me was how much the 
seniors in my State wanted to take care of their children and their 
grandchildren, how much they supported efforts to improve education, how 
much they supported efforts to strengthen the economy, how much they 
were not interested only in their own issues.
    And so I say to you, if you say you don't like this plan in 
Congress, that doesn't mean that the rest of us think you're either rich 
or greedy. You have a right to see that there is decency and honor and 
obligation across generational and income lines as we balance the 
budget. We have to do it in a fair and decent and honorable way.
    Now, here's the problem. It is true that medical costs in the budget 
have become a bigger and bigger and bigger part of the Federal budget. 
It is true that medical inflation is going up faster than the inflation 
rate as a whole. It is also true that we're all living longer. So we've 
got a higher percentage of Americans on Medicare and elderly people on 
Medicaid. Praise the Lord, we're all living longer. That's a good thing. 
I hope it extends to Presidents. [Laughter]
    It's also true that the system itself, through fraud, abuse, and 
other problems, has had a higher rate of inflation so that, 
unfortunately, both the Government and people on Medicare have been 
paying more every year for the same health care in ways that are 
unacceptable. And that if we want to balance the budget, we need to slow 
the rate of growth in health care spending.
    It's also true that the Medicare Trust Fund has to be protected. 
Now, let me talk a little

[[Page 1391]]

about that. You pay Medicare. You know--if you're involved in Medicare, 
you know how it works. You know how it works. There's a Part A which is 
basically hospital and related services paid for by a payroll tax, and 
that goes to providers and essentially that is in the Trust Fund. And 
there's a Trust Fund. There's a Part B that deals with all kinds of 
other services, primarily physician services, medical equipment, and 
other things, which are paid for out of general tax revenues and 
contributions by seniors directly--payments.
    Here is what I want to say to you about this Medicare issue: We have 
proposed a balanced budget--I have--that slows the rate of medical 
inflation and payments to providers to fix the Trust Fund for another 10 
years. And we have proposed to do it exactly like the people who are in 
charge of the Trust Fund, the trustees, say we need to do. And it 
doesn't cost seniors anything more than they are otherwise going to pay 
in the ordinary course of medical inflation.
    The Congress, the majority in Congress, have proposed Medicare cuts 
that are more than twice that much. And less than half of them are going 
into the Trust Fund. The rest are going to pay for the 7-year balanced 
budget and the tax cut.
    So I say, I will work with anybody, anytime, anywhere to fix the 
problems of the Medicare Trust Fund. But it is wrong to take more money 
from people whose average income is way below $20,000 to pay for a 7-
year balanced budget and cuts in other areas and a big tax cut for 
people who don't need it. That is not right. So let's fix the Trust 
Fund, but let's don't dishonor our obligations across generational and 
income lines by pretending that we're fixing the Trust Fund when we're 
taking money from seniors to pay for a tax cut that is too large. That 
is not right.
    Audience member. Hear! Hear! Tell 'em!
    The President. Let's look at the Medicaid problem. Medicaid has 
nowhere near the political support in the country now that Medicare does 
because most people think it's a welfare program. And they think, if 
it's a welfare program, we can probably cut it some.
    I have proposed to slow the rate of spending in Medicaid. Their cuts 
are 3 times as great as mine. The problem is that 70 percent, almost, of 
Medicaid spending goes to elderly people and disabled people for nursing 
home care and in-home care. And if these cuts are as large as they are 
said to be--and for hospital care for low-income people--if these cuts 
are as large as they are said to be, then we will have people who 
through no fault of their own, who don't have any money, who either 
won't be able to get in nursing homes, won't be able to get in-home 
care, and millions of kids who won't be able to get hospital care.
    If you take $450 billion out of the system over the next 7 years, I 
question whether we can keep our urban and rural hospitals open, whether 
the great teaching centers--making us the finest medical country in the 
world in terms of the quality of health care--will be able to do well. 
And there is a limit to how much seniors can afford to pay. Seventy-five 
percent of the people over 65 in this country live on less than $24,000 
a year.
    I came here to say to you, we're going to make some changes in this 
program. We need to save the Trust Fund, but don't you be fooled into 
thinking it costs $270 billion to save the Trust Fund. It costs less 
than half of that. And the rest of that money is going to go right into 
the general treasury and be used to pay for a 7-year budget and a tax 
cut that's too big. And I don't think that is an appropriate thing to 
do. And I don't think you think it is an appropriate thing to do.
    I am not promising pie in the sky. Everybody here knows that the 
average senior on Medicare is paying the same percentage of income out 
of pocket for health care as you were paying before Medicare came in in 
the first place, because medical inflation has gone up so much. You all 
know that there's a lot of fraud and abuse in the system. And by the 
way, both parties agree on that, and I think we'll reach an agreement on 
it. And I want you to know what I'm trying to do about that. We have 
doubled, doubled, prosecutions for fraud and abuse since I've been 
President. We have tripled, tripled, the number of FBI agents working on 
health care fraud since I've been President.
    We need your help. The United States Attorney for this district, 
Kendall Coffey, is here. He gave a report to the group upstairs about 
what he's trying to do here. We need senior groups all over America to 
help us to uncover fraud and abuse. A congressional study said as much 
as 10 percent of the money may go into fraud and abuse. If that's true, 
we can put that into savings, and it doesn't have to come out

[[Page 1392]]

of anybody's pocket, except people who shouldn't be spending the money 
in the first place.
    We are going to have to make some changes. We do have an obligation 
to preserve Medicare for you, for the people who come behind you, for 
your children, and for your grandchildren. It's a program that works. 
But we also have an obligation to make sure that Medicare and Medicaid 
do their job for America's seniors and do their job for the poor 
children of this country.
    It isn't popular to speak up for the poor children today. It isn't 
popular--sort of the fashion is to say, well, if they're poor, whatever 
they get they deserve. The Bible says the poor will always be with us. 
And all those little poor children, they're going to be grown up some 
day. And if they don't have decent health care and decent nutrition and 
good role models and people who care about them, do you think they're 
going to be good citizens who can take care of my generation when we get 
old? So just because they're poor, and they're on Medicaid, too, we 
shouldn't forget about them. We shouldn't act like we have no 
responsibility to them. It's not their fault what families they were 
born into. It's not their fault what their family circumstances are.
    So what I want you to do is this: I want you in one voice to say to 
all of us, ``We don't care if you're Republicans or Democrats; go 
balance the budget, go fix the Medicare Trust Fund, make the changes you 
have to make to do that, but do not take money from elderly people that 
barely have enough to live on, that have made their contributions all 
their lives, and give it to people who aren't even asking for a tax cut 
and don't need it. Don't do that. That doesn't make any sense. It defies 
common sense. Slow the rate of growth in that Medicaid program, but 
don't do it so much that we can't take people into nursing homes. Don't 
do it so much we can't deliver home care to people who need it and 
that's cheaper. Don't do it so much that we have to turn away poor 
children who will be scarred forever if we don't take decent minimal 
care for them. That's not necessary. We don't have to do that to balance 
the budget.'' Send a voice that I know is in your heart.
    I have been--as I said, I have been working on issues of health 
care, consumer rights for seniors for 20 years. I had my first long-term 
care conference as an attorney general almost 20 years ago. And I know 
that the senior population in this country is generous and forward-
looking. But I also know that the only way we can continue to have a 
growing, healthy, strong senior population that is generous and forward-
looking is to be decent and honorable and fair.
    It is fair and decent to fix the Trust Fund. It is right to do what 
we can to crack down on fraud and abuse and to slow the rate of medical 
inflation and to slow the rate of medical inflation in the Medicaid and 
the Medicare program. But it is not right to pay for an arbitrary 
balanced budget and a very large tax cut, a lot of which goes to people 
who don't need it and, to be fair to them, have not even asked for it, 
to turn around and run the risk of putting Medicare out of the reach of 
seniors, putting Medicaid out of the reach of seniors, and undermining 
our solemn obligation to honor one another across the generations. 
That's what we need to do.
    We can get into the 21st century with a growing economy, a balanced 
budget, a stable future, but only if we do it consistent with our 
fundamental values. What is proposed up there is not consistent with our 
values and doesn't make common sense. But we can make common sense, 
balance the budget, save the Trust Fund, and leave Medicare and Medicaid 
in good shape for you and the people that come behind you.
    So tell the Congress and everybody else in Washington to throw away 
the partisan, political, extremist ideology and the rhetoric and get 
down to work on doing America's job for America's future.
    Thank you, and God bless you all.

Note: The President spoke at 2:47 p.m. at Point East Senior Center. In 
his remarks, he referred to Robert Butterworth, Florida attorney 
general, and Ginger Grossman, who introduced the President.