    [Public Papers of the Presidents of the United States: William J. Clinton (1997, Book I)]
    [March 27, 1997]
    [Pages 354-357]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on National Cancer Institute Recommendations on Mammography and
    an Exchange With Reporters
    March 27, 1997

        The President. Secretary Shalala has just briefed me on the National
    Cancer Institute's new recommendations on mammography. These
    recommendations, based on the latest and best medical evidence, give
    clear, consistent guidance to women in our national fight against breast
    cancer. Breast cancer is the most commonly diagnosed cancer among women.
    It affects one in eight women in their lifetimes and has touched the
    families of nearly every American, including my own.
        We may not yet have a cure for breast cancer, but we do know that
    early detection and early treatment are our most potent weapons against
    this dread disease and we know that mammography can save lives. That is
    why it's important to send a clear, consistent message to women and to
    their families about when to start getting mammograms and how often to
    repeat them.
        After careful study of the science, the National Cancer Advisory
    Board has now concluded that women between the ages of 40 and 49 should
    get a mammography examination for breast cancer every 1 or 2 years, in
    consultation with their doctors. The National Cancer Institute has now
    accepted these recommendations. Now women in their forties will have
    clear guidance based on the best science, and action to match it.
        Today I am taking action to bring Medicare, Medicaid, and the
    Federal employee health plans in line with the National Cancer
    Institute's recommendations. First, in the Medicare budget I am sending
    to Congress today I am making annual screening mammography exams,
    beginning at age 40, a covered expense without co-insurance or
    deductibles. Second, Secretary Shalala is sending a letter to State
    Medicaid directors urging them to also cover annual mammograms beginning
    at 40 and assuring them that the Federal Government will pay its
    matching share if they do so. And today I am directing the Office of
    Personnel Management to require all Federal health benefit plans to
    comply with the National Cancer Advisory Board's recommendations on
    mammogram screenings, beginning next year.
        The Federal Government is doing its part to make sure women have
    both coverage and access to this potentially lifesaving test. I want to
    challenge private health insurance plans to do the same. They, too,
    should cover regular screening mammograms for women 40 and over.
        Finally, we know there has been much discussion on this issue and a
    lot of confusion. That is why we are launching a major public education
    campaign to make sure every woman and every health care professional in
    America, that all of them are aware of these new recommendations. This
    is a major step forward in our fight against breast cancer.
        In addition to Secretary Shalala, I want to thank National Cancer
    Advisory Board Chairperson Dr. Barbara Rimer and all the members of the
    Board, along with the NCI Director, Dr. Richard Klausner, for the fine
    job that they did in producing these recommendations.
        I also want to thank the First Lady, who could not be with us here
    because of her visit to Africa. She has devoted countless hours to
    educating women about the importance of mammography, and this is a happy
    day for her. She has especially tried to educate older women to take
    advantage of the Medicare coverage of mammograms, because we know that
    too few of them still do. And that's the last point I would like to
    make. These guidelines and this coverage, it's all very good, but unless
    women are willing to actually take advantage of the coverage, we won't
    have the full benefit of the recommendations and the findings that have
    been made.
        Now I'd like to turn the microphone over to Secretary Shalala to
    make a few comments.

    [At this point, Health and Human Services Secretary Donna Shalala made
    brief remarks.]

    Heaven's Gate Cult Mass Suicide

        Q. Mr. President, do you have any comment on the mass suicide in
    California?
        The President. Well, of course, all I know is what I read about it
    this morning and what I saw last night reported. But it's heartbreaking;
    it's sickening; it's shocking. I think it's important that we get as
    many facts as we can about this

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    and try to determine what, in fact, motivated those people and what all
    of us can do to make sure that there aren't other people thinking in
    that same way out there in our country, that aren't so isolated that
    they can create a world for themselves that may justify that kind of
    thing. It's very troubling to me. But I don't think I know enough to
    make a definitive comment about it.

    Democratic Party Finances

        Q. Mr. President, switching gears on another subject, the Democratic
    Party emerged from this most recent election in the aftermath of all of
    these fundraising problems--it seems to be in pretty bad shape
    financially--enormous debt that they can't repay. What, if anything, can
    you do about this, and how much responsibility do you have to try to get
    the Democratic Party back into shape?
        The President. Oh, a lot, and I have been doing a lot, and I will do
    more. We knew that we would have to spend--last year when it became
    obvious that our congressional candidates were going to be outspent
    massively, we did everything we could to raise a good deal of money at
    the end. But the committees and the Democratic Committee went into debt
    with money that they could legally borrow in the hope of trying to be
    competitive. They actually did a pretty good job. They were still
    outspent, I figure, in the last 10 days, 2 weeks, probably 4 or 5 to 1
    in all of the contested races. But we knew that would happen, and we
    knew it would take some time to pay it back. But I'm not particularly
    concerned about it. I think we will pay it back. And it was, I thought,
    important.
        Keep in mind, we were at the bottom of the barrel in November of
    '94, and in 1995 we did a good job, I think, of building our party back
    and showing what the clear differences were between the two parties. And
    the previous leadership of the party deserves a lot of credit. We got up
    to a million small donors, and they're coming back now. They're
    beginning to make their contributions, and that's very encouraging. So I
    think we'll get there. I'm not particularly concerned about it.
        We made a deliberate decision to kind of downplay the Inaugural and
    not to try to tie too much of that to fundraising, so we're going to
    have to work harder this year. But I've been doing some work, as you
    know, and I will continue to do more.
        Q. Do you think Governor Romer has second thoughts about some of the
    changes that previously--eliminating contributions from subsidiaries of
    foreign companies and also non-U.S. citizens--he seems to be having some
    second thoughts about some of those proposals you made over the past few
    months.
        The President. Well, let me say, I still don't believe--I think, on
    balance, it's better policy to say that people who can't vote shouldn't
    contribute. In terms of the subsidiaries, the real problem there is the
    law says if the money is made in the United States, it can be given in
    the United States. The problem is, how do you ever know that? And so I
    think that he was trying to bend over backwards to get us off on the
    right foot.
        But I'd be willing to talk to him about it. But the main thing is
    we're just going to have to get together and work hard and rally our
    troops and remind them of what we're trying to do here, how we're trying
    to balance the budget, what we're trying to do for education, what we're
    trying to do to move the country forward and get the efforts going.
    We've had several successful events this year. We just have to do more.
    And we knew--what you have to do after an election, when we saw all this
    third party money and all these other things coming down the pike, we
    wanted to give our Members of Congress a chance to be competitive, and
    so we undertook to do so. And I'm glad we did, but we're just going to
    have to work double hard now to pay the money back, and we'll do that.
    We'll pay our debts, and we'll make our budget this year.

    Middle East Peace Process and China

        Q. Have you received any updates from Ambassador Ross or the Vice
    President?
        The President. Yes.
        Q. And what have they been?
        The President. Well, Ambassador Ross had a very good meeting with
    Chairman Arafat, and he's proceeding now on his trip. And I don't have
    anything else to tell you, but he was encouraged by the response of
    Chairman Arafat to the matters that we discussed here before he left.
        I started the day this morning with physical therapy and a talk with
    the Vice President in China, which was also good therapy. [Laughter]

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    And he said to me that in every aspect, his trip had gone quite well and
    better than he had anticipated, and he was anxious to get back and give
    me a report on all the issues that we're concerned about. But I think
    the trip has been a real validation for our strategy of engagement with
    China, of taking our agreements, our disagreements, our matters of
    common interest, our matters of concern directly to them. And he is very
    pleased with the results so far, and I certainly am very pleased with
    the work he's done, with the speech he gave on human rights and with all
    the work that he's done in China so far. I'm encouraged about it. I
    think the trip has been well worth making.

    FBI and Alleged Chinese Efforts To Influence the 1996 Election

        Q. Have you seen that Janet Reno gave Louis Freeh a ringing
    endorsement this morning--every confidence in his leadership at the FBI?
        The President. Well, as I said--of course, she works with him every
    day, and that's why I said yesterday what I did. I was troubled by the
    headline in the New York Times story, but I did not know the facts. And
    I think it's important for me not to assume that someone has done or
    failed to do something that's adverse to the national interest before I
    know it's true. And she's the one that has to make those calls. And as
    she said in her comments, the system that we have--the President
    appoints the Director of the FBI, but the FBI is a part of the Justice
    Department. It's a part of the justice system. And whenever you have
    dual responsibilities in the Government, you're going to have some time
    when you've got to make a close call.
        And I still don't know--as I said, I just literally don't know--I
    could actually tell you whether I agreed or disagreed, if I knew what--
    if and what information had not been forthcoming to the National
    Security Council. I do believe that there should be a--that doubt should
    be resolved in favor of disclosure to the National Security Council of
    essential national security information. But the Attorney General has to
    resolve those things. And I trust her to do it. And so, what she said is
    fine by me.
        Q. Is there a problem if the President of the United States--a lot
    of Americans simply don't understand--the President of the United States
    says, ``I don't know that there's a problem because I haven't
    necessarily been given''----
        The President. Well, I think there is. Yes, I think there is. If I
    knew that one existed, I would agree that there was a problem. But I
    don't know it. And I'm still not sure that there was. I just have to--I
    have to trust the Attorney General to make sure that the National
    Security Council gets the information that we need to make good national
    security judgments here. I think, for example, in the Khobar Towers
    incident, there is absolutely not a shred of evidence that there's
    anything that we have been denied. And so, if I knew that there was and
    I knew what it was and I thought there was a mistake, I'd be happy to
    say that there's an honest disagreement here, but I just don't know that
    there is one.

    Ambassadorial Nominations

        Q. Has your administration been hamstrung in terms of ambassadorial
    appointments, appointments at the State Department and so forth because
    of all of these investigations on the campaign?
        The President. No, not at all. As a matter of fact, we've been
    working on getting ready for the next round of ambassadorial
    appointments. I approved a small number of them, oh, probably a couple
    of weeks ago so we could move in critical countries. But the others
    we're trying to do on a schedule which at least guarantees that all the
    Ambassadors now serving will do the traditional 3-year tour of duty. So
    we have some time on them. But we've worked very hard for the last month
    or so on that, and I don't see those two things as in conflict or a
    problem at all.
        Thank you.

    President's Health

        Q. How do you feel today?
        The President. I feel fine. Every day I'm getting a little more
    mobile, and I'm getting able to, you know, do a little more. I'll tell
    you one thing, I wouldn't wish this on anyone. But it's been a very
    enlightening experience, a very humbling experience. And the respect
    that I feel now for people who spend all day every day in a wheelchair
    or people who spend all day every day in braces and on crutches is
    enormous.
        The dignity and the strength of character that it takes to kind of
    organize your life and carry it out if you're always subject to some
    sort of significant physical disability is enormous. These

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    are things that we all sometimes see, but when you've felt just a little
    taste of it, when you realize what it means to be able to just navigate
    and do the basic things in life--just to dress yourself for the first
    time when you couldn't do it, for example--it just makes you understand
    that the rest of us in society who have been fortunate enough to have
    full use of our physical facilities owe an enormous amount of respect
    and sensitivity to people who don't.
        It's just been a stunning experience for me. I mean, I will never
    again see a person who has to deal with a disability in the same light
    again. I mean, it's just--it's had a profound impact. It's nothing I
    didn't know before, but feeling it and knowing it are two different
    things.
        Q. Thank you, Mr. President.
        The President. Thank you.
        Q. Like your doctor after you all the time?
        The President. Yes. She just wants to make sure I don't blow it.
        Q. I see her--we see her right here.
        The President. There she is.
        Q. She's watching.
        The President. These crutches are quite good. This way you can walk
    by putting your bad leg down and keeping the weight here. Otherwise, you
    have to just do this and then kind of do that. But if you can walk, it's
    a lot easier; the chances of falling are less.
        Q. They're better than the traditional crutches.
        The President. Yes, much better.

    Note: The President spoke at 12:17 p.m., in the Oval Office at the White
    House. In his remarks, he referred to Gov. Roy Romer of Colorado,
    general chair, Democratic National Committee; Ambassador Dennis B. Ross,
    Special Middle East Coordinator; and Capt. Connie Mariano, USN, the
    President's physician.