    [Public Papers of the Presidents of the United States: William J. Clinton (1997, Book II)]
    [November 20, 1997]
    [Pages 1618-1621]
    [From the U.S. Government Publishing Office www.gpo.gov]

    [[Page 1618]]

    Remarks Announcing the Health Care ``Consumer Bill of Rights and
    Responsibilities''
    November 20, 1997

        Thank you very much, first of all, Peter, for your outstanding
    remarks and the power of your example. And I accept your offer to play
    golf. [Laughter]
        I thank all the Commission members and the members of the staff for
    a truly remarkable piece of work. And I'd like to say a special word of
    appreciation to Secretary Shalala and Secretary Herman, who cochaired
    the Commission and who, I believe, did a remarkable job, and I thank you
    very much. I thank the Vice President for his work in overseeing this
    effort and for his concern.
        This whole health care issue is very personal to me and to our
    family, to the First Lady. When I was running for President, I met
    person after person after person who had a cost, a quality, or an
    accessibility issue with the health care system. But long before that,
    as a Governor in what my opponents used to call a small southern State,
    I had the great gift that representing a small population gives you, of
    knowing a high percentage of the people who hired me, from all walks of
    life and all social strata, from all different circumstances. And I just
    kept--I had such ambivalent feelings. I could see in my own State that
    we had the finest health care system in the world. I saw miracle after
    miracle after miracle, I saw person after person given a chance to
    reconstitute his or her life, and then all these terrible problems
    arising from the cost or the quality or the accessibility issues.
        So we've worked very hard on them. The Vice President mentioned the
    quality issues. I would also like to say, this has been a very good year
    across the board for American health care. In the balanced budget bill
    we have $24 billion to provide health insurance to another 5 million
    children, about half of those who don't have health insurance--something
    that has become very important because the number of uninsured Americans
    has continued to rise since 1993. Ironically, even as the percentage of
    people in the work force eligible to purchase health insurance with the
    involvement of their employers has gone up, because of price the
    coverage has gone down.
        We had a significant step in reforming the Medicare program to add
    many years of life to the Trust Fund and provide more choices, including
    preventive care to Medicare recipients and earlier tests for
    mammographies for younger Medicare-eligible women. We had what the
    American Diabetes Association called the most significant advance in the
    care of diabetes since the discovery of insulin 70 years ago, in this
    bill. In a day or so, I'm going to sign the bill reforming the Food and
    Drug Administration and its procedures. The FDA, I might point out, has
    already won an award for its groundbreaking work in accelerating the
    approval of drugs while continuing to meet safety standards to try to
    increase the availability of possibly life-saving medication more
    quickly.
        So a lot of good things happen. Yesterday I signed an adoption bill
    which was the product of an overwhelming bipartisan consensus in
    Congress which will revolutionize adoptions, including adoptions of
    children with special needs, which also will have a terrific health
    impact on some of the most vulnerable children in this country. So I
    want you to see this Commission's work against that backdrop. There is
    an emerging consensus in America that while people may not have wanted
    to bite the whole apple at once in 1994, almost the whole populace wants
    to keep nibbling away at the apple until we actually have solved the
    problems of cost, accessibility, and quality for all responsible
    American citizens.
        What this Commission has done today with their health care consumer
    bill of rights is a truly extraordinary thing--all the more
    extraordinary because the Commission actually represents all walks of
    life and all the different financial equities in the health care debate
    in America. And again, let me say, I thank you very much. We will be
    much closer to making these rights reality for every American because of
    the courage of the Commission and because of the composition and the
    broad experience of the different Commission members.
        Throughout our whole history, our strength has come from our
    families, from our individual

    [[Page 1619]]

    citizens, from our continuing commitment to redefine and expand the
    parameters of opportunity and freedom, and at the same time, to do it in
    a way that brought us closer together as a society instead of dividing
    us further. Those values were in America's Bill of Rights, and they are
    certainly in this health care consumer bill of rights.
        Today, our families face so much change, and of course the changes
    in the way we work, the way we live, the way we relate to each other and
    the rest of the world are quite profound. I think, in a major way, the
    mission of our administration here must be to try to help America
    prepare for these changes so that we can expand the opportunities they
    present and adequately meet the challenges they present, and so that we
    can go forward together.
        Health care is changing dramatically, as we all know. The Vice
    President detailed some of those things. And we have worked hard to help
    people deal with these changes. Now, there are still particular problems
    that plainly require specific solutions. Millions of Americans have seen
    their health plans convert to HMO's and new kinds of health insurance.
    In many cases, managed care does bring lower costs and improved
    preventive care. And the health care industry, I believe, as a whole
    truly shares our goals of improving quality. And I have never been one
    who believed that improving efficiency involved the sacrifice of quality
    and, often, not even a sacrifice of quantity.
        Our administration has reduced the size of the Federal Government by
    300,000, eliminated a few hundred programs and several thousand pieces
    of regulation, and I have yet to have a single American citizen come up
    to me and say, why did you get rid of this or that. So we believe that
    you can have efficiency and improve quality and often improve the sheer
    volume of service as well. That's one of the things that technology
    makes it possible for us to do.
        Still, I think it's fair to say that almost every family feels some
    insecurity at the scope and pace of change in the world, including the
    scope and pace of change in the health care industry. And very often
    people feel actually lost because they have come up against this change
    in a way that is, to be charitable, not positive.
        There are so many people in this country that because of these
    changes feel like they're always going to be on the losing end of cost-
    cutting and quality issues in every sector of life, maybe even where
    they work, and they certainly are most frightened of it when it comes to
    health care, even more frightened than when it comes to their own job, I
    think, because with the unemployment rate being low and real flexibility
    in American labor markets, Americans have proved that they are
    incredibly resilient at getting new jobs. And increasingly, those new
    jobs are as good or better than the ones they lost, something that was
    not true just a few years ago. But when it comes to health care, you
    can't be sure of that kind of recovery, and no matter how much
    confidence you have in your own resilience, somebody else has got to
    help you.
        So even as we are trying to give Americans more job security in a
    changing environment by keeping unemployment low and intensifying our
    efforts to help people if they do lose their jobs to get better skills
    and find a job that is as good or better, we have got to recognize that
    the elemental insecurity that a loss of confidence in the quality, the
    accessibility, or the affordability of health care can breed in our
    society is staggering. The flip side of that is that if we can address
    those concerns, the increased confidence people have in the stability of
    the society as it affects their family and their lives will make them
    immeasurably more able to deal with the challenges of technology and
    globalization and change that no one can repeal.
        So I don't think it is possible to minimize the peripheral impacts,
    positive impacts of having the right kind of consumer bill of rights in
    health care and how much it will do to the sense of stability people
    feel on the job; how much it will do to increase employee productivity
    when they're not worried about their husband or their wife who got
    cancer 3 years ago, or if they're not worried about what's going to
    happen if their kid is in a car accident, like Peter was. If they know
    that at least they're going to have the best chance they can get, it
    will have a terrific impact to stabilize and sort of harmonize our
    society in ways that I think will be immensely positive for the economy.
    And obviously, the business leaders on this Commission agree.
        Now, consider the consumer protection issue in the larger context.
    Today, Americans receive consumer protection when they purchase cars,
    use credit cards, buy toys for their children. All this Commission is
    recommending is that we extend that kind of protection when a person

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    visits a doctor, checks into a hospital, or buys into a health plan.
    Whether it's traditional health care or managed care, we have to make
    sure it's not inferior care. There are basic standards that I believe
    every American should be able to count on wherever they live, whatever
    their needs. Those standards ought to be the right of every citizen.
        Here is what the health care consumer bill of rights says: You have
    the right to be informed about your health plan in plain English. You
    have the right to choose the right doctor for the right type of care;
    the right to medical services in an emergency wherever and whenever the
    emergency arises; the right to know all your medical options, no matter
    how much they cost; the right to respectful care and equal treatment at
    every health care facility by every health care provider; the right to
    know your medical records are confidential and only used for legitimate
    purposes; the right to express your concerns about the quality of care
    you receive and to take action when that care is inadequate.
        This consumer bill of rights, as has already been said, is the
    product of a broad consensus from a broad group of business leaders and
    health insurers, working people and health advocates, doctors and
    nurses. There are still those who oppose it, and that is their right.
    But this is a case where the national interest must prevail over the
    narrow interest, where the family's interest must prevail over the fear
    of change.
        I ask those who are afraid, on the other side, to balance in their
    equation the fear that has been in the hearts of all the Americans who
    have confronted the health care system without this consumer bill of
    rights. We all have to bear our fair share of the uncertainty of change
    if we are all going to feel secure in the face of the future. And that
    seems to me to be the best argument that we can take to those who do not
    yet agree that this is the right thing to do.
        These protections, in fact, are long overdue, and now we have to act
    to make them real for all Americans. Some will require Federal standards
    to be implemented. Where they do, I challenge Congress to make them the
    law of the land. There will be no more important test in the coming
    months of our commitment to strengthen our families. And I look forward
    to working with Congress.
        You heard the Vice President say there's broad bipartisan support
    for moving forward here. But we shouldn't wait for Congress to act,
    especially when it's not necessary. So today I am acting within my power
    as President to implement the rights to the extent that I legally can.
    I'm directing every Federal agency that administers or manages health
    plans to adopt the protections of the consumer bill of rights, and to
    report back to the Vice President about where they need legislation to
    do so. With this step, we can ensure better quality health care for tens
    of millions of Americans, including all Medicare and Medicaid
    beneficiaries and all Federal employees. And I challenge all private
    health plans to adopt the consumer bill of rights voluntarily, to give
    their members greater confidence and security.
        In that connection, I want to thank GTE and one of our Commission
    members, an officer of GTE, Randy McDonald. They are the first large
    company to guarantee the consumer bill of rights to all the 400,000
    people on their health plan, employees and their family members. It's an
    extraordinary step. And if they can do it, others can follow. I don't
    know if Randy is here today, but if he is, will you stand up? Thank you
    very much. God bless you.
        Finally, it would be wrong for us to end this without acknowledging
    that there can be no rights without responsibilities, that our community
    can only go forward when there is a corresponding responsibility for
    every opportunity and every right.
        The new world of health care offers greater choice and more
    fundamental opportunities for health than ever before. And today we
    outlined the rights that every American should have in dealing with that
    health care system. But every American also has an enhanced obligation
    to take an active role in his or her own health care and to take
    responsibility for his or her own health. We spend a lot of money in
    this country every year that we wouldn't spend if we'd just go through
    the day in a sensible way every day. And we have to acknowledge that,
    and we cannot blame the health insurance industry or the health care
    providers or anybody else in the wide world for the burdens we impose on
    ourselves for the extra cost, the lower income, the reduced productivity
    that are the direct result of daily choices made by individual citizens
    that they do not have to make in the way they live their lives, and we
    ought to be honest about that.

    [[Page 1621]]

        And we should never point the finger at other people when we have
    problems until we have first examined ourselves and what we have to do.
    And I know a lot of companies are looking at ways to reward responsible
    behavior and ask that some payment be made for that behavior that
    imposes costs on society as a whole. That's a large part of what we're
    attempting to do in settling this issue of the marketing and selling of
    tobacco to young people in America in ways that violate our laws. So I
    think that has to be a part of this; we can never lose sight of it.
        When President Kennedy proposed a consumer bill of rights over 30
    years ago, he said, ``Under our economic as well as our political form
    of democracy, we share an obligation to protect the common interest in
    every decision we make.'' I am convinced, as I have said repeatedly,
    that the coming years will be a time of remarkable breakthroughs in
    science and medicine, remarkable breakthroughs in the space and in the
    ocean, remarkable breakthroughs in the structure of human genes. They
    will also be a time of remarkable opportunity to relate to other people
    around the world, economically and culturally. They can be, this next 50
    years, the best half-century human society has ever known. But we have
    to look after the common interest. No matter how individualized our
    computers, our telephones, our fax machines, our self-employment--no
    matter what happens, we will still have to protect the common interest
    if we want to have safe streets, good education, good health care, a
    clean environment, and a healthy economy.
        Today, by standing up for individual rights, this Commission has
    advanced the common interest, and America will be much better for it.
        Thank you very much.

    Note: The President spoke at 12:11 p.m. in Room 450 of the Old Executive
    Office Building. In his remarks, he referred to Advisory Commission on
    Consumer Protection and Quality in the Health Care Industry member Peter
    Thomas, Chair of the Subcommittee on Consumer Rights, Protections, and
    Responsibilities, who introduced the President. The Office of the Press
    Secretary also made available the Commission's report, entitled
    ``Consumer Bill of Rights and Responsibilities.''