[Public Papers of the Presidents of the United States: William J. Clinton (1997, Book II)]
[September 15, 1997]
[Pages 1162-1167]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks to the Service Employees International Union
September 15, 1997

    Thank you very much. Thank you. This is a pretty good way to start 
off the week. [Laughter]
    You know, I'm getting up in years now, and--[laughter]--every day I 
start a little slower, it seems like, and I always need kind of a jolt 
of energy. I may be dancing by the time I get back to the White House. 
This may be the afternoon of my first 5-mile run since the accident.
    It's great to see you, and I thank Andy for that remarkable 
introduction and for his remarks and his passionate commitment. I thank 
your executive vice presidents who are up here on the stage with me, and 
all the rest of you for inviting me here.
    We have a large number of people from the White House who have come 
here today. I think I should mention at least two of them. One is a gift 
you gave me or a theft I accomplished--[laughter]--but Karen Tramontano 
is doing a magnificent job. I also would like to note that the Assistant 
to the President and Director of Public Liaison used to work with you at 
the Labor Department, Maria Echaveste, and she is also doing a great 
job, and she's here with me.
    Ladies and gentlemen, I am delighted to be here and delighted to see 
all of you, wishing I had one of those purple T-shirts to jog in. 
[Laughter] I'll get one before I leave. The SEIU--better not do that or 
it will be a story. [Laughter] The SEIU is leading the way for better 
wages, safer workplaces, more full-time jobs, and a brighter future for 
our working families. There's new life, new energy, new creativity in 
the labor movement in America, and a lot of it began right here with 
you, and I thank you for it. Because of your leadership in the workplace 
and your involvement in the political process, not just you but America 
is also back. I've come here today to thank you for what you've done, 
not simply for me and our administration but for the people of the 
United States,

[[Page 1163]]

to strengthen our families and to strengthen our economy and to 
strengthen our future.
    I also want to talk to you about what we can do now to strengthen 
America's health care system and especially to talk about what we have 
to do to reduce fraud in the Medicare program so that it can serve 
America well into the 21st century.
    We've come a long way from 6 years ago when I announced my candidacy 
for President. Then I said that I had a simple mission for America in 
the 21st century. I wanted to keep the American dream alive for every 
person responsible enough to work for it. I wanted to make sure that 
America would continue to be the world's strongest force for peace and 
freedom and prosperity. And I wanted to make sure that we could bring 
our people together across all the lines that divide us amid increasing 
diversity into one America--our oldest and most enduring values--
opportunity for all, responsibility from all, a community of all 
Americans leading the world toward peace and freedom and prosperity.
    We began with a bold new economic course that focused on three 
things: shrinking the deficit; selling more American products and 
services around the world; and investing in our people, in the capacity 
of all of our people, and being determined to leave no one behind. We 
also put a special effort on depressed communities. We had an aggressive 
anticrime strategy to try to bring the crime rate down by putting more 
police officers on the street and keeping more kids out of trouble, 
taking assault weapons off the street, keeping handguns out of the hands 
of people with a criminal or a serious mental health history. We had an 
aggressive effort to help move people from welfare to work. Now, 6 years 
later from the time I started, almost 5 years from the time I became 
President, we see the results: nearly 13 million new jobs, unemployment 
less than 5 percent, poverty down, the biggest drop in welfare rolls in 
history, dramatic drops in the crime rate year after year.
    Maybe even more importantly, about midway through my first term, 
after decades of working harder and harder for lower wages, never 
keeping up with inflation, millions of Americans are finally beginning 
to see a rise in their paychecks. And it's about time. Incomes of 
American families have averaged an increase of $1,600 since the 
beginning of our administration, but it's getting better over time 
because of three things.
    First of all, with your help last year, we raised the minimum wage 
because no hard-working parent should have to try to raise a child on 
$4.25 an hour.
    Secondly, we more than doubled the earned-income tax credit in the 
economic program of 1993, which is worth, on average, over $1,000 a year 
in lower taxes to a family of four with an income of under $30,000 a 
year if they have a couple of children.
    And thirdly, the children's tax credit, which was just adopted--and 
adopted to cover those young public employees that start out, and may be 
eligible for, the earned-income tax credit, too--will be worth another 
$500 a child to working families throughout this country.
    These three things together are going to have a huge impact on the 
family incomes, particularly of people, let's say, in the bottom 40 
percent of the income brackets in the United States.
    From 1945 until the mid-seventies, all of us grew together. From the 
mid-seventies to the early nineties, our economy continued to grow, but 
because of inflation, because of foreign competition, because of all the 
restructuring going on in the American economy, we began to grow apart. 
Now we can grow together again. And I know that's what you want, and 
that's what I want. We've got to grow, and grow together. And that means 
we can't rest, because even though this is a time of extraordinary 
achievement and justifiable optimism for our country, we have to keep 
going until every single American can reap the rewards of a growing 
economy, and we're not there yet.
    In the last budget bill, for the first time ever, we had so much 
increased aid to help people go to college or send their children to 
college--the biggest increase in 50 years since the GI bill--we can now 
honestly say we have now opened the doors of college education to all. 
But people have to walk through them in order to get the training they 
need to get the incomes that they want for themselves and their 
children.
    We also are in the middle of a continuing struggle to secure the 
investments in the budget agreement for our schools and also to embrace 
the notion that we ought to have high national standards of academic 
excellence, which should apply to all of our children in all of our 
school districts--not Federal Government standards, national standards 
that should apply to all of our children.

[[Page 1164]]

    We also have to pass sweeping legislation designed to continue this 
effort to keep tobacco out of the hands of our young children.
    And we have to continue to grow the economy. There are some specific 
things in this budget agreement that are very important, designed to go 
right to the heart of the poorest communities in urban and rural 
America: doubling the number of community development banks that make 
loans to people in those neighborhoods; continuing to make sure that we 
have more and more empowerment zones, the program the Vice President has 
done such a good job on, to give people incentives to invest money where 
there are people who are unemployed or underemployed. That's good for 
our economy, to keep the jobs growing.
    One other thing--and I know that we have often disagreed on this--I 
just want to say one more time. Our analysis is that between one-quarter 
and one-third of our economic growth that made 13 million jobs in the 
last 4 years came because we are selling more American products 
overseas. Why? We have 4 percent of the world's population; we have 20 
percent of the world's wealth. If you want to keep 20 percent of the 
wealth with 4 percent of the population, you have to sell something to 
the other 96 percent. Now, in the next 15 years, our estimates are that 
the developing countries of Latin America and Asia will grow 3 times as 
fast as the United States, Europe, and Japan. And therefore, we have to 
be a part of that.
    The last point I want to make is--all of you know this--our markets 
are already among the most open in the world. They're more open than all 
these countries we're making agreements with. So if we agree to have 
equally open markets, we give up far less than they do, and we open 
markets largely to our high value-added products. That's why I sought 
the fast-track trade authority, not because I want unfair trade 
agreements but because I think we have earned a presumption, at least, 
to be taken seriously when I say to you the 220 trade agreements we have 
negotiated had something to do with the 13 million jobs we have and the 
fact that we have the most successful economy we've had in a generation.
    Should there be labor and environmental standards? Should we work 
hard to raise labor standards for working people around the world so 
that it increases everyone's income? Absolutely. Should we ask people to 
adhere to global standards so that we can preserve the global 
environment? Absolutely. But that means we should, too. That means that 
we should, too. We can't tell another country they should clean up their 
sewage and clean up their water unless we're willing to clean up the 
global air that we--we have to do it, too. We have to do it, too.
    So we've got a lot still to do. But I want to focus in the last few 
minutes of my talk here on what Andy talked about. I want to talk about 
health care: Where we are and where are we going. You know, they said if 
I passed my health care plan that everybody was going to go into managed 
care, and it would be a bad thing. [Laughter] Well, we didn't pass the 
health care plan, and everybody's going into managed care. [Laughter] 
And it's not all bad.
    But also we don't have anything like the choices for health care 
consumers that we had in our plan. So the good news is, we've 
rationalized the management of the health care system. The bad news is, 
we don't have the standards in there and the choices and the consumer 
protections that we would have had.
    Now, we can't go strong into the 21st century if millions of our 
fellow citizens still go to bed every night worrying about whether their 
sons and daughters and parents can see a doctor. I said if we don't do 
something about it, the number of people without health insurance in 
America will continue to rise. And sure enough, it has. Now there are 
over 40 million of us without health insurance.
    We can't be strong in the 21st century if American patients are only 
a dollar sign on a ledger book. We cannot be a strong nation--to be 
fair, too, we can't be a strong nation unless we know that Medicare and 
Medicaid will last and will be relatively free of the fraud and abuse 
that can so easily infiltrate any big program. So we have a lot to do.
    It has become commonplace to say that we have the most excellent 
health care system in the world, but we are not very excellent in making 
sure all Americans can share in it. That is what we have to focus on. 
And it tickled me when Andy said that Bill and Hillary would outlive 
Harry and Louise. I certainly hope so. [Laughter] I have to tell you, 
though, a lot of times in my life I've gotten beat trying to do 
something I thought was right. And I prefer that than not trying in the 
first place. I'm glad

[[Page 1165]]

I tried to do the health care. I'm glad I tried to do that. [Applause] 
Thank you.
    As you might imagine, I've had a lot of time to sort of Monday-
morning quarterback myself and try to figure out how I could have done a 
better job. It is ironic that, having reduced the size of the Federal 
Government by 300,000 to its smallest size since Kennedy, I was accused 
of trying to have the Government take over the health care system; that 
having given more authority to the States than even President Reagan 
did, I was accused of trying to engage in a power grab for the Federal 
Government. I wasn't trying to do that. But the fact is that we have a 
system unlike any in the advanced world. And every other advanced 
country can figure out how to get health insurance to everybody, and we 
can't. And we wind up paying more because of it, because we don't do 
enough preventive health care, we don't do enough primary health care, 
we do too much through the emergency rooms. We have too many people with 
uncompensated care that the rest of us who have insurance pay for in 
higher rates. All because we have refused to try to rationalize this 
process.
    Now, what I tried to do before won't work. Maybe we can do it in 
another way. That's what we've tried to do a step at a time until 
eventually we finish this. We can be very proud of the Family and 
Medical Leave Act. I was glad that your president mentioned that. That's 
the first major legislation I signed. Millions of people no longer have 
to make a choice between succeeding at work and home because of that. 
All the time, people still come up to me and talk about it--I travel 
around the country--just citizens come up and talk to me about their 
experiences under the Family and Medical Leave Act.
    We can be proud that after the so-called Contract With America 
revolution in 1994, we didn't allow them to take away Medicaid, and we 
were able to preserve the social safety net. There are millions of poor 
children, pregnant women, disabled and older Americans who still have 
access to health care. A lot of them don't. A lot of them can't even 
vote, and they may not have a lot of political power. But you stood up 
for them, and I appreciate it, and I hope you're proud of it.
    You can be proud that you supported and that there was enormous 
bipartisan support for the Kennedy-Kassebaum health insurance bill that 
says you can't lose your health insurance when you change jobs or just 
because someone in your family has been sick. That will preserve health 
care for enormous numbers of people, and you should be proud of that.
    And you ought to be proud of the health care provisions of this last 
budget. The biggest increase in investment in health care for children 
since the Medicaid program passed in 1965 is in the balanced budget of 
1997. It will permit us to insure up to half of the children who don't 
have health insurance. And if you'll help us, we might be able to 
actually insure more. Because of the 10 million children in America--40 
million people roughly don't have health insurance, actually a little 
more; 10 million of them are children. Of those 10 million, 3 million, 
believe it or not, are eligible for Medicaid right now. And they're not 
on it, either because maybe their parents are first generation 
immigrants, aren't fluent in English, no one has explained to them that 
they're eligible. Maybe they're people who work for low wages, but they 
think somehow they'll be on welfare if their children take Medicaid.
    It's a lot of work, but we could actually insure more than 5 million 
children with the $24 billion in this bill. If we could get the 3 
million kids who are Medicaid-eligible right now onto Medicaid, we could 
take the same money and insure far more children. And we'll be back to 
you on that. But we need your help.
    In addition to that, this budget also provided new preventive care 
benefits for mammographies, to try to head off prostate cancer, which is 
just as prominent in men as breast cancer is in women, and had what the 
American Diabetes Association said was the most significant advance in 
the care of Americans with diabetes since insulin was discovered 70 
years ago. So this is a good budget.
    But we have to work now to make sure that we devise a system that 
actually covers new children instead of a system that permits employers 
to continue to drop their employees' children from insurance because 
they're going to be picked up in public dollars. We must not do that. We 
must make sure that we cover new children.
    I need your help in this. We cannot waste this opportunity. We've 
got to work with the advocates groups, the local communities, the State 
governments, the health care providers. We cannot blow this. This is an 
enormous thing.

[[Page 1166]]

You know, when you think about the rhetoric of the health care debate 
just a couple of years ago, and now you've got 80 percent of the 
Congress in both Houses voting for the biggest increase in health care 
coverage since Medicaid passed in '65, we have come a long way. And you 
can be proud of that. And you can be glad that now there are Members of 
both parties in Congress who are willing to vote to do this.
    But it is complicated when you're doing this a piece at a time. 
We've got to do it right so we can go on to the next step and the next 
step and the next step. What about all those people that retire at 55 
and lose their employer-based health insurance and can't draw Medicare 
until they're 65? What about all those people? What about all the people 
who have a right to keep their health insurance when they're between 
jobs, but after they've been without a job for a certain amount of time, 
they still can't afford it? I've got a right to own a Jaguar, but I 
don't. [Laughter] So we've got to be careful. We've got to do this 
right. And you can help on this. You can really help us on this. But the 
children of this country have got a lot riding on us doing this right, 
and we need you.
    Finally, let me say, we've got to take some decisive steps to deal 
with some of the changes that are constantly evolving in the health 
industry. We've got to act to protect consumers first. Whether they have 
traditional health care coverage or managed care, we have to make sure 
they don't have inferior care. That's why I appointed the nonpartisan 
quality commission to write a consumer's bill of rights. And let me say, 
I want to thank your secretary-treasurer, Betty Bednarczyk, for serving 
on that. She's doing a good job, and I appreciate it.
    Congress has to pass some legislation. It should ban gag rules in 
private health care plans, just as I did in Medicare and Medicaid. It 
should ban these horrifying drive-through mastectomies, just as it 
banned drive-through baby deliveries. The First Lady and a lot of other 
people have worked hard on this since I called for it in the State of 
the Union, but Congress still has not held a hearing on this. It's time 
to move, and I ask you to help me get Congress to move on this.
    It should be made illegal for health companies to deny or drop 
coverage or raise rates based on genetic information. We're going to 
continue with this Human Genome Project, and that's a good thing. And 
some day in the not-too-distant future, young mothers and fathers will 
bring their newborn babies home from the hospital and they'll actually 
have a genetic map for their kids. And 99.9 percent of the time, I 
guess, or at least the vast majority of the time, it will just be good 
news with good information. Sometimes it will be terribly sad. But even 
when it's sad or challenging or frightening, it will give those parents 
the chance to give their children a longer life or a better life. But if 
we're going to find this information, we can't turn around and basically 
say, because of the march of science we're going to even increase 
further the number of uninsured people in America. And who's going to 
take care of them?
    So this is a very important issue. And again, I ask for your strong 
advocacy on this. Science, yes; research, yes; tell people more about 
the health condition of their children, yes; but don't strip them of 
their insurance because of this march of science.
    Congress should follow the new medical privacy guidelines we issued 
last week and pass legislation to make sure records now stored in 
computers stay just as confidential as records locked in a file cabinet. 
I think that average Americans really worry about this. You do--don't 
you worry that something gets in a computer, it will be halfway around 
the world and somebody is going to send you something in the mail to try 
to get some money out of you or do something? I think people really 
worry about this. How can we preserve privacy and still take advantage 
of the modern computer technology? We want people that deal with us to 
take advantage of computer technology if they can serve us faster or 
better or cheaper. We know they can save a lot of money. But in the end, 
privacy is worth an awful lot, and we don't want to see computer 
technology take it away.
    And the last issue I want to deal with, again, is to say that we 
will never have a health care system as strong as it can be unless we 
strengthen our efforts to root out fraud and abuse in the Medicare 
program. They amount--these kinds of practices amount to a fraud tax on 
all the taxpayers of the country. And for those of you who work in 
health care, they cost public confidence in the work that you do. I know 
home health care workers want to put a stop to fraud and abuse, and I 
look forward to working with you to do that.

[[Page 1167]]

    We put more Federal resources into this. Convictions are up 240 
percent, and we've saved the taxpayers $20 billion already, but it is 
just the beginning. Home health care is one of the country's fastest 
growing industries. We want more people to be cared for at home if they 
can properly be cared for at home. Every month, nearly 100 home health 
providers--new ones--enter the Medicare program. But there is still too 
much evidence of widespread fraud and abuse that has to stop.
    First, we're going to keep scam and rip-off artists from getting 
into the Medicare system in the first place. Today I'm declaring an 
immediate moratorium on the admission of new home health agencies to 
Medicare, and during this moratorium we'll develop tough new regulations 
to ensure that no fly-by-night providers enter or remain in the Medicare 
program. Second, I'm requiring all home health agencies to re-enroll 
every 3 years so that they, too, will abide by these standards. Third, 
we will double the number of audits of home health agencies currently 
involved in the Medicare program.
    Medicare for us is a way to honor our parents and strengthen our 
families. I was glad to fight for the comprehensive reforms that we got 
in the last budget that will give more choices to Medicare customers and 
still keep the program strong for more than a decade. No matter what 
changes we make in the structure of the program, we can't maintain it 
for what it should be if we tolerate unacceptable levels of fraud and 
abuse.
    Earlier today I said that you represented the future of the American 
labor movement and the future of America. Just look around the room, and 
you'll see why--people who have come together across racial, 
professional, geographic lines to fight for a common future. That's what 
we all have to do. That's why I asked the American people to join me 
this year in a great conversation about our racial diversity and where 
we're going with it. What's our unfinished business that we've been 
lugging around for us? What about discrimination that still exists? What 
about destructive attitudes that still exist? What is the unfinished 
racial business of America? Question one.
    Question two is, what about the future? What kind of country is this 
going to be like when, 5 years from now, there's no group with a racial 
majority in our biggest State, California, and when, within 40 years, 
there will be no racial majority in the entire United States? Now, we 
can look at the census projections and tell what we're going to look 
like, but that's not the same thing as saying what we're going to be 
like.
    Everything we talked about today, every single specific issue is 
designed again to guarantee opportunity for everybody who will work for 
it, to maintain the leadership of our country in the world, and to bring 
us together in one community of America. That's what I want you to lead 
for.
    Don't ever be afraid to be an instrument of change. Don't ever be 
afraid to stick your neck out and fight for change. And don't ever be 
afraid to hold yourself up to the scrutiny of life and say we want to 
represent the future of America. You look around this room, and you know 
you can do it. And when you think about how you feel at your very best 
in your work, you think about the best days you ever have working with 
people that are so different from you, you never imagined you'd ever get 
to know them or work with them, that's the way America ought to be every 
day. And that's what we need to keep working for.
    Thank you, and God bless you.

Note: The President spoke at 11:20 a.m. in the Phoenix Room at the Hyatt 
Grand Regency Hotel. In his remarks, he referred to Andrew Stern, 
president, Service Employees International Union; and ``Harry and 
Louise,'' characters in a series of commercials sponsored by the Health 
Insurance Association of America.