    [Public Papers of the Presidents of the United States: William J. Clinton (1998, Book I)]
    [February 20, 1998]
    [Pages 257-259]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks at the Holiday Park Senior Center in Wheaton, Maryland
    February 20, 1998

        Thank you very much, Mr. Vice President. I want to thank all of you for being here today and
    particularly those of you who have been active in health care. I thank
    Secretary Shalala and Deputy Secretary
    Higgins and Secretary
    Herman, who worked very hard on this; and
    Hershel Gober, the Deputy Secretary of
    Veterans Affairs; and Janice Lachance and
    Nancy-Ann Min DeParle, all the people
    who are here from the administration. General Hill, thank you for being here.
        I'd like to thank County Council President Leggett and all the local officials who are here. A special
    word of thanks to Chris Jennings in
    the White House. You know, the staff people who work on these things
    never get enough credit. This is great--the Vice President and I get up
    here, and we give these speeches, and you think how wise we are.
    [Laughter] And the truth is, there is always somebody making us look
    smarter than we are. [Laughter] And I'm very grateful to all the people
    who worked on

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    this, who passionately care about you and people like you all over this
    country who never get the acknowledgements they deserve.
        I thank Beth Layton and all the people
    here at Holiday Park for the work you're doing. I've been feeling very
    sentimental here. Twenty-one years ago, I'm almost sure it was 21 years
    ago this month, when I was a very young public official in my very first
    office of service, I had the State's first conference on senior citizens
    affairs. I never will forget it. I had it in the same place where I had
    my high school prom. [Laughter] And now I have my AARP card. [Laughter]
    I'm amazed at how farsighted I was back then to be concerned about this.
        I thank Marty Wish for his remarkable
    statement and for reminding us why we're working so hard. The first
    person I heard tell that story about ``As Good As It Gets'' was the
    Vice President. And every time anybody sees
    that movie, they always cheer. I understand it's going to be
    disqualified for an Academy Award because it's too close to real life.
    [Laughter]
        I want to thank Representative Morella and Representative Stark
    for being here and for their efforts to make health care quality a
    bipartisan American issue, not a partisan political issue. And I thank
    you both for being here. Thank you very much.
        We were going to have one other person here today, a woman named
    Dian Bower from California, whose son has a very
    serious illness that's being treated in a veterans military--excuse me,
    a military managed care program. And she's very well satisfied with it
    but passionately committed to the concept of a Patients' Bill of Rights.
    But because of the very difficult weather our fellow Americans in
    California have been experiencing--I'm sure you've been keeping up with
    it--she was unable to come. But I would like to thank her for efforts to
    be here.
        I'm pleased to accept this report from the Vice President. I just have to say one word about him. I asked
    the Vice President to undertake a very--what appeared to be a completely
    thankless job. When we took office, we had a deficit of $290 billion,
    and I said, ``Look, we have to find a way to reduce the Federal payroll
    by a minimum of 100,000, and we have to do it without throwing anybody
    in the streets, and we have to do it without losing the confidence of
    Federal employees or breaking their morale. They have to feel good about
    this.'' In other words, I was asking him to take two and two and make
    three or five or something other than four. And he worked with the
    Federal employees groups. Five years later, with the strong support and
    work and partnership of the Federal employees organization, the Federal
    payroll is 300,000 smaller than it was the day I took office. And--and--
    we have had good early retirement programs for the Federal employee. We
    have worked with them in a constructive way. The Government is working
    better, and it has freed up money to invest in putting another 100,000
    police on the street, in improving education and advancing the
    environment and doing all these things.
        But as part of our philosophy of government, we want a Government
    that is both smaller and more active, that gives people the tools to
    make the most of their own lives and acts as a catalyst for new ideas.
    And that's what we're doing here today. And this is perhaps the best
    example of all the wonderful work the Vice President has done in 5 years of reinventing Government, of how you
    can have a Government that's smaller and still does more to meet the
    real needs of the American people. So I want to thank him for that.
        What this report does is point out that we are quite close to making
    sure that our Federal health plans actually comply with the Patients'
    Bill of Rights that I have proposed. And today after I speak I am going
    to sign a directive over here on this desk which directs all our Federal
    agencies to finish the job by taking the necessary steps outlined in the
    Vice President's report to me.
        Now, I want you to understand clearly what this will mean--just this
    action will mean to the lives of the American people. With the authority
    of the Federal Government, we will ensure that a third of all
    Americans--a third of all Americans--are protected by a Patients' Bill
    of Rights. Now, that's every person on Medicare, every person on
    Medicaid, including children and people with disabilities, all of our
    Federal employees and their families that are covered, all of our
    military personnel, and members of the biggest health care system in
    America, all of our veterans and all their families.
        A third of the American people will have now a Patients' Bill of
    Rights that says this: You have the right to know all your medical
    options, not just the cheapest; you have a right to choose a specialist
    for the care you need; you have the right to emergency room care
    wherever and

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    whenever you need it; you have the right to keep your medical records
    confidential--very important; you have the right to bring a formal
    grievance or appeal of a health care decision with which you disagree.
        And we are proving we can make these rights real now for nearly 90
    million Americans. That's how many people we're talking about. And we
    can do this without increasing the deficit, without burdening the system
    or consumers. With this step we are setting a standard for the Nation.
        But we must not stop here. And that's why I am so glad to see
    Congresswoman Morella and
    Congressman Stark here, because now the
    Congress must pass national legislation to protect all Americans with a
    Patients' Bill of Rights. We are doing all we can do here with the
    stroke of the President's pen, but it should be an example that the rest
    of America should follow.
        I know there will be voices of opposition in the Congress and in the
    health care industry. But every American deserves the protection of a
    Patients' Bill of Rights. Those of you who are retired Federal employees
    who are still under a plan, you will be covered today. I bet you feel
    just as strongly as you did before I came here to sign this that
    everybody whose not in a plan you're in deserves the same protection.
    And we need to be clear and unambiguous about that.
        I look forward to working together with Members of Congress in both
    parties who have shown the determination to do something about this.
    This Patients' Bill of Rights is in keeping with our profoundest
    obligations to our parents, to our children, to the neediest, to the
    most vulnerable among us, in keeping with our oldest ideals enshrined in
    the Bill of Rights, and it is an essential part of our effort and our
    obligation to strengthen our Nation for the 21st century.
        We want the benefits of managed care. We all like it when health
    care inflation is not going up at 3 and 4 and 5 times the rate of
    inflation. It gives all of you who are on fixed incomes more disposable
    income for other things that are terribly important to you. But we must
    never, ever, ever sacrifice the fundamental quality of care and the
    security that gives people, knowing that they live in a country that not
    only has the best health care system in the world in theory, it's the
    best in the world, in fact, in their lives.
        Now, the Vice President talked about some of the things we have been
    doing in the last several years. A couple of years ago, Congress passed
    a law I strongly supported that says you can't lose your health
    insurance if you change jobs because someone in your family has been
    sick. The balanced budget amendment that I signed into law last year
    extends the Medicare Trust Fund until 2010. And we now have a Medicare
    commission meeting and working on how to preserve and protect Medicare
    well into the 21st century.
        The balanced budget law also contains an unprecedented $24 billion
    over the next 5 years to add up to 5 million more children to the ranks
    of the insured. And we're working with the States to do that. And
    Secretary Shalala is doing a great job in
    working with the States to make sure that we pick up more of these kids
    that don't have any health insurance. And just last week, I directed
    Federal agencies with programs with children to do more to enroll
    children as quickly as possible.
        This Patients' Bill of Rights is the next important step to make
    sure every American family has the quality health care all families need
    to thrive. It's especially important as our health care system continues
    to change.
        Now, 35 years ago, President Kennedy proposed a consumer bill of
    rights to protect Americans from unsafe products. He said, ``We share an
    obligation to protect the common interests in every decision we make.''
    Those rights are still protecting us today, those consumer rights, every
    time we rent a car or use a credit card or buy a toy for a child. The
    rights we are helping here to establish with the Patients' Bill of
    Rights will protect our children and our grandchildren 35 years from now
    and beyond.
        This is a good day for America, and I am proud to sign the executive
    memorandum to ensure the Patients' Bill of Rights to nearly 90 million
    of our fellow citizens.
        Thank you very much.

    Note: The President spoke at 11 a.m. in the gymnasium. In his remarks,
    he referred to Brig. Gen. Mack C. Hill, USA, U.S. Army Assistant Surgeon
    General for Force Management; Isiah Leggett, president, Montgomery
    County Council; Elizabeth Layton, vice chair, Holiday Park Senior Center
    Advisory Council; and Martin Wish, former chair, Montgomery County
    Commission on Aging.