[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. 
    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.