[Public Papers of the Presidents of the United States: William J. Clinton (1998, Book II)]
[August 29, 1998]
[Pages 1476-1477]
[From the U.S. Government Publishing Office www.gpo.gov]

[[Page 1476]]

The President's Radio Address
August 29, 1998

    Good morning. I'm speaking to you today from the Edgartown 
Elementary School in Martha's Vineyard, Massachusetts. I'd like to talk 
to you about how we can put progress over partisanship in efforts to 
expand access to quality health care for every American.
    Years from now, when we look back on the greatest accomplishments of 
this century, miraculous advances in medical care surely will be at the 
top of the list. But for all the successes of medicine, for all the 
wonders of its quality, parts of our rapidly changing medical system 
that deal with access to medical care are in desperate need of repair.
    Like many of you, I've been appalled by tragic and repeated stories 
of men and women fighting for their lives and, at the same time, forced 
to fight insurance companies focused not on getting them the medical 
care they need but on cutting costs even if it denies that medical care.
    Recently, I met Mary Kuhl, the wife of a 45-year-old man who died 
after his insurance company canceled his emergency heart surgery, 
against his doctor's urgent warnings. I met Mick Fleming, whose sister 
died of breast and lung cancer after she was unfairly denied the 
treatment her doctor recommended, treatment for which she was eligible 
and desperately needed. These stories and these practices are callous 
and unacceptable. We must do everything in our power to give our 
families greater protection at this time of great change in medical 
    These things happen when, against doctors' recommendations, managed 
care plans deny procedures or treatment. Now, nobody wants to waste 
money, and the managed care movement has done a lot of good in slowing 
down unnecessary inflation. But none of us wants to see medical 
decisions affecting our families made by insurance company employees who 
are trained and paid to think like cost-cutting accountants, not care-
giving doctors.
    That's why I've worked so hard to pass a Patients' Bill of Rights, 
available to all Americans in all plans, a Patients' Bill of Rights that 
would say medical decisions should be made by doctors, not accountants; 
emergency room procedures should be made available whenever and wherever 
they're needed; no one should be denied access to a specialist when it's 
needed; no one should be forced to change doctors in the middle of 
treatment just because an employer changes medical plans; there ought to 
be an appeal of a medical decision made by an accountant all the way up 
the chain in the company, quickly, until it gets to a doctor; people who 
are hurt ought to have redress; and medical records should be kept 
    We've worked very hard to make these protections available to 
everyone we could. We've extended the protections of a Patients' Bill of 
Rights to 85 million Americans who get their health care through Federal 
plans, Medicare, Medicaid, the Federal Employee Plan, the Veterans' 
Administration. Today we'll take executive action once again.
    More than 120 million Americans are in workplace health plans that 
are protected under Federal law. The Secretary of Labor has now been 
instructed to ensure that all these people can quickly appeal, through 
an internal review process, any coverage decision that denies the care 
their doctors said was needed and appropriate. That means 120 million 
more people will no longer have to take an HMO accountant's ``no'' for 
an answer. This will bring a lot greater peace of mind.
    In many of these stories we hear about, the HMO actually, 
ultimately, approves the treatment the doctor recommended but only after 
it goes through layer after layer after layer of appeal. And sometimes 
there's no appeal at all. What we're doing today is trying to give quick 
and prompt appeals through an internal review process to the insurance 
companies and plans that are within our jurisdiction. It will help 120 
million Americans. But it's not enough. It is simply not enough.
    We do not have the authority to extend all the critical patients' 
rights protections I mentioned to all the American people, and we won't 
have it until Congress acts. That's why I've worked, since last 
November, with doctors, nurses, consumers, lawmakers of both parties to 
get a strong, enforceable, and bipartisan bill of rights--again, one 
that says you have the right to emergency room care whenever and 

[[Page 1477]]

you need it; the right to see that medical decisions are made by medical 
doctors, not insurance company accountants; the right to know you can't 
be forced to switch doctors abruptly; the right to see a specialist when 
you need it; the right to hold your health care plan accountable if it 
causes harm; and the right to privacy in medical records.
    These protections could have spared the Kuhls, the Flemings, and 
large numbers of other families across our country needless tragedies. 
They are protections all Americans deserve. Unfortunately, not a single 
one of these vital protections is assured in the Republican leadership 
bills now in the House and Senate. Both leave millions and millions of 
Americans without any protections at all. The Republican leadership of 
both Houses has not allowed full and open debate on the issue. The 
Senate hasn't even held a single vote.
    But remember, this is not a partisan issue. Nobody asks your party 
affiliation when you visit your doctor. No one wants to see unfeeling 
practices by insurance companies add to the pain of injury and disease. 
So when the Senate returns from recess next week, I urge lawmakers of 
both parties to make patient protections their first order of business.
    Last year, we worked together in a bipartisan spirit to pass a 
balanced budget which included historic Medicare reforms and the largest 
investment in children's health in more than 30 years. This year, 
Congress must act like that again. It must put progress ahead of 
partisanship and join me in giving Americans a Patients' Bill of Rights 
strong enough, enforceable enough to make quality health care every 
insurance company's bottom line.
    Thanks for listening.

Note: The President spoke at 10:06 a.m. from the Edgartown Elementary 
School on Martha's Vineyard, MA.