    [Public Papers of the Presidents of the United States: William J. Clinton (1999, Book I)]
    [January 4, 1999]
    [Pages 2-5]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks Announcing a Long-Term Health Care Initiative
    January 4, 1999

        The President. Thank you, Patricia, for
    your fine statement and for the power of your example. And we appreciate
    you and your husband being here today and the
    work that you're doing.
        We thank Congressman Hoyer for bringing
    his constituent here today. And we welcome Senator Reid, Senator Breaux, Senator
    Specter, Senator Dodd, Senator Wyden, Congressmen
    Brown, Cardin,
    Moran, and Cummings. And I'd also like to say, Senator Mikulski has a special interest in this issue and wanted to
    be here today, but could not.
        You know, this new year gives us all a sense of making a fresh
    start, a sense of being able to think anew. It should also give us a
    sense of rededication. I'm delighted to see here, along with the members
    of our administration, Secretary Rubin,
    Secretary Shalala, and Janice
    Lachance, so many advocates not only for
    seniors but for the disabled.
        We need to be looking ahead at the issue that Patricia Darlak
    described so clearly and powerfully, to the challenges that the new
    century will present us, because there will be many, many, many more
    stories like hers. That is the fundamental reality. Already there are
    millions of people out there helping to care for an aged or disabled
    loved one, but there will be many more like her in the 21st century.
        Now, that is, for those of us who are part of the baby boom
    generation, what we would call a high-class problem, because we will be
    ``them''--``they''--we will be ``they.'' Is that the right--but the baby
    boom is about to become a senior boom, and like the baby boom, the
    senior boom will change the face of America. During the next 30 years,
    76 million baby boomers will join the ranks of the retired. The number
    of elderly Americans will double by 2030; by the middle of the next
    century, the

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    average American will live to an age of 82. That's 6 years longer than
    the average life expectancy today.
        Now, as I said, those of us who hope to be in that group consider
    that a high-class problem. We also are very encouraged that people are
    living stronger, healthier lives. We are encouraged that disabled
    Americans have more options to live fully and healthily for a longer
    period of time. We are encouraged that all these folks are proving that
    retirement can be a beginning as well as an end. We see all kinds of
    people learning new ideas, taking up new work, doing new community
    services, traveling and going places they never would have imagined
    before.
        But we know that with aging, inevitably, come the infirmities of
    age. Nearly half the people over 85, one of the fastest growing segments
    of our population, need help with everyday, basic tasks--eating,
    dressing, going to a doctor. We cannot expect that every older American
    will be able to fend for himself or herself. And the real question is,
    what are our obligations to help every American get the care that is
    appropriate for each individual case?
        Millions require the care that can only be provided in a nursing
    home. But millions more choose to remain at home with family and
    friends. Indeed, the elderly are remaining at home in record number. The
    same is true of people with disabilities. Today, millions and millions
    of households are caring for elderly relatives or even for neighbors.
    They represent the best of America, fulfilling a family obligation often
    unspoken but deeply resonant in the American character.
        Providing long-term care at home is more and more a common choice,
    but as you have just heard, it is rarely an easy one. Since this kind of
    care is almost never covered by private insurance or Medicare, out-of-
    pocket expenses can be staggering. So, too, are the professional costs.
    Caregivers who hold jobs outside the home--that is, the vast majority--
    may have to take unpaid leave or work fewer hours to fulfill their
    responsibilities. In countless ways, caregiving is vital, meaningful
    work. But as you have heard, it can also be very stressful.
        The First Lady has mentioned some of the things we have worked to do
    to ease the burden of families: improving nursing homes, strengthening
    Medicare, making Medicaid more flexible. But more will be asked of us in
    the 21st century, and more must be done.
        Today we announce a critical new initiative to give care to the
    caregivers, to help Americans provide long-term care for aging, ailing,
    and disabled loved ones. The size of the senior boom demands it. The
    needs of our disabled population require it. The length of our lives
    makes it more important than ever and so does the sacrifice of American
    families who put the well-being of their relatives above their own.
        This is a complicated challenge that requires a range of responses.
    Therefore, to improve long-term care in America and to give it a
    priority and support these families, we proposed to do four things:
    first, to provide a long-term care tax credit, $1,000 for people with
    long-term care needs or for the families that shelter them. It is far
    better to devote this money to help keep the elderly and the disabled at
    home than to spend the same amount to pay for them to live away from
    home. And if it makes it possible for more people to stay home, it may
    well be cheaper, too. Our parents worked and saved and sacrificed for us
    in our youth; adult children are now working, saving, and sacrificing
    for their parents in old age. It is the cycle of life and one we should
    recognize and reward.
        This targeted tax cut of $1,000, paid for in our balanced budget,
    would meet the individual needs of individual families, supplementing
    the care they already provide, empowering them to decide what to do and
    how to do it best. It would help to offset the direct cost of long-term
    care, like home health visits and adult day care, as well as the
    indirect costs, like unpaid leave some caregivers must take. The care
    they provide is invaluable, but we can show that it is valued by our
    society.
        Second, we should create a family caregiver support program, a new
    national network to support people caring for older Americans. In
    decades past, families could do little for ailing relatives but give
    them shelter and love. But today, because of advances in science,
    caregivers tend to everything from dialysis to depression, preparing
    intravenous meals and insulin injections. This initiative enables States
    to create one-stop shops, places caregivers can access the resources of
    the community, find technical guidance, obtain respite and adult day
    care services. This is especially important for those families who are
    thousands of miles away from their loved ones but who still want to
    help. These families

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    want to provide the best possible care. We want to do everything in our
    power to help them.
        Third, we must educate Medicare beneficiaries about long-term care
    options. Medicare does not cover most kinds of long-term care, so it is
    important that beneficiaries understand their alternatives. This
    initiative helps to answer essential questions efficiently: What are my
    choices; what should I look for in private long-term care insurance
    policies? By launching a national education campaign, we can help to
    ensure people get the answers they need when they need them and the
    quality care they deserve.
        Fourth, I am proposing that the Federal Government, as the Nation's
    largest employer, use its market leverage to set an example, offering
    private long-term care insurance to Federal employees. By promoting
    high-quality, affordable care, we can encourage more people and more
    companies to invest in long-term care coverage. We can help more
    employees in every part of our economy to prepare for the future.
        There's no single solution to the challenges of caregiving. But
    together, these initiatives represent a powerful first step to force the
    kind of changes we need in our society. To fulfill our fundamental
    obligations to older Americans and people with disabilities, we must act
    together, members of both parties, both branches of Government, putting
    progress above partisanship. I believe there is an enormous amount of
    interest in and support for this initiative in the Congress, and I thank
    the Members who have come here today.
        I hope that the Congress will do many things on this front in the
    coming session. I hope these initiatives will pass. Senator
    Breaux will soon give us a Medicare Reform
    Commission report; I hope we will save Medicare for the 21st century. I
    hope we will use the surplus to save Social Security for the 21st
    century. All of these things will help to strengthen America as we go
    forward.
        The senior boom is one of the central challenges of the coming
    century. I can tell you that, as literally the oldest of the baby
    boomers, those of us born right after World War II, one of the central
    worries of my generation is that, as we age, we will impose
    unsustainable burdens on our children and undermine their ability to
    raise our grandchildren. We must use this time now to do everything in
    our power not only to lift the quality of life and the security of the
    aged and disabled today, and the baby boom aged and disabled, but to
    make sure that we do not impose that intolerable burden on our children.
        I have asked the Vice President--who
    will speak with us, along with Mrs. Gore, in
    just a moment--to conduct a series of forums around the country on this
    initiative, to solicit other ideas and reach out to people and to build
    grassroots support. We want to hear from the people of the country about
    how we can help to meet the long-term care needs of their loved ones.
        Again, let me thank all the people in the administration who worked
    on this, the Members of Congress who are here, the members of the aging
    and disability community who are here. And I thank you, Patricia
    Darlak, for your moving statement. Hillary
    and I have had our own experiences with long-term care of our parents--
    in my case, our grandparents. We have seen the Vice President and Mrs. Gore deal with
    the same challenge. So this is a personal thing that I think we feel
    very deeply.
        I'd like to say a special word of appreciation to the Vice
    President, because he's had such an
    interest in our family caregiving program. He is now going to speak to
    us from California. He's coming up on the satellite, along with Mrs.
    Gore, and he's got some folks with him who know
    quite a bit about this.
        Good morning, Mr. Vice President. The floor is yours. Good morning,
    Tipper.

    [At this point, Vice President Al Gore and
    his wife, Tipper, made brief remarks by
    satellite.]

        The President. Thank you very much. I want to thank the Vice
    President and Tipper, and also all the folks that are out there with them in
    California, for the example they are setting and the initiatives that
    are being made in California. I know the Vice President is about to go
    to the new Governor's inauguration out there. You ought to take the
    opportunity to put in a plug for what we're doing there. I'm sure you
    will. [Laughter]
        Ladies and gentlemen, let me say again how grateful I am for all the
    people who worked on this proposal, for the advocates for the elderly
    and the disabled who are here, for the very large representation from
    Congress. And thank you again for the passion and the commitment that
    you manifested in your statement and for having the courage to come here
    and tell us

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    about your situation. I hope it will help to change the future of
    America.
        God bless you, and happy New Year. Thank you.

    Note: The President spoke at 11:36 a.m. in the Grand Foyer on the State
    Floor at the White House. In his remarks, he referred to caregiver
    Patricia Darlak, who introduced the President, and her husband, Dennis.