[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.