    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (1999, Book II)]
    [October 5, 1999]
    [Pages 1680-1683]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on Proposed Patients' Bill of Rights Legislation and an Exchange
    With Reporters
    October 5, 1999

        The President. Good afternoon. I am delighted to be joined this
    afternoon by Secretary Shalala, Secretary
    Herman, and leaders of some of our Nation's
    top health, consumer, and provider organizations, including Dr. Thomas
    Reardon of the American Medical
    Association; Beverly Malone, the president of
    American Nurses Association; Judy Lichtman,
    the president of the National Partnership for Women and Families; John
    Seffrin, the CEO of the American Cancer
    Society; and Ron Pollack, the president of
    Families USA.
        Before I leave for the Pentagon to sign legislation to enhance our
    national security, I want to say a few words about legislation to
    enhance the security of patients and the health of our families.
        Tomorrow the House is set to begin the long-awaited debate on the
    Patients' Bill of Rights. We are here today to urge Congress to act
    responsibly and pass strong, enforceable, bipartisan legislation to
    protect working families with the real health care protections they
    sorely need.
        We have had enough of tragic stories from every corner of our land,
    families forced to

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    switch doctors in the middle of pregnancy or cancer treatment, parents
    whose children had to bypass one or more emergency rooms before they
    received care, Americans who saw their loved ones die when their health
    plans overruled a doctor's urgent recommendations. The fact is Americans
    who are battling illness shouldn't have to also battle insurance
    companies for the coverage they need.
        Our administration has done everything we could to protect patients.
    Through executive action, we've granted all of the safeguards in the
    Patients' Bill of Rights to more than 85 million Americans who get their
    health care through Federal plans. This past week I announced we'll
    publish rules to extend similar patient protections to every child
    covered under the Children's Health Insurance Program.
        Many States are also making progress. But no State law, no executive
    action, can do what Congress alone has the power to achieve. Only
    Federal legislation can assure that all Americans, in all plans, get the
    patient protections they need and deserve.
        Congressmen Charlie Norwood>
    and John Dingell have a bill to do just
    that. It's a bipartisan Patients' Bill of Rights that would guarantee
    Americans the right to see the medical specialist they need, the right
    to emergency care wherever and whenever a medical crisis arises, the
    right to stay with a health care provider throughout a program of
    treatment, the right to hold a health plan accountable for harmful
    decisions.
        But before Americans can be assured these fundamental rights, the
    Norwood-Dingell bill must be assured a fundamental right of its own, and
    that's the right to be offered on the House floor, with a straight up or
    down vote. No legislative poison pills. No weakening amendments. No
    parliamentary sleights of hand.
        Let's be clear: This is about more than congressional rules or
    legislative prerogatives. It's about providing Americans basic rights.
    It's about making sure medical professionals are able to do their jobs,
    about providing families with the quality care they deserve, and above
    all, about putting patients' interests above special interests. That's
    what all of us standing here and our allies in both parties in the House
    of Representatives are committed to.
        Now, I'm told this morning some Republican leaders sat down with
    insurance company lobbyists who are fighting to defeat a strong
    Patients' Bill of Rights. On the eve of this vote, I'd like to ask them
    to think about sitting down with America's families instead.
        This is not a partisan issue anywhere in the United States except
    Washington, DC. The legislation that we endorse has the endorsement of
    more than 300 health care and consumer groups across America, including
    groups where I would imagine most of the members are in the Republican
    Party.
        The support for this legislation across America is broad and deep.
    We cannot allow a small group in Congress, representing a large, well-
    financed special interest, to thwart the will of doctors, nurses,
    medical professionals, and working families. We can't allow some
    parliamentary trick to litter this bill up like a Christmas tree and
    then have people vote for it to give people the impression they are for
    the Patients' Bill of Rights, when they are, in fact, against it.
        So again, I ask Republican leaders to be straight with the American
    people. Instead of watered-down provisions, just give the people an up
    or down vote. Let the will of the people prevail. Let them see where
    every Member of the House stands on this profoundly important issue.
    Let's have a fair vote. If we have a fair vote, there will be a
    bipartisan majority for the Patients' Bill of Rights in the House of
    Representatives that reflects the overwhelming bipartisan, even
    nonpartisan, feeling for it out in the United States of America.
        Thank you very much.

    Medicare Reform

        Q. Mr. President, do you believe after meeting with Senator Roth
    today that you'll get a competent Medicare reform program this year? And
    where might you be willing to compromise to get that?
        The President. Well, first of all, I had a very good meeting with
    him, and I'm going to put out a
    statement about it. We talked about Medicare reform. He and Senator
    Moynihan assured me they're still
    committed to that and will work on it in a timely fashion. They also
    talked to me about the need to restore some of the restrictions or cuts
    in funding from the '97 Balanced Budget Act to some of the medical
    providers. I strongly agree with that, and I think we should do it.
        We talked about some trade issues, the importance of the research
    and experimentation tax credit, and a number of other issues that I
    think

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    are quite important that affect all Americans. So we had a good meeting,
    and I prepared and signed off on a statement which goes into greater
    detail about it.

    Comprehensive Nuclear-Test-Ban Treaty

        Q. Mr. President, do you think you could try to postpone the vote on
    the treaty?
        The President. On the test ban treaty?
        Q. Yes.
        The President. Well, let me say this: I think for the Senate to
    reject it would send a terrible message. It would say to the whole
    world, ``Look, America's not going to test, but if you want to test, go
    right ahead. We're not interested in leading the world toward
    nonproliferation anymore.''
        I'm going to have a dinner tonight and talk to a number of Senators
    about it. I think a lot of thoughtful Republicans who normally support
    us in matters like this are, number one, under enormous political
    pressure not to do so, and number two, have the legitimate feeling that
    this very important issue, which in previous Congresses would have
    received 8, 10, 12 days of hearings, a week or more of debate, is for
    some reason being rushed at an almost unprecedented pace.
        So we're going to talk through this. I'm going to make the best case
    I can. I'm going to tell them why I think it's in the national interest.
    But I think it is a very curious position that some of the leaders of
    the opposite party are taking that they don't really want us to start
    testing again, and they know we have the most sophisticated system in
    the world for maintaining our nuclear stockpile without testing, but
    they don't want to vote for this treaty even if that says to Pakistan,
    to India, to China, to Russia, to Iran, to everybody else, you all go on
    and do whatever you want to do, but we're not going to do it. I think
    that's a very curious thing to do and would be very, very damaging to
    the interests of the United States and, even more important, to the
    safety of children in the 21st century all across the world.
        We have been a leader for nonproliferation, including for the
    concept of a test ban treaty since the time of Dwight Eisenhower. He's
    the first person who recommended this. And before this Congress, it
    would have been unthinkable that a treaty of this kind, with these
    protections--particularly with the strengthening reservations that I
    have offered to work with Congress to put in--it would have been
    unthinkable before this Congress that such a treaty would not pass. So
    I'm going to work and do the best I can, and we'll see what happens.
        Q. Sir, there seems to be the compliance, it cannot be verified, and
    that the integrity of the arsenal cannot be maintained absolutely----
        The President. Well, I would like to respond to those two things.
    Number one, on the compliance issue, keep in mind what the reports say--
    that you cannot, with 100 percent certainty, detect small nuclear tests
    everywhere in the world. That's all they say. Our national security
    people, including all of our people at the Pentagon, say that any test
    of the magnitude that would present any sort of threat to the United
    States could in fact be detected, number one.
        Number two, if we don't pass this treaty, such smaller tests will be
    even more likely to go undetected. Why? Because if the treaty goes into
    force, we'll have over 300 sophisticated sensors put out in places all
    across the world, and we'll have the right to onsite inspection, and we
    will also have the deterrent effect of people being found violating the
    treaty. Now, if you don't put the treaty into force, no sensors, no
    onsite inspections, no deterrent, and if the United States walks away
    from it, the rest of the world will think they've been given a green
    light. So I think that argument has literally no merit, because nothing
    changes except our ability to increase our determination of such tests
    with the passage of the treaty.
        Now, on the first argument--the idea that, some say, we can't with
    absolute 100 percent certainty maintain the integrity of the
    stockpiles--that is not what the people who lead the energy labs say.
    That's not what the Joint Chiefs say. Some people disagree--they do.
    They say they're not sure that forever-and-a-day we'll be able to do
    that. I have offered the Senate a reservation to the treaty which makes
    it clear that if ever there comes a time we think we can't preserve the
    integrity of our nuclear stockpile, we can take appropriate steps to do
    so, number one.
        Number two, we spend $4.5 billion a year, with by far the most
    sophisticated system in the world, to maintain that. Now, if all the--
    this treaty doesn't go into effect unless all the nuclear powers and
    several dozen other countries agree to it; 44 in total must agree. If
    they all agree, I'm sure that all the people who are making this
    argument would acknowledge that

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    our system of maintaining the integrity of our stockpile without tests
    is far in advance of what anybody else has. So our relative security
    will be increased, regardless.
        Final point I want to make: None of these people will stand up and
    say, let's start testing again. So what they're saying is, ``Okay,
    America won't test, but if everybody else tests, well, so be it.'' I
    think it would be a big mistake.

    Note: The President spoke at 3:13 p.m. in the South Portico at the White
    House prior to departure for the Pentagon. In his remarks, he referred
    to Thomas R. Reardon, president, American Medical Association; and
    Ronald F. Pollack, executive director, Families USA.