    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (1999, Book II)]
    [July 13, 1999]
    [Pages 1189-1192]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on Proposed Patients' Bill of Rights Legislation and an Exchange
    With Reporters
    July 13, 1999

        The President. Thank you very much, Senator Daschle and other Members of the Senate who are here. I would also
    like to thank the health professionals who have joined us: Beverly
    Malone, the president of the American Nurses
    Association; Dr. Michael Rapp, the president-
    elect of the American College of Emergency Physicians; Dr. Omega
    Silva, a board member of the American
    Medical Women's Association; Dr. Gary Dennis,
    the president of the National Medical Association. They represent over
    200

    [[Page 1190]]

    medical, consumer, and citizens groups who endorse our legislation.
        You heard Senator Daschle say that it has been almost 2 years since
    we started the call for the Patients' Bill of Rights. Ever since, we
    have been gratified by the enormous outpouring of support from
    professional as well as consumer groups. Now, after months and months
    and months of delay, the Republican leadership in the Senate finally has
    agreed to allow an open debate on the Patients' Bill of Rights; and I
    must say, it has been very enlightening.
        The American people have waited a long time for this day, and we
    must not let this opportunity slip away. All Americans in all plans must
    have these basic rights; that's what this is about. Are you for or
    against all Americans and all plans having these basic rights: the right
    to see a specialist; the right to go to the closest emergency room; the
    right to remain with your health care provider throughout a medical
    treatment, whether it's a pregnancy, chemotherapy, or some other course
    of treatment; the right to hold a health plan accountable for its
    decisions if they are harmful?
        Senator Daschle's bill would make each
    of these rights the law of the land. It is strong, meaningful,
    effective, and if you talk to people who have been affected adversely by
    the way HMO's too often operate in this country, it is long, long
    overdue.
        Now as you know, there are some who will try to substitute the
    Republican leadership's own bill. As Senator Daschle has explained, it
    is watered down; it is nowhere near what the American people deserve or
    need. Not only does it offer merely toothless and half-hearted
    protections, it fails to protect all Americans in managed care. We
    estimate now that there are 110 million Americans who would not be
    covered at all by this bill.
        Already the opponents are resorting to this $100 million scare
    campaign. They allege that a strong Patients' Bill of Rights would cause
    premiums to rise beyond the reach of average Americans. They are wrong.
    As Senator Daschle said, the Congressional Budget Office--now, we all
    remember, going back to 1995, from the day the Republicans assumed the
    majority in Congress, how they have said we must always rely on the
    studies of the Congressional Budget Office. We always have to rely on
    the CBO's figures. But now when the health insurance companies say, ``We
    don't want you to rely on the figures anymore, and we're spending $100
    million to discredit the HMO figures that the same Republican leaders
    have held up as the gospel truth for 4 years now''--they say it would
    cost no more than $2 a month.
        And I would remind you that we have some evidence here. I put in
    place, by Executive order, the protections of the Patients' Bill of
    Rights for all those covered by the Federal employees health insurance
    plan, and it costs less than one dollar a month to implement. So we have
    evidence, and we have the study of the group that Congress says we
    should rely on for all of our figures; that is, unless the health
    insurance companies decide differently.
        Now, this is not about dollars; this is about people. It's about
    whether the people of this country come first in the votes of the
    Congress of the United States. The people deserve a bill that protects
    them, not the insurance companies. That is why every single doctors
    organization, every major nurses organization, every major consumer
    group stands with us today.
        Now we're going to have an honest debate. It should be open, and it
    should be complete. No cynical, parliamentary maneuver should bypass the
    need of the American people to know exactly where and why every Member
    of Congress stands on every issue.
        The American people deserve to know whether the Senator they elected
    is for or against the right of people to see a specialist. They need to
    know whether every Senator is for or against the right of a doctor to
    decide and stopping the right of an HMO accountant to delay--sometimes
    indefinitely, often until it is too late--the right of a patient to see
    that specialist. They need to know whether every Senator is for or
    against the right of somebody who is hurt in an accident to go to the
    nearest emergency room and not have to bypass one or two or, in the case
    Senator Dorgan cited yesterday, three emergency rooms before getting
    emergency treatment. They need to know whether you are for or against
    maintaining the same doctor during a pregnancy or a chemotherapy
    treatment if your employer happens to change insurance providers during
    the course of that treatment. And they need to know whether they are for
    or against the right to correct and to get remedies when you are hurt by
    harmful decisions.
        This is not complicated. This is not rocket science. And it is very
    real for the American

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    people out there who feel they have lost control of their ability to
    have a secure relationship with their health care providers. This is
    about the way people live; and we now know that it would not be
    prohibitive in cost, but it could save a lot of lives and untold misery.
        So let's have a clear decision. We've waited a long time for this
    day, and the American people are entitled to know where their Members
    stand and why.
        Now let me say again, this is not a partisan issue anywhere in the
    United States of America outside Washington, DC. Democrats, Republicans,
    and independents all get sick. They all have accidents; they all need
    doctors; and they all have pretty much the same opinion of whether this
    bill should pass in the form that Senator Daschle has presented it. This is only a partisan issue in
    Washington, DC.
        We have found common ground on health care before. We did provide
    the right to keep your health insurance when you change doctors--excuse
    me--when you change employment. We did provide the right of up to 5
    million children to get health insurance. It is unconscionable that we
    would say--here we are in the last year of the 20th century--that we
    would say, with all the miracles of modern medicine, ``I am sorry; we
    have found it necessary to allow health care to be organized in such a
    way that doctors can no longer tell you when you need a specialist'';
    that ``I'm sorry; no matter how badly hurt you are, you may not be able
    to go to the nearest emergency room''; that ``I'm sorry; no matter how
    difficult a chemotherapy or pregnancy treatment is, you may just have to
    change doctors in the middle of the stream''; and ``I'm sorry; no matter
    how badly hurt you are, your insurance company should decide whether you
    get remedies or not.'' We don't need to say that.
        The Congressional Budget Office, held up as the sacred authority on
    financial matters by the Republican majority, says this wouldn't cost
    more than $2 a month a policy. And I'm telling you, there is no excuse
    for not passing it. I hope the Congress will pass this. The Senate has
    got to lead the way, and I thank those Members who are here with us
    today for fighting for all the American people. This is an American
    issue, not a partisan issue, and it ought to be that way when the votes
    are counted.
        Thank you very much.
        Q. What's your prediction? What's your prediction on the Daschle
    bill? Will it pass?
        The President. I don't know----
        Q. You don't know?
        Q. Will you veto the Republican bill? Would you veto the Republican
    bill?
        The President. I don't know what my prediction is. You know, you
    would think that it would be a no-brainer. You would think--70 percent
    of the Republicans in America--in America--support this Patients' Bill
    of Rights. So, 200 medical and health care organizations and consumer
    organizations support it. Senator Daschle says that health insurers are
    spending $100 million to beat it, and we're having all these scare
    tactics, and people are saying, ``Oh, the States can take care of
    this.''
        Let me tell you something. I used to be a Governor, and if I were
    still one, we'd have the strongest bill of rights I could possibly pass
    through my legislature. But the States cannot cover everybody, number
    one; and number two, what they have done is a total patchwork that does
    not provide any uniformity or protection. Now, I was a Governor for 12
    years; I know what these States have done. That is a hollow argument. It
    is not true. This is one of those things that can only be taken care of
    this way.
        Now, you have all these scare tactics. Every time we try to do
    something, we have this kind of tactic. This is what we heard when we
    passed family and medical leave. Every piece of social advance we've
    had, you have these kind of scare tactics. But these folks have $100
    million to spend on this and lots of other money, as well. So you know,
    it's just not right.
        And I figured when the CBO came out with their study, as much as all
    of us heard about the CBO for the last 4 years, that would close the
    door. But this is not about the evidence, this is about political power
    in Washington trying to shut off something that is manifestly in the
    best interests of the average citizen of this country, and not just the
    average citizen, every single person covered by an HMO. And I feel that
    I have some standing to say this, since I have consistently said that
    good HMO's can manage health care better, ever since I got here. But
    this is wrong. It is just wrong.
        And all of these stories that our side on this issue are recounting,
    all these human stories, to hear the others sort of dismiss this as sort
    of anecdotes and accidents and odd-man-out stories is ridiculous. This
    is the way the world

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    works for people out there who feel they have lost control of their most
    basic needs in life.
        And I would just ask every person in America who watches this, who
    has ever had a child, to think: How you would feel if your child was
    riding on a bicycle one day and got hit by a car and had to pass two
    emergency rooms before he or she could get care? How would you feel if
    your husband was at work being treated, in his thirties or forties, for
    cancer, with your whole life still before you, and the employer changes
    treatment--and then they tell you in the middle of the treatment you've
    got to change doctors? Or if your wife was 6 months pregnant and had a
    difficult pregnancy and was told the same thing? Just ask yourself how
    you would feel. And there is nothing on the other side of this.
        We have the study now from the CBO, and we have the evidence of the
    Federal health employment plan which led to increases in premiums of
    less than a dollar a month. That's what our costs were. How would you
    feel? And I want to ask all of you who are reporting this--you can't be
    biased; you have to give their side and ours. But just ask yourself, how
    would you feel? That's what's happening in America today, and we're here
    to try to do something about it. And God willing, and the creek don't
    rise, we'll do it.
        Thank you.

    Note: The President spoke at 9:45 a.m. on the South Lawn at the White
    House prior to departure for Miami Beach, FL. In his address, he
    referred to his memorandum of February 20, 1998, on compliance of
    Federal agencies with the Patients' Bill of Rights (Public Papers of the
    Presidents: William J. Clinton, 1998 Book I (Washington: U.S. Government
    Printing Office, 1999), p. 260).