    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (1999, Book II)]
    [August 23, 1999]
    [Pages 1466-1468]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks at Martha's Vineyard Hospital in Martha's Vineyard,
    Massachusetts
    August 23, 1999

        Thank you very much, Dr. Sullivan and
    Mike. I feel like I was in pretty distinguished
    company tonight with them up here. I admire them both very much. Lou
    Sullivan was an outstanding Secretary of Health and Human Services, a
    great advocate in our Nation's struggle against AIDS, and one thing I
    particularly appreciated, one of the early strong voices in our efforts
    to protect our children from the dangers of teen smoking. And I thank
    you for all you did there and for what you're doing here.
        I have always admired Mike Wallace. I like
    him more when he's boring in on someone besides me. [Laughter] But I
    want to tell you that he made a profoundly moving presentation recently
    at Tipper Gore's National Conference on Mental
    Health, which we helped to put together and which is something Hillary
    and I care a lot about. And I think we are moving to the point in our
    country where we see mental health problems like other health problems.
    And when that day arrives, it will be in no small measure because Mike
    Wallace had the courage to speak out about it. And I thank him for that
    as well.
        Now, I want to say again, although Mike already alluded to it, I'm
    sorry Hillary is not here, but she is
    a little under the weather. And I want her to get well because she has a
    rigorous schedule ahead of her. [Laughter]
        I want to thank Congressman Delahunt
    for being here, and the other elected officials, and

    [[Page 1467]]

    all the members of the hospital board and the people here at Farm Neck
    who have been so kind to me over the years.
        I would like to say a few things in a very straightforward way about
    this issue before you tonight. I spent a lot of my life trying to keep
    hospitals open that serve small populations. And this hospital is an
    interesting situation because, as Dr. Sullivan said, there are 14,000
    year-round residents here and then up to 10 times that many here on any
    given day in the summertime. So, for most of the year, it's a small
    rural hospital in a county in Massachusetts that doesn't have a
    particularly high per capita income, where, according to the information
    I've been given, 20 percent of the people have no health insurance. And
    then there's the summer and all the rest of us who are reasonably
    blessed in life, or we wouldn't be able to afford to come to Martha's
    Vineyard in the summertime. [Laughter] And we all want it to stay open
    and to do well.
        And most of us, when we come here, come here because we don't want
    to think about anything except maybe walking on the beach or taking a
    sail or fighting our limitations out on this golf course, or whatever.
    [Laughter] We don't want to think about anything else--unless, like
    Mike, we get kidney stones or something else
    happens to us. But the people who run the hospital and the people who
    work at the hospital, they have to deal with the economics of modern
    health care, with the dilemma of the population base, and with the fact
    that--you know, they're there all the time. They deliver babies; they
    perform emergency surgery; they take care of the elderly people year
    round. They do things that need doing.
        And there's not a person under this tent tonight that might not need
    this hospital sometime. Now, the plain fact is that, given the economics
    of modern medical care, I know there's--I don't want to get into all the
    things that have been in the paper about this; I'm not sure George
    Soros, Bob Rubin, and Alan Greenspan together could make this thing pay
    every month, every year, unless people like you are willing to help keep
    it open.
        Now, of course, everything should be run as well as possible. But
    I'm telling you, I've been dealing with this for 20 years now, and I've
    kept some hospitals open when I was a Governor of a rural State, and
    I've seen some close. I've won some, and I've lost some. And let me just
    give you a couple of things to think about.
        First of all, this hospital serves a county here on Martha's
    Vineyard that has 20 percent uninsured. I'll bet you anything, and I
    know that there is a health access coalition working on this, but I'll
    bet you anything that there are children on this island who are eligible
    for the CHIP program--the Children's Health Insurance Program--that was
    one of the signal accomplishments of the bipartisan Balanced Budget Act
    of 1997, which provided funds for up to 5 million of the 10 million
    uninsured children in this country to have health insurance, which means
    payments to the hospital when they go there. And so far, even though the
    enrollments have really picked up, this is the first full year when all
    the States have had their programs in place. Only about one and a half
    million of those children have been enrolled, a little over one and a
    half million. And I'll bet anything some of them who haven't are here.
        The second thing I'd like to say is, I bet a lot of the working
    families here, who work for very modest wages, especially in the off-
    season, or the farmers who have very limited incomes, their children,
    and maybe even the adults who are working, could be eligible for
    Medicaid, depending on what the Massachusetts rules are.
        The third thing I would like to suggest is that--in Tennessee, the
    legislature provided an opportunity for working people who had no health
    insurance to actually buy into the Medicaid program. I'm embarrassed to
    tell you I don't know what options exist in Massachusetts for that, but
    we gave them permission to do it in Tennessee because they devised a way
    to show that they could do it on the allocation of Federal money they
    had, and we could do it here as well if it's not being done.
        So we need to look to see what kinds of other ways we can infuse
    cash into the situation. But, as Mike said when we started, one of the
    things we need to remember is that we all need health care. And when you
    show up at the hospital, they don't ask for your party registration.
    That's why we're trying so hard to pass the Patients' Bill of Rights
    down in Washington. Everybody from the AMA to the nurses groups to
    virtually every health provider in the country is for it, because we
    recognize this is something that ought to unite us as a people.

    [[Page 1468]]

        Now, it is a challenge when you have small populations and you want
    high quality care and you want it there 24 hours a day, 7 days a week,
    52 weeks a year, whether there are 100,000 or 14,000 people here. But
    I'd like to say there are a lot of people who aren't here tonight on
    this island who make all of our lives better. There are a lot of
    wonderful people who live here and work here year round, and who would
    never be able, themselves, to afford the kind of vacations that all of
    us take every year and take for granted. And they deserve good health
    care, too.
        So I am very, very grateful to you. If there is anything else I can
    do, Dr. Sullivan, and anybody else here on
    the board, to try to explore what else we can do to enroll more people
    in covered programs that we maybe affect the income stream here, I'd be
    happy to do it. I will do what I can to help. I'm proud of you for being
    here. But what I'd like to say to you is, I think you ought to be
    prepared to come next year, too. [Laughter]
        You know, folks, I've raised a lot of money in my life, and I'm not
    running for anything. [Laughter] So I can spend the rest of my life
    raising money for causes like this, which I like very well. But I say
    that because--based on 20 years of hard work.
        Again, I hope the island and the community and all of you can unite
    behind this hospital. But I know--and I will do everything I can to help
    explore what else can be done here. But you need to make a long-term
    commitment, if this community wants this hospital, that it is something
    worth paying for, because you never know when you'll need it, and you
    certainly know that good people need it and access it every single day.
        Thank you very much, and God bless you.

    Note: The President spoke at 7:16 p.m. at the Farm Neck Golf Club. In
    his remarks, he referred to former Secretary of Health and Human
    Services Louis W. Sullivan, member, Martha's Vineyard Hospital Board of
    Trustees; journalist Mike Wallace; philanthropist George Soros; and
    former Secretary of the Treasury Robert E. Rubin. The President also
    referred to AMA, the American Medical Association.