[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.