[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

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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).