    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (2000, Book I)]
    [March 13, 2000]
    [Pages 446-450]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks to the Community in Cleveland
    March 13, 2000

        Thank you very much. Thank you. First, I think Wanda did a pretty good job, don't you? Let's give her
    another hand. [Applause] I am delighted to be here in Cleveland. I want
    to thank all the people who are up here with me. Alice
    Katchianes, thank you for being here, and
    Mr. Venable, thank you for your
    welcome. If I could sing like that, I'd be in a different line of work.
    [Laughter] I thought that was great.
        I want to thank Congressman Sherrod Brown
    and Congressman Dennis Kucinich,
    Congresswoman Stephanie Tubbs Jones,
    my great friend Lou Stokes, all the other
    officials who are here today. State Representative Jack Ford; County Commissioner Jimmy Dimora; State Senate candidate Donna McNamee, a woman I met at the dedication of the FDR Memorial
    with President Roosevelt's wheelchair, I'm glad to see her here.
        I want to say a special word of appreciation to Congressman Dick
    Gephardt for his leadership and his
    passionate commitment to this and so many other good causes. Without him
    and these other members of our caucus, we wouldn't have a prayer of
    passing this proposal today. And I thank him.
        And I want to say, obviously, how pleased I am to be here with Donna
    Shalala, who is, as Dick Gephardt
    suggested, not only the longest serving but by a good long stretch the
    ablest and best Secretary of Health and Human Services this country has
    ever, ever had. And I love to see her mother,
    and I'm glad she made room for me at tax time. [Laughter] I told her, I
    said, ``You know, when I get out of this job, I hope I need the services
    of a tax lawyer.'' [Laughter] Right now, it's all pretty
    straightforward. But that was, without a doubt, the shortest speech I
    ever heard a lawyer give, what she said to me. [Laughter] You probably
    doubled your business just by being here today.
        I do love coming to Cleveland, and you heard Donna say that we have
    a lot of people in this administration from Cleveland, including my
    Deputy Chief of Staff, Steve Ricchetti, who
    is here today. But Clevelanders, they may go anywhere, but they never
    get it, Cleveland, out of their soul. If you go into Steve's office,
    there is a great photograph from the opening day of baseball at Jacobs
    Field in 1994. Now, I remember that because I threw out the first pitch.
    But Steve's got the picture on the wall because when I threw the pitch,
    everyone was absolutely stunned that it didn't hit the dirt--
    [laughter]--and Sandy Alomar caught it. So
    he really got--I'm incidental to the picture. He's got Sandy Alomar
    catching a ball which he was convinced would go into the dirt. I thought
    I did pretty well for a guy who played in the band, myself. [Laughter]
        Let me say, this is a great time for this city and a great time for
    our Nation. As I said in the State of the Union Address, I hope this
    time will be used by our people to take on the big challenges facing
    America. One of those big challenges is what to do about the aging

    [[Page 447]]

    of America, which is a high-class problem. That is, we're living longer;
    we're living better. And the older I get, the more I see that as an
    opportunity, not a problem. But it does impose certain challenges on us.
        There is also a challenge to modernize our health care systems and
    to do other things to increase the health care of the American people.
    And that's what we're here to talk about today.
        But because this is my only formal opportunity to be before--thanks
    to you--before the press and, therefore, the American people, I would
    like to just refer to another issue that relates to the health and
    safety of the American people, just briefly.
        I have been fortunate enough to have the support of the Members of
    Congress on this stage in our efforts to drive the crime rate down, to
    make our streets safer. And Cleveland and every other major city in
    America is a safer place than it was 7 years ago. We have a 25-year low
    in crime, a 30-year low in the gun death rate. And I am grateful for the
    support I have received to put more police on the street, to have more
    summer school and after-school programs for young people, and to do more
    to keep guns out of the hands of criminals, banning the cop-killer
    bullets, the assault weapons ban, the Brady bill, which has kept half a
    million felons, fugitives, and stalkers from getting handguns.
        Now, all of you know we had some tragic deaths last week. We had
    that 6-year-old girl killed in Michigan by a
    6-year-old boy who was a schoolmate of hers. We had terrible shootings
    in Memphis. And just in the last year we had that horrible incident at
    Columbine High School, almost a year ago, and in the year before that,
    lots and lots of school shootings.
        Now, after Columbine, I suggested that what we ought to do is to,
    number one, make sure there were child safety locks on these guns;
    number two--which would have made a big difference in the case of
    children getting the guns. Number two, make sure we ban the importation
    of large ammunition clips which make a mockery of the assault weapons
    ban, because they can't be made or sold here in America but they can be
    imported. Number three, close the loophole in the background check law,
    the Brady law, which says people can buy handguns at gun shows or urban
    flea markets and not have to do a background check. It's a serious
    problem. And fourth, I think when adults intentionally or recklessly let
    little kids get ahold of guns, they should have some sort of
    responsibility for that. And so I asked the Congress to do that.
        Eight months ago, Vice President Gore
    broke a tie in the Senate and passed a pretty strong bill, and then a
    bill passed in the House that was weaker. And I asked them to get
    together and pass a final bill. And they never even met until last week
    when we got them together after this last round of horrible shootings.
        And I asked all Americans to join me, because I think these things
    are reasonable. This won't affect anybody's right to hunt or sport shoot
    or anything, but it will save kids' lives.
        The response we got from the National Rifle Association was to run a
    bunch of television ads attacking me. And yesterday morning I went on
    television again to talk about these measures. I'm not trying to pick a
    fight with anybody. I'm trying to fight for the lives of our kids. But I
    want you to see what we're up against whenever we try to change here.
        The head of the NRA said yesterday--I
    want to quote--he said that my support of these measures was all
    political, and he said this: ``I have come to believe that Clinton needs
    a certain level of violence in this country. He's willing to accept a
    certain level of killing to further his political agenda and his Vice
    President, too.''
        Well, he could say that on television, I guess. I'd like to see him
    look into the eyes of little Kayla Rolland's mother and say that, or the parents at Columbine or
    Springfield, Oregon, or Jonesboro, Arkansas, or the families of those
    people who were shot in Memphis.
        I say that, again, to emphasize change is hard, but sooner or later,
    if you know you've got a problem, you either deal with it or you live
    with the consequences. And the older you get, the more you understand
    that.
        We do not have--I'm grateful that our country is a safer place than
    it was 7 years ago. I don't think it's safe enough. I don't think you
    think it's safe enough. I don't think you think it's safe enough for
    seniors. I don't think you think it's safe enough for little kids. And
    if we can do more things to keep guns away from criminals and children,
    that don't have anything to do with the legitimate right of people to go
    hunting or engage in sport shooting, we ought to do it. And we ought not
    to engage in this kind of political smear tactic.

    [[Page 448]]

        Now, I feel the same way about this issue. And I want to try to
    explain to you what is going on now with this issue, because most people
    in America--you heard Dick Gephardt talk about it--most people in
    America think, well, why are we even arguing about this? Well, all
    health care issues are fraught with debate today. I know you're having a
    big debate here about hospital closures in Cleveland, and I don't know
    enough about the facts to get involved with it, but I'll tell you this.
    One of the problems we have is, there's too much uncompensated care in
    America.
        And we're trying to--we're trying hard, the people you see on this
    stage, we're trying hard to make sure every child that's eligible is
    enrolled in the Children's Health Insurance Program that was created in
    1997. We want Congress to let their parents be insured under the same
    program. We want people over 55 but under 65, who aren't old enough for
    Medicare but have lost their insurance on the job, to be able to buy
    into Medicare, and we want to give them a little tax credit to do it. If
    we do things like this, then whatever happens in Cleveland or anyplace
    else will have to be determined based on the merits of the case, but at
    least the people who need health care will be able to know that the
    people who give it to them, whether it's hospitals or doctors or nurses
    or whoever, will be able to get reimbursed for it. And that's a very
    important thing. I hope you'll support us in that.
        And then we come to the issue at hand. Now, what's this about, this
    prescription--you all know what it's about. If we were starting--suppose
    I came here today as President and I were in my first year as President
    and I proposed Medicare, just like President Johnson did in 1965 in the
    first full year after he was elected, and I told you in 1965 what he
    said, it would be fine. But in 2000, if I said, ``Okay, I'm going to set
    up this health care program for senior citizens. And you can see a
    doctor, and we'll pay for your hospital care. But even though we could
    save billions of dollars a year keeping people out of hospitals and out
    of emergency rooms by covering the medicine, we're not going to cover
    medicine.'' If we were starting today, given all the advances in
    prescription drugs in the last 35 years, you would think I was nuts,
    wouldn't you? The only reason that prescription drugs aren't covered by
    Medicare is that it was started 35 years ago, when medicine was in a
    totally different place. That's the first thing.
        The second thing I want to say is that it has really cost us a lot
    not to cover these seniors. And you see American seniors, for example,
    who live in New York or Vermont, going to take a bus trip to Canada
    because they can buy drugs made in America for 30 percent less--because
    very often the seniors, the people that are least able to pay for these
    drugs, are paying the highest prices for them.
        Now, that's why our budget has this plan. And I want to tell you
    exactly what we propose and what we're all up here on this stage
    supporting today. We want to provide with Medicare a prescription drug
    benefit that is optional, that is voluntary, that is accessible for
    all--anybody who wants to buy into it can; a plan that is based on price
    competition, not price controls. That is, we don't want to control the
    price, but we want to use the fact that if we're buying a lot of
    medicine, seniors ought to be able to get it as cheap as anybody else.
    And we also want it to be part of an overall plan to continue to
    modernize Medicare and make it more competitive. Because I can tell you,
    I'm the oldest of the baby boomers, and people in my generation, we're
    plagued by the notion that our retirement could cause such a burden on
    our children, it would undermine their ability to raise our
    grandchildren. We don't want that.
        Now, medically speaking, this is not just the right thing to do; it
    is the smart thing to do. As I said, we already pay for doctor and
    hospital benefits. But an awful lot of seniors go without prescription
    drugs--and preventive screenings, I might add--that ought to be a part
    of their health care. We've worked hard to put preventive screenings
    back into Medicare, for breast cancer, for osteoporosis, for prostate
    cancer. These are very, very important. But not having any prescription
    drug coverage is like paying a mechanic $4,000 to fix your engine
    because you wouldn't spend $25 to change the oil and get the filter
    replaced.
        In recent months, I have been really encouraged because a number of
    Republicans have expressed an interest in joining us to do this. And we
    can't pass it unless some of them join us, because we don't have enough
    votes on our own. But so far the proposals they're making, I think, are
    not adequate, and I'll explain why.
        There are two different proposals basically coming out of the
    Republicans. Some of them

    [[Page 449]]

    propose giving a block grant to the States to help only the poorest
    seniors, those below the poverty line. That would leave the middle
    income seniors, including those that are lower middle income, just above
    the poverty line, to fend for themselves. And here in Ohio, 53 percent
    of all the seniors are middle income seniors. None of them would be
    covered by this plan.
        In 1965, when Medicare was created, some in Congress used these very
    same arguments. They said, ``We should only pay for hospital and medical
    care for the poorest seniors.'' They were wrong then, and they're wrong
    now. More than half the seniors today without any prescription drugs at
    all are middle class seniors. I want to say that again. More than half
    the seniors without any prescription drugs at all are middle class
    seniors. On average, middle class seniors without coverage buy 20
    percent less drugs than those who have coverage, not because they're
    healthier but because they can't afford it. And even though they buy 20
    percent less medication--listen to this--because they have no insurance,
    their out-of-pocket burden is 75 percent higher--without insurance, 75
    percent higher.
        So I say, let's do this right. This is voluntary. We're not making
    anybody do it. But we ought to offer it to everybody who needs it. It
    doesn't take much, if you're a 75-year-old widow, to be above the so-
    called Federal poverty line. You can have a tiny little pension tacked
    on your Social Security, and you can be there. But if you've got, as
    you've just heard, $2,300 worth of drug bills a year--and a lot of
    people have much higher--it's a terrible problem.
        Now, some other Members of Congress are proposing a tax deduction to
    help subsidize the cost of private Medigap insurance. If any of you own
    Medigap, you know what's the matter with that proposal. This proposal
    would benefit the wealthiest seniors without providing any help to the
    low and middle income seniors. And the Medigap marketplace is already
    flawed. Today--listen to this--in Washington, the General Accounting
    Office is releasing a report that shows that Medigap drug coverage
    starts out expensive and then goes through the roof as seniors get
    older. On average, it costs about $164 a month for a 65-year-old to buy
    a Medigap plan with drug coverage, and premiums rise sharply from there.
        For example, in Ohio, an 80-year-old person would pay 50 percent
    more than a 65-year-old person for the same coverage under Medigap. This
    is not a good deal, folks. We don't want to put more money into this
    program. It is not a good deal. Even those who offer Medigap plans say
    the approach wouldn't work, because it would force Medigap insurers to
    charge excessively high premiums for the drugs or to refuse to
    participate at all.
        Now, there's another problem that we have in the Congress, which is
    that the congressional majority just last week voted on budget
    resolutions that together allocate nearly half a trillion dollars to tax
    cuts. And if we cut taxes that much, we won't be able to afford this,
    and we may not be able to save Social Security and Medicare and pay down
    the debt and have money left over to invest in the education of our
    children.
        I'm for a tax cut, but we've got to be able to afford it. And we,
    first of all, have got to keep this economy going. We need to pay down
    the debt. We can get out of debt for the first time since 1835, within a
    little more than 10 years, if we just keep on this road. A lot of you
    never thought you'd ever see that.
        We can lengthen Social Security out beyond the life of the baby boom
    generation. We can put 25 years on the Medicare program, which is longer
    than it's had in blows and blows, a long time. And we can add this
    prescription drug coverage. But we can't do it if the tax cut's too big,
    and we shouldn't do it in the wrong way and say you can only get it if
    you're really poor or you can only get it if you buy into Medigap.
        Now, let me tell you why this is such a big deal. The average 65-
    year-old in America today has a life expectancy of 82 to 83 years. The
    average 65-year-old woman has a life expectancy higher than that. The
    fastest growing group of American seniors are those over 85. So to
    knowingly lock ourselves into a program that would get 50 percent more
    expensive as you got older and older and needed more and more medicine
    and had less and less money does not make much sense.
        We have given them a good program. It is the right thing to do. And
    so I would like to ask all of you to help all of these Members of
    Congress on the stage and to tell the people in Washington, ``Look, this
    is not a partisan issue.'' You know, a lot of people say, ``We don't
    want to do this. This is an election year.'' Look, they can name this
    prescription drug program

    [[Page 450]]

    after Herbert Hoover, Calvin Coolidge, and Warren Harding. It's fine
    with me. [Laughter] I don't--put some Republican's name on it. I don't
    care. Just do it, because it's the right thing to do for the seniors of
    this country.
        So I would just implore you, help us pass this. Write to your United
    States Senators. Tell them it's not a partisan issue. Tell them what
    life is like. Tell them it's not right for seniors in Ohio to pay 30 to
    50 percent more for medicine than seniors in Canada pay for the same
    medicine that's made in America in the first place. Tell them it's not
    right for you to need something you can't have, so you get sick, but
    then when you show up at the emergency room, it gets paid for.
        We can afford this. Everybody in America has worked hard for it.
    We've got this budget in good shape. We can make a commitment to our
    future. If you think this is necessary now, imagine what it's going to
    be like when the number of seniors doubles in 30 years.
        That's the last point I want to leave you with. Look how many
    seniors there are in Cleveland today. In 30 years, the number of people
    over 65 will double, and Donna Shalala and
    I hope to be among them. [Laughter] And you think about it. And then the
    average age in America will be well over 80.
        Now, if we have to take care of all these people by waiting until
    they get sick and they go to the hospital, instead of worried about
    hospitals closing, 30 years from now you'll worry about the city going
    bankrupt because everybody will be in the hospital. We've got to be
    healthier. We've got to keep people healthy. We need to keep them
    playing tennis, like Lawyer Shalala there, but
    we also need to be able to give people medication to keep them out of
    the hospital and to manage people in a way that will maximize their
    health. This will be a huge issue.
        So I implore you, this country--this is the first time we've been in
    shape to do this in 35 years. We can do this now. And we can do it now
    and take care of the future. We can help the seniors of today and take a
    great burden off of tomorrow. But we need your help to do it.
        Again, I implore you, talk to your Members of Congress. Talk to your
    Senators. Tell them it's not a partisan issue; it's an American issue.
    It's a human issue, and it's a smart thing to do.
        Thank you, and God bless you.

     Note:  The President spoke at 2:55 p.m. in the Louis Stokes Wing of the
    City Public Library. In his remarks, he referred to Wanda Golias, who
    introduced the President; Andrew A. Venable, Jr., director, City Public
    Library; former Representative Louis Stokes; Edna Shalala, mother of
    Secretary of Health and Human Services Donna Shalala; Sandy Alomar, Jr.,
    catcher, Cleveland Indians; 6-year-old Kayla Rolland, who died after she
    was shot by 6-year-old classmate Dedrick Owens in Mount Morris Township,
    MI, and her mother, Veronica McQueen; and Wayne LaPierre, executive vice
    president, National Rifle Association.