    [Public Papers of the Presidents of the United States: WILLIAM J. CLINTON (2000, Book I)]
    [June 7, 2000]
    [Pages 1106-1107]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on Increasing Participation in Clinical Trials and an Exchange
    With Reporters
    June 7, 2000

        The President.  Good morning everyone. We are here at this early
    hour to talk about a vitally important issue to the health of America's
    senior citizens--indeed, eventually, to the health of all of us.
        We must help more seniors participate in clinical trials that test
    new therapies for illnesses, from cancer to heart disease to
    Alzheimer's. These trials may prolong lives, and they are central to
    finding cures for deadly diseases.
        Today, America's seniors are badly under-represented in clinical
    trials, yet they bear the heaviest share of illness. More than half of
    our cancer patients are over 65, but only a third of those in clinical
    trials are seniors. For breast cancer, the statistics are even worse.
        Today, thousands of important clinical trials don't have enough
    patients because so few seniors are able to take part, and that means
    slower progress towards curing or treating illness. One major factor
    keeping seniors out of clinical trials is patients' lack of certainty
    that their expenses will be covered by insurance. Because Medicare's
    policies on payment for clinical trials have been unclear, seniors
    cannot be sure of coverage if they volunteer for experimental care. Many
    assume they'll be saddled with thousands of dollars in routine medical
    costs if they participate, and they clearly cannot bear such a heavy
    burden.
        For several years, Vice President Gore
    has led our efforts to clean up the confusion and help seniors and
    people with disabilities into clinical trials. We've had bipartisan
    support in Congress, led by Senators Rockefeller and Mack and Congresswoman
    Johnson and Congressman Bentsen and Congressman Cardin.
        Today, after careful study, I am signing an executive memorandum
    directing Medicare to change its policy and remove a major barrier to
    seniors' participation in these trials. Within a week, Medicare will
    begin to cover all the routine medical costs of participation in a
    clinical trial.
        The Department of Health and Human Services and the Health Care
    Financing Administration will begin outreach programs so that patients,
    as well as doctors, researchers, and administrators, all are aware of
    the change. We'll ask for the help of advocates for patients and
    research who have done so much to publicize this issue. We believe that
    with good outreach, thousands of seniors could join trials this year and
    make a dramatic contribution to the progress of medicine, as well as to
    the health of older Americans.
        I am also directing today the Department of Health and Human
    Services to report back to me on ways we can provide additional support
    to clinical trials that are especially relevant to senior citizens, and
    am requesting that the National Institutes of Health look for ways we
    can encourage even more seniors to speed science's progress by
    participating in new clinical trials.
        As America ages, we must provide all our seniors affordable, quality
    health care, and we should be using our cutting-edge science to meet
    that challenge. Simply put, the more seniors we enroll in trials, the
    faster we'll be able to use these advances to save American lives.

    [[Page 1107]]

    We've done this successfully with cancer in children. For decades now,
    more than half of all the children with cancer have joined clinical
    trials, giving us a wealth of evidence about how the disease works and
    how best to fight it. Now we can cure three-quarters of childhood
    cancers. That could never have happened without the participation of
    children in these trials. We should be doing the same for Americans of
    every age.
        Today I've authorized Medicare to help seniors participate. Private
    health care plans should be doing the same for their members. But it
    won't happen also unless Congress takes the next step and passes a
    strong Patients' Bill of Rights. Congress has had that on its agenda for
    6 months now in the Norwood-Dingell bill, which includes a requirement
    that every private insurer cover the cost of participation in clinical
    trials.
        This month, before the summer recess, Congress has a window of
    opportunity to take another real step to make our country stronger and
    safer and healthier. I hope that window will be used, because we need
    this. If we do the Medicare participation in clinical trials and pass
    the Patients' Bill of Rights, then all our citizens will be able to
    participate in these trials, and that will hasten the day when all age
    groups will be more likely to recover from the most serious illnesses.
        Thank you very much.
        Q.  Mr. President, could you disabuse us of the notion that this is
    an attempt by the Vice President to curry favor among a group of
    individuals which have been, in recent years, starting to move away from
    the Democratic Party during an election year?
        The President.  Well, I think the only way I can disabuse you of the
    notion is 7\1/2\ years of activity on this and the fact that it has been
    well known that I have been working on this issue, and so has he, for several months now, trying to work through
    all the legal and administrative issues necessary to get this done. It's
    not as if this is just an issue that popped up on the radar screen.
    We've been working this clinical trial issue alone for years, not only
    the seniors but with children. This is by no means the first action
    we've taken in this area.
        And indeed, there has been a strong bipartisan interest in this with
    all the people involved. I mentioned Senator Connie Mack, Congresswoman Nancy Johnson; they are the two most visible Republicans who have been
    working on this. But we've been--all of us have been working on this for
    some time now trying to get this done. And if I could have gotten it
    done a month ago, 2 months ago, 6 months ago, I would have done that.
        Thank you.

     Note:  The President spoke at 8:09 a.m. on the South Lawn at the White
    House, prior to his departure for Tokyo, Japan.