[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.