[Weekly Compilation of Presidential Documents Volume 30, Number 12 (Monday, March 28, 1994)]
[Pages 601-609]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks in a Health Care Roundtable With Small Business Leaders

March 22, 1994

    The President. Ladies and gentlemen, first let me thank all of you 
for coming here. We have several Members of the United States Congress 
up here in the front. We're very glad to see all of them, and we thank 
them for their presence. And we have small business people here from all 
over America, and we thank you for your presence. We're here primarily 
to hear from the small business people who are here on the panel, and 
perhaps some others if time permits.
    I just want to make a couple of comments. First of all, I very much 
appreciate the work that Erskine Bowles has done as Director of the 
Small Business Administration. I am proud of the fact that I was able to 
appoint someone to this job who was not just someone who had run 
unsuccessfully for office or was otherwise looking for a patronage 
appointment. This man has spent 20 years helping to finance small 
business creations and expansions. And therefore, he has a clearer 
understanding and grasp of what small businesses are really up against 
and the difference between the rhetoric of supporting small business and 
the reality of it than perhaps anyone who has held this job in a very 
long time. Secondly, I want to thank my good friend Congressman LaFalce 
for his leadership on small business issues.
    Finally, let me say that everybody, I think, understands that one of 
the reasons that the United States has not succeeded in providing health 
security for all its people while every other advanced economy has done 
so is the

[[Page 602]]

difficulty posed by the greatest strength of our economy, which is that 
an inordinate percentage of our workers work for small business people, 
very small business, and increasingly, more and more of the new jobs are 
created by small businesses.
    So that presents us with a dilemma. However, we also know if we look 
at the real facts that almost all the job creators among small business 
are making some effort to provide health insurance, and that those which 
do tend to have more stable work forces and higher productivity and 
greater success.
    Just this week I had a good friend of mine up here with his family. 
He's a car dealer in my home State, and he was talking about how he'd 
always insured all of his employees and none of his competitors had. And 
in the last 20 years, three of them had come and gone, and he was still 
there. And one reason was, he never had any employee turnover because he 
always took care of his employees and their health care problems, but 
the struggle to get a bigger pool of insured people so that he could get 
his insurance cost down was a continuing one for him.
    Anyway, that just brings me to this point: This administration could 
not in good conscience have advocated, and I could not support a plan 
that I thought would be, on balance, bad for small business. I believe 
this plan is, on balance, good for small business. If I didn't I 
wouldn't be supporting it. And I will not sign any bill passed by the 
Congress that I do not believe is good for the small business economy, 
because we have to create more jobs in this country.
    Our plan builds on the system we have now, guaranteed private 
insurance. It provides more choices to employees than they now have 
under most health care plans, at least three a year, every year. It 
contains real insurance reforms that are very important to small 
businesses--no discrimination for preexisting conditions, or based on 
the age of the work force. It protects Medicare. It does provide both 
for Medicare people and for the work force and their families, 
prescription medicine benefit and a phased-in, long-term care benefit 
for service at home, for example, for disabled people or elderly people, 
as well as in institutional settings. And it does have an employer 
mandate, but with strong discounts for small businesses with modest 
payrolls and modest profit margins.
    Now, there will be countless discussions about what the proper 
details of that should be, but it seems to me that that is the only 
approach that has a reasonable chance of being successful in this 
environment. And as I said, there are people who will propose variations 
on it, but that, it seems to me, is what we ought to be doing.
    My purpose today is to show that there is a great difference in the 
rhetorical pronouncements of some organized groups and the real life 
experiences of a lot of business people. And we have here people who 
have been affected by the present health conditions. And I am frank to 
say that while most of the people who are on this panel who are 
providing health insurance today would actually pay less under our plan, 
some would pay more, and they know it. But they also know that for the 
first time their competitors would as well, putting them on a more even 
footing.
    So let's get in to the panelists, hear their stories, and give them 
a chance to comment.
    I'd like to start with Mona Castillo who founded Monarch Graphics, a 
trophy and plaque manufacturer in Chicago and who was the Chamber of 
Commerce national minority entrepreneur of the year award winner in 
1993. And I'd like to ask Mona to talk a little bit about her 
difficulties in providing coverage for her employees and finding an 
insurance company who will do it.
    Mona.

[At this point, Mona Castillo, chief executive officer, Monarch 
Graphics, Chicago, IL, discussed difficulties presented by having 
uninsurable employees; Betty Hall, owner, Hall Manufacturing Co., Inc., 
Brookline, NH, discussed loss of coverage by Blue Cross/Blue Shield, 
limiting her company's options for health care coverage; and Spence 
Putnam, chief operating officer, Vermont Teddy Bear Co., Shelburne, VT, 
discussed difficulties providing coverage for employees.]

    The President. Thank you very much.
    Let me just try to emphasize a couple of the points that were made 
here, because they are different issues. Mr. Putnam wants to insure all 
of his employees; today can only insure about two-thirds of them. So he 
would

[[Page 603]]

actually pay more if our plan passed, but he'd get to insure all of his 
employees and they would also have more primary and preventive care than 
they have now and lower deductibles. But he would be, again, on an even 
scale with his competitors.
    Betty Hall talked about--I wanted to make sure you understand what 
she meant when she talked about her situation in New Hampshire, because 
she doesn't have Blue Cross options for her business but does have the 
matching Thornton option. She has an HMO option. And the HMO has a very 
good reputation in New Hampshire and throughout New England; I think 
everybody would admit that. But the individuals who work for her now 
don't have the choice that, if our plan passed, every year her employees 
would get to choose either the HMO or one of two other options. And 
under our plan, she would pay the same no matter what. But if the 
employee wanted to pay a little more for fee-for-service medicine, the 
employee would have that right. So that's how that would work.
    If you go back to what Mona said about two of her employees being 
uninsurable, it's important here, I think, to recognize a certain truth 
about the insurance business itself. While certainly I have been 
critical of insurance practices of which I do not approve, I think it is 
also important for us to understand that given the organization of the 
insurance business today, it is economically impossible for a lot of 
these health insurance companies to do other than they do because they 
are dealing with a very small pool of people.
    So if you insure, let's say, an employee unit the size of her 
company and two of them are really sick or they have two kids who have 
been really sick, then that can double the cost of whatever your annual 
premiums are in a year which is why we have worked so hard to find a 
mechanism--and I'll say more about this in a minute--to let insurance 
companies insure people the way grocery stores make money, a little bit 
of money on a lot of people. And that's what all this--and I'm going to 
say more about this toward the end of the hour because I don't want to 
interrupt the flow of the people talking, but that's the dilemma we face 
about whether there should or should not be a health alliance, a buyer's 
co-op or something.
    You've got to have these folks able to go into big enough pools so 
that the insurance companies themselves do not go broke. They're in 
business, too. And the economics have to work out. And the only way the 
economics can work out is if the risks which all small businesses are 
subject to can be widely spread over a bigger pool. So we'll come back 
to that.
    I want to introduce now Murray Horowitz who currently covers his 
employees today but has had to take some pretty strong steps to keep 
covering them. Murray would you like to speak about that?
    Murray Horowitz. As a pawnbroker, I represent one of the most 
misunderstood industries in the country.
    The President. Want to come to work up here? [Laughter]

[Murray Horowitz, owner, City Pawn Shop, Baton Rouge, LA, discussed 
increasing costs, increasing deductibles, and employees who are 
uninsurable because of preexisting conditions.]

    The President. Same thing--81 million Americans have preexisting 
conditions of some kind or other. This is not a small problem; this is a 
big problem. Those who are in families that are insured through 
government or larger employers are okay now except that most of them 
couldn't change jobs and go to work for any of you or couldn't start 
their own business. You know, a lot of people, that's a lifetime dream 
to start their own business. It takes enough courage, as all of you 
know, to do that if you don't have to worry about this.
    So you've got 81 million Americans, some in the situation of your 
employee who can't get insurance, others who pay very much higher rates, 
and millions and millions--no one knows exactly how many, but literally 
tens of millions--who are locked in the jobs they are now in because 
they can't afford to give them up and lose in coverage. So it's a 
significant issue. Congressman, would you like to say something about 
any of this? I haven't heard from you since the beginning.

[Representative John J. LaFalce, discussed town hall meetings in which 
constituents de- 

[[Page 604]]

scribed dramatic cost increases, increasingly limited choice, and 
increases in deductibles and copayments.]

    The President. We have someone here from your home State, Elaine 
Stone, of American Aviation in New York, who has gone to extraordinary 
efforts to cover her employees at very high cost. I'd like to ask her to 
explain her situation and what the consequences have been.

[Elaine Stone, owner, American Aviation International Corp., New York, 
NY, discussed her desire to provide coverage for all employees and 
described her current self-insured plan which splits funding between the 
corporation and the insurance company.]

    The President. Thank you very much.
    Let me say because of the unique, sort of, semi-self-insured system 
that Elaine has, and because she's had some significant illnesses in her 
work force, she would actually, at least based on the last year or two's 
experience, pay considerably less than she is paying because of the self 
insurance schemes kicked in. It works, again, like everything else--it 
may work very well for large employers, but for someone with a couple of 
dozen employees, it is a very high-risk strategy that can work real well 
until it doesn't anymore.
    I'd like to now talk about people who are kind of the other side of 
that equation, people who would like to cover all their employees but 
can't, and therefore, only cover a portion of them, or have had to give 
up coverage. And I'd like to begin with Judith Wicks who owns the White 
Dog Cafe in Philadelphia. Because, as I'm sure all of you know, the 
people in the restaurant business have been among those most concerned 
about this health care plan because there are so many people who work 
for restaurants and delis and other eating establishments who are young, 
who are single, who don't have health insurance, and who are still 
willing workers there. But there are an awful lot of people who very 
much want to cover folks.
    And the press will remember, we were in an establishment in 
Columbus, Ohio, just a couple of weeks ago, where by accident--we didn't 
plan to go there for health care, but where we had a whole health care 
seminar because only half the employees were covered, and the person 
covering them wanted to cover them all.
    So Judith, why don't you talk a little bit about your situation?

[Judith Ann Wicks, owner, White Dog Cafe, Philadelphia, PA, discussed 
her ability to provide insurance coverage for only a small percentage of 
her employees and indicated that the health care plan would provide full 
coverage for only a small increase in cost and place all restaurants on 
an equal competitive footing. Representative LaFalce discussed sources 
of opposition to the health care plan indicating that instituting the 
plan would place all restaurants in the same competitive positions.]

    The President. Do you think he feels strongly about that? [Laughter]
    Thank you.
    Erskine Bowles. Mr. President, we also have another restauranteur 
here, who runs the Burrito Brothers chain here. They're three Mexican 
fast food restaurants. Eric's also experienced some of these same 
problems that small businesses face in trying to provide health care 
coverage. And Eric, you might want to comment on how you would react if 
it was a level playing field and you could provide reasonable coverage 
at reasonable cost.
    Eric Sklar. First let me say that, what Judy said notwithstanding, I 
hope jobs are lost to Mexican food. [Laughter]
    The President. Well, if I'm setting the pace, you've got a good 
chance of achieving that objective. [Laughter]

[Mr. Sklar, owner, Burrito Brothers, Washington, DC, discussed how the 
health care plan would be good for the restaurant business, citing the 
advantage to businesses of having employees with health care coverage, 
and indicated a willingness to pay more to secure health care for 
employees.]

    The President. Thank you. I just want to say that Eric and Judy 
represent an interesting thing that we have seen basically around the 
country with people who really are trying to do the right thing by their 
employees. If you are in the restaurant business and you insure part of 
your employees, you are in the worst of all worlds. You're still at a 
competi- 

[[Page 605]]

tive disadvantage to people who don't insure anybody, and you feel 
terrible that you can't insure everybody. That's basically what they 
face.
    Administrator Bowles. Mr. President, unfortunately some of the small 
businesses in this country have experienced such absolutely skyrocketing 
costs and the cost of health care, experiencing these 20 to 50 percent 
annual rises in health care, that they simply just no longer can afford 
it. Garth Sheriff is here from Los Angeles. I know Garth has had to drop 
his coverage a couple of years ago when the cost just went so high you 
couldn't afford it.

[Garth Sheriff, owner, Sheriff Associates, Los Angeles, CA, discussed 
the dilemma he confronted of having to choose between keeping an 
employee or keeping health insurance for his firm, the difficulties 
presented by an aging group of workers in terms of insurance costs, and 
concluded with a strong endorsement of the health care plan.]

    The President. Thank you. Thank you very much.
    I'd like to, first of all, thank you and thank your group and thank 
you for sharing your painful experience with us. I'd like to go on and 
sort of pursue this theme a little more and call on Brian McCarthy, who 
owns the McCarthy Flowers, a large florist in Scranton, and ask him to 
tell us a little about his situation.
    Brian.

[Brian McCarthy, owner, McCarthy Flowers, Scranton, PA, discussed the 
problem of attracting unskilled workers from welfare when the workers 
would lose health care coverage from Medicaid for their families and 
also attracting skilled managers who would not take positions without 
adequate health care coverage.]

    The President. Thank you very much. I just want to emphasize one 
comment Brian made, and if I might go back to what our restauranteurs 
also said there. One of the arguments that the Restaurant Association 
makes against our doing this is they say, ``Well, you know we have a lot 
of young single workers that are healthy. They're strapping. They don't 
want insurance, or if they do have it, they ought to be able to get it 
much more cheaply than older workers,'' because young single workers 
will pay higher per person premiums under our plan. That's what 
community rating is all about. If you put people in large pools with 
older people and with families with a lot of kids and the kids have been 
sick, you average it out. So they will pay a modestly greater amount, 
and therefore, the employer contribution for them will be modestly 
greater.
    I'd like to make two arguments in response to that. One is one Brian 
made. A lot of the young single people we want to be workers in this 
country are on welfare. They all have health insurance for themselves or 
their children through the Medicaid program which is as generous as most 
health insurance programs. And yet, we want them to move from welfare to 
work and take jobs in our small businesses and give up health insurance 
for their children so they can then start paying taxes to pay for the 
health care of people who made the other decision to stay on welfare.
    I mean, it's just a--we cannot reform this welfare system unless we 
fix this problem. So there are a lot of young single potential workers 
out there we cannot even get in the workplace unless we deal with this.
    The second point that I'd like to make is that the fastest growing 
group of people in America are older Americans. And people are going to 
be working later and later and later in their lives. Indeed, the gradual 
phase-up of the Social Security retirement age starts in a couple of 
years as a result of the Social Security Reform Act of 1983, raising 
retirement age by a month a year over several years to go up to 67. And 
if you don't want discrimination, if we need older people, if we know 
they're very good employees and they're very reliable and you don't want 
discrimination against them in the workplace, one sure way to avoid it 
is to make sure that their health insurance premiums are not 
discriminatory.
    I see a lot of older people who work in eating establishments, too, 
So this thing, I think, will balance out and is ultimately fair. I 
especially thank Brian for his statement because he does cover all his 
employees today.

[[Page 606]]

And it shows you, I think he really is thinking towards the future.
    Administrator Bowles. Mr. President, we also have here Chris Maas, 
who has experienced some of these same problems of trying to compete for 
labor with absolutely skyrocketing costs in health care.
    Chris, do you want to talk about it a second?
    Chris Maas. We're a small computer consulting firm here in 
Washington. We do most of our work with Washington area lawyers, and we 
need professional help. And the one competitive advantage that we have 
as a little firm--[laughter].
    The President. Every one of you has a one-liner for that, don't you? 
[Laughter]

[Mr. Maas, owner, Potomac Consulting Group, Arlington, VA, discussed the 
problems he confronted in hiring older employees because of the health 
insurance issues that arise. He concluded by stating that his associates 
see the health care issue as a business issue rather than a political 
issue.]

    The President. Good for you. Believe you me, nothing would make me 
happier than to do exactly what you've said. It should not be a partisan 
political issue. And if you get beyond the fog of rhetoric to the hard 
facts of what people's actual individual circumstances are, it's very 
much easier for it not to be a political issue.
    Thank you very much. That was very impressive.
    I want to talk a little bit--by giving these folks a chance to talk 
about how we give small business people the ability to have competitive 
prices in the insurance market.
    And I'd like to start with Stephen Hightower of the Hi-Mark 
Corporation in Franklin, Ohio, and talk about how the absence of that 
has affected his business and his family.
    Stephen.

[Stephen Hightower, president, Hi-Mark Corp., discussed the difficulty 
keeping employees with the corporation without offering health care 
benefits and emphasized the link between welfare reform and health care 
reform.]

    The President. I'd like to now to go to a small family business.
    Kathleen Piper who owns the Pied Piper Flower Shop in Yankton, South 
Dakota.
    I first met her a little over a year ago when she represented small 
business at the economic conference we held in Little Rock shortly 
before I assumed the Presidency. I'd never met her before, and I didn't 
know anything about her, but I was deeply impressed by the comments she 
had to make, and we asked her to come back here today because of her own 
experience on health care.
    Kathleen.

[Ms. Piper discussed how she was no longer able to provide health care 
insurance for her employees. She thanked the Small Business 
Administration for its work in educating small business owners on the 
health care plan.]

    The President. Yesterday when I was in Miami, I met, as I often do 
when I'm traveling around the country, with some children and their 
families from these Make-A-Wish programs, where the kids are desperately 
ill and one of the things they want to do is meet the President. And I 
met with a family, a very impressive family of three children, two sons 
and a daughter, where both sons had a very rare and apparently 
genetically transmitted propensity to have a very rare form of cancer. 
And this family has a lifetime limit on their policy, as three out of 
four Americans do. Three out of four Americans have lifetime limits. And 
they're in a real pickle, because they are going to run up against the 
limit long before the second child--assuming that both the boys survive, 
and they've done pretty well so far, but if they do both survive their 
illness and they're plugging along--then they'll run up against their 
limit long before the second child is out of the house. And then they 
have a third, youngest child and, thank goodness, the young child so far 
has not contracted the disease, and of course, they hope she won't. But 
if she does, then you can just double whatever their problem is.
    Again, I would say--I want to emphasize, though, the only way this 
works with the private health insurance business is that you have to 
find a way not to bankrupt private

[[Page 607]]

health insurance. And a lot of these things--I've had a lot of 
employers--I had a restaurant owner I mentioned in Columbus, Ohio, who 
was very complimentary of her personal health insurers. She said, 
``These people are doing the best they can for me under the 
circumstances given the way their business is organized and the way the 
market is organized.'' That's why you have to reorganize the market and 
put people into larger units and insure people on a community basis.
    One of the most controversial things--I just want to mention this--
one of the most controversial aspects of our plan has been the provision 
for small and medium sized businesses to be in these big buying 
alliances. People have treated it as if it were some big new Government 
bureaucracy.
    I have seen it, quite the contrary, as a way of enforcing community 
rating. That is, there are some States--New York State has a law 
mandating community rating. But if you don't have the system within 
which the little guys can buy together, the law itself won't guarantee 
community rating.
    And yesterday--I just want to read you something--yesterday in the 
Los Angeles Times, there is this article, ``State Alliance Gives Workers 
Health Clout. Forty thousand workers at small California businesses will 
get an extraordinary piece of good news on Tuesday.'' That's today. ``At 
a time when health insurance costs in the country are climbing at 6 to 8 
percent a year, their premiums will actually be reduced, starting July 
1st. These fortunate few are members of the State's unheralded health 
alliance, a purchasing agency that gives companies with between 5 and 50 
workers an opportunity to band together and achieve the same buying 
clout the health care market gives to giant corporations. Even as 
President Clinton's proposal for alliances is being denounced in 
Washington as a blueprint for a menacing new bureaucracy, a staff of 
just 13 State workers in Sacramento has put together a working alliance, 
the first in the Nation, and the customers seem delighted.''
    And in Florida they've got now buying pools of small businesses--
Congressman Gibbons is here. And the Governor told me last night that 
most small businesses that joined these alliances had experienced 
declines in premium costs of between 5 and 40 percent.
    So I say this not to be combative, but just to ask this question: As 
this bill moves through the Congress, if they don't like the way we 
structured the alliances, you've got to find some ways to give the 
little guys big buying power.
    Administrator Bowles. Mr. President, all these buying groups do--and 
I wish to goodness we'd called them buying groups instead of alliances, 
but all these buying groups do----
    The President. I do, too. They liked it when we called NATO an 
alliance. [Laughter]
    Administrator Bowles. ----is, truly, they shift the power of the 
marketplace. They change that supply and demand equation from favoring 
the supplier of health care to favoring us, the consumer and the small 
business owner. It's just identical to what Mr. McCarthy was here saying 
about what happens in the flower business. It gives us, the small 
business owner, some market muscle so that we can cut a good deal for 
our employees. That's what it does.
    Q. Could I ask a question? One of the big arguments that I have 
heard in talking to other businesses is that everybody is concerned 
about the quality of health care, what's going to happen. They're 
afraid. Right now they may have choices; they have certain choices, and 
that's sort of the unknown out there. How is the quality of health care 
going to change?
    The President. I think there are two concerns about the quality of 
health care that I've heard. One is, are you going to cut down on how 
much you spend on health care so much that there won't be enough for 
medical research, for technology, for things to progress? The other is, 
if you deprive people of choices, isn't that a backdoor way of 
undermining quality?
    I mean, in America I think people equate--we all like to make our 
own decisions. So people equate choice with quality. To that I would 
respond in two ways: Number one, if you don't do anything, if we just 
let this alone, if we walk away from here and don't do anything, you 
will see dramatic re- 

[[Page 608]]

ductions in choice. And many of you in this room will contribute to that 
because you will have no choice.
    That's what happened to our friend from New Hampshire here. She 
wished to give her employees the choice between being in the HMO or 
insuring with fee-for-service medicine through Blue Cross. Now she has 
only the HMO option. She is now in the majority of employers in America 
who cover their employees. Now, a slight majority does not provide any 
choice for the employee but, in fact, makes the choice for the employee 
because they have no choice. You know, Mr. Sheriff here, if he were able 
to get back into the health insurance market, probably would have to 
just make the best deal he could, and the employees would have to take 
it or leave it.
    So on the question of quality in terms of choice, under our plan, 
again because of marketing power, we would give-- your obligation as an 
employer would be constant. You would pay the same no matter what. But 
your employees every year, because of the cooperative buying power, 
would be able to choose from among at least three programs.
    And we estimate that in most places they would always have access to 
an HMO. And as I said, many of them are very good, but they'll be better 
if they have competitive pressure. Then, probably there would be a PPO--
that is a professional group where doctors get together and they 
organize health care delivery, and normally those have many more doctors 
and sometimes let people in who are willing to provide the service for 
an approved price, so you get even more choice--and the fee-for-service 
medicine. And that would come up every year. So that's my answer.
    And the second thing is, if you do nothing, you will continue to see 
a squeeze on the quality of medicine in terms of what goes into the 
teaching hospitals and medical research. Why do I say that? I was in 
Boston last week, and I met with the heads of all the teaching hospitals 
after which they came out and endorsed our plan. And they said--every 
one of them said, ``If we don't do anything, we're going to get less and 
less money because the people who come into our hospitals are 
increasingly in managed care plans where they put the squeeze on us, and 
they cut down on the money we get for patient care.'' So under our plan, 
we increase medical research; we increase support for teaching 
hospitals, and that's what we have to do.
    So my argument is quality will suffer if we do nothing. Choice will 
be restricted if we do nothing. If we move, we can increase quality and 
choice in a fair and balanced way.
    I know we've got to wrap up. We have one more person to hear from, 
and the Congressman wants to make a comment.

[Representative LaFalce indicated that the health care plan offered 
better quality care with its emphasis on preventive medicine and pointed 
to the Hawaii system as a model of success.]

    The President. I'd like to hammer that home because a lot of people 
say, ``Well, Bill, everybody goes to Hawaii on vacation. It's a rich 
State.'' Hawaii has a very, very large percentage of people in its 
health care system who are low income people, native islanders, people 
come in from surrounding islands, about a 20 percent load there, quite a 
high load. So the health outcomes for Hawaii include a very large number 
of people who have to be paid for in traditional ways who aren't even in 
the employment system. So you just can't make that argument. I'm just 
trying to reinforce what he said.
    Our last speaker is John Sorenson, from the WECO Supply Company, in 
Fresno, California. He wrote to me about one of his employees. And I 
thought it would be good to kind of let him close because of the concern 
that this employer had for his employee and how it affected his 
business.

[John Sorenson, owner, WECO Supply Co., Fresno, CA, told the story of an 
employee who, because of job changes and changes in the WECO company 
insurance plan, was not covered for the birth of two premature children, 
incurred the full cost of their treatment, and ultimately suffered 
bankruptcy, loss of credit rating, loss of his job, and separation from 
his wife. He concluded that the preexisting conditions caused the 
problem.]

    The President. It was.
    Q. And if you can accomplish that, you've got my vote for the next 
20 times.

[[Page 609]]

    The President. Well, let me tell you, the votes that really matter 
here--first of all, let's give him a hand. I think that was quite a 
moving thing. [Applause]
    I wanted to end with that because I was so moved by the letter that 
he wrote to Hillary. And it seemed to sort of capture so many of these 
things that we talk about in kind of esoteric terms: preexisting 
conditions; people falling in between the gaps; why you can't change 
jobs; all that kind of stuff. And you hear a story and you realize that 
this is the business of America.
    But the votes that really matter here are the votes of the Members 
of Congress. So before we leave, I'd like to ask the Members of Congress 
who sat through this entire panel to please stand and be recognized. I 
see Congresswoman DeLauro there and Congresswoman Eshoo there, who are 
standing, so they can't stand; and Congressman Serrano's in the back. 
Would all the Members of Congress who are here please stand so you can 
see them?
    Thank you, Mr. Bowles. Thank you, Congressman. And thank you most of 
all to these fine members of our small business family in America.
    Thank you. We're adjourned.

Note: The President spoke at 10:46 a.m. in Room 450 of the Old Executive 
Office Building.