[Weekly Compilation of Presidential Documents Volume 30, Number 16 (Monday, April 25, 1994)]
[Pages 826-833]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks to Ameritech Employees in Milwaukee

April 18, 1994

    The President. Thank you very much. Thank you, Senator Kohl. And 
thank you, ladies and gentlemen, for that warm welcome. I started to 
stand on this thing so you would think I might be the Mayor of 
Milwaukee, but on reflection, I decided, like all public officials I'd 
rather be closer to the microphone. [Laughter] I want to thank Senator 
Feingold for his support and his leadership and his fine remarks. 
Congressman Barrett and Congressman Barca, we're glad to see you here. 
Thank you for being here with us. Congressman Gerry Kleczka, thank you 
so much; I'm glad to be here with you in your district and in your 
hometown. I want to say a special word of thanks to the Ameritech team 
for the welcoming here today. Dick Notebaert came out with me, along 
with Morty Bahr on the airplane, so the three of us had a chance to 
visit a little bit about what we would be doing today. And between the 
two of them, they convinced me that this may be the best company in the 
history of the world. They were talking about--[applause] I want to 
thank Gary Keating and Rick Compost in Detroit and Deborah Echols in 
Chicago and all the employees who are there. I also want to say, in 
addition to the fine work done by the CWA, I know that many of you are 
part of the International Brotherhood of Electrical Workers; I thank you 
for your support in this health care effort. There are a lot of people 
here in the audience--I won't recognize all of them, but I would like to 
say a special word of thanks to the speaker of the Wisconsin House, 
Walter Kunicki, an old friend of mine, for being here. Thank you very 
much, sir, for coming. And I'd like to thank the Wisconsin Ameritech 
team, Bronson Haase and Bob Johnson and others. Thank you so much. We're 
glad to be here.
    Ladies and gentlemen, when I came to Wisconsin first as a candidate 
for President, I did so not simply because I wanted to have the honor of 
the job, although it is a very great honor indeed, the highest any 
American citizen can receive, but because I thought the President's job 
was to bring the

[[Page 827]]

American people together and to move our country forward, to seize our 
opportunities, and to honestly face our problems. And we've been trying 
to do that.
    We've seen a lot of talk over the last several years about our 
deficit, for example, but finally now, in the last year, the Congress 
has passed an economic plan that has brought the deficit down, helped to 
create a stronger economic climate, and 2\1/2\ million jobs have come 
into our economy, 90 percent of them in the private sector. That's more 
in 15 months than in the previous 4 years, in fact, twice as many as in 
the previous 4 years.
    Congress now has a budget before it which it is passing in rapid 
fashion, perhaps record fashion, which does what we're supposed to do in 
Washington: make the difficult decisions. It eliminates 100 Government 
programs, cuts 200 others, reduces overall discretionary domestic 
spending for the first time since 1969, and at the same time, spends 
more money on education, on Head Start, on defense conversion, and on 
the new technologies which will create the high-wage jobs of the 21st 
century.
    If this budget passes, for the first time since Harry Truman was 
President we will have 3 years of declining deficits in the Federal 
accounts. That's a pretty good record for a Congress and an 
administration working together, breaking deadlocks, talking less, and 
doing more. I think that's what we were all hired to do.
    Congress has a lot of other interesting work to do this year. It is 
taking up sweeping education reforms, some of them modeled on a lot of 
the exciting things that have gone on here in Wisconsin and some of your 
neighboring States. I signed a bill the other day called Goals 2000 
which, for the first time ever, commits America to world-class standards 
of educational excellence in every school in the country and at the same 
time, promotes a lot of innovative grassroots reforms to achieve them 
and encourages communities to try new and different things.
    We're trying to set up a system now that takes into account the fact 
that young people don't necessarily have to have 4-year college degrees 
to get good jobs as we move toward the 21st century, but they sure need 
more training than they get in high school. So we want a school-to-work 
transition that takes account of the real needs of people who don't go 
on to 4-year colleges.
    Congress has a bill before it to completely redo the unemployment 
system. The unemployment system takes money, I would argue, under not 
entirely fair circumstances now from employers who pay the unemployment 
tax, because it used to be that when people lost their jobs, they were 
called back to their old jobs. So unemployment was a premium the 
employer paid to pay people at a lower level so they could at least get 
along until they got called back to their old jobs. Most workers do not 
get called back to their old jobs today. Most people have to find new 
jobs.
    The economy is churning and changing, and no matter how many new 
jobs we can create, there will still be a lot of change in this economy. 
So we want, instead of an unemployment system, a reemployment system, so 
the minute people lose their jobs, they're immediately eligible for 
retraining and for job help to find new jobs and different jobs, because 
the average 18-year-old will change work eight times in a lifetime, and 
we owe it to ourselves and our future to make sure that always people 
are retrained and placed as quickly as possible. We intend to do that 
this year; that's very important.
    Our administration has been committed to welfare reform, to ending 
the whole welfare system as we know it, something that Wisconsin has a 
great deal of experience in. And I want to say a special word of thanks 
to Mayor Norquist and the city of Milwaukee, who have a national model 
in Project New Hope. It says you can move people from welfare to work. I 
know we can do that; I'm going to talk more about it in a minute. But 
that is another thing we are facing this year. This is an exciting time 
in our Nation's Capital, because people are actually working on the 
problems facing America.
    The first item of business now, when we go back tomorrow in 
Congress, will be the crime bill that's in the House of Representatives. 
And then the House and the Senate will get together. If the best of both 
bills passes, we'll have 100,000 more police officers on the street; 
we'll have huge new opportunities for young people to help prevent

[[Page 828]]

crime, to keep our young people from getting in trouble, and give them 
some things to say yes to; we'll have drug treatment that is very 
important, that we don't now have in a lot of our programs, and alcohol 
abuse treatment; we will have a tough ``Three strikes and you're out'' 
law for people who shouldn't be paroled that we know are likely to 
recreate serious violent crimes; and we'll ban 28 kinds of assault 
weapons, if the best of both bills passes. That ought to happen this 
year in the Congress.
    And I want to say a special word of thanks in that regard to Senator 
Kohl for his leadership in supporting the Brady bill, which we passed 
after 7 years of deadlock last year and his attempt to keep dangerous 
handguns out of the hands of minors who have no business carrying them 
on the streets of our cities.
    Now, last year, according to a lot of independent analyses, this 
Congress and I did more work together in more substantive ways than had 
been done in the first year of an administration in a whole generation, 
in over 30 years. But this year can be better, if we do the things that 
I just mentioned and if we have the courage, finally, to solve this 
health care problem.
    I want to talk a little bit about what specifically is in our plan 
and what some of the problems are, the real problems and the political 
problems with passing this plan, because if you're going to help us pass 
it, you have to understand the pressures that your Representatives in 
Congress are under.
    First of all, what are the problems? Well, at any given time during 
the year, 58 million Americans will be without health insurance out of a 
Nation of 255 million. About 39 million of our fellow countrymen just 
don't have it all year long. Eighty-one million of us--81 million--
almost one in 3, live in families where someone in our family has a 
preexisting condition: a child with diabetes, a mother who has had 
breast cancer relatively early in life, a father who had an early heart 
attack. And these people either pay much higher premiums for their 
health insurance or they can't afford insurance at all or they're 
insured at their present job but they are terrified to leave their job 
for fear that they will lose their insurance. And so, at a time when job 
mobility is highly prized, we see people never leaving their jobs. This 
is a huge problem.
    And 133 million of us, more than half of our population and three-
quarters of the Americans who are insured at work have lifetime limits 
on our policy. So that if one of our children were to be born with a 
serious long-term disease or problem--or in the case of a family I met a 
couple of weeks ago in another State, where they had three children and 
the first two sons were born with a very rare form of cancer which may 
well be treatable and which may well be able to be maintained--they're 
going to run out of their health insurance coverage before the second 
boy gets out of the house. And they'll have to figure out what to do and 
whether they can continue to work and what in the world is going to 
happen to their family.
    Not only that, 100 percent of us just about are at some risk of 
losing our health insurance. If you work for a government or if you work 
for a wonderful company like this, you won't lose it. But what if you 
decided to change your job, or what if you had to quit your job, then 
what would happen?
    And finally, as has already been said, the system we have--I was 
glad to hear Mr. Notebaert say this--is the most expensive system 
administratively in the world. We spend roughly twice as much money on 
paperwork and other administrative costs as any other country in the 
world does, with the consequence that, in America, we spend 14.5 percent 
of our income on health care. Canada spends 10 percent of its income; 
Japan and Germany spend 9 percent of their income. And half of that is 
for good things--I'll say more about that in a minute--and for things 
that we can't do anything about. We're more violent than all these other 
countries, so we have more emergency room bills. We have higher rates of 
AIDS. But half of it is the crazy way our system is organized.
    There was a recent study of two hospitals, one in Canada, one in the 
United States, with the same number of beds, the same vacancy rate, the 
same patient caseload. There were 200 people in the clerical department 
of the American hospital and 6 in the Canadian hospital. You're paying 
for that.
    You're also paying, as has been pointed out, a significant premium 
because we are

[[Page 829]]

the only advanced country that permits some people just to say, ``I 
won't have any insurance; I don't believe I'll be covered.'' But they 
all get health care if an emergency happens or when it's too late and 
they're too sick and they show up at the emergency room. And then the 
cost is passed on to the rest of you in higher premiums.
    There are all kinds of other things we pay for, too. Because we 
don't provide prescription drugs for elderly people in a lot of family 
policies, our hospital bills are much greater, particularly for older 
people, because of maintaining themselves with adequate prescriptions, a 
lot of people on Medicare choose every month between medicine and food. 
But they wind up getting care when it's too late, too expensive, and 
they're in the hospital. And it adds costs to the whole system.
    There are millions of Americans who have disabilities that if they 
were able to have some in-home care would save us money. They would be 
able to get health insurance and millions of them would be able to work 
who cannot work today.
    So our whole system, because we don't cover everybody, because we 
are willing to spend too much on paperwork and, therefore, too little on 
things that keep people well, like primary and preventive health care, 
costs too much and does too little. You might ask, ``Well, if it's all 
that simple why haven't we fixed it?'' Well, because it's not all that 
simple. And I'll explain why.
    There are all kinds of improvements going on now all the time. I 
just got a wonderful demonstration--you all heard about it already--from 
the Wisconsin Health Information Network. And Marsha, the lady who 
showed me, was terrific; I learned a lot and I was--if I hadn't been 
late I would still be out there fiddling with the computer to prove that 
even I could do it, a total computer illiterate. [Laughter] There are 
some things we can do. But I believe with all my heart, having studied 
this now for years and years, that we cannot fix these problems unless 
we have a national response, not a national health care system run by 
the Government but a national response. The Government of the United 
States needs to reorganize the health care system to keep what's best 
and fix what's wrong. And make no mistake about it, there are a lot of 
things that are great about our system: the doctors, the nurses, the 
medical research, the technology, the advances.
    I have a friend from Wisconsin here--Brianne Schwantes. Stand up and 
wave to the crowd here. [Applause] She was born with a problem; her 
bones were prone to break easily. And she comes to the National 
Institutes of Health on a regular basis and gets world-class care. And 
so here she is. And you know where I found her? Working with the flood 
victims in the Middle West, risking her brittle bones to help other 
people who were in trouble. If it weren't for the miracles of our 
system, she would not be able to do that. And we don't have to mess that 
up. But we do have to make some hard decisions. We're going to have to 
either cover everybody or not. If we don't cover everybody, your wages 
are still going to be stressed by paying too much for health care 
because other people won't cover their own. You're still going to have 
horror story after horror story of people who can't get coverage or who 
are terrified of losing it. And we will continue to pay more than we 
should.
    If we do want to cover everybody, we only have two choices. You look 
all around the world; there are only two options. You either have to do 
it through a Government-funded program, like Medicare for everybody--
abolish all insurance, charge everybody a tax and fund it--or you have 
to have insurance for everybody. And if you have insurance for 
everybody, then either the employers have to pay it or the employees and 
employers together have to pay it or the employees have to pay it for 
those who are working, and the Government's got to help for those who 
aren't working, who don't have insurance. Now, you can look all around 
the world. I don't think there are any other options if you believe that 
the only way to fix this is to make sure that we have health security.
    Here's my plan. First, guarantee everybody private health insurance. 
Why do it that way? Because that's a system we have now and just apply 
it to everybody. Nine out of 10 Americans who have health insurance buy 
it at work, and 8 out of 10 Americans who aren't insured have someone in 
their family

[[Page 830]]

who works. So the simplest way is just to extend the system we have now.
    Second, make sure the benefits are adequate, not just catastrophic 
health care but primary and preventive health care, too, mammographies 
for women in the appropriate age group, cholesterol tests for people. Do 
the primary and preventive stuff that will hold down the cost of health 
care and keep us well, as well as take care of us when we're sick.
    Next, permit people to choose their own doctors and health plans. 
Less than half the American people today who are insured at work have a 
choice of the health plan they're a part of. Now, is that because 
there's somebody bad in the system? No, it's because that's all the 
employers and the insurance companies can afford under the present 
system. But if everyone were insured properly, then the employees and 
their families could choose what kind of plan they want. And under our 
plan, every employee in America and their families would get at least 
three choices every year. If you didn't like the choice you had, next 
year you could make another choice. I think that's very important.
    Third, have insurance reforms. Don't permit insurance companies who 
issue health insurance to pick and choose whom to cover. When insurance 
was started for health care by Blue Cross, that's the way it was. 
Everybody paid more or less the same thing, and we were all insured in 
huge pools. And insurance companies then made money the way grocery 
stores do: They made a little bit of money on a lot of people. Today in 
America, there are 1,500 different health insurance companies writing 
thousands of different policies and the reason is, as Mr. Notebaert 
noted, that 25 percent of our money goes to health care paperwork. You 
think about it: 1,500 companies, thousands of different policies, 
everybody with a different deal. Think about how many people you have to 
hire in insurance offices and doctors' offices and clinics just to 
figure out what's not covered, just to figure out what not to pay for.
    And when you put on top of that the cost-control pressures so that 
doctors all over America are going crazy, even as we talk, because they 
have to call some distant insurance company employee to get credit to 
perform a procedure or practice medicine in a way that to them is 
perfectly self-evident and when you add to that a separate Government 
system for the poor, Medicaid, and for the elderly, Medicare, you have a 
paperwork nightmare.
    And it's really tough. So we have got to reform insurance. We've got 
to say, you can't kick somebody off and you can't charge them more just 
because one of their children has been sick. You shouldn't charge an 
older worker more than a younger worker when the average worker is 
changing jobs six, seven times in a lifetime. You've got people losing 
jobs in defense industries that are in their late fifties and early 
sixties who must find new jobs and who cannot find them because their 
employers can't afford to provide health insurance for them. It's not 
right. So we've got to have insurance reform.
    Fourth, I think we ought to protect Medicare, as I said. Leave it 
the way it is; it's working. But extend the benefits to elderly people 
to include a benefit of prescription drugs, which will save money, and 
for help for the elderly and the disabled for long-term care in the home 
and in the community.
    I think these benefits ought to be provided at work. Why? Because 
it's the system we have. Now, you need to know that this is at the 
center of the political debate. And in Washington, a long way from 
Milwaukee, here's what they're saying. They're saying, ``Well, that's 
all very well for Ameritech. They can talk about that, they're a 
successful company, they have a strong union, they pay good wages, 
they've got a great future. But what about all these small businesses in 
America? What about the poor guys with 10 or 20 employees who have a 
very narrow profit margin? They shouldn't have to do this.'' Well--and 
the argument is that they can't afford to do this. They're going to lose 
jobs, and most new jobs are being created in the small business sector, 
and it's a terrible thing, you shouldn't do it.
    Now, what's my answer to that? First of all, there are a lot of 
small businesses in America who are providing health insurance to their 
employees today, and they are at an unfair competitive disadvantage to 
those who don't. I met a woman in Columbus, Ohio, running a restaurant 
and a deli, with 20 peo- 

[[Page 831]]

ple--20 full-time employees, 20 part-time employees. She says to me--
this is a typical story--she says, ``I'm in the worst of all worlds. I 
insure my full-time employees, I don't insure my part-time employees, 
and we pay too much for insurance because I had cancer 5 years ago.'' 
She said, ``I got it coming and going. I pay more than I should. I feel 
guilty that I don't insure my part-time employees. And I get punished 
for insuring my full-time employees because my competitors don't even do 
that. I would gladly pay a little more if you made all my competitors do 
the same thing. That would be all right; I'd be on a fair basis with 
them.''
    I have a friend who is a car dealer at home in Arkansas, in a little 
town--said to me the other day, said, ``You know, I've been feeling 
sorry for myself for 20 years because I always covered my employees, and 
none of my competitors ever did. And I just went around feeling sorry 
for myself. And then I realized that three of my competitors had gone 
out of business, and I made more money last year than I ever have. And I 
think it's because I never lost an employee because I gave them decent 
health care.'' Interesting, right?
    Today, as I was shaking hands leaving the White House, a small 
businessman came up to me and says, ``I have got 80 employees, and I 
implore you to pass this health care. I am tired of these lobbies I pay 
my membership dues to telling you that small business doesn't want this. 
A lot of us cover our employees. I cover my 80 employees. It costs me 20 
percent of payroll. Under your plan my bills would go to 7.9 percent 
because all my competitors would have to do what I do.'' The guy just 
stopped me in the line today on the way out to the helicopter.
    Not only that, under our plan, we give discounts to small 
businesses. If you've got under 70 employees and an average payroll of 
under $24,000, you get a discount. And some of these businesses will 
only have to pay 3.5 percent of payroll for their insurance. The average 
business has about a third of their cost of doing business in labor 
costs. So if you pay 3.5 percent, and that's only a third of your cost 
of doing business, then it's only going to cost you a little more than 
one percent of the cost of doing business to insure your employees.
    I would submit to you that that much, if all your competitors are 
doing it, can either be passed along or the employees themselves will 
absorb it. It will only take one year to lower the raise they were going 
to get by one percent, and then it will all be in there. But that's what 
these Congressmen are hearing, and they're saying, ``If you do this, 
small business in America will come to an end.'' Now, the truth is, most 
small business people are paying 35 percent more than most big 
businesses for the same insurance.
    The other thing they're telling them is, this is a Government-run 
program and Government would mess up a one-car parade. [Laughter] That's 
the other thing they're saying. And we have all felt that at one time or 
another, right? Especially now, it's so close to tax day. But that's 
what they're saying. That's not true.
    Here's what the Federal Government does in our program. The Federal 
Government says everybody's got to have insurance. The Federal 
Government says there must be insurance reforms so that people can be 
insured in large pools. And the Federal Government organizes small and 
medium-sized businesses so they can get buying power to get the same 
competitive rates that people in big business and Government have. And 
we have some basic quality controls which are an extension of what we 
have now. That's what we do.
    We also leave to the States then the ability to decide exactly how 
these mechanisms will be carried out. This is not a Government-run 
program. It is private health insurance and private medical providers 
just like we have today except now the worst abuses of the present 
system will be erased. That is what we are trying to do. And I think it 
is worth doing. I think it needs to be done.
    Let me say to you that you will have to decide whether you agree. 
You'll also have to decide whether you think you can persuade your 
Members of Congress without regard to party that they can do this and be 
reelected. Every time I go into a congressional district, there are 
these furious radio campaigns run to send a message to your local 
Congressman not to bankrupt all the small businesses in the area. But we 
had several hundred small businesses in Washington

[[Page 832]]

the other day all asking us to do this so they could get a fair deal, so 
they could buy insurance on a competitive basis.
    Now, what's behind this? Somebody's got to lose, right? There will 
be some changes. What will they be? If you endorse this program, fewer 
Americans will work in the clerical departments of hospitals, clinics, 
and insurance offices. And the small insurance companies will not be 
able to write policies for hundreds of thousands of people. So in order 
for them to keep writing health insurance, they'll either have to write 
specialty policies, like many do today for extra cancer coverage or 
something like that or somehow find a way to pool with other companies 
or they won't all make it. That's true. That is true.
    You have to decide whether you think it's worth it. Is it worth it 
for every American to have the same health care security that you have 
and to stop your wages from being depressed and your profits from being 
depressed by paying too much for health care and to provide some sort of 
security to the working people of this country. I think it is.
    We will also create more jobs in the health care industry in 
providing long-term care. There will not be a net loss of jobs, but 
there will be a shift of jobs. You need to know that. This is not a free 
thing. But is it a good swap? I think it is a laydown clear choice, the 
right thing for the country. But we have got to decide that.
    And let me close by just--I don't know if these folks are here. I 
had three letter writers, people who wrote--we had a million people who 
have written to my wife or to me on health care--and I think they're 
here. Are Sheryl Brown, Tami Stagman, and Susan Millard here? Are you 
all here anywhere? Stand up there. [Applause] Now, I want you to--now 
these are not abstract theories. These are three citizens of your State. 
Sheryl Brown from Madison wrote a letter to Hillary about her health 
insurance. And her husband came down with a serious illness; he lost his 
insurance. She had to leave her job because she couldn't insure her 
husband and go on public assistance to get the benefits she needed. Then 
when she got herself off welfare and went back to work, her family lost 
their benefits. That's the system we have today.
    If you go on welfare--this is a big State for welfare reform, right? 
I've bragged on Wisconsin until I was blue in the face, about welfare 
reform all over the country. In our country today, if you go on welfare, 
you get health care. If you get off of welfare and go to work and start 
paying taxes, if you live in a family with a preexisting condition or 
you take a minimum wage job, then all of a sudden you are paying taxes 
to pay for the people on welfare to have health care, and you don't have 
it anymore. So if you want welfare reform, you've got to pay for the 
health care of the working people because the people on welfare have got 
it.
    Susan Millard wrote me because she's had a lot of health problems, 
and she's got a job which doesn't provide health benefits. Should she 
just quit and give it up? Aren't we proud of her? Wouldn't we rather her 
work? Isn't it better for us that she works instead of going on public 
assistance?
    And Tami Stagman from Lancaster--in a way the most interesting 
letter of all. She wrote me because she had some serious health 
problems, but she had a good health insurance policy because of her 
husband's job. So she's thinking, what if my husband ever loses his job? 
What if he ever wants to change his job? And what about everybody just 
like me who doesn't have the same policy I have?
    We can fix this, folks. We can fix this if we remember that there 
are real Americans out there who are doing their very best to contribute 
to this country and to move us forward and who deserve to have this 
fixed. It is in our common interest to do it, and I think we're going to 
do it this year.
    Thank you very much. Bless you. Thank you.

[At this point, Bronson Haase, president, Ameritech Wisconsin, presented 
the President with a jogging suit.]

    The President. I want to tell you what your fearless leader had just 
said to me, in a way that you couldn't hear over the microphone--
[laughter]. He said, I want you to have this jogging suit because I keep 
seeing you running in running shorts, and I think

[[Page 833]]

it would be better if you had long pants. [Laughter] Hey, you know it's 
part of my job to make people feel better, and I've made millions of 
Americans feel better about how they look in running clothes. I thought 
it was a good idea. [Laughter]
    Thank you very much. I'll wear them. Great. Thank you.

Note: The President spoke at 11:50 a.m. at the Italian Community Center. 
In this remarks, he referred to Richard Notebaert, chief executive 
officer, Ameritech Corp.; Morton Bahr, international president, 
Communications Workers of America; Ameritech employees Gary Keating, 
Rick Compost, and Deborah Echols; Robert D. Johnson, vice president of 
district four, Communications Workers of America; Mayor John Norquist of 
Milwaukee; and Marsha Radaj, vice president of operations, Wisconsin 
Health Information Network.