[Weekly Compilation of Presidential Documents Volume 33, Number 13 (Monday, March 31, 1997)]
[Pages 417-420]
[Online from the Government Publishing Office, www.gpo.gov]
<R04>
Remarks on the National Cancer Institute's Recommendations on
Mammography and an Exchange With Reporters
March 27, 1997
The President. Secretary Shalala has just briefed me on the National
Cancer Institute's new recommendations on mammography. These
recommendations, based on the latest and best medical evidence, give
clear, consistent guidance to women in our national fight against breast
cancer. Breast cancer is the most commonly diagnosed cancer among women.
It affects one in eight women in their lifetimes, and has touched the
families of nearly every American, including my own.
We may not yet have a cure for breast cancer, but we do know that
early detection and early treatment are our most potent weapons against
this dread disease and we know that mammography can save lives. That is
why it's important to send a clear, consistent message to women and to
their families about when to start getting mammograms and how often to
repeat them.
After careful study of the science, the National Cancer Advisory
Board has now concluded that women between the ages of 40 and 49 should
get a mammography examination for breast cancer every 1 or 2 years, in
consultation with their doctors. The National Cancer Institute has now
accepted these recommendations. Now women in their forties will have
clear guidance based on the best science, and action to match it.
Today I am taking action to bring Medicare, Medicaid, and the
Federal employee health plans in line with the National Cancer
Institute's recommendations. First, in the Medicare budget I am sending
to Congress today I am making annual screening mammography exams,
beginning at age 40, a covered expense without co-insurance or
deductibles. Second, Secretary Shalala is sending a letter to State
Medicaid directors urging them to also cover annual mammograms beginning
at 40 and assuring them that the Federal Government will pay its
matching share if they do so. And today I am directing the Office of
Personnel Management to require all Federal health benefit plans to
comply with the National Cancer Advisory Board's recommendations on
mammogram screenings, beginning next year.
The Federal Government is doing its part to make sure women have
both coverage and access to this potentially lifesaving test. I want to
challenge private health insurance plans to do the same. They, too,
should cover regular screening mammograms for women 40 and over.
Finally, we know there has been much discussion on this issue and a
lot of confusion. That is why we are launching a major public education
campaign to make sure every woman and every health care professional in
America, that all of them are aware of these new recommendations. This
is a major step forward in our fight against breast cancer.
In addition to Secretary Shalala, I want to thank National Cancer
Advisory Board Chairperson, Dr. Barbara Rimer, and all the members of
the Board, along with the NCI Director, Dr. Richard Klausner, for the
fine job that they did in producing these recommendations.
I also want to thank the First Lady, who could not be with us here
because of her visit to Africa. She has devoted countless hours to
educating women about the importance of mammography, and this is a happy
day for her. She has especially tried to educate older women to take
advantage of the Medicare coverage of mammograms, because we know that
too few of them still do. And that's the last point I would like to
make. These guidelines and this coverage, it's all very good, but unless
women are willing to actually take advantage of the coverage, we won't
have the full benefit of the recommendations and the findings that have
been made.
Now I'd like to turn the microphone over to Secretary Shalala to
make a few comments.
[At this point, Health and Human Services Secretary Donna Shalala made
brief remarks.]
Heaven's Gate Mass Suicide
Q. Mr. President, do you have any comment on the mass suicide in
California?
The President. Well, of course, all I know is what I read about it
this morning and what I saw last night reported. But it's heart
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breaking; it's sickening; it's shocking. I think it's important that we
get as many facts as we can about this and try to determine what, in
fact, motivated those people and what all of us can do to make sure that
there aren't other people thinking in that same way out there in our
country, that aren't so isolated that they can create a world for
themselves that may justify that kind of thing. It's very troubling to
me. But I don't think I know enough to make a definitive comment about
it.
Democratic Party Finances
Q. Mr. President, switching gears on another subject, the Democratic
Party emerged from this most recent election in the aftermath of all of
these fundraising problems--it seems to be in pretty bad shape
financially--enormous debt that they can't repay. What, if anything, can
you do about this, and how much responsibility do you have to try to get
the Democratic Party back into shape?
The President. Oh, a lot, and I have been doing a lot, and I will do
more. We knew that we would have to spend--last year when it became
obvious that our congressional candidates were going to be outspent,
massively, we did everything we could to raise a good deal of money at
the end. But the committees and the Democratic Committee went into debt
with money that they could legally borrow in the hope of trying to be
competitive. They actually did a pretty good job. They were still
outspent, I figure, in the last 10 days, 2 weeks, probably 4 or 5 to 1
in all of the contested races. But we knew that would happen, and we
knew it would take some time to pay it back. But I'm not particularly
concerned about it. I think we will pay it back. And it was, I thought,
important.
Keep in mind, we were at the bottom of the barrel in November of
'94, and in 1995, we did a good job, I think, of building our party back
and showing what the clear differences were between the two parties. And
the previous leadership of the party deserves a lot of credit. We got up
to a million small donors, and they're coming back now. They're
beginning to make their contributions, and that's very encouraging. So I
think we'll get there. I'm not particularly concerned about it.
We made a deliberate decision to kind of downplay the Inaugural and
not to try to tie too much of that to fundraising, so we're going to
have to work harder this year. But I've been doing some work, as you
know, and I will continue to do more.
Q. Do you think Governor Romer has second thoughts about some of the
changes that previously eliminating contributions from subsidiaries of
foreign companies and also non-U.S. citizens? He seems to be having some
second thoughts about some of those proposals you made over the past few
months.
The President. Well, let me say, I still don't believe--I think, on
balance, it's better policy to say that people who can't vote shouldn't
contribute. In terms of the subsidiaries, the real problem there is the
law says if the money is made in the United States, it can be given in
the United States. The problem is, how do you ever know that? And so I
think that he was trying to bend over backwards to get us off on the
right foot.
But I'd be willing to talk to him about it. But the main thing is
we're just going to have to get together and work hard and rally our
troops and remind them of what we're trying to do here, how we're trying
to balance the budget, what we're trying to do for education, what we're
trying to do to move the country forward and get the efforts going.
We've had several successful events this year. We just have to do more.
And we knew--what you have to do after an election, when we saw all this
third party money and all these other things coming down the pike, we
wanted to give our Members of Congress a chance to be competitive, and
so we undertook to do so. And I'm glad we did, but we're just going to
have to work double hard now to pay the money back, and we'll do that.
We'll pay our debts, and we'll make our budget this year.
Ambassador Ross and Vice President Gore
Q. Have you received any updates from Ambassador Ross or the Vice
President?
The President. Yes.
Q. And what have they been?
The President. Well, Ambassador Ross had a very good meeting with
Chairman
[[Page 419]]
Arafat, and he's proceeding now on his trip. And I don't have anything
else to tell you, but he was encouraged by the response of Chairman
Arafat to the matters that we discussed here before he left.
I started the day this morning with physical therapy and a talk with
the Vice President in China, which was also good therapy. [Laughter] And
he said to me that in every aspect, his trip had gone quite well and
better than he had anticipated, and he was anxious to get back and give
me a report on all the issues that we're concerned about. But I think
the trip has been a real validation for our strategy of engagement with
China, of taking our agreements, our disagreements, our matters of
common interest, our matters of concern directly to them. And he is very
pleased with the results so far, and I certainly am very pleased with
the work he's done, with the speech he gave on human rights and with all
the work that he's done in China so far. I'm encouraged about it. I
think the trip has been well worth making.
FBI and Alleged Chinese Efforts To Influence the 1996 Election
Q. Have you seen that Janet Reno gave Louis Freeh a ringing
endorsement this morning--every confidence in his leadership at the FBI?
The President. Well, as I said--of course, she works with him every
day, and that's why I said yesterday what I did. I was troubled by the
headline in the New York Times story, but I did not know the facts. And
I think it's important for me not to assume that someone has done or
failed to do something that's adverse to the national interest before I
know it's true. And she's the one that has to make those calls. And as
she said in her comments, the system that we have--the President
appoints the Director of the FBI, but the FBI is a part of the Justice
Department. It's a part of the justice system. And whenever you have
dual responsibilities in the Government, you're going to have some time
when you've got to make a close call.
And I still don't know--as I said, I just literally don't know--I
could actually tell you whether I agreed or disagreed, if I knew what--
if and what information had not been forthcoming to the National
Security Council. I do believe that there should be a--that doubt should
be resolved in favor of disclosure to the National Security Council of
essential national security information. But the Attorney General has to
resolve those things. And I trust her to do it. And so, what she said is
fine by me.
Q. Is there a problem if the President of the United States--a lot
of Americans simply don't understand--the President of the United States
says, ``I don't know that there's a problem because I haven't
necessarily been given''----
The President. Well, I think there is. Yes, I think there is. If I
knew that one existed, I would agree that there was a problem. But I
don't know it. And I'm still not sure that there was. I just have to--I
have to trust the Attorney General to make sure that the National
Security Council gets the information that we need to make good national
security judgments here. I think, for example, in the Khobar Towers
incident, there is absolutely not a shred of evidence that there's
anything that we have been denied. And so, if I knew that there was and
I knew what it was and I thought there was a mistake, I'd be happy to
say that there's an honest disagreement here, but I just don't know that
there is one.
Ambassadorial Nominations
Q. Has your administration been hamstrung in terms of ambassadorial
appointments, appointments at the State Department and so forth because
of all of these investigations on the campaign?
The President. No, not at all. As a matter of fact, we've been
working on getting ready for the next round of ambassadorial
appointments. I approved a small number of them, oh, probably a couple
of weeks ago so we could move in critical countries. But the others
we're trying to do on a schedule which at least guarantees that all the
Ambassadors now serving will do the traditional 3-year tour of duty. So
we have some time on them. But we've worked very hard for the last month
or so on that, and I don't see those two things as in conflict or a
problem at all.
Thank you.
President's Health
Q. How do you feel today?
[[Page 420]]
The President. I feel fine. Every day I'm getting a little more
mobile, and I'm getting able to, you know, do a little more. I'll tell
you one thing, I wouldn't wish this on anyone. But it's been a very
enlightening experience, a very humbling experience. And the respect
that I feel now for people who spend all day every day in a wheelchair
or people who spend all day every day in braces and on crutches is
enormous.
The dignity and the strength of character that it takes to kind of
organize your life and carry it out if you're always subject to some
sort of significant physical disability is enormous. These are things
that we all sometimes see, but when you've felt just a little taste of
it, when you realize what it means to be able to just navigate and do
the basic things in life--just to dress yourself for the first time when
you couldn't do it, for example--it just makes you understand that the
rest of us in society who have been fortunate enough to have full use of
our physical facilities owe an enormous amount of respect and
sensitivity to people who don't.
It's just been a stunning experience for me. I mean, I will never
again see a person who has to deal with a disability in the same light
again. I mean, it's just--it's had a profound impact. It's nothing I
didn't know before, but feeling it and knowing it are two different
things.
Q. Thank you, Mr. President.
The President. Thank you.
Q. Like your doctor after you all the time?
The President. Yes. She just wants to make sure I don't blow it.
Q. I see her--we see her right here.
The President. There she is.
Q. She's watching.
The President. These crutches are quite good. This way you can walk
by putting your bad leg down and keeping the weight here. Otherwise, you
have to just do this and then kind of do that. But if you can walk, it's
a lot easier; the chances of falling are less.
Q. They're better than the traditional crutches.
The President. Yes, much better.
Note: The President spoke at 12:17 p.m., in the Oval Office at the White
House. In his remarks, he referred to Gov. Roy Romer of Colorado,
general chair, Democratic National Committee.