[Weekly Compilation of Presidential Documents Volume 34, Number 11 (Monday, March 16, 1998)]
[Pages 391-400]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks to the American Medical Association National Leadership 
Conference

March 9, 1998

    Thank you very much for that warm welcome. And thank you, Dr. 
Wootton. He was giving his talk, and I was listening, and I was 
thinking: I agree with all that; there's nothing left for me to say. If 
I knew a couple of funny stories, I could just tell them and leave and 
thank you for the opportunity. [Laughter]
    Dr. Dickey, congratulations on being the president-elect. Dr. 
Reardon, thank you for serving on the Advisory Commission on Consumer 
Protection and Quality. Dr. Smoak, thank you for telling me there's 
nothing incompatible between a doctor named ``Smoke'' and a campaign 
against tobacco. [Laughter] Dr. Jensen, ladies and gentlemen.
    I am honored to be here and to be working with the AMA on so many 
important fronts. We have, in the past, sometimes had honest differences 
on policy but have always agreed on our profound obligation to the 
health of our Nation's families. We're walking together in a step-by-
step approach to health care reform, expanding the promise of new 
medical technologies, extending health care opportunities to the most 
vulnerable Americans.
    Together we've helped Americans to keep their health coverage when 
they change jobs or someone in their families gets sick. And in last 
year's balanced budget agreement we helped to make sure that up to 5 
million uninsured children will get the medical coverage they deserve 
and the help they need, with the biggest increase in health coverage for 
children since 1965.
    We have worked to increase medical research and to support greater 
efforts at preservation and care for conditions from breast cancer to 
diabetes. Last year, in our balanced budget plan, the diabetes component 
was said by the American Diabetes Association to be the most important 
advance in the treatment and care of diabetes since the discovery of 
insulin.
    We found the right family doctor for America, Dr. David Satcher, our 
new Surgeon General. Last month your voices were strong and united in 
support of his nomination, and I thank you, and America's families thank 
you. The lesson of these endeavors is that when we work together, we can 
get things done.
    This is a very great moment for America on the edge of a new 
century, a new millennium, and a completely new economy and new global 
society. We see dramatic changes in the way our people work and live and 
relate to each other and the rest of the world. Our economy is the 
strongest it's been in a generation. In 5 years, we have 15 million new 
jobs, the lowest unemployment rate in 24 years, the lowest inflation 
rate in 30 years, the highest homeownership rate in the history of the 
country. Our social problems are on the mend. Crime is at its lowest 
rate in 24 years. The welfare rolls are the lowest in 27 years. Teen 
pregnancy and out-of-wedlock births are declining. Our leadership is 
unrivaled around the world as we work for peace and freedom and 
security.
    Still, as I said in the State of the Union Address, these good times 
do not give us the opportunity to rest or withdraw. Instead, if we are 
wise, we will use this as a time to act and to build, to secure our 
prosperity and strengthen our future, first of all, by not spending this 
budget surplus we waited 30 years for before it exists and putting 
Social Security first, saving Social Security for the 21st century so 
that the baby boom generation does not either bankrupt Social Security

[[Page 392]]

or bankrupt their children and their retirement. That's what we should 
do before we spend that surplus.
    This is a time to widen the circle of opportunity. That's what we're 
doing with adding 5 million children to the health care rolls. In spite 
of the fact that we have a 4.6 percent unemployment rate, there's still 
neighborhoods, mostly in urban America, sometimes in rural America, 
where the recovery has not yet been felt. And our greatest opportunity 
to continue to grow the economy with low inflation is to bring the 
miracles of free enterprise and high technology into these neighborhoods 
that have not yet felt them.
    We also have to look at our long-term challenges. And I'll just 
mention two or three that go beyond health care but will affect you, 
your children, and your grandchildren. First, as the recent 
International Math and Science Test results for seniors showed, we may 
have the best system of college education in the world, and we have now 
opened the doors of college to everyone with tax credits and 
scholarships and work-study provisions and community service provisions, 
but no one seriously believes we have the best system of elementary and 
secondary education in the world. And we must keep working to raise 
standards and increase accountability and increase performance until we 
do have the best system of elementary and secondary education in the 
world.
    Second, we have to recognize that what you do for a living, worry 
about people's health, is going to increasingly be affected by global 
development. Global travel patterns have given us something called 
``airport malaria'' now, a phenomenon no one ever knew about. And we 
have to recognize furthermore that a lot of what we deal with in health 
care will be affected by the overall condition of the environment. 
That's why the issue of global climate change is so important. We have 
malaria now at higher altitudes than ever before recorded because of 
climate change. A lot of you are probably noticing as you hear from me 
that your allergies are a little worse in the springtime with El Nino, 
even in Washington, when you don't think it could ever be any worse than 
it is normally. So we have to deal with the climate change issue.
    We have to deal with the problems of weapons of mass destruction. 
Even as we reduce the nuclear threat, we see on the horizon the prospect 
that small-scale nuclear weapons or biological or chemical weapons in 
the hands of terrorists, drug traffickers, organized criminals, rogue 
states, could change the whole future of security for our children. We 
have to cooperate more with other countries for peace and prosperity 
around the world.
    In a few days, I'm going to Africa, and I will be the first sitting 
American President ever to visit the nations in Africa where I'm going 
to visit. But they're a big part of our future, economically, 
politically, and in terms of our shared concerns over health and 
environmental matters.
    Now, I'd like you to see the particular issues I want to discuss 
today in this larger context. Are we doing what we should be doing to 
prepare this country for a new century, to widen the circle of 
opportunity, to strengthen the bonds that unite us together, to 
reenforce our values, to make our freedom mean more in the future? All 
of these issues should be seen against that background.
    This is a moment of great promise, but it's also a moment of great 
obligation. Every American decisionmaker, including all the Members of 
the Congress, but all the rest of us as well, must decide whether we 
believe that. Because when times are good, the easiest thing to do is to 
relax, enjoy it, express relief.
    If anybody told me the day I took office as President that in 5 
years the stock market would go from 3200 to 8500 and we'd have 15 
million new jobs and almost two-thirds of the American people would be 
in their own homes, and all the other things, I would have said, 
``maybe, but probably not.'' Having achieved that, and having stepped on 
all the hot coals that were necessary to get from where we were then to 
where we are now, it is easy for people to say, ``Well, let's relax.'' 
That would be a terrible mistake. That's the number one message I have 
today. We have to move. Prosperity and confidence give us the freedom of 
movement that we have to seize. We have to move. This is not a time to 
sit still. It's a time to bear down and go forward, and we need your 
help.

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    Now, there are fewer than 70--70--working days left in Washington 
before Congress adjourns. Now, this is an election year, and the work 
schedule is always somewhat shorter in an election year, and that's 
understandable. But it's unusually limited this year. How will the 105th 
Congress go down in history? I want it to go down in history as a 
Congress that saved lives by passing the Patient's Bill of Rights, by 
passing tough and sweeping tobacco legislation, by passing the Research 
Fund for the 21st Century with its big increase in medical research, and 
extending health care coverage to those who presently are uninsured. 
That's what I want this Congress to go down with.
    The next 70 days will tell the tale. Will this Congress go down in 
history as one that passed landmark legislation to save lives and 
strengthen America for the new century, or one that was dominated by 
partisan election year politics?
    The calendar tells us that this is an election year. That's a good 
thing; we need one every now and then. [Laughter] Have the debates and 
have the discussion. But as I have told every Member of Congress in both 
parties with whom I have discussed this, no matter how much we get done 
this year there will still be things at the end of the year on which 
honorable people in both parties disagree, more than enough over which 
to have an honest, fruitful, meaty election. This election should not be 
allowed to obscure the fact that the American people want it to be not 
only an election year but a productive legislative year for the health 
and welfare of our country and our future.
    Dr. Wootton has already talked about the Patient's Bill of Rights, 
but I want to say a few things about it. Because my mother was a nurse 
anesthetist, I grew up around doctors from the time I was a little boy. 
They were the first professional people that I ever knew. Most of them 
were the kind of people we'd all like our children to grow up to be. 
They were hard-working, able, kind, caring people. Most doctors today 
are as well. But the world of medical practice is very different today 
than it was 40 years ago, when I first started looking at it though the 
eyes of a child--not altogether worse, of course. There are many things 
that are better. We have higher life expectancy, the lowest infant 
mortality rate we've ever recorded, the highest rate of childhood 
immunization, dramatic advances in medicines and medical technologies 
and all kinds of treatments.
    We also have more than 160 million Americans in managed care plans. 
And while there have been some problems with them, all of us have to be 
glad when health care costs don't go up at 4 or 5 times the rate of 
inflation.
    Still, it's often harder for you just to be doctors. When a doctor 
spends almost as much time with a bookkeeper as with a patient, 
something is wrong. If you have to spend more time filling out forms 
than making rounds, something is wrong. And most important to me, when 
medical decisions are made by someone other than a doctor and something 
other than the best interests of the patient is the bottom line, then 
something is wrong. I think we should have a simple standard: 
traditional care or managed care, every American deserves quality care.
    We all have our stories, and yours are more firsthand and perhaps 
fresher than mine, but I never will forget reading a few weeks ago about 
a woman who worked in an oncologist's office to verify insurance 
coverage and get authorizations for medical procedures, who told us the 
story of a 12-year-old boy with a cancerous tumor in his leg. The doctor 
wanted to perform a procedure to save the boy's leg, but the health plan 
said no. It seems that for that condition, the only approved procedure 
was amputation. And that was the only procedure the plan would pay for. 
The child's parents appealed the decision, but they were turned down. 
They appealed again and were turned down again. Only when the father's 
employer weighed in did the health plan change its mind. By then, it was 
too late, the boy's cancer had spread, and amputation was the only 
choice left. Of course, it was covered by the health plan.
    That is a choice no family should have to make. If the doctor had 
been able to do the right thing, the child would have been better off, 
and the system would have been better served.
    We have the best trained, best skilled doctors in the world, the 
best medical education,

[[Page 394]]

the best medical technology. We're all getting a lot smarter than we 
used to be about prevention. The first thing your president said to me 
is, ``I'm a cardiologist. Take this golf club, and stay in good shape.'' 
[Laughter] We're getting better at it. But it is madness to strain at a 
gnat and swallow a camel. And it happens, over and over and over again.
    There are no fewer than 500 stories that could come up in this 
audience right now within a half an hour not all that different from the 
one I just told. That is what we seek to address. That's what the 
Patient's Bill of Rights is all about, to put medical decisions back 
into the hands of doctors and their patients. I have already acted, as 
your president said, to ensure that Federal employees and their 
families, military personnel, veterans and their families, everyone on 
Medicare and Medicaid, altogether about a third of our people, are 
covered by the Patient's Bill of Rights.
    And across our Nation, State legislators and Governors, both 
Republican and Democratic, are doing what they can. Forty-three States 
have enacted into law one or more of the basic provisions of the 
Patient's Bill of Rights. But State laws and the patchwork of reforms 
can't protect most Americans. At least 140 million of them are without 
basic protection. That's why we need the Federal Patient's Bill of 
Rights with the full force of Federal law.
    The Hippocratic oath binds doctors, and I quote, ``to follow that 
method of treatment which according to my ability and judgment I 
consider for the benefit of my patient.'' That is your responsibility, 
and should be your patient's right: to know all the medical options, not 
just the cheapest; primary care when possible, specialists when 
necessary. That's why the Patient's Bill of Rights lifts the gag order 
on our Nation's doctors and allows patients to follow your best 
recommendations by appealing unfair decisions by managed care 
accountants.
    Patients also should have a right to keep their medical records 
confidential. Doctors must feel free to write down the whole truth 
without it ending up on the Internet or in the hands of employers and 
marketing firms or increasing a patient's insurance rates.
    Again, the Hippocratic oath says, ``all such shall be kept secret.'' 
That's why the Patient's Bill of Rights safeguards the sanctity of the 
doctor-patient relationship. Patients have a right to emergency services 
wherever and whenever they need it. And when the EMT's are wheeling a 
new arrival into the emergency room, the last thing you or the patient 
should have to worry about is the fine print on the health plan.
    Again I say, there are less than 70 days remaining in this 
legislative session, but there is broad bipartisan support in this 
Congress for this legislation. We have acted in our administration; 
states have acted; the AMA has acted. You must impress upon the Congress 
the urgency of passing this legislation. Believe me, a majority of the 
Congress, a huge majority in both Houses and Members of both parties, 
are for this. It is just a question of mustering the will to get the job 
done and going through some of the very difficult issues around the 
edges that have to be resolved. But there is utterly no reason not to do 
this this year. You can get it done if you work at it.
    The other great issue before the Congress in health care is, of 
course, tobacco. Now, you're right, Dr. Wootton, I did read ``The 
Journal of the American Medical Association'' special edition on 
tobacco. I read it all from start to finish. And it was a great service 
to me and to the American people, and I thank you very much for it.
    Again, you can argue about some of the fine print, but the big 
picture is clear: Every single day, even though it is illegal in every 
State in America, 3,000 kids start to smoke; 1,000 of them will die 
earlier because of it. This amounts to a national epidemic and a 
national tragedy. You know as well as I do that more people die from 
smoking-related illnesses every year than from most other things that 
cause death in America put together. As physicians, you also know that 
in the end, the only way that we have to deal with this today with 
absolute conviction is with preventive care: Don't do it in the first 
place.
    Now, for more than 5 years, we have worked to stop our children from 
smoking before they start. We launched a nationwide campaign with the 
FDA to educate children

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about the dangers of smoking, to reduce access of children to tobacco 
products, to put a stop to tobacco companies that spend millions mass-
marketing to our young people.
    Last fall I asked the Congress to pass comprehensive, bipartisan 
legislation to reduce teen smoking by raising the price of cigarettes up 
to a dollar and a half a pack over the next several years, imposing 
strong penalties on tobacco companies that keep on advertising to 
children, and giving the FDA full authority to regulate children's 
access to tobacco products.
    If we do this, we can cut teen smoking by almost half in 5 years. We 
can stop almost 3 million children from taking that first drag. We can 
prevent almost one million premature deaths. But again, the clock is 
ticking.
    And yes, there are lots of complicated issues. You know, because 
this is a five- or six-part package, there are several committees and 
subcommittees involved. And because there is some controversy around the 
edges about how much money should be raised how quickly from the tobacco 
tax and what it should be spent on, there are some difficult issues to 
be resolved. And yes, I know that there are only 70 days. But if we know 
that the lives of 1,000 children a day are at stake, how can we walk 
away from this legislative session without a solution to the tobacco 
issue?
    There are two other issues I'd like to mention to you. The first 
relates to Medicare. This week--or, excuse me--last week, I attended the 
first meeting of the Bipartisan Medicare Commission appointed by the 
leaders of the House and the Senate and the White House to look for 
long-term reform for Medicare for the 21st century. As you know, we have 
secured the Medicare Trust Fund for another decade with some very 
difficult decisions. But there are a lot of unresolved issues out there, 
and in some ways the complexity of the Medicare problem is greater than 
the complexity of the Social Security problem. At least it has to be 
dealt with sooner in time. So I want to urge your support for the 
Medicare Commission and your involvement in it.
    I also have made a specific proposal with regard to Medicare that I 
believe should be passed this year without regard to the work of the 
Medicare Commission, and I ask you to carefully review it, and I hope 
you'll support it. It would give a vulnerable group of Americans, 
displaced workers 55 and over--people who either voluntarily take early 
retirement, and they're promised health care, but the promise is broken, 
or people who are laid off, and they can't find another job, and they 
lose their job-related health insurance--and other seniors, principally 
people who are married to folks who lose their old health insurance 
because they start being covered by Medicare, but they're not old enough 
to be on Medicare so they lose the family coverage, and they don't have 
anything--it would take this group of Americans and give them the chance 
to buy into Medicare at cost.
    The Congressional Budget Office just reported that the policy will 
cost even less and will benefit even more people than we in our 
administration had estimated, and agreed with us that it will have no 
burden whatever on the Medicare Trust Fund. It will not shorten the life 
of the Trust Fund, nor will it complicate in any way our attempts at the 
long-term reform of Medicare. We're talking about somewhere between 
three and four hundred thousand people that are just out there, that had 
health insurance and now don't have any--at a particularly vulnerable 
time in their lives. So I hope you will support that.
    The second thing I'd like to ask for your support for involves a 
project that Hillary has worked very hard on to sort of leave some gifts 
for our country in the new millennium. The project motto is ``Honoring 
our past and imagining our future.'' Among other things, we're working 
with the Congress to get the funds necessary to save, for example, the 
Star-Spangled Banner, which is in terrible shape. We need to spend, 
believe it or not, $13 million to restore the flag and to make sure that 
the 200 years of lighting don't destroy the Declaration of Independence 
and the Constitution and the Bill of Rights and to try to get every 
community in the country to find those things in each community which 
are most important to their history and save them.
    But we're also looking at the future. And perhaps the most important 
thing about the

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future-oriented nature of this project is the Research Fund for the 21st 
Century, which has a huge increase in research for all forms of 
scientific research and development but especially have the largest 
increase in funding for the NIH in history and doubling the funding for 
the National Cancer Institute.
    We are on the verge of unlocking a number of medical mysteries, as 
you know. Last year, for example, we had the first sign of movement in 
the lower limbs of laboratory animals with severed spines. The human 
genome project is proceeding at a rapid pace, with implications which 
still stagger the imagination. Again I say, we have the money to do 
this. We can do this within the balanced budget. And while there may not 
be time to resolve every issue I'd like to see resolved in this 
Congress, we should nail down now this Research Fund for the 21st 
Century. There has been terrific support, in the Republican as well as 
in the Democratic caucuses. This has not been a partisan issue. It is 
just the question of getting the job done in the next 70 days.
    So while you're here, let me say again, a big part of building 
America for the 21st century is building a healthier America and 
building an America where people feel secure with the health care they 
have, and they feel it has integrity. We need the Patient's Bill of 
Rights. We need action on the tobacco front. We need reform of Medicare 
long term. We need to help these people that are falling between the 
gaps because they're not old enough yet. And we need to continue in an 
intensified way our commitment to research. Let us take the benefit of 
our prosperity and finally having a balanced budget and invest the kind 
of money in research that we know--we know--will ensure benefits beyond 
our wildest imagination.
    We can do all this in the next 70 days, but to do it we'll have to 
do it together. I need your help. Your patients need you help. Your 
country will be richly rewarded if you can persuade the Congress to act 
in these areas.
    Thank you, and God bless you.

Note: The President spoke at 11:58 a.m. in the ballroom at the Sheraton 
Washington Hotel. In his remarks, he referred to Dr. Percy Wootton, 
president, Dr. Nancy Dickey, president-elect, Dr. Thomas Reardon, 
chairman of the board, Dr. Randolph Smoak, vice chairman of the board, 
and Dr. Lynn E. Jensen, chief executive officer and interim vice 
president, American Medical Association.


<R05>
Remarks at Housatonic Community-Technical College in Bridgeport, 
Connecticut

March 10, 1998

    Thank you very much. First of all, I think Pamela did a terrific job 
with her speech. And secondly, when Anthony stood up, I thought to 
myself, in a few years Congressman Shays will be retiring, and I--
[laughter]--may be looking at his successor right there. He was great. 
[Laughter] I love it. Senator Dodd, you might want to hire him as a 
consultant this year. [Laughter]
    Mr. Mayor, I'm delighted to be back in Bridgeport with you and 
Jennifer and the officials of the city government. I thank Senator Dodd 
and Congressman Shays and Representatives Barbara Kennelly and Rose 
DeLauro for joining us today; Attorney General Blumenthal, Treasurer 
Paul Sylvester, Speaker Ritter and members of the legislature.
    Like Senator Dodd, I want to extend my condolences on behalf of 
Hillary and myself to the families of the victims of the shooting 
incident in Newington, and our prayers are with them.
    And like Senator Dodd, on a happier note, I want to congratulate 
Connecticut for getting both its teams into the NCAA. [Laughter] So did 
Arkansas. [Laughter] Thank goodness we don't have a contest anytime 
soon. And what Senator Dodd didn't say is that UCONN's men's team is 
actually playing in Washington this week. And so I think you all should 
keep score and see which Members of your congressional delegation show 
up to root the home team on. [Laughter]
    I'm glad to be back in Bridgeport. I really like this community, and 
I have admired the courage with which the people here have struggled in 
the tough years and moved to move the community forward. I should tell 
you, whenever I come to a place you all notice that there are a few 
members of the press who come with me. [Laughter] And

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sometimes it seems that we're on opposite sides of the line, but you 
should know that one member of the press, Larry McQuillan, who works for 
Reuters New Service, and is actually the president of the White House 
Press Corps this year, is from Bridgeport. He will write a totally 
biased, favorable story--[laughter]--about this wonderful college and 
child care program today, I can assure you.
    I want to thank President Wertz for showing me around the school and 
the unbelievable art collection here, which you should be very proud of. 
And I want to thank Marie Nulty for taking me through the wonderful 
preschool program.
    In the ``Early Childhood Lab Schools Parent Handbook'' there is the 
following quote: ``A child is like a butterfly in the wind. Some can fly 
higher than others, but each one flies the best it can. Each one is 
special. Each one is different. Each one is beautiful.'' After going 
through this child care center, it seems to me that that is a motto that 
every teacher I saw lived and worked by, and that every child I met was 
made to feel special every day.
    The reason I came here today is twofold: First of all, because of 
the extraordinary leadership for children and especially on the child 
care center issue--child care issue, of Senator Dodd, along with the 
Members of your House delegation who are here, who have been terrific on 
this issue; and second, because what I see here today is what I believe 
every child in America needs, and it's important that we graphically 
demonstrate to the country that with so many parents in the work force 
are going back to school, there is a crying unmet need which the mayor 
graphically and numerically demonstrated in his remarks just here in 
Bridgeport, all over the country for the kind of high quality child care 
that you offer here.
    Today we have to make a commitment to extend that option to every 
family in America that needs it. I want to talk about what we in the 
Federal Government can do on our own to improve child care at Federal 
centers, but most importantly, I want to talk about what Congress should 
do in the next 70 days to help every working family give their children 
the kind of child care we see here.
    As has been said already, these are good times for America. We have 
15 million new jobs, the lowest unemployment rate in 24 years, the 
lowest inflation rate in 30 years, the highest homeownership rate in 
history, the lowest welfare rolls in 27 years, the lowest crime rate in 
24 years. And I'm proud of it. These numbers only matter insofar as they 
reflect differences in the lives of ordinary Americans--a different life 
story that can be told. The reason I was proud to be introduced by 
Pamela Price is that she embodies the changing story of America over the 
last 5 years, and that's what we want for every American who's willing 
to work for it.
    In last year's historic balanced budget agreement we provided a 
child care tax credit of $500 per child for families; expanded health 
care coverage to 5 million more children in lower income working 
families who don't have access to it now; and perhaps most important, 
have virtually opened the doors of college to all Americans. For 
example--and you can compare it, what it means here at Housatonic--in 
the last years we have added 300,000 work-study slots, hundreds of 
thousands of more scholarships; we've made the interest on student loans 
tax deductible; 100,000 young people have worked their way through 
college or earned money for college by serving in AmeriCorps in 
community service projects. You can now save for a college education in 
an IRA and withdraw from the IRA tax free if the money is used for a 
college education. But most important, now there is a $1,500 tax 
credit--that's not a deduction, a credit--a reduction of your tax bill 
for the first 2 years of college, and a lifetime learning credit that is 
substantial, but not quite that large for junior and senior years, for 
job training programs, for graduate schools. I think we can really say 
that insofar as community-based institutions like this are concerned, we 
have opened the doors of college to all Americans who are willing to 
work for it. And that is a profoundly important achievement for our 
country.
    Senator Dodd talked about what the Family and Medical Leave Act 
means. The American dream is now in reach for more and more families. 
And that is a very, very good thing. But as you heard Pamela say, what

[[Page 398]]

made all this work for her as she was struggling to put her life on 
track was knowing that her child would be in a safe, healthy, positive 
child care environment. And if we really want to open the doors of 
opportunity to all Americans, we not only have to finish our agenda of 
bringing job opportunities and business opportunities into every 
neighborhood and every city like Bridgeport in America, we have to make 
sure that if the jobs and the educational opportunities are open, the 
parents can actually go without having to worry that they're neglecting 
their children.
    We can never have a country that is fully successful if millions of 
people every day get up and look forward to a day in which they are 
terrified that they will have to make a choice between being a 
responsible parent and a good worker or a good student. If we have to 
choose, we lose. Society has no more important work than raising 
children. If everyone did that successfully, I think we would all agree 
we'd have less than half the problems we have today.
    On the other hand, this economic boom we celebrate was fueled by 
having nearly two-thirds of the American adults in the work force, the 
highest percentage of people in the work force in history. That's how 
you get a low unemployment rate. Well, by definition, a lot of those 
folks are parents with children who have to be supervised and nourished 
and supported and helped.
    So when you think about this child care issue, if you look at it the 
way I do, not just as President, but as a parent and as someone who's 
worked all his life, I say to myself, we cannot have a country that asks 
people to make a choice between succeeding at home and succeeding at 
work, and insofar as we have to choose, we lose. When we know we can 
succeed at home and at work because of an effective child care center, 
every American wins. The country wins. We're stronger in the 21st 
century; our families are stronger; our economies are stronger; they 
reinforce each other. That's really what this child care issue is all 
about.
    Now, we've worked hard on this for the last 5 years. We've helped a 
million more parents to pay--or the parents of a million more children 
to pay for child care. But obviously--remember the mayor's numbers for 
Bridgeport--there is a huge amount of work to be done here. And today 
we're releasing a report that confirms the overwhelming need still 
existing all across America. The report shows that States have come up 
with a lot of innovative ideas, and the Congress allocated $4 billion 
more to States for child care as a part of welfare reform. But even with 
all that, it is clear that the resources are simply not there yet to 
meet the needs of all the families in America. States have been forced 
to turn away literally thousands upon thousands of low-income families.
    In Connecticut, the State Child Care Bureau has to restrict its aid 
to families on welfare or teen parents in high school. They've actually 
stopped taking applications from families that are so-called ``working 
poor'' altogether.
    So here we are at a time of unprecedented prosperity, when people at 
the lower end of the income scale are finally beginning to get pay 
raises and have some security in their jobs, but we know they can't 
afford quality child care without help. So here we are at a time, the 
best of times for our country, and yet we still have millions of people 
getting up every day going to work worrying about their children. We are 
forcing them to make choices that no family should have to make, that no 
country should tolerate, and that we will pay for down the road sooner 
or later. So what we want to do is pay for it now, the right way and 
have a good, positive environment.
    Now, let me say some of the things that I intend to do with the 
Federal child care centers. We care, the Federal Government cares in its 
child care centers for some 215,000 children--quite a few. We want them 
to be a model for the Nation. Today I'm going to direct my Cabinet to do 
four things:
    First, to make all the centers fully accredited by the year 2000. 
Now, what does that mean, in terms of quality of facilities, training 
for workers and child-to-staff ratios? Today, believe it or not, 76 
percent of our military child care centers are already accredited, but 
only 35 percent of our non-military centers are. We'll make both 
categories 100 percent in the next 700 days.

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    Second, we have to make sure that all the centers conduct thorough 
background checks on workers. In too many States there is no checking to 
see if the people we trust with our children are even trustworthy in the 
eyes of the law. Connecticut is one of the few States that actually does 
require a criminal background check of child care workers. Every State 
should do it, and the Federal Government should certainly do it.
    Third, we have to make sure that all Federal workers know about all 
their child care benefits and options in the first place.
    And finally, we're going to do more work with the private sector to 
make Federal child care better and more affordable. If we do all that, 
there will still be millions of kids out there and their parents who 
need help. In the balanced budget I have presented to Congress for this 
year, I've proposed a comprehensive and responsible plan to strengthen 
child care. There will be other proposals to do the same thing.
    Now, Congress is only going to meet about 70 more days this year. I 
know you say, ``Well, it's only March,'' but anyway that's--in 
Washington, Congress plans to only sit about 70 more days. Now, there is 
enormous support, I believe, among people in both parties in our country 
and, I believe, among people in both parties in the Congress for taking 
action on child care. I have a plan, and there are others which would 
double the number of children receiving child care subsidies, at a 
million or more new kids, give tax cuts to businesses which provide 
child care, expand child care tax credits to 3 million working families, 
and improve the standards of child care centers and provide more funds 
to train--adequately train--workers in child care centers.
    Now, we're not talking about peanuts here. Let me tell you what 
we're talking about. The tax credits that we will offer, if Congress 
would pass them, would mean that a family of four living on up to 
$35,000 a year that has high child care bills would not pay any Federal 
income tax. That would be a terrific incentive to help working families 
afford quality child care. And for lower income working families who 
don't owe any Federal income tax anyway, if we increase the block grant 
going to the States, it goes to subsidized care for lower income working 
families, plus the money that we have given the States for people moving 
from welfare to work--we will be able to make a huge dent in this 
problem.
    If Congress acts, we can make child care safer as well as more 
affordable. We can even give scholarships under our plan to talented 
caregivers to train more people. We also can expand after school 
programs to keep 500,000 more kids, when they get a little older, off 
our streets and out of trouble after school. I think that's very 
important. As I said, there are only 70 days left. There are always, 
with something this big, some controversy around the edges of the issue. 
But all these things can be resolved if the Congress will make up its 
mind to act. Because these 70 days of meetings where they can vote will 
be spread over most of the year. There's still time for committee 
meetings, for staff to do their work, for all that kind of stuff to 
happen. We can do this. We do not need to wait another year just because 
this is an election year to pass this. We need to do this now.
    The other thing I want to say that's related to this, is that 
Congress must pass comprehensive tobacco legislation to reduce teen 
smoking and raise the price of cigarettes by up to a dollar and a half a 
pack, impose strong penalties on companies that continue to advertise to 
children, and give the FDA full authority to regulate tobacco products 
and children's access to them. The revenues we raise from the tobacco 
company would help to make a partial contribution to the child care plan 
that I have proposed as well.
    Again I say, there's some controversy--there's some issues that have 
to be resolved in this tobacco settlement, to get the legislation. But I 
want to, again, graphically illustrate--I just watched all those little 
kids in that room, those two rooms, these beautiful children--every 
single day, even though it is illegal in every State in America, 3,000 
more children begin to smoke; 1,000 of those 3,000 children will die 
sooner because of that decision. Hardly anybody becomes a chronic, 
lifetime smoker who does not start in their teenage years.
    So I know there are only 70 days left, and I know this is a big 
bill. But I know that

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there are Democrats and Republicans in substantial numbers who want to 
do this. We should not let the calendar get in the way of the urgent 
need for action. We can pass the child care reforms, and we can fund 
them. And we can pass the tobacco legislation, and we must. Just think 
about it: 1,000 kids every day that wants--just like all these children 
did in here. Just think about it, every single day. There is no need to 
wait. There is no excuse for waiting. The time to act is now.
    I leave you with this thought. I'm glad you clapped when I said 
these are good times for America. And you ought to be proud of 
yourselves, because the whole country helped to create these good times. 
And the efforts that we make in different areas, from the economy to 
crime to welfare reform to early childhood to health and education, they 
all reinforce each other. But sometimes when times are good and people 
clap and they feel good, they relax. I tell you, when times are good but 
challenges are large and the future is coming at you like a fast train 
down a track--and that's how the 21st century is coming at you, with 
things changing more rapidly than ever before--then an obligation is 
imposed to use the good times to act, not to relax.
    So I say to all of you, the Members of Congress who are here are 
ready to act, so give them all a pat on the back, but do everything you 
can to send a clear and unambiguous signal that you do not want the 
election year to be a relaxation year; you want it to be a legislating 
year for the children of this country to make them stronger in the new 
century. After all, it's only 700 days away. Let's spend 70 days to make 
sure that in 700 days we'll have the healthiest, strongest children in 
the history of our Nation.
    Thank you, and God bless you.

Note: The President spoke at 11:30 a.m. in the Performing Arts Building. 
In his remarks, he referred to Pamela A. Price, a student with a child 
in the college's child care program, who introduced the President, and 
her son, Anthony; Mayor Joseph P. Ganim of Bridgeport, and his wife, 
Jennifer; State Attorney General Richard Blumenthal; State Treasurer 
Paul Sylvester; Thomas D. Ritter, speaker, State House of 
Representatives; Janis M. Wertz, president, Housatonic Community-
Technical College; and Marie Nulty, director, Early Childhood Laboratory 
School. The President also referred to an incident on March 6, 1998, in 
Newington, CT, in which an employee of the State Lottery Commission 
entered the commission's headquarters and killed four officials and then 
turned the gun on himself.