    [Weekly Compilation of Presidential Documents Volume 36, Number 23 (Monday, June 12, 2000)]
    [Pages 1310-1311]
    [Online from the Government Publishing Office, www.gpo.gov]

    <R04>
    Remarks on Departure for Tokyo, Japan, and an Exchange With Reporters

    June 7, 2000

    Clinical Trials/Patients' Bill of Rights

        The President.  Good morning everyone. We are here at this early
    hour to talk about a vitally important issue to the health of America's
    senior citizens--indeed, eventually, to the health of all of us.
        We must help more seniors participate in clinical trials that test
    new therapies for illnesses, from cancer to heart disease to Alzheimers.
    These trials may prolong lives, and they are central to finding cures
    for deadly diseases.
        Today, America's seniors are badly under-represented in clinical
    trials, yet they bear the heaviest share of illness. More than half of
    our cancer patients are over 65, but only a third of those in clinical
    trials are seniors. For breast cancer, the statistics are even worse.
        Today, thousands of important clinical trials don't have enough
    patients because so few seniors are able to take part, and that means
    slower progress towards curing or treating illness. One major factor
    keeping seniors out of clinical trials is patients lack of certainty
    that their expenses will be covered by insurance. Because Medicare's
    policies on payment for clinical trials have been unclear, seniors
    cannot be sure of coverage if they volunteer for experimental care. Many
    assume they'll be saddled with thousands of dollars in routine medical
    costs if they participate, and they clearly cannot bear such a heavy
    burden.
        For several years, Vice President Gore has led our efforts to clean
    up the confusion and help seniors and people with disabilities into
    clinical trials. We've had bipartisan support in Congress, led by
    Senators Rockefeller and Mack and Congresswoman Johnson and Congressman
    Bentsen and Congressman Cardin.
        Today, after careful study, I am signing an executive memorandum
    directing Medicare to change its policy and remove a major barrier to
    seniors' participation in these trials. Within a week, Medicare will
    begin to cover all the routine medical costs of participation in a
    clinical trial.
        The Department of Health and Human Services and the Health Care
    Financing Administration will begin outreach programs so that patients,
    as well as doctors, researchers, and administrators, all are aware of
    the change. We'll ask for the help of advocates for patients and
    research who have done so much to publicize this issue. We believe that
    with good outreach, thousands of seniors could join trials this year and
    make a dramatic contribution to the progress of medicine, as well as to
    the health of older Americans.
        I am also directing today the Department of Health and Human
    Services to report back to me on ways we can provide additional support
    to clinical trials that are especially relevant to senior citizens and
    am requesting that the National Institutes of Health look for ways we
    can encourage even more seniors to speed science's progress by
    participating in new clinical trials.
        As America ages, we must provide all our seniors affordable, quality
    health care, and we should be using our cutting-edge science to meet
    that challenge. Simply put, the more seniors we enroll in trials, the
    faster we'll be able to use these advances to save American lives. We've
    done this successfully with cancer in children. For decades now, more
    than half of all the children with cancer have joined clinical trials,
    giving us a wealth of evidence about how the disease works and how best
    to fight it. Now we can cure three-quarters of childhood cancers. That
    could never have happened without the participation of children in these
    trials. We should be doing the same for Americans of every age.
        Today I've authorized Medicare to help seniors participate. Private
    health care plans should be doing the same for their members. But it
    won't happen also unless Congress takes the next step and passes a
    strong Patients' Bill of Rights. Congress has had that on its agenda for
    6 months now in the Norwood-Dingell bill, which includes a requirement
    that every private insurer cover the cost of participation in clinical
    trials.
        This month, before the summer recess, Congress has a window of
    opportunity to take

    [[Page 1311]]

    another real step to make our country stronger and safer and healthier.
    I hope that window will be used, because we need this. If we do the
    Medicare participation in clinical trials and pass the Patients' Bill of
    Rights, then all our citizens will be able to participate in these
    trials, and that will hasten the day when all age groups will be more
    likely to recover from the most serious illnesses.
        Thank you very much.

    2000 Election

        Q.  Mr. President, could you disabuse us of the notion that this is
    an attempt by the Vice President to curry favor among a group of
    individuals which have been, in recent years, starting to move away from
    the Democratic Party during an election year?
        The President.  Well, I think the only way I can disabuse you of the
    notion is 7\1/2\ years of activity on this and the fact that it has been
    well known that I have been working on this issue, and so has he, for
    several months now, trying to work through all the legal and
    administrative issues necessary to get this done. It's not as if this is
    just an issue that popped up on the radar screen. We've been working
    this clinical trial issue alone for years, not only the seniors but with
    children. This is by no means the first action we've taken in this area.
        And indeed, there has been a strong bipartisan interest in this with
    all the people involved. I mentioned Senator Connie Mack, Congresswoman
    Nancy Johnson; they are the two most visible Republicans who have been
    working on this. But we've been--all of us have been working on this for
    some time now trying to get this done. And if I could have gotten it
    done a month ago, 2 months ago, 6 months ago, I would have done that.
        Thank you.

     Note:  The President spoke at 8:09 a.m. on the South Lawn at the White
    House.