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Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: George H.W. Bush Presidential Records Collection/Office of Origin: Speechwriting, White House Office of Series: Speech File Draft Files Subseries: Chron File, 1989-1993 OA/ID Number: 13638 Folder ID Number: 13638-009 Folder Title: American Oktoberfest-Painsville, Ohio 9/5/92 [OA 5812] [1] Stack: Row: Section: Shelf: Position: G 26 18 4 4 1572 Sept. 5 / Administration of George Bush, 1992 Note: This proclamation was released by the the people of south Florida and Louisiana. Office of the Press Secretary on September That is the American spirit, and Gretel, we're 5, and it was published in the Federal Reg- very grateful to you. ister on September 9. While we're talking about the tragedy in the south, I want to salute today the contin- gents of Ohio's finest: the Ohio National Guard 179th Airlift Group, back from their Remarks at Octoberfest in mission of mercy to south Florida, one mili- Painesville, Ohio tary person down there helping family after September 5, 1992 family. It is a wonderful concept, and we're proud of them all. Some of them served in Thank you all. What a great turnout. that Desert Storm, too, and they did a first- Thank you so very much. Thank you. Thank class job there, believe me. And the country you very much, Mike. Thank you, Mike has not forgotten. DeWine, our next United States Senator. So, in summary, it's great to be here in Thank you very, very much for that welcome. Painesville to help open up this year's Barbara and I are thrilled to be with you, Octoberfest. You've got the four basic food glad to be with you and Fran. It's good to groups: pancakes and syrup, bratwurst and see Bob Bennett, our chairman; national beer; and not one stick of broccoli anywhere committeewoman Martha Moore over here; in sight. This is a first-class and Bob Gardner, who's running for Con- Well, this celebration has always been a gress. We want to see him elected. He's sit- celebration of cultures, but this year, in a very ting over there. Of course, a very special special way, it's a celebration of the spirit. thanks to the Bencics. I'll tell you, what great We've witnessed a world of change. Across hosts they are: Steve, Gretel, Martin, Carl, Europe, across continents, from Panama City Edith, and Linda. What a wonderful family. to Prague, millions of men and women now When I talk about family values I think of celebrate a new birth of freedom. their discipline, their love of country, and In Germany-and I think of that because their hard work. of my friendship with Steve-and in Ger- I bring greetings today from your Gov- many a wall has fallen. We should take great ernor and from my very good friend, George pride in knowing that the German people Voinovich. What an outstanding Governor give us, the United States, great credit for you have. He understands this country. You standing up for their unity, for reunification know, Steve told me that this is the first time of Germany, and for their freedom. We that the Governor has missed this event since should be proud of that. For the people here 1966; and the only reason he did it, because today, people who came to America from the he's on a trade mission to Southeast Asia. old country, who prayed for this day to come, He's opening up new markets for Ohio the change we've witnessed, this change goods, and that means creating jobs for Ohio we've worked for, is a miracle come true. workers. I know he's going to miss all his There are those-to quote the poet-who bratwurst. I'm sure egg rolls taste great, but will say that the liberation of humanity, the you can't put syrup on egg rolls. And freedom of man and mind, is nothing but Voinovich will find that out. a dream. They are right. It is the American Now, I don't know whether you all got to dream. The American dream led to so much do what Barbara and I did, but I hope you've of this freedom around the world. Today, our all seen Gretel's cake. But you may not know challenge is to bring that spirit home, and the story behind this enormous cake. I don't Mike DeWine said, home from the towns want to give away her age, but 50 years ago your parents and grandparents were born in when she was a little girl, the war in Europe to this new world we call America, and to separated her from her mother. The Red focus this great Nation on the new missio Cross came to Gretel's rescue, so today she's at hand. returning the favor. Everyone who eats a I know the main attraction this morning piece of that cake is contributing food to help is pancakes-[laughter]-not politics. I sa- George Bush, 1992 Administration of George Bush, 1992 / Sept. 5 1573 rida and Louisiana. lute not only the Republicans that are here, health care reform is a key part of my agenda it, and Gretel, we're but I know there are many, many Democrats for economic security for every family in this bout the tragedy in with us, and I'm very proud and pleased country. about that. But today I want to-and I've This year, you watch, health care is going te today the contin- got to admit something, with the enthusiasm the Ohio National to be a Republican issue. We have a good of this welcome, the temptation is for me up, back from their program. My Democratic opponents are di- to get up here and tear into the Governor vided between two bad programs, both of h Florida, one mili- of Arkansas, which I've got to do from time helping family after which would put Government in charge of to time. But today, and I hope you'll bear health care. concept, and we're with me, I want to just take a few minutes The fact is we can reform the system with- e of them served in to talk to you about a serious matter, some- and they did a first- out pushing our economy into intensive care. thing I hope you'll be thinking about as you We must build on the strengths of the system me. And the country go into that voting booth on November 3d, that's given us the highest quality care in the about the way we can change America's world, on consumer choice, on innovation great to be here in health care. and state-of-the-art medicine, while control- en up this year's So this isn't a rally speech. I want to talk the four basic food ling costs and expanding access. We need an to you-a little substance on health care. I efficient health care system built on competi- vrup, bratwurst and want to tell you first a story, a story about tion to control costs, not Government control of broccoli anywhere the McNally family from Dorset, Ohio. I first and rationing care. Above all, we need a learned about them when Tiffany McNally has always been a health care system that gives all Americans wrote me at the White House 2 years ago. real security, security that you can count on, out this year, in a very Four members of Tiffany's family have a rare the coverage you need. My plan meets every oration of the spirit. blood disease, and Tiffany, who is adopted, single one of these objectives. d of change. Across was born with fetal alcohol syndrome. Now, We can make health care more accessible is, from Panama City what if Mr. McNally were laid off, or worse by making health insurance more affordable. en and women now fill, lost his job? Or what if he found a better Take a family of two parents and two kids. freedom. ob, but the catch was no new health insurer Let's say the family's income, the total in- hink of that because would carry him or his family? He'd have come is $13,000. They're working hard to Steve-and in Ger- to stay put and let that opportunity pass him make ends meet: low enough to put them Ne should take great by. at the poverty line, high enough to make the German people Well, that is wrong. That's why we have them ineligible for Medicaid. Right now, that ates, great credit for to change the health care system in America. family may fall through the cracks, may not nity, for reunification Health care reform isn't just about studies be covered through work, and may not be their freedom. We and cold statistics. It's about real worries and able to afford any health care coverage at For the people here real lives. We have the answers to those wor- all. Under my plan, that would change. This e to America from the ries. family would get a $3,750 health care credit, 1 for this day to come, Let's face it, the problem is not the quality payable to the health care insurer of their nessed, this change of health care. American health care is num- choice. iracle come true. ber one in the entire world. Since 1980, every For middle-income individuals and fami- quote the poet-who life expectancy is up; infant mortality is lies, all the way up to those making $80,000, ion of humanity, the down; death rates from heart disease down; my plan provides a health insurance tax cred- nind, is nothing but deaths from stroke down. Right now, 200 it or deduction that will ease the burden of it. It is the American million Americans have access to quality care health insurance costs. Iream led to so much system. All told, this plan will bring health care the world. Today, our But that high quality, high-tech medical coverage to almost 30 million uninsured hat spirit home, and care comes at an unacceptable price: An esti- Americans and new help to nearly 95 million ome from the towns mated 30 million Americans have no insur- Americans that are struggling to meet health parents were born in ance at all, and millions more, like the care's runaway costs. call America, and to IcNallys, are afraid to change jobs for fear on the new missio My plan provides security to families like losing the health insurance that they've the McNallys and then others that are caught got. All told, America's health care now tops up in what health care experts call "job lock," traction this morning $800 billion a year, and the cost is rising 2 the fear that because of what they call pre- ]-not politics. I sa- to 3 times the rate of inflation. That's why existing medical conditions, changing jobs 1574 Sept. 5 / Administration of George Bush, 1992 will cost you and your family your health in- You know, we probably have to stop using surance. We're going to change all of that. that comparison. That comparison made a My plan cuts runaway costs by making the few people hot under the collar. I even g system more efficient. And the key is some- one letter from Russia telling me, "Quit run thing we call health insurance networks, ning down the KGB." [Laughter] pooling together individuals and businesses Nationalized health care, and here's what that too often can't afford to offer health in- we're in for: long waiting lines, lists for sur- surance to their workers or that worry that gery, shortages of the high-tech equipment one worker's illness or accident could drive responsible for so many of the miracles of everyone else's health insurance right modern medicine. One example: Right through the roof. Insurance costs obey the now-you've got great facilities in Cleve- law of large numbers: the larger the group land-but right now the Cleveland Clinic being insured, the lower the cost per individ- performs 10 coronary bypass surgeries-I ual; the broader the risk is spread, the lower see we've got a doctor from the clinic over the administrative overhead. here. [Laughter] Well, that's great. They per- We're also going to cut health care costs form 10 bypass surgeries a day; high tech, by wringing out waste and excess in the high quality, special, excellent surgery with- present system. That's why we have targeted out any wait. But if you live across Lake Erie malpractice insurance for reform. You know in Canada, the wait for coronary bypass sur- this, and I know it, and every American gery is up to 6 months, and that's not the knows it. High malpractice premiums mean kind of system that America wants or Amer- higher doctors' bills, expensive, unnecessary ica needs. tests, higher hospital cost, costs passed along Then there's the cost. According to some not only to the patient but to every American studies, nationalized health care would mean taxpayer. Last year alone, legal costs inflated a whopping $250 billion to $500 billion a year our doctors' bills by $20 billion. You in new taxes. But you won't hear about hig) shouldn't have to pay a lawyer when you go er taxes from the folks that are pushing th to the doctor. scheme. Just ask them about some of the side When health care costs total more than effects of their plan, and they just say, "Take what we spend on our kids' education and two aspirin; call me after the election." our country's national defense combined- [Laughter] education and defense combined, health care Well, this is what this election is about: costing more-even small changes can save who's got the good ideas, and who's got some us billions. If we made all the changes I've lousy ones. We've the right ideas on health talked about, my plan would save nearly $400 care. They have the wrong ones. billion in the next 4 years. My opponent backs a plan that goes by I listen to the American people, and you a different name, but in the end it takes you want to know you've got insurance you can to the same place, nationalized health care. count on. I don't hear you calling for higher It's called "play or pay." Listen for that one taxes to finance a Government takeover of during the fall, "play or pay." Here's what our hospitals. I will never approve such a pro- it means: Each employer must "play", mean- gram. ing shell out for insurance for employees, or Yet that is exactly what some of my oppo- "pay", extract a payroll tax to finance Govern- nents want, to nationalize our health care sys- ment health coverage. tem: put Government in control; let Govern- "Play or pay" will leave a lot of small busi- ment fix the prices; let Government ration nesses, those we are counting on to lead the the kind of care that people get, and how recovery we need so desperately, with two much, what kind, and when they'll get it. Go crummy options: cut workers' wages to pay the Government route, and you know what for mandated health care, or fire some wor we'll get: our health care system that com- ers and use the savings to cover the rest. A bines the efficiency of the House of Rep- cording to an independent Urban Institute resentatives post office with the compassion study, the "pay" part of this plan is no play- of the KGB over there in Moscow. ground. It will require at least a 7-percent of George Bush, 1992 Administration of George Bush, 1992 / Sept. 5 1575 ly have to stop using payroll tax. Now you small-business people American worker and to the American family comparison made a here, you that have your sleeves rolled up and get off your backsides and do something the collar. I even g running a restaurant or running a neighbor- about it. elling me, "Quit run hood store of some kind, think about that If you think I'm a little frustrated with this aughter] one. gridlocked Congress, you are right. We ought care, and here's what According to estimates, that kind of tax will to clean House. On this Labor Day weekend, ng lines, lists for sur- cost this country 700,000 jobs. For an em- we should remember what Jefferson called high-tech equipment ployee earning $24,000 a year say, that pay- the sum of good government: Whether it re- y of the miracles of roll tax would mean $1,700 chopped right out ne example: Right spected the right of each one of us, Thomas of his paycheck. Higher prices, lower wages, facilities in Cleve- Jefferson said, and I quote, "A wise and fru- lost job: Any way you look at it, that is the the Cleveland Clinic gal government shall not take from the wrong prescription for America. mouth of labor the bread that it has earned." bypass surgeries-I So in the end, this "play or pay" is no dif- from the clinic over In Jefferson's day, doctors made house calls ferent from nationalized health care. I'm 'hat's great. They per- on horseback and life was short. Today, we tempted to call it "pay and pay and pay ies a day; high tech, have miracle medicines that can pluck us again." It's an open invitation for employers from death's door. <cellent surgery with- to stop offering health benefits, throw the But all this is of no matter if we can't afford live across Lake Erie problem in the Government's lap, and dump coronary bypass sur- it, not if it is reserved only for the privileged millions of Americans that are working into .S, and that's not the a public plan like Medicaid. or the prosperous, not if it bankrupts the erica wants or Amer- families of America. We must not take from Right now, the cost of health care eats up 13 percent of all the goods and services that the mouth of labor the bread that you have t. According to some we produce. Do you really want to turn an- earned. We must fix the health care system alth care would mean of America. other huge chunk of our economy over to 1 to $500 billion a year the Government? We can't afford to saddle Once again, let me say I hope this hasn't von't hear about hig) ourselves with a health care cure that's worse been too long and too specific, but this strikes that are pushing th than the disease, especially when we have at the core and the well-being of every single about some of the side a much better alternative. family in America. There is no better place d they just say, "Take Now you can see why I believe health care to talk about family and family values than after the election." is going to be a Republican issue this year. it is right here with Steve and Gretel. To My opponent just isn't up to the mark on all of you, my thanks for this warm Ohio wel- his election is about: health care. A major newspaper that I don't come. May God bless the greatest, freest IS, and who's got some quote too often these days, the New York country on the face of the Earth, the United right ideas on health Times-[laughter]-described Bill Clinton's States of America. Thank you all. ong ones. attention to health care issues as, I quote, S a plan that goes by "occasional." It's no surprise why. After hav- Note: The President spoke at 10 a.m., at the in the end it takes you ing Governor Clinton for 12 years, one in Lake County fairgrounds. A tape was not tionalized health care. four folks in Arkansas don't even have health available for verification of the content of v." Listen for that one these remarks. insurance. Bill Clinton has promised he'll do or pay." Here's what for America what he's done for Arkansas. er must "play", mean- And my question is: Why would we let him? ince for employees, or I want to start our program that's been tax to finance Govern- sitting up on Capitol Hill for a while moving Remarks on Arrival at Greenville, forward. Move forward on health reform. South Carolina ave a lot of small busi- And Congress comes back from what they September 5, 1992 ounting on to lead the call a work period-they've been on vacation desperately, with two for a month and a half-next Tuesday. My Thank you all very, very much. What a workers' wages to pay opponents are divided. Even they know their great welcome back to this wonderful State. are, or fire some wor proposals won't work. And I say, let Congress Listen, I am so proud that the First Lady S to cover the rest. A start by passing my small business health care of South Carolina is with us, our old friend, ndent Urban Institute reforms to bring affordable, quality health Iris Campbell. You've got a great Governor, of this plan is no play- care to millions of Americans who don't have and you've got a great First Lady. And they re at least a 7-percent it now. Make it a Labor Day present to the represent this State with honor and dignity. Document No. 348225ss WHITE HOUSE STAFFING MEMORANDUM 92 SEP 4 P1:18 DATE: 9/4/92 ACTION/CONCURRENCE/COMMENT DUE BY: --- PRESIDENTIAL REMARKS: AMERICAN OCTOBERFEST SUBJECT: PAINESVILLE, OHIO - SATURDAY, 9/5-9:30ar ACTION FYI ACTION FYI VICE PRESIDENT MCBRIDE BAKER MOORE SCOWCROFT MULLINS DARMAN PETERSMEYER BATES PORTER BRADY PROVOST BROMLEY ROSS CALIO SMITH DEMAREST TUTWILER FITZWATER ZOELLICK GRAY BOSKIN HOLIDAY KAUFMAN HORNER MCGROART REMARKS: The attached has been forwarded to the President. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 THE WHITE HOUSE WASHINGTON September 4, 1992 02 2 SEP 4 All : 33 MEMORANDUM FOR THE PRESIDENT FROM: DAN MC GROARTY our SUBJECT: PROPOSED REMARKS AT OCTOBERFEST I. SUMMARY On Saturday, September 5th at 9:30 a.m., you will deliver remarks to an audience of 1,500 at the 30th Annual Steve Bencic Original American Octoberfest in Painesville, Ohio. II. DISCUSSION Your remarks (approximately 20 minutes / teleprompter), following a pancake breakfast, focus on your health care proposal by highlighting its real-world practicality through a real-life example. Following your remarks, you will participate in a few of the Octoberfest activities. PROPOSED cuts MARKED. As McGroarty (Walters/Bunton you September 4, 1992 11:15 a.m. [health] 410 pm PRESIDENTIAL REMARKS: HEALTH CARE PAINESVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic [BENZ-ick]. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time Governor Voinovich has missed this event since 1966. He's on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // I'm sure Korean spring rolls taste great but you can't put syrup on a spring roll. [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but 50 years ago, when Gretel was a little girl, the war in Europe separated her from her Mother. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. The survivors of Hurricane Andrew have been eating military rations for 8 days. We have a cargo plane on stand-by -- ready to descend on them with 500 pounds of Gretel's cake. I know there won't be a crumb left in sight. [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units [xxx and xxx], on route now to southern Florida. ]] 2 It's great to be here in Painesville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not a sprig of broccoli to be seen. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Panama City to Prague, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. But today I want to take a few minutes to speak to you about a serious matter, something I hope you'll be thinking about as you go into that voting booth November 3rd: About the way we can change America's health care system for the better. // 3 I want to tell you a story about the McNally family from Dorset, Ohio -- I first learned about them when Tiffany McNally wrote me at the White House two years ago. Tiffany turned 16 just last week. Tistury's Her Mom is healthy -- but her Dad has a rare members blood disease. So do her two sisters and her two brothers. Tiffany doesn't have the blood disease you see, she was she adopted. But through her natural mother, Tiffany was born with Fetal Alcohol Syndrome. // Tiffany's mom works part time as a church secretary; her dad is a utility worker. A routine visit to the doctor costs more than Mrs. McNally earns all week. See, it sounds tough. But my point today isn't to tell you how tough things are at Tiffany's cut. house. As Mrs. McNally says: "They make do." But what if Mr. McNally were laid off -- or worse still, if he lost his job. Well, in Mrs. McNally's words: "They'd be sunk or let EVEN say Mr. IF McNally found a better job -- but the JOB Lock catch was: No new health insurer would carry him or his family. He'd have to stay put, and let that opportunity pass him by. Well, that is wrong. That's why we have to change the health care system in America. Reforming health care reform O isn't just about studies and cold statistics -- it's about real worries / real lives. The problem 10 not the Let's be clear: The one thing this crisis is not about is the quality of care. American health care is first rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Death rates from heart 4 disease are down. Deaths from stroke -- down. Part of the reason is one of the best kept secrets in Washington: since I took office, we've increased funding for federal medical research more than 150 percent. We're going after everything from AIDS to Alzeimers -- to save the young and old of America. // STOT Right now, 200 million Americans have access to this quality care system But that high quality, high-tech medical care comes at an unacceptable price: 34 million Americans have no insurance at all -- and millions more are afraid to change jobs for fear of losing the health insurance they've got. America's health care costs now top $800 billion dollars a year -- and the cost is rising two to three times the rate of inflation. // And don't kid yourselves. We all pay for high health care costs more than once. High health costs are a drag on our economy drive up the deficit -- and soak up money you need for other important family expenses. 11 That's why health care reform is a key part of my agenda for economic security. // This election year, health care is going to be a Republican issue. // We've have a good program, and my Democratic opponents are divided between two bad ones -- both of which would put government in charge of health care. Right now, the cost of health care eats up 13 percent of all move the goods and services we produce. The last thing I want to do is put the government in charge of a huge chunk of the American economy that is already bigger than the Pentagon. // America P. 5 simply cannot afford to take a gamble on government-run health care. // STET The fact is We can reform the system without pushing our economy into intensive care. We must build on the strengths of stet the present system: on consumer choice, on innovation and state- of-the-art medicine -- while controlling costs and expanding access. We need an efficient health care system built on competition to control costs -- not government control and rationing care. One that keeps costs down -- opens up access and allows choice in care But above all, a health care system that gives all Americans real security -- security / that if you change jobs, if you or your kids develop serious health problems, that you can you 11 still be able to count on the coverage you need. // My plan meets every one of these objectives. We start making health care more accessible -- by making health insurance more affordable. For low income individuals and families I propose a health insurance credit -- up to $3,750 dollars a year that will guarantee a quality health insurance package for the poor Take a family of two parents with a child: One working and with a parent employed by a company that doesn't provide health 9 coverage Let's say that family S total income is $13,000 -- low enough to put them at the poverty line, but high enough to make them ineligible for Medicaid. Ye Right now, that family may falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would highest possible 6 qualify for $3,750 health care credit -- payable to the health care insurer of their choice. (And large state insurance pools will ensure that our credit will pay the full cost of a quality health plan.) 11 11 For middle-income individuals and families - - all the way up to those making $80,000 dollars -- my plan provides a health insurance tax credit or deduction that will ease the burden of health insurance costs. // My plan will bring health care coverage to almost 30 million uninsured Americans .security to people who, for far too long, and baing have had to do without. And all told, my plan means new help for nearly 95 million Americans + -% of American families) now struggling to meet health care's runaway costs. My plan provides security to families like the McNallys and STET others caught in what health care experts call "job lock" -- the fear that because of what they call "pre-existing medical conditions," changing jobs will cost you and your family your health insurance. STET My plan cuts runaway costs by making the system more efficient. The key is something we call Health Insurance Networks -- pooling together individuals and businesses that too often can't afford to offer health insurance to their workers -- or that worry that one worker's illness or accident could drive everyone's health insurance through the roof. Here's how it works. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual -- the broader the risk is spread -- the lower the 7 administrative overhead. Think of it this way: The more people on your side, the better the bargain you can strike. What kind of a deal can you get bargaining with a dealer to buy one car? Now let's say you get together with some friends -- or with a purchasing co-op -- and then go back to negotiate with the car dealer? You'd drive a harder bargain -- and get the same car for a better price. Well, the same thing works for health care. We've got to use market forces to drive down costs and increase efficiencies. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor.) Right now, people are doing just that: High malpractice premiums mean higher doctors bills, expensive, unnecessary tests and higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. Last year alone, legal costs inflated our doctors' bills by $20 billion dollars. These are the kind of changes we want to make When health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. And if we made all the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // I listen to the American people. You want to know you ve got insurance you can count on -- whether you keep your job / 8 lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. And yet that's what some of my opponents want: To nationalize our health care system. Put government in control: let government fix prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB." // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is up to six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. That's not the kind of system America wants or needs. And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // ADD JOKE 9 My opponent backs a plan that goes by a different name -- but in the end, takes you to the same place: Nationalized health care. It's called "Play or pay," and here's what it means: Each employer must "play" -- meaning: shell out for insurance for employees, or "pay" -- extract a payroll tax to finance government health coverage. // Well, Play or Pay will leave a lot of small businesses -- with two curummy n options ( none of us would envy: Cut workers' wages to pay for mandated health care. Or fire some workers and use the savings to cover the rest. // According to an independent Urban Institute study, the "pay" part of this plan is no playground. It will require at at least a 7 percent payroll tax. And by one estimate that will cost this country 700,000 jobs. For an employee earning $30,000 dollars a year -- that payroll tax would mean $2100 chopped out of his paycheck. // Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay STET and pay again." It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. We can't afford to saddle ourselves with a health care cure that's worse than the disease. Especially when we have a good alternative. // 10 Congress comes back from recess next Tuesday. I want to start moving forward on reform. My opponents are divided -- even they know their two proposals won't work. I say: Let Congress start by passing my small business health care reforms -- and bing package that will mean affordable, quality health care for to millions of Americans who don't have it now. Make it a Labor Day present to the American worker. // I know this morning I've asked you to hear me out on a serious subject. But real health care reform is a matter -- literally -- of life and death importance to working men and women and their families. / What about my opponent? Well, earlier this year, one of America's major newspapers described Bill Clinton's attention to health care issues as -- and I quote -- "occasional." And it cited this fact: One in four Arkansans has no health insurance - - a much higher rate than the national average. Bill Clinton's been Governor of his state for 12 years. What if he keeps his promise to do for America what he did for Arkansas? Then where will we be? // I thought you should know that one candidate sees health care reform as more than a slogan -- more than another excuse to make government bigger or take more of your taxes. On this Labor Day weekend, we should remember what Lincoln called the true test of government: Whether it respected the right of each one of us -- and I quote -- "to put into his own mouth the bread that his own hands have earned." // 11 In Lincoln's day, doctors made log cabin calls and life was short. Today, we have miracle medicines that can pluck us from death's door. // But all this is of no matter, if we cannot afford it. Not if it is reserved only for the privileged or the prosperous. Not if it bankrupts the families of America. We must "put in the mouth of labor the bread that you have earned." We must fix the health care system of America. 11 Once again, my thanks to Steve and Gretel and to all of you for this warm Ohio welcome -- and may God bless the United States of America. # # # THE WHITE HOUSE WASHINGTON Health Care September 4, 1992 for RB2 review. MEMORANDUM FOR THE PRESIDENT FROM: DAN MC GROARTY our SUBJECT: PROPOSED REMARKS AT OCTOBERFEST I. SUMMARY On Saturday, September 5th at 9:30 a.m., you will deliver remarks to an audience of 1,500 at the 30th Annual Steve Bencic Original American Octoberfest in Painesville, Ohio. II. DISCUSSION Your remarks (approximately 20 minutes / teleprompter), following a pancake breakfast, focus on your health care proposal by highlighting its real-world practicality through a real-life example. Following your remarks, you will participate in a few of the Octoberfest activities. DMr, R.Zoellich's nec's pm. 3 McGroarty (Walters/Bunton) September 4, 1992 11:15 a.m. [health] PRESIDENTIAL REMARKS: HEALTH CARE PAINESVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic [BENZ-ick]. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time Governor Voinovich has missed this event since 1966. He's on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // I'm sure Korean spring rolls taste great ... but you can't put syrup on a spring roll. [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but 50 years ago, when Gretel was a little girl, the war in Europe separated her from her Mother. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. The survivors of Hurricane Andrew have been eating military rations for 8 days. We have a cargo plane on stand-by -- ready to descend on them with 500 pounds of Gretel's cake. I know there won't be a crumb left in sight. [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units [xxx and xxx], on route now to southern Florida. ]] 2 It's great to be here in Painesville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not a sprig of broccoli to be seen. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Panama City to Prague, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. But today I want to take a few minutes to speak to you about a serious matter, something I hope you'll be thinking about as you go into that voting booth November 3rd: About the way we can change America's health care system for the better. // weve got to cut this down 3 I want to tell you a story about the McNally family from Dorset, Ohio -- I first learned about them when Tiffany McNally wrote me at the White House two years ago. Tiffany turned 16 just last week I's Her Mom is healthy -- but her Dad has a rare @ 4 menter blood disease. So do her two sisters and her two brothers. & And Tiffany doesn't have the blood disease you see, she was she adopted. But through her natural mother, Tiffany was born with Fetal Alcohol Syndrome. // Tiffany's mom works part time as a church secretary; her dad is a utility worker A routine visit to the doctor costs more than Mrs. McNally earns all week. See, it sounds tough. But my point today isn't to tell you how tough things are at Tiffany's house. As Mrs. McNally says: They make do." But what if Mr. McNally were laid off -- or worse still, if job he lost his job. Well, in Mrs. McNally' words: "They'd be sunk. " or let's say Mr. McNally found a better job -- but the catch was: No new health insurer would carry him or his family. He'd have to stay put, and let that opportunity pass him by. Well, that is wrong. That's why we have to change the health care system in America. Reforming health care reform isn't just about studies and cold statistics -- it's about real worries / real lives. Let's be clear: The one thing this crisis is not about is the quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Death rates from heart 4 disease are down. Deaths from stroke -- down. Part of the reason is one of the best kept secrets in Washington: since I took office, we've increased funding for federal medical research more than 150 percent. We're going after everything from AIDS to Alzeimers -- to save the young and old of America / /. Right now, 200 million Americans have access to this quality care system. But that high quality, high-tech medical care comes at an unacceptable price: 34 million Americans have no insurance at all -- and millions more are afraid to change jobs for fear of losing the health insurance they've got. America's health care costs now top $800 billion dollars a year -- and the cost is rising two to three times the rate of inflation. // And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money you need for other important family expenses. // That's why health care reform is a key part of my agenda for economic security. // This election year, health care is going to be a Republican issue. // We've have a good program, and my Democratic opponents are divided between two bad ones -- both of which would put government in charge of health care. Right now, the cost of health care eats up 13 percent of all D. you really want to turn that the goods and services we produce. The last thing I want to do is put the government in charge of a huge chunk of the American much more of our economy to the government economy that is already bigger than the Pentagon. H America Move top9 (Insen4) 5 simply cannot afford to take a gamble on government run health care. / "Stal The fact is: We can reform the system without pushing our economy into intensive care. 11 We must build on the strengths of the present system: on consumer choice, on innovation and state- of-the-art medicine -- while controlling costs and expanding access. , H We need an efficient health care system built on competition to control costs -- not government control and rationing care. One that keeps costs down -- opens up access -- and allows choice in care A But above all, a health care system that gives all Americans real security -- security / that if you change jobs, if you or your kids develop serious health problems, you'll still be able to count on the coverage you need. // My plan meets every one of these objectives. We start making health care more accessible -- by making health insurance more affordable. For low-income individuals and families, I propose a health insurance credit -- up to $3,750 dollars a year that will guarantee a quality health insurance package for the poor. Take a family of two parents with a child: One working Cld As we parent -- employed by a company that doesn't provide health hold a coverage. Let's say that family's total income is $13,000 -- low higher# enough to put them at the poverty line, but high enough to make may them ineligible for Medicaid. / Right now, that family 6 falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would 6 qualify for $3,750 health care credit -- payable to the health care insurer of their choice. (And large state insurance pools /will will ensure that our credit will pay the full cost of a quality lose then health plan.) H For middle-income individuals and families - - all the way up to those making $80,000 dollars -- my plan provides a health insurance tax credit or deduction that will ease the burden of health insurance costs. // My plan will bring health care coverage to almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. And all told, my plan means new help for nearly 95 million Americans ( -% of American families) now struggling to meet health care's runaway costs. My plan provides security to families like the McNallys and others caught in what health care experts call "job lock" -- the fear that because of what they call "pre-existing medical conditions," changing jobs will cost you and your family your health insurance. My plan cuts runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- pooling together individuals and businesses that too often can't afford to offer health insurance to their workers -- or that worry that one worker's illness or accident could drive everyone's health insurance through the roof. Here's how it works. Insurance costs obey the "law of large numbers:' The larger the group being insured, the lower the cost per individual -- the broader the risk is spread -- the lower the Isave this sentere 7 administrative overhead. ) Think of it this way: The more people on your side, the better the bargain you can strike. What kind of a deal can you get bargaining with a dealer to buy one car? Now let's say you get together with some friends -- or with a purchasing co-op and then go back to negotiate with the car dealer? You'd drive a harder bargain -- and get the same car for a better price. Well, the same thing works for health care. wer We ve got to use market forces to drive down costs and increase efficiencies. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' bills, expensive, unnecessary tests and higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. Last year alone, legal costs inflated our doctors' bills by $20 billion dollars. These are the kind of changes we want to make. When health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. And if we made all the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / 8 lose your job / or change your job I don't hear you calling for higher taxes to finance a government take-over of our hospitals. And yet that's what some of my opponents want: To nationalize our health care system. Put government in control: let government fix prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB." // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is up to six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months That's not the kind of system America wants or needs. And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // clinto 99 Audits not surprise why: After beary havey being Governor for 12 years, one in form Arkansans dont even have health insurance! A What if he does 9 45 America what he d.d to Ankarsas Thank twice about trot My opponent backs a plan that goes by a different name -- prospect but in the end, takes you to the same place: Nationalized health care. It's called "Play or pay," and here's what it means: Each employer must "play" -- meaning: shell out for insurance for employees, or "pay" -- extract a payroll tax to finance government health coverage. // Well, Play or Pay will leave a lot of small businesses -- with two crummy options, none of us would envy: Cut workers' wages to pay for mandated health care. Or fire some workers and use the savings to cover the rest. // According to an independent Urban Institute study, the "pay" part of this plan is no playground. It will require at at least a 7 percent payroll tax. And by one estimate, that will cost this country 700,000 jobs. For an employee earning $30,000 dollars a year -- that payroll tax would mean $2100 chopped out of his paycheck. // Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay and pay again." It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. We can't afford to saddle ourselves with a health care cure that's worse than the disease. Especially when we have a good alternative. // Insut a Requblican isku A from p 4 GiNow you can see why I believe Health Cane is going to be my the this year. 91 my opponent Natreth just isn't up to the mark on health care Chk health came issue t I Ginohe "occassiml". A A majn in Ark newspaper, The New york Times, desnihed B.11 Clintons attentan to 10 Congress comes back from recess next Tuesday. I want to start moving forward on health reform. My opponents are divided -- even they know their two proposals won't work. I say: Let Congress start by passing my small business health care reforms -- a package that will mean affordable, quality health care for millions of Americans who don't have it now. Make it a Labor Day present to the American worker. // I know this morning I've asked you to hear me out on a serious subject. But real health care reform is a matter -- literally -- of life and death importance to working men and women and their families. / The New York Times, What about my opponent? Well, earlier this year, one of America's major newspapers described Bill Clinton's attention to health care issues as -- and I quote -- "occasional." And it doesn't dont eventowe cited this fact: One in four Arkansans has no health insurance - a much higher rate than the national average. Bill Clinton's been Governor of his state for 12 years. does What if he keeps his promise to do for America what he did for Arkansas? Then where will we be? // I thought you should know that one candidate sees health care reform as more than a slogan -- more than another excuse to make government bigger or take more of your taxes. On this Labor Day weekend, we should remember what Lincoln called the true test of government: Whether it respected the right of each one of us -- and I quote -- "to put into his own mouth the bread that his own hands have earned." // 11 In Lincoln's day, doctors made log cabin calls and life was short. Today, we have miracle medicines that can pluck us from death's door. / / But all this is of no matter, if we cannot afford it. Not if it is reserved only for the privileged or the prosperous. Not if it bankrupts the families of America. We must "put in the mouth of labor the bread that you have earned." We must fix the health care system of America. 11 Once again, my thanks to Steve and Gretel and to all of you for this warm Ohio welcome -- and may God bless the United States of America. # # # 348225SS Document No. WHITE HOUSE STAFFING MEMORANDUM NOON, THURS., SEPT. 3 9/2/92 DATE: ACTION/CONCURRENCE/COMMENT DUE BY: PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SUBJECT: SEPTEMBER 5, 1992 ACTION FYI ACTION FYI VICE PRESIDENT Y MOORE BAKER x MULLINS SCOWCROFT DARMAN Saully N/c to our PETERSMEYER PORTER Wilensky BRADY x PROVOST BROMLEY ROSS CALIO N/C SMITH DEMAREST TUTWILER FITZWATER X ZOELLICK 10:30 KAUFMAN GRAY N/C BATES HOLIDAY BOSKIN To 034cr HORNER By phone MCGROARTY MCBRIDE REMARKS: Please provide comments on the attached directly to Dan McGroarty, Rm. 122, x2930, with a copy to this office NO LATER THAN NOON, THURSDAY, SEPTEMBER 3. Thank you. RESPONSE: Called 11:00 PHILLIP D. BRADY Assistant to the President 12:00 and Staff Secretary Ext. 2702 McGroarty/Walters September 2, 1992 4:00 p.m. 2002 P4: 08 [health] PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time he's missed out on Steve and Gretel's cooking since 1966 -- but he's got good reason today. Governor Voinovich is on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but years - ago, when Gretel was 2 years old, the war in Europe separated her from her family. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. That's the best in the American spirit: plenty of heart, always generous, always ready to help neighbors in need. //]] And after x-thousand Meals Ready to Eat, we may just airlift Gretel's cake to Miami to take care of dessert. !! [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units XXXX and XXX, on route now to southern Florida. ]] 2 It's great to be here in Painsville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not one sprig of broccoli in sight. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Managua to Moscow, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. So today I've set aside the standard Labor Day speech. I want to do something a little different -- I want to take a few minutes to speak to you about a serious matter, something you should be thinking about as you go into that voting booth 3 November 3rd: About the way we can change America's health care system for the better. // Think about the challenges we face as a nation: Anyone concerned about America's competitiveness has to see controlling health care costs as key to a healthy economy. / Think about the concerns we have as parents: Health care -- for ourselves, for our kids -- has to top the list. // Maybe you're worried about what happens to your health care if you change jobs -- or worse still, if you lose your job. Maybe you've got a child with a long-term illness. You're worried that if you leave your job -- even to take a better one - - you'll lose your health care. [[LETTER FROM CLEVELAND GIRL, TIFFANY MCNALLY, ON FAMILY'S HEALTH PROBLEMS ]] // The one thing this crisis is not about is quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Deaths from heart disease are down. Deaths 200 CEA from stroke -- down. One big reason is the [xx] percent increase in federal medical research in everything from Alzheimers to AIDS. And right now, the vast majority of Americans have access to this quality care system. But the cost we pay for health care has skyrocketed. Maybe it won't surprise anyone who's made a trip to the pharmacy for prescription pills lately - - but America's annual health care costs have risen from $74 billion dollars in 1970 to $800 billion dollars today. And still, more than 30 million Americans have no insurance at all. 4 And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money we need for other vital public programs. // -Edelete Back in Washington, some of the political pundits say that health care is a Democratic issue. Well, I don't believe that, and I'll tell you why: We've got the compassion -- and the common sense -- to change our system for the better. Health care reform is a key part of my agenda for economic security. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. You see, I think that government is too big and it spends too much. Right now, the cost of health care eats up 13 percent of all the goods and services we produce. The last thing I want another huge clunk CEA to do is put the government in charge of 13 percent more of the American economy. // And yet that's what some people want: To nationalize our health care system. Put government in control: let government set prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // 5 You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB. " // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. // And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // But you won't hear about higher taxes from the folks pushing that scheme. Ask them about the side-effects of their plan, and they just say: Take two aspirin -- and call me after the election. // But there's another proposal out there that's every bit as harmful to the economy. Maybe you've heard of it -- it's called "Play or pay, " and here's what it means: Each employer must "play" -- meaning: provide insurance for employees, or they can "pay" -- a payroll tax to finance government health coverage. Well, Play or Pay will leave a lot of small businesses -- businesses that are the heartbeat of this American economy 6 -- with a tough choice: One, cut workers' wages to pay for mandated health care. Two, fire some workers and use the savings to cover the rest. Or three: raise prices, and try to pass along the cost to the consumer. Some reliable studies say a 7 percent payroll tax will cost this country 700,000 jobs. Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. // In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay. It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. And because the new payroll taxes in Play or Pay can't possibly pay for the program - - you, the American taxpayer, will have to pick up the tab. // The fact is: We can reform health care without pushing our economy into intensive care. // We start with these objectives: a health care system built on choice -- not government control. One that keeps costs down -- and opens up access. But above all, a health care system that gives all Americans real security -- security / that if they change jobs, if they or their kids develop serious health problems, they'll still be able to count on the coverage they need. // My plan meets every one of these objectives. We can start making health care more accessible by making health insurance more affordable. For low-income individuals and families, I propose a health insurance credit -- up to $3,750 7 dollars a year to help people buy private health insurance. Middle-income individuals and families -- all the way up to those making $80,000 dollars -- will get a health insurance tax deduction. All told, that's new help to purchase health insurance for 70 million Americans. Take a family of two parents with a child: One working parent -- employed by a company that doesn't provide health coverage. That family's total income is $10,000 -- low enough to put them under the poverty line, but high enough to make them ineligible for Medicaid. / Right now, that family falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would qualify for $3750 health care credit -- payable to the health care insurer of their choice. / / All together, my plan will bring health care coverage to almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. // And as we open up health care to all Americans, we can cut runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- to pool small businesses that too often can't afford to offer health insurance to their workers, or worry that one worker's illness or accident could drive everyone's health insurance through the roof. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual. Think of it this way: What kind of a deal can you get bargaining 8 with the grocer to buy one box of cereal? Now let's say you got together with everyone on your street, or better yet everyone in your town, and then went back to buy cereal? You'd drive a harder bargain and get a better price. The same thing works for health care. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' bills, higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. [[Last year alone, legal costs inflated our doctors bills by XX billion dollars. ]] Some I know are skeptical -- they think the savings won't add up. But I can tell you, when each year's health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. I won't detail this morning the way the Health Insurance Networks I mentioned will save money by helping cut red tape and paperwork -- the way we'll simplify and speed up claims processing, or bring the growth in government health programs under control. But I will say this: If we made the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // 9 So today I challenge the Congress: Start with my small business reforms -- with the package that will mean affordable, quality health care for millions of Americans who don't have it now, and pass my plan. And I ask all of you here to join me -- tell the Congress it's time to act. // You know, when you're President, you get a lot of advice -- from all over the country, from people of all ages. Here's one example, from a boy named Cory, 11 years old, on what a President should do when you're fighting with Congress, and you just can't get things done. Here's the quote: "Meet at the Capitol at midnight, and check the Constitution to see who's right." // Well, if it gets things done maybe it's worth a try. / I know there are those who say this nation has seen its best day. They don't know the whole world still believes in America's magic. They don't see the whole world thinks America is just another way of saying the future. Now that the entire world is turning our way -- toward free government, free markets, less bureaucracy, less red tape and more competition -- we can't turn back. America will move forward -- mold the future into a new American century. We can lift this country to new heights, to new hope. And we will build the strong, secure America we want to pass on to our kids. // Once again, my thanks for this warm Ohio welcome -- and may God bless the United States of America. # # # TO 9/4 McGroarty (Walters/Bunton) 10:15am September 3, 1992 **REVISED per R. ZOELLICK** 5:45 p.m. [health] Steve /Dan: PRESIDENTIAL REMARKS: HEALTH CARE I think this is in pretty good PAINESVILLE, OHIO / shape; pls see myedi SEPTEMBER 5, 1992 9:30 A.M. 2) P/S see last pageth idea [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic [BENZ-ick]. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time Governor Voinovich missed this event since 1966. He's on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // I'm sure Korean spring rolls taste great but you can't put syrup on a spring roll. [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but 50 years ago, when Gretel was a little girl, the war in Europe separated her from her Mother. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. The survivors of Hurricane Andrew have been eating militay Meals Ready to Eat T for 8 days. We have a cargo plane on stand- by -- ready to descend on them with 500 pounds of Gretel's cake. know /won't I don't think there 11 be a crumb left in sight. [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units [xxx and xxx], on route now to southern Florida. ]] 2 It's great to be here in Painesville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not a sprig of broccoli to be seen. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Panama City to Prague, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. So today I've set aside the standard Labor Day speech. I want to do something a little different -- I want to take a few minutes to speak to you about a serious matter, something you I hope should be thinking about as you go into that voting booth 3 November 3rd: About the way we can change America's health care system for the better. // Think about the challenges we face as a nation: Anyone concerned about America's competitiveness has to see controlling health care spending as key to a healthy economy. / Think about the concerns we have as parents: Health care -- for ourselves, for our kids -- has to top the list. // I want to tell you a story about a family from Dorset, Ohio -- a family I first learned about when Tiffany McNally wrote me at the White House two years ago. Tiffany just turned 16 last week. Her Mom is healthy -- but her Dad has a rare blood disease. So do her two sisters and her two brothers. Tiffany doesn't have the blood disease -- you see, she was adopted. But through her natural mother, Tiffany was born with Fetal Alcohol Syndrome. // Tiffany's mom works part-time as a church secretary; her dad is a utility worker. A single, routine visit to the doctor costs more than Mrs. McNally earns all week. My point today isn't to This is tell you how tough things are in Tiffany's house. I'd say really keeping things together the way they do is a miracle -- but you bad to (subjune ask the McNallys -- they'll say they "make do = No, I want to focus on one thing Tiffany and her family were shouldn't have to worry about: If Mr. McNally was laid off -- or worse still, if he lost his job, well in Mrs. McNally's words: "They'd be sunk." Let's say Mr. McNally found a new job -- a better job -- but the catch was: No new health insurer would 4 carry him or his family. He'd have to stay put, and let that opportunity pass him by. Well, that is wrong. That's one of the things we've got to change -- and that's why I want to see my plan passed. A story like Tiffany's family's touches all of us. Because health care reform isn't just about studies and cold statistics -- it's about real worries / real lives. Let's be clear: The one thing this crisis is not about is quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Death rates from heart disease are down. Deaths from stroke -- down. Part of the reason is one of the best kept secrets in Washington: And that is that, since I took office, we've increased funding for federal medical research more than 150 percent, in everything from Alzheimers to AIDS. Right now, 200 million Americans have access to this quality care system. But that high quality, high-tech medical care comes at an unacceptable price: 34 million Americans have no insurance at all -- and millions more are afraid to change jobs for fear of losing the health insurance they've got. America's health care costs now top $800 billion dollars a year -- and the cost is rising two to three times the rate of inflation. // And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money you need for 5 other important family expenses. // That's why health care reform is a key part of my agenda for economic security. // This election year, health care is going to be a Republican issue. // We've got a good program, and my Democratic opponents are divided -- between two bad ones, both of which would put government in charge of health care. Right now, the cost of health care eats up 13 percent of all the goods and services we produce. The last thing I want to do is put the government in charge of another huge chunk of the American economy. // America simply cannot afford to take a gamble on government-run health care. // The fact is: We can reform the system without pushing our economy into intensive care. 11 We start with these objectives: an efficient health care system built on competition to control costs -- not government control and rationing care. One that keeps costs down -- and opens up access -- and allows choice in care. But above all, a health care system that gives all Americans real security -- security / that if they change jobs, if they or their kids develop serious health problems, they'll still be able to count on the coverage they need. // We've got to build on the strengths of the present system: on consumer choice, on innovation and state-of-the-art medicine - - while controlling costs and expanding access. My plan meets every one of these objectives. We start making health care more accessible -- by making health insurance more affordable. For low-income individuals and 6 families, I propose a health insurance credit -- up to $3,750 dollars a year that will guarantee a quality health insurance package for the poor. Take a family of two parents with a child: One working parent -- employed by a company that doesn't provide health coverage. That family's total income is $13,000 -- low enough to put them at the poverty line, but high enough to make them ineligible for Medicaid. / Right now, that family falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would qualify for $3750 health care credit -- payable to the health care insurer of their choice. (And large state insurance pools will ensure that our credit will pay the full cost of a quality health plan.) // For middle-income individuals and families -- all the way up to those making $80,000 dollars -- my plan provides a health insurance tax credit or deduction that will ease the burden of health insurance costs. // chk Iveseen 37-38 My plan will bring health care coverage to almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. And all told, my plan means new help for nearly 95 million Americans now struggling to meet health care's runaway costs. My plan provides security to families like the McNallys and others caught in what health care experts call "job lock" -- the fear that because of "pre-existing medical conditions," changing jobs will cost you and your family their health insurance. 7 My plan cuts runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- to pool together individuals and businesses that too often can't afford to offer health insurance to their workers -- or that worry that one worker's illness or accident could drive everyone's health insurance through the roof. Here's how it works. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual -- the broader the risk is spread -- the lower the Think of it the way: the more people on your side, the administrative overhead. Think of it this way: What kind of a better bengers Imminks deal can you get bargaining with a dealer to buy one car? Now you can you stark. The anelogy is let's say you got together with some friends -- or with a will purchasing co-op -- and then went back to negotiate with the car fruits) scard dealer? You'd drive a harder bargain -- and get the same car for a better price. Well, the same thing works for health care. ) We've got to use market forces to drive down costs and increase efficiencies. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' bills, expensive, unnecessary tests and higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. Last year alone, legal costs inflated our doctors' bills by $20 billion dollars. 8 Some I know are skeptical -- they think the savings won't add up. But I can tell you, when each year's health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. And if we made all the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. And yet that's what some of my opponents want: To nationalize our health care system. Put government in control: let government fix prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB." // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- 9 without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is up to six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. That's not the kind of system America wants or needs. And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // My opponent backs a plan that goes by a different name -- but in the end, takes you to the same place: Nationalized health care. It's called "Play or pay, and here's what it means: Each employer must "play" -- meaning: shell out for insurance for employees, or "pay" -- extract a payroll tax to finance government health coverage. // Well, Play or Pay will leave a lot of small businesses -- businesses that are the heartbeat of this American economy -- with two options none of us would envy: One, cut workers' wages to pay for mandated health care. Or two, fire some workers and use the savings to cover the rest. // According to an independent Urban Institute study, a 7 percent payroll tax will cost this country 700,000 jobs. For an employee earning $30,000 dollars a year -- that payroll tax would mean $2100 chopped out of his paycheck. // Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay 10 and pay again. " It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. We can't afford to saddle ourselves with a health care cure that's worse than the disease. Especially when we've got an alternative for affordable health care for all Americans. // Congress comes back from recess next Tuesday. I want to start moving forward on reform. My opponents are divided -- even they know their two proposals won't work. I say: Let Congress start by passing my small business health care reforms -- a package that will mean affordable, quality health care for millions of Americans who don't have it now. Make it a Labor Day present to the American worker. // I know this morning I've asked you to hear me out on a serious subject. But real health care reform is a matter -- literally -- of life and death importance to working men and women and their families. / And I thought you should know that one candidate sees health care reform as more than a slogan -- more than another excuse to make government bigger or take more of your taxes. On this Labor Day weekend, we should remember what Lincoln called the true test of government: Whether it respected the right of each one of us -- and I quote -- "to put into his own mouth the bread that his own hands have earned." // We don't respect that right by enlarging government. We respect it by ensuring liberty -- protecting the freedom of each 11 individual to live and work as they see fit, the freedom of each American family to live safe and secure. // Once again, my thanks to Steve and Gretel and to all of you for this warm Ohio welcome -- and may God bless the United States of America. # # # Perhaps Hi time to start to ky the predicate for the Ark record. disuss What do you think about working these ,dear in when you Just Pay /play this year altentor (4/2/92) as" occasional" to the shill NYT Lealth - described care lines of & Clintons on sudden Arkansas has convented One in 4 Arkansans than nationwise has - NO health / Pin insurer, 7) much Her her lower for years : What it he le did does to Vegans his Go promise there t does - for America what we be Arkansa ? Then where will THE WHITE HOUSE WASHINGTON Demarest 92 SEP 4 A10: 44 Marla Dorahne 7845 P.3 do last not $ want to hut the pharmacy's wants to leave it qeneric "health care" Clinton has focused on phas. as creating high costs THE WHITE HOUSE WASHINGTON 32 SEP 3 P5: 29 September 3, 1992 MEMORANDUM FOR DAN MCGROARTY FROM: STEPHEN G. RADEMAKER SR ASSOCIATE COUNSEL TO THE PRESIDENT SUBJECT: Presidential Remarks: Labor Day Parade Pursuant to Phillip Brady's request, Counsel's Office has reviewed the above-referenced matter. We have no objection to the draft presidential remarks. CC: Phillip D. Brady Document No. 348266 WHITE HOUSE STAFFING MEMORANDUM DATE: 09/02/92 ACTION/CONCURRENCE/COMMENT DUE BY: 2:00 p.m. 09/03 SUBJECT: PRESIDENTIAL REMARKS: LABOR DAY PARADE, HAMTRAMCK, MI - 09/07 ACTION FYI ACTION FYI VICE PRESIDENT MOORE BAKER MULLINS SCOWCROFT PETERSMEYER DARMAN PORTER BRADY PROVOST BROMLEY ROSS CALIO SMITH DEMAREST TUTWILER FITZWATER ZOELLICK GRAY MCGROARTY KAUFMAN HOLIDAY HORNER MCBRIDE REMARKS: Please provide any comments directly to Dan McGroarty no later than 2:00 p.m. on Thursday, 09/03, with a copy to this office. Thanks. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 348225SS Document No. WHITE HOUSE STAFFING MEMORANDUM 9/2/92 NOON, THURS., SEPT. 3 DATE: ACTION/CONCURRENCE/COMMENT DUE BY: PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SUBJECT: SEPTEMBER 5, 1992 ACTION FYI ACTION FYI VICE PRESIDENT MOORE BAKER MULLINS SCOWCROFT PETERSMEYER DARMAN PORTER BRADY PROVOST BROMLEY ROSS CALIO SMITH DEMAREST TUTWILER FITZWATER ZOELLICK GRAY KAUFMAN HOLIDAY BATES BOSKIN HORNER MCBRIDE MCGROARTY REMARKS: Please provide comments on the attached directly to Dan McGroarty, Rm. 122, x2930, with a copy to this office NO LATER THAN NOON, THURSDAY, SEPTEMBER 3. Thank you. RESPONSE: Comments given direct ding from PHILLIP D. BRADY Assistant to the President Seally to ME Bloorly and Staff Secretary Ext. 2702 McGroarty/Walters September 2, 1992 4:00 p.m. 02 SEP 2 P4: 08 [health] PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time he's missed out on Steve and Gretel's cooking since 1966 -- but he's got good reason today. Governor Voinovich is on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but years - ago, when Gretel was 2 years old, the war in Europe separated her from her family. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. That's the best in the American spirit: plenty of heart, always generous, always ready to help neighbors in need. //]] And after x-thousand Meals Ready to Eat, we may just airlift Gretel's cake to Miami to take care of dessert. !! [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units XXXX and XXX, on route now to southern Florida. ]] 2 It's great to be here in Painsville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not one sprig of broccoli in sight. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Managua to Moscow, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. So today I've set aside the standard Labor Day speech. I want to do something a little different -- I want to take a few minutes to speak to you about a serious matter, something you should be thinking about as you go into that voting booth 3 November 3rd: About the way we can change America's health care system for the better. // Think about the challenges we face as a nation: Anyone concerned about America's competitiveness has to see controlling health care costs as key to a healthy economy. / Think about the concerns we have as parents: Health care -- for ourselves, for our kids -- has to top the list. // Maybe you're worried about what happens to your health care if you change jobs -- or worse still, if you lose your job. Maybe you've got a child with a long-term illness. You're worried that if you leave your job -- even to take a better one - - you'll lose your health care. [[LETTER FROM CLEVELAND GIRL, TIFFANY MCNALLY, ON FAMILY'S HEALTH PROBLEMS ]] / / The one thing this crisis is not about is quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Deaths from heart disease are down. Deaths from stroke -- down. One big reason is the [xx] percent increase in federal medical research in everything from Alzheimers to AIDS. And right now, the vast majority of Americans have access to this quality care system. But the cost we pay for health care has skyrocketed. Maybe it won't surprise anyone who's made a trip to the pharmacy for prescription pills lately - - but America's annual health care costs have risen from $74 billion dollars in 1970 to $800 billion dollars today. And still, more than 30 million Americans have no insurance at all. 4 And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money we need for other vital public programs. // Back in Washington, some of the political pundits say that health care is a Democratic issue. Well, I don't believe that, and I'll tell you why: We've got the compassion -- and the common sense -- to change our system for the better. Health care reform is a key part of my agenda for economic security. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. You see, I think that government is too big and it spends too much. Right now, the cost of health care eats up 13 percent of all the goods and services we produce. The last thing I want to do is put the government in charge of 13 percent more of the American economy. // And yet that's what some people want: To nationalize our health care system. Put government in control: let government set prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // 5 You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB." // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. // And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // But you won't hear about higher taxes from the folks pushing that scheme. Ask them about the side-effects of their plan, and they just say: Take two aspirin -- and call me after the election. // But there's another proposal out there that's every bit as harmful to the economy. Maybe you've heard of it -- it's called "Play or pay, and here's what it means: Each employer must "play" -- meaning: provide insurance for employees, or they can "pay" -- a payroll tax to finance government health coverage. Well, Play or Pay will leave a lot of small businesses -- businesses that are the heartbeat of this American economy 6 -- with a tough choice: One, cut workers' wages to pay for mandated health care. Two, fire some workers and use the savings to cover the rest. or three: raise prices, and try to pass along the cost to the consumer. Some reliable studies say a 7 percent payroll tax will cost this country 700,000 jobs. Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. // In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay." It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. And because the new payroll taxes in Play or Pay can't possibly pay for the program - - you, the American taxpayer, will have to pick up the tab. // The fact is: We can reform health care without pushing our economy into intensive care. // We start with these objectives: a health care system built on choice -- not government control. One that keeps costs down -- and opens up access. But above all, a health care system that gives all Americans real security -- security / that if they change jobs, if they or their kids develop serious health problems, they'll still be able to count on the coverage they need. // My plan meets every one of these objectives. We can start making health care more accessible by making health insurance more affordable. For low-income individuals and families, I propose a health insurance credit -- up to $3,750 7 dollars a year to help people buy private health insurance. Middle-income individuals and families -- all the way up to those making $80,000 dollars -- will get a health insurance tax deduction. All told, that's new help to purchase health insurance for 70 million Americans. Take a family of two parents with a child: One working parent -- employed by a company that doesn't provide health coverage. That family's total income is $10,000 -- low enough to put them under the poverty line, but high enough to make them ineligible for Medicaid. / Right now, that family falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would qualify for $3750 health care credit -- payable to the health care insurer of their choice. // All together, my plan will bring health care coverage to almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. // And as we open up health care to all Americans, we can cut runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- to pool small businesses that too often can't afford to offer health insurance to their workers, or worry that one worker's illness or accident could drive everyone's health insurance through the roof. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual. Think of it this way: What kind of a deal can you get bargaining 8 with the grocer to buy one box of cereal? Now let's say you got together with everyone on your street, or better yet everyone in your town, and then went back to buy cereal? You'd drive a harder bargain and get a better price. The same thing works for health care. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' bills, higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. [[Last year alone, legal costs inflated our doctors bills by XX billion dollars. ]] Some I know are skeptical --- they think the savings won't add up. But I can tell you, when each year's health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. I won't detail this morning the way the Health Insurance Networks I mentioned will save money by helping cut red tape and paperwork -- the way we'll simplify and speed up claims processing, or bring the growth in government health programs under control. But I will say this: If we made the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // 9 So today I challenge the Congress: Start with my small business reforms -- with the package that will mean affordable, quality health care for millions of Americans who don't have it now, and pass my plan. And I ask all of you here to join me -- tell the Congress it's time to act. // You know, when you're President, you get a lot of advice -- from all over the country, from people of all ages. Here's one example, from a boy named Cory, 11 years old, on what a President should do when you're fighting with Congress, and you just can't get things done. Here's the quote: "Meet at the Capitol at midnight, and check the Constitution to see who's right." // Well, if it gets things done ... maybe it's worth a try. / I know there are those who say this nation has seen its best day. They don't know the whole world still believes in America's magic. They don't see the whole world thinks America is just another way of saying ... the future. Now that the entire world is turning our way -- toward free government, free markets, less bureaucracy, less red tape and more competition -- we can't turn back. America will move forward -- mold the future into a new American century. We can lift this country to new heights, to new hope. And we will build the strong, secure America we want to pass on to our kids. // Once again, my thanks for this warm Ohio welcome -- and may God bless the United States of America. # # # THE WHITE HOUSE WASHINGTON Its smT! Gail - - gee for days mil Would you please take a look at this? If you find any factual addities or unclear language, please call me or Jeannie Bunton at x 7750. Thanks, Ed Walters Speechwriting McGroarty/Walters September 2, 1992 4:00 p.m. [health] PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time he's missed out on Steve and Gretel's cooking since 1966 -- but he's got good reason today. Governor Voinovich is on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but years - ago, when Gretel was 2 years old, the war in Europe separated her from her family. The Red Cross came to Gretel's rescue --- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. That's the best in the American spirit: plenty of heart, always generous, always ready to help neighbors in need. //]] And after x-thousand Meals Ready to Eat, we may just airlift Gretel's cake to Miami to take care of dessert. // [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units XXXX and XXX, on route now to southern Florida. ]] 2 It's great to be here in Painsville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. 11 And not one sprig of broccoli in sight. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Managua to Moscow, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. So today I've set aside the standard Labor Day speech. I want to do something a little different -- I want to take a few minutes to speak to you about a serious matter, something you should be thinking about as you go into that voting booth 3 November 3rd: About the way we can change America's health care system for the better. // Think about the challenges we face as a nation: Anyone concerned about America's competitiveness has to see controlling spending health care costs as key to a healthy economy. / Think about the concerns we have as parents: Health care -- for ourselves, for our kids -- has to top the list. // Maybe you're worried about what happens to your health care if you change jobs -- or worse still, if you lose your job. serious Maybe you've got a child with a long-term illness. You're worried that if you leave your job -- even to take a better one - - you'll lose your health care. [[LETTER FROM CLEVELAND GIRL, TIFFANY MCNALLY, ON FAMILY'S HEALTH PROBLEMS ]] // The one thing this crisis is not about is quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Deaths from heart disease are down. Deaths from stroke -- down. One big reason is the [xx] percent increase in federal medical research in everything from Alzheimers to AIDS. And right now, the vast majority of Americans have access to this quality care system. But the cost we pay for health care has skyrocketed. Maybe it won't surprise anyone doctnath who's made a trip to the pharmacy for prescription pills lately - ^ - but America's annual health care costs have risen from $74 billion dollars in 1970 to $800 billion dollars today. And still, more than 30 million Americans have no insurance at all. 4 And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money we need for other vital public programs. // Back in Washington, some of the political pundits say that health care is a Democratic issue. Well, I don't believe that, and I'll tell you why: We've got the compassion -- and the common sense -- to change our system for the better. Health care reform is a key part of my agenda for economic security. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. You see, I think that government is too big and it spends too much. Right now, the cost of health care eats up 13 percent of all the goods and services we produce. The last thing I want to do is put the government in charge of 13 percent more of the American economy. / / And yet that's what some people want: To nationalize our health care system. Put government in control: let government set prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // lugh! Jo where This IRS medbetter in 5 You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB." // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. // And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // But you won't hear about higher taxes from the folks pushing that scheme. Ask them about the side-effects of their plan, and they just say: Take two aspirin -- and call me after the election. // But there's another proposal out there that's every bit as harmful to the economy. Maybe you've heard of it -- it's called "Play or pay, " and here's what it means: Each employer must "play" -- meaning: provide insurance for employees, or they can "pay" -- a payroll tax to finance government health coverage. Well, Play or Pay will leave a lot of small businesses -- businesses that are the heartbeat of this American economy 6 -- with a tough choice: One, cut workers' wages to pay for mandated health care. Two, fire some workers and use the savings to cover the rest. Or three: raise prices, and try to pass along the cost to the consumer. Some reliable studies say a 7 percent payroll tax will cost this country 700,000 jobs. Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. // In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay." It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. And because the new payroll taxes in Play or Pay can't possibly pay for the program - - you, the American taxpayer, will have to pick up the tab. // The fact is: We can reform health care without pushing our economy into intensive care. // We start with these objectives: a health care system built on choice -- not government control. One that keeps costs down -- and opens up access. But above all, a health care system that gives all Americans real security -- security / that if they change jobs, if they or their kids develop serious health problems, they'll still be able to count on the coverage they need. // My plan meets every one of these objectives. We can start making health care more accessible by making health insurance more affordable. For low-income individuals and families, I propose a health insurance credit -- up to $3,750 7 dollars a year to help people buy private health insurance. Middle-income individuals and families -- all the way up to those making $80,000 dollars -- will get a health insurance tax deduction. All told, that's new help to purchase health insurance for 70 million Americans. Take a family of two parents with a child: One working parent -- employed by a company that doesn't provide health coverage. That family's total income is $10,000 -- low enough to put them under the poverty line, but high enough to make them ineligible for Medicaid. / Right now, that family falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would qualify for $3750 health care credit -- payable to the health care insurer of their choice. 11 All together, my plan will bring health care coverage to almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. // And as we open up health care to all Americans, we can cut runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- to pool small businesses that too often can't afford to offer health insurance to their workers, or worry that one worker's illness or accident could drive everyone's health insurance through the roof. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual. Think of it this way: What kind of a deal can you get bargaining 8 with the grocer to buy one box of cereal? Now let's say you got together with everyone on your street, or better yet everyone in your town, and then went back to buy cereal? You'd drive a harder bargain and get a better price. The same thing works for health care. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' bills, higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. [[Last year alone, legal costs inflated our doctors bills by XX billion dollars. ]] Some I know are skeptical -- they think the savings won't add up. But I can tell you, when each year's health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. I won't detail this morning the way the Health Insurance Networks I mentioned will save money by helping cut red tape and paperwork -- the way we'll simplify and speed up claims processing, or bring the growth in government health programs under control. But I will say this: If we made the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // 9 So today I challenge the Congress: Start with my small business reforms -- with the package that will mean affordable, quality health care for millions of Americans who don't have it now, and pass my plan. And I ask all of you here to join me -- tell the Congress it's time to act. // You know, when you're President, you get a lot of advice -- from all over the country, from people of all ages. Here's one example, from a boy named Cory, 11 years old, on what a President should do when you're fighting with Congress, and you just can't get things done. Here's the quote: "Meet at the Capitol at midnight, and check the Constitution to see who's right." // Well, if it gets things done maybe it's worth a try. / I know there are those who say this nation has seen its best day. They don't know the whole world still believes in America's magic. They don't see the whole world thinks America is just another way of saying the future. Now that the entire world is turning our way -- toward free government, free markets, less bureaucracy, less red tape and more competition -- we can't turn back. America will move forward -- mold the future into a new American century. We can lift this country to new heights, to new hope. And we will build the strong, secure America we want to pass on to our kids. // Once again, my thanks for this warm Ohio welcome -- and may God bless the United States of America. # # # H.R.411 S.B. credit enhancement. Signit at event fomorrow? THE WHITE HOUSE WASHINGTON 92 SEP 3 P1:55 Holiday "Health Care" Paul p.4 3rd H our hospitals healthcare HAS SENT BY:Xerox Telecopier 7020 ; 9- 3-92 :12:49PM ; 4562983- 2024566218:# 1 348225SS 92 SEP 3 PI: 20 Document No. WHITE HOUSE STAFFING MEMORANDUM - DATE: 9/2/92 NOON, THURS., SEPT. 3 ACTION/CONCURRENCE/COMMENT DUE BY: PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SUBJECT: SEPTEMBER 5, 1992 ACTION FYI ACTION FYI VICE PRESIDENT MOORE BAKER MULLINS SCOWCROFT PETERSMEYER DARMAN PORTER BRADY PROVOST BROMLEY ROSS CALIO SMITH DEMAREST TUTWILER FITZWATER ZOELLICK GRAY KAUFMAN Extended Page 1.1 BATES HOLIDAY BOSKIN HORNER MCGROARTY MCBRIDE REMARKS: Please provide comments on the attached directly to Dan McGroarty, Rm. 122, x2930, with a copy to this office NO LATER THAN NOON, THURSDAY, SEPTEMBER 3. faxed Thank you. RESPONSE: see comments PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 SENT BY:Xerox Telecopier 7020 ; 9- 3-92 12:50PM ; 4562983-> 2024566218:# 2 McGroarty/Walters September 2, 1992 4:00 p.m. 02 SEP 2 P4: 08 [health] PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic. // I bring greetings today from your Governor and my good friend, George Voinovich. This is the first time he's missed out on Steve and Gretel's cooking since 1966 -- but he's got good reason today. Governor Voinovich is on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but - years ago, when Gretel was 2 years old, the war in Europe separated her from her family. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Extended Page 2.1 Florida and Louisiana in their moment of need. That's the best in the American spirit: plenty of heart, always generous, always ready to help neighbors in need. //]] And after x-thousand Meals Ready to Eat, we may just airlift Gretel's cake to Miami to take care of dessert. 11 [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units XXXX and xxx, on route now to southern Florida. 11 SENT BY:Xerox Telecopier 7020 ; 9- 3-92 :12:50PM ; 4562983- 2024566218:# 3 2 It's great to be here in Painsville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not one sprig of broccoli in sight. 11 This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Managua to Moscow, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home Extended Page 3.1 from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. So today I've set aside the standard Labor Day speech. I want to do something a little different -- I want to take a few minutes to speak to you about a serious matter, something you should be thinking about as you go into that voting booth SENT BY:Xerox Telecopier 7020 ; 9- 3-92 :12:51PM ; 4562983- 2024566218:# 4 3 November 3rd: About the way we can change America's health care system for the better. // Think about the challenges we face as a nation: Anyone concerned about America's competitiveness has to see controlling health care costs as key to a healthy economy. / Think about the concerns we have as parents: Health care -- for ourselves, for our kids -- has to top the list. // Maybe you're worried about what happens to your health care if you change jobs -- or worse still, if you lose your job. Maybe you've got a child with a long-term illness. You're worried that if you leave your job -- even to take a better one . - you'll lose your health care. [[LETTER FROM CLEVELAND GIRL, TIFFANY MCNALLY, ON FAMILY'S HEALTH PROBLEMS 1] // The one thing this crisis is not about is quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Deaths from heart disease are down. Deaths Extended Page 4.1 from stroke -- down. One big reason is the [XX] percent increase one Ju .f inAfederal medical research in everything from Alzheimers to AIDS. And right now, the vast majority of Americans have access to this quality care system. But the cost we pay for health care has skyrocketed. Maybe it won't surprise anyone feder who's made a trip to the pharmacy for prescription pills lately - = but America's annual health care costs have risen from $74 bacheck billion dollars in 1970 to $800 billion dollars today. And still, more than 30 million Americans have no insurance at all. The alla wenveil it' but a In the etud here careo GB V SENI DT.Aerox lelecopier 7020 ; g- 3-92 :12:52PM ; 4562983- 2024566218:# 5 4 And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money we need for other vital public programs. // Back in Washington, some of the political pundits say that health care is a Democratic issue. Well, I don't believe that, always had and I'll tell you why: We've got the compassion -- and the but now we have the opportunity common sense nto change our system for the better. Health care reform is a key part of my agenda for economic security. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. You see, I think that government is too big and it spends too much. Right now, the cost of health care eats up 13 percent of all the goods and services we produce. The last thing I want to do is put the government in charge of 13 percent more of the Extended Page 5.1 American economy. // And yet that's what some people want: To nationalize our health care system. Put government in control: let government set prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. . played I think poly delete. 11 this has SENT BY:Xerox Telecopier 7020 ; 9- 3-92 :12:53PM ; 4562983-> 2024566218:# 6 5 You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB. 11 Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. 11 And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // But you won't hear about higher taxes from the folks pushing that scheme. Ask them about the side-effects of their plan, and Extended Page 6.1 they just say: Take two aspirin -- and call me after the election. 11 But there's another proposal out there that's every bit as harmful to the economy. Maybe you've heard of it -- it's called "Play or pay, " and here's what it means: Each employer must "play" -- meaning: provide insurance for employees, or they can "pay" -- a payroll tax to finance government health coverage. Well, Play or Pay will leave a lot of small businesses -- AS you businesses that are the heartbeat of this American economy Play can is or or Pay. provide is word about a for or money but or as hucks with the for see pay for really Prin how pay doll come SENT BY:Xerox lelecopier 7020 ; 9- 3-92 :12:53PM ; 4562983- 2024566218:# 7 6 -- with a tough choice: One, cut workers' wages to pay for mandated health care. Two, fire some workers and use the savings to cover the rest. Or three: raise prices, and try to pass along the cost to the consumer. Some reliable studies say a 7 percent payroll tax will cost this country 700,000 jobs. Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. // In the end, "Play or pay" is really no different from nationalized health care. I'm tempted to call it "pay and pay." It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. And because the new payroll taxes in Play or Pay can't possibly pay for the program - - you, the American taxpayer, will have to pick up the tab. // The fact is: We can reform health care without pushing our economy into intensive care. // We start with these objectives: a health care system built on choice -- not government control. Extended Page 7.1 One that keeps costs down -- and opens up access. But above all, a health care system that gives all Americans real security -- security / that if they change jobs, if they or their kids develop serious health problems, they'll still be able to count on the coverage they need. 11 My plan meets every one of these objectives. We can start making health care more accessible by making health insurance more affordable. For low-income individuals and families, I propose a health insurance credit -- up to $3,750 SENT BY:Xerox Telecopier 7020 ; 9- 3-92 12:54PM ; 4562983-> 2024566218:# 8 7 dollars a year to help people buy private health insurance. Middle-income individuals and families -- all the way up to those making $80,000 dollars -- will get a health insurance tax deduction. All told, that's new help to purchase health insurance for 70 million Americans. Take a family of two parents with a child: One working parent -- employed by a company that doesn't provide health coverage. That family's total income is $10,000 -- low enough to put them under the poverty line, but high enough to make them ineligible for Medicaid. / Right now, that family falls through the cracks --- can't afford any health care coverage at all. Under my plan, that would change: this family would qualify for $3750 health care credit -- payable to the health care insurer of their choice. // All together, my plan will bring health care coverage to almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. // Extended Page 8.1 And as we open up health care to all Americans, we can cut runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- to pool small businesses that too often can't afford to offer health insurance to their workers, or worry that one worker's illness or accident could drive everyone's health insurance through the roof. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual. Think of it this way: What kind of a deal can you get bargaining SENT BY:Xerox Telecopier 7020 ; 9- 3-92 12:55PM ; 4562983- 2024566218:# 9 or why the pharmacest one bottle 8 of vitamins etc with the groeer to buy one box of cereal? Now let's say you got together with everyone on your street, or better yet everyone in your town, and then went back to buy cereal? You'd drive a harder bargain and get a better price. The same thing works for health care. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawver when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' bills, higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. [[Last year alone, legal costs inflated our doctors bills by XX billion dollars.]] Some I know are skeptical -- they think the savings won't add up. But I can tell you, when each year's health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can Extended Page 9.1 save us billions. I won't detail this morning the way the Health Insurance Networks I mentioned will save money by helping cut red tape and paperwork -- the way we'll simplify and speed up claims processing, or bring the growth in government health programs under control. But I will say this: If we made the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. 11 SENT BY:Xerox Telecopier 7020 ; 9- 3-92 :12:55PM ; 4562983- 2024566218:#10 9 So today I challenge the Congress: Start with my small business reforms -- with the package that will mean affordable, quality health care for millions of Americans who don't have it now, and pass my plan. And I ask all of you here to join me -- tell the Congress it's time to act. 11 You know, when you're President, you get a lot of advice -- from all over the country, from people of all ages. Here's one example, from a boy named Cory, 11 years old, on what a President should do when you're fighting with Congress, and you just can't get things done. Here's the quote: "Meet at the Capitol at midnight, and check the Constitution to see who's right." 11 Well, if it gets things done maybe it's worth a try. / I know there are those who say this nation has seen its best day. They don't know the whole world still believes in America's magic. They don't see the whole world thinks America is just another way of saying ... the future. Now that the entire world is turning our way -- toward free NOW Extended Page 10. 1 government, free markets, less bureaucracy, less red tape and more competition -- we can't turn back. America will move forward -- mold the future into a new American century. We can lift this country to new heights, to new hope. And we will build the strong, secure America we want to pass on to our kids. // Once again, my thanks for this warm Ohio welcome -- and may God bless the United States of America. # # # lov Neunis for clearance. 348225SS AC Document No. DR WHITE HOUSE STAFFING MEMORAN - 9/2/92 3 18.36 NOON, THURS., SEPT. 3 DATE: DUE BY: PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SUBJECT: SEPTEMBER 5, 1992 ACTION FYI ACTION FYI VICE PRESIDENT MOORE BAKER MULLINS SCOWCROFT PETERSMEYER DARMAN PORTER BRADY PROVOST BROMLEY ROSS CALIO SMITH DEMAREST TUTWILER FITZWATER ZOELLICK GRAY KAUFMAN HOLIDAY BATES BOSKIN HORNER MCGROARTY MCBRIDE REMARKS: Please provide comments on the attached directly to Dan McGroarty, Rm. 122, x2930, with a copy to this office NO LATER THAN NOON, THURSDAY, SEPTEMBER 3. Thank you. RESPONSE: PHILLIP D. BRADY Assistant to the President and Staff Secretary Ext. 2702 McGroarty/Walters September 2, 1992 4:00 p.m. 02 CEP 2 P4: 08 [health] PRESIDENTIAL REMARKS: HEALTH CARE PAINSVILLE, OHIO SEPTEMBER 5, 1992 9:30 A.M. [Acknowledgements.] And of course, hats off to our hosts - - Steve and Gretel Bencic. // I bring greetings today from your-Governor and my good friend, George Voinovich. This is the first time he's missed out on Steve and Gretel's cooking since 1966 -- but he's got good reason today. Governor Voinovich is on a trade mission to South Korea -- opening new markets for Ohio goods, and creating new jobs for Ohio workers. // [[You've all seen Gretel's cake, but you may not know the story behind it. I don't want to give away her age, but years - ago, when Gretel was 2 years old, the war in Europe separated her from her family. The Red Cross came to Gretel's rescue -- so today she's returning the favor, to help the people of South Florida and Louisiana in their moment of need. That's the best in the American spirit: plenty of heart, always generous, always ready to help neighbors in need. //]] And after x-thousand Meals Ready to Eat, we may just airlift Gretel's cake to Miami to take care of dessert. !! [[And I want to salute today the contingents of Ohio's finest -- Ohio National Guard units XXXX and xxx, on route now to southern Florida. ]] 2 It's great to be here in Painsville to help open this year's Oktoberfest. You've got the four basic food groups: pancakes and syrup / bratwurst and beer. // And not one sprig of broccoli in sight. // This festival has always been a celebration of cultures -- but this year, in a very special way, it is a celebration of the spirit. We've witnessed a world of change. Across Europe, across continents, from Managua to Moscow, millions of men and women now celebrate a new birth of freedom. For the people here today -- people who came to America from the Old Country -- who prayed for this day to come, the change we've witnessed -- this change we've worked for -- is a miracle come true. There are those -- to quote the poet -- who will say that the liberation of humanity, the freedom of man and mind, is nothing but a dream. And they are right. / It is the American Dream. Today, our challenge is to bring that spirit home -- home from the towns your parents and grandparents were born in, to this new world we call America. To focus this great nation on the new mission at hand. // I know the main attraction this morning is pancakes, not politics. So today I've set aside the standard Labor Day speech. I want to do something a little different -- I want to take a few minutes to speak to you about a serious matter, something you should be thinking about as you go into that voting booth 3 November 3rd: About the way we can change America's health care system for the better. // Think about the challenges we face as a nation: Anyone concerned about America's competitiveness has to see controlling health care costs as key to a healthy economy. / Think about the concerns we have as parents: Health care -- for ourselves, for our kids -- has to top the list. // Maybe you're worried about what happens to your health care if you change jobs -- or worse still, if you lose your job. Maybe you've got a child with a long-term illness. You're worried that if you leave your job -- even to take a better one - - you'll lose your health care. [[LETTER FROM CLEVELAND GIRL, TIFFANY MCNALLY, ON FAMILY'S HEALTH PROBLEMS ]] // The one thing this crisis is not about is quality of care. American health care is first-rate, number one in the world. Since 1980, average life expectancy in America is up -- infant mortality is down. Deaths from heart disease are down. Deaths from stroke -- down. One big reason is the [xx] percent increase in federal medical research in everything from Alzheimers to AIDS. And right now, the vast majority of Americans have access to this quality care system. But the cost we pay for health care has skyrocketed. Maybe it won't surprise anyone who's made a trip to the pharmacy for prescription pills lately - - but America's annual health care costs have risen from $74 billion dollars in 1970 to $800 billion dollars today. And still, more than 30 million Americans have no insurance at all. 4 And don't kid yourselves. We all pay for high health care costs -- more than once. High health costs are a drag on our economy -- drive up the deficit -- and soak up money we need for other vital public programs. // Back in Washington, some of the political pundits say that health care is a Democratic issue. Well, I don't believe that, and I'll tell you why: We've got the compassion -- and the common sense -- to change our system for the better. Health care reform is a key part of my agenda for economic security. // I listen to the American people. You want to know you've got insurance you can count on -- whether you keep your job / lose your job / or change your job. I don't hear you calling for higher taxes to finance a government take-over of our hospitals. You see, I think that government is too big and it spends too much. Right now, the cost of health care eats up 13 percent of all the goods and services we produce. The last thing I want to do is put the government in charge of 13 percent more of the American economy. // And yet that's what some people want: To nationalize our health care system. Put government in control: let government set prices, let government ration the kind of care people get -- how much, what kind, and when they'll get it. / Go the government route, and you know what we'll get: A health care system that combines the efficiency of the House Post Office with the compassion of the KGB. // 5 You know, that comparison made a few people hot under the collar. I even got one letter from Russia telling me: "Quit running down the KGB." // Nationalize health care, and here's what we're in for: Long waiting lists for surgery -- shortages of the high-tech equipment responsible for so many of the miracles of modern medicine. One example: Right now, the Cleveland Clinic performs 10 coronary bypass surgeries a day. High tech, high quality surgery -- without any wait. But if you live across Lake Erie in Canada, the wait for coronary bypass surgery is six months. Need your tonsils out? Take a number: The waiting list in Canada is 3 and 1/2 months. // Do we want that? And then there's the cost. According to some studies, nationalized health care would mean a whopping $250 to $500 billion dollars a year in new taxes. // But you won't hear about higher taxes from the folks pushing that scheme. Ask them about the side-effects of their plan, and they just say: Take two aspirin -- and call me after the election. // But there's another proposal out there that's every bit as harmful to the economy. Maybe you've heard of it -- it's called "Play or pay,' and here's what it means: Each employer must "play" -- meaning: provide insurance for employees, or they can "pay" -- a payroll tax to finance government health coverage. Well, Play or Pay will leave a lot of small businesses -- businesses that are the heartbeat of this American economy 6 -- with a tough choice: One, cut workers' wages to pay for mandated health care. Two, fire some workers and use the savings to cover the rest. or three: raise prices, and try to pass along the cost to the consumer. Some reliable studies say a 7 percent payroll tax will cost this country 700,000 jobs. Higher prices, lower wages, lost jobs: Any way you look at it -- that's the wrong prescription for America. // In the end, "Play or pay" is really no different from anlpay nationalized health care. I'm tempted to call it "pay and pay," again It invites employers to stop offering health benefits, throw the problem in the government's lap, and dump millions of working Americans into a public plan like Medicaid. And because the new payroll taxes in Play or Pay can't possibly pay for the program - - you, the American taxpayer, will have to pick up the tab. // The fact is: We can reform health care without pushing our economy into intensive care. // We start with these objectives: a health care system built on choice -- not government control. and real affordablety. One that keeps costs down -- and opens up access But above all, a health care system that gives all Americans real security -- security / that if they change jobs, if they or their kids develop serious health problems, they'll still be able to count on the coverage they need. // My plan meets every one of these objectives. We can start making health care more accessible by making health insurance more affordable. For low-income individuals and families, I propose a health insurance credit -- up to $3,750 7 dollars a year to help people buy private health insurance. Middle-income individuals and families -- all the way up to those making $80,000 dollars -- will get~a health insurance tax deduction. All told, that's new help to purchase health insurance for 70 million Americans. (check the I it the-fal Take a family of two parents with a child: One working 95 parent -- employed by a company that doesn't provide health coverage. That family's total income is $10,000 -- low enough to put them under the poverty line, but high enough to make them ineligible for Medicaid. / Right now, that family falls through the cracks -- can't afford any health care coverage at all. Under my plan, that would change: this family would qualify for $3750 health care credit -- payable to the health care insurer of their choice. // All together, my plan will bring health care coverage to 34 million almost 30 million uninsured Americans -- security to people who, for far too long, have had to do without. // And as we open up health care to all Americans, we can cut runaway costs -- by making the system more efficient. The key is something we call Health Insurance Networks -- to pool small businesses that too often can't afford to offer health insurance to their workers, or worry that one worker's illness or accident could drive everyone's health insurance through the roof. Insurance costs obey the "law of large numbers:" The larger the group being insured, the lower the cost per individual. Think of it this way: What kind of a deal can you get bargaining 8 with the grocer to buy one box of cereal? Now let's say you got together with everyone on your street, or better yet everyone in your town, and then went back to buy cereal? You'd drive a harder bargain and get a better price. The same thing works for health care. We're also going to cut health care costs by wringing out waste and excess in the present system. That's why we've targeted malpractice insurance for reform. You shouldn't have to pay a lawyer when you go to the doctor. Right now, people are doing just that: High malpractice premiums mean higher doctors' expension, unaccessing tests, bills, / higher hospital costs -- costs passed along not only to the patient, but to every American taxpayer. [[Last year alone, legal costs inflated our doctors bills by XX billion dollars. ]] Some I know are skeptical -- they think the savings won't add up. But I can tell you, when each year's health care costs total more than what we spend on our kids' education and our country's national defense -- combined -- even small changes can save us billions. I won't detail this morning the way the Health Insurance Networks I mentioned will save money by helping cut red tape and paperwork -- the way we'll simplify and speed up claims Through electronic billing, processing L or bring the growth in government health programs under control. But I will say this: If we made the changes I've talked about, my plan would save nearly 400 billion dollars in the next four years. // Save money reduce the escalating cosh of health core, and bring affordable and secure health care to all That's what my compreheneror plan for health care offer. 9 So today I challenge the Congress: Start with my small business reforms -- with the package that will mean affordable, quality health care for millions of Americans who don't have it now, and pass my plan. And I ask all of you here to join me -- tell the Congress it's time to act. // You know, when you're President, you get a lot of advice -- from all over the country, from people of all ages. Here's one example, from a boy named Cory, 11 years old, on what a President should do when you're fighting with Congress, and you just can't get things done. Here's the quote: "Meet at the Capitol at midnight, and check the Constitution to see who's right." // Well, if it gets things done ... maybe it's worth a try. / I know there are those who say this nation has seen its best day. They don't know the whole world still believes in America's magic. They don't see the whole world thinks America is just another way of saying ... the future. Now that the entire world is turning our way -- toward free government, free markets, less bureaucracy, less red tape and more competition -- we can't turn back. America will move forward -- mold the future into a new American century. We can lift this country to new heights, to new hope. And we will build the strong, secure America we want to pass on to our kids. // Once again, my thanks for this warm Ohio welcome -- and may God bless the United States of America. # # #