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PHOTOCOPY
PRESERVATION
UNIVERSAL COVERAGE
-
I
POTUS Remarks
Univers al Coverage-
PHOTOCOPY
PRESERVATION
THE WHITE HOUSE
WASHINGTON
20 July 1994
MEMORANDUM TO THE PRESIDENT
FROM:
Harold Ickes
HV
SUBJECT: Additional talking points regarding health care for
joint leadership meeting on 20 July
Based on the controversy and speculation by the press and
others about some of your comments to the National Governors
Association ("NGA") yesterday regarding mandates and the
percentage of coverage, you may well be asked about your
definition of universal coverage. Based on wire service
accounts, you responded, in part, to a question from Governor Ben
Nelson as follows:
"[A] couple of states that are already at or above
90%, where they can imagine themselves reaching through
various mechanisms 95, 96, 97% coverage."
***
"We are not going to get right at 100%, but we know
that you've got to get somewhere in the ballpark of 95
or upwards so you can stop cost shifting
You subsequently stated to the press pool following your
remarks to the NGA as follows:
"You cannot physically cover 100%. It's impossible.
Nobody can do that. We don't cover 100% of the people
in Social Security and it's universal. Social Security
is universal. I want a universal program, but we can't
physically get to 100%.
Talking Points
-
It is critical that you send the right message today to
reassure the supporters of universal coverage (on the
Hill and elsewhere) that you have not changed your
position on universal coverage.
During the last month or so the press and others have
been pressing for the Administration's definition of
universal coverage. We have consistently said that
universal coverage means a guarantee in the law of
health benefits for every American that can never be
taken away.
NOA
ulc
Memorandum to the President
-
You said nothing yesterday that you haven't said all
along.
-
Universal coverage is our touchstone.
-
Even with a law requiring that every American receive
health benefits, it is virtually impossible that every
American will obtain health benefits. There are always
some who won't come forward or who will otherwise fail
to get coverage.
For example, Social Security is a universal coverage
program but not every older American takes advantage of
it. We were at 97% for many years and only recently
reached 98% coverage under Social Security.
Likewise, every child is required to attend school, but
unfortunately, there is not 100% attendance.
-
You should avoid talking about percentages in
discussing universal coverage for health benefits.
-
But you have said all along that you are flexible on
how to get to universal coverage.
-
And you should emphasize that universal coverage will
be phased in -- it will not be implemented overnight.
-
Triggers: If pressed on a trigger mechanism and what
will happen if the required percentage coverage is met,
thereby precluding "pulling the trigger", you should
emphasize that it shows the voluntary system is working
well and will continue to increase coverage above the
stipulated percentage in the law.
Mandates: You have always said that you find it
difficult to see how to achieve universal coverage
without some mixed mandate system -- shared
responsibility between employers and employees -- but
if somebody has a better idea that will work, you will
certainly consider it.
-
Must work: Any system proposed for universal coverage
must be workable.
-
In addition, based on the evidence to date, proposals
that don't achieve universal coverage with a system of
cost controls don't seem to work. Cite the Catholic
Hospital Study.
2
PAGE
53
FOCUS - 42 OF 54 STORIES
Copyright 1994 Federal Information Systems Corporation
Federal News Service
JULY 23, 1994, FRIDAY
SECTION: IN THE NEWS
LENGTH: 1239 words
HEADLINE: PRESIDENT CLINTON'S SATURDAY RADIO ADDRESS
BODY:
PRESIDENT CLINTON: Good morning. Ever since Franklin Roosevelt, seven
presidents of both parties have worked to reform our nation's health care
system, to provide health coverage to all Americans. That's always been the
goal: to make sure that hard- working middle-class families had the medical and
the economic security they need to build good lives for themselves and their
children.
Now, for the first time in more than a decade, the American people are again
insisting that we reform health care, to contain cost and provide coverage for
everybody. With your votes across the country in the last couple of years,
you've told Washington in clear terms that you want guaranteed health security.
And as your president, that's exactly what I've been fighting for.
It's more urgent today than it has been in years -- not only because America
pays far ore of our income for health care than anybody else, but because we're
going in the wrong direction. Ten years ago, about 88 percent of our people had
health insurance coverage. Today, it's below 83 and dropping. In the just the
last five years, five million Americans have lost their health insurance.
But my clear and unchanged goal is universal coverage that will protect
hard-working Americans. We've already come a long way in this debate. Both
houses of Congress will soon begin their historic floor debates because, for the
first time American history,
committees of Congress have actually voted out bills that will guarantee
coverage to all Americans.
Yet many interest groups are still fighting against it. Already over $100
million has been spent by interests trying to persuade you to back away from
real reform, trying to persuade you that it can't work. Fortunately, I think
most people see through these ad campaigns. Eight in 10 Americans insist they
still want universal coverage. And, fortunately, we've got an example of where
it works.
In the state of Hawaii, where employers and employees share responsibility and
all are required to purchase insurance, there is coverage for all workers and
their families, and small business insurance rates are 30 percent below the
national average. That's right. In a state like Hawaii, where everything else
is more expensive than the rest of the country, health insurance is cheaper,
because everybody does their part and everybody's covered.
Still, at this moment of decision, you're going to be bombarded with a
last-ditch special interest media blizzard aimed at derailing reform and
frightening you. That's why it's so important right now that you keep your
focus on what matters most. How are we going to guarantee health security for
all Americans? And don't let anybody convince you it can't be done. Every
other advanced country has done it, and in our country one state's been doing it
for 20 years now.
One of the things a lot of people will say to you is that we ought to have
PAGE
54
Federal News Service, JULY 23, 1994
FOCUS
some modified half-measures to make things a little better. Unfortunately, a
lot of these half-measures may not work. Let's just take the case for insurance
reforms. Here's why it won't work:
One of the proposed insurance reforms that all of us would agree with is that
people ought to be able to buy insurance, even if someone in their family has
been sick and has a so-called preexisting condition, and if they change jobs,
they ought to be able to carry the insurance with them and not lose it. Here's
why just doing that is not enough:
If you don't require everybody to have insurance, if you don't require
universal coverage, that means low-risk individuals -- younger people, single
people -- aren't necessarily included in these insurance pools, which means that
the pool has relatively more sick people. Higher-risk insurance pools means
that premiums go up for those that are current insured. What happens then?
That means some more healthy individuals drop out because they don't think
they'll get sick and small businesses that are on the margin of profitability,
well, they also often drop out. That means the pool is even smaller, which
means the risk is even higher,
which means that rates get raised again, which means even more younger, healthy
people drop out and more small businesses drop out. It's a vicious cycle.
To make matters even more complicated and tougher, when the uninsured low-risk
people do get sick or have accidents, they still get health care, but it's too
late, too expensive, at the emergency room, and very often they can't afford to
pay for it themselves. So their costs get passed on from medical providers back
through the insurance system back onto the Americans who are still paying
insurance. And the premiums rise again. And again it becomes harder for
working people to afford insurance.
A recent study by the Catholic Health Association demonstrates how all these
forces work together to hurt the middle class. Every year, according to the
Catholic Health Association, these limited reforms would pick $27 billion from
the pockets of working Americans and their families who do pay for insurance --
$800 apiece for families earning between $30,000 and $40,000. Can you imagine
the outcry if Congress tried to impose a direct tax of that kind on working
families? But that's exactly what these non- universal plans will wind up
doing.
Right now, we're hearing from the same kind of critics we hear from every time
this country fights to help middle-class families with efforts like Social
Security and Medicare. They say small business will be hurt by this. They say
it's too bureaucratic, that it's too costly, that Americans will lose their
choice. But the truth is this is not a government plan. It's private insurance
for all Americans. We phase it in on a period of several years. There's less
regulation than when it was originally proposed. Choice is protected. And we
contain cost.
And, remember, most small businesses do insure their employees, and they pay 30
to 40 percent more for it than they would if they were buying in big pools like
government or big business. Only Hawaii has required all small businesses to
participate, and their rates are lower.
These are the kind of objections that we've heard every time we've tried to do
something like Social Security or Medicare. President Johnson heard these
objections during the Medicare debate until the very end of the vote. But 29
years ago next week, he was able to sign legislation creating a system that has
helped hundreds of millions of older Americans and their families.
The American people made it clear then that they wanted reform, and today the
pen President Johnson used to sign that legislation is mounted in a position of
honor in the White House just down the hall from where I'm speaking. And if
PAGE 55
Federal News Service, JULY 23, 1994
FOCUS
you tried to repeal Medicare, members of Congress from both parties would never
let it happen.
Your concerns and your voices have carried us this far in this historic debate.
Now we have to keep our focus for a few more weeks so we can a battle that has
been fought for 60 years. Together, America can join the ranks of other
countries. America can do what we've needed to do a long time: create a health
care system that guarantees health insurance for all Americans. And in doing
that, we can make sure our middle class has a chance to keep growing for another
generation of American children.
Thanks for listening.
LANGUAGE: ENGLISH
LOAD-DATE-MDC: July 23, 1994
PAGE
47
FOCUS - 40 OF 54 STORIES
Copyright 1994 Federal Information Systems Corporation
Federal News Service
JULY 27, 1994, WEDNESDAY
SECTION: WHITE HOUSE BRIEFING
LENGTH: 3146 words
HEADLINE: REMARKS BY PRESIDENT CLINTON
AT A CEREMONY CELEBRATING THE ANNIVERSARY
OF THE AMERICANS WITH DISABILITIES ACT
BODY:
PRESIDENT CLINTON: (Applause.) Thank you. Thank you. Thank you. Thank you
very much. Thank you. Thank you very much.
It is wonderful to see this sea of Americans here at the White House today.
Senator Harkin and I were back there talking and he was beaming because he had
so much to do with the ADA, and I was listening to the first lady and to Tipper
and to the vice president give their fine speeches, and they were all so good I
was wishing I could just sit there and not have to say anything -- (laughter) --
enjoy the day and welcome you here.
I thank especially the members of Congress who are here -- Congressman Hoyer,
Congressman Fish, Congressman Major Owens, and Congressman Goodling --
(applause) -- thank you for being here, sirs.
Two who are not here because they are on the Hill working -- I want to mention
Senator Kennedy and Congressman Jack Brooks, who worked so hard on this --
(cheers, applause) -- former Congressman Tony Coelho (sp), who has done a
magnificent job as chair of the President's Committee on Employment of People
with Disability. I thank all of the people who are here on this stage, and I
want to say something today about the spirit of bipartisanship. I will say more
later, but I would remind you that it would be wrong for the day to go by
without pointing out that this bill was signed into law by my Republican
predecessor, President Bush, and I thank him for doing that. (Applause.)
I'd also like to introduce three young people from Gallaudet University who are
here who are part of one of our administration's most important initiatives and
an illustration of why we have to keep working to open the doors of opportunity
to all Americans. They are Jennifer Nasukowitz (ph), Amy Hopkins, and Madeleine
Fredrickson (sp). I've asked them to stand. Stand up there. (Applause.)
They are completing their training to be participants in the first class of our
national service program, Americorps. (Cheers, applause.) Beginning this
September, they will be part of 20,000 young Americans who will be working to
help to reclaim our sense of national community. They'll be working to help
reclaim the natural beauty of the Chesapeake Bay, and together they'll be
working to revolutionize our sense of what we can do together, and in return
they'll get a little bit of help to continue their education.
You know, as the vice president said, when we went across this country and
sought the opportunity to serve here, our slogan was "Putting People First."
What that meant to me was pretty simple. As we hurtle toward the next century,
as we come to the end of the Cold War, we owe it to our people to do some basic
things. First of all, to try to create a world of greater peace and prosperity.
That's what we've been about here the last two days with the king of Jordan and
the prime minister of Israel. (Applause.) Second, to restore the American
PAGE
48
Federal News Service, JULY 27, 1994
FOCUS
economy. Third, to rebuild our American community with stronger communities,
stronger families. Fourth, to empower all Americans to live to the fullest of
their God-given abilities and to expect them to assume the responsibility to do
so. (Applause.)
We are at a moment in history when our values, what we believe is morally right,
and our interests, what is clearly good for us in a tangible, material way, are
one. We do not have a person to waste, and that is why -- (applause) -- that is
why we are here today to rededicate ourselves to an America where every man,
woman and child can reach the fullest of their God-given potential.
Like every civil rights law in our history, the Americans with Disabilities Act
is just that; it's about potential. It is not a handout. It stands for what's
best in our heritage -- empowering Americans to build better lives for
themselves.
In that tradition, I pledge as your president to see that this act is fully
implemented and aggressively enforced in our schools, our workplaces, in
government and in public places, for the benefit of all persons with
disabilities -- the blind and visually impaired, the deaf and hard of hearing,
persons with mental retardation, persons with mental illness, persons who are
mobility impaired, all people who have problems that can be overcome. That's
what this act is about. (Applause.)
MORE
AMERICANS WITH DIS./CLINTON ET AL PAGE 4 07/27/94
We must move from exclusion to inclusion, from dependence to independence, from
paternalism to empowerment. (Applause.) Your future and the future of those
whom you represent is at the heart of my vision for America in every aspect.
Consider this. If our goals here at home are to restore our economy, to rebuild
our American communities and to empower individuals, how can we achieve them
unless you are part of all of them?
Look at the progress which has been made and look at where we have to go. In
the last 18 months, we have passed a bill cutting the deficit by record amounts,
reducing the federal government to its smallest point since John Kennedy was
president, having three years of deficit reduction for the first time since
Harry Truman was president, and it's produced 3.8 million jobs and a 1.5 percent
drop in the unemployment rate; but we've got a long way to go. (Applause.)
We've got a long way to go because millions of Americans with disabilities could
be working and contributing if this society opened it to them. (Cheers,
applause.)
We are working up here to strengthen our American community. Congressman Brooks
today is back in the Congress working on the crime bill, which will put more
police officers on our street and ban assault weapons and toughen sentences but
also give our children something to say yes to. There are billions of dollars
there to invest in programs to get kids out of trouble before they are too far
gone. It will rebuild our American community. But how can we be a community if
millions of you are isolated from our common life and our common purposes? We
can never be an American community. (Applause.)
The secretary of education is working to implement the most important
empowerment agenda of all, along with the Department of Health and Human
Services and others. We are trying to implement a lifetime education system,
starting with Head Start for all children who need it and going through lifetime
learning for people when they change jobs in the workplace. But how can this
work; unless you are part of the empowerment agenda of America, we will never be
fully empowered. (Cheers, applause.)
So I say to you, if our job is to put people first, to rebuild the economy, to
strengthen our communities, to empower our people, we cannot do that job
PAGE
49
Federal News Service, JULY 27, 1994
FOCUS
unless you walk every step or ride every step or get there however you can.
We need you. And without you, we cannot do it. (Applause.)
In this global economy, as the secretary of labor never tires of telling me, the
only thing we have that people can never take away from us, is the mind and the
heart and the spirit of our people. (Applause.) That's good news. It means the
mind of our people and the spirit of our people can be used sometimes without
lifting large weights, or doing great physical labor. It means we can open the
possibility of employment to more people. But it also means, if we really want
to win for all Americans, we must believe and act on the premise that we do not
have a person to waste.
(Applause.)
When I was first elected governor -- it seems like 100 years ago now -- but 1
back in the late 70's before the Americans with Disabilities Act came along, of
the 50 or so people that worked in my office, three were blind. I got to the
point where I didn't notice because they were just great employees. It struck
me as crazy for them not to be part of a workforce they could contribute to.
Today I have had the honor of appointing 44 outstanding people with disabilities
to important jobs in our government, including Judy Heumann, who's here with me
today, the assistant secretary for the office of special education. (Applause.)
She had to fight for her first job as a teacher. She's fought for disability
rights for her entire life. Now she's fighting for the future of every child in
America.
I say that to make this a point. We have not appointed a single solitary person
because of their disability. They have all been appointed because of their
ability to serve the American People. (Applause.)
Why is this health care issue so important to this agenda?
There are many reasons. We are the only country in the world that's going
backwards in health care coverage with an advanced economy. A few years ago, 88
percent of our people were covered; now we're down to 83 percent. In the last
five years alone over 5 million Americans have lost their health insurance
coverage. That is very troubling. We're spending too much money to get too
little, throwing billions of dollars away on paperwork and bureaucracy every
year so that we don't have the money we need.
Look at this cabinet behind me -- to fight drugs, to take care of veterans'
health care needs, to build a transportation network for the 21st century, to
spend on education and training programs, to spend on the needs of the poor, and
to fight crime -- that's just the cabinet members behind me. Why? Because we
are holding all spending flat while health care spending explodes -- not for new
health care, more money for the same health care.
But most of all, it is a human problem. The other day in Western Pennsylvania,
I was introduce by two women: one a mother of five children who had become ill,
and she and her husband lost their health insurance, and all their children; the
other, a 62-year-old woman who had been a dairy farmer all of her life --
seven-day-a-week work, no slacking in that business, and she finally had lost
her health insurance at the time in her life when she needed it most. And if
you look out at this sea of people and all those whom you represent, the fact
that the health insurance system of American discriminates against millions of
people because of their disabilities or because they have had serious illnesses
or because they are too old, when they switch jobs or when their employer gets
in trouble, and the fact that it is wildly discriminatory against small
business, which is creating most of the new jobs in this country, but paying 30
or 40 percent for health insurance than those of us in government or working
PAGE
50
Federal News Service, JULY 27, 1994
FOCUS
for big businesses do -- all these things are keeping us from putting every
person's talents to use, and especially -- especially the disabled Americans who
could be in the workforce if their employers could afford to provide them health
insurance. (Cheers, applause.)
The people who fought for the Americans for Disabilities Act understood that.
They originally had health care reform in the act, and it had to be dropped
because they knew that this bill would be delayed for years if it had to deal
with the difficult, and complicated, and politically explosive issue of health
care reform.
But I tell you, my fellow Americans, now is the time to act and to go forward
and to finish the work that was done in the beginning six years ago. (Cheers,
applause.)
AUDIENCE: Now Now! Now Now!
PRESIDENT CLINTON: Now is the time.
There are those who say, well, we can just reform the insurance laws and say
everybody is entitled to insurance and everybody is entitled to take it from job
to job, and subsidize the poor more. Let me tell you, if we do that, we will
cut Medicare for the elderly, we'll do a little more for the poor in the short
run, we'll do nothing to help people be part of the working middle class because
what will happen is insurance premiums will go up, coverage will go down, small
businesses on the margin will stop covering, and people who wish to be part of
the working middle class will have fewer, not more opportunities over the long
run to work and live to the fullest of their capacities. We do not want to
create a system where the only way you can have health care is if you are poor
and go on welfare, if you go to jail, if you go to work for a big employer, or
the government, or you are wealthy. We want a system that covers everybody so
you can be what you want to be.
Let me tell you that for over a year -- and in my case, as a citizen of this
]
country and when I was a governor for now more than four years -- we have
pursued every avenue, we have examined all evidence, we have solicited every
suggestion for how to provide this kind of opportunity and security for all
Americans. I have seen no one yet who has come up with a better idea than
shared responsibility between employers and employees for private health
insurance in our private health care system. It already works for most families,
that's the way most families are covered, and in the state of Hawaii, it works
for all families. In Hawaii, for 20 years there has been a requirement for
shared responsibility for private insurance between employers and employees.
And whenever I bring this up, people say, well, yes, Mr. President, but in
Hawaii, everybody goes there because they want a vacation. It's sunny and
people are healthier there. Everything is more expensive there so what
difference does it make if health insurance is more expensive? Everything costs
more.
Look at the facts: first of all, 20 percent of the people in the health system
in Hawaii are poor, native islanders. Secondly, health insurance is the only
thing in Hawaii that is not more expensive than any place else in America. It's
30 percent cheaper for small businesses than the average cost of health
insurance in America because everybody pays and no one avoids their
responsibility. (Applause.) And the people are healthier because they have
primary and preventive care, like the first lady was talking about. (Cheers,
applause.)
As has been pointed out, somewhat embarrassingly, to them, there are many
American companies now in the forefront of the fight against universal
1
PAGE
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Federal News Service, JULY 27, 1994
FOCUS
coverage who provide coverage to all their employees when they open businesses
in other countries and they do just fine. And they can do just fine here, too.
What is different about this moment in history? Well, I'll tell you what's
different. For the first time ever, you have the American Medical Association
FROM THE AUDIENCE: We're here! (Cheers, applause.)
PRESIDENT CLINTON: Thank you. Somebody was whispering, "What's different at
this moment in history is the president's crazy enough to take on this fight."
(Laughter.)
No; what is different? This time the American Medical Association, the American
Association of Family Practice, the pediatricians, the American Nurses
Association, the medical schools of the United States, the American Association
of Retired People, the AFL-CIO, and an association literally, literally of
hundreds of thousands of small businesses and many of the biggest businesses in
the country, as well as a majority of the American people all have agreed that
the best way to do this is to have employers and employees share the
responsibility for buying private insurance.
Now, how are we going to do it? Let me say that I desperately want a bipartisan
bill. I have reached out to members of the other party. This bill passed with
a bipartisan majority. At one point, two dozen Republican senators supported
Senator Chafee's bill for universal coverage, but every time I have reached out,
they have moved further away. I feel like I keep reaching out I wish we were
in a car and they would eventually run up against the door and have to come back
to my way, because I keep reaching out.
Let me say that 22 years ago, 22 years ago a Republican president, Richard
Nixon, and the incumbent one of the incumbent Republican senators from
Oregon, Robert Packwood, offered a bill to require employers and employees to
share the responsibility for private health insurance. If it was a good idea 20
years ago, it is a better idea today when things have gotten more difficult in
terms of cost and coverage, and we ought to do it. (Applause.)
Now, let me say you heard the vice president with that quote from the Republican
consultant saying let's send them home empty-handed.
We've done that a lot, you know. We've done that a lot. It took five years to
pass the ADA. When I showed up in town here it had taken seven years until we
could finally pass the Brady Bill last year. (Applause.) Seven years. Seven
years. Seven years until we could finally pass the Family and Medical Leave
Law, last year. (Applause.) Very important to you. Seven years until we could
finally get the worldwide trade agreement that will add a half a million jobs in
America between now and the end of the decade.
A lot of times, if you want bipartisan consensus on a tough issue, it takes
forever, but I tell you, we dare not wait longer. For 60 years, presidents of
both parties have known we should cover all Americans. We now see health care
costs going up and the only government spending going up is in health care while
we are desperately trying to bring this deficit down and invest in our future.
And we know that in only five years, 5 million Americans have lost their
coverage. We are at an historic moment. For the first time ever, there are
bills on the floor of both Houses of the Congress that will give Americans
health care. We must say we don't care about politics. There are Democrats and
Republicans and Independents in this audience. There are people here today who
voted for all three people who ran for president last time. I do not give a rip
what your politics are, but I do want you to have health care so you can
contribute to America's future. (Applause, cheers.)
(Chants of "Health care now.")
That's right. Let me say this. Let me say this. I love these chants, but
PAGE 52
Federal News Service, JULY 27, 1994
FOCUS
this is what often happens in our society, we're all here preaching to the
saved. And I ask you. I ask you to go to Congress with a simple message, and
to go back home to your community with a simple message. Let us discard
politics, let us put people first, and let our focus be simply this: What will
work? I have no pride of authorship, nothing would please me more than if
somebody else's name, a hundred names, four hundred names, five hundred names in
both Houses of Congress would be on a health care bill -- but we dare not do
something which holds out false hope. Let's do what works. Let's complete the
work of the Americans with Disabilities Act. Let's say to the whole world, this
is one country that knows we don't have a person to waste, and we're going into
the next century with all of our people, arm in arm.
God bless you. Thank you very much. (Applause, Cheers.)
END
LANGUAGE: ENGLISH
LOAD-DATE-MDC: July 27, 1994
PAGE
40
FOCUS - 39 OF 54 STORIES
Copyright 1994 Federal Information Systems Corporation
Federal News Service
JULY 29, 1994, FRIDAY
SECTION: WHITE HOUSE BRIEFING
LENGTH: 3789 words
HEADLINE: PRESIDENT CLINTON ADDRESSES UNITY '94 MINORITY JOURNALISTS CONFERENCE
BODY:
PRESIDENT CLINTON: Thank you, Connie. I want to add my congratulations to Nancy
Maynard and to say hello to my friend Wilma Mankiller and to all of you in
Atlanta at the Unity '94 convention.
I want to say a special word of congratulations, too, to the four minority
journalists associations meeting together for the first time at this
ground-breaking occasion. I must say that all of us have heard a lot about your
meeting and are following it with great interest.
We're living in an extraordinary time, when people in America and all across the
world are searching for common ground, for new solutions in a time of change.
This has been a great week for America. The king of Jordan and the prime
minister of Israel have shared a stage on the White House lawn, opened a new era
of dialogue and cooperation between their people. At the same time, halfway
around the world the president of Russia made an announcement that by the end of
August, for the first time since the end of World War II, all Russian troops
would be gone from Germany and Central and Eastern Europe -- a significant goal
of our policy with Russia over the last year and a half. Over and over, we have
learned from experiences like these that people can transcend great historical,
political and cultural obstacles in the name of progress for humanity. And
we've also learned that here at home the American people are our greatest asset
as we try to meet the challenges of the coming century. All of us can take
pride that we've helped Arabs and Israelis and other former enemies to bridge
their own differences. But their examples must also inspire us to strengthen
our own sense of community and to celebrate the rich diversity of the American
culture.
The job of your associations is to see that more Americans of diverse
backgrounds, races and ethnic heritage have an equal chance in journalism. It's
also to make sure that the nation sees the faces and hears the voices of
non-white Americans whose ideas and achievements too often are ignored. And my
job here in Washington is to ensure that every citizen has an equal chance at
the American dream. I've said it many times and I firmly believe that we don't
have a single person to waste, that every person, no matter what his or her
background, has an idea, a vision, an opinion, to share that can enrich our
nation.
That's why I've been fighting to create new opportunities for people who work
hard, take responsibility, try to make something of their lives. I believe
everybody has something to give, and we have to make it possible for everyone to
give his or her best.
One of my proudest accomplishments as president is the people I've appointed
I've appointed to serve in this administration. If you look at the top
positions in the White House and Cabinet today, you will see the most able,
talented group ever assembled. These appointees also happen to make up the most
diverse administration in the history of our republic. If you look at our
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nominations to the federal bench, you will see that a higher percentage of them
have been rated well-qualified by the American Bar Association than in any
previous administration since these rankings began to be made.
Well, a majority of those appointees are also people of color and women -- not a
minority, but a majority -- for the first time ever. None of these people were
chosen because they were African American or Hispanic or Asian American or
American Indian or because they were women. They were selected because they
were the best qualified for the job. And they are proof that the American dream
is still alive and within reach of those who choose to pursue it. Still, we
can't ignore the burdens and barriers that prevent too many of our people from
moving forward in their lives still today. It is our job to renew the American
dream.
I sought the presidency because I was worried that our country was going in the
wrong direction. The deficit was going up. The economy was on the decline.
Washington was placing heavier and heavier burdens on the backs of middle-class
Americans, and we were coming apart when we ought to be coming together. I
believed then and I believe now that our job in this time is to restore the
economy, rebuild our sense of community, empower individuals to take
responsibility for their own lives, and put government on the side of ordinary
Americans.
In just 18 months, we've begun to renew that American dream. Our economic
strategy will produce the smallest federal bureaucracy in 30 years, and three
years in a row of deficit reduction for the first time since Harry Truman was
president, while providing tax cuts for 15 million working American families and
millions of small businesses.
What's been the result of this economic strategy? Well, the economy has created
3.8 million new jobs. Inflation is the lowest in two decades. Just today we've
seen more evidence that this strategy is working. Today's report shows that the
gross domestic product of the United States grew at a very impressive rate of.
3.7 percent in the last quarter, while inflation remained low. And more
important, we're reaching out with greater energy and compassion to responsible
working families who too often have to struggle to make ends meet.
Already, in just a year and a half, through the increase in the earned income
tax credit, 15 million working parents have been able to get lower income taxes
to encourage them to stay in the work force and to be good parents without
having to go on welfare. We've made it easier for millions and millions of
young people to get college loans by making those loans available with lower
interest rates and more flexible repayment schedules. We've established more
job training and school-to-work apprenticeships to help young people who aren't
going to college find and keep good jobs. We've sought tax incentives and grant
money to stimulate economies in needy areas through things like our empowerment
zones and enterprise communities and new community development banks, reform of
the Community Reinvestment Act, and by making low-income housing credits
permanent.
Some of these achievements, to be sure, have come easier than others, but I knew
when I asked for this job that progress would not always be easy and that we'd
have to fight for the kind of change that we need. Very often it takes years to
get things done -- the Brady bill, seven years; the Family Leave law, seven
years; years for Motor Voter -- but these things are worth it because these
things together and the efforts we are making have brought us to a pivotal,
exciting moment in our history.
So we have not fixed the problem. I think we've taken a small step forward and
we'll continue working 24 hours a day trying to increase that and, if it makes
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sense, to try to go open that airfield in Kigali as well.
There are a lot of other places that we are, as well, where we have mid-air
refueling aircraft so we do not have to bring airplanes in to land, waste an
hour refueling and then go on. So refuel much of the military air in the air to
speed up the effort.
Additionally, we've had an awful lot of good, need equipment onboard Army
prepositioned ships. They usually are in and around Diego Garcia. On the day
that the president gave us the mission, we ordered those ships to steam towards
Mombasa because we have enough water purification equipment there, we have
enough distribution capacity -- water distribution capacity there to meet all
our needs. And so the first ships -- first two ships are going to land tomorrow
in -- dock tomorrow in Mombasa. We have already forward-deployed C- 130
airplanes, CH-53 helicopters that can sling-load much of their equipment.
And we're going to form -- if we're certain that the security conditions are
right -- a very large ground convoy that will take the large oversized equipment
overland into Goma. So starting about tomorrow and the next few days, we will
have at our disposal an awful lot of the badly needed stuff for water
purification, in addition to additional trucks that are needed over there,
bulldozers and what-not. So that's another hop that we have established here.
And we'll continue keeping it open because that's a good place to bring other
humanitarian supplies in and then shuttle them forward.
If you just think about what's happened this week alone, it's been remarkable
for our nation -- on the verge of an historic victory in the toughest, largest,
smartest federal attack on crime in the history of the United States, not only
making peace in the Middle East, but trying to bring more peace to the families
and children of America. Just think for a minute about what this crime bill
means for all of us as citizens, for us as mothers and fathers, husbands and
wives and children.
Look at the cost of crime to our economy, look at the cost of crime to our sense
of community, to the idea that we are an American family, to our sense of
personal freedom, the cost of crime to our efforts to empower every individual,
including too many young people who are growing up in terribly difficult
circumstances. Crime is holding too many of us back from reaching the American
dream, splintering families, making people afraid of their neighbors,
interfering with our children's education, robbing us of our literal sense of
personal freedom. No matter what other goals we seek for ourselves and our
families and our children, and for our country, we simply have to be able to
live together with a shared respect for law and order and civility.
The most important thing about this crime bill is that it creates a whole new
way of thinking about how to deal with crime, one that doesn't pit one group of
Americans against another, it doesn't ask us to make a false choice between
tough punishment and strong prevention, it calls for a sensible balance between
the two, it doesn't ask us to make a false choice between going after criminals
and going after guns. It recognizes that those sorts of debates divided us for
too long while more and more children were dying on our streets.
The crime bill strengthens the police, our system of punishment, and our means
of prevention. It will put 100,000 more police on our streets, a 20 percent
increase in the number of police officers patrolling our neighborhoods. More
police trained and properly deployed means lower crime and prevention.
The bill includes a ban on assault-style weapons, something few people ever
dreamed would be accomplished. It includes a ban on ownership of handguns by
minors, it will send a strong message to criminals that behavior that is
criminal and repeated will not be tolerated and that punishment will be tough
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and swift, and it will invest $9 billion in crime prevention over the next six
years, something that law enforcement officers in every state and city asked us
to do, so that we could give young people more safe places to go, more positive
role models, more opporunities to fulfill themselves in healthy, constructive
ways. And we have a program to make our schools safer so that our children can
learn again in the absence of fear.
For six years, this crime bill was debated over and over again. Why is it about
to succeed? Because after intense argument and disagreement, as majority of
people were able to find common ground, they were able to put people over
politics. Now I want Congress to put this bill on my desk within two weeks so
that I can sign it before our children go back to school.
Now if you think six years was long enough to wait for a crime bill, and surely
we could all agree that 60 years is far too long to wait while -- before
Americans -- all Americans are guaranteed health security that can never be
taken away. And health security, after all, is another crucial piece of the
American dream.
Many people across our country know what it's like to dig and scrape all their
lives to have the opportunities that you've been given and that you've earned.
If you are like me, you actually know somebody without health insurance or
somebody at risk of losing their health insurance. You know somebody whose
coverage is so meager they avoid the doctor because it costs too much. You know
people who are eager to work but are trapped in the welfare system because it
the only way they can be assured of health care coverage for their children. We
know these people because there are millions and millions of them out there,
people who struggle all their lives and play by the rules so that they can move
forward, make progress, build security for their families, only to be knocked
off the ladder because of the pink slip, the catastrophic illness, or a simple
change in jobs.
Indeed, we're moving in the wrong direction in our health care system. We're
moving in the wrong direction when $5 million hardworking people, people with
jobs, have lost their insurance in the last five years. Indeed, there's a
smaller percentage of Americans insured today than there were ten years ago.
Ever since I began pushing for reform, I've made it clear that I was open to
suggestions about how to achieve it. I've listened to concerns about the
approach we originally proposed, and in response to what all kinds of Americans
told us, I've agreed that we should modify that approach to make it simpler,
less bureaucratic, more flexible, to do more for small business. But I remain
committed, and I hope all of you will be committed, to giving every American
health security, health that is guaranteed in law.
We must have a system, I believe, where everyone shares responsibility, a
private system that works. That is certainly what the vast majority of
Americans want because today the hardworking, middle-class Americans have that
kind of coverage. Today we've moved a step closer to health care security. The
House speaker, Tom Foley, and the majority leader, Dick Gephardt, said they
would put forward a bill that achieves universal coverage and controls cost.
They've met their goal and the goal of the American people in doing that.
The House bill tells the American people that they have been heard.
It is simpler, more flexible, more sensitive to small business. Gone is the
bureaucracy they didn't like. Protections for small businesses have been
strengthened. The bill is being phased in over a longer period of time. All
Americans can keep their health plan and their doctor, and everybody will have
coverage.
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We know from experiences across the country that this will work. We also know
what doesn't work. We have seen in state after state that if you have insurance
reforms that sound very good without expanding to universal coverage, what is
usually going to happen is that the cost of insurance goes up and then people's
options for health care or even the number of people with health insurance go
down. But we also know from looking at the example of Hawaii that a private
system of universal coverage, in which employers and employees share
responsibility for paying for private insurance premiums, will not only control
costs but will also lead to greater coverage and a healthier population.
We know it can be done. After all, in Hawaii nearly everything is more
expensive than anyplace else in the United States, but health care premiums for
small business are 30 percent cheaper.
Now, after 60 years of waiting, after 14 years in which costs have been going up
dramatically, after a decade in which more and more Americans are losing
coverage instead of getting coverage, and most of those who lose their insurance
are working people, it's time to say to every American, if you change jobs, if
you get sick, if you're laid off, if your child has a serious illness, you will
always be able to afford health care as a citizen of the richest nation on
Earth.
Tomorrow I'm going to Independence, Missouri, to Harry Truman's hometown, to
talk about health care. Harry Truman was a man of great decency and common
sense and courage who believed that America that would be much stronger if every
American had health security. He was right. And he fought hard for it, though
he didn't succeed. And because he was right, president after president,
presidents of both parties, have fought for that goal.
Well, now it's up to us to fulfill their vision and once again to renew the
American dream. It's time to build on our economic progress, build on the
success of the crime bill, build on the progress we're making toward world
peace, and take this next critical step by passing real, substantive health care
reform. That is the challenge our generation faces today, and it is our great
opportunity. Thank you very much.
Q (Inaudible.)
PRESIDENT CLINTON: Undocumented workers would not receive under our plan a
health security card unless they had jobs anyway so they got it because they
were in the workplace. But under our plan we have a significant expansion in
funds for public health units, which are open to all people today and where a
lot of the vaccinations, for example, are done today. In my state, over 80
percent of our children, including even upper middle-class children, are
vaccinated through the public health units. So what we attempted to do to deal
with this clear and present problem in the United States is to have a
substantial increase in funding for public health and to do outreach so that we
can vaccinate all the children and give basic health services to the children
who are within the United States.
Q (Inaudible.)
PRESIDENT CLINTON: Well, first let me say that I don't agree with the
characterization there. If you look at the work that the Civil Rights Division
of the Justice Department has done, it's been more active than any civil rights
division in a generation, under the leadership of Deval Patrick. Look at the
Dennys settlement. Look at a lot of the other issues in which they have been
involved.
If you look at the work that Henry Cisneros did in highlighting and directly
confronting the problems in Vidor, Texas, in public housing; if you look at the
work that we have done in trying to involve at the grassroots level community
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groups of minorities in things like developing the empowerment zone concepts,
the community development banks, I think it is plain that this is an
administration that is committed to stamping out racism -- both in a negative
sense by standing up to it and in a positive sense by working to bring people
together to overcome it. If you can think of anything else I can and should do,
I would be glad to have your recommendations and your suggestions.
But the idea of stamping out racism, in my view, permeates everything I do --
when I try to give kids a better life, a safer street, a better future, and I
keep telling the American people we don't have anyone to waste, we've got to
have everybody in here together.
You know, one of the earlier questions referred to how the administration or
what my opinion was about the way things were covered given the makeup of the
press. I have been repeatedly criticized by various sources in this town for
trying to be more diverse and trying to reach out and to achieve greater
diversity, although no one has ever said that we couldn't have excellence and
diversity at the same time. So I am trying to build the fight against racism
into everything we do, both in a positive and negative sense.
But I will say again, if anybody there -- not just you, Dorothy, but anybody --
has any other suggestions about what I can do, I would be happy to hear them,
and I will do my best to respond.
Q (Inaudible.)
PRESIDENT CLINTON: (Inaudible) -- that we have to achieve universal coverage.
The fight now is over how best to do it. And what I have to tell you is that
there is a big argument about whether it can be achieved in any way other than
the way I have proposed. I will not sign a bill that I think makes a false
promise to the people of the United States. We have got to sign a bill that
achieves full coverage for the American people. If you don't do it, you can't
contain costs. You can't give the breaks that small business needs over the
long run. You can't achieve these things.
So, yes, if Congress passes a bill that is different from the one I originally
proposed, would I veto it? It depends on whether it achieves full coverage. If
it is a credible attempt to do that, then I'm open to it; but it must be a
credible, credible bill to do that.
And that's the only thing I ask all of you to focus on now. Instead of letting
the political rhetoric control this debate on health care, let us ask simply
what will work. The other day -- let me just give you this in closing because
this is very important, and if I don't achieve anything else today in this
conversation that I've had with you, which I've enjoyed immensely, if I can
achieve this, agreement with you on this, it would be something profound to me.
This is a very complicated issue, health care. I have studied it for years and
years. But the more complex it gets, the more you understand that in the end it
comes down to some simple choices.
In every nation that has covered everybody, quality health care can be provided
at lower cost than in the United States, the only nation that doesn't cover
everybody. So what I ask us all to do, as others come forward with their ideas
and bend over backwards to avoid what I think we should do, which is to require
all employers and employees to take responsibility through private insurance,
let us ask: Will it work? We are going in the wrong direction. We are losing
coverage and exploding costs. I am not going to sign a bill that I think
perpetrates these problems on the American people.
If someone else can figure out how to get universal coverage in a different way
than I have achieved it, I would be open to that. I have not seen it yet.
That's why the American Medical Association, the National Medical Association,
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FOCUS
the American Nurses Association, other physicians groups, and huge numbers of
businesses and consumer groups have endorsed our approach. So that's what we
ought to be doing. We shouldn't be trying to get ourselves into word games now
about what mechanism is appropriate. The only test is what works. And I know my
plan will work if we share responsibility and cover everybody.
Thank you very much.
Q (Inaudible.)
PRESIDENT CLINTON: And tell him I said hello, and thank you.
Q (Inaudible.)
PRESIDENT CLINTON: (Inaudible) -- and thank you, ladies and gentleman.
Congratulations on your meeting.
END
LANGUAGE: ENGLISH
LOAD-DATE-MDC: July 29, 1994
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Copyright 1994 Federal Information Systems Corporation
Federal News Service
AUGUST 3, 1994, WEDNESDAY
SECTION: WHITE HOUSE BRIEFING
LENGTH: 1553 words
HEADLINE: REMARKS BY PRESIDENT CLINTON
AT THE HEALTH SECURITY EXPRESS "REFORM RIDERS"
WELCOME AT THE WHITE HOUSE
BODY:
PRESIDENT CLINTON: My fellow Americans, Congress has to decide whether it's
going to listen to the insurance companies or to Jan Cox's last wish.
(Applause.)
We all know what the problem is here. You've just ridden a bus across the
country, seeing real people who are just working hard, making the best they can
of their lives, wanting a decent break. Those of you who have had these kinds of
personal experiences that Daniel and Carolyn and John talked about can't figure
out why we spend more than anybody else on health care, cover fewer people than
any other country, and get poor health results. It is because organized,
intense, discreet, minority interests are doing very well on a system that costs
more than any other country's and covers fewer people. And every time you try
to change it, they say, well, the world will come to an end. Well, like Hillary
said, we ran for this job, along with the vice president and Mrs. Gore, because
maybe we could be the home office of the American Association of Ordinary
Citizens, and that's what we wanted to do. (Cheers, applause.)
And every time we try to make a change, that's what they said. When we showed up
here, the deficit was going up and the economy was going down. And I put
together a plan, and I urged the people in the -- on the other side to work with
me, and they said, no, if we go for this, the sky will fall, the economy will
collapse, and so we'll all vote against it and call it a big tax increase. But
the truth is the plan cut spending, raised taxes on the richest 1-1/2 percent of
Americans, gave 15 million working people a tax cut, thanks to the secretary of
education, gave 20 million American an opportunity to refinance their college
loans at a lower interest rate, and lo and behold, it produced a drop in
unemployment and 3.8 new jobs, and the sky didn't fall. Now the deficit is
going down and the economy is coming up, but it's hard to overcome these
organized, intense interests.
We had a different sort of a fight over the big trade battle last year over
NAFTA. They said if you do this the economy will collapse, but lo and behold,
the Congress, this time with a bipartisan effort, passed NAFTA, and we're
exporting five times as many cars to Mexico as we were last year. They are our
biggest, most growing market.
Change is hard up here because even though most members of Congress were once
just like you, when they get up here they are a long way from home, and they
know that you and the president are presented to the folks back home partly
through the rhetoric and the money spent by organized, intense minority
interests. And somehow, some way this fight has got to be about Daniel Lumly
(sp) and Carolyn Moseley (sp) and John and Jan Cox. That's what it's got to be
about. (Applause.)
It's got to be about my friend, Justin Dark (sp), sitting back there, and all
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the Americans with disabilities who could be in the work force making money,
paying taxes, contributing to our future if they could just get health insurance
while they're in the work force -- (cheers, applause); all the nurses who hired
on to help people get well and instead spend all their time calling insurance
companies to try to figure out if this or that procedure can be done by the
doctor in the first place.
Goodness only knows how many folks we employ in this country that would be
working more productively in any other country. We have to put hundreds of
thousands of people to work every day to figure out who is not covered or what's
not covered in an insurance policy. Not anybody else in the world is spending
their time and spinning their wheels putting people to work, asking them to
spend their entire working life reading the fine print of insurance policies to
see what is not covered. Can you imagine a more unsatisfying thing to do with
your life? (Applause.)
Lee Brown, the -- our drug policy leader do you know why he's here today?
Because if we could pass health insurance for all Americans, it would include
drug treatment for all Americans. (Applause.) Now he's a policeman. He spent
all of his life trying to lower crime and fight criminals, be tough on law and
order, but he learned as a police officer that a lot of people are in trouble
with drug and alcohol abuse, and they need treatment. And we've saved billions
and billions of dollars. And it's not like we don't know what to do.
Twenty years ago Hawaii said, "Everybody here is going to get insurance, we're
going to have employers and employees cover their health insurance.' And if
you've never been to Hawaii, I hope you get to go someday, it's a wonderful
place, but everything there is more expensive than anyplace else because it's
way out on a island somewhere -- everything except health care, where the
premiums for small business are 30 percent below the national average because
everybody pays and no one runs away. And everybody is covered. (Applause.)
And you ought to be taken care of whether you are a young man riding a
motorcycle in the prime of your life, or a young woman giving yourself to
nursing, or a man following a religious mission to work at a Christian radio
station, or any other thing. It just ought to be that way.
We have a consensus in this country on universal health care. What we do not
have is a consensus among people elected to represent the American people on
making the tough decisions necessary to get universal health care. (Applause.)
There are lots of things like that in life. Much of us, including me, would
like to be thinner, but we don't diet. (Laughter.) A lot of people would like
to be stronger, but they don't lift weights. In the end, it comes down when
you've got to do something that everybody wants to do, but it's not easy to do,
the people that hired on have to make the decisions.
And the members of the United States Congress hired on, just like I did. We
didn't say, "Vote for me in a representative form of government and I will make
all the necessary decisions to solve the problems of the country except those
that are difficult, controversial and make people mad." (Cheers, applause.) That
was not the deal. And you need to hang around this town and you need to tell
your stories because the questions that I get asked are, well, what about this
detail or that bill or who's up or who's down?
I say I have answered my question. My question is am I for you or not? Answer:
Yes. (Cheers, applause.) Secondly, second question, did I offer a plan to solve
your problems? Answer: Yes. (Applause.) Third question, was I willing to meet
people who had different ideas or better ideas more than halfway? The answer is
yes. (Applause.)
These bills provide for a longer phase-in. They give less orders, fewer orders,
and they give more options to small business. They give a better financial
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break to small business. They are less bureaucratic. We have listened to the
American people, and Congress has presented bills to do that. They've bent over
backwards to recognize that the American people want options and they don't like
to be told to do anything. I don't blame them. Nobody likes that. But the
conservative thing to do is to ask everybody to carry as much of their own load
as they can, and then for the rest of us to help.
Those who are opposed to universal coverage say we've got a whole class of
people we're not going to ask to carry any load at all, and we'll ask everybody
who's already doing their part to do even more. I think we have the
conservative position, my fellow Americans, the responsible position. Everybody
should do what they can, and then we'll help those who need more. (Cheers,
applause.)
I just want to ask you to remember this. Make this debate about John and Jan
Cox, about the story Carolyn Mosely (sp) told, about the dreams of the future,
teaching our children that Daniel Lumley (sp) has, and about the personal
stories that are here in this audience and all across America. Don't let it
become part of some rhetoric, hot air process, conflict, interest group deal.
And say a simple word. We have moved. We have reached out to people of
different views and different parties.
This is not a partisan issue. I don't have any earthly idea what political
party these three people are in or who they voted for for president, and I do
not care. I want them to have health care. (Cheers, applause.) You make the
debate about them and remind the Congress that, just like the president, they
signed on to represent ordinary Americans, to make the tough decisions, and not
to walk away.
And this is a decision America has walked away from for 60 years. President
Truman three times asked the American people to get the Congress to solve this
problem, and the Congress said no. President Nixon 23 years ago asked the
Congress to require employers and employees to split the difference and cover
with private health insurance all Americans.
Now, it's been long enough, folks. I know we're supported to deliberate up
here. (Laughter.) But we have now deliberated through three generations.
(Laughter, applause, cheers.)
THE CROWD: (Chanting.) Health care now! Health care now!
PRESIDENT CLINTON: Pass it now for them and for you! God bless you all!
(Applause.)
END
LANGUAGE: ENGLISH
LOAD-DATE-MDC: August 3, 1994
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Copyright 1994 American Broadcasting Companies, Inc.
All rights reserved
ABC NEWS
SHOW: ABC Breaking News
August 3, 1994
Transcript # 163-1
TYPE: Package
SECTION: News; Domestic
LENGTH: 6296 words
HEADLINE: Text - Clinton Press Conference on Rwanda, Health Care
GUESTS: Pres. BILL CLINTON;
HIGHLIGHT:
President Clinton holds a press conference and answers questions about Rwanda,
Haiti, health care and estimations of his presidency.
BODY:
ANNOUNCER: This is an ABC News Special Report, a presidential news
conference. Now reporting from Washington, Ted Koppel.
TED KOPPEL, ABC News: Good evening. The White House would like us all to know
that this is President Clinton's 75th press conference. If you have the sense
that you may have missed a few of those, you're almost certainly right.
President Clinton has answered a lot of questions from a lot of reporters, but
when it comes to full dress, prime time press conferences with all the
accredited White House correspondents, there have been only two previous ones.
Tonight marks the third. Needless to say, this is not his favorite forum.
High on the president's agenda this evening will be health care, the crime bill,
and probably an effort to focus a little more attention on his administration's
achievements. What's on the minds of the assembled reporters? Well, here's
ABC's White House Correspondent, Brit Hume. Brit?
BRIT HUME, ABC News: Ted, the president is almost certainly going to be asked
about two other issues, one of them being Haiti, where the U.N., as you know,
has authorized the United States and other member countries to use all necessary
means to topple the military dictatorship if it comes to that. The president is
likely to be asked about whether he will seek a similar authorization, as
President Bush did before the Gulf War, from Congress. White House officials
have been saying in recent days that the president has all the legal authority
he needs, so we're interested in knowing whether he will seek that anyway. And
he's also certain to be asked about the Whitewater hearings and Roger Altman.
TED KOPPEL: And as the president comes now toward the podium, I should point out
he is going to begin with a statement before he starts taking questions. Here
then with his third White House press conference, President Bill Clinton.
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Pres. BILL CLINTON: Good evening, ladies and gentlemen. Tonight I want to speak
with you about crime, health care, and the progress of our national economic
strategy.
As I have said so many times, the central mission of this administration,
renewing the American dream, requires us to restore economic growth, rebuild
American communities, empower individual citizens to take personal
responsibility for their own futures, and make government work for ordinary
citizens again. We are making progress.
Remember - we are about now a year from the time when Congress passed our
economic recovery plan. I remember then that our opponents said if that plan
passed, the sky would fall, unemployment would go up, the deficit would explode.
Well, they were wrong. Look at the facts. We cut $255 billion in spending,
raised tax rates on only 1.2 percent of the wealthiest Americans, cut taxes for
15 million working families of modest incomes, made 90 percent of our small
businesses eligible for a tax cut, and 20 million Americans available- or
eligible to refinance their college loans at lower interest rates. Now the
deficit is going down three years in a row for the first time since Harry Truman
was president. We've got almost four million new jobs, very low inflation, a
1-1/2 percent drop in unemployment.
There were other skeptics later who said the sky would fall if we passed the
North American Free Trade Agreement. They, too, were wrong. We can see this
year that automobile sales, for example, in Mexico- to Mexico are growing at
five times the rate of last year, and our trade with Mexico is growing more
rapidly than that with any other country.
And while I know an awful lot of people are still hurting, the road ahead looks
good. According to Fortune magazine, for the first time in a decade, all 50
states will expand their private economies next year. Let me say that again.
For the first time in a decade, all 50 states will experience economic growth
next year. None of this came without a fight, and now we're involved in two
more historic fights. The first is on crime.
We have a chance to pass the toughest, smartest crime bill in the history of the
United States after six years of bickering over it. Let me remind you of what
that bill will do. It will put 100,000 police officers on the streets of our
communities - a 20 percent increase. It will make 'three strikes and you're
out' the law of the land. It will ban deadly assault weapons and handgun
ownership by minors. It will provide tougher sentences for violent criminals
and more prisons to put them in. And we've listened to police, prosecutors and
community leaders who tell us that they need much more for prevention programs
to give our young people something to say 'yes' to as well as something to say
'no' to. Believe it or not, there are still special interests here in
Washington trying to derail this crime bill, but we are fighting them and the
American people will win this fight, too.
Still, the recovery we are building, the communities we are trying to make
safer, the individual citizens we're trying to empower to compete and win in the
global economy - all of these people are at risk unless and until we reform
health care. Our system still costs too much and covers too few. It is
actually going in the wrong direction. In the past five years, five million
more Americans have lost their health insurance, almost all of them working
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people and their children.
We're fighting for health care reform not just for those who don't have health
insurance but for those who do have it and who could use it - lose it because
they have to change jobs, because someone in their family gets sick, because
they simply have to pay too much for it. They deserve better and we're fighting
to see that they get it.
We want to guarantee private, not government, insurance for every American. The
plan I originally proposed has been changed and much of it for the better. The
proposals before Congress are less bureaucratic. They're more flexible. They
provide more protection and support for small business. They contain a
reasonable phase-in time, over a period of years, to make sure we get it right.
No bureaucrat will pick your doctor. You can keep your own plan or pick a
better one. This approach controls government spending but relies on
competitive forces in the free market to restrain the growth of private health
insurance premiums. Much of it has changed for the better. But one rock-solid
principle remains - private insurance, guaranteed, for everyone.
We know it will work. For 20 years Hawaii has required employers and employees
to split the cost of insuring all employees. People still pick their doctors
there. Health care is getting better there. The economy is doing well there.
And almost everything in Hawaii is more expensive than it is here on the
mainland, except for health insurance, where small businesses pay health
insurance costs that are on average 30 percent lower than they are in the rest
of America.
Now, after 60 years of trying and 18 months of sometimes-trying debate, the
question of guaranteeing coverage for all Americans has come to the floor of the
Congress and will be decided in the next few weeks in a few critical votes. The
votes will be soon, and they will be close. I want to urge the American people
to tell their senators and congressman to put aside partisanship and think of
the American people and their fundamental interests and needs. We have an
historic opportunity. We dare not pass it up. This is a fight for the American
people we also have to win.
TOM RAUM, Associated Press, Mr. president, in January you waved a pen and said
you would veto legislation that didn't guarantee every American private health
insurance that could never be taken away. Now you've indicated you will support
a Senate bill that does not guarantee coverage and sets a goal of 95 percent,
leaving millions of Americans uninsured. Are you now revising your veto threat?
And doesn't the fact that you indicated you support this less-ambitious Senate
plan make it harder for House members to go along with the bill that's more like
your original proposal?
Pres. BILL CLINTON: Well, first of all, I disagree with your characterization of
the Mitchell bill. I believe it will achieve universal coverage for all
Americans, and that is the one criteria I have set out. What the Mitchell bill
says is that, if you make a dramatic amount of progress in a short time - that
is, if you move from where we are not at about 83 percent of coverage up to 95
percent in a few years - that is evidence that we can achieve full coverage in
the near future without requiring insurance to be bought. That is what that
bill says. If it is deficit-neutral and if it is passed in the way that it is,
I believe it will achieve full coverage, because what the bill also says is,
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if we don't make that amount of progress in a few years, there will be a
requirement on the Congress to provide for full coverage and, if the Congress
doesn't act, then automatically employers and employees will be required to
purchase insurance. I believe it does meet the objective that I set out in the
State of the Union Address, and I would sign it.
Mr. RAUM: What about the second part of the question, Mr. president? Doesn't it
make the fact that you have now indicated support for a less-ambitious Senate
bill - won't that make it harder to persuade House people to go along with a
stronger bill?
Pres. BILL CLINTON: Well, what the Mitchell bill does is to put the employer
requirement at the end of the process, rather than at the beginning. And
Senator Mitchell is convinced that that is the most ambitious bill he can pass
but that it meets the requirement. And it says to the people who have not been
supportive of our approach, 'Look, we'll try it in a competitive way first, and
if that doesn't work, then we'll have a requirement.' I think the same debate is
going on in the House. My own view is that the questions now should shift to
the members of the other party, to the congressional Republicans. At one time,
when we started this debate and I said I wanted universal coverage, many members
in Congress stood up and clapped of both parties. At one time, there were two
dozen Republican senators on a bill to give universal coverage to all Americans.
They have all abandoned that bill. We have reached out to them, as was our
responsibility to try to work together in a bipartisan fashion, and every time
we have done it, they have moved away.
So the questions now should shift to them. Are we going to cover all Americans
or not? Are we going to have a bill that provides health care security or not?
If you don't like our approaches in the Senate and the House, what is your
alternative? That's what I hope we'll see.
LORI SANTOS, United Press International: Mr. president, on Haiti, you finally
received the approval of the United Nations to launch an invasion if necessary.
Why do you need a green light from the international community and not from the
American Congress? Will you ask lawmakers to take it up?
Pres. BILL CLINTON: Well, first, let me say that I agree with the resolution
adopted by the Senate today that the action of the United Nations should not be
interpreted as an approval by Congress. It has no impact on what Congress would
do. Second, let me say I think all Americans should be pleased that the United
Nations has stated with a strong, firm voice that includes many voices from our
own area that we should keep on the table the option of forcibly removing the
dictators who have usurped power in Haiti and who have trampled human rights and
murdered innocent people.
Now, let me remind you all of what our interests are there. We have Americans
living and working there, several thousand of them. We have a million Haitian
Americans in this country who have family and friends there. We have an
interest in promoting democracy in our hemisphere. We have an interest in
stabilizing those democracies that are in our hemisphere. For the first time
ever, 33 of the 35 nations in the Caribbean and Central and South America are
governed by popularly-elected leaders, but many of those democracies are
fragile. As we look ahead to the next century, we need a strong and democratic
Latin America and Central America and Caribbean with which to trade and grow.
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So those are our fundamental interests.
I would welcome the support of the Congress, and I hope that I will have that.
Like my predecessors of both parties, I have not agreed that I was
constitutionally mandated to get it, but at this moment I think we have done all
we need to do because I don't want to cross that bridge until we come to it. We
have kept force on the table. We have continued to move it up as an option as
the dictators there have been more obstinate. But it is premature, in my
judgment, to go beyond that now.
Rita?
RITA BRAVER, CBS News: President Clinton, a number of political analysts,
including some who are quite friendly to you, have said that the focus on the
Whitewater affair has both undercut public confidence in you and also in your
ability to get your programs through Congress. Do you agree with that? And what
impact do you think Whitewater has had, particularly with the hearings this
week?
Pres. BILL CLINTON: Well, I would think first of all that in the last couple of
weeks it should have been very helpful to the administration because we have
seen three reports, one from the special counsel, Mr. Fiske, who has said that
there was absolutely no violation of the law in any of these contacts, and then
two - one of the Office of Government Ethics, and one by Mr. Cutler, the White
House counsel - saying that no ethical rule was violated. Secondly, we have
been fully cooperative, as we always said we would be. So, from my point of
view, we've done all we could.
Now, I can't say what the impact has been. All I can tell you is that I said we
would cooperate fully and we have. I have said repeatedly that I did nothing
wrong, and I didn't. And I have continued to work for the welfare and the
interests of the American people. Almost all - I've watched none of these
hearings, I've not kept up with them. I've been working on jobs, and health
care, and the crime bill, and peace in the Middle East, and doing the things I
was hired to do by the American people. They will have to make up their minds,
when all the dust clears, what they think the impact of it is. But I'm
convinced we're having a very productive time, I think we'll get this crime
bill. We have health care bills providing universal coverage on the floor of
both houses of Congress for the first time in the history of the republic. No
president since Harry Truman has been able to do that, and many have tried,
including president Nixon. So I feel good about the progress we're making, and
that's all I can worry about. I've got to get up here every day, and go to
work, and try to help the American people.
Karen?
KAREN BALL, 'New York Daily News': Mr. President, Roger Altman ran into a real
buzz saw in the Whitewater hearings and even some Democrats are questioning his
truthfulness. Does he have the credibility to continue as number two at
Treasury? Are you going to ask for his resignation?
Pres. BILL CLINTON: Well, let me say, first of all, he spoke with the Senate
committee for more than ten hours yesterday. That's a very long time. And he
answered all of their questions. He then spoke for several hours with the
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House committee today. In that he admitted that he had not given all the
information to them in a timely fashion that he should have, but he said
repeatedly that he had not willfully misled them. I would like to emphasize,
first of all, I do not countenance anybody being less than forthright with the
Congress. There have been many people, including people that are not
particularly friends of our administration, who had talked about how we have
been much more cooperative with these investigations than previous
administrations have been. That's what I told the American people I would do,
and that is what I have done.
But, if you look at the facts - let's go back to the fundamental facts - there
was no violation of the law, there was no violation of any ethics rule. The
Secretary of the Treasury has pointed out that Mr. Altman has done a superb job
in his position. He was critical to the passage of our economic program that
produced almost 4 million jobs in 18 months. He was important in the passage of
our trade initiatives. He has done a good job there. The secretary of Treasury
has confidence in him and so do I. And I think he has now answered all the
questions that the Senate could possibly have about an incident that involved no
violation of the law and no violation of ethics.
Yes?
KEN WALSH, 'U.S. News and World Report': Mr. President, to come back to Haiti
for a moment, you mentioned a number of American interests that we have in
Haiti, but what is - involves national security that's at stake? Is there
anything in Haiti that involves our security that would require us to go in and
invade the country?
Pres. BILL CLINTON: Well, first of all, I think our security is caught up in
whether the people in this hemisphere are moving toward democracy and open
markets and observation of the rule of law. And, when one country in our
hemisphere on our back door has an election, votes for a leader, that leader is
deposed by people who murder, who kill, who rape, who maim, who throw the human
rights monitors out, who now won't even let people leave who have been approved
for leaving, it seems to me that if you look at the possible ramifications of
that on other countries in the Caribbean and in Central and South America, that
is where our security interest is.
I can tell you that as I was calling other nations to get them to help in the
safe haven project, to be willing to take some Haitians who leave, that is the
thing that other leaders mentioned to me over and over again. 'We know that
many of our democracies are fragile, but we're moving in the right direction.
We don't want to see Latin America take one more wrong turn. We're moving
right, we want to stay right. And I think that is profoundly important to us.
Andrea, and then-
ANDREA MITCHELL, NBC News: Mr. President, in just another few weeks we will know
whether North Korea has transformed more fuel rods into weapons grade plutonium.
What are the consequences if North Korea does make more weapons grade plutonium?
And are you prepared to carry out that threat?
Pres. BILL CLINTON: I think I can do no better than to reiterate what I have
always said, that North Korea's fate is still in its own hands, it must decide
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what it's own future should be. I think at this time, when North Korea has
shown a willingness to stop reprocessing and to stop refueling and when our
talks are about to begin again next Friday, we should take the facts as we have
them and keep working for progress.
This is an issue which is very important to the long-term security of the United
States, the question of a country that belongs to the non-proliferation regime
deciding to become a nuclear power, the prospect that nuclear capacity could be
transferred either by design or by accident to other countries or to rogue
groups. This is a very serious thing for our long-term security, and we have
spent a lot of time to make sure we are firm and deliberate. But that firmness,
that deliberateness, has led to these talks, which were interrupted when Kim Il
Sung passed away. We start the talks again on Friday. The agreement the North
Koreans made is still holding about refueling and reprocessing. I think we
should focus on that now and keep working for a satisfactory conclusion.
Gene?
Have you any confidence that we will know whether they violate these agreements?
Pres. BILL CLINTON: Yes, I believe that. I have no reason to believe that we
will not know if that agreement is violated.
GENE GIBBONS: Mr. President, as you pointed out in your opening statement, the
economy has been growing. Last week we saw the peace agreement - or the
framework for peace agreement between Israel and Jordan. Yet, your approval
rating continues to slide in the polls. To what do you attribute that? Is it
the message? Is it the messengers? And a related part of that question - Has
Leon Panetta made any recommendations to you for changes in the White House to
improve things here?
Pres. BILL CLINTON: Well, first of all, I'm not the best judge of that. Maybe
I'm just not as good a talker as you folks thought I was when I got elected
president. Maybe there's so much going on it's hard for anything specific to
get through. Maybe it's partly a function of the times in which we live.
Whenever we move from one historic era into another, where we - at the end of
World War I, at the end of World War II, moving into the Cold War, now at the
end of the Cold War moving toward the 21st Century, our people are filled with a
mixture of hope and concern. Also every American is genuinely concerned about
something now, whether it's their economic circumstances, their health care,
insecurity over crime, concern about what's happening to the fabric of our
society with so many children out of wedlock and so many families breaking down.
There's something gripping the concer of most Americans. And, when people have
these balances going on - hope or fear - it is sometimes difficult to get
through with the hope and progress. I can't worry about that. All I can do is
to show up for work here every day. And, as I said today to the folks who rode
buses, try to make this the home office of the American Association for Ordinary
Citizens. And, if I keep doing that, I think that the future will take care of
itself. My only concern is to continue to be able to be effective and that's
what I will work for.
Brit?
BRIT HUME, ABC News: Mr. President, on health care there were indications on
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Capitol Hill today that time is now becoming an important factor - there's a
need to get legislative language; there's a need to various budgetary estimates
- and that it may be very difficult before the end of this month. Are you
prepared now to insist that Congress remain in session and not take its recess
until there is action in both houses?
Pres. BILL CLINTON: Well, my belief is that Senator Mitchell has done enough
work on his bill and that the House bill has been out there in its basic
framework so that the recess will probably have to be delayed, but could still
occur. I do believe that they should and will stay here until they can take
action on those bills - each house on its own bill. I believe that will happen,
and I think that's a good thing because that's a way of their putting the
American people first, which is something I think should be done.
Dan?
DAN BALZ, 'Washington Post': A two-part question on health care - When you put
your own health care plan forward, you said you wanted to build on the private
insurance industry. The House bill that Congressman Gephardt has put forward
could turn control of almost half the health care system over to the federal
government. Why do you support that approach as opposed to your original idea?
And secondly - Is Senator Mitchell's bill your new bottom line - your new
minimum? If there is anything less than that coming out of the Senate, would
that draw a veto?
Pres. BILL CLINTON: Let me answer the second question. My goal has been what it
has always been. I want a system that will take us to universal coverage. If
it takes a few years to get there, that's fine with me, we don't want to mess it
up. We want to have the chance to continue to work and strengthen the program
along the way. In the case of the House bill, as you know, I have always
thought that we ought to allow every American to buy into the Federal Employees
Health Insurance Bill, which is essentially a private plan. The House bill
offers a Medicare program, if you will, like the senior citizens buy into now,
but only if people decide not to buy private health insurance. So it still has
a preference for private health insurance, and I think that is consistent with
what I think we should do. I still believe the best thing to do is to build
more on the system that most of us have now.
Peter?
REPORTER: Which of those do you favor, the Mitchell approach or the Gephardt
approach?
Pres. BILL CLINTON: Well, I'm not going to get into being a legislator. My job
is to try to keep the American peoples' eye on the ball and to try to keep the
members of Congress working together. What I favor is now for our friends on
the other side of the aisle, and all of the Democrats to get together, think a
bout the interests of the American people, and come up with a program that
solves the problem.
Let me just say, if I might, just stop for a moment and say I think it is
terribly important in this debate, when these issues tend to be complex and
detailed, to keep our eye on the central reality here, which is how do we solve
the problem?
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I asked two of the people that rode those buses to come here tonight, I want
them to just stand up. David - Daniel Lumley and John Cox. And let me answer
your question this way. Daniel Lumley was a young man who lost his arm riding a
motorcycle. He wants to be a school teacher, he wants to be a public servant,
he wants to know that he'll always be able to get health insurance when he
works, even though he has a very apparent preexisting condition. Like millions
and millions of Americans with disabilities, he can work and do fine, and pay
taxes, which releases the burden on the rest of us if he can get insurance.
John Cox left his job with health insurance and went to work for a Christian
radio station because he thought it was his mission in life to do that. He
thought he was covered by health insurance, and he thought his employer was
paying it, and he wasn't. When his wife came down sick, because they didn't
have health insurance, even though he was working, they didn't go to the doctor.
They just talked to a doctor over the phone for months and months. Finally she
became so ill they had to see a doctor at an emergency room. By that time she
had cancer that had progressed to the point when it could not be fully treated.
He took this bus ride across the country when his wife was dying because she
wanted him to. She died during the bus ride, he buried her two days ago, and he
came up here today to be with us.
My answer to you is, if the program works for John Cox and for Daniel Lumley,
I'll be for it.
WOLF BLITZER, Senior White House REPORTER: Mr. President?
Pres. BILL CLINTON: Wolf?
BLITZER: Mr. President, if I could ask you a specific question on these
Whitewater hearings, which I know you're not watching but many of us were
watching until 2 o'clock in the morning last night. One of the problems that
Roger Altman, the deputy Treasury secretary, seems to have is that he didn't
recuse himself or step down as chairman of the Resolution Trust Corporation
because he feared that there could be some sort of appearance of a conflict. He
had decided to step down but was talked out of it by Bernard Nussbaum, your
former counsel, and other White House aides. That seems to be the source of a
lot of problems that he has. And Josh Steiner, the Treasury chief of staff,
says that you and the first lady were furious that Roger Altman told a New York
Times editorial writer about this decision before you learned about it.
What was so bad about his decision to recuse himself if there was nothing that
he could have done to interfere in the RTC investigation of Madison Guaranty
Savings and Loan?
Pres. BILL CLINTON: First of all, I never would promote anybody interfering in
any investigation. I welcome this investigation. And it will vindicate what I
have been saying all along. I had no problem with Mr. Altman deciding of his
own independent judgment, in consultation with his superior, the secretary of
the Treasury, that he ought to recuse himself. The only thing that upset me was
I did not want to see him stampeded into it if it was the right thing to do. I
just wanted the decision to be made on the merits. I think it's a pretty
simple, straightforward position I had and I think it was the right one.
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George?
GEORGE CONDON, Jr., Copley News Service: Mr. President, Atlanta Braves owner,
Ted Turner, last week called on you to intervene with government arbitration to
head off a baseball strike. Now that your Labor secretary has met with both
sides of the talks, do you see any government role in this matter? Do you see
anything you personally can do to head off the strike?
Pres. BILL CLINTON: Let me say first of all just as a life-long baseball fan, I
suppose I have a greater interest in this than maybe a president even should. I
mean, the prospect of seeing records that are 30 and 40 years old broken, for
those of us who like the offensive as well as the defensive side of baseball, I
mean this is an exhilarating thing. I think it would be heartbreaking for the
American people if our national pastime didn't get through this whole season.
And it's a great opportunity for these young players and what they can become.
Secondly, the secretary of Labor, as you pointed out, did meet with the
representatives of the players and the owners, and we discussed what could be
done and tried to facilitate a better communications between them. There may be
some other things which can be done, but at this time the situation is
sufficiently delicate that I think we need to leave it at that. If we can play
a constructive role we will. We do not want to play a destructive role. We all
hope that somehow the strike can be averted.
Mara?
MARA LIASSON, National Public Radio: Mr. President, there are many Democratic
members of the House, your allies, who disagree with you, they don't believe
that Senator Mitchell's bill is a universal coverage bill. Are you ready to
tell them that you think that Senator Mitchell's bill is the best that can
possibly come out of Congress this year?
Pres. BILL CLINTON: Well first of all, let's remember how a bill becomes law.
[laughter] I mean, a bill - it's very important. Senator Mitchell has to find a
majority for a bill that can pass the Senate. Then there must be a majority of
people supporting a bill that passes the House. The Senate task is very hard
because, except on the budget, a tiny minority, 41 percent of the Senate, can
keep any other bill from even coming to a vote. He has a difficult task. Then
the bill goes to a conference and a final bill will come back and will be voted
on in both houses. We have seen many times how a bill passes the House, a bill
passes the Senate, a final one comes out that's different from either one. We
don't know what will happen.
Let me tell you what I hope will happen. What I hope will happen is that these
- that the debates on the floor of the Senate and the House will be widely
publicized, heavily watched, and that the debate will grip the imagination of
ordinary American citizens who themselves may not be part of any discrete
interest group, and that there will be a climate in the country welling up, as I
believe it is now, for action that works, that solves the human problem. I
believe George Mitchell, as many of the senators pointed out, in a situation
which every time he tried to do something, the members of the other party moved
away from a position they had previously had. Normally in a bill - when a bill
becomes law, if you take one position and the people in another party take
another, you move toward them, they move toward you, you work out an
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agreement. Here is a case where we had 24 senators of the other party committed
to universal coverage, and they have all abandoned the plan they were originally
for, and as he has moved toward them, they have moved away. In that
environment, I think he has done a fine job with a bill that I personally
believe will achieve universal coverage, and that's all I can say. It is my
opinion that it will work.
KATHY LEWIS, 'Dallas Morning News': Mr. President, strictly from a management
standpoint, given the conflicting recollections of the various members of the
Treasury Department team, do you believe that they can continue to work together
effectively?
Pres. BILL CLINTON: Well, the management of the Treasury Department is under the
jurisdiction of the secretary of the Treasury. All I can tell you is the
important thing for the American people is the Treasury Department has worked
very well. Nearly every American - nearly every expert in this town believes
that it has worked very well across a whole broad range of issues, and that the
secretary of the treasury has done an absolutely superb job in both domestic and
international economic arenas, with the support of his team. The management
questions are things that he will have to resolve, but I will say again there
was no violation of the law, there was no violation of the ethics rules, the
errors which were made have been acknowledged, and questions have been answered
at extreme length. I think that is a very good thing.
TED KOPPEL: Well, the president nearly back for one more question there, but
he'd taken about 30 of them already, covering a wide panoply of issues on
foreign and domestic issues. The foreign ranging from Haiti to North Korea and
Syria, the domestic ranging from Whitewater and health care to the baseball
strike. We will be back in just a minute or two. When we return, we'll be
joined by the Senate Minority Leader, Bob Dole, and we will go live to
Port-Au-Prince, Haiti, to speak with the president of the Haitian Senate.
[commercial break]
TED KOPPEL: The president's press conference went so long that we do not have
time to go to Haiti right now to talk to the president of the Haitian Senate.
We'll be doing that a little bit later tonight on Nightline. But joining us now
live from Capitol Hill is the Senate Minorty Leader, Bob Dole. You've got a
beautiful prop there next to you. Might as well go to it right away, senator.
Sen. ROBERT DOLE (R-KS), Senate Minority Leader: Well, this is the Mitchell
bill, the Clinton-Mitchell bill, we just had delivered to us about an hour ago.
It's about 1,400 pages, it weighs 14 pounds, and this is what we're supposed to
explain to the American people in a matter of the next few days, and it's going
to be very, very difficult.
TED KOPPEL: The president has made it pretty clear that he expects you and the
House to stay there until you get it done.
Sen. BOB DOLE: That's not a problem with me, unless rumors are true in the
House, where there's some indication that they might not vote until after the
recess. Now if that happens in the House, then I don't think the Senate should
proceed. We ought to have the same opportunity to go home and visit our
constituents about this most important bill in the last 20, 25 years.
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ABC Breaking News, August 3, 1994
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TED KOPPEL: The president associated himself during his press conference with
your vote today on Haiti. One hundred senators said in effect, 'Well, we're not
going to do what the U.N. says. He's going to have to come to Congress.' And he
suggested he was willing to do that, but not now.
Sen. BOB DOLE: Well I wasn't quite clear. I mean, it seemed to me that he was-
he didn't he would come to Congress. He said he agreed with the resolution.
Obviously, U.N. approval is not congressional approval. I think he first has to
make the case to the American people. He didn't make it tonight. There's no
American lives threatened in Haiti. There's no real national interest in
intervention in Haiti, and that's why we think he should come to Congress before
we risk American lives and then also start occupying Haiti for who knows how
long.
TED KOPPEL: Senator, it sounded- I think if you read between the lines, as
though there was something less than a wholehearted support for Roger Altman as
deputy Treasury secretary. What did you hear?
Sen. BOB DOLE: Well, I think he did what he probably should have done. Roger
Altman is a good friend of his and has been a long-time supporter. I don't run
around saying people should resign, but I do think somebody wasn't totally
accurate in their testimony, particularly in the Senate Banking Committee. I
watched about three hours of that testimony last night.
TED KOPPEL: Senator Dole, forgive me for jumping in. We're fresh out of time.
You're going to be nice enough to join us also a little bit later on Nightline.
I look forward to that.
Sen. BOB DOLE: Right.
TED KOPPEL: And I would also like to draw your attention to Turning POint with
my collegue, Diane Sawyer. Tonight, they'll be doing their program on inside
the Branch Davidian Compound - Waco, the Untold Story. I'm Ted Koppel in
Washington. For all of us here at ABC News, good evening and we'll see you
later, I hope.
ANNOUNCER: This has been an ABC News Special Report.
The preceding text has been professionally transcribed. However, although
the text has been checked against an audio track, in order to meet rigid
distribution and transmission deadlines, it may not have been proofread against
tape.
LANGUAGE: ENGLISH
LOAD-DATE-MDC: August 8, 1994
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Copyright 1994 Cable News Network, Inc.
All rights reserved
CNN
SHOW: NEWS 7:01 am ET
August 4, 1994
Transcript # 820-4
TYPE: Live Report
SECTION: News; Domestic
LENGTH: 407 words
HEADLINE: Clinton Talks to Press About Haiti, Health, Whitewater
GUESTS: Pres. BILL CLINTON; Sen. ROBERT DOLE (R-KS), Minority Leader;
BYLINE: GENE RANDALL
HIGHLIGHT:
President Clinton told a press conference that he would welcome congressional
support of the Security Council's military option in Haiti, but he said he won't
make that a condition for military action.
BODY:
ANDREA ARCENEAUX, Anchor: Good morning and welcome to Daybreak. With the
debate entering a critical stage in Congress, President Clinton continues
pressing for Democratic health care plans. With the latest or with more on the
president's news conference last night, here's CNN's Gene Randall, live at the
White House. Good morning, Gene.
GENE RANDALL, Political Correspondent: Good morning Andrea. It was only the
third time since becoming president that Bill Clinton had taken a news
conference into television's prime time. And though questions about the
Whitewater hearings got their share of the spotlight, the president's focus was
health care reform and his support for a pair of Congressional proposals, one a
Senate plan that falls short of the president's initial goals including
universal coverage.
Pres. BILL CLINTON: We want to guarantee private, not government insurance for
every American. The plan I originally proposed has been changed and much of it
for the better. The proposals before Congress are less bureaucratic, they're
more flexible. They provide more protection and support for small business.
They contain a reasonable phase-in time, over a period of years, to make sure we
get it right.
Sen. ROBERT DOLE (R-KS), Minority Leader: With all due respect to Senator
Mitchell, he's my friend, I applaud him for putting a bigger bill together than
the president's. It's got a lot of big government in it, it's got 17 tax
increases in it. It's got a lot of mandates in it. It's not a good bill. It's
sort of a government run health care system.
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18
NEWS, August 4, 1994
FOCUS
RANDALL: On Whitewater, the president said last night he was not watching the
televised hearings. Asked about his embattled Deputy Treasury Secretary, Roger
Altman, Mr. Clinton said he still has confidence in him. On Haiti, Mr. Clinton
indicated if he makes a decision for an invasion, while he would welcome the
support of Congress, it would not be a condition for the use of force. And in
response to a question about why he has so few formal news conferences, Mr.
Clinton smiled and said, 'That's been a mistake, and I plan to change that.
Gene Randall, CNN, the White House.
The preceding text has been professionally transcribed. However, although
the text has been checked against an audio track, in order to meet rigid
distribution and transmission deadlines, it may not have been proofread against
tape.
LANGUAGE: ENGLISH
LOAD-DATE-MDC: August 4, 1994
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Copyright 1994 Cable News Network, Inc.
All rights reserved
CNN
SHOW: NEWS 6:28 am ET
August 4, 1994
Transcript # 599-1
TYPE: Package
SECTION: News; Domestic
LENGTH: 545 words
HEADLINE: Clinton Defends Reform, Altman in Press Conference
GUESTS: Pres. BILL CLINTON; Sen. ROBERT DOLE (R-KS), Minority Leader; Pres.
CLINTON; Sen. PHIL GRAMM (R-TX);
BYLINE: IRV CHAPMAN
HIGHLIGHT:
President Clinton took the offensive yesterday at a press conference, pushing
for compromise on health care. But he was forced to defend Robert Altman when
questioned about firing the Treasury Deputy.
BODY:
STUART VARNEY, Anchor: The White House last night tried to rewrite the
headlines.
DEBORAH MARCHINI, Anchor: Faced with damage from the Whitewater hearings and
plummeting approval of the President, it put on a show. President Clinton's
third prime time news conference covered topics from North Korea to Haiti. But
the clear reason for the president's appearance was to push for health care
reform. It's a pocketbook issue which helped him win the presidency and he
staked his reputation on providing health coverage for every American. More
than the president's own credibility is at stake, so is the fate of
congressional Democrats in November's elections. But to win passage of a health
reform bill, the president has clearly had to make more and more compromises.
Irv Chapman reports.
IRV CHAPMAN, Business News Correspondent: The president began the day rallying
support for health care reform, though his own plan had been through the Capitol
Hill meat grinder. He ended the day explaining why the proposal, much modified
by Democratic leader George Mitchell, to match the realities of Senate politics,
still meets his demand for guaranteed private insurance for every American.
Pres. BILL CLINTON: I think he has done a fine job with a bill that I personally
believe will achieve universal coverage, and that's all I can say. It is my
opinion that it will work. Senate Republican leader Bob Dole afterward showed a
copy of the Mitchell Bill, 1400 pages, promising his own shorter health bill by
the end of the week.
PAGE
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NEWS, August 4, 1994
FOCUS
Sen. ROBERT DOLE (R-KS), Minority Leader: -pre-existing condition affordability.
Why don't we go ahead and do those things? That's what I say to the President,
we can't, if he says we've got to have everything. It may mean we'll do
nothing. Why don't we take care of these 20 or 30 provisions that Democrats and
Republicans agree on. CHAPMAN: Mr. Clinton was asked if the Whitewater
investigation was reducing public confidence and therefore his ability to
promote health reform and other proposals.
Pres. CLINTON: I've watched none of these hearings, I've not kept up with them.
I've been working on jobs and health care and the crime bill and peace in the
Middle East and doing the things I was hired to do by the American people.
CHAPMAN: The president minimized Roger Altman's role in not providing
information to Congress in a timely fashion, as he put it. He's done a superb
job as number two official at the Treasury, still has Mr. Clinton's confidence.
That, a Senate Banking Committee Republican said, that will change.
Sen. PHIL GRAMM (R-TX) : And I have no doubt the president will reach the right
decision and the right decision is going to be that Mr. Altman is going to have
to leave.
CHAPMAN: The president insisted he welcomes the Whitewater investigation and
took the testimony so far as evidence that he and his administration did nothing
illegal, or unethical.
Irv Chapman, CNN Business News, Washington.
The preceding text has been professionally transcribed. However, although
the text has been checked against an audio track, in order to meet rigid
distribution and transmission deadlines, it may not have been proofread against
tape.
LANGUAGE: ENGLISH
LOAD-DATE-MDC: August 4, 1994
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Copyright 1994 Federal Information Systems Corporation
Federal News Service
AUGUST 24, 1994, WEDNESDAY
SECTION: WHITE HOUSE BRIEFING
LENGTH: 3756 words
HEADLINE: CHICAGO B'NAI B'RITH INTERNATIONAL CONFERENCE
REMARKS BY PRESIDENT CLINTON
VIA SATELLITE FROM THE WHITE HOUSE
BODY:
PRESIDENT CLINTON: (Applause, cheers.) Thank you. Thank you very much,
President Shiner (sp), distinguished guests, ladies and gentlemen. Thank you
for that very warm greeting. And I certainly can identify with the tension of
waiting for election results to come in.
I'm very glad to be with you today, if not in body, then very much in spirit.
It's an honor to address the international convention of an organization that
has done so much for our country. I understand that, along with delegates from
40 of our 50 states, there are among you representatives from 36 nations. I
want each of you to know this country's gratitude for the extraordinary work
B'nai B'rith has performed since its founding in 1843. Your tireless dedication
to community service, health, education and housing for the elderly and your
staunch opposition to bigotry of any kind long ago earned our respect and our
thanks.
Allow me to add my voice to the chorus saluting Kent Shiner (sp) as he steps
down after four distinguished years as your president. Kent joined Hillary -- or
hosted Hillary and me at the Jefferson Memorial last October when B'nai B'rith
celebrated its 150th anniversary. I admire anyone who survives and thrives for
a full term as president. So congratulations to you, Kent, on a job well done.
(Applause.)
This is a remarkably exciting time both at home and abroad for issues of
particular concern to B'nai B'rith and to me. At home, we're on the verge of
winning the fight to make our streets safer for law-abiding Americans. We're
closer to the day when health care will no longer be a privilege for some but a
right for all. Our economy is recovering, over four million new jobs in the
last year and a half. We're moving in the right direction at home. Abroad,
we've witnessed progress in one year toward peace in the Middle East that can
literally take our breath away. And let me say a few words on these subjects.
This past weekend, Democrats and Republicans in the House of Representatives
joined in an unprecedented effort to set aside the petty concerns of partisan
politics and acted quickly to address the real concerns of real people about
crime.
Not only did they pass a crime bill that the American people desperately want
and need, but they showed the bipartisan spirit and good faith we desperately
need here in Washington to make this national government work again.
Now the Senate has a chance to follow suit to pass the toughest, smartest, most
bipartisan crime bill in our nation's history, a bill built on bipartisan roots
of the crime bill that Republicans and Democrats in the Senate passed late last
year by a vote of 95 to 4. This bill is centrist and bipartisan to its very
bones -- 100,000 new police officers, billions more for prisons, "three strikes
and you're out," prohibiting juveniles from owning handguns, a ban on deadly
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Federal News Service, AUGUST 24, 1994
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assault weapons, and much needed and working crime prevention programs, and a
massive cut in the federal bureaucracy to pay for these crime-fighting efforts.
That's right, we're reducing the federal bureaucracy to its smallest size since
the Kennedy presidency and putting all the savings into a trust fund to pay for
the crime bill.
These aren't Democratic or Republican ideas, they're common sense solutions that
the American people support because they can really make a difference against
crime and violence now and in the future. For six years the American people have
waited while Congress debated a crime bill, even as they watched the average
violent criminal go free in just four years. It's time to act now. This is
about keeping faith with the millions upon millions of American families who
work hard, pay the taxes, obey the laws and don't ask very much from our
government, but they do want to raise their children in a country that is safe
and secure. The American people don't want a criminal justice system that makes
excuses for criminals. They also are tired of a political system that makes
excuses for politicians. It's time to put away the excuses, the blames and the
politics and join forces to pass this crime bill now. And I urge all of you to
call your senators without regard to party and tell them just that. (Applause.)
For many years now, B'nai B'rith has been a leader in providing health care to
all kinds of Americans.
When I spoke to you at the Jefferson Memorial, I described the hospital you
opened in my hometown of Hot Springs, Arkansas, some 90 years ago. The (Leo N.
Levy ?) Hospital still cares for hundreds of people every year without regard to
their ability to pay. That same generous spirit should animate our national
health care system.
After 60 years of trying, we're closer than ever to providing health security
for all Americans. For the first time in our history, both the House and the
Senate are considering comprehensive and effective health reform measures.
These efforts are long overdue. Health costs are too high and rising too fast.
Coverage is actually shrinking in America. Millions in the middle class are
losing their insurance every year, many of them for good. There are 5 million
working Americans and their children who don't have health insurance today who
had it just five years ago.
Meeting this challenge requires more from us than politics as usual. This,
again, shouldn't be about politics or special interests; it should be about
putting the interests of our families, our nation and our future first. I
believe we can do it if we will leave aside ideology and partisanship and follow
the example that the House did Sunday in passing the crime bill. To do it,
we'll have to join together, to stand up to some intense pressures to guarantee
that every American has solid, affordable, private health insurance. Every
other major advanced country has done it. It's time for America to do the same.
Lastly, let me say I know you share the joy that I feel in the progress that's
been made toward peace in the Middle East. For more than four decades,
Americans have identified with and supported Israel's struggle for survival and
acceptance in a hostile region. Now, after so much bloodshed, so many lost
opportunities, Arabs and Israelis are reaching out to each other to settle their
differences through conciliation, compromise and peaceful coexistence. Some of
you were on the South Lawn of the White House to witness the historic handshake
between Chairman Arafat and Prime Minister Rabin, and some of you joined us in
the Rose Garden when King Hussein and the prime minister showed the world what
war and peace can mean in the Middle East.
I hope and I believe that the time is not far off when we'll see a comprehensive
peace in the region, a peace that binds Israelis, Palestinians, Jordanians,
Syrians and Lebanese so that all their children can know a better future. The
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Federal News Service, AUGUST 24, 1994
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United States has been proud to serve as a full partner in the search for peace
-- not by imposing peace or making life and death decisions for others, that
must be the responsibility of the leaders and the people of the region; rather,
our role is to facilitate negotiated compromise and to underwrite reasonable
risk-taking, and that is exactly what we've done.
I applaud the bold steps that Israel has taken, and I salute the courage of the
Arab leaders who have stood up to the scurrilous charge that they are somehow
selling out the Arab cause by securing for their own people a future of peace,
prosperity and hope. Now we must demonstrate that the international community
supports this courage and ensure that the people of the region realize the full
benefits of these peace-making efforts. At the same time, we have a right to
expect that all the participants in the peace process live up to the commitments
they've made. In this regard, it's heartening to hear from many Palestinians
their genuine desire for democratic elections, representative government and
transparent and accountable institutions -- these things they need and they
deserve nothing less.
As we move ahead in the peace process we need to keep in mind some basic
principles. First, peace must be real, not just the absence of war but a
qualitative change in the relations between Israel and its neighbors; full
diplomatic ties, an end to the boycott, open borders for people in trade, joint
economic projects. And it would be inconsistent with real peace for any of the
parties to host or sponsor those who reject accommodation with Israel,
especially terrorist groups.
Second, peace must be secure. The parties themselves must reach agreement that
provides for mutual security. In the case of the Israel-Syria negotiations,
this administration, following consultations with Congress, stands ready to
participate in the arrangements these parties reach. And just as this
administration has acted to sustain and enhance Israel's qualitative military
edge, so too it will help to compensate for any strategic advantages Israel may
choose to give up for peace.
Finally, peace must be comprehensive. We will work hard to achieve
breakthroughs in the Syrian and Lebanese tracks, and when we do, we'll also
expect the wider Arab and Muslim worlds to normalize their relations with
Israel. Let me emphasize here that we're committed to bringing the Arab boycott
of Israel to an end now. (Applause.) First of all, the boycott harms American
companies and it has no place in the peace process. Through the Gaza/Jericho
Accord and the transfer of authority elsewhere in the territories, the
Palestinians have entered into a new economic relationship with Israel.
Continuing the boycott harms not only Israel but the Palestinians as well. At
the same time, the Washington declaration affirms that the abolition of all
boycotts is the shared goal of Israel and Jordan. With serious progress being
made on the Syrian negotiating track, retaining this relic of a bygone era
cannot possibly be justified. The boycott must be ended. (Applause.)
Building peace is extraordinarily hard work.
We know that the dark forces of hatred and terror remain deeply entrenched. In
recent weeks, terrible attacks against Jews in Argentina, Panama and England
have underscored the heinous acts some will commit to undermine this peace
process. Among you today are members of those communities, including Joseph
Herrari (sp) from Panama, who lost a nephew on the plane that was bombed from
the skies over his country.
Mr. Herrari (sp), I pledge to you and to everyone else in the room we'll do all
that we can to help bring the perpetrators of this crime and the other crimes to
justice. (Applause.)
Our policy is clear: to weaken and isolate those who reject a more peaceful
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future for the peoples of the troubled region. The two key obstacles of that
future are Iraq and Iran and the radical groups they continue to support.
In the case of Iraq, we must maintain the international consensus in favor of
strict sanctions. This clear expression of international will has compelled
Saddam Hussein finally to begin to cooperate with U.N. weapons inspectors. But
the true nature of Saddam's regime remains clear. Relief workers and weapons
inspectors face constant harassment and intimidation. Terrorism plagues the
Iraqi people. Witness last month's tragic death of a prominent Shi'ite leader,
the summary executions of bank managers, and the recent assassination of an
Iraqi dissident in Beirut by Iraqis accredited as diplomats. Baghdad still
refuses to recognize the sovereignty and borders of Kuwait, and the regime
continues to destroy the lives of the marsh Arabs of southern Iraq. These facts
serve as reminders of why we must and why we will maintain the sanctions.
Of equal importance is our effort to contain Iran, the world's leading state
sponsor of terrorism. We pledge to work with like- minded countries to meet the
challenge of Iran's support for terrorist groups, its efforts to acquire weapons
of mass destruction, and its campaign to subvert moderate regimes that have
opted for peace. We must do this. We call upon all our allies to recognize the
true nature of Iranian intentions and to help us convince Tehran that we will
not tolerate rogue behavior.
Now, let me conclude on a happier and more positive note. It's been said that,
unless a person is a recipient of charity, he or she should be a contributor to
it. Your work through B'nai B'rith gives life to that generous thought. So
this week, as you reflect on your wonderful acts of community service and plan
new ones, let me once again express the gratitude of our nation for all you've
done and all that you will do.
Thank you very much. (Applause.)
MR. KENT SCHINER (President, B'nai B'rith) : Mr. President, you can hear by the
applause the acceptance of those words that you gave us, words of hope, words of
peace. Let me take this opportunity to thank you. In the past you have
graciously thanked B'nai B'rith for our contributions to the community. This
afternoon it is my turn to thank you for what you have done to promote world
peace, particularly in the Middle East, and for your efforts to address the
problems of health care and crime. We thank you. (Applause.)
As you know, Mr. President, we have members in 51 countries around the world,
and we have a few here that would like to ask you a question. May I ask the
first one to identify himself and ask his question.
Q Mr. President, I am -- (name inaudible) -- president of B'nai B'rith of
Argentina. At this convention there are delegates from Panama, Argentina and
Great Britain, three countries which recently suffered, witnessed the terrorist
attacks committed by international terrorists. The recent bombings in Buenos
Aires, Panama and London, not to mention the World Trade Center in New York
City, indicate a global wave of violence directed against innocent citizens.
What is your administration actually can do and will do to combat this threat
domestically and internationally?
PRESIDENT CLINTON: Let me tell you what we are doing. First of all, you can see
from the results of our efforts to solve the World Trade Center bombing case
that we are very aggressive in pursuing these cases. We are intensifying our
international cooperation, working with Argentina, Great Britain and Panama and
other countries to try to help resolve who did these terrible acts of terrorism
and apprehend the perpetrators. In addition to that, we are increasing our
cooperation through intelligence and law enforcement services with countries
throughout the globe to try to prevent such acts from occurring in the first
place.
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So we're trying to intensify our efforts at prevention and intensify our efforts
at catching people when they do these terrible things. And I think we will have
some considerable success. But we must not be naive. There are a lot of people
who have a big vested interest in the continued misery of people in the Middle
East, the continued anxiety of Arabs, particularly Palestinians and others, and
they hate the fact that peace is winning converts and making progress. So as we
move through the peace process, if we continue to have success the enemies of
peace will continue to look for opportunities to make innocent people pay the
price so that they can continue to make money and accumulate political power on
the human misery that has dominated the Middle East for decades. So they'll be
there, but we are doing what we can and we are putting more resources into the
effort to stop them before they do and to catch and punish them if we're
unsuccessful in stopping them in the first place. (Applause.)
MR. SCHINER: Thank you very much.
Q Good afternoon, Mr. President. My name is Janet Wiseberg (sp). I'm from
Saint Louis, Missouri. I'm a house care consultant. The B'nai B'rith board of
governors passed a resolution in April of this year that would guarantee that
all individuals or families are assured adequate and affordable health care
coverage, provide home and community-based services, and assure coverage for
those with preexisting conditions.
B'nai B'rith applauds your efforts and the first lady's efforts for placing
health care reform as an urgent matter on the American agenda. It is our
understanding that the proposal put forth by the so-called "mainstream" group of
senators has gained much support and has gutted the Mitchell bill, cutting the
home and community-based long-term care by 85 percent. Despite the fact that
your bill and the Mitchell bill did not include means testing, it is my
understanding that the mainstream group has recommended a stringent means test
making home and community-based services available only for those who fall with
150 percent of poverty. The most distressing development is that the mainstream
group has eliminated coverage for prescription drugs.
Sir, my question is, at this critical juncture in the debate, what is your
commitment to home and community-based long-term care, no means testing, and
prescription drug coverage?
PRESIDENT CLINTON: Well my commitment is just as broad as it ever was. I think
the provision of the prescription drugs, the long term care, is very important.
But let me inject a little political reality here. The real problem is that we
have members of the United States Senate, including some people who have been
very good friends of B'nai B'rith, who are walking away from what is the only
known way to provide universal coverage, control cost increases in the out
years, and still generate enough money to provide these services, which is
simply to require all employers and employees to provide insurance and then
provide discounts to those who can't afford to pay the full cost. Once you say
we're giving up on the requirement that employers provide health insurance and
their employees help to pay for it, even in five years or six years from now, in
the so-called hard trigger that Senator Mitchell advocated, once you walk away
from that then you find the Senate basically getting into taxes and government
regulation to try to raise a huge amount of money from people who are already
paying for their health insurance and already have good health insurance to go
throw it at people who have insisted on not being asked to do anything on their
own in the hope that they can induce them with somebody else's money to do
something they ought to do anyway.
And that leaves less money for prescription drugs and long-term care. Now that's
basically what's happened.
This whole debate has been mischaracterized. I think that our position is the
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essentially conservative one where we simply ask everybody to do their part,
since they are benefitting from the health care system, and buy private health
insurance, and then help them if they can't afford to buy at the full price.
But everybody is asked to do something.
The so-called moderate and conservative people are trying to find ways to raise
money from people who are already doing their part to basically overly subsidize
people who don't have insurance and employers who could afford to pay and don't
in the hope that they can plead with them to do something that they are
unwilling to require in the law. And that is the nub of all of our other
problems.
If you are asking me where I am, I am still where I always was. I will do my
very best to provide it. I talked to a member of the Congress today who needed
some long-term care at home for an ailing parent. We need to do this; we need
it desperately. But I would urge you to talk to the members of Congress in both
parties who've been your friends and ask them to look at the real world instead
of the kind of ideological box that they have put themselves in and do something
that will work.
The main thing we must do is we must do something that will work, and it will be
better not to do anything at all than to adopt a program that would actually
increase costs of health care and reduce coverage. That's what we don't want to
do. (Applause.)
Q Hello, Mr. President, I'm Irving Silver, Mobile, Alabama, chairman of the
B'nai B'rith Center for Public Policy. We certainly appreciate the role played
by your administration and the Congress and for the part they have played in
helping to bring about and support the Washington Declaration signed by Israel
and Jordan. We are especially pleased by the confidence-building measures
already taken by King Hussein and Prime Minister Rabin to advance the
relationship between their two countries.
On the other hand, Yasser Arafat and the leaders of the Palestinian authority
continue to dampen the agreement between the PLO and Israel by negative actions
and statements. What is the administration doing, Mr. President, to impress
upon Arafat and the PLO, the PLO leadership that its agreement with Israel can
only succeed if it accepts the spirit as well as the letter of its provisions?
PRESIDENT CLINTON: Well, we're telling him just what you said, and we're doing
it on a regular basis. The secretary of state is in constant contact with Mr.
Arafat, we are working with the PLO people. We understood all along that because
they had never actually run a country before and operated a government in all of
its manifestations, with all of its problems, that there would be more
difficulties here, operational difficulties in making the agreement actually
work. But we are working hard on that, and we are also trying to provide
assistance and support, as well as pressure, when that will help to get them to
do what they are supposed to do.
We've also been very blessed in having a group of Jewish American and Arab
American business people who are working together and are prepared to make some
investments in those areas if we can get the PLO to in a position where they
can actually effectively and implement this. So I believe that the biggest
problem is one of capacity, and I think that the limited capacity is undermining
the question of will from time to time. We just have to keep the pressure on
and also have to keep working practically to increase the capacity for this
agreement to be implemented by the PLO.
Thank you. Thank you. (Applause.)
MR. SCHINER: Again, Mr. President, on behalf of the half million people and
members who affiliate with B'nai B'rith in 51 countries on six continents, we
thank you for your warm greeting and your important message. Thank you very
PAGE 10
Federal News Service, AUGUST 24, 1994
FOCUS
much, Kent. Thank you. (Applause.)
END
LANGUAGE: ENGLISH
LOAD-DATE-MDC: August 24, 1994
PAGE
1
FOCUS - 1 OF 54 STORIES
Copyright 1994 Federal Information Systems Corporation
Federal News Service
SEPTEMBER 3, 1994, SATURDAY
SECTION: IN THE NEWS
LENGTH: 1336 words
HEADLINE: PRESIDENT CLINTON'S SATURDAY RADIO ADDRESS
BODY:
PRESIDENT CLINTON: Good morning. For most Americans this Labor Day weekend is
our last chance to catch our breath before the hustle and bustle of the fall.
I'm on vacation with my family, and many of you may be driving to the beach or
the lake for the last long weekend of summer. Maybe you're planning to do some
back yard -- back to school shopping or have a back yard barbecue for your
family and friends. Or perhaps you're one of the unsung heroes of Labor Day --
the police officers, the health care workers -- who have to be on the job this
weekend.
Whether you're working or relaxing, let's take a few minutes to remember the
story of Labor Day and what it says about the promise of American life.
One hundred years ago America created this national holiday to honor our working
men and women. One hundred Labor Days later, it's founders would be proud to
know that the vast majority of our working people have lifted themselves into
the great American middle class. We didn't do it with handouts, but by working
-- hard working, smart working. The American way is to offer opportunity and
challenge people to make the most of it. We have a unique partnership between
government, business, labor and individual citizens. It's given us the public
school system, the state universities, collective bargaining, the G.I. Bill, to
name just a few. All partnerships that have given Americans the tools to build
better lives for themselves.
For the past two decades, however, more and more people have had a harder time
achieving the American dream. Too many Americans have found themselves working
longer and harder for stagnant wages. Crime and terrible social problems have
rendered our quality of life more tenuous. Global economic competition and
serious, serious problems at home have really complicated our lives.
The American people have suffered and, for too often and too many ways, the
national government has ignored these problems or even made some of them worse.
We have actually managed to quadruple our national debt in the decade of the
'80s, while reversing and declining in our commitment to invest in our people
and our economic future. I ran for president because I think our nation's
mission at the close of the 20th century must be to keep the American dream
alive in the 21st century. We need a plan for the future that puts our people
first, that has a partnership that creates opportunity, insists on more personal
responsibility from our people, and enables us to rebuild our communities.
We face tough challenges. And change is always hard. The status quo has always
had powerful friends. But the families we honor on Labor Day deserve better.
Last year we began to put into place this strategy for the future, beginning
with an effort to renew our economy and put our economic house in order, with
the biggest budget deficit reduction package in history, including $255 billion
in spending cuts, tax increases for the wealthiest one and a half percent of
Americans, and tax relief for 15 million working families with children, to
encourage them to keep working and not fall back into welfare.
PAGE
2
Federal News Service, SEPTEMBER 3, 1994
FOCUS
We pried open new markets around the world for American workers with NAFTA, a
world-wide trade agreement, new openings to Japan and the rest of Asia, serious
efforts to sell American products -- everything from airplanes to apples.
While we cut spending, we actually invested more in the life- long education and
training that our people will need in the global economy, from head-start to
apprenticeships for young people who don't go on to college, to constant job
training opportunities for people once they're in the work force.
The friends of the failed policies of the past the people who raised taxes on
the middle class, lowered them on the wealthy, reduced investment in our people
and exploded our deficit -- they predicted this economic strategy would fail.
They said it would produce disaster. But, instead, in just 19 months, our
economy has created more than 4.2 million new jobs -- 93 percent of them in the
private sector. Yesterday we got more good news; we reached 2 million new jobs
this year, and the year still has four months to go. And that total includes
135,000 new manufacturing jobs created this year. For the first time in 10
years, manufacturing jobs have increased for eight consecutive months.
In addition, 20 million young Americans are already eligible to re-finance their
college loans at lower interest rates with longer repayment terms. And we're
going to have three years of deficit reduction for the first time since Harry
Truman was president, creating a more stable future for our children.
Restoring opportunity, honoring work and family and community; that's what this
administration and our mission are all about. A big part of that is personal
security. And all of you saw that as the debate over the crime bill unfolded in
the last several weeks. We have reduced the size of the federal bureaucracy by
over 270,000 over the next six years and taken all that money to give it back to
local communities to make children and families safer 100,000 more police,
more prisons, longer sentences for serious offenders, the programs to help young
people have something to say "Yes" to, to prevent crimes -- drug courts, boot
camps, education and job training programs, jobs and activities for young
people, and a ban on juvenile ownership of handguns and on assault weapons.
Again, there was bitter opposition. The status quo had powerful friends, but
the American people and the American future won. In everything we do, we must
honor work and family and community. That's why we're fighting for health
security for working Americans by providing universal coverage and controlling
costs, why we're working to reform the welfare system, to help people move from
public assistance to productive jobs, and why we're changing the unemployment
system to a re-employment system to help people continuously get the training,
the counselling, the information they need about new jobs.
Our work won't be done until all Americans enjoy the dignity of work, the
security of world-class skills, and the opportunity to build a life for
themselves and their children that is better. That can only be done by taking a
new direction, not a government which says we can do alone, and certainly not a
government that sits on the sidelines, but one that works in partnership with
business and with our individual working men and women and their families.
On Labor Day Monday -- I'll be visiting with workers at a shipyard in Bath,
Maine, where that partnership is taking place, where labor and management have
made a uniquely American covenant with themselves and with their government --
with themselves to share the responsibility and rewards for the company's
success, and with their government to take a little help to move from a
defense-based economy to prove that they can compete and win in a global economy
that involves far more than defense. Those shipyard workers in Maine exemplify
the best in the American spirit the understanding that, when we pull together
for the common good, we are unstoppable.
This Monday, Labor Day, you will see that spirit all across our country -- in
PAGE
3
Federal News Service, SEPTEMBER 3, 1994
FOCUS
Milwaukee at the Labor Day parade, and Little Rock
at the Old Time American Union picnic. In Michigan, as they have on every Labor
Day since 1958, you will see tens of thousands of people walking the five miles
across the Mackinac Bridge, connecting the state's upper and lower peninsulas.
Next Sunday in Washington, D.C., there will be a special Labor Day mass at the
National Shrine of the Immaculate Conception, to bear witness to the timeless
truth that work gives structure and meaning to our lives and is divinely
ordained.
Whatever you're doing this weekend, I wish you all the best for yourselves and
your families. I thank you for listening and for your dedication to our
country.
LANGUAGE: ENGLISH
LOAD-DATE-MDC: September 3, 1994
PHOTOCOPY
PRESERVATION
Universal Coverage
FOCUS
HEALTH
JULIE KOSTERLITZ
BACK TO THE FUTURE
F
rom "A Decade of Health Care
But the flood of sick people into
Reform," published in National
the system forced insurers to hike
Journal on April 30, 2004:
their rates to small businesses and
At 11:45 P.M. on Oct. 6, 1994-
individuals by 50 per cent more than
after months of rancorous debate
they had intended. That caused hun-
and just 15 minutes before Congress
dreds of thousands of relatively
was to adjourn and head home to
young, healthy Americans to drop
face the electorate-the American
their coverage. Worried insurers
Good-Enough-for-Now Health Care
complained about "reverse cherry
Reform Act passed. The vote in the
picking" by consumers and doubled
House was 284-149 (and two absten-
the next year's planned premium
tions); in the Senate, it was 79-20,
increases.
with one Senator absent because of
The individuals and small busi-
a heart attack sustained during a
Peter Kuper/INX
nesses who remained in the purchas-
protracted filibuster.
ing cooperatives didn't notice the
Enactment of an incremental
rate hikes right away: Pooling had
reform measure had been some-
lowered their rates significantly the
thing of a foregone conclusion since
first year, and the second-year rate
earlier in the year, when the chairmen of three House commit-
increase persuaded many of them to switch to lower-priced
tees were able to eke out only slim majorities on their panels for
health maintenance organizations (HMOs).
legislation that would guarantee health insurance coverage to all
In the meantime, HMOs discovered that they could make
Americans. A Senate committee defeated similar legislation by
fabulous profits by getting lean and mean. That meant not only
five votes.
getting efficient, but also finding ways to turn away the unin-
A comprehensive reform bill was "simply too much of a bur-
sured. Doctors used to be able to take charity cases and pass
den on small business and the American taxpayer," said Rep.
along the costs to paying patients; now, though, they had bud-
Kent Afford, the critical vote on the House Committee on
gets to meet and could no longer play Robin Hood.
Large and Popular but Expensive Entitlements. It was Afford, a
And there were still plenty of uninsured people. Although the
southern Democrat then embroiled in a tough Senate race,
number dropped initially from 37 million to 36 million, most
whose opposition to the Democratic leadership bill was widely
employers of low-wage workers found that buying insurance
seen as a turning point in the debate.
coverage was still uneconomical. Without help from their
AGENHCRA (pronounced agon-hicra)-as it became
employers, lower-income people could not afford coverage. The
known-took a targeted approach to what ailed America most.
unemployed were out of luck, too.
Or, to be more accurate, to what ailed middle America most.
Uninsured people could go to the new community health cen-
Middle Americans, Congress wisely noted, were largely
ters and affiliated public hospitals. But these facilities were over-
happy with their health insurance and afraid of messing with it.
whelmed, with six-hour waits in the emergency rooms and three-
In fact, the main thing that bothered them was that anyone
month waits for office visits. With medicare and medicaid
with a hangnail risked being turned down for health insurance
reimbursements slashed, many private doctors refused to see
as a bad risk, or charged astronomical sums for it. Bad health,
poor elderly people and welfare recipients; these patients
after all, can strike anyone, and even the insurance industry
showed up at the clinics, too.
recognized that this "cherry picking" was not making for a
Liberals proposed additional spending for the clinics, but the
good image.
1998 Don't-We-Already-Pay-Enough-for-Those-People Budget
And so, AGENHCRA required insurers to take all comers.
Act included no new spending for them. Deficit hawks noted
And they couldn't charge the old or sick an arm and a leg for
that the budget for the clinics had grown at four times the pro-
their policies either-henceforth they could charge only an arm.
jected rate. "I think we all want to provide a safety net for the
Individuals and small businesses could join what would be
truly needy," said Afford, by then a Senator and oft-mentioned
called People's Insurance Purchasing Cooperatives to pool their
candidate for President. "But we also live in an era of limits."
risks and their purchasing power, thereby diminishing the extra
There were a few predictable horror stories-such as the His-
premium that small employers once had to pay. The self-
panic woman who died in childbirth on the lawn of a Miami hos-
employed could take tax deductions for 100 per cent of their
pital. Several Members of Congress proposed requiring health
insurance costs. And for the poor and uninsured, there was the
plans to treat charity patients. But the business community
promise of a new network of community health centers,
balked, saying that would lead to higher prices for insured
financed by cuts in the medicare program for the elderly and the
patients and their employers. In the end, state governments had
medicaid program for welfare recipients. Insurance forms were
to raise taxes to keep the clinics afloat.
streamlined, malpractice suits were banned. Waste, fraud and
It wasn't until the millenium, when the purchasing coopera-
abuse were to be eliminated.
tives collapsed under the weight of their high-risk clientele and
The relief among middle Americans was palpable. On Jan. 1,
recession swelled the ranks of the uninsured by millions, that
1995, a million people who had previously been denied coverage
middle-class Americans took to the streets to demand universal
because of poor health deluged the offices of health insurers
health care coverage.
from coast to coast. The coverage was expensive, but most of
Sen. Afford dropped his presidential bid, retired from the
these bad risks weren't poor, and they were happy to pay.
Senate and joined a prestigious Washington law firm.
NATIONAL JOURNAL 4/30/94 1039
Catholic Health Association
Healthcare Reform Issue Paper No. 5
Reform Will Fail
Without Universal Coverage
Prepared by:
Catholic Health Association
of the United States
Division of Government Services
Washington, D.C.
202/296-3993
July 27, 1994
CHA.
THE CATHOLIC HEALTH ASSOCIATION
OF THE UNITED STATES
Catholic Health Association
Healthcare Reform Issue Paper No. 5
Reform Will Fail
Without Universal Coverage
Prepared by:
Catholic Health Association
of the United States
Division of Government Services
Washington, D.C.
202/296-3993
July 27, 1994
REFORM WILL FAIL WITHOUT UNIVERSAL COVERAGE
Incremental healthcare reform will leave most of the uninsured without coverage.
In a recent study for the Catholic Health Association, Lewin-VHI concluded that
insurance market reforms would cover only about 1.1 million of the nation's 37
million uninsured. When subsidies are added for low income populations -- as in
Representative Jim Cooper's "Managed Competition Act" -- only about 40 percent
of the currently uninsured would be covered.¹ The Congressional Budget Office
came to a similar conclusion about the Cooper proposal, estimating that 24 million
persons would remain uninsured in 1996 (Exhibit 1).²
Without universal coverage, managed competition will fail. Specifically, insurance
market reforms and partial subsidies in an approach like the Cooper proposal will:
Drive up premium costs
Destabilize insurance markets and make insurance unaffordable for
many businesses and families
Undercut managed competition as plans and providers compete by
avoiding the uninsured rather than becoming more efficient
Impair indigent care providers by eroding cross-subsidies for the
uninsured
Exacerbate access problems for the remaining uninsured
This paper discusses each of these problems in turn.
1.
Drive up premium costs
Lewin-VHI concluded that insurance market reforms coupled with subsidies--as in
the Cooper proposal--would increase average annual insurance premiums for
families already insured by $260. This is because the people who will opt to buy
insurance as it becomes more available under a non-universal reform approach are
those who are most likely to need it -- that is, persons who are already ill or more
likely to become ill because of their age or health status. Young and healthy
people, on the other hand, will tend to forego coverage. The result will be higher
average premiums for the overall insurance pool.
2
"This increase in overall average premiums," concluded the Lewin-VHI study, "is
largely averted under a program of universal coverage... This is because a
universal coverage plan would require all individuals to participate in the insurance
pool including healthier individuals who receive little health care."³ Universal
coverage, reported Lewin--VHI, would increase average family premiums by less
than 2 percent, or about $78 per year.4
CBO also noted this problem in the Cooper proposal, projecting that insurance
premiums would be higher than under the President's proposal, even assuming an
identical benefit package.
These projections are consistent with actual experience in New York State which
recently implemented insurance market reforms without universal coverage.
Community rating, combined with mandatory acceptance and other key reforms
in the small group market, resulted in a 19 percent increase in premiums for small
firms, and an 18 percent increase in average premiums for individuals.
2.
Destabilize insurance markets and make insurance unaffordable for
many businesses and families
This is the ironic impact of expanded insurance availability without universal
coverage. While many people will gain coverage under insurance market reforms,
others will find rising premiums unaffordable. Signs of this impact are already
evident in New York. As of January 1 1994, according to state insurance
department data, 25,477 fewer people had insurance in the individual and small
group market than when community rating and other reforms took effect 9 months
earlier. That represents a 1.2 percent decline in coverage.⁷
The Lewin-VHI study noted that this dynamic can destabilize insurance markets
and render the potential success of non-universal approaches to reform tenuous at
best:
Universal coverage reduces consumer exit and entry into
health insurance markets because if people can move
freely in and out of the system, the healthy will tend to
avoid insurance coverage until they become ill To the
extent this issue is not addressed in a reform proposal,
3
premiums are driven up, encouraging more people to
become uninsured.⁸
The result is an upward "premium spiral" as illustrated in Exhibit 2. Especially
troubling is the implication of this dynamic for the small businesses that currently
provide insurance to their workers. Employer-based coverage has already declined
in recent years, but with non-universal reform there is a significant risk that even
more small businesses will find premiums unaffordable.
3.
Undercut managed competition as plans and providers compete by
avoiding the uninsured rather than becoming more efficient
The goal of managed competition is to create a "level playing field" among plans
and providers. Consumers are then made more sensitive to costs, placing pressure
on plans to become more efficient in order to attract enrollees. But without
universal coverage, the easiest way to lower costs will be to avoid the uninsured.
Managed care plans will increasingly seek physicians and hospitals without the
"hidden tax" associated with the medically indigent. Providers, in turn, will come
under tremendous pressure to avoid the uninsured.
This problem is exacerbated by government underpayment for Medicare,
Medicaid, and other government programs. According to the Prospective Payment
Assessment Commission, Medicare pays hospitals only about 93 percent of costs,
a figure that does not reflect the most recent round of Medicare cutbacks.⁹
Similarly, Medicare pays physicians an average of 59 percent of what private
insurers pay, and state Medicaid programs pay on average 73 percent of Medicare
rates.
10 Providers that continue to serve these populations will face an escalating
and unfair competitive disadvantage under managed competition.
Trouble signs are already appearing on this issue. A new UCLA/RAND study
concludes that:
hospitals in California substantially reduced -- by about
36 percent -- their overall provision of uncompensated
care compared to what they would have provided
between 1980 and 1989 as a result of the increasing
pressure from three different sources: Medicare, the
4
Medi-cal (Medicaid) selective contracting system; and the
price competition induced by private payers organized
into managed care networks.
4.
Impair indigent care providers by eroding cross-subsidies for the
uninsured.
It is precisely those physicians and hospitals that serve the uninsured, the poor,
and the elderly that will be put most at risk without universal coverage. Additional
cutbacks in Medicare and Medicaid are already a certainty given the federal budget
deficit and state budget woes. Indeed, all of the major reform proposals --
Democratic and Republican -- include major Medicare reductions. As these
reductions occur, increasing competition will strip out traditional cross-subsidies
for government programs and the uninsured. Providers that have traditionally
served the uninsured will face the untenable choice of either abandoning needy
populations or losing financially.
In the case of hospitals, a desirable outcome of competition will be the closing and
consolidation of many facilities. But an undesirable outcome will be to have the
wrong hospitals close those that serve underfinanced and vulnerable populations,
especially in rural and inner city areas. The best way to avoid this problem
without massive regulatory intervention is to cover the uninsured.
5.
Exacerbate access problems for the remaining uninsured
Opponents of universal coverage often stress that an approach like the Cooper
proposal would expand insurance to cover "97 percent of health care spending and
91 percent of Americans. The 97 percent figure assumes, however, that the 24
million persons who remain uninsured would continue to receive inadequate care.
Currently, the uninsured receive only about 60 percent as much care as their
insured counterparts,¹³ and much of what they do receive occurs in expensive
settings and for conditions that have become more severe due to postponed
treatment. Compared to their insured counterparts, the uninsured are:
Twice as likely to have no regular source of care.¹⁴
5
Twice as likely to use the emergency room as their regular source of
care. 15
Over three times as likely to report that "there was a time when they
needed medical care and did not get it for financial reasons;"¹⁶
72 to 112 percent more likely (among children) to go without a
physician visit for pharyngitis, acute earache, recurrent ear infections,
and asthma. 17
42 to 60 percent less likely (among women) to receive adequate
preventive screening for hypertension, cervical cancer, breast cancer,
and glaucoma. 18
29 to 75 percent less likely to receive selected high-cost or high
discretion inpatient procedures such as coronary artery bypass
surgery, total knee replacement, and total hip replacement.¹⁹
Two to three times more likely to die once they are hospitalized for
particular diagnoses. 20
25 percent more likely to die prematurely.21
Increased competition without universal coverage can only exacerbate these
patterns. In the final analysis, all of our efforts on healthcare reform will and
should be judged by whether we eliminate these unjustifiable discrepancies.
Managed competition without universal coverage will fail for many reasons. Most
troubling, however, will be the failure to prevent and treat illness for millions of
working Americans.
EXHIBIT I
COOPER PROPOSAL LEAVES 24 MILLION UNINSURED
Uninsured (in millions)
18
16
Uninsured in Current System
14
Uninsured Under Rep. Cooper's
"Managed Competition Act"
12
10
8
6
4
2
O
< $15,000
$15-30,000
$30-46,000
$46-61,000
$61,000 +
Under Poverty
100-200%
200-300%
300-400%
400% +
of Poverty
of Poverty
of Poverty
of Poverty
Note: Incomes catagorized by percentages of poverty; dollar ranges shown for family of four; projections are for 1996.
Source: Congressional Budget Office, "An Analysis of the Managed Competition Act", 5/94; Tables 4-1,2.
The Catholic Health Association of The United States
2
The Vicious, Upward Spiral
Incremental Reform Increases Insurance Premiums and the Number of Uninsured
Insurance reforms extend
coverage to sick and high
users of care.
Shrinking insurance
pool has higher average
costs for the less
healthy who remain.
Premiums rise again.
Newly insured sick drive
up average premiums for
currently insured. *
Higher premiums cause
some healthy individuals
and firms to drop coverage.
*Universal coverage averts this problem by also including healthier, lower-cost individuals in the
insurance pool, thereby holding down average premiums.
Source: The Catholic Health Association of the United States
8
1.
Lewin-VHI, Inc., Coverage, Premium and Household Spending Implications
of Health Reform, prepared for the Catholic Health Association of the
United States, July 18, 1994, p. 3.
2.
Congressional Budget Office, An Analysis of the Managed Competition Act,
April 1994, p. 20.
3.
Lewin-VHI, Inc., p. 5
4.
Lewin-VHI, Inc., p. 6.
5.
Congressional Budget Office, An Analysis of the Managed Competition Act,
April 1994, p. 8.
6.
Matthew P. Schwartz, National Underwriter, April 12, 1993, V97(15),
pg.2.
7.
Hilary Stout, "Community-Rated Health Plans Prove Popular, but Success
May Depend on Universal Coverage, Wall Street Journal, June 15, 1994,
p.20.
8.
Lewin-VHI, Inc., p. iv.
9.
Prospective Payment Assessment Commission, Medicare and the American
Health Care System, Report to the Congress, June, 1994, p. 56.
10.
Physician Payment Review Commission, Annual Report to Congress, p. 73.
11. Glenn Melnick and Joyce Mann, Western Consortium for Public Health and
UCLA/RAND, Unpublished study findings as reported in "Health Care Financing and
Organization," Robert Wood Johnson Foundation, March, 1994.
12.
Healthcare Leadership Council, "97 Percent of Health Care Spending and
91 Percent of Americans can be Covered Without Price Controls or
Mandates" (Press release dated Many 20, 1994)
13.
Lewin-VHI, Inc., The Financial Impact of the Health Security Act,
December 9, 1993.
14. The Robert Wood Johnson Foundation Access Survey, 1986.
15. The Robert Wood Johnson Foundation Access Survey, 1986.
9
16. The Kaiser/Commonwealth Fund Second National Health Insurance Survey,
November 10, 1993, Louis Harris and Associates, Inc.
17. J.J. Storrdard, R.F. St Peter, and P.W. Newacheck, "Health Insurance
Status and Ambulatory Care for Children," New England Journal of
Medicine, May 19, 1994, Volume 330, Number 20, p. 1421.
18. Steffie Woolhandler, MD, MPH and David Himmilstein, MD. "Reverse
Targeting of Preventive Care due to Lack of Health Insurance." Journal of
the American Medical Association, May 20, 1988, Vol. 259, No. 19.
19. Jack Hadley, Ph.D., et.al. "Comparison of Uninsured and Privately Insured
Hospital Patients." JAMA, January 16, 1991, 265(3), p. 374.
20. J. Hadley, E.P. Steinberg, and J. Feder, "Comparison of Uninsured and
Privately Insured Hospital Patients: condition on Admission, Resource Use,
and Outcome," JAMA 1993; 270:737-41.
21. Peter Franks, MD, et.al., "Health Insurance and Mortality." JAMA,
August 16, 1993, 270(6), p.737.
WHY WE NEED UNIVERSAL COVERAGE:
Incremental measures cannot accomplish most goals of health reform.
Almost every goal of comprehensive reform depends on universal coverage.
1) Without universal coverage, the hard working middle-class is left behind.
Partial solutions will protect the wealthy and help the poor, but stick it to the middle-class.
These half-measures and quick fixes would leave every middle class American at risk of losing
their insurance. And at least 24 million Americans who work for a living would have no
coverage at all. People like Jim Bryant and his family. Jim Bryant works 70 hours a week,
juggling two jobs, but has no health insurance for his family. And the Congressional Budget
Office also says that under the 91% scheme. "health insurance coverage would probably be
more limited for middle-income people than the rich or poor. [CBO analysis, 5/94, pp. 17, 20]
2) Without universal coverage, every American remains at risk of losing their insurance.
Those who urge Band-Aid solutions say they're reforming the health care system. But they fail
to provide every American with the ironclad guarantee that they'll have private health insurance
that can never be taken away. According to a new study by Families USA, under a partial
solution over one million Americans a month will still lose their insurance. We need universal
coverage because every family - including middle-class families must be protected. [Families
USA Special Report, 6/94, p. 1]
3) Without universal coverage, the link between work and reward is broken.
Think of the message that non-universal reform would send to literally millions and millions of
working Americans. It would say, much as we do today, "If you are lucky enough to work for
someone who will help you with your insurance, or if you are poor enough and down on your
luck enough to qualify for government assistance, then you'll have health security. But, if you're
in the middle and you get up every day and work for a living, your health coverage is always at
risk."
In fact, surveys suggest that as many as 30 percent of people feel locked into their current jobs
because they fear losing the health insurance their families depend on. The CBO has said that
incremental reforms will "reduce" but not solve this problem. ["Health Benefits Found to Deter
Switches in Jobs," The New York Times, 9/26/91; CBO, 4/94, p. 28]
4) Without universal coverage, we pay more to cover less.
The CBO has said that under the President's proposal, "significant deficit reduction will be
achieved by 2004." Under the 91% scheme where billions in government subsidies are used
to help the poorest people buy insurance a $300 billion shortfall would result by 2004.
Meanwhile, the President's proposal would guarantee coverage to everyone, while the 91%
scheme wouldn't guarantee coverage to anyone. [CBO analysis, p. 22]
5) Without universal coverage, insurance reforms won't work.
Today, insurers pick and choose who to cover -- charging sick people significantly more based
on their health care "experience". One of the main goals of the President's proposal is to
prohibit insurers from discriminating against people: no more charging sick people more than
healthy people, young people more than old, small businesses more than large businesses. This
will return insurance to what it used to be everyone pays in at the "community rate" and their
insurance is there when they need it.
But, the Wall Street Journal says that "experts insist and real-life evidence shows" that insurance
reforms such as community rating would be "nearly impossible without universal coverage".
In fact, when one state recently enacted insurance reform without universal coverage, rates for
the insured went up by 35% and the number of people with insurance declined. Why? Because
all the sick people who had previously been denied coverage entered the system, driving up the
rates for everyone. This caused young, healthy people and their employers to drop their
coverage, which drove rates even higher. In fact, the CBO has said that incremental reforms can
cause "an upward spiral" of premiums, with fewer people covered at the end. [WSJ, 6/15/94; WSJ,
5/27/94; CBO, p. x1v]
6) Without universal coverage, thousands of Americans will stay on welfare.
Studies have shown that thousands of people are on welfare because it's the only way their
families can get health care coverage. An analysis of the effects of the Clinton proposal
estimate that at least 840,000 people or 15% of welfare rolls -- will leave if the President's
reform passes. While some incremental reform proposals would solve this, insurance reforms
without subsidies would do nothing to encourage people to leave welfare for a job. Just like
today, they say to those on welfare: "If you stay on welfare, you and your family will be
protected by comprehensive health benefits. If you leave welfare and get a minimum-wage job,
not only are you unlikely to get health care but your taxes will pay for health care for those who
remain on welfare." [Ellwood and Adams, Health Care Financing Review, 1990 Supplement: University of
Wisconsin, L.A. Times, 11/18/93]
7) Without universal coverage, people with insurance will pay for those without insurance.
When people without insurance get in an accident and go to the emergency room, they receive
the health care they need. But when they can't pay their bills, the hospital shifts these costs onto
people with private insurance. Some experts estimate that $25 billion in health care costs are
shifted onto people with private insurance each year. Without universal coverage, this "cost-
shift" will remain in the system -- penalizing those who take responsibility and letting millions
of others "ride free". [Congressional Budget Office, May 1993]
2
8) Without universal coverage, for all workers, responsible businesses bear the burden.
Today, the businesses that provide their employees with insurance pay for those who do not. A
recent study found that as much as one third of premiums currently paid by employers who
provide coverage for their employees and dependents goes to cover the shortfall from companies
who do not cover their employees and families. In 1991, employers spent $26.5 billion to cover
dependents who are employed by firms that did not offer insurance. [Hewitt Associates, 1/94;
National Association of Manufacturers/Lewin-ICF. 12/91]
9) Without universal coverage, billions will be wasted on expensive, last-minute care.
Until all Americans have comprehensive benefits stressing preventive and primary care, billions
of dollars will continue to be wasted on expensive, last-minute care. A national survey of
hospital emergency room departments determined that fifty-five percent -- or 50 million -- of the
90 million emergency room visits in 1992 were for ailments that were not medical emergencies
and could have been treated in a doctor's office. An emergency room visit costs at least three
times that of a visit to a community-based physician in the same area. [National Hospital Ambulatory
Medical Care Survey, 1994; HHS, Inspector General Report, 1992]
10) Experts Agree -- We Can't Get Cost Control Without Universal Coverage:
Rashi Fein, Medical Economics, Harvard University: "We cannot have real savings and
real cost containment without universal enrollment. Such enrollment is not a welcome bonus
delivered with cost containment dollars; it is what makes cost containment possible. Only with
universality can we eliminate the practice of making patients with insurance pay the medical
costs of those without it. [New York Times, 10/28/93]
Ted Marmor and Jerry Mashaw, Yale University: "It is the experience of every
industrialized democracy with a universal health insurance program that cost control becomes
easier when the plan is universal, not harder. that counsel currently offered by critics -- go
slow in adding new benefits until we can assure everyone that the savings are real -- is advice
that is likely to doom the plan to failure. Universalism and cost control go hand in hand.
Otherwise it is politics as usual, full of special pleading.' [L.A. Times, 10/7/93]
The Washington Post: "Universal coverage is not only a fair and noble objective, consistent
with America's values: it is also essential if health care markets are to work well. [Editorial
Page, 6/16/94]
Alain Enthoven: "By putting market pressure on providers to cut costs, market reforms
promoting competition -- absent universal coverage - could exacerbate access problems. It
would be more humane, economical and rational simply to adopt a policy providing coverage to
virtually everybody through an integrated financing and delivery organization that provides
primary and preventive care as a part of a comprehensive benefits package. "Health Affairs, 1993]
3
To: Verveer, Melanne
From: GOLDBERG_JS
6-30-94 9:22am D. 2 of 5
WHAT WILL HAPPEN IF WE PASS BOB DOLE'S PLAN,
INSTEAD OF A UNIVERSAL COVERAGE PLAN ?
Middle Class Americans Will Be Left Out
Small Businesses Will Pay More
Government Costs Will Rise
Insurance Reforms Won't Work
Cost Shifting Will Continue
The Number Of Uninsured Will Continue To Increase
1. Middle Class Americans Will Be Left Out
Without universal coverage "health insurance coverage would prohably he more
limited for middle income people than the rich or poor." [CBO, 5/94, pp. 17, 20]
Partial solutions will leave 24 million Americans, more than two thirds of them in
middle class working families without coverage Their taxes will pay for health care
for millions of others who do not work, but they won't be able to gct coverage for
themselves. [Based on CBO, 7/93; CBO 5/94; Alain Enthoven, Health Affairs, 1993]
"Already the fraction of adults who work but have no public or private insurance has
risen to 17.5% in 1992 from 15.3% in 1988, the Census Burcau says. And employment
is growing fastest in industries that tend not to offer health insurance." ["Health-Care
Inaction Can Carry a High Cost," The Wall Street Journal, 6/27/94]
2. Small Businesses Will Pay More
The high cost of insurance is expected to cause 30% of small businesses currently
providing insurance to drop coverage in the years ahead. This will further raise
premiums for the smallest companies that do provide. [Health Affairs. Spring 1992]
"By using their clout with health care providers to demand lower costs, big employers help
squeeze out inetticiencies. But they also stop helping hospitals care for those with no
insurance or with government insurance Those costs won't disappear however. As big
companies shed them, insurance premiums for smaller employers will be forced
up." ["Health care Inaction Can Curry u High Cust," The Wall Street Journal, 6/27/94]
To: Verveer, Melanne
From: GOLDBERG_JS
6-30-94 9:22am
p.
3
of
5
3. Government Costs Will Rise
"Today, many who lack insurance still gct health carc if they gct sick enough, either
through federal or local government programs or through charity. But as employers
squeeze the health system harder and the number of uninsured grows, free care probably
will be harder to find and the quality is likely to deteriorate And the government's
costs, from the Medicaid program for the poor to emergency rooms at municipal hospitals,
will climb." ["Health care Inaction Can Carry a High Cost,' "The Wall Street Journal, 6/27/94]
"Most of the pending health-reform plans would [require government to] spend tens of
billions of dollars a year so low-income families or their employers can afford
insurance." ["Ilealth-Care Inaction Can Carry a High Cost," The Wall Street Journal, 6/27/94]
"The social and economic consequences of once again retreating from far-reaching
reform are clear: more uninsured Americans and higher costs for the government."
["Health-Care Inaction Can Carry a High Cost," 'The Wall Street Tournal 6/27/94]
4. Insurance Reforms Won't Work
"Universal coverage is not only a fair and noble objective, consistent with America's
values: it is also essential if health care markets are to work well." [Editorial Page, The
Washington Post, 6/16/94]
"It will be nearly impossible without universal coverage to outlaw the common
industry practice of refusing to cover people with known medical problems, so-called
pre-existing conditions." [Wall Street Journal, 6/15/94]
According to a new study by Families USA, under a partial solution over one million
Americans a month will still lose their insurance. [Families USA Special Report, 6/94, p.1]
To: Verveer, Melanne
From: GOLDBERG_JS
6-30-94 9:22am p. 4 of 5
5. Cost Shifting Will Continue
"Economically, universal coverage is essential to bringing health care cost increases under
control; so long as millions of Americans remain underinsured and uninsured, cost
shifting will continue, leaving a mechanism for unwarranted price inflation in health
carc." [Star Tribunc, 6/16/94]
"Lack of full coverage leads to cost shifting from those who do not pay and those who
provide free care, to those who do pay for health insurance [Alain Enthaven Health
Affairs, 1993]
When the uninsured can't pay their bills, hospitals shift these costs onto people with
private insurance -- at a rate of approximately $25 billion a year. [CBO, 5/93]
"We cannot have real savings and real cost containment without universal
enrollment. Such enrollment is not a welcome bonus delivered with cost containment
dollars; it is what makes cost containment possible. Only with universality can we
eliminate the practice of making patients with insurance pay the medial costs of those
without it." [Rashi Fein, Medical Economics, Harvard University]
"It is the experience of every industrialized democracy with a universal health insurance
program that cost control becomes easier when the plan is universal, not harder. that
counsel currently offered by critics -- go slow in adding new benefits until we can assure
everyone that the savings are real -- is advice that is likely to doom the plan to failure.
Universalism and cost control go hand in hand." [Ted Marmor and Jerry Mashaw, Yale
University. L.A. Times, 10/7/93]
6. The Number Of Uninsured Will Continue To Increase
"As big companies shed [costs], insurance premiums for smaller employers will be forced
up. This probably will lead more of them to stop offering insurance. to limit coverage
for workers' families or to rely more on part imers and temporary workers who
often don't get health insurance." ["Health-Care Inaction Can Carry a High Cost," The Wall
Street Journal, 6/27/94]
"By putting market pressure on providers to cut costs, market reforms promoting
competition -- absent universal coverage - could exacerbate access problems."
[Alain Enthoven]
To: Verveer, Melanne
From: GOLDBERG_JS
6-30-94 11:59am p. 5 of 5
"The social and economic consequences of once again retreating from far reaching
reform are clear: more uninsured Americans and higher costs for the government."
["Health-Care Inaction Can Carry a High Cost, The Wall Street Journal, 6/27/94]
Health Reform, Bjt,650
First Lady Urges Reform Allies to Stand Firm on Universal Coverage
With PM-Health-Ad Watch
By CHRISTOPHER CONNELL= Associated Press Writer=
WASHINGTON (AP) Hillary Rodham Clinton is exhorting health reform allies
to redouble efforts to win passage of universal coverage, warning them bluntly
that all else will be lost without that.
The first lady, in a private pep talk Monday with leaders of labor unions,
seniors' organizations, medical and other groups, delivered an emphatic
message that President Clinton will veto any bill that fails to set a specific
date for universal coverage, participants said.
She told them that health care for all was at risk in part because the
opponents of proposals requiring employers to pay for health insurance have
been united while proponents of reform were divided about what their top goals
were.
She was very forceful, very emphatic, said John Rother of the American
Association of Retired Persons.
The White House effort to rally its troops came on the very day that a
nemesis of the Clinton health plan, the Health Insurance Association of
America, unleashed a new $2 million ad campaign featuring Harry and Louise,
the yuppie couple with trepidations about where Clinton and Congress are
heading.
Two new 30-second spots invoke fears of rationing and soaring premiums.
They are aimed at pressuring lawmakers not to impose restraints on medical
spending and let the insurers charge older workers up to three times as much
as younger workers.
In one of the ads, the anxious Harry asks his wife, ``They're talking
price controls?'
Rationing, the way I read it, says Louise. You know, long waits for
health care and some services not even available.
Government-controlled health care Congress can do better than that,
her husband rejoins.
The White House, which accused the industry of spreading falsehoods in the
earlier Harry and Louise ads, quickly pounced on the new versions.
They are back with a vengeance and with the same old scare tactics,
budget director Leon Panetta said.
What are insurance companies doing today if they are not in fact engaged
in rationing'' when they reject people with pre-existing conditions? asked
Panetta.
The ads will run on local network affiliates in Washington, D.C., and
California, New York, Georgia, Louisiana, Montana, Tennessee, Oklahoma,
Missouri, North Dakota and New Mexico.
Also Monday, a new poll indicated that while most people are satisfied
with both their health care and their insurance, 40 percent said universal
coverage should be the top priority of health care reform.
The NBC News poll found that 73 percent understand just some of the health
care debate or none at all.
Eighty-one percent of those surveyed were satisfied with their current
health care. And although 75 percent said they were satisfied with their
insurance, 19 percent fear they might lose it. Sixty-three percent said they
would stay in a job just to keep their insurance.
The poll, with a three percentage point margin of error either way, was
based on interviews June 5-8 with 1,502 adults.
Harry and Louise went off the air in February after $10 million worth of
ads that helped sink Clinton's idea of forcing most Americans into mandatory,
insurance-purchasing cooperatives.
Bill Gradison, president of the insurers' trade group, said they support
universal coverage, allowing people to keep coverage when they change jobs and
limits on restrictions for pre-existing conditions.
We want a comprehensive bill to pass,' said Gradison.
ALTH-REFORM 2NDLD
ST LADY WARNS THAT HEALTH CARE GOAL IS ``AT RISK''
s: Recasts, updates throughout, edits)
WASHINGTON, June 21 (Reuter) - Hillary Rodham Clinton has told health
are reform allies that passage of a bill guaranteeing universal health
insurance is now at risk, the Washington Post reported in its Tuesday
editions.
In a private meeting with representatives of labour, seniors, consumers
and health-care professional groups, the first lady firmly reiterated the
president's VOW to veto any bill that does not guarantee coverage to all, the
Post said, citing participants who described her tone as fiery.
The meeting was the first White House admission of the seriousness of its
difficulties with Congress on the issue. It followed a cabinet-level meeting
with President Clinton Sunday night ``in which officials acknowledged they had
lost control of the health care debate and agreed to refocus their efforts on
the bottom line, the Post reported.
In another sign that Clinton's health care reform plan is in trouble, an
NBC News poll released Monday night showed Americans tend to trust Congress,
not President Clinton, with the task of reforming health care.
The poll, conducted June 5 to 8, asked 1,502 adults whom they thought
would do a better job reforming health care -- President Clinton or
Congress?''
A total of 42 percent chose Congress while 29 percent picked Clinton, who
has made universal health care for Americans a key goal of his administration.
This is most surprising since Congress is one of the least-trusted
institutions in America, NBC News said in a summary.
Meanwhile, Harry and Louise'' returned to the airwaves Monday in a new
series of television ads backing an insurance industry offensive against price
controls and other proposals in health care reform plans.
The Health Insurance Association of America (HIAA) said it supports
President Clinton's call for guaranteed health insurance for every American.
But HIAA President Bill Gradison said the fictional characters, who helped
raise public doubt about Clinton's reform plan, are returning to take aim at
proposals the industry does not like.
At the same time, Clinton said reform plans in Congress that would
succeed in providing health benefits to only 91 percent of the population do
not go far enough and lawmakers need to make a commitment to cover
everyone.
The so-called 91-percent solution essentially would guarantee what we
have now: the poor would get health care, the wealthy would get health care,
the middle class would be at risk of losing it, Clinton said on NBC's
Today' show.
Senate Finance Committee Chairman Daniel Patrick Moynihan said Sunday
Congress was unlikely to pass a bill this year that guarantees immediate
health benefits for everyone.
The key committee is considering compromise proposals that supporters say
would cover about 91 percent of the population, compared to about 85 percent
currently, and take care of about 97 percent of health spending. Supporters
argue that even in Hawaii, which has a Clinton-style health system in place,
only about 94 percent of the population is covered.
Harry and Louise's return was not welcomed by the White House, which is
pressing Congress to pass comprehensive health reform before the November
congressional elections.
It appears Harry and Louise are back -- and they are back with a
vengeance and with the same old scare tactics -- the same old scare tactics
that have defeated health care reform year after year after year after
year, White House budget director Leon Panetta said in a speech to a policy
group.
The administration also released a study showing that the percentage of
uninsured Americans rose to 17.2 percent in 1992, compared with 12.5 percent
White House Intensifies
Universal Coverage Fight
Senator Mitchell May Push Kennedy Health Bill
By Dana Priest and Helen Dewar
14
dent's VOW to veto any bill that does
Washington Post Staff Writers
not guarantee universal coverage, ac-
cording to participants, who de-
Pounding the lectern in front of
scribed her tone as "fiery." She asked
her, Hillary Rodham Clinton told a
them to redouble their pressure on
group of health care allies yesterday
Congress to pass an acceptable plan.
that passage of a bill with guaran-
The meeting was the first White
teed health insurance for all Ameri-
House admission of the seriousness of
cans "is now at risk" and criticized
the administration's difficulties with
them for promoting their own paro-
Congress on the issue. It followed a
chial interests ahead of the central
Cabinet-level meeting with President
goal of universal coverage.
Clinton Sunday night in which officials
In a private meeting at the Old Ex-
acknowledged they had lost control of
ecutive Office Building with represen-
the health care debate and agreed to
tatives of labor, seniors, consumers
refocus their efforts on the bottom
and health care professional groups,
line.
Clinton firmly reiterated the presi-
See HEALTH, A4, Col. 3
ASSOCIATED PRESS
HHS Secretary Shalala holds a study that shows the percentage of uninsured Americans rising to 17.2 percent.
Universal Coverage at Risk, White House Says
HEALTH, From A1
A senator close to the leadership deliberations called the
"That's why we've narrowed down what we stand for,"
reported plan "a fall-back position
but a real viable
said one Cabinet member who attended.
option." He said Mitchell is prepared to use the Kennedy
The prospects for a Clinton-like health bill had some
bill "if the Finance Committee fails to do something com-
rough going last week when leaders of the pivotal Senate
prehensive."
Finance Committee told the president they were dead-
One senior Senate health policy aide said Mitchell's
locked over financing universal coverage and offered two
plan is "to get it out on the floor and really focus the pub-
alternatives that Clinton later said he did not think would
lic debate on the issue of universal coverage." He noted
meet his goal. On Sunday, Committee Chairman Daniel
that even as polls have shown declining support for the
Patrick Moynihan (D-N.Y.) said he did not think Con-
Clinton plan, large majorities have continued to say that
gress would pass a bill with iron-clad promises of cover-
universal coverage is an important goal.
age for all.
President Clinton said on NBC-TV's "Today" show
The Clintons' hard line was reinforced by private as-
yesterday, "We should not walk away from this Congress
surances they have received from Senate Majority Lead-
er George J. Mitchell (D-Maine) that he is ready to try to
without a commitment to cover everyone."
force an alternative acceptable to them through the Sen-
"We now have three million more Americans without
ate past a threatened Republican filibuster, senior admin-
health insurance than we had three years ago," Clinton
istration and congressional officials said yesterday.
said. He said he was unwilling, in the face of that trend,
The Mitchell strategy is to use the health care bill
to accept Moynihan's proposition that a bill covering 91
passed by Sen. Edward M. Kennedy's (D-Mass.) Labor
percent of Americans would represent "real progress."
and Human Resources Committee as the vehicle for Sen-
Health and Human Services Secretary Donna E. Shal-
ate debate as early as next month. The Kennedy bill
ala also released a study showing that the percentage of
would pay for universal coverage mainly by requiring
uninsured Americans rose to 17.2 percent in 1992, com-
employers to pay most of their workers' health insur-
pared with 12.5 percent in 1980.
ance, but would lighten the burden for small businesses.
In her afternoon meeting, Hillary Clinton told the
Under this scenario, Mitchell reportedly would offer a
string of modifications of his own and invite other sena-
group she thought they had "taken it for granted" that
tors to recast the measure on the Senate floor.
Congress would pass a bill that included universal cover-
The Kennedy bill was endorsed by only one Republi-
age and had let business and industry opponents get the
can-Sen. James M. Jeffords (Vt.). Moynihan has insist-
upper hand.
ed that to pass the Senate, a bill must have at least a half-
"I think they're right. None of the other stuff holds to-
dozen Republican votes to offset Democratic defections
gether without universal coverage" said John Rother,
and halt a possible GOP filibuster.
chief lobbyist for the American Association of Retired
But, according to administration sources, Mitchell has
Persons, who attended the meeting. "She was angry and
argued that if he and Kennedy can craft a 51-vote Demo-
frustrated. This was a call to Jesus."
cratic majority on the Senate floor, public pressure might
"It was an effort to say we ought to all be pitching in
be enough to collapse a Republican filibuster, as it did in
on the core principle," said Alan Reuther, director of leg-
earlier battles on the Brady gun control law and the ban
islative affairs for the United Auto Workers. "I think the
on assault weapons.
message was well received."
Mitchell was en route back to Washington from the
West Coast yesterday and was unavailable for comment.
Staff writer David S. Broder contributed to this report.
THE WASHINGTON POST TUESDAY, JUNE 21. 1994
22
On-Line, On Sale and On the Rise: Global Shopping Booms
By Sharon Waxman
and Germany have begun to take advantage of
and computer. "This is something different from
Special to The Washington Post
cheap long-distance telephone rates by signing up
the multinationals, who have been around for
with small, computer-based services.
years. This is a whole new experience in relative
PARIS-Employees at the Organization for
Consumers around the world are turning to a
terms."
Economic Cooperation and Development (OECD)
new global marketplace for goods and services:
Much of it is happening without planning. For
in Paris order clothes from the Lands' End cata-
Direct-mail catalogue companies, computer man-
instance, L.L. Bean Inc., the Freeport, Maine-
logue over CompuServe, the on-line computer
ufacturers, niche telephone services and parcel
based sports outfitter, was amazed to note that in
network.
delivery companies are all part of an invisible in-
1992 it had $48 million in international sales,
Japanese consumers have used Dell Computer
ernational shopping mall.
most from Japan, without any marketing effort.
Corp.'s telephone-only ordering system to give
"The use of technology has really created a
The next year the company set up an internation-
the mid-size U.S. computer retailer 1 percent of
platform for growth," said Jonah Gitlitz, head of
al division-with 200 foreign-language speaking
the computer market there.
the Direct Marketing Association Inc., a trade
telephone operators-to handle the traffic. Next
And individuals and small businesses in France
group for retailers who market by mail, telephone
See GLOBAL, A6, Col. 1
PCs, Mail and Phone Have More People Shopping Globally
GLOBAL, From A1
GOING GLOBAL
a consumer's point of view."
year, L.L. Bean will join Lands' End
Change has begun, though. Some
Inc. of Dodgeville, Wis., on an on-line
European postal services are deregu-
The rapid growth of home
has contributed to the
computer network.
lating to allow private competition
shopping in Europe
boom in international sales for
"We never made a conscious deci-
even for daily delivery, and private
sion to become a global marketer-it
companies such as L.L. Bean
express mail services such as DHL
happened to us," said Laurel Milos,
CHANGE FROM 1987 TO 1992
IN MILLIONS
and Federal Express are lowering
LL. Bean's international director.
$150
their costs creatively by, for example,
Experts say retailers are merely
Spain
190%
transporting bulk mail to the country
nibbling at the edges of a potentially
125
of destination and then mailing it
enormous market. But access is re-
through the national postal system.
Germany
79%
But consumers abroad also have to
strained by problems such as exorbi-
100
pay sales or value-added taxes, cus-
tant and often illogical transport
costs, the lack of internationally coor-
toms duties and handling charges,
Italy
75
dinated toll-free numbers and the ab-
32%
without knowing in advance how
much they will add to the cost of a
sence of a sufficient international le-
50
purchase. Retailers are working on
gal framework to offer controls and
France
23%
solutions: L.L. Bean, for example, is
guidelines.
25
negotiating with various countries to
One expanding area of the global
allow customers to prepay customs
marketplace is international tele-
Britain
phone service. Because of new com-
6%
0
and handling charges that the compa-
'90
'91
'92
'93
'94
ny then remits to the government, a
puter technology, a myriad of small
test
SOURCES: OECD. L.L. Bean
system it is already using in Canada.
U.S.- and British-based telephone
THE WASHINGTON POST
The cost of long-distance calls and
companies have established footholds
the unavailability of international toll-
in Europe in the past year by offering
long-distance rates that are often 40
nology, the growth of a global mar-
ic-to this expanding area of com-
free numbers also present problems.
ketplace is also due to the changing
Although toll-free numbers can now
or 50 percent lower than those of the
merce. Transport is a particularly ca-
European national monopolies.
mentality of consumers who are in-
pricious problem for international
be set up between certain countries,
creasingly computer-literate and un-
no one has conceived of a system for
The companies offer two services.
consumers, who are often socked
perturbed by the thought of buying a
creating a single toll-free number that
In one, the customer calls a computer
with huge customs and handling
one may call from anywhere in the
in the United States or Britain and is
good or service located across the
charges after buying something
world.
"called back" by the computer, patch-
globe-or in cyberspace.
abroad.
Once these man-made barriers are
ing them into the relatively inexpen-
"I buy a lot of my services in the
Retailers and experts say that
surmounted, experts say, the sky is
sive U.S. or British long-distance tele-
States," said Timothy Baker, a lawyer
there is often no logic to transport
the limit for consumers and retailers.
phone lines. The other involves the
with the OECD's committee on con-
charges. "A 10-pound package deliv-
"As barriers come down, interna-
installation of a dedicated telephone
sumer policy. "I use an MCI phone
ered from the United States to
tional alliances are going to bring big
line between two often-used num-
card and I rent my cars for France in
France costs $70 by post and takes
advantages, we think, to the consum-
bers, in which the customer pays for
the United States; it's a lot less ex-
three to four weeks," Baker said.
er," said William Marmon, legal and
installation of the line and then uses it
pensive."
"By a private express mail service it
external affairs director for MCI
for free.
But at the moment, there are for-
costs $56. Sending to Austria costs
Communications Corp. "And that pro-
Beyond the galloping pace of tech-
midable barriers-mainly bureaucrat-
half [that]. It's all over the map from
cess is just beginning."
THE ASHINGTON POST TUESDAY, 21. 1994
24
Clinton Insists
Warning From Packwood
Strong Opposition to 'Mandates'
Asked recently whether there was sup-
The president's hard-line strategy
port for raising the money necessary to
comes in the face of strong opposition in
Health Reform
finance 91% coverage, Sen. Bob Packwood,
Congress to "mandates" in the president's
the ranking Republican on the Finance
plan that would require all employers to
Committee, abruptly said Congress may
help pay for their workers' insurance.
Cover Everyone
have to be content with a lower target of
Earlier Sunday, Senate Finance Commit-
about 88%.
tee Chairman Daniel Patrick Moynihan
During the Sunday meeting at the
(D., N.Y.) publicly warned the administra-
White House, the president argued that
tion that it must be prepared to accept
President Resists Pressure
cost containment isn't possible without
legislation that stops far short of the
universal coverage. He said he promised to
president's goal. Implicit in Mr. Clin-
To Back Down on Vow
veto any bill that doesn't guarantee health
ton's stance is the possibility that the
coverage for everyone, and he said he
administration could yet try to go around
Of Universal Coverage
wouldn't break that promise. And he ar-
the Finance Committee if it fails to produce
gued the 91% solution would leave a
a bill to his liking.
huge budget deficit and would lack ade-
"The Senate Finance Committee is not
By DAVID ROGERS
quate cost controls.
the Senate," said House Majority Leader
And JEFFREY H. BIRNBAUM
"He made a commitment to universal
Richard Gephardt (D., Mo.), reflecting
Staff Reporters of THE WALL STREET JOURNAL
coverage, and that's what's driving this
frustration across the Capitol. And while
WASHINGTON Rejecting calls for
thing," one participant said.
the president remains committed to work-
compromise from some of his own aides
According to one participant, Mrs. Clin-
ing with the Senate committee, he point-
and from key congressional Democrats,
ton told the story of a woman small
edly rejected Mr. Moynihan's suggestion
President Clinton insisted he isn't pre-
business owner from Topeka, Kan., who
that a voluntary, more incremental bill
pared to give up his goal of guaranteeing
expressed concerns about the Clinton plan
that achieves only 91% coverage would be a
health coverage for all Americans.
and it's many requirements. But at the end
"great beginning.'
In a morning interview on NBC televi-
of the two-hour session, the woman told
That 91% standard grows out of a
sion, Mr. Clinton said bluntly: "We have to
Mrs. Clinton that she believed the health-
Congressional Budget Office report in
care system was in trouble and that
April analyzing a business-backed plan
'Harry and Louise' Reappear
providing health coverage for everyone
best-known by its two Southern Demo-
After having suspended its controversial
was a worthy goal.
cratic sponsors, Tennessee Rep. Jim Coo-
television commercials featuring Harry
Other aides said the president was
per and Sen. John Breaux of Louisiana.
and Louise, the fictitious couple who
given quiet comfort by polls that show
The CBO has said that bill would leave
were instrumental in killing support for
Democrats are more trusted on the health-
many working-class and middle-class fam-
the president's large mandatory health
alliances, the Health Insurance Associa-
Please Turn to Page A8, Column 2
ilies uncovered, and would require tens of
tion of America will spend $2 million to
billions of dollars of subsidies, for which
air new spots. Article on page A24.
there is no clear financing plan.
cover all Americans, and that's the real
issue.
It doesn't have to be done
tomorrow. It ought to be phased in over a
period of just a few years. But we ought not
to walk away without a bill that provides
health care to all Americans."
The interview followed an hourlong
meeting at the White House Sunday night,
at which the president and Hillary Rodham
Clinton made impassioned arguments to
top aides that they should continue to press
for universal health-care coverage. By
holding firm, the president hopes to force
his critics to justify less ambitious plans
that wouldn't assure health care for mil-
lions of middle-class and working-class
families.
Mr. Clinton's comments yesterday
morning were followed quickly by a series
of speeches by members of his Cabinet who
Continued From Page A2
had participated in the weekend meeting.
care issue than Republicans. Although the
Mr. Panetta and Ms. Shalala sounded the
imposing a tax on insurance providers to
point went unstated at the meeting, many
same theme, even as Ms. Shalala released
damp the market for high-cost health plans
of the president's advisers think that if the
a department report showing that the
and recapture some of the industry's
health bill doesn't pass this year, Demo-
percentage of Americans without health
profits as the level of coverage expands.
crats can get away with blaming Republi-
coverage grew to 17.2% in 1992, compared
Subsidies would be phased in to eventu-
cans for its failure.
THE WALL STREET JOURNAL TUESDAY, JUNE 21, 199
with 12.5% in 1980.
ally cover families with income up to 240%
Some of the president's advisers have
Problems for Both Parties
of the poverty level. But to stretch the
been advocating compromise with Senate
While administration officials continue
available dollars, the New Jersey Demo-
GOP moderates. Though there is sharp
disagreement, some even feel the presi-
to insist they are anxious to strike some
crat said the money could be used initially
dent would have gotten a better health-
compromise, there is a fear that each
to help poor families buy at least insurance
care bill if he'd been willing to compromise
concession by the president would be met
to cover large out-of-pocket, catastrophic
several months ago. But Mr. Clinton's
by further demands, shifting the debate
costs. If the 96% isn't achieved in five
impassioned comments apparently stifled
away from his initial goals. While still
years, a set of mandates would be trig-
dissent at the Sunday meeting.
outwardly hopeful, both sides admit the
gered, requiring individuals to buy insur-
debate may be lurching toward a political
ance but also demanding a still unspecified
Bottom Line: Stay the Course
endgame in which Democrats score points
contribution by their employers.
The administration's bottom line deci-
by portraying the Republicans as obstruc-
Interim financing would depend heav-
sions: stay the course on universal cover-
tionists and Republicans try to push the
ily on Medicare savings and increased
age; continue to talk to lawmakers and
president into an embarrassing veto con-
tobacco taxes.
reach out to Republicans; encourage quick
frontation.
The idea borrows from the same cost-
committee action in the House, where
There is, in fact, concern among Senate
control theories used to justify proposals to
more progress is being made lately; con-
Republicans that the party could be dam-
limit tax benefits for the more expensive
tinue to provide technical assistance to
aged if it is seen by voters as having killed
health plans. The major difference is the
anyone who needs it on Capitol Hill; and in
health reform. But Mr. Clinton's greater
burden wouldn't fall directly on business
public discussions, steer clear of the ar-
problem may be among Democrats, who
or labor, but would instead apply first to
cane aspects of health-care reform, and
insurance providers, who then would have
emphasize instead the broader goals, par-
are skittish about the shape of his plan and
a further incentive to market less costly
ticularly universal coverage. The White
its demands on business.
plans.
House meeting Sunday included Mr. Clin-
This skepticism goes beyond tradition-
-David Wessel contributed to this arti
ton, his wife, Deputy White House Chief of
ally conservative southerners to include
cle.
Staff Harold Ickes, Vice President Gore,
the likes of New Jersey Sen. Bill Bradley, a
Chief of Staff Thomas McLarty, Treasury
moderate-to-liberal member of the Fi-
Secretary Lloyd Bentsen, Health and Hu-
nance Committee and an ally of Chairman
man Services Secretary Donna Shalala,
Moynihan. Mr. Bradley is part of a centrist
White House Budget Director Leon Pan-
camp that advocates a more incremental
etta, White House health-policy adviser Ira
approach to achieve universal coverage.
Magaziner, top White House lobbyist Pat-
In an effort to spur debate, he outlined
rick Griffin, senior adviser George Ste-
options yesterday that set a standard of
phanopoulos, White House Counselor Da-
achieving 96% coverage over five years.
vid Gergen and Deputy Treasury Secre-
Mr. Bradley has raised the possibility of
tary Roger Altman.
59
Insurers' Harry and Louise Campaign
Returns to TV to Cut Up Health Plan
By HILARY STOUT
Staff Reporter of THE WALL STREET JOURNAL
"Right. Government-imposed spending
WASHINGTON Public Enemies No. 1
limits for every region of the country,'
and 2 of the Clinton health-care plan are
says Louise.
back on the airwaves.
"So, if our plan runs out of money?"
Harry and Louise, the fictitious televi-
wonders Harry.
sion couple who were instrumental in
"Rationing, the way I read it," replies
killing support for the president's large
Louise. "You know, long waits for health
mandatory health alliances, are now going
care and some services not even avail-
after proposed caps on health insurance
able," she says.
premiums and community rating-that is,
Robert Chlopak, who is helping coordi-
on uniform premiums for most people.
nate the advertising campaign for a group
generally supportive of the Clinton health
Spending $2 Million for Spots
proposal, said the TV couple's latest
After suspending its controversial
charges will have a much tougher time
Harry and Louise commercials in late
sticking than the previous Harry and Lou-
February, the Health Insurance Associa-
ise ads.
tion of America said yesterday that it is
"They can raise rationing, but it be-
spending $2 million to air new spots. In
comes a lot easier for us to say, 'The people
one, Louise utters one of the most emotion-
who have been jacking up your prices are
laden and explosive words in the health-
trying to fool you into opposing price
care deba rationing.
controls,". Mr. Chlopak said.
The announcement is horrible news for
the president's allies on health-care re-
Attacking 'Community Rating'
form. Harry and Louise are widely viewed
The second spot takes aim at "pure
as doing more than any other interest
community rating," a system by which
group to cast doubts in the public's mind
everyone would pay the same rates for
about the Clinton approach to health-care
health insurance, no matter their age,
reform.
lifestyle or medical history. The insur-
In one of the new spots, Louise says
ance association wants to be able to vary
government caps on health-insurance pre-
premiums according to age. To make their
miums - measures included in the Clinton
case, they introduce Harry's brother, Pat,
bill as well as in bills approved by a Senate
who says during a driveway basketball
committee and two House subcommit-
game that community rating in his state
tees - would lead to rationing of medical
has driven the insurance premiums he
care.
pays, as a young and healthy person, from
"They're talking price controls," says
$1,200 to $3,200 a year.
Harry, driving to work with his wife,
"More than double!" gasps Harry.
Louise.
"Yeah, thousands dropped thier insur-
/ ance. I mean, we actully have fewer cov-
ered now than before," says Pat.
"Congress can do better than that,"
replies Harry.
At a briefing to announce the new ads,
the insurance industry association's presi-
dent, Willis Gradison, said the group
strongly supports one of the most contro-
versial elements of the Clinton plan:
; THE WALL STREET JOURNAL TUESDAY, JUNE 21, 199
a requirement that all employers pay part
of their workers' health insurance. In fact,
the group released a third ad: this one
intended for newspapers in the Washing-
ton area, in which Harry and Louise say
they want universal coverage.
Earlier this spring, the insurance asso-
ciation negotiated an agreement with
then-House Ways and Means Committee
Chairman Dan Rostenkowski (D., III.) in
which it promised not to air its Harry and
Louise ad while the panel was debating a
health-reform bill. In return, Mr. Rosten-
kowski made some concessions on insur-
ance reforms. But Mr. Rostenkowski has
since stepped aside from his chairman's
post in the wake of being indicted. And the
acting chairman, Rep. Sam Gibbons (D.,
Fla.), has made some changes that didn't
please the association. Mr. Gradison says
the deal is off.
60
Hillary Clinton Says Veto
Is Possible on H alth Bill
Demands Universal Coverage; Nothing Less
His 96 percent suggestion reflects
By ADAM CLYMER
the general uncertainty about what,
tion of anonymity Meanwhile, the
Special to The New York Times
realistically, constitutes "universal
First Lady said, their opponents had
WASHINGTON, June 20 - Hillary
coverage.' The Clinton position,
imperiled the prospect of universal
Rodham Clinton demanded today
while acknowledging vaguely that
coverage.
that supporters of national health in-
some people would slip through the
She said it was time for the organi-
surance stop focusing on their own
cracks, has been that coverage of "all
zations to hit home to their mem
particular concerns and start telling
Americans" was its goal.
and through them to Congres
members of Congress that they want
the middle class would conti
legislation with nothing short of guar-
Bradley? No. Moynihan? Yes.
suffer if universal coverage
anteed universal insurance coverage.
The Bradley proposal, coming
attained, because the poor
an
She told health care advocates that
from one of the more liberal mem-
rich already have medical care
President Clinton would veto legisla-
bers of the Finance Committee, was
tion that provided less than universal
not mentioned at Mrs. Clinton's pep
Setting a Date
coverage, like the 91 percent cover-
rally, participants in the meeting
The First Lady said the Pres
age anticipated for a plan offered by
said. But Mrs. Clinton was asked
would not sign legislation cha
Representative Jim Cooper of Ten-
about the friendly comments Senator
insurance laws if the measure did not
nessee and Senator Dave Durenberg-
Daniel Patrick Moynihan of New
also provide for universal coverage.
er of Minnesota. That proposal re-
York, chairman of the Finance Com-
And she said that legislation must
quires employers to offer workers
mittee, made about the Durenberger
specify a date by which universal
insurance but does not make them
measure Sunday on the NBC News
coverage would be attained. It is Jan.
pay for it.
program "Meet the Press."
1, 1998, in Mr. Clinton's bill, but it is
The President spoke out insistently
She did no comment directly on
clear the Administration would nego-
this morning for the need to cover all
Mr. Moynihan, said Bob Chlopak, a
tiate about the date.
Americans, but he avoided wering
consultant for the Health Care Re-
The President said this morning:
directly when asked if he would veto a
form Project, an organization repre-
"It doesn't have to be done tomorrow.
bill promising 91 percent coverage.
senting various supporters of nation-
It ought to be phased in over a period
"We ought not to walk away without a
al health insurance. But he said she
of a few years." But he said, "We
bill that provides health care for all
had told the group that the Finance
should not walk away from this Con-
Americans," he said on the NBC
Committee needed to be a focus of
gress without a commitment to cover
News program "Today."
their attention because several mem-
everyone."
Mrs. Clinton, meeting at the Execu-
bers needed to know about the impor-
Mr. Bradley, who said he had dis-
tive Office Building with almost 100
tance of universal coverage.
cussed his ideas with other moderate
representatives of organizations gen-
Later today Mr. Chlopak made
members of the Finance Committee
erally in favor of national insurance,
public a letter to the President from
but had neither a formal legislative
told them their parochial victories on
80 organizations, including doctors'
proposal nor cost estimates in hand,
issues important to their own groups
organizations, unions and church
said his plan met the universal cover-
would not mean anything if Mr. Clin-
groups. They called on Mr. Clinton to
age test Mr. Clinton had set.
ton had to veto the bill because it fell
threaten to veto any health care bill
He proposed to pay for the subsi-
short of universal coverage. She drew
so-called "soft trigger," under
dies in his plan with taxes on ammu-
a standing ovation.
Congress would promise to
nition, handguns and tobacco, along
Bradley Changes Position
gain in a few years if this year's
with a new proposal to "assess" in-
legislation did not produce a stated
surance companies directly when
But while the Administration was
percentage of insured.
they sold expensive health insurance
digging in its heels, it suffered a set-
"Soft triggers are like blanks:
policies. His formula, for which he
back when Senator Bill Bradley of
They sound real, but have no force or
offered no cost estimates, would be to
New Jersey, one of the uncommitted
effect," the letter said.
take the average of the cheapest two-
Democrats on the deeply divided Fi-
nance Committee, shifted positions
More From 'Harry and Louise'
thirds of all policies in a market area,
then assess the companies 35 or 40
and said the nation should not require
More support for universal cover-
percent of all premiums above that
employers to pay for insurance.
age came when the Health Insurance
level.
That requirement is a central part.
Association of America, whose "Har-
He explained new opposition to re-
of President Clinton's plan and the
ry and Louise" television ads ques-
quired employer payments, which he
variations on it advanced by Demo-
tioned the Clinton plan last winter,
had supported earlier if small compa-
cratic Congressional leaders, who ar-
chimed in with a newspaper adver-
nies were exempted, by telling re-
gue it is the only sure way to reach
tisement. The association maintains
porters here that he had become con-
that the various proposed changes in
vinced the costs would hurt small
insurance law, like requiring compa-
business anyway, would invite "gam-
nies to insure all applicants, would be
ing," or manipulation to take advan-
Bradley chang his
less effective without universal cov-
tage of proposed subsidies, and could
erage because people might wait un-
not be passed anyway.
mind on requiring
they got sick to insure themselves.
Mr. Bradley said that if insurance
But it also released two new televi-
changes and subsidies for families
employers to pay for
sion ads in which the couple attack
with incomes up to about $34,000 did
specific insurance law changes. In
not produce 96 percent coverage in
one, they contend that limits on in-
insurance.
five years, then people should be
creases in insurance premiums, a
quired to insure themselves. At
feature of many of the Democratic
point he would also impose a small
bills, are sure to cause shortages and
payroll assessment on employers
rationing. In the other, they denounce
who did not insure workers, he said.
the goal of providing all Americans
community rating, under which in-
with private health insurance by
surers must charge all comers the
somewhere between 1998 and 2000.
same rate, as likely to sharply in-
Most Republicans denounce it as like-
crease premiums and to cause people
ly to strangle small business and cost
to drop their existing insurance.
vast numbers of jobs.
Mrs. Clinton complained that the
Mr. Bradley advocated another
groups she had gathered spent too
route to near-universal coverage,
much of their energy trying to make
saying that if insurance changes and
sure that their own members' needs
subsidies did not produce 96 percent
were dealt with "asking for this and
coverage in five years, people should
asking for that," said a participant in
be required to insure themselves.
the meeting who spoke on the condi-
THE NEW YORK TIMES, TUESDAY, JUNE 21, 1994
8
EQUATORIAL GUINEA
MADAGASCAR
SIERRA LEONE
Rich in re-
One of Africa's true horrors,
sources but
now ruled by the nephew of Ma-
Had successful elections,
Besieged in the east by Liber-
racked by
cias Nguema Biyoko, who once
lengthy but free; the new Presi-
ian-supported rebels, lacking in
civil war, now
mowed down opponents in soc-
dent, Albert Zafy, faces huge
popular support, a corrupt mili-
in its 19th
cer stadium as rock music was
economic decline after 20 years
tary Government has promised
year. Peace
played.
of one-man rule.
civilian rule.
talks mud-
dling along in
ERITREA
MALAWI
SOMALIA
Lusaka, Zam-
bia. José Eduardo dos Santos is
The only country to change colo-
With the old tyrant in a hom-
the current leader.
nial-era boundaries, after a 30-
burg hat, Hastings Kamuzu
The case study in the failure of
year independence war with
Banda, struck down at the polls,
international intervention; Gen.
BENIN
Ethiopia; self-reliant and tough.
his successor, Bakili Muluzi,
Mohammed Farah Aidid is still
promises reforms.
a power, the clans are still at
ETHIOPIA
each other's throats.
First French-speaking country
to successfully navigate the
MALI
Threw out its brutal Soviet-
shoals from dictatorship to mul-
SOUTH AFRICA
tiparty state.
backed dictator in 1991; the old
The revolution that dumped the
empire is breaking into ethnic
dictator Moussa Traoré has
The recent election serves as a
BOTSWANA
groupings to prepare for more
given way to elected Govern-
model throughout Africa; lead-
elections.
ment, but it faces poverty and
ers admire President Nelson
Long an island of relative pros-
uprisings by Tuaregs in the
Mandela's courage in embrac-
perity and democracy in a once-
GABON
north.
ing the opposition.
troubled region of black-white,
East-West conflicts.
Swimming in oil and also swim-
MAURITANIA
SUDAN
ming in discontent and debt; the
BURKINA FASO
longtime leader Omar Bongo's
Opposition boycott of elections
Africa's largest country is dev-
claim to have won December
has kept old powers in control,
astated by Africa's longest war,
Desperately
election widely disbelieved.
the Maurs still dominate the
the Islamic Government in the
poor, drifting
blacks, and the desert
north against the Christian-ani-
since the 1987
encroaches.
mist rebels in south.
coup that
GAMBIA
SWAZILAND
killed the rad-
ical, charis-
The English-speaking sliver in
THE NEW YORK TIMES, TUESDAY, JUNE 21, 1994
MAURITIUS
matic mili-
French-speaking Senegal has
King Mswati II is still following
a conservative course of main-
tary leader,
long practiced multi-party poli-
Its economic growth rates, sta-
tics.
taining traditional practices but
Thomas
bility and assiduous regard for
with a slight opening to democ-
Sankara. Blaise Compaoré is the
GHANA
multiparty democracy have
ratic principles.
current leader.
long made it an island in more
Africa's first
ways than one.
TANZANIA
BURUNDI
in everything
in the post-
MOZAMBIQUE
Facing a long uphill climb to
Scene of recurring tribal mas-
economic recovery; former
sacres, lost its chance for recon-
war wave of
At long last the civil war is
President Julius K. Nyerere's
ciliation with last year's coup
decoloniza-
that killed first Hutu president.
tion in re-
winding down and a peace
high-minded but disastrous rule
agreement is holding; every-
is receding; elections scheduled.
volving-door
thing depends on demobilization
CAMEROON
coups, in hit-
of armies and elections.
TOGO
ting bottom
Split between French- and Eng-
and in climbing back through
NAMIBIA
A popular push for democracy
lish-speakers, fighting with
I.M.F program. Jerry J. Rawl-
was thwarted by sleight of hand
Nigeria and the World Bank,
ings is the current leader.
ruled by a corrupt, ethnically
Under its new Swapo leadership,
from the longtime dictator,
based and repressive elite.
GUINEA
it is practicing democratic Gov-
Gnassingbé Eyadéma; turmoil
ernment and market econom-
and ethnic tensions result.
CAPE VERDE
Saw a hotly contested election;
ics; future is closely tied to
South Africa next door.
UGANDA
still unable to shake off legacy
A nation of volcanic Atlantic is-
of Ahmed Sékou Touré's African
Trying to
lands that abandoned Marxist
socialism, which bankrupted a
NIGER
overcome a
economics but needs aid to sur-
once-rich land.
two-decade
vive; chronically drought-
A multiparty system voted into
curse of dic-
stricken.
GUINEA-BISSAU
place in 1992; Government is
fighting on all fronts — rebel Tu-
tatorship and
CENTRAL AFRICAN REPUBLIC
The Government has allowed a
aregs, falling uranium prices,
ethnic war-
growing Islamic militance.
fare, Presi-
multi-party system to descend
dent Yoweri
Undergoing a difficult but so far
slowly, almost reluctantly, on a
Museveni is
successful passage to democra-
backwater former Portuguese
NIGERIA
cy. Former Emperor Jean-
experimenting with single-
colony.
Bédel Bokassa, now out of jail,
The swagger-
"movement" politics.
wanders in white robes, crazy.
IVORY COAST
ing giant of
West Africa
ZAIRE
CHAD
Former eco-
reneged on
The gold
nomic "mira-
elections
standard in
Long in the shadow of Libya's
cle" now
after they
territorial claims, rife with jock-
were held;
corruption
down on its
and misman-
eying among clans; President
luck; the new
still ruled by
Idriss Déby's guards commit
President,
confused and
agement, the
human rights violations.
personality
Henri Konan
rapacious military Government.
cult rule of
Bedié, jails
Gen. Ibrahim Babangida is the
Mobutu Sese
COMOROS
journalists
current leader.
Seko is grad-
Had been run for years by a
for writing insulting articles.
ually fading away amid anarchy
RWANDA
French mercenary who helped
and poverty.
KENYA
South Africa evade sanctions;
Africa's hell, pure and simple,
still the scene of intrigue that
ZAMBIA
Heading
with prospects ahead of more
undercuts elections.
downhill fast
grisly killings by either Hutus or
Kenneth D.
under Jomo
Tutsis, barring outside interven-
Kaunda sur-
CONGO
Kenyatta's
tion.
prisingly lost
Held elections to replace long-
successor,
elections and
Daniel arap
SÃO TOME AND PRINCIPE
time Marxist dictator, unsettled
surprisingly
by fighting between ethnic mili-
Moi, who
turned over
plays tribal
A smooth democratic transition,
tias; Israelis in charge of presi-
power; new
politics,
helped by much aid from
dential security.
President,
crushes dissidents and permits
France and Portugal, has a
Frederick
DJIBOUTI
widespread corruption.
decade of mismanagement to
J.T. Chiluba, beset by burden of
overcome.
Elections inspired by Paris un-
LESOTHO
economic catastrophes.
covered deep divisions between
SENEGAL
ZIMBABWE
two main groups, Afars and
The tiny kingdom surrounded by
Issas; French maintain large
South Africa has byzantine poli-
Long a multiparty democracy,
tics and a restive, underpaid
military presence.
has been unsettled by February
An economic
army that killed the Deputy
riots over devaluation; two prin-
and political
Prime Minister in April.
cipal opposition leaders held in
success
313
jail without trial.
under Presi-
LIBERIA
dent Robert
Civil war has claimed more
SEYCHELLES
Mugabe,
than 150,000 lives, brought in an
Its strongman, France Albert
though still
all-African intervention force;
René, won 1991 election; the
fraught with
peace talks reduce fighting but
biggest problem for the island
tensions involving whites, par-
it continues.
paradise is a decline in tourism
ties and land.
caused by European recession.
7
The New York Times
A
Faceoff in Finance
T
HE TWO great goals of health care reform
who want to do some insurance reform and
are to achieve or approximate universal
provide some limited subsidies to make insurance
coverage while containing costs. Each comes
marginally less expensive and more available, and
at a price. The coverage has to be financed; the
that's about all. A group of moderates would do
cost containment by definition requires that pa-
more insurance reform, provide more generous
tients and providers get by with less.
subsidies and create a commission to make rec-
The politicians want to come as close as
ommendations that Congress would have to con-
possible to the goals while minimizing the price.
sider (but not adopt) if the subsidies and other
That's understandable-and in this case not just
steps failed to reduce the number of uninsured to
the usual effort to have a thing both ways. Health
roughly 5 percent of the population from roughly
care isn't a rivers and harbors bill. The real-
15 percent today by early in the next century.
world costs as well as political costs of making a
That's a weak trigger. Chairman Daniel Pat-
mistake could be huge. Which leads us, as it has
rick Moynihan has proposed a stronger one that
Congress, to what have come to be known in
could lead to employer mandates much as the
health care speak as triggers.
Triggers are promissory notes. They are
president has proposed. His bill contains warning
meant not just to pick up votes but to strike a
lights in the form of cost containment "targets"
as well.
balance between commitment and caution, which
in health care may not be a bad idea. The notion
The Dole proposal supports reform in name
is to start out with relatively modest reforms to
while largely avoiding it in fact. It may well be
see what they can achieve, but to promise that if
that Congress will choose to enact reform in
they don't achieve certain results within a certain
stages by first testing what modest steps will
time, additional steps will be taken. Which steps
yield. That's not unreasonable. But at the very
(if any) and under what circumstances are what
least, a Congress that wants to start small while
the members then fight about.
being taken seriously needs to set clear goals as
The Senate Finance Committee is having that
to future coverage and cost, and impose on its
fight now. Some members of the committee
successors a timetable and procedures for
support the president's plan to mandate universal
achieving them. A vote not to do even that is a
coverage mainly through the workplace while
vote in favor of a system in which health care
limiting annual increases in health insurance
consumes a seventh, rising toward a fifth, of all
premiums to contain costs-but they don't have
the money Americans have available to spend,
the votes. At the other end of the spectrum is a
and yet a seventh of the population remains
group of Republican minimalists led by Bob Dole
uninsured.
Summit for the Koreas
J
UST THREE MONTHS ago North Korea
Carter's mission to Pyongyang have been a
was threatening to drown Seoul in a "sea of
sobering reminder of its continuing dependency
fire." But on Tuesday at the same table in
and vulnerability. This gives it an immense stake
Panmanjom, a North Korean official accepted
in broadening its own new channel to the North,
his country's first summit with South Korea on
even while making the military preparations
July 25-27 in Pyongyang. The meeting flows
essential for the coming test of wills. The imme-
from the recent developments that led North
diate agenda includes family reunions (for 40
Korea and the United States to decide to resume
years the North has kept millions of members of
negotiations in Geneva on July 8 on the security,
divided families from contacting kin in the
political and economic terms by which the North
South), economic ties and steps to take political
might yield its nuclear option.
and military confrontation off a hair trigger.
Kim Il Sung is founding father of the 48-year-
There is also a compelling longer-term agenda.
old Communist regime in the North and perpe-
Seoul must weigh the costs and benefits of
trator of massive aggression and terrorism
against the South. He has audaciously reviled the
pursuit of Korean reunification-and of non-
South's Kim Young Sam as the "traitor" head of a
pursuit. It must calculate if its conventional
"puppet" regime, preferring to deal directly with
strength and American ties permit it to abandon
the United States. But Washington, faithful to its
the American nuclear umbrella, which North
ally, insisted that Seoul be included. At that, Kim
Korea has made part of the price for its own
Il Sung won a provision-that the summit be
nuclear disavowal. Looking at their power-
canceled in the event of a "provocative" act-
packed region, some South Koreans wonder if
that gives him an opening to duck out. Nor would
the North Korean bomb program might not be
he accept giving his Korean partner the courtesy
changed from a threat in the hands of the North
of a reciprocal visit. Perhaps he is reluctant to
into a useful deterrent in the hands of a reunified
show the North's television audience the con-
Korea.
sumer-rich, democratic reality of a country he
Merely to cite these questions is to indicate
has depicted as miserable and oppressed.
that South Korea's dealings with the North bear
For South Korea, the events following Jimmy
deeply on American interests too.
THE WASHINGTON POST THURSDAY, JUNE 30, 1994
Health Care Obstructionists
Two powerful committees - Senate Finance
These two will probably behave shabbily, but
and House Ways and Means - - are rushing to pass
Senators Boren, Danforth and Durenberger would
health-reform bills. The Finance Committee bill is
be foolish to follow them. All three will be leaving
sound, but so far lacks majority support; conserva-
Congress at the end of the year. They should look to
tive Democrats and moderate Republicans are
their reputations. Mr. Boren will demolish any
pressuring the chairman, Daniel Patrick Moynihan
claim to distinction in his new career as educator if
of New York, to give up on a key plank, universal
he lets his bull-headedness destroy his own party's
coverage. The Ways and Means bill would achieve
effort to extend medical care to millions of hard-
universal coverage; but the rest of it is a farce,
working Americans.
incorporating ruinous amendments virtually dictat-
Similarly, Mr. Danforth will have no further
ed by the American Medical Association.
claim to his reputation as the most humane Senate
The political calendar will not permit more
Republican if he helps Mr. Dole sacrifice health
dawdling and posturing. The committees must com-
care on the sword of anger and ambition. As for
plete most of their work this week. Then the Senate
Senator Durenberger, he has one last chance to end
majority leader, George Mitchell, and the House
a spotted career with a moment of distinction.
majority leader, Richard Gephardt, can pound
These three and Senator Chafee will deserve lasting
flawed committee bills into workable legislation in
condemnation if they scuttle the best chance since
time for floor votes before the November elections.
the Truman era to give Americans the peace of
mind that comes with health insurance.
Other parts of the chairman's bill are also
The immediate stumbling block is a coalition of
sensible. But the bill is best for what it omits: a
conservative Democrats and moderate Republi-
destructive assault on managed-care plans that is
cans on the Senate Finance Committee who so far
at the center of the Ways and Means bill.
refuse to accept any sensible way to guarantee
The bill of the Ways and Means chairman, Sam
every American insurance within a reasonable
Gibbons, has one big virtue: an unconditioned em-
number of years.
ployer mandate. But it would protect fee-for-service
Bob Dole of Kansas, the minority leader, and
plans, which the A.M.A. loves, by destroying man-
Bob Packwood of Oregon say they want reform but
aged-care plans, which scrutinize physician treat-
do not seem serious about compromise; Republi-
ment. The bill would force plans to hire doctors they
cans John Chafee of Rhode Island, John Danforth of
do not want to use - undermining the plans' ability
Missouri and Dave Durenberger of Minnesota are
to raise the quality and lower the cost of care.
serious and want universal. coverage. But they,
Worse still, the bill makes illegal existing
along with David Boren, Democrat of Oklahoma,
health maintenance organizations, like Kaiser Per-
oppose the most feasible system proposed: employ-
manente, that charge low premiums in exchange
er mandates, which would require employers to pay
for restricting patients to a closed panel of doctors;
for policies chosen by their workers.
apparently the committee has little stomach for
Mr. Moynihan has proposed a worthy compro-
letting consumers decide what is best for them. The
mise: Let voluntary reforms along with subsidies
bill would also force employers to subsidize work-
for low-income families - a combination the Re-
ers who chose expensive fee-for-service coverage.
publicans say they adore whittle the ranks of the
There are other destructive provisions, including a
insured; but if by 2000 at least 95 percent of
proposal to impose price controls.
Americans are not insured, then employer man-
Ways and Means is right on universal coverage
dates would automatically kick in.
and dead wrong on insurance reform. Unless Mr.
The opposition has so far not budged. Mr. Dole
Moynihan gets his way, the Senate Finance Com-
has lowered himself to taking irrelevant potshots at
mittee will make the opposite mistake. The way out
Hillary Rodham Clinton; Mr. Packwood seems in-
of this bind is for both committees to pass bills,
tent on adding "obstructionist" to his sullied ré-
however flawed, and let the leaders put together a
sumé rather than irritate the minority leader, who
compromise that has a chance to pass as the
can protect him during ongoing investigations of
majority Democrats and survivalist Republicans
sexual harassment.
legislate in the shadow of the fall election.
THE NEW YORK TIMES, THURSDAY, JUNE 30, 1994
If we don't pass health care this year
American families will pay more for health care with less secure benefits and diminishing
choices. Many workers will continue to trade wage increases or stay locked in jobs that don't suit
them just to hang on to the health benefits they've got.
Health care spending per worker will be over $7,000 in 1994. By the year 2000, health care
spending per worker will rise to $12,386, or 25 percent of compensation.
Without reform, by the year 2000, American workers will lose almost $600 in wages each
year just to keep their health benefits [Commerce Department]
American businesses will drop or pare back coverage, or continue to pay more for employee
health benefits.
One and a half million fewer full-time workers receive health benefits directly through an
employer today, compared to 1988. [University of North Carolina, 8/92]
In the future, 30 percent of small businesses currently providing insurance will drop their
insurance coverage because of the high cost. [Health Affairs, Spring 1992]
Choices will decline for those with insurance, as employers try to stem rising costs by switching
to managed care plans with a small number of "approved" doctors. And as more families find
themselves without insurance, those with any history of illness will join the 81 million
Americans labeled as having "pre-existing conditions".
In 1988, 89% of employers offered indemnity (fee-for-service) plans. In 1993, only 65% of
employers offered such plans. ["Health Benefits in 1993", KPMG Peat Marwick]
Up to 30% of employees report that they are afraid to leave their job for fear of losing
continuous health insurance coverage.
Doctors will have less and less control over their practices and the care they provide their
patients, as people at insurance companies without medical degrees second-guess medical
decisions and dictate "necessary care".
The federal budget will be overwhelmed by health care spending on Medicare and Medicaid.
This will add to the deficit, raising the pressure to cut back on benefits in those programs. State
budgets will also be increasingly eaten up by Medicaid, paring back on crime-fighting and
education to pay for health services for welfare recipients.
Two-thirds of the growth in federal spending between 1993 and 1996 will be accounted for
by health care spending.
In 1992, Medicaid spending totaled $102 billion, a 33% increase over 1991. By 1995,
Medicaid spending is expected to reach $198 billion. (National Association of Budget Officers)
In 1993, for the first time, states spent more money on health care than they did on tax-
financed higher education. (National Association of State Legislatures)
STRONG SUPPORT
THE NEW YORK TIMES, WEDNESDAY, JULY 20, 1994
FOR HEALTH PLANS
right."
If Mr. Smith was resigned, Estia
Eight of 10 Americans Back
Douglas, 68, a grandmother and Dem-
ocrat from Orlando, Fla., was riled.
Universal Care, Poll Says
"The Republicans are coming up
their lingering difficulty in adjusting
with a lot of garbage about how we
to a First Lady with overt power.
Al
can't afford to cover everybody," she
Charles Jansen, a 72-year-old re-
said. "Well, we couldn't afford to send
tired electronic technician from
By MAUREEN DOWD
a man on the moon either, but we did,
Wichita, Kan., complained that Mrs.
Amid the cacophony of warring
didn't we?"
Clinton should not be helping make
health care plans and partisan jibes,
Although the public has a clear
appointments since she was not elect-
preference for universal coverage, a
ed. Mr. Jansen, a Democrat, was
the public remains strongly commit-
slight majority believed that it would
asked what his wife, a Republican,
ted to getting a plan passed and con-
be all right if Mr. Clinton compro-
thought.
tinues to endorse universal coverage.
mised at 95 percent coverage.
"I'm afraid to ask her," he replied.
Americans are now as concerned
"It'll have to be scaled down, it'll
Summoning up his nerve, he asked
about health care as they are about
never pass the way it is," Mr. Smith
his wife, Dorothy, how she felt about
crime, and a majority say they are
said. "Clinton is like the guy who
the First Lady and reported back:
willing to pay higher taxes to get
wants $75 for his bicycle so he asks
"She gave a typical wife answer, that
everyone insured, according to the
$150 to start with. It's just a selling
the woman should have input into
latest New York Times/CBS News
game."
White House decisions."
poll.
Clinton Compromise Urged
The President's rating on handling
Eight in 10 polled continue to say
the economy has been stable for
Roma Templeton, 39, an office su-
months at 43 percent. But, peppered
that it was "very important" that
pervisor from League City, near
by stories about Haiti, Rwanda, Bos-
every American receive health insur-
Houston, agreed that the President
nia and North Korea, Americans are
ance coverage.
"should compromise on a few things
more dubious about the 47-year-old
"The President should not compro-
to get it passed and then work on
President's ability to navigate the
mise on that," said Roberta Lake, a
those things later."
gray waters of this nerve-racking
21-year-old graduate of Wooster Col-
Ms. Templeton said she was not
post-cold war world. The approval of
lege in Ohio who has moved back to
averse to higher taxes. "Either you
his foreign policy stewardship has
pay more in taxes or you pay more in
her mother's house in Maryland until
slipped to 36 percent, from 50 percent
health care," she said. "It's one or the
she begins an internship with the
in January.
other."
dean of black students at Wooster.
Asked about Mr. Clinton's ability to
Like others interviewed, she sug-
deal "wisely" with a difficult interna-
"This is a biggie for me because I
gested that perhaps Mr. Clinton and
tional crisis, only 32 percent ex-
was diagnosed last summer with
his wife, Hillary, should have brought
pressed confidence, while 64 percent
multiple sclerosis, and I'm not in-
the country along a little more slowly.
said they were uneasy.
sured. The percentage of Americans
"The way he presented it, he just
who would get left out are those who
threw this whole big, huge issue at
you. No one had time to digest it or
"He drifts a little bit too much
need it most."
pick it apart. Whenever someone acts
Mr. Jansen said. "Right or wrong,-he-
Miss Lake was one of the respond-
like it's his way or no way, I just draw
should pick out a way and stay with
ents who agreed to follow-up inter-
a line in the dirt and say I ain't
it."
views after participating in the na-
crossing that line."
"He's a great talker, he says a lot
tionwide telephone poll of 1,339 adults,
Reflecting the deepening disillu-
of stuff I like to hear, but then nothing
taken Thursday through Sunday. The
sionment with Washington, there has
poll has a margin of sampling error
been a slight erosion in the size of the
happens," Mr. Jansen continued, add-
ing somewhat cheerfully, "I'm not
plus or minus three percentage
majority that believes in the Govern-
going to be around in another -10
ment's responsibility to guarantee
points.
years, so I won't have to worry about
medical coverage, and in the size of
it anyway."
President Clinton having
that pay
trouble getting traction on a spec-
higher taxes to get universal cover-
Roberta Lake said she worried that
trum of issues. His overall job ap-
age.
Mr. Clinton needed more experienced
proval rating slipped slightly to 42
Split on Abortion
hands around him. "I guess it's good.
percent, just about the same percent-
The public was split on the issue of
putting trust in my generation," she
age that elected him in 1992, and
said. "But I know how I am and
employer mandates and abortion
public confidence on his foreign af-
wouldn't want a bunch of 21-year-dids
coverage.
fairs performance continues to erode.
Forty-nine percent said employers
running things."
While he has succeeded in pushing
should be required to pay most of the
Although some White House offire
health care to the top of the national
cost of health insurance for all their
cials worry that Paula Jones's sexual
agenda, Mr. Clinton has not benefited
workers, while 40 percent said em-
harassment suit might be a drag on
from it politically because he is mired
ployers should only be required to
the President's poll numbers, a marr
in growing skepticism about Wash-
offer their workers a chance to buy
jority of those polled continued to say
their own health insurance.
ington's ability to quickly pass any
that Mr. Clinton has "about the same
sort of health care plan.
Fifty-three percent said abortion
honesty and integrity as other Presi
should not be covered by a basic
Most people said they would be
dents."
disappointed if Congress never
health care plan, but 16 percent want-
ed abortion automatically covered,
With Congressional hearings on the
passes a health care plan, and a sub-
stantial number 39 percent said
and 28 percent said it should be an
Whitewater matter scheduled to be-
available option.
gin next week, nearly half of these
they would be less likely to re-elect a
member of Congress who voted
As the Clintons lead a selling blitz
polled continued to reserve judgment
against a health care plan.
this week on their health care plan,
on whether the Clintons did anything
they will at least find an audience
wrong.
The yearning for overhauling the
that agrees that the problem is press-
health care system and attaining uni-
ing. For the first time this year, when
Her words laced with the twangroi
versal coverage clearly has a wistful
asked to name the most important
her native West Virginia, Mrs. Doug.
side, since 78 percent of those polled
problem facing the country, 19 per-
las, the Orlando grandmother, de:
now say they think Congress will not
cent chose health care, equal to the 19
clared that Mr. Clinton was "the
be able to agree on a plan before the
percent that cited crime and violence.
greatest President we've had in my
end of the year.
Hillary Rodham Clinton's favorabi-
lifetime."
Leonard Smith, a 40-year-old un-
lity rating has risen slightly from last
employed plumber and part-time
spring, with 38 percent now express-
farmer from a town in southeastern
ing a positive view and 26 percent a
lowa called Figourney "You know,
negative one.
like that actress Sigourney Weaver"
Some of the male respondents in-
- sees it this way: "Clinton's trying
terviewed after the poll talked about
to do something that needs to be done,
but he himself doesn't have the power
to do diddly squat. If the Democrats
are for something, the Republicans
automatically think they have to be
against it. They won't work for what's
COVERAGE OF 95%
tom line is what it has always been:
guaranteed health coverage for every
MIGHT BE ENOUGH,
American. And that's what he said to
that doesn't work," Mr. Clinton said
the governors today. Are we willing to
after his speech. "We must not do
discuss ways to guarantee universal
something that is a fraud."
CLINTON CONCEDES
coverage? Absolutely. Are we chang-
On Saturday, the governors said
ing the goal? Absolutely not."
they opposed the Senator's call for
Indeed, what Mr. Clinton said today
strict limits on Federal spending for
reflected the Administration's long-
Medicaid; today, Mr. Dole went out of
standing unspoken position: Although
his way to assure them that he was
SEEKS GOVERNORS' HELP
Mr. Clinton and his wife have repeat-
not committed to that plan and hoped
edly talked about "universal cover-
to work with them to resolve the
age," their model is the Social Securi-
issue.
ty system, which reaches about 98
Mr. Clinton, in turn, went out of his
Health Battle Gets Personal as
percent of Americans.
way to reach out to Democratic gov-
But the Administration has never
ernors, who endorsed his goal of uni-
President and Dole Fence
said that in public before. The fact
versal coverage on Monday but re-
that Mr. Clinton did so today was an
mained silent on the question of how
Over Health Overhaul
important signal to Congress, the
to pay for it. While Mr. Clinton said
governors and the public that, as Con-
his proposal to require employers to
gressional leaders prepare their final
shoulder most of the burden repre-
drafts, he is ready to make a deal.
sented "the best and fairest way," he
By DOUGLAS JEHL
"We know we're not going to get
was more explicit than he has been
BOSTON, July 19 - Suggesting
right at 100 percent," Mr. Clinton said
before in saying that he would be
that he is ready for compromise on
in response to a question after his
open to other alternatives.
health care legislation, President
speech, "but we know that you've got
But the President's remarks, re-
Clinton softened his call for insurance
to get somewhere in the ballpark of 95
coverage for all Americans today,
or upwards so that you stop the cost
gardless of how he intended them,
shifting, and you have some - and
added to the anxiety level on Capitol
saying 95 percent or 98 percent might
you have economies of scale for all
Hill and might make the Democratic
do.
the small businesses that are partici-
leaders' already difficult job that
One day after the National Gover-
pating." Cost shifting occurs when
much harder. Particularly in the
nors' Association rejected his pro-
medical care providers raise prices
House, the leaders have been trying
for patients with insurance to cover
hard to get members to commit
posal that employers pay much of the
the cost of care for those who do not.
themselves to a requirement that em-
cost of their workers' insurance, Mr.
White House officials said the Pres-
ployers pay for the bulk of their work-
Clinton repeated his willingness to
ident had wanted to inject realism
ers' insurance.
THE NEW YORK TIMES, WEDNESDAY, JULY 20, 1994
consider other ways to pay for cover-
into wrangling over what universal
Watching Mitchell
age. But he said his advisers had
coverage might mean and wanted to
found serious problems with other
advertise his flexibility in working
But the melding process continued
methods they had studied, and he
with Republicans to find common
on Capitol Hill. The House leadership
met with the committee leaders who
repeated his contention that making
ground. But they and the President
employers pay was the fairest and
insisted that his comments should in
are trying to get a consensus bill,
no way be seen as a sign that he had
largely patterned on the measure
most efficient way to finance expand-
ed coverage.
moved his bottom line.
passed by the Ways and Means Com-
mittee. They expect to have this bill
In a speech to the governors' group,
Deep Rift Remains
ready by the end of the week and will
Mr. Clinton said his litmus test for
In particular, Mr. Clinton's concil-
begin shopping it around to members
health care legislation would be "a
iatory language did not obscure the
of the Democratic caucus, looking for
phased-in deliberate effort" to
clash between the White House and
further refinements that can get
achieve universal coverage, and that
Mr. Dole about how far to go toward
them up to 218 vòtes, the number
a plan that would reach at least 95
meeting the President's goal of pro-
needed for passage.
percent of Americans might be ac-
viding insurance coverage for all
But they are also hoping for some
Americans.
signal, by the end of the week, of what
ceptable. Up to now, he has empha-
In Mr. Dole's speech, he repeated
Senator George J. Mitchell, the ma-
sized coverage for "every Ameri-
his call for changes in insurance reg-
jority leader, will be able to accom-
can."
ulations and subsidies to make cover-
plish. Representative Thomas S. Fo-
Currently about 85 percent of
age more widely available. He
ley, Speaker of the House, was asked
Americans have health insurance.
warned against those who would
today what he would do if Mr. Mitch-
Most people who lack coverage live in
"push and push and push, and try to
ell reported that he simply did not
working households.
have it all."
have the votes for any kind of employ-
Mr. Clinton spoke after Senator
With the battle over the shape OF
er mandate.
Bob Dole, the Republican leader, de-
health care legislation moving into its
Mr. Foley replied, "I will say,
most crucial phase, the presentations
'George, I'm sure you're wrong.'
livered a tough speech to the gover-
by Mr. Clinton and Mr. Dole to the
Mr. Foley today reiterated his de-
nors in which he staked out a hard-
annual gathering of the National Gov-
termination to get a vote on a health
line position on the coming debate
ernors' Association added a personal
care bill before the House adjourns
over health care. He said the Presi-
dimension to a debate that has been
for its August recess. That is sched-
dent's proposals for universal cover-
waged for months at a distance and in
uled to begin Aug. 12, but many pre-
age and employer mandates were
abstract terms.
dict that the date will be pushed back.
"dead" on the Senate floor, and he
Although the two men never ap-
In their appearances at the gover-
accused Mr. Clinton of pushing too
peared on the stage together, the ses-
nors' conference today, both Mr. Clin-
hard for too much too quickly.
sion otherwise brought some of the
ton and Mr. Dole cast themselves as
Mr. Clinton's remarks appeared to
theater of a presidential debate, with
tireless fighters who are determined
their aides scurrying to press rooms
that health care legislation will clear
cause consternation among some of
afterward to try to manipulate re-
Congress by fall. Mr. Dole said he
his supporters on Capitol Hill, and
porters' perceptions.
would ask Congress to forsake its
they may have added to the burden of
Mr. Clinton and Mr. Dole were both
summer vacation if necessary,
Democratic leaders seeking to build
clearly determined not to be seen as
move Mr. Clinton praised as "most
support for employer-paid insurance.
obstructionist, and both were careful
encouraging."
Hillary Rodham Clinton, in an ap-
to pad their thrusts and to cushion
But while the President did not do
pearance today on the program
their words with language more typi-
cal of veteran negotiators than politi-
so directly, he was plainly referring,
"Good Morning America," said, "The
only thing that will work is to get
cians.
to what he regards as the greatest
flaw in Senator Dole's health care
everybody into the system." When
Clinton Still Skeptical
plan: its reliance on an overhaul of
Mrs. Clinton was asked if the White
Mr. Clinton also made it clear that
insurance rules. Several times, Mr.,
House would insist on universal COV-
Clinton reminded the governors that
he still looked with great skepticism
erage in any bill. she replied. "Well, I
efforts by the states to expand access
on Mr. Dole's plan, which the Presi-
think that if you don't insist on it, at
to health care through similar
dent warned could raise costs and
changes had met with little success.
least being phased in at some point,
lead to a decline in the number of
you you make the problem worse."
Americans with coverage. For exam-
For his part, Senator Dole said,
Mr. Clinton's remarks sparked
ple, if insurers were required to offer
"As far as the employer mandate;
fears among his allies on Capitol Hill
coverage to everyone, regardless of
that may happen sometime. It's DOL
their health, but all people were not
going to happen this year." He added;
that he was retreating even as they
required to buy insurance, some peo-
"You only have to count to 100 in the
were trying to shore up his support,
-and the White House immediately
ple might put off buying it until they
Senate. I think we've got the votes,
became sick. That would raise the
and I don't think that's going to
began trying to dispel the impression
rates for the healthy and cause some
change in the next 30 days." He went'
that the President was backing down.
people to drop their insurance.
on, "I think the seeds of a bipartisam
Leon Panetta, the President's chief
"I am not willing to do something
plan still exist. if the Administration
of staff, said, "The President's bot-
is willing to come our way."
you
The New York Times CBS NEWS Poll
Americans' Attitudes on Health Care
120m
1964
What is the most important
How important is it that every
Should President Clinton stick
problem facing the country
American receive health
to his goal of making sure 100%
today?
insurance coverage?
of Americans have health
insurance coverage?
on
30%
Not very
Crime
Compromise
1090
25
important 3%
so that 95%
Somewhat
of Americans
00
20
important
are covered
17%
53%
15
413 A
Health care
Stick
10
to goal
11421)
5
Very
42%
important
alads
0 '94
79%
vine
F
A
M
J
is
CUD
THE NEW YORK TIMES, WEDNESDAY, JULY 20, 1994
Should employers be required
Will Congress pass a health care
If, in the next year, Congress
to pay most of the cost of
plan before the end of this year
does not pass any health care
JUC
health insurance for their
or will they be unable to agree?
reform, and the current health
et
workers or should they just
care system continues as it is,
be required to make available
80%
would you be pleased
insurance that workers
70
or disappointed?
can pay for?
60
50
Unable to agree
Make
40
Pleased
available
Required
30
Will pass a plan
24%
40%
to pay
20
49%
10
Disappointed
0
'94
69%
F
A
J
Based on polls conducted by The New York Times and CBS News. The latest
poll was conducted by telephone July 14-17 with 1,339 adults nationwide.
AU
How the Poll Was Taken
The latest New York Times/CBS News
adjust for variations in the sample relat-
WHITE HOUSE
Poll is based on telephone interviews con-
ing to region, race, sex, age, and educa-
July with 1,339 adults
tion:
around the United States, excluding Alas-
In theory, in 19 cases out of 20 the
In an appearance on the ABC News program "Good Morning
ka and Hawaii.
results based on such samples will differ
America,' Hillary Rodham Clinton endorsed coverage for everyone.
The sample of telephone exchanges
by no more than three percentage points
"The only thing that will work is to get everybody into the system,"
called was selected by a computer from a
in either direction from what would have
she said. Asked if the White House would insist on universal
complete list of exchanges in the country.
been obtained by seeking out all Ameri-
The exchanges were chosen to assure
can adults.
coverage in any bill, she replied, "Well, I think that if you don't insist
that each region of the country was repre-
For smaller subgroups, the potential
on it at least being phased in at some point, you will make the
sented in proportion to its population. For
sampling error is larger. For example,
each exchange, the telephone numbers
for blacks, it is plus or minus nine per-
problem worse.
were formed by random digits, thus per-
centage points.
mitting access to both listed and unlisted
In addition to sampling error, the prac-
numbers. Within each household, one
tical difficulties of conducting any survey
adult was designated by a random pro-
of public opinion may introduce other
CONGRESS
cedure to be the respondent.
sources of error into the poll. Variations
The results have been weighted to take
in question wording or the order of ques-
The Democratic leadership in the House met with heads of the health
account of household size and number of
tions, for instance, can lead to somewhat
committees, who are putting together an initial effort at a consensus
telephone lines into the residence and to
different results.
bill. They expect to have it ready by the end of the week, and will
begin showing it to members of the Democratic caucus, looking for
further refinements that can get them to 218 votes, the number
DIARY
needed for passage. Speaker Thomas S. Foley repeated his
determination to get a vote on a bill before the House adjourns for it:
Health Care Developments
August recess, now scheduled to begin Aug. 12, but widely
predicted to be pushed back.
YESTERDAY
President Clinton and Senator Bob Dole of Kansas, the minority
LOBBYISTS
leader, addressed the nation's governors on health care while leaders
Rock the Vote, the group that organized a campaign to get young
in Congress continued their work on legislation.
people to register to vote in 1992, began an effort to distribute a
million copies of a nonpartisan guide to health proposals. Organizers
also released a survey that found that many young people had to
GOVERNORS
forego medical care in the past year because they could not afford 11
In a speech to the National Governors' Association, President Clinton
softened his call for insurance coverage for all Americans, saying that
95 percent or 98 percent might do. One day after the governors
rejected his proposal that employers pay much of the cost of their
workers' insurance, Mr. Clinton suggested to the group at its meeting
in Boston that he would consider other financing methods, though he
thought employer payments were fairest and best. Senator Dole,
speaking before Mr. Clinton, said the President had tried to do too
much, too soon. He added that the President's proposals for
universal coverage financed in large part by payments from
employers were "dead" in the Senate.
3
Birthrate for Unwed Women
Up 70% Since '83, Study Says
By STEVEN A. HOLMES
Special to The New York Times
Al
WASHINGTON, July 19 - With the
debate over reducing the country's
welfare rolls focusing renewed atten-
tion on the rising birthrate among
benefits to women whose babies are
unwed women, the Census Bureau
conceived while they are on welfare.
reported today that such births
But a group of Republicans in the
soared by more than 70 percent from
1983 to 1993.
House, contending that welfare pro-
vides a financial incentive for poor,
at first marriages rising last year to
According to the bureau, 6.3 million
unmarried women to bear children,
26.5 years for men and 24.5 years for
children, or 27 percent of all children
women. The figures represent the
goes Mr. Clinton one step further,
under the age of 18, lived in 1993 with
highest median age at marriage for
freezing welfare payments at current
a single parent who had never mar-
both men and women since 1890.
levels and denying cash benefits to
ried, up from 3.7 million in 1983.
9The delay in marriage is greatest
single mothers under the age of 18.
While indicating that the annual
among blacks, with 22 percent of
increase in the number of children
"I think these figures dramatize,
black women age 40 to 44 never hav-
once again, that our welfare policies
ing been married, compared with 7
born out of wedlock slowed somewhat
are going in absolutely the wrong
percent of white women and 9 percent
in the 1980's, the report also docu-
direction," said Representative Jan
of Hispanic women.
mented the sharp rise in these kinds
Meyers of Kansas, who is the archi-
of births over the last three decades.
tect of the Republican bill.
Role in Social Problems
While there were 243,000 children liv-
But some researchers say that
But it is the drastic rise in the
ing with one parent who had never
freezing or denying welfare benefits
birthrate among unwed women and
married in 1960, by last year that
would not have much, if any, effect on
girls that is most likely to draw atten-
number had climbed to 6.3 million.
the soaring illegitimacy rates. They
tion in the coming months as Con-
note that the out-of-wedlock birthrate
"It's astonishing," said Kristin
gress debates several issues. The
rose in the 1960's when the value of
phenomenon of out-of-wedlock births
Moore, director of Child Trends, a
welfare benefits went up. Yet the rate
has been cited as a factor in a host of
Washington-based research organi-
continued to rise in the 1970's and
social problems, including increased
zation that studies adolescent preg-
80's, even though the value of the
crime, drug abuse, welfare dependen-
nancy. "It's really a substantial so-
benefits declined because they did not
cy and poor educational attainment.
cial change, and it's happened really
keep page with inflation.
Indeed, the bureau's report pre-
fast."
sented stark evidence of the socio-
The figures are compiled in an an-
nual report by the Census Bureau
Concerns about
economic disadvantages confronted
by children living in one-parent
titled "Marital Status and Living Ar-
households, as against those in two-
welfare's effect on
parent families. And the report indi-
rangements." The findings mirror
cated that those disadvantages were
the results of other studies in recent
years including those done by the
families.
much more acute for a parent who
never married.
Census Bureau - that show out-of-
According to the Census Bureau,
wedlock births still on the rise.
the median family income in house-
The report demonstrated the ex-
"Research suggests that welfare
holds where two parents were
tent to which blacks are affected by
accounts for some, but not all of this
present was $43,578. In contrast, in
the changes that are roiling the tradi-
phenomenon, said Martha Farns-
one-parent-families where the moth-
tional family-structure. According to
worth Riche, director of policy stud-
er was divorced, the median income
the report, 57 percent of black chil-
ies for the Population Reference Bu-
was $17,014, and where she had never
dren are living with one parent who
reau, a private research group.
been married, the median income
was $9,272.
has never married, compared with 21
Family Trends
Similarly, 10.6 percent of children
percent of white children and 32 per-
The statistics included in the annu-
living in two-parent families were
cent of Hispanic children.
al report also document other trends
living below the poverty line. But 38.4
The latest figures are likely to fuel
associated with the breakdown of the
percent of children living with di-
the debate over competing Demo-
traditional American family:
vorced mothers and 66.3 percent of
cratic and Republican proposals on
The number of unmarried adults
those living with mothers who had
how to cut the country's welfare rolls.
nearly doubled, to 72.6 million from
never married were living below the
37.5 million, from 1970 through 1993,
poverty line.
In its bill, the Clinton Administra-
with 58 percent of this group made up
tion emphasizes the need to identify
of adults who have never married.
the fathers of children born out of
The number of people who are
wedlock and hold them responsible
divorced tripled to 16.7 million in 1993
for financial support of their children,
from 4.3 million in 1970.
9Men and women alike continue to
requires single mothers under the
age of 20 to remain in school to contin-
delay marriage, with the median age
ue to receive welfare benefits and
allows states to limit additional cash
Continued on Page A8, Column 1
THE NEW YORK TIMES, WEDNESDAY, JULY 20, 1994
Talking Points on Universal Coverage - July 19, 1994
*
The President's bottom line is what it has always been -
guaranteed health care coverage.
*
We have always said that we are flexible on HOW we achieve
universal coverage, but not WHETHER we achieve universal
coverage.
*
The President understands that 78% (Washington Post/ABC News)
of the American people want universal coverage. And he's
committed to providing it.
*
Let's look at what has been said already this week on what will
happen without universal coverage: AFSCME released a study
saying that there would be a $115 unfunded mandate on states from
the non-universal Dole plan. The Catholic Health Association
released a Lewin Study showing middle class premiums will
increase by as much as $700 each year in some categories under
non-universal vs. universal plans. And groups representing older
Americans shot down non-universal plans that raid Medicare and do
nothing to help seniors. Today, Secretary Bentsen will release a
study which illustrates that 84% of the uninsured are in working
families.
*
Universal coverage is about giving every American - especially
hard working middle class Americans - an ironclad guarantee that
they will have health care coverage that will never be taken
away, even if they get sick or lose their job.
*
We are going to continue to fight hard for universal coverage.
We are going to continue to fight for the millions of hard
working middle class Americans who will be left out in the cold
if we enact legislation that does not achieve universal coverage.
The President said that we would never reach 100% He seemed to
indicate that 95% would be acceptable. Is 95% the
Administration's definition of universal coverage?
*
Our definition is that every American have a guarantee in law
of health care coverage that can never be taken away.
*
The President was saying that we must have a guarantee in law
that every American have health care coverage.
* The real question here is what happens if we don't achieve
universal coverage. The fact is that the every American must be
guaranteed health care coverage if we are to protect the middle
class and control costs.
Would you ever really achieve 100%
*
Obviously, there will always be someone sitting under a bridge
who will not be in the system. But the President remains
absolutely committed to guaranteeing that every American have
health care coverage that can never be taken away.
* Social Security is a universal coverage program and not every
older American takes advantage of it.
The President and First Lady indicated that universal coverage is
a goal to work toward, not an absolute bottom line. Is this
true?
* We have a phase-in our bill. We have said that we would be
flexible on phase-in but it needed to be within a reasonable time
period and at a date certain. This is our position.
* Obviously, we are not going to achieve universal coverage
overnight. That's why we phase it in. There will be a road
toward universal coverage, but the road must achieve universal
coverage. Every American must have a guarantee in law of health
care coverage that can never be taken away.
Wasn't the President signalling new flexibility on employer
mandates?
* The President has said all along that he is flexible on how we
get to universal coverage, but not whether we get to universal
coverage.
* As the President said yesterday, he still believes that shared
responsibility is the "best and fairest" way to achieve universal
coverage.
CNN said that this new change in strategy was Leon Panetta's
idea. Is this true?
* There is no change in strategy. The President remains
absolutely committed to achieving universal coverage.
(ED: complete writethru, adding details from clinton speech)
Clinton willing to consider alternative
BOSTON, July 19 (UPI) Although stating that he could accept health care
reform legislation that doesn't rely on employers paying the tab, President
Clinton Tuesday challenged critics to produce an alternative that will lead to
universal coverage for all Americans.
Clinton also told the National Governor's Association that he would not
accept partial insurance reforms which he claimed only would lead to rising
costs and not broaden coverage for workers.
``We must do what we know will work if we will just be guided by that,
we will come up with a bill that the American people will be proud to have us
sign without regard to their party, the president said.
You will have to find a way to cover all Americans, he asserted.
Clinton found ``encouraging' the comments made by a more conciliatory
Senate Republican leader Bob Dole who preceded him on the speaker's platform.
The Kansas Republican assured the governors the seeds of a bipartisan health
care reform plan still exists ``if the administration is willing to come our
way.
Dole also said he believes passage of a health care reform measure is
possible this year.
A lot of these insurance reforms very much need to be implemented but if
they are not implemented in the right way they will simply raise the costs for
everybody else, Clinton said.
The evidence, governors, is that if you do these insurance reforms and
you don't do something that you know will increase coverage among working
people, the impact of the insurance reforms will be to decrease coverage among
working people, Clinton warned.
We have to do something that we know will work, Clinton said. That
is my only bottom line.
I've never ruled out another option, he added, referring to employer
mandates, I just haven't found another one that works.
Clinton said that ``if everybody would just forget about all the rhetoric
and do something that will work, then a compromise would be possible.
Let's do not mislead the American people, if we're going to act, let's
do something that will leave people in New Mexico, in Utah and Montana, better
off.
We could pass a bill and all shout hallelujah and get by the November
elections but there will be real consequences, Clinton argued.
I will say again, it depends on what else is in there (the
legislation) as to what he would finally accept.
There may be some other way than employer mandates to do this, he
said, but urged the governors to not to pass legislation that will decrease
coverage for working people.
Maintaining a posture of middle ground, Clinton reminded the governors
that it was the Republicans who proposed in 1972 an insurance program based on
a 50-50 split between employers and employees, adding that I don't believe
that the Republican Party has moved that far from its moorings in the last 22
years.
I'm asking them to come home a little bit. And I still think we can do
it.
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Clinton/Universal Coverage-3: Would Accept Phased-In Coverage
Clinton also suggested that he was open to the idea of accepting a bill that
did not require employers to cover all their employees, ''if we knew we were
moving toward full coverage. However, White House officials have said they
know of no other politically practical way of getting to universal coverage
except through an employer mandate.
Clinton also restated his position that he could accept a bill in which
universal coverage was ''phased-in' over a period of years.
Also speaking to the Governors was Senate Minority Leader Bob Dole who
accused the administration of 'ratcheting up the rhetoric'' on health care.
''It's time for a second opinion, Dole said. The Senate leader also said
Clinton's plan to require emploers to provide insurance to all their workers
was dead in the Senate.
''I can count, he said, adding there was no way an employer mandate would
pass this year.
Dole is author of a less-ambitious plan supported by 40 of the Senate's 44
Republicans that does not require either universal coverage or an employer
mandate.
(END) DOW JONES NEWS 07-19-94
1:32 PM
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Clinton Gives Definition Of 'Universal Coverage' In Speech
WASHINGTON -DJ- President Clinton appeared to finally give a definition of
what is meant by ''universal coverage'' for health care insurance, setting a
95% lower limit as the level at which economic savings can occur.
In a speech at the National Governors' Association in Boston, Clinton
compared proposed coverage under his health care proposal to coverage under
the current Social Security program.
Clinton's remarks were monitored in Washington.
''We have had 97% (of the population covered by) social security for many
years, said Clinton.
''Just by improvements in bookeeping (Social Security coverage increased)
to a little above 98%,' Clinton added. ''So, we know that we're not going to
get right at 100%'' for health care coverage.
''But you have to get somewhere in the ballpark of 95% or up so that you
stop the cost shifting and you have economies of scale for all the small
businesses that are participating" in the health care plan, Clinton said.
(MORE) DOW JONES NEWS 07-19-94
12:36 PM
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PM-Governors-Clinton, 2nd Ld-1st Add, a0544, 470
BOSTON: universal coverage.''
Despite the ratcheting up the rhetoric by the White House and the
Democratic National Committee ... I think the seeds of a bipartisan plan still
exists if the administration is willing to come our way, Dole said.
In particular, Dole referred to recent speeches by Clinton and other
administration officials claiming the nation's middle class would be the real
losers if a universal coverage plan does not pass.
Dole asserted such a strategy sought to foment class warfare.
This issue is not about Bill Clinton and Bob Dole, and the Republicans
versus the Democrats
...
or the poor versus the middle class, said Dole, a
1996 GOP presidential hopeful.
He suggested Congress forgo its August recess to keep working on health
care overhaul.
I think health care reform is too important to be turning into
a
battle of political personalities, he said.
Democratic governors demanded here Monday that Congress guarantee health
coverage. But they were silent on how to pay for the plan, undercutting White
House hopes for a stronger show of support from Clinton's former statehouse
colleagues.
Republican governors, meanwhile, voiced sympathy toward Dole's health care
proposal but stopped short of endorsing it. They want to abandon his call for
caps on Medicaid and find a new way to pay for his plan.
The Dole plan is backed by 40 of the Senate's 44 Republicans.
And today, Republican South Carolina Gov. Carroll Campbell introduced Dole
by offering praise for his health-care plan.
One major disagreement with this bill: the Medicaid cap, Campbell
said. But, he added, ``As I said, Bob Dole is a friend of governors, so we're
working with him on this section of the bill.
For his part, Dole said: ``We knew you had a problem with the Medicaid cap
...
I understand your concerns and I believe we can work together.'
Dole said: The American health care system is the best in the world,
performing near-miracles every day.'
He said a radical overhaul like the one proposed by Clinton would
jeopardize this system.
The price of health care reform should not be the takeover of one
seventh of the economy by the federal government and a new burden on middle
class Americans.
I'm not against covering every person in America. But I want to know how
to get there and how to pay for it, Dole said during
a question and answer question with governors.
Dole defended his attack on Clinton, saying he didn't know if he was being
the good Dole or the bad Dole
...
I'm just trying to respond to what I hear
around the country.
Dole did compliment Clinton and Mrs. Clinton for getting it (health
care) on the national agenda.
Meanwhile, an ABC: 11th graf a0521
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PM-Governors-Clinton,0835
Dole Says Democrats Ratcheting Up the Rhetoric' in Health Debate
Eds: Note Kansas/Missouri interest; A version also moving on national wires.
By TOM RAUM= Associated Press Writer=
BOSTON (AP) Senate Minority Leader Bob Dole, firing the first shot in a
showdown with President Clinton over health care, accused the White House and
the Democratic National Committee today of `ratcheting up the rhetoric'' and
frustrating efforts at compromise.
It's time for a second opinion, the Kansas Republican told the
nation's governors. Dole has his own health care plan, which does not include
the guaranteed coverage element that is central to Clinton's plan.
We're looking for a bipartisan solution, just as I believe the governors
are looking for a bipartisan solution. And we hope it's out there somewhere,
Dole told the summer meeting of the National Governors Association.
He spoke an hour before Clinton was to take the podium to defend his
administration's health care reform plan back-to-back speeches that had some
of the trappings of a presidential debate.
Dole said the nation's health care system does need some repair
but
it doesn't need a complete overhaul.
In advance of today's showdown, first lady Hillary Rodham Clinton pressed
the administration's case for universal health coverage, saying that without
it, the cost for middle income working Americans who currently have
insurance will increase, because the insurance companies will have to insure
those who are sick and have preexisting conditions. And they will make up the
difference by increasing the cost on the rest of us.
Mrs. Clinton, appearing from New York on ABC, said Clinton still insists
on coverage for everyone and added: I don't think Congress will pass a bill
that doesn't have at least some plan to get universal coverage.
Despite the ratcheting up the rhetoric by the White House and the
Democratic National Committee
I think the seeds of a bipartisan plan still
exists if the administration is willing to come our way, Dole said.
In particular, Dole referred to recent speeches by Clinton and other
administration officials claiming the nation's middle class would be the real
losers if a universal coverage plan does not pass.
Dole asserted such a strategy sought to foment class warfare.
This issue is not about Bill Clinton and Bob Dole, and the Republicans
versus the Democrats
or the poor versus the middle class, said Dole, a
1996 GOP presidential hopeful.
He suggested Congress forgo its August recess to keep working on health
care overhaul.
I think health care reform is too important to be turning into
a
battle of political personalities, he said.
Democratic governors demanded here Monday that Congress guarantee health
coverage. But they were silent on how to pay for the plan, undercutting White
House hopes for a stronger show of support from Clinton's former statehouse
colleagues.
Republican governors, meanwhile, voiced sympathy toward Dole's health care
proposal but stopped short of endorsing it. They want to abandon his call for
caps on Medicaid and find a new way to pay for his plan.
Dole said today that an overhaul like the one proposed by Clinton would
jeopardize a successful system.
The price of health care reform should not be the takeover of one
seventh of the economy by the federal government and a new burden on middle
class Americans.
I'm not against covering every person in America. But I want to know how
to get there and how to pay for it, Dole said during
a question and answer question with governors.
Dole defended his attack on Clinton, saying he didn't know if he was being
the good Dole or the bad Dole
I'm just trying to respond to what I hear
around the country.
Dole did compliment Clinton and Mrs. Clinton for `getting it (health
care) on the national agenda.'
Meanwhile, an ABC News poll released Monday found the public split, 48-48,
over whether the U.S. health system needs a major overhaul or just a good
tuneup. By a 52-43 margin, those surveyed felt holding down health costs was
more important than guaranteeing insurance for all.
But while they opposed Clinton's health plan, 50-43, those surveyed also
rated health care above crime as the most important issue for the president
and Congress to address. The telephone survey of 1,004 adults conducted July
14-17 had a 3.5 point margin of error.
Neither the administration plan nor the Dole proposal received
particularly high marks from the governors here.
The Democratic governors passed a resolution embracing a guaranteed
coverage provision. That put a majority of the nation's governors on record
supporting guaranteed health benefits that cannot be taken away.
The Dole plan does not mandate coverage. But it does set up new standards
for insurance companies to follow including forbidding insurers from
declining to cover a previous condition of a newly insured worker.
At a Democratic fund-raiser in Portland, Maine, Monday night, Clinton
sharpened his attacks on GOP opponents, citing a huge disconnect between the
rhetoric and the reality.
With Senate Majority Leader George Mitchell at his side, Clinton said,
We need to complete a battle that was begun by Franklin Roosevelt and Harry
Truman.
But, he said, every time Senator Mitchell has reached out to compromise
they (Republicans) have moved further away.
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7/13/94
The President and the Congress are guaranteed health
insurance.
We Democrats believe every American should have the same
guarantee.
The Republicans disagree.
They like their guaranteed health insurance.
But they don't want you to have it.
We Democrats say, if it's good enough for the President and
Congress, it's good enough for all Americans.
Tell the Republican Members of Congress that you want the
same guarantee of health insurance they have.