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EXECUTIVE OFFICE OF THE PRESIDENT 02-May-1995 02:07pm TO: Karen R. Guss FROM: Barbara D. Woolley Public Liaison SUBJECT: Acknowledgements for COA Panel Karen, I assume you will get these acknowledgements to speech writer. The First Lady should acknowledge in her comments the following. Senator David Pryor (D-AR) for introduction. He is the Chair of the White House Conference on Aging. Donna Shalala, Secretary of Department of Health and Human Services. (She will not be there, she is testifying on the Hill.) Fernando Torres-Gil, Assistant Secretary for Aging, Department of Health and Human Services. Bob Blancato, Executive Director, White House Conference on Aging. University of Maryland "Reach Out for Health" Service. Provided the Mobile Mammogram unit the First Lady toured before the event. The panel participants. Many of the participants flew in from across the country to share their stories or professional expertise in helping us reach older women to get mammograms. sc/draft May 3, 1995 FIRST LADY HILLARY RODHAM CLINTON WHITE HOUSE CONFERENCE ON AGING MAMMOGRAPHY SESSION MAY 4, 1995 [Acknowledgements: Senator David Pryor, Chair of WH Conference on Aging; Donna Shalala, Secretary of HHS; Fernando Torres-Gil, Assistant Secretary for Aging, HHS; Bob Blancato, Executive Director, WH Conference on Aging; University of Maryland "Reach Out for Health" Service; panel participants] Thank you, Senator Pryor, for that kind introduction. We are going to miss your generous spirit and wisdom in the Senate when you retire. I would like to thank everyone for coming here this week for this conference. Your participation is critical if we are to find answers to the wide range issues confronting so many older Americans today. Col the you know, a NA. health caren A serious threat to America's the health One of those issues is the frightening increase in breast older get from cancer among women of all ages, and particularly among older women is breast women. One out of eight women in America will contract cancer Sen Klein breast cancer in her lifetime. Eighty percent of new breast cancers occur in women aged 50 and older, and half of all new cases occur in women 65 and older. The threat of breast cancer touches every American. We all know someone -- a grandmother, a mother, a sister, an aunt, a daughter, a friend, or in my case, a mother-in-law, who has suffered or Medic In 1991, manmography was added Medicore benefit. is suffering from this disease. That is why I was SO concerned to learn that less than 40% of women aged 65 and older on Medicare have used the Medicare mammography benefit. Over the past few months, I have had the opportunity to meet with older women, health care professionals, and breast cancer survivors. Through these meetings -- which we called "listening sessions" -- we were able to gain a better understanding of how we could increase the use of mammography among older women. I learned a great deal from the doctors, nurses, and older women who took part in the sessions, as did the experts from the Health Care Financing Administration and the Public Health Service's Office on Women's Health. Earlier this week, I was delighted to kick-off the Clinton Administration's campaign to increase awareness of the importance of mammography among our nation's older women. In conjunction description 2dd From internet strut. of Managram awarness with Mother's Day, we are calling the first phase the "Mamagram" campaign. It will continue as a year-long Medicare and mammography initiative, that will include outreach through Medicare carriers and intermediaries, state health departments, and local aging agencies In about ten days it will be Mother's Day, and I know I can count on everyone in this room to use it as an opportunity to show your love by encouraging your grandmothers mother, sister, aunt, daughter, or friend, to get a mammogram to help them live longer, healthier lives. Because those of you here for the White House Conference on Aging are leaders and role models in your communities, you have a unique opportunity to carry this message back to your friends, colleagues, and neighbors and adapt it M so ### that it will get results in your community Medicare Mammography Statement for the Internet The threat of breast cancer in increasing in this country -- 1 out of 8 women born the United States will contract this terrible disease during her lifetime. And the risk of breast cancer increases with age. That's why it is so important for older women to get regular mammograms. Medicare covers mammograms, but the data show that, over a two year period, fewer than 40 percent of women aged 65 and older who are on Medicare take advantage of this benefit. To increase the use of mammography among our nation's older women, the Clinton Administration has launched a Medicare mammography awareness campaign. In honor of Mother's Day, we are kicking off this initiative with a "Mama-gram" campaign. The campaign will include public add service announcements and store displays, bill inserts and grocery store bags carrying information about mammography and Medicare. In addition, free "mama-grams" mammography pre-printed reminders -- will be available at greeting card shops and FTD florists to be slipped into a Mother's Day card or bouquet. As part of our campaign, we are making the following information about Medicare and mammography available on the Internet. Please share it with your friends! Mammograms are the best weapon we have against breast cancer. They can find breast cancer early, when it is too small to be felt or seen. Early detection of breast cancer saves lives and makes treatment easier. If you are a woman on Medicare aged 65 and older, you should know that Medicare covers mammograms every other year even if there is no reason to believe that there is a problem with the health of your breasts. If you have symptoms or if other circumstances suggest that you may have breast disease, Medicare will cover more frequent mammograms when they are ordered by a doctor. To ensure the reliability of mammograms, the Food and Drug Administration (FDA) has put in place quality standards for mammography facilities, and the Agency for Health Care Policy Research (AHCPR) has published guidelines that tell health care professionals and consumers what they need to do to obtain high quality mammograms. When you get a mammogram, make sure that the facility you are using is displaying a certification from the FDA. The older you are, the more important it is for you to take care of your breasts. This means getting regular mammograms, clinical breast exams from your doctor or other qualified health professional, and examining your breasts regularly yourself. For more information about mammograms and breast cancer, call the National Cancer Institute hotline at 1-800-4-CANCER (1-800-422-6237). . Beginning May 15, 1995, you can also get information about Food and Drug Administration certified mammogram facilities at this number. about Medicare coverage of mammograms, call the Health Care Financing Administration's hotline at 1-800-638-6833. about how to get a copy of a pamphlet from the Agency for Health Care Policy and Research about high quality mammograms, call 1-800-358-9295. 5/3/95 REMARKS BY PRESIDENT WILLIAM JEFFERSON CLINTON 1995 WHITE HOUSE CONFERENCE ON AGING WASHINGTON, D.C. MAY 3, 1995 [Acknowledgements: Senator Pryor, conference chair; Secretary Shalala; Secretary Jesse Brown; Senator Mikulski; Senator Cohen; Rep. Martinez; Rep. Morella; Arthur Fleming; Bob Blancato, conference executive director; Hugh Downs, Master of Ceremonies; distinguished delegates; and those of you across the country who are watching this conference via satellite ] Let me begin by saying how sad we are that one of the best friends older Americans have ever had is retiring from the Senate. Senator Pryor once volunteered as an orderly in Washington area nursing homes to document the dire conditions seniors lived under. When he couldn't get Congressional leaders to listen, he conducted hearings out of a trailer in a parking lot. [Trailer led to creation of Claude Pepper's House Aging Committee; as Chairman of the Senate Special Committee on Aging, Pryor led the fight to contain prescription drug costs]. I will miss his fighting spirit and his ageless wisdom. We all owe him our thanks. I am proud to convene the 1995 White House Conference on Aging. And I am pleased to have just signed the proclamation marking May as Older Americans Month. This is the fourth of these conferences in the history of our country, the first to be held since 1981 and the last of the 20th century. These conferences have a productive history: from the establishment of Medicare, Medicaid and the Older Americans Act as a result of the 1961 conference, to the creation of the House Select Committee on Aging as a result of the 1971 conference. But this conference is about looking forward, not backward. All across our country, we are reversing the way we think about older Americans. We have twice as many older Americans today as 30 years ago, and, in the next 30 years, that number will double again. People over 55 are younger, healthier, better educated than ever before, and are beginning entirely new careers as they grow older. Your job here, more than anything else, is to help determine how to use the accumulated experience and judgment of older Americans to make our country stronger. That is the purpose of our National Senior Corps, which works with AmeriCorps, our national service initiative. Like those volunteers, older Americans are a new source of social energy for America, and, as the poet said, the best is yet to be. Your conference agenda confirms that you are more concerned with the future than the past. Issues such as crime, ethics, and ways to inspire a renewed sense of community affect all Americans, no matter what their age. To be honest, seniors are in a better position than ever to help us address these concerns. In 1982, just one year after the last conference, it became true for the first time in our history that older Americans were less likely to be poor than the average American. In the full span of the history of this country, that is a stunning change -- and a very great achievement. We have seen this happening over the course of the last several decades; in fact, since 1959, the poverty rate among the elderly has declined by more than 65 percent. Why has this happened? Because we have kept faith in this country with a social compact that was first forged 60 years ago when President Roosevelt created Social Security. And we have strengthened that compact again and again: with Medicare and Medicaid, with automatic cost-of-living-adjustments for Social Security, with community-based services under the Older Americans Act like "Meals on Wheels," transportation and efforts to prevent the abuse of the elderly. We have made a commitment to every American who works hard and plays by the rules that their retirement will be secure. This Administration is committed to the core principles that have made Social Security work. First, everybody participates. Second, it promotes and rewards work. And third, it represents our commitment to keep seniors out of poverty. We will uphold those principles and make sure that the promise of Social Security is preserved. America has a solemn commitment to every working person -- no matter what their age -- and to their families: Social Security will be there for them when they need it. My administration has done even more to make sure your retirement is safe and solvent when you need it: Pension Benefit Guaranty Corporation; Retirement Protection Act ERISA All of these achievements are good, noble, and the right things to do. Every American should be proud that, in this century, we have completely altered the way our people live out their lives, providing a new hope for a lifetime of purpose and dignity. But we must remember that with great opportunity goes great responsibility. Our job today is to preserve this progress -- not only for all of you, but for generations of Americans to come. 2 You are here to look ahead, to the next ten years and beyond, not just to the past or to your concerns alone. You are moving in the right direction. But the truth is, too many younger Americans are not. We have to think about what you have always been concerned about: How to pass on an even better life to our children and our grandchildren. From the year I was born right after World War II until the late 1970s, people at all levels of this country grew together in an unprecedented period of prosperity. But we have to face the fact that 60 percent of working Americans today are earning the same or lower wages than they did 15 years ago. We have a new class of poor people, mostly unmarried women and their children -- and we must do much more to discourage pregnancy outside of marriage and to improve education for parents and their children. At the root of all these problems is that we have a new split in the middle class, and the fault line is education -- those who have it are doing fine, those who don't are falling behind. But we must face this fact: The budget deficit that exploded in the 12 years before I became President is undermining our ability to give our children a better future, to educate our children and to build opportunity for more Americans. For the past two years, my Administration has made great strides to deal with that deficit, cutting it by $600 billion. We have frozen discretionary spending. Now I want you to hear this: If it were not for the interest on the debt that was run up between 1981 and 1992, our budget would be in balance today. Despite all we have done, we know we have to do more. I have been saying consistently for nearly three years: We cannot get a hold of the deficit without addressing growing health care entitlement spending. Over the next five years alone, almost 40 percent of the growth in federal spending will come from the rise in federal health care costs. They are growing faster than GDP. Faster than overall inflation. Faster than almost all other items of government spending. But you and I know, there is a right way to address health care costs and a wrong way. The right way is to start from the perspective of those people the system is intended to serve -- and to ask what does it take to preserve and strengthen that system. The right way is what I called for in my 1993 Address to the Joint Session of Congress and in my 1994 and 1995 State of the Union messages: We must strengthen Medicare and Medicaid by containing their costs; but only as part of sensible health care reform that works for everyone. That is what I asked Congress to do last year. But Congress failed to act. We must go forward. I have challenged Congress to move in a step by step manner to reduce costs and expand coverage for the American people, including long-term care. 3 I want to remind you what I have said all along. I will judge any health care proposals -- including any change in Medicare or Medicaid -- by four critical principles: Coverage, choice, quality, and affordability. My test is simple: Does the change expand coverage or increase the numbers of uninsured? Does it expand choice so that Medicare beneficiaries have a range of options that include managed care -- or does it force people to give up their doctor? Does it reform Medicare and Medicaid to make them work better without threatening the quality of care? Does it keep health care affordable for seniors? Let me be clear: I will not support any proposals that do not meet these criteria. A central part of the right way of dealing with this problem is to address the long-term solvency of the Medicare Trust Fund. But we must do it honestly. The Fund is in better shape now than when I took office because of the actions we took in our 1993 budget and because of the strong economy. My health care proposal last year would have significantly strengthened the Trust Fund. And I remain committed to working with members of Congress in both parties to save and strengthen Medicare as part of sensible health care reform that works for everyone. That's the right way. The wrong way to address health care spending is to simply slash Medicare and Medicaid. The wrong way is to go backward by reducing coverage. The wrong way is to undermine health care services in rural and inner city communities which are already underserved. The wrong way is to make changes in Medicare that coerce beneficiaries and limit their choice. And finally, the wrong way is to use the largest Medicare and Medicaid cut in history as a bank to pay for tax cuts for the well-off. That is simply wrong. You can't save Medicare by stealing from it. And I will fight anyone who tries to do it. Now there is another part of the right way to address these problems that I want to talk about today. Waste, fraud and abuse in our health care system are jeopardizing the health of beneficiaries and ripping off the government. Since the beginning of my Administration, under the leadership of HHS Secretary Shalala and Attorney General Reno, we have vigorously cracked down on fraud and abuse. I am pleased to announce today that as part of phase two of the Vice President's Reinventing Government initiative, we are taking an additional strong measure: Forming a multi-state effort to identify, prosecute and punish those who willingly defraud the government and who victimize the public. This will be an unprecedented partnership of federal, state, and private agencies in five states with nearly 40 percent of all Medicare and Medicaid beneficiaries: New York, Florida, Illinois, Texas, and California. For every dollar we spend, we will save six to eight dollars -- a win-win situation for everyone except the perpetrators of fraud. 4 The theme of your conference is "Generations Aging Together." I like that, because it reminds us of what we all owe to one another. Younger generations owe the generation of our parents and grandparents the deepest gratitude for your sacrifices on our behalf: For helping to build the greatest prosperity the world has ever known; for giving us more opportunity than any generation before us; for taking on the great challenges of this century -- from ending legal segregation to expanding our frontiers to space. And, as we will remember again in just a few days when we commemorate V-E Day, we owe you for the courage you showed in securing freedom around the world. [I would particularly like to salute the veterans with us today for their sacrifices.] To all who gave so much, we owe you the security of living out the rest of your lives in productive peace and dignity. But we also know that all of us owe generations to come at least the same opportunity and hope that we have had. That is our responsibility, and we must fulfill it together. Thank you, and God bless you all. 5