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Office of the Press Secretary

Embargoed for Release
Until Saturday, September 25, 1993
at 10:06 A.M. EDT


The Roosevelt Room

THE PRESIDENT: Good morning. Last Wednesday evening, I asked Congress to take up the challenge of providing health security to every American, to help write the next great chapter in our nation's history. Already your response has been positive and dramatic, creating what I believe will be an irresistible momentum for reform, while insisting that we be careful to do it right. And I am increasingly confident that before it adjourns next year, Congress will pass and I will sign a bill that guarantees each American comprehensive health benefits that can never ever be taken away.

In the debate between now and that day, a debate I welcome, our most urgent priority must be to ensure that we preserve what is right with American health care and fix what is wrong.

So today I want to take a few minutes to talk with you about the plan that I am suggesting and how it will work for you -- what will stay the same and what will change.

First, I want you to know that after considering all the options and looking at the systems in place in other countries in the world, I decided that our nation does not need a government-run health care system. So our plan builds upon the private system, which provides health care to the vast majority of you today. Nine of 10 of you who have private health care coverage now, get it through the place you work. In the future, you will do it just like you do now. Because that's what works now, I think it should work for everyone.

Second, under our health care plan, 63 percent, more than six in 10 Americans who have health insurance today, will pay the same or less than you do today for benefits that are the same or greater, including the right to choose your doctor. If you get good health care, if you like your benefits, if your employer pays 100 percent of your health care costs, nothing will change.

Let's say you work for Super Software, a small computer company that employs about 150 people, and that today your company provides you excellent health benefits, your choice of doctors, and picks up the whole tab. That won't change. You will still sign up for a health plan at work, see the doctors you want, and get the same benefits.

Now, suppose you work for a giant auto company and your union has fought hard for your benefits; you've even had to give up a wage increase or two to get them. Well, under this new plan, you will keep those benefits.

What do you get out of this plan? You get security. You get the knowledge that you'll never lose health coverage even if you lose or change your job or you get very, very sick. You also know that no matter what happens, there's a limit to what your employer can do to reduce the benefits or your choice of plans.

I know that many people also want to know whether you'll still be able to choose your doctor. Again, I say the answer is yes. And no matter what kind of plan you're in today, you will all benefit because under this new system, the cost of health care will go up much more slowly than they've been going up for the last 10 or 12 years. And you'll be able to choose from at least three plans providing comprehensive coverage. You'll also be able to choose your doctor no matter what plan you decide to join because you can follow your doctor into whatever plan he or she joins.

Now, a lot of families have more than one doctor. Say you're a working mother who values your obstetrician, and you trust your children's pediatrician. You want to know if you can see them both. There's still no need to worry, because doctors will be able to join more than one plan and keep treating the same patients they see today.

Finally, we're going to maintain the quality of American health care. We can do that by making sure that there are quality standards met by all the health care plans -- by spending our money smarter, less on paperwork and unnecessary costs and more on medical research, health care centers and preventive care; by freeing your doctors and nurses from the paperwork they've got to wade through everyday; and by giving you information, valuable information, on variations in costs and outcomes in medical procedures in your area.

These are the things that are right, that make sense, that will keep the quality that we've got today.

Now, let's talk about what needs to be changed in this huge health care system of ours. We begin with the need for security. No American can be absolutely guaranteed today that he or she will never lose health care. But we begin by making that guarantee -- a comprehensive package of health care benefits, the kinds of benefits that only people with the best plans and the best companies get today, that never can be taken away, even if you lose your job or move to another town or state or someone in your family gets very sick.

And then we're going to do something, frankly, that we should have done a long time ago. We're going to provide every American, no matter what kind of plan you sign up for, with free preventive care. Things like immunizations for children, prenatal care for pregnant women, mammograms, cholesterol screenings -- things that will keep us healthy and save us all a lot of money over the long run.

Many Americans will actually have more choices in the kinds of health care they get because everyone will have a choice of at least three health care plans in connection with their job. Today, only about a third of Americans have a choice of more than one plan when they're insured at work. That's a lot more than most Americans have.

We're also going to clear out the paper and the fine print. No more fighting with some insurance bureaucrat hundreds of miles away in order to get what your policy owes you anyway. And no more doctors telling stories of the hundreds of patients they could have served every year if only they weren't swamped in red tape.

This will simplify our system and literally save tens of billions of dollars a year. Don't take my word for it, ask any doctor or nurse or hospital administrator about the growth of unnecessary paperwork in the last decade, mandated by both government and insurance companies. It adds about a dime to every single dollar we spent in health care. And it has resulted in hospitals hiring four times as many clerical workers as doctors being added to their staffs.

Something else is going to be different, too. We're going to ask each of you to take more responsibility. Six of every 10 of you will pay the same or less than you do now for the same or better benefits. But some people will pay more -- people who are getting a free ride today; businesses that contribute nothing to cover their employees; and others who offer bare bones coverage with huge deductibles and copayments; and those employees will have to pay something for their health care. Young, single adults will pay more, too, especially those who are in the best of health and don't see any reason to buy health insurance -- the ones who, when they end up in the emergency room without insurance, pass those costs on to the rest of us.

For small businesses and people on very low wages, there will be discounts to make sure we don't cost jobs or hurt people, but everybody should take some responsibility for their own health care. It's not fair to the rest of Americans when you don't.

There will also be more responsibility on those in the systems -- less for insurance regulation and overhead; a crackdown on fraud and abuse; fewer frivolous malpractice lawsuits; fewer unnecessary procedures done just to get the money; and more responsibility for individuals for their own health; strong efforts and incentives to reduce teen pregnancy and low birthweight babies; to reduce the rate of AIDS. These are the kinds of things we have got to do.

But in the end, the most important thing that will change is this: Every American will get something that today no amount of money can buy -- the security of health care that can never be taken away no matter what. No matter how good your coverage is today, you can lose it. You can lose it all at once or it can be gradually taken away year after year.

Our goal then is health care security for all Americans. The only way to get there is to keep what's right with our system -- the best medical care in the world, the best medical technology, the best medical professionals -- and fix what's wrong.

We're going to protect quality and choice, but we're going to make some changes. We're going to simplify this system. We're going to get billions of dollars of savings. We're going to ask people who don't pay anything now to assume more responsibility for their own health care. That way we can give you health care security without a big tax increase.

In the weeks ahead, we'll be describing in greater details what needs to be done. But the most important thing is: health security. We can do it.

Thanks for listening.