THE WHITE HOUSE
Office of the Press Secretary
PRESS BRIEFING
BY CHRIS JENNINGS, PRESIDENTIAL HEALTH CARE POLICY ADVISOR,
AND MIKE MCCURRY
The Briefing Room
1:17 P.M. EDT
MR. MCCURRY: Ladies and gentlemen, welcome to today's daily briefing at the White House.
Q Has the President gotten over jet lag?
MR. MCCURRY: The President enjoyed his trip. Let me tell you a little bit about the President's triumphant tour through Europe. We'll revisit all the key highlights. You don't want to do that? No, he's fine. He had the morning off, since he worked a good part of the weekend and he will be doing the event, aforementioned event, in a very short while here about discrimination -- those who have been screened for some genetic defect.
Chris Jennings, the President's Health Care Policy Advisor, is here. If you have any questions on that, I think we've got some paper that's helpful in describing the proposed legislation. Any questions you would like to pose on this?
Q Just one question I would just like to pose to you, though, is, do you feel that you're going to have a time certain or positive signals for its certain passage?
MR. MCCURRY: I think that the fact that the legislation is attracting bipartisan support, that the chair of one of the relevant committees will have some things to say that we hope will be positive about the bill bodes very well for consideration of the legislation in this Congress, and hopefully in a short while.
Q Is this an across-the-board endorsement of genetic testing? I mean, is he endorsing that we should get tested?
MR. MCCURRY: I think the report submitted to the President by the Secretary of Health and Human Services says -- extraordinary technology involved with understanding better the genetic processes of the human body has great potential in terms of health care treatments and the design of health care delivery strategies itself, but it also at the same time has certain risks and perils associated with it that need to be carefully addressed. That's obviously the purpose of this legislation.
Q But should people get tested?
MR. MCCURRY: I think that there are a variety of things that you hear often people encourage screening for. That's just a sensible, good health practice and as a matter of public health policy we do encourage people to work with their doctors, their physicians, and their health care plans for the kind of treatments and screening that are recommended.
Q What does the health insurance industry say, and has he won their cooperation on this?
MR. MCCURRY: Chris, do you want to take -- why don't you -- let me have Chris Jennings, the President's Health Care Policy Adviser, take that.
MR. JENNINGS: We've talked to the insurance industry. They're not yet completely on board on this initiative.
Q What a surprise. (Laughter.)
MR. JENNINGS: But, in actuality, they did support legislation the last Congress, the Kennedy-Kassebaum legislation -- I know many of the insurers did -- that did have at least the first step in this area. So it's a question of the details and the implementation of this underlying legislation, but I anticipate that we'll be able to work at least with most of the progressive insurers to get some support for this legislation.
Q Could you just explain the difference between what Kennedy-Kassebaum did in this area and what you're doing now?
MR. JENNINGS: Well, this legislation expands this to the individual market. The insurance reforms that were included in the last Congress really applied -- in terms of the genetic information protections, applied more to the group market. This will extend it to the individual market. It will also make certain that there will be no group, whether it's group or individual, that can be discriminated on the basis of premium hikes based on group genetic screening information, which we have not seen a lot of nationally at all, but there are some people who suggest that that could potentially be a concern in the future. But primarily it's more towards the individual marketplace, and also to further clarify that we want to make sure that we remove all barriers towards the use of genetic screening information for the appropriate biomedical research efforts that NIH and other institutes are very much interested in.
Q You mentioned that it had some protections on individuals that may be affected from getting their premiums hiked. What's to say that an across-the-board hike isn't coming down the pike, because -- if they decide to go along with this legislation?
MR. JENNINGS: Well, actually, 19 states that have enacted this legislation across the board, and they have not seen any significant premium increase as a result of this legislation.
Q Chris, is there a difference between the way the test results would be treated if -- say, with breast cancer if you've never had it before, whereas what if you had it two years ago, you went through a year of treatment. Is there any difference --
MR. JENNINGS: This doesn't address the issue of patient privacy protections overall, this is the issue of genetic predispositions. So if you've already been diagnosed, that's going to be handled in an overall review process that's been taken place at the Department of Health and Human Services, due out in August. But this focuses explicitly -- this initiative focuses explicitly on the issues of genetic predispositions and the great fear that parents of children have, that maybe I will not ask my child to go under any type of genetic screening for fear that in the years future they will not be able to access insurance.
Q But even if you've already had it, if you haven't had the genetic testing before, you might want to get it because it might tell you whether or not you're more likely to have a recurrence later.
MR. JENNINGS: Yes, well that's absolutely the case, and there will be and there are ongoing analyses going on in the Department of Health and Human Services to protect those concerns as well.
Q But has there been a lot of denial of insurance because of --
MR. JENNINGS: Well, there has been some examples of that and you will see in today's speaker who presents the President some specific examples of concerns in that area. The degree that it's documented is unclear right now, although in a recent 1996 science survey, fully one-fifth, actually over one-fifth of those surveyed who do have genetic predispositions reported that they have been discriminated against by insurance plans. That's a very, very significant and concerning development.
Q What is the excuse the insurance companies give?
MR. JENNINGS: I'm sorry?
Q What reason do they give for denying, just that you may get cancer someday?
MR. JENNINGS: Well, there is a concern, of course, that if you get selected against -- insurers always have this concern in a voluntary market, when you don't cover everyone, if you wait until you've actually found out that you have a specific trait or a specific disease, that you might be selected against. In other words, sick populations may go and only try to get insurance when they become sick, so any type of tools that they can use to avoid risk has been something that some people -- some within the industry have looked at.
In fact, Mike is just reminding me that in the early '70s, very, very early genetic screening information and techniques used for sickle cell anemia were used, both in terms of insurers and employment, that discriminated against African Americans, which was a very significant concern the President is going to be addressing later on.
Legislation was subsequently passed to ban that, but interestingly enough, the information that insurers were using to try to target particular individuals was actually -- is actually inaccurate. If you pulled up one trait rather than two traits, they thought that that meant that you had a predisposition for sickle cell anemia, when in fact you had less of a chance altogether.
So this is why these confidentiality protections are so important in this legislation the President is going to be speaking about later today.
Q The fact sheet mentioned two items that the President is adding in addition to the Snowe legislation, and the one had to do with giving more authority to the HHS Secretary. Could you explain that, why it gives --
MR. JENNINGS: Well, it's mostly just to build on the very, very strong foundation that both Senator Snowe, a Republican from Maine, as well as Congressman Slaughter included, which explicitly says what type of protections we want to apply; in other words, we want to make sure that insurers can't be using this information inappropriately, but in so doing, we want to make it explicitly clear that the type of research that people like Dr. Francis Collins, the Director of the National Institute of Genome Research and other people at NIH -- can have access in an appropriate, confidential way to genetic screening information so it doesn't undermine in any way our biomedical research efforts.
Q So what does this do?
MR. JENNINGS: So the Secretary's authority will make sure that as we move in this area, that we are not overly broadening the applications of this legislation.
Q And it allows the Secretary to do what, to allow --
MR. JENNINGS: To target specific areas that aren't as broad as those outlined in the Snowe-Slaughter legislation.
Q Could they be released to certain people for certain cases?
MR. JENNINGS: In certain cases, absolutely yes.
Q Are there diseases that come about as a result of genetic predisposition that are not covered by this legislation?
MR. JENNINGS: Not that I'm aware of. None whatsoever. I will tell you that most of the testing right now in genetic screening -- it's in the infant stages, but there is great, great hopes and potential for the future. We should make certain that we celebrate the great potentials of genetic screening information as well, genetic information, to warn individuals to seek early treatment and interventions. That's very, very encouraging, but in so doing, we want to make sure that the confidentiality of patients are protected and that we avoid any type of discrimination.
Q What, if anything, can be done for individuals that are covered by self-insured plans?
MR. JENNINGS: Actually, primarily that's already been taken care of in the Kennedy-Kassebaum legislation that was enacted last fall on genetic screening information.
Q The legislation is designed to target the insurance industry in large part to prevent them from discriminating. Given the government's recent actions on human radiation experiments and other things, what's to prevent the government itself from abusing the information?
MR. JENNINGS: Well, I'll tell you, I don't think that this administration nor the National Institutes of Health, the National Institute of Genome Research -- when you talk with Francis Collins, perhaps even after the event today, you will see the commitment to patient confidentiality and protections. He actually, I must say, has been the driving force within the administration on moving in this area, so I feel quite confident that as long as the leadership that is currently in the Institutes, from Dr. Varmus to Dr. Collins, throughout the Institutes that I have no fears whatsoever in that regard.
MR. MCCURRY: Thanks, Chris.
MR. JENNINGS: Thanks.
MR. MCCURRY: Thank you. Anything else?
Q Outside of talking about the elements of the tax bill the President addressed in his Saturday Radio Address, are you coming to the table tomorrow with something different or some new proposal or any type of compromise to get this going?
MR. MCCURRY: I think the President arrives in the spirit of bipartisanship that's defined all the work on a bipartisan balanced budget agreement. He has put his ideas squarely on the table, he has accommodate the views of the Republican majority in Congress by incorporating some of their concerns and priorities in his own revised proposal and he brings what he thinks is a very solid tax proposal and very solid spending priorities that embrace some of the views of the bipartisan majority to the table, and our hope is that if good faith prevails, that there will be an agreement as this process goes forward.
Q Mike, since he made his proposal he's moved on means testing. Is he going to explain exactly what he would accept?
MR. MCCURRY: I suspect they will have a discussion of that issue.
Q Can you give us any specifics about what would be an acceptable means testing?
MR. MCCURRY: In the course of last week, I think our concerns about the Senate-passed bill were made clear enough that you can understand that while the principle is one that we have never ruled out, we have some very real concerns about the applicability of the principle in the Senate-passed bill, and we've made clear how we think those can be addressed.
Q So just the IRS issue is the only one really?
MR. MCCURRY: That's an issue; it's also how you structure the testing of incomes so that you can apply the right means test.
Q Does the President still think that the Republican plan widens the gap between the rich and the poor, in the sense of the richer getting a better tax break?
MR. MCCURRY: Well, any tax package that provides any type of substantial capital gains tax relief and estate tax relief, even if you attempt to target it, is going to skew the benefit to the upper income. We acknowledge that, but at the same time we acknowledge that that is a very high priority of the Republican majority and in a sense we had to accept --
Q So the President is accepting it?
MR. MCCURRY: We have to accept some of their priorities in order to get the type of targeted relief we want for things like education assistance, the child care tax credit expansion, which both parties favor, and the President's specific education initiative tax proposals. But in order to get that agreement, a Democratic President has to acknowledge that a Republican Congress is going to have priorities. Their priorities tend to be those that address the estate tax issue, the capital gains tax issue, and that necessarily skews some of the benefit of tax legislation towards the upper income.
We've tried to moderate the effect of that by keeping a very precise targeting on the President's education initiative, which is where you get the broadest available tax relief to middle income people.
Q Time was when one of the main priorities around here was reducing the deficit, and now there is some suggestion that it would be better for reducing the deficit if there were no budget at all, if the President and Congress simply did nothing, because this, of course -- the budget proposed here and the budget on the Hill both serve to, over the long haul, increase spending.
MR. MCCURRY: Well, that analysis is absolutely wrong. The budget agreement that was reached between the President and the leadership provides for a net $200 billion in additional deficit reduction over the next five years. That's 250 less than the deficit tab that the American people would have absent the agreement, and that even takes into account new tax cuts, new public investments, some of the assumptions you make about how the fiscal spending patterns will occur over the years.
There is no question in the President's mind that we will be better off with a balanced budget agreement that will embrace, for the next five years, the strategy of budget deficit reductions that we launched in 1993. The 1993 economic plan has worked for the American people. It's produced the very strong economic performance we've seen now over the last four and a half years. And we need to continue that and, in a sense, ensure that that strong economic performance will continue by moving ahead on balanced budget discussions and ultimately implementing the agreement that was reached.
But that key element, $200 billion of deficit reduction that would not be present absent the agreement, is something the President feels strongly about. It is mythical to think that the deficit will disappear on its own, even if you had -- I mean, we've had a very good year. We acknowledge that. Tax receipts are up. The President's economic strategy, the agreement -- the current budget agreement is going to produce lower deficits, even lower deficits than anticipated, but those deficits will start to climb again in the out-years and can get back up in the $100 billion range if we don't act now to keep us on the glide path to zero -- to a balanced budget.
Q Has there been an announcement on food aid to North Korea?
MR. MCCURRY: There is an announcement coming out in the State Department shortly on the U.S. response to the latest appeal by the World Food Program. They had asked, I think, for upwards of $45 million in new food relief for North Korea, which is suffering from a famine. The State Department is set to announce the U.S. response.
Q Apparently, they are announcing it now.
MR. MCCURRY: They're announcing it over there, yes.
Q I just want to clarify something you said -- you said the deficit was going to climb in the out-years if we don't act now, meaning this budget stops it from climbing in the out-years, or it will climb if you don't take the next step, which is to do something about entitlements?
MR. MCCURRY: Well, if you assume the current baseline, the deficit will rise again --
Q So you're saying even under this budget agreement, the deficit's going to rise. So you're not --
MR. MCCURRY: We have -- even under this budget agreement, you get some uptick in the next year, but then you continue the pathway to zero. Absent that agreement on the current baseline, you go back up to $100-billion-a-year deficits.
Q So you're only talking about getting to zero by 2002. When you said the out-years, you're not talking about what happens after that?
MR. MCCURRY: Zero by the year 2002 based on what we anticipate the performance of the economy to be.
Q Yes, but your own numbers show that after 2002 it starts back up again if there is not entitlement reform.
MR. MCCURRY: That's not correct. I don't believe that's correct. I can check further on it.
Q This agreement keeps the budget in balance, even when the baby boomers retire?
MR. MCCURRY: There is, in the years 2002 to 2007, I think that you see continued lower deficits, though we acknowledge that as you get into 2010, 2015, 2020, there are issues associated with spending under entitlement programs that have to be dealt with. The President has acknowledged that and thinks that we ought to deal with that.
Q Mike, how much is the administration budgeting for the civil rights advisory panel on race?
MR. LOCKHART: I don't know what the budget is, but it's reprogrammed money.
MR. MCCURRY: It's reprogrammed money from existing authorizations --
Q Do you know how much it is?
MR. MCCURRY: -- but I'll have to check and see. We'll see if we can't get that figure.
Q There is a report out by the Heritage Foundation today that suggests that federal contractors were specifically targeted for the White House coffees; that knowing that they might be more inclined to give money, they were specifically asked to a number of coffees.
MR. MCCURRY: I'm not familiar with the report. Maybe we can have some of our Counsel's Office people look at it for you.
Q Mike, could you speak to the concerns about the President's digitized role in "Contact" this weekend and taking certain past statements and manipulating them into the script?
MR. MCCURRY: I think the White House Counsel set forth some of the concerns we have. I don't know that the President himself has seen the film. I have not heard the President express any real concern, but as a general practice, the White House Legal Counsel raises concerns when we have them about the use of the President's image, and this was a case obviously where the Counsel thought it was appropriate to remind the makers of the film that there are some legitimate restrictions on those uses.
Q The letter didn't go out and suggest -- or request any specific remedy?
MR. MCCURRY: That's correct.
Q Do you know why that is?
MR. MCCURRY: Because the movie was ready to debut in movie theaters across the nation and there wasn't much he could do about it at that point.
Q Well, what specifically did the White House Counsel say that they had a problem with in the film?
MR. MCCURRY: I mean, in the letter, it's just the use of the President's image and words to make a fictional point in a plot unrelated to the context in which the President made real remarks was disturbing and had some elements that were of real concern to the Legal Counsel.
Q But you didn't need to give them permission, they didn't ask your permission, there was nothing that happened in advance?
MR. MCCURRY: There was no -- to my knowledge, no formal granting of approval by the White House to the project.
Q Are you going to sue?
Q When they saw it, were they particularly dismayed? Did they feel that he would definitely be misconstrued in this -- in that particular context of the film?
MR. MCCURRY: Do you have the letter? I think the letter speaks for itself, is pretty clear, and we released it over the weekend.
Q Mike, you've had a lot of this recently. I mean, Jerry's Subs and magazines all kind of using Clinton as their --
MR. MCCURRY: Look, there is a difference between legitimate parody, freedom of expression when it comes to satire, parody, political commentary. That's different and that's all within the First Amendment and freedom of speech. But there is a difference in which the President's image, which is his alone to control, is used in a way that would lead a viewer to imagine that he had said something that he didn't really say.
Q I understand there was another movie that used the President's image, "The First Son," where he was talking on the phone to his -- where a real picture of President Clinton talking on the phone, was talking on the phone to his successor. Did this arouse the same concerns, or was that somehow --
MR. MCCURRY: I never heard of the movie. (Laughter.) I don't even know. Anything else?
Siskel and Ebert day at the White House. (Laughter.) All right, what else?
Q The letter -- do you hope that the letter is read by those in Hollywood, that, you know, let's cut it out and don't do it anymore?
MR. MCCURRY: Obviously, we hope that -- the purpose of the President's letter and having publicized it is to remind people that there are certain restrictions on the use of the President's image, the image of the White House for commercial purposes.
Q Will that letter be released?
Q Well, what recourse have you got?
MR. MCCURRY: We released it last week, did we not? We released it last week.
Q But what recourse do you have if those restrictions aren't honored?
MR. MCCURRY: The Counsel's Office can tell you. I think there is some, but I think the principal benefit is to just advise those in the creative community that there are some restrictions so that as they are doing their own creative work, they can understand better what those restrictions are.
Q So that's all you're going to do on this one?
MR. MCCURRY: I'm not aware of anything else beyond the Counsel's letter contemplating.
Q Mike, the President's going to --
Q These are restrictions in law or --
MR. MCCURRY: I think they're intellectual property, just copyright and intellectual property concerns.
Q The President is going to be speaking to the NAACP on Thursday -- I know this is reaching ahead a little bit a few days, but it seems like Chairwoman Evers-Williams has, in her words, set the record straight on the organization's position on integration. Any reaction on that?
MR. MCCURRY: That debate we will follow closely because of course the President will address the NAACP convention on Thursday, but I think I'll leave it to the President to address those issues he chooses to address when he speaks Thursday.
Q Mike, any feedback from the President on his initiatives on race that started this morning -- that actually got under way?
MR. MCCURRY: Not any feedback directly from the President. They've had a very good meeting. They are right now in a luncheon with members of the Cabinet and doing some additional work. My understanding is Chairman Franklin hopes to take the group into a discussion of the work plan for this initiative this afternoon. And they seem to be making very good headway in really putting some real substantive structure and process to the initiative that the President announced in San Diego.
Q Will they ever have private meetings? Or is every single one public?
MR. MCCURRY: We have pledged to conduct their work consistent with the federal Open Skies statute -- whatever it is. (Laughter.)
Q -- said they can't have private meetings or never?
MR. MCCURRY: They can -- when they are transacting business formally in a meeting setting, that's open to the public.
Q How often will they meet?
Q How much guidance has the White House given them on what direction they should take or not take?
MR. MCCURRY: There have been some discussions, but we've -- looking for the best thinking that the advisory board can bring to the subjects the President has outlined. I think in a sense the best guidelines we've given them are the President's speech itself, his presentation of what he hopes the goals and objectives will be for the discussion that he intends to pursue for the next year. And I think they are mindful of what the President has set out as the structure and guidelines for the initiative itself.
Q How's the President's knee?
MR. MCCURRY: The President's knee, I'm glad you asked -- an update. He's going to be out on the golf course.
Q Today?
MR. MCCURRY: Maybe.
Q Ugh. Has he ever heard of heat stroke?
MR. MCCURRY: Doctor Adkison -- remember Dr. Adkison, the fine orthopedic surgeon out at Bethesda who, along with Dr. DeMaio, were the two surgeons who operated on the President's knee, have done an 18-week review of the President's rehabilitation and they pronounced themselves satisfied that he's made extraordinarily good progress in his recovery. And they will be -- he's now -- the President will now be able to move around without the use of his knee brace except when he plays golf, which the doctors have now said that he can do, although I think he's confined to nine holes, if I understand correctly.
Q Mike, didn't we hear him say that he was going to play 18 this week? Didn't that come out of his own mouth?
MR. MCCURRY: He may -- they are going to let him do 18? I guess they decided he could do 18. (Laughter.) Unless you're shooting over 50 on the front nine, then you'd keep it to just nine only. The score will look a lot better in that case.
Q He came down those steps mighty slow the other night.
Q Did he actually dance Saturday night?
MR. MCCURRY: He came -- they've cautioned him to be careful as he goes up and down stairs, to wear the knee brace when he's playing golf, and to otherwise be careful. But the focus now is no longer on protecting the knee muscle itself, but on beginning to build the strength up of the knee. So the President has been working out on a treadmill. He'll probably return to jogging on a treadmill sometime soon. And he's otherwise getting back to 100 percent.
Q Did he actually dance on Saturday at the Gore wedding?
MR. MCCURRY: I have no clue. Anyone go to the Gore wedding? He was asked for a dance according to a local news report in a local newspaper, but whether or not he accepted the invitation or not, I don't know. I can't imagine he did not.
Okay.
Q One more question. Isn't this kind of ahead of the schedule? Wasn't he supposed to not be able to golf until August?
MR. MCCURRY: He is about -- maybe about one month or so ahead of where they thought he would be. But that's based on the more than satisfactory progress the President made according to his doctors.
Q When did they do the review?
MR. MCCURRY: Over the weekend, yesterday.
Q Mike, what's up for tomorrow?
MR. MCCURRY: Tomorrow, the President will meet with the bipartisan leadership group on budget and tax issues. I imagine he'll also give them a report on his just concluded trip to Europe, and the White House review team examining the proposed tobacco settlement will be meeting with tobacco industry representatives. That's your day at the White House.
How many of you call the voice mail thing and get a little --
Q Are they supposed to give a definitive answer?
MR. MCCURRY: Have people been calling our voice mail and getting the recording of the day at the White House? (Laughter.) Well, if you're a radio station out there in America you get free live actuality feeds from the White House voice mail actuality line by calling -- a number you can reach by contacting the White House Press Office. (Laughter.) But it's really great, and if you tune in you will hear a very familiar voice giving you the words on here's what's on today at the White House.
Q What's going to happen at the tobacco meeting?
MR. MCCURRY: Conversation.
Q No definitive answers on --
MR. MCCURRY: This is not -- we have been meeting with various affected parties and constituencies as we continue our review of the proposed settlement. We met with public health advocates -- Dr. Kessler last week, as I think you know, and we meet with industry representatives tomorrow, and I suspect we'll see some in the tobacco growers community maybe even later this week.
Q Big news in the congressional meeting?
MR. MCCURRY: I mean, not in the sense that there is something definitive that has to come out of that meeting. I think they need to really explore where they are, what the process will be. I think the President is very keen on hearing from Majority Leader Lott and from the Speaker on what the congressional process will be. And I think the President approaches the meeting with the spirit of -- in the spirit of bipartisanship that has underscored his presentation of some ideas that try to acknowledge the priorities the Republican majority has.
Q Do you see them going off topic and the leaders kind of encouraging the President on a different subject, to rein in some of the AWOL witnesses that are being subpoenaed for the Thompson hearings?
MR. MCCURRY: I'd be surprised if they get into that.
Q What does he think of the NEA budget being eliminated -- in the House?
MR. MCCURRY: I think the President feels very strongly about the budget proposal he sent to Congress, which would not only have sustained funding for the National Endowment for the Arts, but would have increased it slightly. It is a small, small sliver of the federal budget. But it's an important statement of our priorities as Americans that we value the arts that so enrich the lives of Americans, and the President is very concerned about proposals that would terminate the agency. There is some restricted funding that's now been proposed, but the President hopes in further conversations with Congress that we can work through adequate funding, albeit small to begin with, for some small measure of federal support for arts.
Q And what is the veto threat exactly -- that he'll veto this bill if what?
MR. MCCURRY: This is an interior appropriations bill which the President would find objectionable and vetoable if it included the termination of the agency.
Q So just termination is the only threat?
MR. MCCURRY: We have a statement of administration policy on this bill and I'll refer you to that.
Q He would veto it?
MR. MCCURRY: Check the exact, precise wording in our statement of administration policy.
Okay, see you tomorrow.
THE PRESS: Thank you.
END 1:47 P.M. EDT