View Header


Office of the Press Secretary

For Immediate Release July 21, 1998
                        REMARKS BY THE PRESIDENT
                       IN HEALTH CARE ANNOUNCEMENT 

The Oval Office

3:16 P.M. EDT

THE PRESIDENT: Thank you, Secretary Shalala, and Nancy Ann DeParle, and the advocates who are here. I wish your mother were here, Secretary Shalala. I have met her, and even a skeptical press corps would believe your account of her in full if they could see her.

The duty we owe to our parents is one of the most sacred duties we, as Americans, owe to each other. Nowhere is that duty more important than when a family makes the choice to move a parent into a nursing home. When that time comes, all of us need to know that all our parents will be well cared for.

Today, more than 1.6 million Americans live in more than 16,000 nursing homes nationwide. When the baby boom generation moves into retirement, the number will rise even higher. By 2030, the number of Americans over the age of 85 will double, making compassionate quality nursing home care even more important.

At their best, nursing homes can be a Godsend for older Americans and their families, providing a save haven in times of need. But at their worst, they can actually endanger their residents, subjecting them to the worst kinds of abuse and neglect. For nearly six years, as Secretary Shalala said, we've worked hard to give our most vulnerable citizens the security and health services they need to live in peace and safety.

I am committed to honoring the great social compact between the generations, first let me say, by reserving every penny of the budget surplus until we save Social Security first. The historic balanced budget I signed last summer preserves the Medicare trust fund into the 21st century. We've taken action to root out Medicare fraud and abuse, saving taxpayers over $20 billion.

Finally, we're fighting to meet the challenge of our changing health system by enacting a patients' bill of rights, to include access to specialists and the right to appeal health care decisions. I have extended those rights already to Medicare beneficiaries; they should be the rights of every American.

One of the most important way we can help our senior citizens is by improving the quality of care in our nursing homes. In 1995, when Congress tried to eliminate federal assurances of nursing home quality, I said no. It was the right thing to do. That same year, we put into place tough regulations to crack down on abuse and neglect in our nursing homes. Since then we have made real progress, as Secretary Shalala said, stepping up on-site inspections and helping nursing homes to find and fix problems.

As the HCFA report Secretary Shalala talked about shows all too clearly, however, the job is far from over. When people living in nursing homes have as much fear from dehydration and poor nutrition as they do from the diseases of old age, when families must worry as much about a loved one in a nursing home as one living alone, then we are failing our parents and we must do more.

Today, I'm acting within my power as President to crack down on unsafe nursing homes. Effective immediately, HCFA will require states to step up investigations of nursing homes, making on-site inspections more frequent and less predictable, so there is no time to hide neglect and abuse. Whenever we find evidence that a nursing home is failing to provide its residents with proper care, or even mistreating them, we will fine that facility on the spot. And if state enforcement agencies don't do enough to monitor nursing home quality, we will cut off their contracts and find someone else who will do the job right.

I'll continue to do everything I can to fight nursing home abuse and neglect, and to give more options to elderly, disabled, and chronically-ill Americans who choose to stay at home. But Congress also must act. This week I am proposing comprehensive legislation to protect older Americans with a national registry to track nursing home employees down known to abuse nursing home residents, and criminal background checks to keep potentially abusive employees from being hired in the first place. I ask the Congress to put progress ahead of partisanship on this issue, and pass this legislation to improve our nation's nursing homes this year.

Choosing to move a parent or a loved one into a nursing home is one of life's most difficult decisions. But with these steps we can at least give families a greater sense of security in knowing we are doing everything we possibly can to make our nursing homes safe and secure.

Thank you very much.

Q Do you think the Congress would be against the registry, per se?

THE PRESIDENT: No, I have no reason to believe they would be, and I hope they would pass it.

Q What do you mean by putting partisanship aside?

THE PRESIDENT: Well, we haven't had a lot of bills coming out of Congress this year, but I hope very much that they will pass this. I don't believe -- not since 1995, when there was an attempt to strip the federal authority standards has there been a serious move on this issue. And I believe there are a lot of Republicans, as well as Democrats, in Congress who will support this. So I'm quite hopeful that it will pass.

Q How about the patients' bill of rights; do you think you're going to get that?

THE PRESIDENT: Well, I don't know. That's up to them. We have to have some significant amount of Republican support to get a strong bill. We have to have 60 votes to break a filibuster in the Senate, and obviously a majority in the House, sufficient to actually make sure the bill could come to a vote. But we're still working on it and it's terribly important.

Everywhere I go in the country -- you know, I was just home last weekend and I was stunned at the number of people who came up to me and just started talking about it, and talking about their own experiences and how important they thought it was. So I'm very hopeful we'll get it.

Q How can you parlay that, then, into a real public response?

THE PRESIDENT: Well, I'm working at it. We've had a lot of events on the patients' bill of rights. I'm trying to get the public involved in this, trying to get them to express their opinions to their members of Congress and I will continue to do so.

Q I wanted to ask you about another issue, sir. Now that the Secret Service agents have testified, are you concerned about what they might be saying, one; and, two, do you find yourself holding them more at arm's length, sir?

THE PRESIDENT: The Secret Service has made its own decisions about what to say and how to do it, based on their professional sense of responsibility, and I'm not going to get into this. I've refused to comment on it so far and I'm going to continue to refuse to comment.

Q Mr. President, your administration is making a new push to end the standoff with Libya over the Lockerbie bombing, including possibly holding a trial in a neutral country, under U.S. or Scottish jurisdiction. Are you optimistic that this climate might help and what has brought on this new push?

THE PRESIDENT: Well, we have always said that our first goal was to bring the perpetrators of Pan Am 103 murders to justice. That's our first purpose. And since I got here we've been looking for ways to do that. We have had conversations with representatives of the British government, as well. We've always said we thought that there had to be a trial under American or Scottish law. There may be some possibility of standing up a Scottish court in another country, but there are lots of difficulties with it as well, apparently.

All I can tell you is that it's one of the things that we have explored with a view toward accelerating the day -- it's been a long time now, it's been a lot of years since that terrible day when Pan Am 103 crashed over Lockerbie. And we're looking at it, but I don't know that it can be done. Our people have spent a lot of time on it. We've talked to the British at great length about it. We're trying to find some way that has real integrity, that will work. But there are all kinds of practical difficulties that I'm sure our folks can explain. I don't know if we can do it, but we're working on it.

Q What brought it up now? I mean, what all of a sudden, after so many years?

THE PRESIDENT: I don't know why it is just now coming into the press. But it's not just being brought up now. We have literally been working for years; I have personally been engaged in this for years, trying to find a way to get the suspects out of Libya, into a court where we thought an honest and fair and adequate trial could occur.

And in a case like this, like every other case, as the years go by you run more and more chances that something will happen to the evidence that is available, to any witnesses that might be available. So we've had a sense of urgency about this for some time. But my guess is that it has come to public light because a significant number of conversations have had to be held between the American and the British authorities and between others in potential third-party venues, like the Netherlands. And I know there's been some discussion of that. But it has not been resolved yet.

Thank you.

Q Is there any indication that the Libyans might go on, sir?

Q Sir, can you comment on CNN's nerve gas report, that the Pentagon --

THE PRESIDENT: All I know is what Secretary Cohen has said to you, to the public and to me, which is that their view is that it did not occur.

Thank you all very much.

END 3:29 P.M. EDT