THE WHITE HOUSE
Office of the Vice President
REMARKS AS PREPARED FOR DELIVERY BY VICE PRESIDENT AL GORE AMERICAN MEDICAL ASSOCIATION GRASSROOTS CONFERENCE
Thank you, Dr. Lewers, for that kind introduction. Now, you're the kind of doctor I really like -- one that only has good news. I'm grateful not only for Dr. Lewers's skilled leadership of the AMA, but also for his commitment to promoting safety on our nation's highways. When a seatbelt saved his life, Dr. Lewers learned first-hand that prevention is the best medicine.
I also want to thank Dr. Thomas Reardon for inviting me here today, and for serving so ably on our Quality Commission.
Although she isn't here today, I want to thank Dr. Nancy Dickey for her leadership, for her friendship, and for being an inspiration to countless young people -- especially women -- wanting to enter that noblest form of public service: medicine.
I also want to thank the AMA for being an integral part of the greatest health care system in the world. Throughout this century, you have played a tremendously important role in protecting the health of our families -- from your work to expose fraudulent and dangerous treatments, to your leading role in the battle to eradicate polio, to your crusading voice against teen smoking. Most recently, we worked together to confirm two outstanding leaders -- David Satcher as Surgeon General, and Jane Henney as head of the FDA. I'm grateful for your partnership.
As some of you may know, I recently had the pleasure of welcoming a doctor into my own family. My son-in-law -- the father of my first grandchild -- is a physician in New York. As I've gotten to know him, I've learned a little about being a father-in-law -- and a lot about medicine. And one thing is clear: medicine is not just a profession; it's a calling.
Central to that calling is the fact that physicians are never satisfied. You are always working to find better treatments, looking for new ways to fight the oldest diseases and ailments, and working around the clock to keep the members of the American family healthy.
I am here today because I'm not satisfied, either.
I'm not satisfied when too many Americans have life-or-death medical decisions made not by doctors, but by HMO bureaucrats at the other end of a phone line -- people with no license to practice medicine, and no right to play God.
I'm not satisfied when we are on the verge of ground-breaking medical discoveries -- mapping the entire genetic blueprint of the human body, and unlocking the deepest secrets of disease -- yet millions of American children still go without the most basic coverage and care.
I'm not satisfied when I meet women like eighty-eight year-old Florence Seitz from New Hampshire. She told me that she is so hard-pressed to pay for her prescription drugs, that again and again she cuts her dosages in half -- gambling with her health to save precious pills and dollars.
I'm not satisfied when good and decent people who work in our health care system have to deny life-saving care to their patients. Who can forget Carol Anderson, the billing manager from Virginia, who burst into tears at your forum last year when she told us how she had to deny care that would have saved a 12-year-old boy's leg? Medicine wasn't meant to be practiced this way.
I agree with the AMA: we need change in our health care system. Change that keeps what is right, while fixing what is wrong with American health care. Change that puts doctors and patients in charge again. Change that works for working families.
It is time to ensure a set of patients' rights -- so that all Americans get the quality care they are entitled to.
It is time to expand access to affordable, quality health care to every child in America.
And it is time to take giant steps toward our ultimate goal: access to affordable, quality health care coverage for every American.
The first step we must take is a basic one: we must pass the Patients' Bill of Rights into law.
One health plan even suggested that patients should call the HMO before calling 911. What's next? Prior, written approval for a heart attack?
In just two weeks, the House is expected to vote on a strong, bipartisan Patients' Bill of Rights. Powerful interests are already lined up against this plan. They are openly arguing to members of Congress that it's politically safe to resist reform -- that it's OK to stand with the special interests, and against the people's interests.
That's why the President and I need your strong voice, now more than ever before.
We need to draw a line in the sand:
You should be able to see a specialist when you need to -- without pleading phone calls and endless appeals.
When it's an emergency, you should have access to an ER -- when and where you need it.
When your doctor is reviewing treatment options, he or she should be able to tell you all the options, not just the cheapest.
If you're pregnant or being treated for cancer, you shouldn't have to change doctors in the middle of treatment.
And when a health plan unfairly deprives you of coverage, you should be able to hold them accountable. Doctors are held accountable by the decisions they make, and so should HMO's.
Some in Congress are still pushing for a so-called Patients' Bill of Rights that is like the watered-down Senate bill: it leaves out over 110 million Americans, and doesn't even guarantee the right to see a specialist.
That's not a bill of rights -- it's a bill of goods. And we won't have it.
You have been one of the Administration's strongest allies in this fight. As we enter this next battle, we need your help once again. So when you go up there to Capitol Hill this afternoon, tell Congress: stop listening to the special interests, and start working to pass a real Patients' Bill of Rights into law. Doctor's orders.
The need for change has never been greater. Just today, we gained important new evidence of the limits too many American seniors face in HMO's.
According to an HHS report that I am releasing today, many of our seniors in HMO's are finding themselves shut out of affordable prescription drug benefits -- in many cases, the very benefits that enticed them to join an HMO in the first place.
Across the nation, co-payments and premiums are going up, while benefits are going down. In the past year alone, the average co-payment increased by over 20 percent. And in the coming year, 50 percent more plans will have a $500 cap on drug benefits. That wouldn't even cover five months of one of the most revolutionary new arthritis drugs.
In rural areas, this trend only makes a bad situation worse -- since rural families have access to fewer managed care plans, and only 4 percent of rural families have access to plans that offer prescription drug benefits at all.
At a time when startling medical advances are adding years to our lives, the need for affordable prescription drugs is only becoming more important. That is why, as we use the surplus to strengthen Medicare for the future, we must help seniors who have their benefits cut by Medicare HMO's. We must ensure that all those in Medicare have an affordable prescription drug benefit.
But of course, we can work to ensure the highest quality health care in the world -- but it still won't help working families if they can't afford it.
I believe in the ideal expressed by President Kennedy early in the fight for what later became Medicare: "Whenever the miracles of modern medicine are beyond the reach of any group of Americans, for whatever reason -- economic, geographic, occupational or other -- we must find a way to meet their needs and fulfill their hopes. For one true measure of a nation is its success in fulfilling the promise of a better life for each of its members."
That is why we must keep pushing until the day when this nation provides quality, affordable health coverage for every family.
We should begin with the earliest years, by extending access to affordable health coverage to every American child.
That means making sure we reach every child who is already eligible under our children's health initiative -- the historic expansion of children's health coverage we passed in 1997. We need new incentives for states to identify and enroll uninsured children -- and new rewards for states that do a good job.
Then we should make America's schools and school districts the focus of an unprecedented outreach and enrollment campaign.
We should expand our children's health initiative so that families earning up to 250% of poverty are eligible for the benefits it provides.
And we should empower states to expand coverage to all parents whose children are eligible either for Medicaid or our children's health initiative.
Next, we should address this fundamental fact: one of the fastest-growing sectors of our economy -- small business, which has accounted for the vast majority of new jobs these past seven years -- has become one of the hardest places for a working family to find health care.
I believe we should help small businesses -- like doctors' offices -- band together to negotiate for lower rates for their employees' coverage. And we should provide special tax benefits and grants for those that do.
We should also help individuals who don't get coverage in the workplace. Today, companies that provide coverage get a tax break. But not individuals who have to get coverage on their own. That's just not fair, and we have to change it. I'd like to see a 25 percent refundable tax credit to cover their costs for health insurance. And I believe it's time to reform the individual insurance market, so that it becomes truly affordable for those who need to buy into it.
If we take these steps, we can make health care affordable for millions of Americans who can't afford it today. But as you know well, we still need a strong safety net, so nobody will be left without care when they need it.
And I believe we should do more to strengthen America's community health centers and public hospitals so that they can focus on the critical challenges that they face on the frontlines of health care -- challenges such as prevention, immunization, and outreach.
These are the kinds of steps that can move us toward the health care system we all seek one in which doctors call the shots, not accountants; one which protects the rights of patients, not HMO lobbyists; one which moves toward access to affordable coverage for every American.
Recently, we have seen some far different ideas. Just this week, one Republican called for "profound" changes in Medicare and Social Security -- coupled with an endorsement of the Republican Congressional tax plan that would spend the entire surplus without leaving a penny for Medicare, and would threaten the future of Social Security.
I have a far different view. We need to strengthen Medicare, and expand it to provide affordable prescription drug coverage. We don't need to drain away the surplus and walk away from our vital health needs. That's change, all right -- but change in the wrong direction.
Together, we can embrace a brighter vision of America's future -- one in which the quality and accessibility of our health care keeps pace with today's stunning medical advances.
Just think about the progress that has been made not only in the past year, or even in the past month -- but in the past week alone. In the past seven days, the FDA approved the first antibiotic that can treat some of the most drug-resistant germs. Researchers presented new evidence that supports new therapies to shrink tumors without the traumatic side effects associated with surgery, chemotherapy or radiation. And the Mayo Clinic announced a small but promising study using blood plasma replacement to alleviate the most severe forms of multiple sclerosis.
Medicine is transforming the way we live -- and also how long we live. Now we must transform our health care system to make it work for working families. I know all of you are dedicated to leading the charge up on Capitol Hill today.
So I thank you for your leadership on the front lines of our health care system -- in our examination rooms, operating theaters, and clinics. And I thank the AMA for its leadership in public policy as well. Together, we can make the 21st Century the healthiest and most hopeful time in all of human history. Thank you.