Remarks Governor Bill Clinton Address to the American Nurses Association Pittsburgh, California August 15, 1992 Thank you. Thank you. Thank you. Thank you very much. Thank you ladies and gentlemen for being here. We're keeping ourselves healthy getting our quota fresh air for the day. I want to thank Genna Trotter Best, Barbara Lumpkin, and Judy Martin-Hollind for the support of the nurses of America and for this historic endorsement. I want to thank all the people who are here today but know two in particular, who are friends of mine. First, your Congressman, George Miller and the Congressman to be, Wendell Williams. I ask you to remember that this country can not get a good national health plan without a president committed to it. And a Congress to vote for it. This endorsement is especially meaningful to me because I am the first child in three generations of my family not to become a nurse. My grandmother, God rest her soul, and my mother, may think I have finally arrived today. Ladies and gentlemen, the crisis we face in health care has a deeply human face and a stark economic reality. The truth is we can not make America, the place it ought to be for all our people, until we finally join the ranks of other advanced nations and provide a basic package of comprehensive but affordable health care to all Americans. And the truth is we can never get our government's budget deficit under control, restore the health of our manufacturing economy, rebuild small businesses of American and have a thriving, growing, productive society until we can join the ranks of our competitors with an affordable package of health care for all. In no state is the health of the American people, the health of the health care system and health of the economy, more clearly evident than in California today. The interrelationship of these problems has lead California to an eleven billion dollar state budget deficit occasioned by a twenty-five percent drop in state revenues and continued exploding cost of a fractured over-extensive, entirely too bureaucratic health care system. You heard Gina refer to this, but I want each one of you to focus on this as Americans. While the average American is working harder for lower wages than they were making ten years ago, we are spending thirty percent more of our income on health care than any other nation in the world, thirty percent more. And yet, over thirty five million of our fellow Americans have no health insurance. Each year more small businesses stop insuring their employees because they can't afford it. And more and more larger businesses evade insurance by hiring more part-time and temporary employees. This is an occasion for sympathy for everyone. For only the United States Government refuses to help its business community in controlling health care costs. Only the United States Government throws the small business community and the manufacturing sector to the wolves. And tells them to figure out how to handle it. And then, they are put into the position of being the bad guy with their own employees. And a feudal attempt to avoid paying, for that is the ultimate lesson we all pay for the system we have one way or another, anyway. If we don't pay in higher insurance costs, and higher worker's compensation costs; we pay in higher taxes and bigger deficits; in increasing social security, and in massive costs in the out years for every child that is born with birth weight with an unavoidable mental or physical problem. We'll all pay for that. (Inaudible).....eventually get some kind of health care but only when its too, too expensive; the cows out of the barn and the bills passed onto the rest of us. Only the United States...only the United States waste as much money as we do on the organization of insurance, the proliferation of paperwork, and the regulation of the government of health care and the way that it adds billions of dollars to the cost of health care. Very few countries do what we do and say we're going to pay more for more services whether they're needed or not; whether they're at the appropriate level or not; whether they could have been provided at lower cost at an earlier stage by people who would properly be trained to provide them, like nurses and nurse practitioners. The other day, my opponent in this election, Mr. Bush said that I wanted to give the American people a health care system that had the compassion of the KGB and the competence of the House Post Office. I would argue today my friends, that's exactly what we have---the most inefficient system in the world. We must find a way to keep what is good about our system and change what is not. What is good is that we have a lot of wonderful providers--nurses, doctors, hospitals, other professionals-- who are out there trying to help the people who come within there purview and we should retain the best features of that. We should give more power, not less power to our consumers to make judgments about their health care and their lives. But we should enable them to make judgments at cost that we can all afford. That's what the American Nurse's Association has tried to do with their health care plan. In the first hundred days of our Administration, Al Gore and I will send to the United States Congress an attempt to pass a program that finally will bring America in line with the rest of the world; with a plan for a comprehensive, affordable health care, for every citizen in this country as a right, not a privilege. Contrary to the assertion of our opponents, it will not be a bureaucratic nightmare, it will be less bureaucratic than the present system and will save tens of billions of dollars by mandating insurance reform so that people can change jobs even though they got a sick family member and so that we will be insured in broad, large pools, not small, expensive groups. There will be a basic package of benefits that must be included in everyone's coverage so that we can simplify the billing that, now is a headache for every hospital and doctors office in America. The United States of America today, with many places have a nurses' shortage. Clerical employment in hospitals is going up four times the rate of health care giver employment because of the crazy bureaucratic nightmare of our financing system and we're going to have to simplify it. We must stop rationing health care on the front end by putting more clinics out in inner cities and rural areas and making basic health care accessible to all Americans. We must give people incentives...strong incentives to join health care groups so that their health care can be managed and they're not paying more for each particular system so that we can control the cost of health care and give people up front service when they need it. We need to stop this crazy system we have now which is loaded on the back end, instead of the front end of the health care need and which spends too much money on things which are unnecessary. We've got to manage this system better and we can. We know how to do it. There are people in America doing it today. We can take the best of our free enterprise system with an organized framework established by the national government and turn this system around. And let me say one other thing. Down at Houston next week, our opponents are going to say that this will take a big tax increase. Well, let me say, everyday you're paying a tax increase for health care. Everyday the rising cost of health care is breaking your back. What I want to do is not lead with a big tax increase, but lead with a costs control; lead with the insurance reform; lead with the managed care; lead with reducing the cost of drugs and technology; lead with squeezing the unnecessary costs out of the system. And then, if there is money to be paid by those employers who offered no insurance coverage, for example, now, it would be at a far lower rate than they would have to pay under this system. And people would be ask to pay based on their real ability to pay not based on a system that is out of control, inhumane, running a muck, and making money only for middle people, instead reinvesting money in the money in the health of American citizens. We are going to change this system. Ladies and gentlemen, you must decide in this election whether you have the courage to try new ideas, leave the old ways and make America competitive and healthy, and vital and diverse and strong in the Post Cold War Era. Nothing can be done...I will say it again, nothing can be done to really bring this deficit under control; to really make our economy health again; and make the country more humane again unless we are willing to acknowledge that we don't have it right on health care, other countries have done better and we're going to have to do what has to be done to provide affordable health care to all Americans. And when they tell you...when they tell you next week, it can't be done in Houston, you just remember this: In Germany, look at the carpenters back there--the working people that's for us--in Germany, for the last six years, the cost of health care has been kept under inflation and the average manufacturing worker makes twenty percent more than the average American; works a shorter work week; gets a four week paid vacation a year, and has affordable health care. Don't tell me it can't be done. And when they tell you it can't be done in America, look at Hawaii where they have the guts to require insurance reform a few years ago and where they put money into basic health clinics. And well, you may say, they're all rich and healthy. But that's not true. Twenty percent of the people in the Hawaiian health care system are poor, native islanders who come there to get health care and health insurance are fifty percent below the American national average and they cover ninety-eight percent of the people who live there. Don't tell me it can't be done. Don't forget whose being hurt on this. Don't forget all the people who don't have long term health care and who are forced to spend themselves into poverty and put themselves into institutions instead of being able to stay at home with nursing care and personal care and pay only a percentage of their income because we don't have a system. I met a woman the other day who had seven children. She had a fifty thousand dollar a year job and she had to quit that job and get on welfare because one of her kids was so sick, nobody would pay the bill unless she got medicaid. I met a woman the other day with a college degree, dying to go to work but she had a beautiful young child with spindibifida and no one would hire her so the only way she could take care of her child was to stay on welfare so she could get medicaid. I met a young couple the other day with three children and the youngest child had cerebral palsy and they could not be insured through the mother's health insurance plan. She worked for a small community non-profit organization with twenty employees. And their choice was to fire that woman and put her family into the streets or raise their premiums for each employee two hundred dollars a month. Is that the kind of choices Americans are to be making? And do you want that kind of choice when insurance companies today only put eighty-four cents on the dollar into health care as opposed to ninety-five cents in all of our competing countries and we're squandering sixty billion dollars a year on insurance profits and administrative costs alone? Do you want that kind of system? You just have one choice. And Al Gore and I need your vote. Thank you very much. And God Bless you.