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REMARKS BY THE FIRST LADY
DURING A SPEECH TO THE
ARC
October 8, 1993
MRS. CLINTON: Thank you very much for that very warm welcome.
It is such a pleasure to be here with David Dunn and the other officers and
the board of the ARC and all of those in this audience and around the
country who support the work of the ARC. And I'm also pleased to be here
with the governor of Rhode Island, Governor Sundlun, and both Senator
and Mrs. Pell, who came to be with us today. And I am particularly
pleased to have been introduced by someone you have known a long time and
I've only been able to claim an acquaintanceship of less than a year,
but whom I admire so greatly, Senator Chafee. From the very first
time that the President asked me to work on this very important task, he
has been such a constructive and helpful counselor and advisor. And I
think it's only fair to say that we now do have a president who is
committed to health care reform. And we have leaders like Senator
Chafee who have worked on health care reform for many years who will
help create the climate of cooperation that will lead to a bipartisan,
nationally accepted health care reform in 1994. And I am very grateful.
(Applause) This is an issue that we know will be very discussed
all over the country in all kinds of forums like this but even more
importantly, in living rooms, in coffee shops, around the water coolers.
People are going to be talking about health care reform. And I think it is
a conversation that is long overdue and very welcome. And those of
you in the ARC have experience in knowing what is needed to make systems
respond to human needs. And we are so grateful that the ARC has taken such
a strong stand of support in favor of health care reform. I want
personally to thank the ARC for the very positive response that you issued
in response to the President's health care speech. And I want to thank
David and others for being with us at the White House when we kicked
off this campaign for health care reform because you have been working with
us through your officers and representatives now for a number of months.
And your help and your constructive advice has enabled the
administration to come forward with the plan that has and will continue to
make a contribution as we work through the Congress to the final
resolution. You know, often better than most Americans, how easy
it is to be victimized by a health care system that discriminates against
preexisting conditions, that does not offer adequate, long-term care
choices, such as personal assistance and other support that people with
mental retardation and their families need to rely on to fulfill their
lives and to be productive citizens. We are trying in our health care
reform approach to deal with several of the problems that are most
important to the ARC. We want to expand home- and community-based
services to persons with disabilities. (Applause) You know so well
that we have to have the capacity to support people while they live in
their home or in alternative living arrangements. And that you know so
well that it is the right thing to do, both in terms of the human
connection and in terms of the economic. For too long we have looked
to institutionalized care. And, as the wonderful introduction of Senator
Chafee pointed out, we're beginning to understand the human and
economic costs that that has made on our society. But we still have not
recognized how much better it would be if we could provide more support for
home- and community-based arrangements. The health care reform
plan will move beyond even the legislation that was mentioned and will
finally make it clear that, regardless of income or age, individuals
with severe disabilities should have the option to choose home- based
care or community-based care. (Applause) Also, as part of the overall
plan, we are leaving in place these programs that have provided help
and assistance. In fact, really, the theme of health care reform, as
far as the President is concerned, is let's preserve what is right about
-- (End tape 1, side 1.) -- Medicaid home- and
community-based waiver programs. (Applause) In fact, we would like to be
able, assuming we can afford to do so, to increase the living
allowances for residents of ICFMR from the $30 to higher than that, maybe
as high as $100 per month if we're able to do that. (Applause) You
know, when the President in his speech held up that health security card --
I hope you saw that on television. He didn't hold it up and he didn't say,
"Well, you'll only be able to get this if you're a certain age or if
you've never been sick or if you do not have any mental retardation." He
held it up, and he said, "Every American will be entitled to this card and
the services that it will represent." (Applause) And we want to make that a
right that every American can have. (Applause) There are so many
features of health care reform that will enshrine this basic principle
about every American being entitled to receive health security and at
an affordable cost that preserves and enhances quality. But
particularly for people with mental retardation and their families, we see
it as a way to end the discrimination that has for too long existed in our
health care system. I was talking with some friends of mine about
their small business. They employ four people. So there are four
families plus their own on their policy. Several years ago one of their
employees had a child who was born with Down's Syndrome. And all of a
sudden they were faced with what so many people are faced with everyday in
our country. Do you want to continue to insure this family with
this child? Do you want to have to pay more? Because if you continue to
insure this family, the costs for all your families will go up. And my
friend, whom I have known ever since high school who is a small
businessman, said, "You know, what a choice for me to be asked to make, to
turn my back on an employee and his family that were part of my family
and my small business, or to reach down even deeper out of the wages of my
employees, out of our profits, and provide health care insurance."
He continued to do so. And he called me the other day to say, "You know, I
made what I know was the right choice. It was the right choice for my
business. It was the right choice for my employee and his family. But no
American should have to make that choice. All Americans should be
entitled to health care coverage no matter who they are or what happens to
them during the course of their life." (Applause) And that is the bedrock
principle (inaudible). In the coming months, as the Senator referred
to in his comments, you will be asked to judge health care reform by a
number of questions. And I hope that you will keep them in mind as we go
forward during this very important conversation. In the news
release that the ARC issued supporting health care reform and the
President, it said that the ARC wants to measure any reform against a set
of five principles from a disability perspective, and these are
nondiscrimination, comprehensiveness, appropriateness, equity, and
efficiency. Everyone of those fits into the principles that the
President outlined and that are also embodied in the alternative that
Senator Chafee has worked so hard on. It has to be comprehensive. And that
means it has to provide a comprehensive set of benefits. It
cannot discriminate against any American. It must be appropriate in the
sense that we should build on what works. It should provide access to
adequate quality, affordable health care in appropriate settings based
upon the choices that individuals make that are best for them and their
families. It must -- it must have equity. And if it is
comprehensive and does not discriminate, it should have equity. But it
needs to have safeguards built in so that all of us feel that we are not
being taken advantage of or discriminated against. And it must
have efficiency, efficiency in the better delivery of health care services
and a more cost- effective (inaudible). This will be one of the
greatest debates that we will be having, how much efficiency we are
able to achieve. But the ARC, for many of the programs that you
are involved with, you have seen models that work. You know more
efficient ways of delivering health care services to people with mental
retardation. That is true across the country. And what we need is to build
in incentives so that efficiency is rewarded and that those who are
inefficient, who don't deliver high quality care at a cost-effective,
affordable rate, will learn how to do better because there will be
incentives in the system for them to become more efficient. And we
will need your voice and your experiences speaking loudly to people all
over America about how we can do the job better. I share the confidence and
optimism that Senator Chafee just said in his introduction. I know, I
know we're going to have health care reform in 1994. We are going
to have it because it is the right thing to do, because we know that to
stay with the status quo is no longer an option, and because so many
people, including those in the ARC, have worked too long and too hard to
try to make things better for us to give up now on what is a historic
opportunity. So I came today mostly to say thank you -- thank you
not only for the support you have given in the last months to this health
care reform effort, but thank you for the support and the advocacy and the
caring and the examples you have given to this country for decades.
Our time has finally arrived. If we work together, we will see the
fruits of your labor. And we will all be proud to be Americans and to live
in a country that gives us the best opportunities in the world, if we are
only willing to take responsibility (inaudible). Thank you all very
much. (Applause) * * * * *
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