REMARKS OF THE FIRST LADY AT
THE UNIVERSITY OF COLORADO
March 14, 1994
Thank you very much. It is a real pleasure to be back in Colorado and to be back on this campus. I am grateful for Congressman Scaggs being with us. He has been a terrific supporter of the efforts and change in the last year, and has supported the president on the efforts to change our health care system. We're very grateful for that leadership.
I'm delighted to be with your president and chancellor. I want to thank Patrick and Steph and (inaudible) for their introductions and for the work that they've done to make this possible. I have to tell you, I've done a lot of things in my life, but I have never, even in front of a crowd of two, tried to sing anything a capella. I thought that showed a lot of nerve and class.
You know, it's like anything else in life, if you don't try it, you never know. You know, there was an old saying in Arkansas that my husband used to love, which I never really understood. But the older I get, the more sense it makes, which says something about me probably more than it, and that is you can't tell how far a frog will jump until you punch it. There's a lot of frogs being punched these days in Washington because we're trying to figure out how far this country and how far this government can go to make good on the promise of change in a new vision of America.
You know, when I was last here, we talked and there was a huge crowd and a lot of support for the campaign that my husband was waging because it was a campaign about the future; what kind of country we were going to have, what kind of people we were going to be. I took a lot of energy and excitement and enthusiasm back with me because of the conversations that I had along a rope line and in a private meeting with some of your student leaders.
What I try to remember every day when we're doing what we are working so hard to do for you and for us in Washington are the faces of the people I have seen all over this country. You know, it is really easy once you do get to Washington to forget that politics and government should be about you. It should be about your needs, about your interests, and about your futures. If we are not planning for what happens in the next generation, we sell you short and we undermine the capacity of our country to be strong and productive as we move towards the 21st century.
So I have kept these pictures, these snapshots, this sort of mental video going all the time. I probably have spent more time in the past year talking one on one and in groups with people about what they hoped for for the country, particularly what they hoped for with health care than anything else.
I'm really here to make a report to you. What I want you, particularly the students, but all the rest of us, to know is what we're trying to do, where we are in the process, and why it is important to you. This is not some abstract policy debate. This should not be politics as usual. This should be about one of the most important things in any of our lives, our health and how we're going to be sure that the finest health care system in the world, the one we have now, the finest doctors, the finest nurses, the finest hospitals, will be there for you in 10, and 20, and 50 years.
So that's what really motivated my husband when he said let's take a look at what we can do better to provide health care that is affordable and of high quality to every American. What I want to do today is describe for you what the president's approach is so that you know how he has thought through what he thinks will work.
As the congressman said, the first thing about the president's approach is he wants guaranteed private insurance for every American with benefits that can never be taken away no matter who you are, where you live, or who you work for. Particularly here, as we stand behind with the flat irons looking over us, and I know how much many of you value physical exercise and activity and wellness and prevention, I want you to know that the president believes in prevention also.
In his plan, we are going to start reversing the kind of backwards approach to health care we've had in this country. You know, you cannot get insurance coverage if you take your child for a well-child exam, but you can get it if the child gets hurt or real sick and shows up at the emergency room. Let's start rewarding prevention and trying to avoid sickness instead of rewarding a health care system that is premised on sickness.
So, number one, guaranteed private insurance for every American no matter what age, no matter where you live or work, with comprehensive benefits that stress primary and preventive health care.
Number two, let us once and for all outlaw the kind of insurance practices that make it impossible for many Americans to get health care and which charges far too much for millions of other Americans, making health care unaffordable.
You know, probably the most emotional moments I've had this past year have been when I have talked with people who have found themselves unable to take care of themselves and their families and be able to provide health care and provide insurance because they got sick. I always thought when you got sick is when you needed to be taken care of.
What happens in literally billions and tens of millions of families, families represented in this crowd today, are if you do have what is called a preexisting condition, you have diabetes, if you've ever had any other kind of chronic disease, if you had cancer 20 years ago, you therefore are either ineligible for insurance or you have to pay a much higher price than your friends and family members who do not have such a condition. The president's plan outlaws that.
Secondly, if you read the fine print on your insurance policy, you will find often something called a lifetime limit. What that means is that if you get really, really sick and you have to be in the hospital for a long period of time or you need some kind of continuing medical treatment, you better be careful because if your lifetime limit is $50,000 or $500,000 or, in the case of families I have met with, $1 million, once you reach that, you no longer are insurable.
Can you imagine what it is like for the families that I have met? I'll tell you just one quick story. I talked with a mother and father who had two healthy children. Their third child was born with very serious complications at birth. These were two people who both worked, made a very good living, paid their taxes, did what they thought they were supposed to do, had insurance. Because their third child was so ill, the child had to stay in the hospital from birth.
Within a year, their lifetime limit of $1 billion were exceeded. What that family was told when they came to the hospital and said we no longer have insurance, we're going to keep trying to buy some more insurance, they were told well, here's what you need to do. Put your baby on welfare so the state will pay for the insurance.
The parents said we want to bring our baby home. We want to be able to take care of her at home. We want to get round-the-clock help so that we can take care of her, but we can't find anybody who will help us with the insurance for that. They were told there's no way out of that. You no longer have insurance for this child. If you bring the child home, you have no help at all. If you leave the child in the hospital and keep the child on welfare, then the child will be paid for.
At the time that I talked with this family, that baby had been in the hospital for 15 months. There are thousands of stories. So the president's approach outlaws lifetime limits. When you need insurance the most, you should have insurance forever.
The third important point is that you should be guaranteed choice of doctor and choice of health plan. This is probably the point that has been debated and had more misinformation about it than any other. Those who oppose health care reform have said loud and clear oh, be careful. If the president's approach goes through, you won't be able to see your doctor.
Well, let me tell you something, if you work for somebody who helps provide you insurance now, you are no longer guaranteed any choice because fewer than half of the people who get their insurance from work, which is where most of us get it, are being told they no longer have a choice. What they're being told is you have to use these doctors and this hospital because we've cut a deal with them and they're going to keep the price down. Well, the problem is that we need to change the whole system to keep the price down so that you can have your choice of doctor and hospital and that's what reform is guaranteed to do.
The fourth one I want to make, and this may seem a little bit far from this crowd of young people, students primarily, but the president's approach wants to guarantee and improve Medicare for older people. Now, why is that important? Well, most of us have seen our parents and our grandparents needing medical care. You need more medical care.
Even if you hike and run and do everything else all your life, you eventually get to be a certain age where you need more medical care. What happens with people on Medicare now is that they have found that because our whole system doesn't control costs, the prices available under Medicare are being reduced which means now more and more physicians are reluctant to treat a lot of people on Medicare.
We want to give prescription drugs to people on Medicare so that they can be better taken care of and not be bankrupted. We want to do something else, and that is to provide some alternatives to nursing homes for older people. Now, think about that.
Right now, if you get older and you are sick or you are young and you become disabled, I'm sure most of you in this crowd know some young person who, because of a car accident or something else, has become disabled and needs long-term care, what happens now?
We don't give the kind of help we should for people to be able to stay in their own homes. We don't give the kind of help we should for people to have some kind of assisted living during the day but still be able to stay with their families. What we do is we say the only real help you have is the nursing home. I want, when I'm 65, to have alternatives besides a nursing home and I think you do too, and the president believes everybody ought to have that.
Finally, the fifth point I want to make is that the president's approach guarantees insurance the way most of us get insurance today, at the place we work. Most of us who are insured do so by contributing some money and having our employer contribute some money. Therefore, we get our health insurance.
Now, there are only three ways to fund health care for everybody in America. I've seen some signs and I respect the people who are single payor advocates because they believe in providing health care for every American. What they will propose is that we have the elimination of private insurance and instead have a tax system that provides health care financing for everyone.
The president decided that he would prefer to stay with a public/private system. He does not support a government health care system. He wants to have a guaranteed private insurance system, but the single payor people are very honest in the way they describe how health care would be financed.
The second way to get everybody covered in the country is to do what is called an individual mandate. In other words, every one of you would be responsible. Like you are in many states to go out and buy auto insurance, you would be responsible to go out by yourselves and buy health insurance. This also recognizes you have to do something to get everybody covered, but the president does not think it's a good idea to begin to eliminate our employer/employee system by having the entire burden put on the individual.
What he believes we should do is to build on what works. It's an American solution to an American problem. We should build on the employer system. The employers contribute, those of us who work contribute, and all of us then are paying our fair share. There are no more free riders in the health care system.
What happens today, and you can go to Boulder or any other town in Colorado, and you can walk down the street and you can see the stores that help buy insurance and the factories that do and those that don't. But if you work somewhere without insurance, like the nearly 40 million Americans who do not have insurance, most of whom work, if you get sick, you go to the same hospital. We do take care of you in our country, but if you can't pay the bill, then the cost of your medical care is put on to the bills both of the government and of those who have private insurance.
I got a letter from a man in Colorado who wrote me last March and said I don't know what's happening. I'm a small business person. I bought my insurance in 1985. It costs me $100 a month for myself, my wife, and my two children. By 1993, it was over $450 a month. My staff called him and asked him what was happening with him now. He said I'm so glad you called. It just went up to nearly $800 a month and nobody will tell me why. I am not getting any more health care.
I'll tell him why. Number one, he's a small business person, the most discriminated class of anybody when it comes to getting health insurance. Number two, he is paying his share of the uninsured because when he goes to that hospital, he wants to make sure we have our doctors and our nurses and our high-tech equipment. But if we keep having so many people who are not paying anything for their health care being taken care of, the bill has to go to him, to me, to those of you who are in the system.
So those five points -- guaranteed private insurance, outlawing the insurance practices that discriminate against people, guaranteeing choice of doctor and health plan so you can have the quality you deserve to have and you make the choice every year, preserving and improving Medicare, and providing health insurance through the work place, are the five major parts of the president's approach.
Some will tell you that it's a very different approach, that it has things attached to it that are not there are all. So I want you to know what the facts are because if we do nothing, what will happen is the number of uninsured will grow, the health care costs for small business people who are individuals, who are families, will continue to explode, and we will see our system beginning to deteriorate under that kind of financial pressure.
Let me just add one other point because health care reform is not just about how much money we can save, how we reorganize delivery, how we get more people to take care of themselves and be more responsible, it is all those things. But it something more.
If you had seen as many people as I have over the past year who have been left out of the health care system, have been denied health care when they needed it most, you would feel as I do that this is far beyond any kind of policy. This is really a challenge to what kind of people we intend to be and how we will take care of each other.
I want to be able in the next year to go back to the places I've been and to look at the people who have shared their stories with me and tell them that we finally in our country have heard them, and that we finally have agreed that health care should be a right, that every one of us should be taken care of when we need it because there's not one of us who knows whether tomorrow we will need some kind of serious health care help.
So this is really a struggle for the future. It's a struggle for determining who we are as a people. We have, I believe, the will to meet that challenge. But the only way we can do it is for each of you to take a hard look at yourselves where you are in your lives and to know that the kind of country we will have for you in the future depends upon the decisions we make today.
Let people hear your voices raised for a health care system that takes care of all of us, that leaves no one out. Then, when we have secured health care security for everyone, we will have the kind of basic personal security that will enable us to go on into the 21st century. This is about the future. This is about you. I am very pleased that you're going to be part of this struggle with us. Thank you all very much.
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