Families USA Fourth Annual Conference

Friday, January 22, 1999

I'm delighted to join with Families USA -- an organization that, in its short history, has truly shaped history. In the past few years, you have been at the forefront of every major debate we have had about the health of American families: from reforming and strengthening Medicare, to reaching out to uninsured children, to improving the quality of care amid the great changes in today's health care system.

Of course, we're here to focus on the battles of the future. And I want you to consider this fact: this is the last conference you will hold in the 20th Century. Together, we must all decide: what will American health care be like in the 21st Century -- not just next year, but in 10 years, or in 50 years? How can we shape this new century into the healthiest and most hopeful time in human history?

To be sure, this is a time of unprecedented breakthroughs in health and medicine. We are nearing the completion of the Human Genome -- the first full instruction manual for the human body. We are on the verge of the first preventive cancer medicines. New treatments are slowing the development of Alzheimer's and lifting people from the dark depths of depression. Researchers have begun to regenerate nerve cells, raising the prospect that victims of spinal cord injuries will actually be able to rise up and walk again. That's why President Clinton and I have focussed so heavily on biomedical research -- including the basic, fundamental research that can unlock the deepest secrets of illness and disease.

That's the good news. But we know that, for all our progress in expanding access to health care, step-by-step, too many are still in danger of being left out.

How can we marry today's stunning advances with all the people who need them? As President Kennedy once told us, "the health of our nation is a key to its future -- to its economic vitality, to the morale and efficiency of its citizens, to our success in achieving our own goals and demonstrating to others the benefits of a free society." To build a stronger America in the 21st Century, we must build an even stronger health care system.

Today, I want to discuss two critical challenges in doing so: first, making sure that we meet the vital and changing needs of our most vulnerable people -- especially children, the disabled, and the elderly. Second, making a great health care system even better, by ensuring the best health care, not just the cheapest.

Let's start with the elderly. My generation is the first generation to have more parents than children -- and the needs of our elderly parents are powerfully on our minds. So many people have told me about their helpless grief at not being able to afford a home health visitor for a frail mother or father; home health aides can cost two hundred dollars a day. Many are thinking daily of their homebound parents far away, who may be living alone, and risk a fall or a fracture with no one to look out for them.

I believe the words of the poet Longfellow: that "as the evening twilight fades away, the sky is filled with stars invisible by day." We must honor and care for our parents -- and that means meeting the great challenge of long-term care.

For years, Families USA has been sounding this alarm. With nearly half the people over the age of 85 -- the fastest growing segment of our population -- needing help with basic everyday tasks; and with the number of elderly Americans set to double by 2030 -- ignoring this issue is ignoring America's future.

That is why President Clinton and I have proposed a new Family Caregiver Support Program to link the millions of Americans who care for the chronically ill or disabled, and a new long-term care tax credit for the disabled and their caregivers. I believe it is high time we offered more care to the caregivers.

While we support those who undertake this kind of home-based care, we can also make it easier for seniors to stay in their own homes and communities -- rather than in nursing homes, where they lose the patterns that make up their lives. Just yesterday in Florida, I announced a series of new measures to do so. We want to allow states to use Medicaid to pay for community-based care, just as they can now use these funds for nursing home care. Second, we will convert more existing housing into assisted living facilities, through a new elderly housing initiative. We must widen the circle of dignity in old age -- and that means maintaining the comfort that comes from family and community.

As you all know, the President has laid out a bold plan to save Social Security for our future. We must also save Medicare -- one of the landmark acts of health policy in the history of this nation.

Already, we have extended the life of the Medicare trust fund by 10 years -- and we are committed to extending it for at least another decade. That is why we are proposing to use one out of every six dollars of the surplus over the next 15 years to guarantee the soundness of Medicare until the year 2020. And we want to save and improve Medicare, which is why we are working to meet the greatest growing need of seniors -- affordable prescription drugs.

Of course, until we reach a consensus on the future of Medicare, we must make sure it remains strong for the present. Right now, millions of seniors on Medicare are eligible for help with their premiums through Medicaid, but aren't getting it. It was a Families USA report which first focused our attention on this failing -- and thanks to you, it is now a problem we are fixing. Last fall, we sent every single one of our 40 million Medicare beneficiaries special packets on this cost sharing -- which generated an unprecedented number of calls to state insurance assistance programs around the country. I am proud to report that this March, our Department of Health and Human Services' "Reach Out" group will hold a national conference on the best ways to educate seniors about the help they need and deserve through Medicaid.

I also want to thank Families USA for promoting the use of our Social Security field offices to enroll seniors in these assistance programs. We've already received applications from 10 states that want to join this new demonstration project.

And I urge all of you: keep serving as that angel on our shoulder, reminding us why Social Security and Medicare are lifelines -- and why Americans who depend on them shouldn't feel like they're walking on tightropes.

We must do more to care for the aging. But we must care for those at the dawn of life as well. There are currently over 10 million uninsured children in America. Groucho Marx once joked that "a hospital bed is like a parked taxi with the meter running." For too many children without health care, that is indeed the reality. And it is unacceptable -- especially when over four million of them are eligible for Medicaid, and millions more have become eligible under the Children's Health Program we all worked so hard to pass.

Studies have shown us that uninsured children are more likely to be sick as newborns, less likely to be immunized, and less likely to be treated for recurring illnesses like ear infections and asthma -- illnesses that can have lifelong consequences. Can we really afford not to make these investments?

Our landmark children's health initiative was an important step, but the battle didn't end with the signing of the bill. Yes, over 45 states have already had their programs approved, and yes, more will come back for further expansions. Yes, we have involved every part of the Federal government -- from HUD to Head Start -- in identifying eligible children, something the President committed us to doing at the annual Family Conference Tipper and I held last summer. We are also working with the private sector -- from hospitals to pharmacies to grocery stores --to sign up more children in need. But we can do more to break down the barriers between eligibility and enrollment.

That is why today, I am proud to report that this year's budget will include a major new $1 billion investment to help us find and enroll uninsured children across America. With these funds, we will enable states to make it easier to enroll; to launch ad campaigns; to educate community volunteers; and to put special eligibility workers out on the streets. We will do everything in our power to find and enroll every eligible child in America -- to give the blessing of health care to millions who are without it today.

Finally, we must realize that it is not enough to expand access to care -- though that is vitally important. In the nation that leads the world in developing cutting-edge medicines and therapies, we must ensure the highest quality health care as well. That means passing a Patients' Bill of Rights. I want to thank Ron Pollack, who served on our Advisory Commission on Quality, and helped us craft our Patients' Bill of Rights. Ron has constantly been a wellspring of innovative ideas on this issue -- like creating ombudsmen so that patients and their families have unbiased informational resources in their dealings with HMOs. Ron knows: medical decisionsshould be made by doctors -- not some bureaucrat on the other end of a phone line, who has no medical license, and no right to play God.

Now I hear that some in the Senate are planning to reintroduce the bill we opposed last year. It covers only one third of the people our bill would cover, and doesn't even guarantee access to a specialist. That's not a Bill of Rights -- it's a bill of goods.

There are powerful interests lined up against this. But you have shown that we can win this fight. At the state level, you built the coalitions that brought together legislators, consumer advocate groups, and others. You rallied the support and energy, and ultimately applied the pressure to make it happen. Now America needs your help again. Let's tell the Congress: pass the Patients' Bill of Rights into law.

I believe we are blessed to live at a time when America's health care is better than ever before. Millions of Americans receive high quality medical attention from the world's finest hospitals, clinics, and research institutions. And we owe so much of that progress to the high purpose and the grassroots activism of the people in this room. Our challenge now is to build on what we have achieved -- to make America stronger, by making it healthier. Every American deserves the chance to make the most of their own God-given potential. But you can't reach for your dreams if you can't stay healthy and strong. That's why our common cause is so important. We don't have a moment to waste -- because we don't have a single person to waste. Thank you -- and keep up the good work.


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