MEMORANDUM Date: May 2, 1994 To: Senator Dole / Sheila Burke From: Alec Vachon Re: FYI/Clinton Meets with Disability Groups on Health Care Reform * Clinton met with 150-200 representatives of disability groups this morning at the White House to lobby for his health care reform plan. His remarks preceded a March on health care reform across the Memorial Bridge at 10:30 a.m. and a rally at the Lincoln Memorial from 12:30 3-30 p.m. by people with disabilities. A copy of Clinton's remarks are attached, together with an AP wire study. * I think Clinton was also trying to avoid having disability activists chain themselves to the front gate of the White House. (As you may recall, this is the season for that -­we had some threats last year in this regard.) Although the Clinton plan does contain some good things for people with disabilities, it does not contain a provision for attendant care, which is the number one priority for many activists. * Among Clinton's key points: --many people with disabilities do not work because they cannot get private health insurance and would lose their federal medical insurance. (N.B.: You made a similar point in your 25th anniversary statement. However, despite substantial anecdotal evidence, I have not seen any systematic data on this point.); and --attacked so-called "bogus ad" and touted provisions for small business in his plan. 16 USN 05-02-94 11:31 EST 240 Lines. Copyright 1994. All rights reserved. BC-CLINTON-REMARKS Transcript of Remarks by President Clinton to Disability Groups To: National Desk Contact: White House Press Office, 202-456-2100 WASHINGTON, May 2 /U.S. Newswire/ --Following is a transcript of remarks by President Clinton to a meeting of representatives from disability groups: The East Room 9:55 A.M. EDT THE PRESIDENT: Well, thank you, Stephanie and Denise, and thank you all for being here. I want to thank ADAPT, the National Council for Independent Living, the Consortium for Citizens With Disabilities --(applause); recognize my good friend, Tony Coehlo, Marca Bristo, the Chair of the National Council on Disabilities, pending confirmation. (Applause.) I'm honored to be given this book of signatures of genuine American heroes who are fighting every day for their own rights and for genuine health care reform for all Americans. I want to say a special word of thanks to Justin Dart, who has risen above partisanship to provide an example for all of us about what it really means to keep fighting the good fight. Not only for Americans with disabilities, this is a fight for all Americans who are touched by these problems. (Applause.) And I want to say a special word of thanks to Kate Miles and her family for being here today; for her determination, her courage, her love and for her ability to get up here and tell their very moving personal story. I say this to make a special point. The issues affecting Americans with disabilities --they say, well there are 49 million Americans with some sort of disability; and there are 255 million of us total. But if you consider all the family members of all of the Americans with disabilities, you're getting very close to a majority of us who would be affected in a positive way by the provisions of the health security act that help Americans with disabilities --just those provisions. And in a very moving and human way, Kate Miles and Robert and their children --husbands, all the families they stand for all across America, they have reminded us what this is all about. The theme of your rally today is "Bridge to Freedom" And I want to talk a little about that. The Americans with disability law was a bridge to freedom. But it's only part of the equation. It's only part of the equation. What about economic freedom? How many Americans with disabilities are denied the chance to do work they are able to do not because of discrimination per se, but because of the way the health care system works. This is not just a health care issue, it's a work issue. How much better off would the rest of us be if every American with a disability who was willing to work, could work because of changes in the health care system? It'self-defeating to say that the Americans with disabilities -- you can have health benefit, but only if you spend yourself into poverty; and, above all, you must not work. (Applause.) Forty-nine million Americans with disabilities, 24 million with severe disabilities --half with no private health insurance. The health care system is failing Americans with disabilities, but in so doing is failing us all, is making us less productive than we would otherwise be, less strong than we would otherwise be. It is costing more tax dollars and robbing us of taxes that would come to America's treasury not from higher tax rates, but from more Americans working and paying taxes in the ordinary course of their lives. We had better fix it now. After all of the incredible debates, after all of the amazing ads where --and Justin just referred to one of them --you know, these ads where they say --somebody calls up and says we'll have to call the government and see if you can get your doctor --all these incredibly bogus ads. We had better do this now. We had better do this now. Otherwise, the forces of disinformation --organized disinformation --will think that the American people actually prefer to have the most expensive, wasteful, bureaucratically cumbersome health care insurance financing system on the entire face of the earth; that they prefer that as opposed to giving a decent break to this fine family and to all of you. I don't believe the American people prefer that, and we had better make sure that no one draws that historic lesson from this health care debate. (Applause.) There's a lot of talk today about the whole term "empowerment". It risks becoming a buzzword. There is an empowerment television network. But, frankly, I like it. It encaptures something that is uniquely American --the idea that people ought to be able to live up to the fullest of their God-given abilities; and that the government should facilitate people fulfilling themselves, not just be a paternalistic government doing things for people. I have believed in that for four years. Long before I ever became President, I worked on things that I thought would promote empowerment --more choices for parents and children in education, tax breaks for lower income working people, some of the things that we've also promoted here in Washington. The Family and Medical Leave Act here in my presidency was an empowerment bill that enables people to be good parents and good workers at the same time. The empowerment zone concept that we passed through theeconomic program last time. Lower student loans -- lower interest rates for student loans and better paybacks is an empowerment notion. National Service is an empowerment notion; let people have the strength at the grassroots level to solve their own problems. Empowerment involves work and family and self-fulfillment in a responsible way. How can we empower the American people when 81 million of us live in families with preexisting conditions; when the average American, in the normal course of an economic lifetime now will change jobs eight times; when this fine man cannot change a job, even if he gets a better job offer, because he can't insure his child? Is that empowerment? No, it is the very reverse. So when we try to fix it, what do our adversaries say? They're trying to have the government take over the health care system. False. Private insurance, private providers, empowerment for this man, this woman, these children, their families and their futures. (Applause.) Can you stay around here until this is over? (Laughter.) You're great. Now, they say --let's not kid ourselves --if this were easy, it would have been done already, right? Somebody would have been --people have been trying to do it for 60 years. What is the nub of this? The nub is the question of how to cover everybody; and then how to give small businesses the same market power in buying insurance that big business and government have. Because all across America, government and big business are downsizing, and small businesses are growing. I might say, that means we better fix this now, because 10 years you'll have a smaller percentage of people working for government and big business, and a larger percentage of people working for small business. And if we do not fix this now, this is going to get worse, not better. We already have about 100,000 Americans a month losing their insurance permanently. In the future, if we're going to be caught up in the kind of world that I want, where we have open borders and we trade and we have these churning, fascinating, ever-changing economies, we had better fix it now, because people will change jobs more often, not less often. This is a profoundly important issue. But we cannot do it unless we find a way for everyone to have access and actually be covered by insurance. Nine out of 10 Americans who have private insurance today have it at work. Eight out of 10 Americans who don't have insurance, like this fine young man here, are in families where there is at least one working person. Therefore, it makes logical sense to say that people who do work should be covered through work with a combination of responsibility, just as this family has, from the employers and the employee, and then people who are not working should be covered from a public fund. That is our plan; hardly a government takeover of health care. And it makes sense for the government to empower small business to be able to afford this by providing the opportunity to be in buyers' co-ops so that small businesses, self-employed people and farmers can buy insurance on the same term big business and government can, and thereby can't afford to hire persons with disabilities. Because they would be insured in big pools so that if there is one big bill for this young man here, the insured does not go broke. And, furthermore, it makes sense to give small businesses a discount because a lot of them have financial burdens and lower profit margins, and so we do that. That is the role of the government in this --require people who don't provide insurance to their employees to do it in partnership with their employees, let small businesses go into big buyers' co-ops so they can buy insurance on the same terms that the President and the Congress can, and people who work for big companies can. Eliminate discrimination so that people can move from job to job by removing the problems of preexisting conditions. And, finally, face the fact that if you look at the aging population and the disabled population, we must do something to support long-term care that is community-based and home-based. (Applause.) This is empowerment. This plan helps a person with a disability to be able to take a job by including a tax credit for personal assistance services worth 50 percent of what he or she earns. That's empowerment. But home and community based long-term care is also empowerment. And it also, over the long run, will be less expensive. Does it cost more in the short run? Yes, it costs some extra money. But if you look at the population trends in this country, if you look at the people with disabilities who are surviving and having lives that are meaningful, if you look at the fastest-growing group of Americans being people over 65, within that group the fastest growing being people over 80, this is something we have to face as a people. We will either do it in a rational way, or we will be dragged, kicking and screaming into it, piecemeal Band­Aid-like, over the next 10 years. But, make no mistake about it. We cannot run away from this, because we cannot afford either to have everybody in the world forced into a nursing home or living in abject neglect. (Applause.) We can't do one of the two things. (Applause.) So I say to you, all of you know that there is no perfect solution, no easy solution. All of you know that our bill, in order to pay for it, phases some of these services in. But it recognizes the reality of who we are as a people and what we need. We need the work of every American who can work. We need the respect, the dignity of every American. And we need to provide the opportunity for every American to live up to his or her capacity in the least restrictive environment that that person might choose. We need to secure for the American economy the services of every person who wishes to be and is capable of being a successful worker. We need to stop seeing government health care expenditures go up two and three times the rate of inflation every year to pay more for the same health care. We need to stop spending more money on paperwork and administrative costs because of the health care financing system in this country than any other country in the world. We can do all of that and keep the doctors, the nurses, the health care system we have. That's why there are so many thousands and thousands, indeed millions now, of nurses, health care providers and physicians who have supported our cause. And so I ask you, the real problem with this, I am convinced, is that there is no way --to use to political vernacular, to kiss it, to keep it simple, stupid. That's what people always tell me, you know. (Laughter.) The real problem here is that we bear the burden of every move, those of us who want change; because we live in a system that is complicated. So it is not simple to fix it. So I plead with you, a lot of you will contact members of Congress who voted for the Americans with Disabilities Act who are not yet prepared to vote to make sure every American has health insurance, and who do not understand yet that you cannot eliminate preexisting conditions; and you cannot eliminate other discriminatory practices; and you cannot afford to begin to provide long-term care that is community-based and home-based unless you set up a system where everybody has health care insurance, where small businesses can buy on the same terms big business and government can, and where insurers insure in big enough pools so that nobody goes broke when they do insure a family where a member has a disability, and where small businesses get a discount. Those are the things we try to do with the power of government. It is a legitimate thing to do, but when you strip it all away, what we're really trying to do is to empower the families of this country to live in dignity, to work in dignity and to fulfill themselves. And in a strange way, this is a battle that the disability community, known so well to the members of Congress, being so successful in the passage of the Americans With Disabilities Act, this is a battle that you may be able to lead for the rest of America, that they do not understand. (Applause.) < >-end-of-autobreak(l)--< >-autobreak(2)-follows-< 722 AP 05-02-94 10:54 EST 61 Lines. Copyright 1994. All rights reserved. PM-Clinton-Health,480< Clinton Says His Health System Will Give Handicapped More Freedom< By RON FOURNIER Associated Press Writer WASHINGTON (AP) With much of his audience in wheelchairs, President Clinton said today all Americans will be better off if the health care system is changed to give handicapped people more freedom to work. Although his health care reform plan does not meet all the needs of the disabled, Clinton said it will give tax credits for some handicapped workers, better long-term care benefits and affordable health care for all Americans, including the disabled. ''What about economic freedom? How many Americans with disabilities are denied the chance to do the work they can do not because of discrimination per se, but because of the way the health care system works,'' Clinton said at a boisterous East Room rally for disabled Americans, many of whom showed up at the White House 90 minutes early for the event. ''How much better off would the rest of us be if every American with disabilities who was willing to work could work because of changes in the health care system?'' Clinton said. ''It's self-defeating to say to Americans with disabilities, 'You can have health benefits, but only if you spend yourself into poverty.''' The audience of about 125 left Clinton's speech for a ''Bridge to Freedom'' march from Arlington, Va., to the Lincoln Memorial. ''Free our people! Free our people!'' they chanted after Clinton finished. In introducing the president, Kate Miles choked on her words while urging government officials to pay for coverage of in-home care for her son. ''In an institution, nobody is going to get up with him in the night when he's having a seizure and let him know that it's OK and Mommy loves him,'' she said. Justin Dart, former chair of the President's Committee on the Employment of People with Disabilities, gave a stirring speech for health care reform. ''We are willing to die for our countries but not for our insurance companies,'' he said. ''No more excuses. No more exclusion. No more profiteering. No more Band-aid solutions.'' Moved by the remarks, Clinton urged the advocates to lobby for his health care plan in Congress. ''What do our adversaries say: We're trying to have the government take over the health care system. False,'' Clinton said. Pointing to the audience, the president said his plan would provide ''private insurance. Private providers. Empowerment for this man. This women. These children, their families and their future.'' The White House plan would phase in community-based alternatives to nursing homes and other institutions. It also would provide a tax credit covering 50 percent of their personal care services up to $15,000 a year. Disabled groups want immediate coverage for attendants who come to their home, but White House spokeswoman said' that won't be immediately covered.