Presidential Radio Address - 23 July 1994

by William Jefferson Clinton

Good morning. Ever since Franklin Roosevelt, seven Presidents of both parties have worked to reform our Nation's health care system to provide health coverage to all Americans. That's always been the goal, to make sure that hard-working middle class families had the medical and the economic security they need to build good lives for themselves and their children.

Now, for the first time in more than a decade, the American people are again insisting that we reform health care to contain costs and provide coverage for everybody. With your votes across the country in the last couple of years, you've told Washington in clear terms that you want guaranteed health security. And as your President that's exactly what I've been fighting for.

It's more urgent today than it has been in years, not only because America pays far more of our income for health care than anybody else but because we're going in the wrong direction. Ten years ago, about 88 percent of our people had health insurance coverage. Today, it's below 83 percent and dropping. In just the last 5 years, 5 million Americans have lost their health insurance. But my clear and unchanged goal is universal coverage that will protect hard-working Americans.

We've already come a long way in this debate. Both Houses of Congress will soon begin their historic floor debates because, for the first time in American history, committees of Congress have actually voted out bills that will guarantee coverage to all Americans.

Yet many interest groups are still fighting against it. Already, over $100 million has been spent by interests trying to persuade you to back away from real reform, trying to persuade you that it can't work. Fortunately, I think most people see through these ad campaigns. Eight in ten Americans insist they still want universal coverage. And fortunately we've got an example of where it works in the State of Hawaii, where employers and employees share responsibility and all are required to purchase insurance. There is coverage for all workers and their families, and small business insurance rates are 30 percent below the national average. That's right, in a State like Hawaii where everything else is more expensive than the rest of the country, health insurance is cheaper, because everybody does their part and everybody's covered.

Still, at this moment of decision, you're going to be bombarded with a last-ditch special interest media blizzard aimed at derailing reform and frightening you. That's why it's so important right now that you keep your focus on what matters most: How are we going to guarantee health security for all Americans? And don't let anybody convince you it can't be done. Every other advanced country has done it. And in our own country, one State's been doing it for 20 years now.

One of the things a lot of people will say to you is that we ought to have some modified half measures to make things a little better. Unfortunately, a lot of these half measures may not work.

Let's just take the case for insurance reforms. Here's why it won't work. One of the proposed insurance reforms that all of us would agree with is that people ought to be able to buy insurance, even if someone in their family hasbeen sick and has a so-called preexisting condition. And if they change jobs, they ought to be able to carry the insurance with them and not lose it.

Here's why just doing that is not enough. If you don't require everybody to have insurance, if you don't require universal coverage, that means low-risk individuals, younger people, single people, aren't necessarily included in these insurance pools, which means that the pool has relatively more sick people. Higher risk insurance pools means that premiums go up for those that are currently insured. What happens then? That means some more healthy individuals drop out because they don't think they'll get sick, and small businesses that are on the margin of profitability, well, they also often drop out. That means the pool is even smaller, which means the risk is even higher, which means the rates get raised again, which means even more younger healthy people drop out and more small businesses drop out. It's a vicious cycle.

To make matters even more complicated and tougher, when the uninsured low-risk people do get sick or have accidents, they still get health care, but it's too late, too expensive at the emergency room, and very often they can't afford to pay for it themselves. So their costs get passed on from medical providers back through the insurance system, back onto the Americans who are still paying insurance. And the premiums rise again. And again, it becomes harder for working people to afford insurance.

A recent study by the Catholic Health Association demonstrates how all these forces work together to hurt the middle class. Every year, according to the Catholic Health Association, these limited reforms would pick $27 billion from the pockets of working Americans and their families who do pay for insurance, $800 apiece for families earning between $30,000 and $40,000 a year. Can you imagine the outcry if Congress tried to impose a direct tax of that kind on working families? But that's exactly what these nonuniversal plans will wind up doing.

Right now we're hearing from the same kind of critics we hear from every time this country fights to help middle class families with efforts like Social Security and Medicare. They say small business will be hurt by this. They say it's too bureaucratic, that it's too costly, that Americans will lose their choice.

But the truth is, this is not a Government plan, it's private insurance for all Americans. We phase it in on a period of several years, there's less regulation than when it was originally proposed, choice is protected, and we contain costs.

And remember, most small businesses do insure their employees, and they pay 30 to 40 percent more for it than they would if they were buying in big pools like Government or big business. Only Hawaii has required all small businesses to participate, and their rates are lower.

These are the kinds of objections that we've heard every time we've tried to do something like Social Security or Medicare. President Johnson heard these objections during the Medicare debate until the very end of the vote. But 29 years ago next week, he was able to sign legislation creating a system that has helped hundreds of millions of older Americans and their families. The American people made it clear then that they wanted reform. And today, the pen President Johnson used to sign that legislation is mounted in a position of honor in the White House, just down the hall from where I'm speaking. And if you tried to repeal Medicare, Members of Congress from both parties would never let it happen.

Your concerns and your voices have carried us this far in this historic debate. Now we have to keep our focus for a few more weeks so we can win a battle that has been fought for 60 years. Together, America can join the ranks of other countries. America can do what we have needed to do a long time, create a health care system that guarantees health insurance for all Americans. And in doing that, we can make sure our middle class has a chance to keep growing for another generation of American children.

Thanks for listening.