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https://clinton.presidentiallibraries.us/files/original/a1bc48e147a1093d2f6a0a363da72864.pdf
31fde2b2f7edb5786151e4e6e48088c9
PDF Text
Text
FOIA Number:
2006-0885-F
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
Collection/Record Group:
Clinton Presidential Records
Subgroup/Office of Origin:
Health Care Task Force
Series/Staff Member:
Zelman
Subseries:
OA/ID Number:
3796
FolderlD:
Folder Title:
[[Secretary Shalala's Comments] [Loose]
Stack:
Row:
Section:
Shelf:
Position:
56
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4
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�07-09-93 12:05PM FROM OASPA HEWS DIV
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DEPARTMENT OF HEALTH &. HUMAN SERVICES
P002/014
Office of the Secretary
Washington. D C, 20201
MEMORANDUM
To:
From:
Subject:
Date:
Walter Zelman
K r i s t i n e DeBrj^nd Dan Porter f i e l d
^
Secretary Shalala's George Washington
U n i v e r s i t y T h i r d Annual Health P o l i c y
I n s t i t u t e remarks
7/9/93
For your review, attached i s a d r a f t of Secretary
Shalala's remarks f o r the George Washington U n i v e r s i t y
T h i r d Annual Health Policy I n s t i t u t e on Tuesday,
J u l y 13.
This i s an endowed l e c t u r e , and the audience w i l l be
comprised of about 200 health care executives.
Secretary Shalala has signed o f f on the speech as a
whole — but she wants t o make sure a l l the elements
are c l e a r , accurate, and i n f o r m a t i v e .
Please r e t u r n the d r a f t t o K r i s t i n e by t h i s afternoon:
phone (202) 690-7470, fay (202) 690-7318.
Thank you.
�07-09-93 12:05PM FROM OASPA NEWS DIV
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REMARKS
DONNA E. SHALALA
SECRETARY OF HEALTH AND HUMAN SERVICES
AT
THE GEORGE WASHINGTON UNIVERSITY
THIRD ANNUAL SUMMER HEALTH POLICY INSTITUTE
JULY 13, 1993
WASHINGTON, DC
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Thank you, Peter [Budetti] and Richard [Southby] for the
invitation to be here today.
opportunity
I an honored to have the
to give the Harold and Jane Hirsh Distinguished
Lecture, and would l i k e to thank Mr. and Mrs. Hirsh personally.
One of the lessons I've learned throughout my career i s that
the best way to get a grasp on an issue i s to l i s t e n to the
people who are l i v i n g i t .
The real passion in our health care debate i s not so much i n
the numbers and the theories and the formulas.
the human l i v e s .
The passion i s in
I t ' s i n the struggles, the fears, and the
aspirations of the American people.
I t ' s i n the/burningy'desire
our people feel for a health care
system that protects them and their families, f^f ^ ^ ^ - ^ ^ T T * r f ^ L , /
In Florida, I met a furniture store owner who can't afford
insurance for some of his most valuable employees —
h i s parents,
who work i n h i s business.
In Iowa, I met a farmer who told me he had to s e l l a cow a
month to pay for health insurance for his farm workers.
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In Ohio, I visited a neonatal unit and saw two-pound babies
kept alive only by wires and monitors hooked up to their tiny
bodies.
The reason for their suffering — their mothers hadn't
received prenatal care.
V)
There's a common theme in America:
People are paying too
much for health care and getting too l i t t l e — and many are
getting nothing at a l l .
What inspires me most is the American people's enduring
desire for progress — and our responsibility as public servants
to bring progress about.
In the quiet moments between health care meetings at the
White House and HHS, I sometimes visualize how our decisions will
play out in the future.
^
Imagine the year i s 2023 — 30 years from now — and a GW
\ I graduate student named Carmen Diaz i s writing about the collapsed
Jhealth care system of the 1990s. She has sought me out in
Wisconsin to find out how we built our effective and humane 2l3t
century system.
\
And here's what the system of Carmen's era looks like:
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"'7
In the year^2023*,/ every American has coverage — and the
cost of providing-that security rises only at the rate of
inflation.
Businesses provide insurance for a l l employees — and at
predictable prices.
Insurance companies cover everyone -- not just the
healthiest Americans, £nd they don't exclude people with preexisting conditions.
^
<\o
m
pMfr
tM*t,
p
•octors have an^economic incentive-Nto practice primary care'.
In the year 2023, Americans choose from a wide range of
affordable health plans — including fee-for-service. They
ehooss their plan through health care alliances, organized by
their home states.
0
6
Thanks to the world's best network of community healtk) ^ ^
/(
centers, America practices prevention on a grand scale,
Widespread prenatal care, well-baby care, and preschool
vaccinations have given us the world's lowest infant mortality
rate.
�07-09-93 12:05PM FROM OASPA NEWS DIV
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That's a big improvement from the 1990s when we ranked 24th
in the world in infant mortality.
Mammograms and regular reproductive health care are a part
/of every woman's health care routine —
and because of some great
NIH research in the 1990s, we have a comprehensive illness
prevention strategy for women, as well as for men.
Senior citizens —
that's us in the 21st century —
can
afford long-term care and prescription drugs, without sacrificing
their l i f e ' s savings.
And no one has to worry that an illness or a pink slip will
terminate their insurance policy —
a calamity that threatens a l l
of us today.
That's America's health care system in three decades.
That's the system that sustained Carmen Diaz even before she was
born —
and throughout her l i f e .
You see, I imagine that Carmen Diaz could be anyone —
any background.
from
She would get the same health care whether she
was the daughter of a factory worker, a scientist, a musician, or
a mailcarrier.
�07-09-93 12:05PM FROM OASPA NEWS DIV
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TO 94567739
v
\$
Qj
/ But l e t ' s say she is the daughter of r e t i r l d migrant
workers, and before the Clinton health care plan her family
couldn't even afford the most basic health care.
They moved from town to town following the crops and rarely
had access to a community health center.
They didn't get checkups, and there was no record of which
c h i l d got immunized, and when.
After health care reform, the Diaz family became part of a
health alliance that provided them with comprehensive coverage, a
choice of health plans, and helpful information about each plan.
They were happy t o be able to E l i tor quality health care —
they simply had never had the option before.
As a result of health care reform, Carmen's mother began
taking n u t r i t i o n a l supplements when her doctor told her about
osteoporosis.
Her father received some sound preventive advice about d i e t
and exercise, to control his high blood pressure.
The whole Diaz family v i s i t e d c l i n i c s across the sunbelt —
wherever they worked — for regular checkups.
1
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ID 94567739
Carmen grew up healthy.
P009/914
She was able to earn A's in school,
and gain admission into George Washington's prestigious graduate
program in health services management and policy.
Good health liberated her to learn and grow and reach her
potential.
That's a great vision —
and in 30 years, I expect to be
able to look back with pride at our reform effort as a landmark
piece of social legislation.
An achievement that ranks with the
New Deal and Social Security in renewing the American Dream.
Here's how we're going to get there:
We're going to create a uniquely American system by taking
the best ideas from many approaches —
and keeping health care
firmly rooted in the private sector.
Our plan will require states to organize health alliances,
massing the purchasing power of hundreds of thousands of state
residents.
Most of these consumers will be employees in small and
medium-sized buninecses —
the kinds of businesses t h a t
struggle to strike affordable deals on health insurance.
now
�07-09-93 12:05PM FROlLOASPsiBilLUt/
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\T0j45^12ii
The state health alliances will reverse the dynamic between
\
businesses and insurance companies.
Instead of businesses
pleading for good rates and coverage, insurance companies will be
competing with one another to win contracts.
They'll have to provide a comprehensive package of benefits
at a reasonable cost.
These alliances will offer consumers a menu of affordable
health plans from insurers and providers —
including fee-for-
service.
lyy 0
There's another c r i t i c a l piece to our plan:
The federal
V\ government will set an overall budget for health care — but the
^ <J\7
states wil1
decide where and how to spend that money.
Me won't play a heavy regulatory role.
Me won't t e l l the
state of New York, or the state of North Dakota how to organize
their alliances.
We want to give states flexibility, not rigid
federal rules and micromanagement.
We're s t i l l working on the financing — but the premise i s
that employers and workers will snare the cost of coverage. A l l
Americans will contribute throughout their working lives, and a l l
Americans will get security.
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8
Now I ' l l t e l l you a l i t t l e about the kinds of benefits you
can expect.
We're s t i l l working on the numbers, but we're guided
by well-defined principles.
Health coverage w i l l be comprehensive, and you'll always
have choice of doctor and plan.
The emphasis w i l l be on primary and preventive care.
Your insurance w i l l be portable^-- so you can take i t w i t h j ^ *
you no matter where you travel —
or i f you move.
I t w i l l be continuous, so you'll be covered i f you lose your
j^b, or i f your spouse loses her job — qo matter what.
^
^ ^\
Most of a l l , your coverage w i l l he r e l i a b l e .
You'll have
^he security of knowing i t ' s there when you need i t .
Now, I'd l i k e to talk about how health care reform w i l l
affect two of our traditional constituencies at the Department of
Health and Human Services — the poor and the elderly.
H i s t o r i c a l l y , Medicare and Social Security have dramatically
improved the l i v e s of our elderly, reducing poverty rates
significantly.
But as you know, many of our elderly are s t i l l
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1
9
very near poverty, or even below the poverty l i n e — especially
women l i v i n g alone.
In the short term, we're not planning on folding Medicare
into the system.
' i^A
\Jb\
That would be too disruptive.
But we are looking clooely at covering prescription drugs
and long-term care — which are not covered under Medicare.
Looking at the issue of long-term care i s c r i t i c a l .
We
haven't made tho decisions yet, but we think there are
s i g n i f i c a n t savings to be found in long-term care alternatives.
Alternatives l i k e home- and community-based care, instead of
costly extended stays in hospitals and nursing homes.
As for the poor, many of whom get government assistance,
we're examining ways to fold Medicaid into the new system.
This
w i l l take some time — and we'll have to continue to provide
additional support, such as transportation to public c l i n i c s .
The Americans who are going to benefit most from health care
reform are the working poor.
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10
Families l i k e the f i c t i o n a l Carmen Diaz's —
who work hard
in low-wage jobs that either do not provide insurance or provide
i t at a cost that i s out of reach.
For years, many of these working Americans have gone without
health insurance —
Medicaid.
while we covered the non-working poor through
That's one of the great inequalities we're seeking to
remedy.
In fact, by making sure that everyone who works get
coverage, we w i l l wipe out one of the obstacles that keeps people
on welfare.
Right now,
there are many Americans who want to get off
welfare but feel they can't because they desperately need their
Medicaid benefits.
When welfare recipients are no longer held hostage to
Medicaid, we'll see our workforce expand, and our welfare r o l l s
shrink.
I can imagine that i f a young student l i k e Carmen Diaz were
doing research on the 1990s, she might review some videotapes of
today's T.V. news shows.
�07-09-93 12:05PM FROM OASPA NEWS DIV
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11
And she might see talking heads pontificating that the
health care c r i s i s i s too big a beast to be tamed,
interest groups are too powerful —
But i t i s pot impossible.
saying that
that reform i s impossible.
We can take on the special
interests who are fighting for the status quo and win progress
for the American people.
We have everything i t takes to make reform happen:
We have recognized that there i s a c r i s i s .
We have a consensus that we need an immediate solution.
And we have strong leaders in the Clinton Administration
w i l l i n g to face down the opposition to make health care security
a r e a l i t y for every American.
I'm not sure where I ' l l be in 30 years:
I might be playing on the senior golf tour, I might be
hosting Meet the Press —
but wherever I am, I ' l l be proud of the
Clinton Administration's work designing and implementing a health
care system for a l l Americans.
Thank you.
�
Dublin Core
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Title
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Health Care Task Force Records
Creator
An entity primarily responsible for making the resource
White House Health Care Task Force
Is Part Of
A related resource in which the described resource is physically or logically included.
<a href="https://catalog.archives.gov/id/10443060" target="_blank">National Archives Catalog Description</a>
Description
An account of the resource
<p>This collection contains records on President Clinton’s efforts to overhaul the health care system in the United States. In 1993 he appointed First Lady Hillary Rodham Clinton to be the head of the Health Care Task Force (HCTF). She traveled across the country holding hearings, conferred with Senators and Representatives, and sought advice from sources outside the government in an attempt to repair the health care system in the United States. However, the administration’s health care plan, introduced to Congress as the Health Security Act, failed to pass in 1994.</p>
<p>Due to the vast amount of records from the Health Care Task Force the collection has been divided into segments. Segments will be made available as they are digitized.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+1"><strong>Segment One</strong></a><br /> This collection consists of Ira Magaziner’s Health Care Task Force files including: correspondence, reports, news clippings, press releases, and publications. Ira Magaziner a Senior Advisor to President Clinton for Policy Development was heavily involved in health care reform. Magaziner assisted the Task Force by coordinating health care policy development through numerous working groups. Magaziner and the First Lady were the President’s primary advisors on health care. The Health Care Task Force eventually produced the administration’s health care plan, introduced to Congress as the Health Security Act. This bill failed to pass in 1994.<br /> Contains 1065 files from 109 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+2"><strong>Segment Two</strong></a><br /> This segment consists of records describing the efforts of First Lady Hillary Rodham Clinton to get health care reform through Congress. This collection consists of correspondence, newspaper and magazine articles, memos, papers, and reports. A significant feature of the records are letters from constituents describing their feelings about health care reform and disastrous financial situations they found themselves in as the result of inadequate or inappropriate health insurance coverage. The collection also contains records created by Robert Boorstin, Roger Goldblatt, Steven Edelstein, Christine Heenan, Lynn Margherio, Simone Rueschemeyer, Meeghan Prunty, Marjorie Tarmey, and others.<br /> Contains 697 files from 47 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+3"><strong>Segment Three</strong></a><br /> The majority of the records in this collection consist of reports, polls, and surveys concerning nearly all aspects of health care; many letters from the public, medical professionals and organizations, and legislators to the Task Force concerning its mission; as well as the telephone message logs of the Task Force.<br /> Contains 592 files from 44 boxes.</p>
<p><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+4"><strong>Segment Four</strong></a><br /> This collection consists of records describing the efforts of the Clinton Administration to pass the Health Security Act, which would have reformed the health care system of the United States. This collection contains memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, newspaper articles, and faxes. The collection contains lists of experts from the field of medicine willing to testify to the viability of the Health Security Act. Much of the remaining material duplicates records from the previous segments.<br /> Contains 590 files from 52 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+5">Segment Five</a></strong><br /> This collection of the Health Care Task Force records consists of materials from the files of Robert Boorstin, Alice Dunscomb, Richard Veloz and Walter Zelman. The files contain memoranda, correspondence, handwritten notes, reports, charts, graphs, bills, drafts, booklets, pamphlets, lists, press releases, schedules, statements, surveys, newspaper articles, and faxes. Much of the material in this segment duplicates records from the previous segments.<br /> Contains 435 files from 47 boxes.</p>
<p><strong><a href="http://clinton.presidentiallibraries.us/items/browse?advanced%5B0%5D%5Belement_id%5D=43&advanced%5B0%5D%5Btype%5D=is+exactly&advanced%5B0%5D%5Bterms%5D=2006-0885-F+Segment+6">Segment Six</a></strong><br /> This collection consists of the files of the Health Care Task Force, focusing on material from Jack Lew and Lynn Margherio. Lew’s records reflect a preoccupation with figures, statistics, and calculations of all sorts. Graphs and charts abound on the effect reform of the health care system would have on the federal budget. Margherio, a Senior Policy Analyst on the Domestic Policy Council, has documents such as: memoranda, notes, summaries, and articles on individuals (largely doctors) deemed to be experts on the Health Security Act of 1993 qualified to travel across the country and speak to groups in glowing terms about the groundbreaking initiative put forward by President Clinton in his first year in the White House. <br /> Contains 804 files from 40 boxes.</p>
Publisher
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William J. Clinton Presidential Library & Museum
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2006-0885-F
Text
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Paper
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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[Secretary Shalala’s Comments] [Loose]
Creator
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Task Force on National Health Care
White House Health Care Task Force
Walter Zelman
Identifier
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2006-0885-F Segment 2
Is Part Of
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Box 46
<a href="http://clintonlibrary.gov/assets/Documents/Finding-Aids/2006/2006-0885-F-2.pdf" target="_blank">Collection Finding Aid</a>
<a href="https://catalog.archives.gov/id/12093090" target="_blank">National Archives Catalog Description</a>
Provenance
A statement of any changes in ownership and custody of the resource since its creation that are significant for its authenticity, integrity, and interpretation. The statement may include a description of any changes successive custodians made to the resource.
Clinton Presidential Records: White House Staff and Office Files
Publisher
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William J. Clinton Presidential Library & Museum
Format
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Adobe Acrobat Document
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Preservation-Reproduction-Reference
Date Created
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2/6/2015
Source
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42-t-12093090-20060885F-Seg2-046-013-2015
12093090