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THE WHITE HOUSE
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Office of the Press Secretary
For Internal Use Only
May 2, 1994
INTERVIEWS OF THE FIRST LADY
. SATELLITE MEDIA TOUR
BY' INTERVIEWER:
J
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, Q: Mrs. Clinton, to listen to the health care
debate, it is apparent that one of the keys to your health
care program is the concept of employer mandates, where
employer~ will have to pay a certain percentage of all
workers'\health care coverage.
I think your plan calls for
80 pe!rcent. This seems to be one of the most contentious
issues.
If ,(he Congress were to pass health care without
employer manJ~tesl but with a health plan with the burden on
employees that calls for new taxes, would the President sign
that plan into law?
MRS. CLINTON: Well, Jim, we will have to wait and
see what the Congress does.
But you put your finger on one
of the main issues, because we believe that the best thing to
do is what is now done .. Most of us who are insured are
insured at the workplace. The employer and the employee
share the responsibility, and we think that's the way it
should be.
But the Congress is going to look at all of the
different options and try to come up what it thinks is the
best plan. And we're going to wait and see what they come up
with.
But it's very important that everybody have
responsibility, and we think the best way to do that is what
already works for most of us.
Q:
It seems that the White House is now finally
being able to focus attention on health care again. But for
months it seemed to be blocked by the fog of the Whitewater
controversy.
I have to ask you, how much responsibility do
you personally accept for Whitewater and the diversion of the
public's attention from your husband's legislative agenda?
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MRS. CLINTON: Well, I don't think there ever has
been any real diversion.
You know, all during .those months,
work went on.
I traveled allover the country.
The
President traveled.
We had enumerable meetings with both the
Congress and groups from around the country.
We would not be
where we are today if we had been diverted.
So looking at it from my perspective, what I'm very
pleased about is that for the last year and several months
now, we have worked steadily on health care reform, have not
been diverted, and have continued to try to work with the
Congress and concerned people allover the country about how
we are going to, solve this problem.
And I have to say that one of the people we have
worked very closely with from the very beginning is your
Senator, Senator Wofford.
He has been extremely helpful and
has been continuing to sound the alarm about the need for
health care reform.
Q:
Mrs. clinton, even a year andta half .into your
husband's administration, or almost, his biggest problem
seems to be the same problem that dogged him during the
campaign:
that the electorate just can't bring itself to
trust him as much as it wants to trust its Presidents. What
is it about your husband or about the American people that
makes such a persistent problem for you?
MRS. CLINTON: Well, again, I don't see that as a
problem.
I see 'a President who's accomplished so much in the
last 15 months. This includes the first responsible budget
that is actually bringing the deficit down for the first time
in years, a budget which I think has helped to spur economic
activity and the creation of many, many new jobs allover the
country.
Very important legislation, like national service
and a new student loan program so that working kids and their
families can afford college, or something like the Family and
Medical Leave Act or the Motor-Voter Bill, which could never
get by the President before.
Or even something as important
as the Brady Bill, which this President had the guts to sign.
So I see a very tough president taking on very tough issues
against very tough odds.
And, you know, when you address tough problems,
you're going to be controversial, because let's face it, Jim,
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there are a lot of people in this country who like things the
way they've been. They are able to profit from the existing
system. So they have a lot of interest in being opposed to
the President.
But what I'm excited about is, despite the
opposition, look at the record of accomplishment.
I think
most Americans are working more and actually feeling better
about where we are in our country today because of the
changes that he's brought to Washington.
Q:
I know that important people in the public
sector seem to acknowledge polls only when they are working
in their favor.
But all the data that pollsters are getting,
and I'm sure you know this data much better than I do,
suggests that if your husband has a problem with the American
people, it is a problem of trust. And clearly you are as
aware of that as anyone in government, with the possible
exception of your husband.
I'm just curious to know, what is it about the
dynamic between your husband and the American electorate, or
the significant portion of the American electorate that has
this problem, that seems to create this as a persistent,
nagging issue in your husband's administration?
MRS. CLINTON: Well, I just don't see things that
way.
What I see is a President who's taking on tough issues,
.and a lot of controversy is attached to taking on tough
issues.
You know, there were a lot of very powerful people
who make a lot of money who were not pleased that the
President began to put some fairness back into the tax
system.
And for a year, they said, "You know, President
Clinton is going to tax you," and tried to scare people. And
maybe that's what you're talking about.
People said, well -
he said he wasn't. Well, 10 and behold, along came April 15,
the day we all dread, and only 1.2 percent of the richest of
Americans saw their taxes go up. All the rest of America saw
their taxes either stay the same or go down.
NOW, we can't help it if there's a well-organized
opposition that spends a lot.of money and says outrageous
things on radio and TV and in direct-mail campaigns that
raises doubts in people.
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But, you know, my husband and I believe that the
truth eventually wins out. And we trust the American people.
And once they know the truth, as they learned when they paid
their taxes, they will know that they have a president who is
fighting for them against great odds. That's what's
important.
You know, all the talk and all of the rhetoric that
goes on doesn't amount to very much. What really counts is
who's standing up for the American people and who is getting
things done. And I think the record's very clear that it's
this President.
Q:
Mrs. Clinton, thank you very much.
MRS. CLINTON:
Thank you very much, Jim.
Q: Appreciate talking to you.
MRS. CLINTON:
Glad to talk to you.
BY INTERVIEWER:
Q:
Mrs. Clinton, thanks for joining us. Today the
governor of New Jersey, Christine Todd Whitman, one of the
new political stars of this area, called your health plan a
"prescription for disaster. II You know why?
MRS. CLINTON:
NO, I don't.
I haven't heard that.
Q: Well, she said that, number one, price controls
won't work, and 'number two, that the medical community is
being excluded,from your operation.
MRS. CLINTON: Well, neither of those are true, and
let me respond.
First of all, as to the medical community,
this plan has been endorsed by the organizations that
represent the majority of American physicians. We have
support from the internists and the obstetricians,
gynecologists, and the family physicians, and the general
surgeons.
And we have support from a number of other groups
that have hundreds of thousands of doctors in their
membership. We also, on a number of key points, have support
from the American Medical Association.
Doctors were involved
every step of the way in shaping this plan, and have been
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involved in consultations, both with the administration and
the Congress for more than a year.
So I'm afraid that she's
just misinformed, because I want her to know that.
Q: What about price control?
control issue that she mentioned?
What about the price
MRS. CLINTON: Well, I think that's an interesting
argument because we don't have price controls in the plan the
President has proposed. What the President has proposed is
that you need a budget and that decisions about medical care
should be made within that budget. And I think Governor
Whitman has advocated a very tough budget in New Jersey
because she knows you can't make tough decisions if you don't
have a budget.
We think you ought to have a budget when you're
talking about what you're going to spend on health care.
In fact, we want 'to get away from price controls that many
states and some of the federal programs have tried to impose.
We don't think you should tell doctors and hospitals, "Here's
exactly what you can charge." We think that is self
defeating.
What we do believe is, we ought to say, "We have an
enormous amount of money that we are spending on health care
in America. Let's spend it more efficiently." I think
that's good budgeting. And I think most governors who've had
to deal with tough budgets would agree that when you've got
Medicaid costs and other health care costs driving your
budget, isn't it time we made some sensible decisions about
how we're going to allocate resources so that we can actually
cover more people more cost-effectively?
Q:
I'll tell you what I hear the most from people
throughout our Delaware Valley community. They're very
concerned that in a very serious situation, a triage-type of
environment would develop, and perhaps they wouldn't get the
care they need for emergency surgery.
MRS. CLINTON: Yes, and I know, Larry, that is part
of the concern, and I understand that.
It's also been part
of the scare tactics that people have tried to inject into
this debate. The same kinds of things that were said against
Medicare, for example, when it was being proposed. But
actually, the opposite is true.
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Right now in the Delaware Valley, you have many
people who are denied health care or unable to afford all the
health care they want.
Usually what happens is that when
they need emergency care, the triage care that you're talking
about, they end up getting it, but often later than they
should. And then the rest of us pay for it, if either they
are uninsured or not fully insured.
Q: Are you telling me that you can assure me that
if I needed open-heart surgery, I wouldn't have to wait two
weeks for it if people were in line?
MRS. CLINTON: Absolutely.
In fact, in
Pennsylvania you know better than most states that we spend
more money on open-heart surgery than any other country in
the world, and we don't take care of all the people who need
it because we have a huge difference in hospitals, just in
pennsylvania, as to what it costs for open-heart surgery.
I've been very impressed with what Pennsylvania has
done to actually get the facts out.
In Pennsylvania, you can
have an open-heart surgery performed for anything from
$20,000 to $80,000. There is no evidence that the higher
price surgery is better for the patient than the lower price
surgery.
So in fact, if you had a budget and you had people
actually making better decisions about health care, you would
be able to provide more open-heart surgery at a reduced cost
to more people than we currently do under our current system.
But in addition to that, we would start paying for services
like nutritional counseling and stress reduction, which are a
whole lot cheaper than open-heart surgery, and actually, if
prepared correctly, can reverse heart disease.
But most insurance policies won't pay for that, but
they will pay for the open-heart surgery. We're advocating
more sensible, realistic expenditures so that more people -
not fewer, but more people -- get the services they really
need.
Q: One final question.
Do you think that you and
the President are out of the woods, image-wise, on this
Whitewater controversy?
MRS. CLINTON: Well, you know, I don't think in
those terms because I think the American people have always
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known that. the truth will come out. That's what the Special
Counsel is for.
And they're more interested in whether the
President and the Congress are solving their problems, not
rehashing old things that don't amount to much.
So what I hope will happen is that everybody pays
attention to issues like how we create more jobs, how we get
assault weapons out of the hands of teenagers~ how we reform
health care and the welfare system~
I think that's why
people sent the President to the White House.
Q:
Mrs. Clinton, thanks for joining us.
MRS. CLINTON:
Thank you.
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BY INTERVIEWER:
Q Mrs. Clinton, I'd like to begin by hearing your
response to having your personal life scrutinized. You were
criticized for not talking to the media sooner, and then when
you finally did, your talk was analyzed down to your pink
sweater. What's your response to that?
MRS. CLINTON: Oh, Julie, I'm just glad I did it.
And I'm glad that I had a chance to answer people's
questions, and I'm glad to be talking about health care and
getting assault weapons off the street and doing some things
that I think people in Oregon are a lot more interested in.
Q:
Do you think that put Whitewater to rest?
MRS. CLINTON:
I think that most people have not
been that interested in it, and that everyone is waiting for
the Special Counsel to issue his report, whenever that
happens, but .that's mostly, what I hear, and what people talk
to me about, is making sure that Washington tends to their
business.
And by that, they mean the issues they're
concerned about everyday.
Q What about criticism that you painted yourself
as a public servant and then your actions didn't seem to
represent that?
MRS. CLINTON: Well, I've always tried to do the
very best job I could to fulfill my obligations to my family
and to the public service that I believed in. And I think
any fair reading' of the work that I've done over my lifetime
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would support that.
Q Let's talk about health care reform.
Here in
Oregon, we of course have a health care reform plan underway.
Part of the problem, though, is that as the state runs out of
money, the number of people eligible has been cut.
So how
would that be different under a federal plan?
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MRS. CLINTON: Well, because under the President's
plan, everyone will be covered, not just people who are in
the Medicaid program or who are very poor but working. We
don't think that will ever work as well as it should,
although I'm very proud of what Oregon has done, because
you've taken the lead.
But everybody needs to have health
insurance.
Until everybody is covered, we cannot possibly
control the costs in the health care system. And if we do
not cover everyone, then we will continue to shift the costs,
either onto those of us who are privately insured, because,
you know, every time somebody is taken care of in a hospital
and they can't pay, you and I pay for it through our
insurance premiums or we pay through it for our taxes.
And either of those alternatives are quickly going
to run out of steam unless we get everybody covered. And
that's why the President's plan will actually make the Oregon
approach work more effectively, we believe.
Q But what happens if it just turns out to be a
big money loser and there's a huge drain on the system?
Where are you going to find that money?
MRS. CLINTON: That's just not going to happen.
The reason it's a money drain now is because you're trying to
take care of people who are within a certain income level and
you're trying to provide some services but not other
services. Meanwhile, the rest of the system, the privately
insured, the working uninsured, the Medicare recipients, they
are under no such efforts to try to control the costs in
their system.
So you can't possibly bring down health care costs
if you're only dealing with one element of the entire system.
If everybody is covered, Julie, you will have people who are
currently working, but uninsured, making a contribution. You
know, we, have nearly 40 million uninsured Americans who are
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not paying for their health care coverage.
more dollars that will go into the system.
That is billions
One of the great misconceptions about health care
reform is that somehow we're going to be putting less money
into the system in the short run.
Well, in fact, we're going
to be putting more money into the system.
But it's going to
be used more efficiently because we will be able to make
decisions about how to use our resources more effectively.
Q Most people are already experiencing efforts to
cut health care costs and they don't like it.
For example,
they have only one doctor that they can go to -
MRS. CLINTON:
That's right.
Q -- and a number of procedures that need to be
followed before they can have surgery or et cetera.
So they
don't like that. ,How would that be any different or even
worse under the government's plan?
MRS. CLINTON: Well, let me try to explain this,
because that's a very important question. Right now, people
are swimming upstream in their efforts to control costs,
because the whole system has no control. So an individual
employer is having to tell employees, "I'm sorry, you cannot
go to your doctor anymore." That's what health care reform
under the President's approach is going to reverse.
You see, if we do nothing, Julie, this situation
you've just described will only get worse.
More and more
people will lose their insurance. More and more of those of
us who are insured will be told who we can see and who we
can't see.
It is only under the President's plan that you
will be guaranteed choice. And it will be your choice, not
your employer's choice.
Every problem you just mentioned and every problem
that I hear is not a result of reform.
It is a result of the
system we have today.
And if we do not change that system,
it will only get' worse.
So actually the best way to solve our probl~ms, to
guarantee choicejto eliminate insurance abuses, to make sure
everybody's covered so that we can control quality and cost,
will be through reform.
And that's why it is so important.
Because if we do nothing, it's only going to get worse in
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Oregon and around the country.
Q How can you convince people that they're going
to get more than what they have now, even though they might
have to pay more? One Northwest legislator put it this way,
"I am not going to be able to go back and get support in my
district if people are convinced that they're going to have
to pay more for less than they have right now."
MRS. CLINTON:
But they're not going to. And if
people would study the President's plan, instead of listening
to people who have a vested interest in opposing it, they
would know that under the President's plan, if you are
insured today and you have what amounts to the average or
better insurance benefits in the country, you will pay the
same or less for those benefits.
I want to stress that.
We have set up the President's plan so that those
of us who are insured, who have been paying for the health
care system, we will be rewarded. And we will not pay more.
We will pay the 'same or less for those benefits.
Health care
reform is a big winner, both for the uninsured, who will get
the security of'insurance, but also for those of us who are
insured.
Because -- I don't know about you, but I've yet to
meet any American who has insurance today who can absolutely
be sure they will have the same insurance covering the same
services at the same cost next year.
You don't have that
security now.
Under health care reform, you will.
And
that's why it is so important we do it.
Q
Mrs, Clinton, thank you for talking to us.
MRS. CLINTON:
Thank you, Julie.
BY INTERVIEWER:
Q
Mr~.
Clinton?
MRS. CLINTON:
Q
Yes.
This is Ginger Casey from Providence, Rhode
Island.
MRS. CLINTON:
remember meeting you.
Well, Ginger, how are you?
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Q oh, ~hat's wonderful.
(phonetic) friend.
MRS. CLINTON:
I remember.
I'm Nancy Schneiderman's
I'm glad to talk to
you.
.us today.
Q Well you too, ma'am.
I'm so glad you could join
And I know you've been probably -
(Interruption to tape.)
MRS. CLINTON:
I can't hear her.
Q (Inaudible) over again, so I'll try to keep it a
little bit fresh for you.
MRS. CLINTON:
Great, thank you.
Q Ma'am, you and the President have been going
across the country pushing the health care reform package,
and yet recent polls seem to indicate that popularity for it
is slipping. Why?
MRS. CLINTON: Well, I think there is a disconnect
between what people call the President's plan and what's in
it. And what I have found, which is so interesting, is that
millions and millions of dollars have been spent by all kinds
of special interests against the President's plan. And, you
know, all kinds of horror stories and, you know, made-up
stories are being told.
So people are naturally concerned
about the plan.
But when you ask people what they want from health
care reform, what they want is what the president's plan has.
They want guaranteed private insurance where the government
doesn't run it and you don't have government doctors. You
have the same kind of health care we now have, but everybody
has private insurance.
They want an end to the insurance abuses where
people with preexisting conditions have to pay more or cannot
get insurance, and the end to lifetime limits so that when
you really need insurance, it will be there. They want
guaranteed choice of doctor and health plan. And right now
fewer than half of the Americans who are employed with
insurance have that.
Under the President's plan, they would.
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They want to make sure Medicare is preserved and
improved. And they want to get their health insurance at
their workplace. All of those are part of the President's
plan.
So when you -
Q You think that the public, though, could be
suffering from a little bit o£ information overload? It
seems that all of the special interest groups connected to
the health care industry have their own plans now and they're
pushing -- everybody it seems has their own agenda on this
issue.
How do people sift it all through?
MRS. CLINTON: Well, that's one of the reasons I'm
so glad to talk to you, because I know there's a'lot of
misinformation out there. There's all kinds of radio ads, TV
ads, direct-mail campaigns, just trying to scare people to
death, practically, and we want to get the truth out because
the President has no argument with anyone who thinks there's
a better way to make sure everybody is taken care of at an
affordable cost.
But we do have an argument with people who are
trying to scare folks and misinform them.
So we are going to
do the best we can to get the real story out. And once
people hear the real story, they like what the President is
proposing.
Q Well, public support aside, how can you take on
the most powerful special interest groups in this country,
groups that are actual financial survival for many
politicians? Won't lawmakers be more inclined to support the
groups that support them?
MRS. CLINTON:
Not if they hear from people. Not
if people pick up their phones or pick up their pens and
write letters, make calls to radio stations, to newspapers,
to their Congressman's office, and say, you know, "I want you
to represent me.
I don't want you to represent special
interest." You know, if it had been up to the special
interest, we never would have gotten Medicare. They fought
it tooth and nail.
But finally Americans said, "Enough. We want our
older Americans to be given the dignity of decent health
care." Well, now we want to take care of everybody under 65.
And they need to speak up on their own behalf, so that the
special interests don't have the last word, the people have
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the last word.
And I'm very confident that if people did
that/ it will work.
Q Aren't you concerned though, ma'am, that many
politicians would be apt to say, "Well, you don't know all
the details.
I've seen the plans and, actually, plan X is
much better than the President's plan for our constituents
here"?
MRS. CLINTON: Well, they can try to say that, but
a lot of those plan XS can't really be explained because they
don't meet the needs of people. And I really would like to
have members of Congress asked those questions by informed
consumers and voters.
So I don't worry about that at all.
What I worry about is that in the face of a very
well-organized campaign against real health care reform, too
many citizens will say, "What can I do?" You know, "I'm just
a housewife," or "I'm just a mother," or "I'm just a teacher;
I'm just a nurse; I'm just a businessman." And all of us
need to say health is the most important thing we have. We
need to speak out. That's what I want to see happen.
Q Were you prepared for the onslaught of people
who are against this plan? Were you prepared for the media
campaigns against it?
MRS. CLINTON: Yes, because that's been the
history.
If you go back to social security, Franklin
Roosevelt wanted to get health security and he couldn't
because of special interests.
Neither could Harry Truman.
And it took a very long time to get Medicare.
We've always known that was going to be a tough
battle, because you're right, there are many groups that are
making much, much in the way of profits from the way the
health care system works now.
They don't want change. They
never have wanted change. We wouldn't have social security.
We wouldn't have Medicare if we had let the special interests
have their way.
So let's not let them have their way.
Let's make sure we finish the job that Franklin
Roosevelt and Harry Truman started and give every American
the right to health care, which is what I think we should all
have.
Q
Mrs. Clinton, we are out of time, but I want to
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thank you so very much for coming on our program.
delightful to speak with you again.
MRS. CLINTON:
you again, Ginger.
Q
Thank you.
And it was
11m glad to speak with
Take care.
MRS.. CLINTON:
You too.
BY INTERVIEWER:
Q My first question for viewers here is, give us
some sense of where we are with regard to the plan that is
currently proposed, and when do you actually anticipate
seeing something on paper that Americans can live by?
MRS. CLINTON: That/s a good question, Ben.
I
think we/re making a lot of progress in the Congress, and I
would think we would have a plan within the next month or two
that would come out of the congressional process. There may
be several plans that actually emerge, and then the people
will have a chance to compare them.
But the major points of the President/s plan are
the ones that I want your viewers to really focus on, because
in poll after poll, when people are asked what they wantl
what they want is what the President is proposing. They want
private guaranteed insurance. They want an end to insurance
abuses, like preexisting conditions or lifetime limits,
blocking the way to people having decent, affordable
coverage.
They want guaranteed choice of doctor and health
plan, which only the President's plan will absolutely
guarantee.
They want to see Medicare improved with
prescription drugs and long-term care options besides nursing
homes. And they want a fair and affordable way to pay for
it. And most people really favor getting their insurance at
the workplace, where most of us get our insurance, with the
employer and the employee sharing the costs.
So those are the major features of the President/s
approach, and I think those are the major features that will
be in the plans that will be debated.
Q
When we talk about the "they," let us define
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"they," if you would, Mrs. Clinton.
I've seen various
statistics.
Roughly how many Americans are without
insurance?
MRS. CLINTON: Approximately 40 million are
uninsured. And the vast majority of those, over 80 percent,
are working Americans, or in the homes of working Americans.
Those are the people, Ben, who are behind the retail counter
or at the gas station or waiting on you in the restaurant,
who have no insurance, who get up every day and go to work,
pay taxes which provide health benefits to people on welfare.
Now, in addition to those 40 million, there are
another about 25 million who have some insurance, but often
terribly unavailable insurance, in the sense that maybe
they've got, like, a $5,000 deductible, so they really have
to be sick. Or they've got a very low lifetime limit, so if
they get cancer, God forbid, they don't have enough money to
take care of themselves without going into bankruptcy or
debt.
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So that's a total of 65 million. There are a
hundred million or so Americans who are insured through
private insurance.
But none of us who is insured can
absolutely be sure that we will have the same insurance at
the same price covering the same services this time next
year.
So really, when you get right down to it, not any
of us has absolute security except for older Americans who
are above the age of 65, who qualified for Medicare, which we
all pay for.
So what we're trying to do is to give Americans
under 65 the same security that Americans over 65 now have.
Q Mrs. Clinton, I only have two minutes, so there
are many questions I'd love to ask, but here is one that I
think is very important. There are concerns about abuses in
the system, especially when you're talking about fixed prices
for consumers.
And I guess, in one way of phrasing it, the concern
is that consumers may gobble up much more in the way of
services, since they are not price- and cost-sensitive to a
one-cost plan.
How do you guarantee that there will not
abuses on the part of those who are being served?
MRS. CLINTON:
That's a good question, Ben, and in
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fact, under the President's approach, we will actually be
reducing such abuses, because what happens now is that when
providers, doctors and hospitals are paid by the test that
they prescribe or the diagnosis they make or the operation
they perform, there can a lot of abuse.
But instead, if the way that they are paid is on a
flat rate to 'try to keep people well, then they have an
incentive to try to do things that are cost effective. So,
for example, we will begin to pay for nutrition counseling to
try to help prevent or reverse heart disease, not just wait
until someone needs an expensive ·bypass operation.
There are many examples where, if we actually
provide preventive health care and we pay for it, we will
save all 6f us money in the long run.
So we actually will be
reducing the kinds of abuses that you rightly point out are
present in our system today.
Q Thank you, Mrs. Clinton.
11m told I donlt have
even time to squeeze in one more question so I appreciate it.
MRS. CLINTON:
Thank you, Ben.
BY INTERVIEWER:
Q . Mrs. Clinton, thank you for this opportunity out
of your busy schedule.
MRS. CLINTON:
Thank you, Meg.
Q Let me ask you very quickly before we talk about
specifics.
Your job, so to speak, right now is to convince
the American public to convince their representatives to vote
for the President's plan. Has that been made tougher in
light of all the Whitewater situation?
MRS. CLINTON: No, Meg, because, you know, health
care is such a big and important issue, and live never
-stopped working on it.
I have continued to travel around the
country and meet with groups and individual citizens and
members of Congress, because this is an issue that is really
a once-in-a-generation issue.
It's.like Medicare was when we
finally took care of older people, or social security.
I just hope that every American will pay attention
to this debate and really sort out all of the false
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information and the political attacks that are really being
driven by special interests that don't want any change from
what we're trying to do, which is to guarantee health
security to every American.
QForgive me for interrupting.
Let's sort out
some of those, as you say, possibly are myth. We know of
instances where managed care by insurance companies can be
detrimental to patient care.
I've had situations.
I know
people who.have had situations.
sometimes procedures are denied or rationed by a
nurse sitting in.a state eight states away to a person where
five doctors say you need this procedure. Are these alliance
boards going to be more of that, more of the same?
MRS. CLINTON: Absolutely not.
In fact, what we're
trying to do is stop that.
There should not be somebody
sitting eight states away telling your doctor what he can or
cannot do, but'that's exactly what's happening today.
In
fact, if we don't reform the system, that's what's going to
happen more and more until many of us are going to be denied
any choice at all, and our doctors are going to be denied
choice in the way that they treat us.
I really don't like what has been happening and the
way that you describe it. And reform is designed to prevent
that.
There isn't.·any such thing as an alliance board that's
going to be doing that.
In fact, really, a better term is -
-- the co-ops are going to be collecting the money, but the
health plans, the doctors, the nurses, the hospitals at the
local level, are going to be making the decisions. That's
where the decision should be made.
Somebody should not be sitting in· some other state
telling your doctor in New Orleans what he can or cannot do.
But if, we don't reform this system, that's exactly what
you're going to see more of.
Q Part of the equation is tort reform.
You and I
both pay every time there's a bogus lawsuit that is settled
out of court. That's going on a lot lately, and doctors
don't have the choice, as you say, to go into court.
Malpractice is killing doctors and we're all paying for it.
Experts tell me that tort reform is a minor part of
the President's plan. And doctors are upset because they
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weren't in on the making of the plan.
them, Mrs. Clinton?
How do you respond to
MRS. CLINTON: Well, doctors certainly were in on
the making of the plan. All the way through, we had doctors
involved, we consulted with many doctors. And the major
doctors' groups that represent hundreds of thousands of
doctors, like the family physicians, the internists, and the
pediatricians and the obstetricians, they are all supporting
the principles of the President's plan. And the AMA is
supporting a number of the principles.
So I think it's more accurate to say that doctors
have been involved.
Now, not every doctor likes everything
that's been proposed.
But, of course, you can't expect that
from anything.
But what I'm pleased about is that there is
malpractice reform in the President's plan.
And it is important malpractice reform that will
begin to protect doctors when they make difficult decisions,
and will require alternative dispute resolution, and will
tell plaintiffs and their lawyers they cannot get to court
unless there's some independent certification that they
deserve to be·there, and which will cap attorneys' fees.
So
there's real tort reform and that's very important.
Q And finally, Medicare and Medicaid. They are
still part of your plan.
Some' people say that's political
because, with the other 35 million people being insured, why
do we still need the financial burden of Medicaid and
Medicare?
MRS. CLINTON: Well, now, Medicaid is not going to
be in existence anymore.
It's going to be eliminated as a
separate program, which I think will save us money. That's
one of the ways we will save money. Medicare will continue
because it does take care of the persons over 65. And thank
goodness we have Medicare, because at least we are providing
guaranteed health coverage for older Americans.
So what we want to do is improve Medicare, and
that's going to be very important if we can add prescription
drugs and home health and other alternatives to nursing home
care. That will be much better and actually more cost
effective for people like my mother and older Americans.
Q
Again, thank you for the opportunity out of your
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busy schedule.
MRS. CLINTON:
Thank you, Meg.
BY INTERVIEWER:
us.
Q Mrs. Clinton, thank you very much for
We appreciate the time.
MRS. CLINTON:
joining
Thank you.
Q As you well know, health care reform in
Washington State is well underway. And in talking with some
people here, there is some concern that we, somehow, will end
up paying for it twice, that the people of Washington will
pay higher taxes for our health care reform package, and that
if and when a federal plan is passed, we in Washington will
be asked to pay again. What's to prevent this from
happening?
MRS. CLINTON: Well, there's not any tax increase
that's in the President's plan, other than on cigarettes and
tobacco products.
So there will not be any duplication,
except for those people. who use those products, which we
think is linked to health reasons, which is why we supported
that.
But there will not be any increase in taxes under the
President's approach.
Employers and employees, just as you
have done in Washington, will be paying for health care.
And we are very conscious of the remarkable
progress that you are making in Washington, and intend to
construct the federal framework in a way that washington and
other states, which have gotten out ahead of the rest of the
country, will have their efforts rewarded and not penalized.
That is something we intend to do and are working very
closely with your Senators and Representatives to make sure
we do it right.
Q WeIll how will that work? I mean, I think
there's a lot of confusion among people here who are
wondering I with our health care reform plan now in effect and
the process moving forward, when the federal plan is passed,
how will we be affected here?
MRS. CLINTON: Well, you know, part of the idea
behind the President's plan is to have a federal framework,
but for each state to decide how to implement it. So, in
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effect, what you have already passed would be the basis for
your implementation. And other states have taken different
approaches.
But Washington and its approach would fit,within
the federal framework.
, So what you've already done with requiring
employer-employee shared responsibility, that would fit right
in. There wouldn't have to be much of a change at all.
So I
really think that your being out ahead of everybody else will
not only guarantee a head start for the people of Washington,
but we will be very sensitive to making sure that we don't do
anything that upsets what you have already accomplished.
Q Well, with Washington State's process underway,
and other states now joining in as well and tackling this
issue as well themselves, what is the need for a federal
framework? And some people say that this is just going to
create another huge bureaucracy.
MRS. CLINTON: Oh, I just disagree.
We already
have one of the biggest bureaucracies in the world in the
private insurance market, and it charges all the rest of us
about a 20 or 25 percent premium on our insurance premiums.
We couldn't have designed a more bureaucratic and expensive
. system than the'one we currently have.
The reason why Washington and every state needs a
federal framework is that if only Washington in the Northwest
were to proceed as you have -- with your employer-employee
shared responsibility, for example -- then employers might
leave your state and go to a state where they have no
obligations whatsoever.
In a federal framework where every American is
guaranteed a benefits package, a worker in washington who
gets transferred to another state will know that he or she
will be guaranteed health coverage when they move to another
state.
So it is to the benefit of the entire nation that
there be some basic requirements for everybody to meet, but
then, within that federal framework, to make sure we let
states do what is right for them.
Because it's important that the people in
Washington know that, as much progress as you have made,
there are other states and other parts of the country who
haven't done anything.
We have states where more than 25
percent of the population is uninsured. That is a drag on
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21
the entire national system, that drives up Medicaid costs,
that drains Medicare, that raises insurance rates.
So it is to everyone's benefit that we have a
federal framework with state flexibility.
And that's what we
are trying to achieve.
Q Mrs. Clinton, what will your role be in these
coming months? will you be up on Capitol Hill lobbying
personally in congress?
MRS. CLINTON:
I'm going to do, Kathy, whatever I
can do, and whatever the President asks me to do, to try to
make sure we have health care reform this year.
I'm going to
continue traveling around the country and making speeches and
talking with people, because I just think it is so important.
You know, health care reform is right in so many
ways.
It's going to save us money economically as businesses
and individuals, as states and federal governments. And it's
the right thing to do.
So I'll just be in there pitching.
I
believe in this so much, and I want to be sure that every
American has the right to health care.
Q And we hope to talk to you again as the process
goes on, Mrs. Clinton. Thanks for taking the time to be with
us today.
MRS. CLINTON:
Thank you.
Kathy.
BY INTERVIEWER:
Q What I'd like to start with is, two of the
biggest concerns about the Health Care Reform Plan are, one,
that it would set up another huge bureaucracy, and two, the
cost of it. Let's talk about the bureaucracy, first of all.
Can you tell us how these regional insurance groups would
work and whether we should be worried about another
bureaucracy?
MRS. CLINTON: Well, actually, they're going to
replace a lot of the bureaucracy we already have.
You know,
you and II if we are insured, we pay for a really big
bureaucracy, mostly in the private insurance market and the
billing departments of hospitals and in the clerical help
that doctors have.
We pay for all of that, and we don't need
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it.
In fact, if we can use these alliances, which I
call purchasing co-ops or buyers' clubs, we will have very
few people, basically, just serving to funnel our money to
whomever we choose -
(End side 1, tape 1.)
MRS. CLINTON:
employees like my husband or your
members of Congress. Right now, your tax dollars help to pay
for 75 percent of our insurance. And the federal government
acts as kind of a buyers' club, or alliance. They go into
the marketplace, and they say to people, "If you want to sell
insurance or health plans to federal employees, come tell us
what they are and go ahead and sell them." And every year,
my husband and members of Congress get to make a choice.
There are very few people who actually have to run
that system. And that takes care of 9 million Americans. So
we see the same -- much leaner bureaucracy with far fewer
people and very many fewer regulations doing it, because
they're not going to be delivering health services. They're
merely going to be serving as a channel for information and
collection. And we think that will actually save all'of us
money in the long run.
Q Who's the middleman that we're cutting, though,
out in that system?
MRS. CLINTON: We are cutting out insurance
underwriters. We are cutting out a lot of insurance agents.
We are cutting out billing departments and clerical
employees, because if you think about how you buy insurance
now, you often have employers, who either go into the market
themselves and get advice for independent agents or insurance
companies, or if you have a big employer, they have their
whole benefits department.
You pay for all of those people~
Then you have insurance companies that have to tell
you what services you can buy and how much it wiil cost you
based on how old you are or whether you've ever been sick.
We eliminate all of that. Then you've got billing ,
departments and hospitals who have to go over the bills with
fine-toothed combs and respond to over 1500 different
insurance policies. We eliminate all of that.
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Then you've got people who work for your doctor who
have to call up insurance companies and argue with them to
decide whether or not something your doctor thinks should be
done is covered by the insurance policy. We eliminate all of
that.
So when you start going down the list, we eliminate
literally thousands and thousands of regulations and hours
that are spent in a bureaucracy that we don't need.
I'm more interested in who takes care of me, not in
who totes the bill up. And I don't think we need to have
that kind of bureaucracy at all.
And that's what we're
trying to get rid of.
Q The Oregon Health Care Plan, as you know,
rations types of services to the poor.
If we don't do that
on a national level, can we afford to pay for all those
services?
MRS. CLINTON: Yes.
You know, the Oregon plan was
a very important step in trying to make some tough decisions.
But as you point out, it only made those tough decisions with
respect to the poor.
And what we argue is that there is more
than enough money in the entire system for the rich and the
working and the middle class, the rich, the poor, all of us.
There's more than enough money to take care of our
health needs, but there is no incentive for the system to
squeeze out the unnecessary costs, like all of the
bureaucracy that I just mentioned to you.
And also the fact
that we pay for tests and procedures. We pay when people get
sick. We don't pay to keep them well.
We need to change the incentives in the system and
actually deliver care more cost effectively.
If we do that,
there is more than enough money to go around.
But if we
continue to try to only take ~are of services for the poor,
or only try to cut a cost here or there, we will not be able
to perform medical care in the quality way in the future that
we have come to take for granted in our country.
Q I only have a few more seconds with you, Mrs.
Clinton, but isn't the key right now getting the American
public on board so that they can then pressure their
congressmen to go along with the President's health care
plan? And how can you do that? How can you get Americans on
board when their concern is "It's going to all change anyway
before it comes up for a vote"?
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24
MRS. CLINTON: Well, Marsha, that's a real good
question that we ask every day here at the White House,
because we know that when people learn about the President's
approach, they like it.
They like the fact they will be guaranteed private
insurance, and we'd eliminate all of these insurance costs
and abuses, and we guarantee your choice of doctor and health
plan, and we would preserve and improve Medicare, and we
would provide health insurance at the workplace, which is
where most of us get it. Once people know that, they become
enthusiastic.
So my job, and the job of everybody working
for real health care reform, is to get the message out.
And then we hope people in Oregon and around the
country will pick up the phone and they'll call those radio
talk shows and they'll write that letter to the editor, and
they'll call their member of Congress. And we will achieve
real health care reform this year if people know what's at
stake and know the sensible way we're trying to get it done.
Q All right. Thank you very much, Mrs. Clinton,
for talking with us today.
I appreciate it.
MRS. CLINTON:
Thank you.
(End of tape.)
* * * * *
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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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Lissa Muscatine - Press Office
Creator
An entity primarily responsible for making the resource
First Lady's Office
Press Office
Lissa Muscatine
Date
A point or period of time associated with an event in the lifecycle of the resource
1993 - 1997
Is Part Of
A related resource in which the described resource is physically or logically included.
<a href="http://clinton.presidentiallibraries.us/items/show/36239" target="_blank">Collection Finding Aid</a>
<a href="http://catalog.archives.gov/id/7431941" target="_blank">National Archives Catalog Description</a>
Identifier
An unambiguous reference to the resource within a given context
2011-0415-S
Description
An account of the resource
<p>Lissa Muscatine first served in the Clinton Administration as a speechwriter. Within the First Lady’s Office, she served as Communications Director to the First Lady.</p>
<p>Lissa Muscatine’s records consist of materials from First Lady Hillary Clinton’s Press Office, highlighting topics such as health care, women’s rights, the Millennium Council, Hillary Clinton’s 2000 Senate campaign, and deal extensively with press interviews given by the First Lady; her domestic and foreign travel; and speeches and remarks, on a wide variety of topics, given by her before and during her time as First Lady. The records include interview transcripts, press releases, speeches and speech transcripts.</p>
Provenance
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Clinton Presidential Records: White House Staff and Office Files
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Clinton Presidential Library & Museum
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Adobe Acrobat Document
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1,324 folders in 27 boxes
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Paper
Dublin Core
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FLOTUS Press Office Interview Transcripts Volume III 02/02/94 - 05/31/94 [Binder]: [05/02/94 Satellite Media Tour]
Is Part Of
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Box 4
<a href="http://clintonlibrary.gov/assets/Documents/Finding-Aids/Systematic/2011-0415-S-Muscatine.pdf" target="_blank">Collection Finding Aid</a>
<a href="http://catalog.archives.gov/id/7431941" target="_blank">National Archives Catalog Description</a>
Creator
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First Lady's Office
Press Office
Lissa Muscatine
Identifier
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2011-0415-S
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
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Clinton Presidential Library & Museum
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11/26/2012
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2011-0415-S-flotus-press-office-interview-transcripts-volume-iii-02-02-94-05-31-94-binder-05-02-94-satellite-media-tour
7431941