A call for action: excerpts from the president's speech CLINTON'S HEALTH PLAN

September 23, 1993

Excerpts from President Clinton's address on health care to a joint session of Congress, as recorded by the Associated Press:

Tonight I want to talk to you about the most critical thing we can do to build that security. This health care system of ours is badly broken, and it is time to fix it.

Despite the dedication of literally millions of talented health care professionals, our health care is too uncertain and too expensive, too bureaucratic and too wasteful.

It has too much fraud and too much greed. At long last, after decades of false starts, we must make this our most urgent priority, giving every American health security -- health care that can never be taken away, health care that is always there. That is what we must do tonight.

I want to talk to you about the principles that I believe must embody our efforts to reform [the] American health care system: security, simplicity, savings, choice, quality and responsibility. . . .

We have to preserve and strengthen what is right with the health care system, but we have got to fix what is wrong with it.

Now, we all know what's right. We're blessed with the best health care professionals on Earth, the finest health care institutions, the best medical research, the most sophisticated technology. My mother is a nurse. I grew up around hospitals. Doctors and nurses were the first professional people I ever knew or learned to look up to. They are what is right with this health care system.

But we also know that we can no longer afford to continue to ignore what is wrong. Millions of Americans are just a pink slip away from losing their health insurance, and one serious illness away from losing all their savings. Millions more are locked into the jobs they have now just because they or someone in their family has once been sick and they have what is called a pre-existing condition.

And on any given day, over 37 million Americans, most of them working people and their little children, have no health insurance at all. And in spite of all this, our medical bills are growing at over twice the rate of inflation and the United States spends over a third more of its income on health care than any other nation on Earth, and the gap is growing, causing many of our companies in global competition severe disadvantage.

Quality and cost

We want to give groups of consumers and small businesses the same bargaining clout that the biggest corporations now have. We will force plans to compete on the basis of price and quality, rather than making money by turning away people who are sick, or performing unnecessary procedures. And we will back the system up with limits on how much plans can raise their premiums. We will create what has been missing for too long: a combination of private market forces and sound policy to support that competition.

We propose to give every American a choice among high-quality plans. You can stay with your current doctor, join a network of doctors and hospitals or join a Health Maintenance Organization. If you don't like your plan, every year you'll have the chance to choose a new one. . . .

In recent years the number of administrators in our hospitals has grown by four times the rate that the number of doctors has grown. A hospital ought to be a house of healing, not a monument to paperwork and bureaucracy. . . .

Reform must produce savings in this health care system. It has to. We are spending over 14 percent of our income on health care. Canada's is at 10. Nobody else is over nine. We're competing with all these people for the future.

Coverage for all

The second thing I want to say is that unless everybody is covered and this is a very important thing unless everybody is covered, we will never be able to fully put the brakes on health care inflation. Why is that? Because when people don't have any health insurance, they still get health care. . . .

Freeing the health care providers from costly and unnecessary paperwork and administrative decisions will save tens of billions of dollars.

We spend twice as much as any other major country does on paperwork. We spend at least a dime on the dollar more than any other major country.

We also have to crack down on fraud and abuse in the system. That drains millions of dollars a year. It is a very large figure according to every health care expert I've ever spoken with.

So I believe we can achieve large savings and that large savings can be used to cover the unemployed uninsured and will be used for people who realize those savings in the private sector to increase their ability to invest and grow, to hire new workers or to give their workers pay raises, many of them for the first time in years. . . .

We propose to give every American a choice among high-quality plans. You can stay with your current doctor, join a network of doctors and hospitals, or join a health maintenance organization. If you don't like your plan, every year you'll have the chance to choose a new one. The choice will be left to the American citizen, the worker, not the boss and certainly not some government bureaucrat.

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