[THE FOLLOWING IS THE HEALTH-CARE PORTION OF A WIDE-RANGING SPEECH GIVEN TO THE DEMOCRATIC LEADERSHIP COUNCIL BY PRESIDENT CLINTON. ELIPSES ... INDICATE OMITTED PORTIONS. FOR THE COMPLETE TEXT, CHECK THE USENET NEWSGROUP 'ALT.POLITICS.CLINTON' -- Steve Freedkin, LIST.HEALTHPLAN Manager -- *not* a government official] THE WHITE HOUSE Office of the Press Secretary _____________________________________________________________________ For Immediate Release December 3, 1993 REMARKS BY THE PRESIDENT TO THE ANNUAL CONFERENCE OF THE DEMOCRATIC LEADERSHIP COUNCIL The Sheraton Washington Washington, DC 10:31 P.M. EST THE PRESIDENT: Thank you very much. Thank you very much, Senator Burrough and, ladies and gentlemen, thank you for that warm welcome. It's wonderful to be back here. [...] Now, next year we have a lot of challenges ahead of us: health care, welfare reform, re-doing the system of education and job training and unemployment, to mention the three biggest, perhaps. And I would like to say just a word about each of them in terms of the ideas of the DLC. First, we have to provide our workers and businesses the security they need to know that they will not be bankrupted by an illness or paralyzed by the constant fear of the loss of coverage. Almost nobody in America today really knows for sure that they will never lose their health care coverage -- for sure, no matter what happens to them or what happens to their business. I want you to know what this budget really looks like, and the only reason the deficit is a continuing problem. I wish I had a graph here. If I had a graph here and this were zero on spending -- this is zero, zero increases. Here is where defense is going: down. Domestic spending: flat. That means every time we put more money into Head Start we have cut that much money somewhere else. Interest on the debt is going up some because even though interest rates are low, the corpus of the debt is getting bigger. Then our revenues are going up like this, about eight percent next year, retirement going up because the cost of living that everybody gets who is on Social Security or any kind of retirement. But the big numbers are Medicare, 11 percent, one year. This is at three-and-a-half percent inflation max, right? One percent growth in the Medicare rolls, two percent growth in the Medicaid rolls. Medicare going up 11 percent, Medicaid going up 16 percent. That is it. At a time when the most conservative Republicans in the Congress would say we should be spending more on new high-technology ventures and in defense conversion and in trying to help us adjust from a defense to a domestic economy, that's what we're spending our money on. And I talked to executive after executive facing the same thing. But there is good news. The federal health insurance program, which is big and has bargaining power, has actually had many of its policies lower this year than they were last year. The State of California, which is in terrible financial shape, so everybody knows they don't have a lot of money and which has huge bargaining power, has negotiated a cost increase in its premiums less than the rate of inflation. So what do we have to do with health care, again, to avoid the stale debate of right and left. One side says, well, the President's system is just going to cure itself and another is saying that the government ought to take it over and operate it. What can we do? If you go back to what you wrote and mandate for change -- when Jeremy Rosner was back in domestic policy instead of foreign policy -- you say we should be able to change the rules of the private health care market to produce universal coverage and lower cost, better quality care. I agree with that. We have to offer the American people a new choice that is guaranteed private insurance. I think there have to be two changes in the existing system. First of all, you have to provide health insurance that you can never lose, whether you are in or out of work, and no matter what kind of job you are in, because a lot of people are going to go from big companies that have big benefits to smaller companies in the inevitable restructuring of the economy. And you have to give greater consumer power, market power, to small businesses and to self-employed people. And in order to do it you have to go to a broad-based community rating scheme, in my judgment, so that there is no disincentive for little companies to hire people who have had somebody in their family who has been sick, who has had a pre-existing condition. Now, every other country in the world with which we compete, including those that are doing quite well, has figured out how to do this. We're the only people who haven't figured out how to do it. I just refuse to believe that we can't figure out how to give health care security to everybody in this country and to give equal bargaining power, market power, in the marketplace to small businesses and self-employed people. I just refuse to believe that, I think we can. (Applause.) We can disagree about a lot of things, but I think everybody would admit we ought to have a system in which there is a good comprehensive benefit package, including primary and preventive care that is given to every family. And that people have to assume some personal responsibility for it and ought to be prepared to pay something for it, but that we ought to do that. If we don't, you're going to continue to see your federal government faced with insolvency. We're going to continue to have to cut all of our spending from domestic investments, many of which 80 percent of the people in this room think we ought to be making. We're going to continue to see massive cost shifting from the government to the private sector and within the private sector from some companies to others, and often the companies with the most generous health care benefits are the ones that are the most vulnerable in global competition. This is a nutty system, and we have to fix it. And we have to fix it without messing up what is wonderful about it -- the quality of care, the availability of emerging technologies. The things that people do today in this health care system that are very good -- we can fix what's wrong without messing that up. And there are a lot of options we can pursue to get there, but I would just urge you to stick with what was in the mandate for change. Do not give up on universal coverage. And do not give up on the proposition that there has to be a competitive capacity for employers, including small businesses and the self-employed. If you will stay with that, then we can reach an agreement next year which will be the most historic domestic achievement for this country in a generation. And we have to do that. (Applause.) [...] Thank you very much, and God bless you. (Applause.) END 11:18 p.m.