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that as well. I ask the American people to con- NOTE: The President spoke at 10:53 a.m. on the tinue their steadfast support. I believe that they South Lawn at the White House, prior to his de- will. I am confident we will prevail. parture for , PA. In his remarks, he Thank you very much. referred to President Slobodan Milosevic of the Federal Republic of Yugoslavia (Serbia and Mon- tenegro).

Remarks on the Patients’ Bill of Rights in Philadelphia, April 9, 1999

Thank you, Joan, for making the trip up here new ideas for what we should be doing as a and for your very, very moving account of your people were coming out of the Governors’ man- experience. I want to thank all of you who have sions of the country. In the 1990’s, most of come here today: John Sweeney; and Congress- the new ideas and most of the innovations have men Brady, Borski, and Fattah; Congresswoman come out of the mayors’ offices. There’s not DeLauro; my good friend Congressman Dingell, a better mayor in America than , who flew up with me this morning; and Con- and I’m very proud of him. I also want you gressman Dave Bonior. to know that he has worried me to death on I’d like to thank the other Members of Con- a number of issues for Philadelphia—[laugh- gress who are here: Congressmen ter]—but none more than the Philadelphia Navy and Joe Hoeffel, from Pennsylvania; Congress- Yard. And I am so glad we got that worked men Donald Payne and Rob Andrews from New out, so that the city can be—[applause]—— Jersey; Congresswomen Carolyn Maloney, Caro- And you know, I’ve been working on this lyn McCarthy, Congressman Joe Crowley from Patients’ Bill of Rights for a long time. And New York; Congressman Ted Strickland from I’ve listened to all the Members of Congress Ohio. That’s a pretty impressive group, and we speak, to my good friend John Sweeney, to the had Congressman Pallone here a little earlier, mayor, and to Joan, and—did you watch the from New Jersey. I thank them all. Oscars? You know, where Benigni, that great I also want to thank Judy Lichtman from the Italian actor, says—the second time they called National Partnership for Women and Families; him up, he said, ‘‘This is a terrible mistake. Ron Pollack and Families USA; Fran Visco and I used up all my English!’’ [Laughter] They used the National Breast Cancer Coalition; Beverly up all my English! [Laughter] They have said Malone and the American Nurses Association. And there are 150 other provider, consumer, everything that needs to be said. and patient organizations, all of them working But I would like to make a couple of points, for the Patients’ Bill of Rights. I thank them to hammer home what this is about and why all. That’s very, very impressive. we’re here. First of all, we’re here in Philadel- I want to thank the local Pennsylvania leaders phia, as has been said, not only because it is who are here: Senator Schwartz; Senator Fumo; the home of the Constitution, the Declaration former Congresswoman Marjorie Margolies- of Independence, the Bill of Rights; it was also, Mezvinsky; Representative Bill DeWeese, the interestingly enough, the home of the very first Democratic House leader. And I think the city petition drive. Back in 1701, the citizens of council president is here, Anna Verna, and other Philadelphia launched what I think was the first members of the Philadelphia City Council. I successful petition drive in the New World, thank them all for coming. when they asserted and won the full and unfet- But I want to say a special word of congratu- tered right to practice whatever religion they lations to the mayor. This is the last year of chose. his term. You know, I was a Governor for a Philadelphia, thanks to Ben Franklin, was the dozen years, and I loved every day of it. And home of America’s first hospital, later America’s in the late 1970’s and early 1980’s, most of the first medical school and first nursing school, still

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one of the most important medical centers not came President. It was going to bankrupt the only in the but in the world. country. We should want all organizations, in- Now, this petition, as Rosa DeLauro said cluding health care organizations, run as effi- when she gave you the right address, is a little ciently as possible. But every organization that bit more modern. But we have to do it. And forgets its primary purpose is doomed to fail. I’d like to say why and what the larger stakes The primary purpose is not to deliver cheap are, and go back over this one more time. health care; the primary purpose is to deliver Why are we having to do this petition? I quality health care as inexpensively as possible. mean, this is a bill supported by over 70 percent Now, I wish we had somebody here rep- of the American people and by almost equal resenting the other side, standing here beside margins, in every research document, almost another microphone. Here’s what they would equal margins, by Republicans and Democrats say. They’d say, ‘‘Well, Mr. President, that’s very and independents. As a matter of fact, it is vir- compelling, and you got a nice applause line. tually the only issue that I have worked on in But the truth is, there are just hard decisions, the last 5 years where there is almost no dif- and you’ve got to decide whether you want to ference by party in levels of support, except bankrupt us or not, and this Patients’ Bill of in Washington, DC. Rights will bankrupt us.’’ So let me make a Now, why is that? That’s because the people countercase. who are against it, basically the large HMO’s, Here’s what we asked for in the bill. Number the insurers, have got the ear of the congres- one, the right to have a specialist when you sional majority, and they have a lot of political need it. That’s Joan’s story, right? She got the influence. And how Washington works, for good specialist, all right, after she lost her sight. I’ve or ill, is that—people say, ‘‘Well, who cares if sat with people who got the specialist after their there are a lot of people for it; this is not very loved one lost their life or when it was too high up on their scale. The economy’s doing late to do the medical procedure. Because the fine. Most people are all right. There aren’t way these things are organized—you heard John all that many stories like Joan’s. We’ll let this slide.’’ talk about his doctor friend who got fired— Now, that’s what’s going on here. We need if you’re down the chain in the review process this petition drive because unless there is a in one of these organizations, you just know clear, unambiguous signal from the people of one thing: You are never going to get in trouble the United States—not just that we want this, for saying no. not just that we need this, not just that we You know, put yourself in the position of a believe in this—the organized forces of the sta- young person working for an HMO; suppose tus quo will do nothing. They will say, ‘‘Oh, you’ve got a little kid; suppose you’re worried well, the President went to Philadelphia, and about your Christmas bonus; suppose you’ve got he brought all the Congress Members here. And to save your job. You will never get in trouble there were 100 Members of Congress around if you say no, because you say, ‘‘Well, they can the country, but they probably can’t break always appeal it to somebody else higher.’’ So through on the evening news tonight because delay is one of the biggest problems here— of Kosovo. That’s another excuse we’ll have to the right to see a specialist when you need it. let this thing slide.’’ The right to emergency room care, wherever You know, this is the kind of thing you can and whenever you need it. I know you find do when you’re not running for office anymore. this hard to believe if it’s never happened to You can be more frank with people. [Laughter] you, but Philadelphia’s a pretty big city, with I’m just telling you, that’s what’s going on. a lot of hospitals; if you get hurt on one side Now, I have talked about this until I am blue of Philadelphia, and the hospital that your HMO in the face. I have met with people like Joan, works with is on the other side, they can go and I have heard these stories. And I want you past three hospitals after you’ve been hit by to know that I feel a special responsibility to a car. That’s wrong. You know, that may not do this, because I don’t oppose all managed seem like a big deal unless that happens to care. I think managed care has done some good you, but that’s wrong. in this country. Health care costs were going The right to have your doctor level with you up at 3 times the rate of inflation when I be- and discuss all your treatment options.

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The right to a timely and independent appeals Now, today, the Republican leadership in the process. House is not even debating a comprehensive The right to hold your plan accountable if bill. In the Senate the leadership plan does not it causes you or a loved one harm. ensure access to specialists, does not prevent The right to know—this is a big deal—the the health care plans from forcing you to change right to know that you won’t be forced to switch doctors in mid-treatment, does not give you ade- doctors in the middle of a treatment, like a quate recourse if your health plan fails to pro- pregnancy or a chemotherapy treatment. That vide adequate care, and because it applies only may seem unbelievable, but a lot of employers, to self-insured plans, actually leaves more than particularly smaller employers—to be fair to 120 million patients without all these guarantees. them, they have to change their providers from Now, this is a clear choice. But again, I say, time to time. They’re always struggling to try this does not need to be a partisan issue. This to get affordable coverage. All we say is, ‘‘Okay, is not a partisan issue anywhere in America but nobody wants to stop you from changing your Washington, DC. I’ve heard tell that most doc- providers, but if one of your employees is 7 tors are Republicans, but the AMA is for this. months into a pregnancy, or another one is half- The Nurses Association is for this. The health way through a chemotherapy treatment, then care providers are for this. And I’m telling you, the provider, the new provider can’t force them a lot of us who have supported the idea of to change the people that are giving them the more efficient management of the health care health care.’’ It seems to me that this is basic system are for it. What is the purpose of the human decency. health care system? It is quality health care at Now, we have worked hard to do our part the least cost. and to try to honestly explore the contention Now, let me just ask you one last thing. Ev- of the opponents of this bill that this is going erybody says, anybody says, ‘‘Well, one of the to cost them too much money. We are the single things that worries me about the modern world largest buyer, the Federal Government, of pri- is that we’re going to leave people behind.’’ vate health insurance. Today—today—we are Well, I’ve been working for 6 years to stop completing the process of giving the 9 million that. You heard the mayor mention Chaka men, women, and children who receive their Fattah’s work with us to try to make sure all health benefits through the Federal Government of our kids can go to college. We changed the all the vital patient protections recommended law so that we wouldn’t leave anybody behind; by the Health Care Quality Commission. We’re everybody could afford to go to college. informing—listen to this—all 285 companies We talked about this part of Philadelphia who provide coverage for Federal employees being in the empowerment zone. We are now that if they want to do business with us, they’ve offering to Congress a new market initiative to got to add the last two of our protections. bring jobs to the poorest part of America by We’ve already imposed the rest of the re- giving people who invest in those areas the same quirements; now we’re saying you can’t make incentives we give them if they invest in some people switch doctors in the middle of treat- other country—to have the same incentive to ment, and you have to provide full disclosure invest in America and create jobs, to close the of what the plans cover, what incentives are job gap in America. offered to doctors, and how satisfied other pa- So we’ve got to close the education gap; we’ve tients have been with their care. got to close the job gap; we’ve got to close Now, here is the important point. This is the the technology gap. But this is closing the health answer to the opponents of our bill. A new care gap. Do you know what would happen to analysis by the Office of Personnel Manage- me this afternoon if I started having the symp- ment—Janice Lachance, the head of that office, toms Joan did? Do you have any idea what is here with me today—shows that providing would happen to me? Within 15 minutes, I’d all these protections—listen to this—all these be on a helicopter; within half an hour I’d be protections will cost less than $1 per person there. I would have whatever specialist was per month—less than $1 per person per month. needed, and I would get it. And when I’m gone I think that is worth it to stop the story that from the Presidency, because I’ll have a good Joan just told us, and the hundreds of stories pension, and if, God willing, I stay healthy, a around this country. decent income, the same thing would happen.

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Maybe it would take an hour longer. Not a for it; the system in Washington is resisting it; month longer. [Laughter] and the people still rule if they will make their Now, we can laugh about this, because some- voices heard loud enough. Stand up and be times it hurts too much to cry. But I am telling heard. you, the political reality is that the system be- Thank you. lieves it can resist the opinion and the desire of the American people. That is what this peti- NOTE: The President spoke at 1:57 p.m. in the tion drive is all about. Great Hall at Memorial Hall. In his remarks, he And don’t you think it won’t make a dif- referred to Joan Bleakly, a patient who was denied ference. This could be a good education for access to a specialist; John J. Sweeney, president, a lot of people all over America. They could AFL–CIO; Judith L. Lichtman, president, Na- teach people how to use the Internet for the tional Partnership for Women and Families; Ron- first time by putting their name on this petition. ald F. Pollack, vice president and executive direc- We ought to have schoolchildren doing it. We tor, Families USA; Frances M. Visco, president, ought to have civic clubs doing it. We ought National Breast Cancer Coalition; Beverly L. Ma- to have religious organizations doing it. People lone, president, American Nurses Association; ought to be accessing—this could be their first State Senators Allyson Y. Schwartz and Vincent experience on the Internet J. Fumo; State Representative H. William But the reason we are here, the true, honest- DeWeese, Democratic House leader; Anna C. to-goodness reason we’re here is that everybody Verna, president, Philadelphia City Council; knows we need to do it; we have now proved Mayor Edward G. Rendell of Philadelphia; and we can afford to do it; the whole country is actor-director Roberto Benigni.

Radio Remarks on the Philadelphia Shipyard April 9, 1999

Last week the U.S. Navy and Philadelphia labor, and Government will modernize the ship- signed several important agreements that are yard and train workers to produce state-of-the- good for the city, the Navy, and our Nation. art commercial ships. Congratulations to the I want to thank Mayor Rendell, the people of people of Philadelphia on an important new eco- the United States Navy, and others who were nomic venture. critical to this important achievement. These agreements, combined with the decision by the NOTE: The President’s remarks were recorded at Norwegian company Kvaerner to invest here, approximately 12:30 p.m. in the administrative of- will help transform Philadelphia’s huge and his- fices of Memorial Hall in Philadelphia, PA, for toric naval shipyard, generating thousands of later broadcast. In his remarks, he referred to high paying jobs, helping to revitalize America’s Mayor Edward G. Rendell of Philadelphia. These commercial shipbuilding industry. Working to- remarks were also made available on the White gether, this remarkable partnership of business, House Press Office Radio Actuality Line.

Statement on Signing the Sudbury, Assabet, and Concord Wild and Scenic River Act April 9, 1999

I have today signed into law H.R. 193, the of the Sudbury, Assabet, and Concord Rivers ‘‘Sudbury, Assabet, and Concord Wild and Sce- in as part of the National Wild nic River Act.’’ The Act will designate portions and Scenic Rivers System. I am pleased that

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