REMARKS OF THE FIRST LADY AT
THE UNIVERSITY OF COLORADO
 March 14, 1994

Thank you very much. It is a real pleasure to be
back in Colorado and to be back on this campus. I am
grateful for Congressman Scaggs being with us. He has been a
terrific supporter of the efforts and change in the last
year, and has supported the president on the efforts to
change our health care system. We're very grateful for that
leadership.

I'm delighted to be with your president and
chancellor. I want to thank Patrick and Steph and
(inaudible) for their introductions and for the work that
they've done to make this possible. I have to tell you, I've
done a lot of things in my life, but I have never, even in
front of a crowd of two, tried to sing anything a capella. I
thought that showed a lot of nerve and class.

You know, it's like anything else in life, if you
don't try it, you never know. You know, there was an old
saying in Arkansas that my husband used to love, which I
never really understood. But the older I get, the more sense
it makes, which says something about me probably more than
it, and that is you can't tell how far a frog will jump until
you punch it. There's a lot of frogs being punched these
days in Washington because we're trying to figure out how far
this country and how far this government can go to make good
on the promise of change in a new vision of America.

You know, when I was last here, we talked and there
was a huge crowd and a lot of support for the campaign that
my husband was waging because it was a campaign about the
future; what kind of country we were going to have, what kind
of people we were going to be. I took a lot of energy and
excitement and enthusiasm back with me because of the
conversations that I had along a rope line and in a private
meeting with some of your student leaders.

What I try to remember every day when we're doing
what we are working so hard to do for you and for us in
Washington are the faces of the people I have seen all over
this country. You know, it is really easy once you do get to
Washington to forget that politics and government should be
about you. It should be about your needs, about your
interests, and about your futures. If we are not planning
for what happens in the next generation, we sell you short
and we undermine the capacity of our country to be strong and
productive as we move towards the 21st century.

So I have kept these pictures, these snapshots,
this sort of mental video going all the time. I probably
have spent more time in the past year talking one on one and
in groups with people about what they hoped for for the
country, particularly what they hoped for with health care
than anything else.

I'm really here to make a report to you. What I
want you, particularly the students, but all the rest of us,
to know is what we're trying to do, where we are in the
process, and why it is important to you. This is not some
abstract policy debate. This should not be politics as
usual. This should be about one of the most important things
in any of our lives, our health and how we're going to be
sure that the finest health care system in the world, the one
we have now, the finest doctors, the finest nurses, the
finest hospitals, will be there for you in 10, and 20, and 50
years.

So that's what really motivated my husband when he
said let's take a look at what we can do better to provide
health care that is affordable and of high quality to every
American. What I want to do today is describe for you what
the president's approach is so that you know how he has
thought through what he thinks will work.

As the congressman said, the first thing about the
president's approach is he wants guaranteed private insurance
for every American with benefits that can never be taken away
no matter who you are, where you live, or who you work for.
Particularly here, as we stand behind with the flat irons
looking over us, and I know how much many of you value
physical exercise and activity and wellness and prevention, I
want you to know that the president believes in prevention
also.

In his plan, we are going to start reversing the
kind of backwards approach to health care we've had in this
country. You know, you cannot get insurance coverage if you
take your child for a well-child exam, but you can get it if
the child gets hurt or real sick and shows up at the
emergency room. Let's start rewarding prevention and trying
to avoid sickness instead of rewarding a health care system
that is premised on sickness.

So, number one, guaranteed private insurance for
every American no matter what age, no matter where you live
or work, with comprehensive benefits that stress primary and
preventive health care.

Number two, let us once and for all outlaw the kind
of insurance practices that make it impossible for many
Americans to get health care and which charges far too much
for millions of other Americans, making health care
unaffordable.

You know, probably the most emotional moments I've
had this past year have been when I have talked with people
who have found themselves unable to take care of themselves
and their families and be able to provide health care and
provide insurance because they got sick. I always thought
when you got sick is when you needed to be taken care of.

What happens in literally billions and tens of
millions of families, families represented in this crowd
today, are if you do have what is called a preexisting
condition, you have diabetes, if you've ever had any other
kind of chronic disease, if you had cancer 20 years ago, you
therefore are either ineligible for insurance or you have to
pay a much higher price than your friends and family members
who do not have such a condition. The president's plan
outlaws that.

Secondly, if you read the fine print on your
insurance policy, you will find often something called a
lifetime limit. What that means is that if you get really,
really sick and you have to be in the hospital for a long
period of time or you need some kind of continuing medical
treatment, you better be careful because if your lifetime
limit is $50,000 or $500,000 or, in the case of families I
have met with, $1 million, once you reach that, you no longer
are insurable.

Can you imagine what it is like for the families
that I have met? I'll tell you just one quick story. I
talked with a mother and father who had two healthy children.
Their third child was born with very serious complications at
birth. These were two people who both worked, made a very
good living, paid their taxes, did what they thought they
were supposed to do, had insurance. Because their third
child was so ill, the child had to stay in the hospital from
birth.

Within a year, their lifetime limit of $1 billion
were exceeded. What that family was told when they came to
the hospital and said we no longer have insurance, we're
going to keep trying to buy some more insurance, they were
told well, here's what you need to do. Put your baby on
welfare so the state will pay for the insurance.

The parents said we want to bring our baby home.
We want to be able to take care of her at home. We want to
get round-the-clock help so that we can take care of her, but
we can't find anybody who will help us with the insurance for
that. They were told there's no way out of that. You no
longer have insurance for this child. If you bring the child
home, you have no help at all. If you leave the child in the
hospital and keep the child on welfare, then the child will
be paid for.

At the time that I talked with this family, that
baby had been in the hospital for 15 months. There are
thousands of stories. So the president's approach outlaws
lifetime limits. When you need insurance the most, you
should have insurance forever.

The third important point is that you should be
guaranteed choice of doctor and choice of health plan. This
is probably the point that has been debated and had more
misinformation about it than any other. Those who oppose
health care reform have said loud and clear oh, be careful.
If the president's approach goes through, you won't be able
to see your doctor.

Well, let me tell you something, if you work for
somebody who helps provide you insurance now, you are no
longer guaranteed any choice because fewer than half of the
people who get their insurance from work, which is where most
of us get it, are being told they no longer have a choice.
What they're being told is you have to use these doctors and
this hospital because we've cut a deal with them and they're
going to keep the price down. Well, the problem is that we
need to change the whole system to keep the price down so
that you can have your choice of doctor and hospital and
that's what reform is guaranteed to do.

The fourth one I want to make, and this may seem a
little bit far from this crowd of young people, students
primarily, but the president's approach wants to guarantee
and improve Medicare for older people. Now, why is that
important? Well, most of us have seen our parents and our
grandparents needing medical care. You need more medical
care.

Even if you hike and run and do everything else all
your life, you eventually get to be a certain age where you
need more medical care. What happens with people on Medicare
now is that they have found that because our whole system
doesn't control costs, the prices available under Medicare
are being reduced which means now more and more physicians
are reluctant to treat a lot of people on Medicare.

We want to give prescription drugs to people on
Medicare so that they can be better taken care of and not be
bankrupted. We want to do something else, and that is to
provide some alternatives to nursing homes for older people.
Now, think about that.

Right now, if you get older and you are sick or you
are young and you become disabled, I'm sure most of you in
this crowd know some young person who, because of a car
accident or something else, has become disabled and needs
long-term care, what happens now?

We don't give the kind of help we should for people
to be able to stay in their own homes. We don't give the
kind of help we should for people to have some kind of
assisted living during the day but still be able to stay with
their families. What we do is we say the only real help you
have is the nursing home. I want, when I'm 65, to have
alternatives besides a nursing home and I think you do too,
and the president believes everybody ought to have that.

Finally, the fifth point I want to make is that the
president's approach guarantees insurance the way most of us
get insurance today, at the place we work. Most of us who
are insured do so by contributing some money and having our
employer contribute some money. Therefore, we get our health
insurance.

Now, there are only three ways to fund health care
for everybody in America. I've seen some signs and I respect
the people who are single payor advocates because they
believe in providing health care for every American. What
they will propose is that we have the elimination of private
insurance and instead have a tax system that provides health
care financing for everyone.

The president decided that he would prefer to stay
with a public/private system. He does not support a
government health care system. He wants to have a guaranteed
private insurance system, but the single payor people are
very honest in the way they describe how health care would be
financed.

The second way to get everybody covered in the
country is to do what is called an individual mandate. In
other words, every one of you would be responsible. Like you
are in many states to go out and buy auto insurance, you
would be responsible to go out by yourselves and buy health
insurance. This also recognizes you have to do something to
get everybody covered, but the president does not think it's
a good idea to begin to eliminate our employer/employee
system by having the entire burden put on the individual.

What he believes we should do is to build on what
works. It's an American solution to an American problem. We
should build on the employer system. The employers
contribute, those of us who work contribute, and all of us
then are paying our fair share. There are no more free
riders in the health care system.

What happens today, and you can go to Boulder or
any other town in Colorado, and you can walk down the street
and you can see the stores that help buy insurance and the
factories that do and those that don't. But if you work
somewhere without insurance, like the nearly 40 million
Americans who do not have insurance, most of whom work, if
you get sick, you go to the same hospital. We do take care
of you in our country, but if you can't pay the bill, then
the cost of your medical care is put on to the bills both of
the government and of those who have private insurance.

I got a letter from a man in Colorado who wrote me
last March and said I don't know what's happening. I'm a
small business person. I bought my insurance in 1985. It
costs me $100 a month for myself, my wife, and my two
children. By 1993, it was over $450 a month. My staff
called him and asked him what was happening with him now. He
said I'm so glad you called. It just went up to nearly $800
a month and nobody will tell me why. I am not getting any
more health care.

I'll tell him why. Number one, he's a small
business person, the most discriminated class of anybody when
it comes to getting health insurance. Number two, he is
paying his share of the uninsured because when he goes to
that hospital, he wants to make sure we have our doctors and
our nurses and our high-tech equipment. But if we keep
having so many people who are not paying anything for their
health care being taken care of, the bill has to go to him,
to me, to those of you who are in the system.

So those five points -- guaranteed private
insurance, outlawing the insurance practices that
discriminate against people, guaranteeing choice of doctor
and health plan so you can have the quality you deserve to
have and you make the choice every year, preserving and
improving Medicare, and providing health insurance through
the work place, are the five major parts of the president's
approach.

Some will tell you that it's a very different
approach, that it has things attached to it that are not
there are all. So I want you to know what the facts are
because if we do nothing, what will happen is the number of
uninsured will grow, the health care costs for small business
people who are individuals, who are families, will continue
to explode, and we will see our system beginning to
deteriorate under that kind of financial pressure.

Let me just add one other point because health care
reform is not just about how much money we can save, how we
reorganize delivery, how we get more people to take care of
themselves and be more responsible, it is all those things.
But it something more.

If you had seen as many people as I have over the
past year who have been left out of the health care system,
have been denied health care when they needed it most, you
would feel as I do that this is far beyond any kind of
policy. This is really a challenge to what kind of people we
intend to be and how we will take care of each other.

I want to be able in the next year to go back to
the places I've been and to look at the people who have
shared their stories with me and tell them that we finally in
our country have heard them, and that we finally have agreed
that health care should be a right, that every one of us
should be taken care of when we need it because there's not
one of us who knows whether tomorrow we will need some kind
of serious health care help.

So this is really a struggle for the future. It's
a struggle for determining who we are as a people. We have,
I believe, the will to meet that challenge. But the only way
we can do it is for each of you to take a hard look at
yourselves where you are in your lives and to know that the
kind of country we will have for you in the future depends
upon the decisions we make today.

Let people hear your voices raised for a health
care system that takes care of all of us, that leaves no one
out. Then, when we have secured health care security for
everyone, we will have the kind of basic personal security
that will enable us to go on into the 21st century. This is
about the future. This is about you. I am very pleased that
you're going to be part of this struggle with us. Thank you
all very much.

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