This is an archive page.  The links are no longer being updated.

REMARKS BY:	DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:		U.S. Chamber of Commerce, Washington., D.C.
DATE:		October 13. 1999

After I met with Tom Donohue a couple of weeks ago, I started to think about my remarks here this afternoon. And I considered beginning with a few well-chosen words about what makes a successful business leader successful. Perhaps a quote from Robert Heller. Or maybe Peter Drucker.

And then I recalled something James Glassman wrote a long time ago.

"Entrepreneurship," he wrote, "is the last refuge of the trouble-making individual."

Well, speaking as one who's proudly worn that moniker herself from time to time, I know I'm in the right place. But today I think we're here to stir up trouble of the most important kind.

By creating this forum, the Chamber is sending the message that 44 million Americans going without health insurance isn't only a crisis for those men and women and their families.

But that it's a crisis for everyone who shares a stake in this country's future -- and no one has a bigger stake than American business. That's always been true, of course. That's why, half a century ago, industrialists like Henry Kaiser and Charlie Wilson became pioneers in the provision of health insurance. And if a healthy workforce was an ingredient for their success in the economy of the 20th Century, I'm convinced it will be absolutely essential to yours in the 21st.

Ted Baker, of the University of Wisconsin's School of Business, put it best when he said that in the new economy, a healthy workforce isn't a byproduct of success, but a precondition for it. The fact that you've organized this conference tells me you understand that. And I'm here to tell you this Administration does, too. We have from the beginning.

From the very start we've addressed the fact that in this new economy an employer-based system of health insurance requires a new kind of partnership with government. That's why even though the crisis of the uninsured may not always be on the front page, it's never been on our back burner.

That's why we worked to win passage of the Kassebaum-Kennedy law that finally enabled workers to change jobs without fear of losing their health care. That's why we've worked with the states and approved a series of Medicaid waivers for projects to control costs and expand coverage. That's helping to provide coverage today to more than one million parents and children.

And that's the reason why in 1997 we worked with Congress to create CHIP: the Children's Health Insurance Program. It's our initiative to guarantee health care for kids whose families earn too much to get into Medicaid, but too little to purchase care on their own.

And let me talk to you for a moment about CHIP. Even though it's been only 26 months since President Clinton signed the law creating it, we've already approved plans to get CHIP up and running in all 50 states, five territories and the District of Columbia. In fact, the states are projecting that, next year, there will be 2.6 million children all across this country receiving health care through CHIP -- almost all of them from working families.

Now, that's impressive. But the truth is there are still millions of kids in this country who could be enrolled in Medicaid or CHIP. That's why this Administration is launching one of its biggest outreach campaigns ever. We've already established a toll-free number to reach more eligible families. And, just yesterday, the President issued an executive memorandum to identify and enroll uninsured children through America's schools.

It's an enormous undertaking, and the fact is there's only so much government can do. That's the reason why we're turning to our partners in the business community to help us get the word out about CHIP. Some already have. Proctor and Gamble, Safeway, GM, McDonald's and K-Mart have all joined our CHIP outreach campaign.

Other companies are as well, and I'm personally inviting each of you to join them. But our agenda isn't only focused on young workers and their families. As you know, the President remains committed to enabling Americans between the ages of 55 and 65 to buy-in to Medicare. This is particularly crucial for women who depended on their husband's health insurance, and -- through no fault of their own -- are left stranded when their spouse retires.

And there are other initiatives that can make a difference, too. There's the Jeffords-Kennedy-Roth- Moynihan proposal that would see to it that when disabled Americans join the workforce, they don't have to leave their Medicare or Medicaid benefits behind.

This is critically important for business because we know that the majority of the disabled of working age would be on the job provided they could keep their health care. And there's our initiative to provide tax incentives to promote small business purchasing coalitions that allow employers who are creating jobs, to also provide health benefits.

Some describe these employers as being part of America's health care problem. But with purchasing coalitions they actually become part of the solution. And, here again, I invite each of you to join us in this effort which has already been endorsed by the Chamber.

I know that, working together, we can extend health care to the families who, today, are going without it. Even more, I'm convinced we don't have to sacrifice quality in the process.

Many of you will remember that's what led the President to create the Advisory Commission on Consumer Protection and Quality in the Health Care Industry. I think most of you know it as the Quality Commission. And that's why I think our success in winning bipartisan approval of the Norwood-Dingell Patients' Bill of Rights in the House of Representatives was so vitally important.

This legislation would give patients and their families the strong voice they need in today's medical marketplace. But, even beyond that, last week's vote represents a crucial recognition that Americans not only want health insurance that's affordable, we also want it to be accountable.

In short, we've created a system that is managing costs, but not managing care. A system that promotes efficiency, but not quality. And that's why the Patient's Bill of Rights is so necessary.

It responds to the three failings of managed care today. The first is the failure of too many plans to provide comprehensive, coordinated service. The second is the strain these plans have placed on the doctor-patient relationship. And the third is the failure of many plans to develop the information systems needed to promote quality care.

Now, I know the Chamber took a very different position and argued that the cost of accountability would cause countless Americans to lose their insurance. Never mind that the Congressional Budget Office projected that the Patients' Bill of Rights would increase premiums by less than $2 a month.

What Congress understood was that the real issue isn't cost . . . it's confidence. It's that, with managed care, Americans believe they're at risk of being denied the care they need. And that, unless we take action now, American's are going to continue to lose faith in the health care system they depend on. The system you helped create.

That's the reason why we were able to win bipartisan support in the House -- and I want you to know that's why I'm convinced we'll see final passage of a good, strong Patients' Bill of Rights.

I hope you'll join us in this effort. After all, it's your employees who've said loud and clear that they want to be the beneficiaries of a changing health care system, not its victims.

There's another issue where I hope we can work together -- and that's strengthening and modernizing our Medicare system. The President has offered this Congress a program that would do just that. It would build on the new management approaches and competitive reforms we've put in place at Medicare. Changes that have already returned more than $1.2 billion dollars to the Medicare Trust Fund . . . reduced overpayments by 45 percent over the last two years alone . . . and saved taxpayers almost $39 billion dollars.

But, maybe more important than any of that, is the fact that we've driven down the growth rate for health care costs. And, in the process, begun to change the culture of the health care industry. Now it's time to take the next step.

The President's plan would not only continue our drive to modernize Medicare and promote real competition, it would put the program on solid financial footing for years to come.

It's a plan that would cut waste -- and improve efficiency. And, it would do something else, too: offer a voluntary prescription drug benefit. And let me emphasize this drug benefit would be managed not by the government, but by you: the private sector.

I think most of us would agree that, if Medicare had been created 10 or even 20 years ago, it would include coverage for prescription drugs. That's why the stance taken by the Chamber has been a disappointment. Not just to me, but, I think, to millions of senior citizens and their families. Because while "Flo" warns against the evils of big government in her medicine cabinet, the truth is there are too many Americans whose cabinets are almost bare.

They're the 13 million Medicare beneficiaries who have no prescription drug benefits today. And the millions of others who are at risk of losing them. These people aren't fictional characters in TV ads. They're Americans like Hanna Bratman. Hanna's a widow living in Chicago . . . and she has asthma.

Now, Hanna is able to breathe, provided she uses her inhalers. But that medicine is costing her about $2,800 dollars a year. That's 10 percent of her annual income. Hanna says, "There's no option anywhere for people like me." She adds: "It's hard to describe the fear of not knowing whether you'll be able to afford the next medication your doctor prescribes."

I'm convinced the voice of the business community ought to be heard in the debate over Medicare's future. But I believe you owe it to women like Hanna to make sure it's not a voice that misrepresents the problem - - or the Administration's response to it. After all, if people like Families USA, the American Nurses Association, HIAA and the Chamber can join together to raise the issue of the uninsured, I know we can work together to strengthen and modernize Medicare for the next century. What's more, I think we have to.

Whether as a university president -- or as HHS secretary -- I've always been convinced that the corporate involvement is essential to the success of any worthwhile endeavor.

Winston Churchill put it best, I think, when he said that "some see private enterprise as a predatory target to be shot, others as a cow to be milked, but few are those who see it as a sturdy horse pulling the wagon."

That's why I wanted to be here today. To tell you that I think we can have a health care system that offers insurance and accountability. And a Medicare system that provides the benefits Americans need, but at a price America can afford.

We need both. Not just because our families need it -- but because we can't compete and win in this new global economy without it. I invite you to become a part of that process. It's time to lower our voices . . . and roll up our sleeves. We've got a lot of work to do.

Thank you.