


			 THE WHITE HOUSE

		  Office of the Press Secretary
		      (Milwaukee, Wisconsin)
______________________________________________________________
For Immediate Release                         April 18, 1994     

	     
		     REMARKS BY THE PRESIDENT
		      TO AMERITECH EMPLOYEES
	     
	     
		     Italian Community Center
		       Milwaukee, Wisconsin   



11:50 A.M. CDT
	     
	     
	     THE PRESIDENT:  Thank you very much.  Thank you,
Senator Kohl.  And thank you, ladies and gentlemen, for that warm
welcome.  I started to stand on this thing so you would think I
might be the mayor of Milwaukee -- (laughter) -- but on
reflection, I decided, like all public officials I'd rather be
closer to the microphone.  (Laughter.)
	     
	     I want to thank Senator Feingold for his support and
his leadership and his fine remarks.  Congressman Barrett and
Congressman Barca, we're glad to see you here.  Thank you for being
here with us.  (Applause.)  Congressman Gerry Kleczka, thank you so
much; I'm glad to be here with you in your district and in your
hometown.  (Applause.)
	     
	     I want to say a special word of thanks to the
Ameritech team for the welcoming here today.  Dick Notebaert came
out with me, along with Morty Bahr on the airplane, so the three of
us had a chance to visit a little bit about what we would be doing
today.  And between the two of them, they convinced me that this
may be the best company in the history of the world.  They were
talking about -- (applause.)
	     
	     I want to thank Gary Keating and Rick Compost in
Detroit, and Deborah Echols in Chicago, and all the employees who
are there.  I also want to say, in addition to the fine work done
by the CWA, I know that many of you are part of the International
Brotherhood of Electrical Workers; I thank you for your support in
this health care effort.
	     
	     There are a lot of people here in the audience -- I
won't recognize all of them, but I would like to say a special word
of thanks to the Speaker of the Wisconsin House, Walter Kunicki, an
old friend of mine, for being here.  Thank you very much, sir, for
coming.  (Applause.)
	     
	     And I'd like to thank the Wisconsin Ameritech team --
Bronson Haase and Bob Johnson and others.  Thank you so much.
We're glad to be here.  (Applause.)
	     
	     Ladies and gentlemen, when I came to Wisconsin first
as a candidate for president, I did so not simply because I wanted
to have the honor of the job, although it is a very great honor,
indeed -- the highest any American citizen can receive -- but
because I thought the President's job was to bring the American
people together and to move our country forward; to seize our
opportunities and to honestly face our problems.  And we've been
trying to do that.
	     
	     We've seen a lot of talk over the last several years
about our deficit, for example, but finally, in the last year, the
Congress has passed an economic plan that has brought the deficit
down; helped to create a stronger economic climate; and two and a
half million jobs have come into our economy -- 90 percent of them
in the private sector.  That's more in 15 months than in the
previous four years -- in fact, twice as many as in the previous
four years. (Applause.)
	     
	     Congress now has a budget before it which it is
passing in rapid fashion, perhaps record fashion, which does what
we're supposed to do in Washington -- make the difficult decisions.
It eliminates 100 government programs, cuts 200 others, reduces
overall discretionary domestic spending for the first time since
1969 -- (applause) -- and at the same time, spends more money on
education, on Head Start, on defense conversion, and on the new
technologies which will create the high-wage jobs of the 21st
century.  (Applause.)
	     
		  If this budget passes, for the first time since
Harry Truman was President we will have three years of declining
deficits in the federal accounts.  That's a pretty good record for
a Congress and an administration working together, breaking
deadlocks, talking less and doing more.  I think that's what we
were all hired to do.  (Applause.)
	     
	     Congress has a lot of other interesting work to do
this year.  It is taking up sweeping education reforms -- some of
them modeled on a lot of the exciting things that have gone on here
in Wisconsin and some of your neighboring states.  I signed a bill
the other day called Goals 2000 which, for the first time ever,
commits America to world-class standards of educational excellence
in every school in the country; and at the same time, promotes a
lot of innovative grass-roots reforms to achieve them, and
encourages communities to try new and different things.
	     
	     We're trying to set up a system now that takes into
account the fact that young people don't necessarily have to have
four-year college degrees to get good jobs as we move toward the
21st century, but they sure need more training than they get out of
high school.  So we want a school-to-work transition that takes
account of the real needs of people who don't go on to four-year
colleges.  (Applause.)
	     
	     Congress has a bill before it to completely redo the
unemployment system.  The unemployment system takes money, I would
argue, under a not entirely fair circumstances now from employers
who pay the unemployment tax.  Because it used to be that when
people lost their jobs, they were called back to their old jobs.
So unemployment was a premium the employer paid to pay people at a
lower level so they could at least get along until they got called
back to their old jobs.  Most workers do not get called back to
their old jobs today.  Most people have to find new jobs.
	     
	     The economy is churning and changing and no matter how
many new jobs we can create, there will still be a lot of change in
this economy.  So we want, instead of an unemployment system, a
reemployment system, so the minute people lose their jobs, they're
immediately eligible for retraining and for job help to find new
jobs and different jobs.  Because the average 18-year old will
change work eight times in a lifetime and we owe it to ourselves
and our future to make sure that always people are retrained and
placed as quickly as possible.  We intend to do that this year;
that's very important.  (Applause.)
	     
	     Our administration has been committed to welfare
reform, to ending the whole welfare system as we know it --
something that Wisconsin has a great deal of experience in.  And I
want to say a special word of thanks to Mayor Norquist and the city
of Milwaukee, who have a national model in Project New Hope.  It
says you can move people from welfare to work.  I know we can do
that; I'm going to talk more about it in a minute.  But that is
another thing we are facing this year.  This is an exciting time in
our Nation's Capital, because people are actually working on the
problems facing America.
	     
	     The first item of business now, when we go back
tomorrow in Congress, will be the crime bill that's in the House of
Representatives.  And then the House and the Senate will get
together.  If the best of both bills passes, we'll have 100,000
more police officers on the street; we'll have huge new
opportunities for young people to help prevent crime, to keep our
young people from getting in trouble and give them some things to
say yes to; we'll have drug treatment that is very important that
we don't now have in a lot of our programs, and alcohol abuse
treatment; we will have a tough three strikes and you're out law
for people who shouldn't be paroled that we know are likely to
recreate serious violent crimes; and we'll ban 28 kinds of assault
weapons -- if the best of both bills passes.  That ought to happen
this year in the Congress.  (Applause.)
	     
	     And I want to say a special word of thanks in that
regard to Senator Kohl for his leadership in supporting the Brady
Bill, which we passed after seven years of deadlock last year; and
his attempt to keep dangerous handguns out of the hands of minors
who have no business carrying them on the streets of our cities.
(Applause.)
	     
	     Now, last year, according to a lot of independent
analyses, this Congress and I did more work together in more
substantive ways than had been done in the first year of an
administration in a whole generation -- in over 30 years.  But this
year can be better, if we do the things that I just mentioned and
if we have the courage, finally, to solve this health care problem.
	     
	     I want to talk a little bit about what specifically is
in our plan and what some of the problems are -- the real problems
and the political problems with passing this plan -- because if
you're going to help us pass it, you have to understand the
pressures that your representatives in Congress are under.
	     
	     First of all, what are the problems?  Well, at any
given time during the year, 58 million Americans will be without
health insurance out of a nation of 255 million.  About 39 million
of our fellow countrymen just don't have it all year long.
Eighty-one million of us -- 81 million -- almost one in three, live
in families where someone in our family has a preexisting condition
-- a child with diabetes, a mother who has had breast cancer
relatively early in life, a father who had an early heart attack.
And these people either pay much higher premiums for their health
insurance or they can't afford insurance at all, or they're insured
at their present job but they are terrified to leave their job for
fear that they will lose their insurance.  And so, at a time when
job mobility is highly prized, we see people never leaving their
jobs.  This is a huge problem.
	     
	     And 133 million of us, more than half of our
population, and three-quarters of the Americans who are insured at
work have lifetime limits on our policy.  So that if one of our
children were to be born with a serious long-term disease or
problem -- or in the case of a family I met a couple of weeks ago
in another state, where they had three children and the first two
sons were born with a very rare form of cancer which may well be
treatable and which may well be able to be maintained -- they're
going to run out of their health insurance coverage before the
second boy gets out of the house.  And they'll have to figure out
what to do and whether they can continue to work, and what in the
world is going to happen to their family.
	     
	     Not only that, 100 percent of us just about are at
some risk of losing our health insurance.  If you work for a
government or if you work for a wonderful company like this, you
won't lose it.  But what if you decided to change your job, or what
if you had to quit your job -- then what would happen?
	     
	     And finally, as has already been said, the system we
have -- I was glad to hear Mr. Notebaert say this -- is the most
expensive system administratively in the world.  We spend roughly
twice as much money on paperwork and other administrative costs as
any other country in the world does.  With the consequence that, in
America, we spend 14.5 percent of our income on health care.
Canada spends 10 percent of its income; Japan and Germany spend
nine percent of their income.  And half of that is for good things
-- I'll say more about that in a minute -- and for things that we
can't do anything about.  We're more violent than all these other
countries, so we have more emergency room bills; we have higher
rates of AIDS.  But half of it is the crazy way our system is
organized.
	     
	     There was a recent study of two hospitals, one in
Canada, one in the United States, with the same number of beds, the
same vacancy rate, the same patient caseload.  There were 200
people in the clerical department of the American hospital and six
in the Canadian hospital.  You're paying for that.
	     
	     You're also paying, as has been pointed out, a
significant premium because we are the only advanced country that
permits some people just to say, I won't have any insurance; I
don't believe I'll be covered.  But they all get health care if an
emergency happens, or when it's too late and they're too sick and
they show up at the emergency room.  And then the cost is passed on
to the rest of you in higher premiums.
	     
	     There are all kinds of other things we pay for, too.
Because we don't provide prescription drugs for elderly people in a
lot of family policies, our hospital bills are much greater,
particularly for older people, because of maintaining themselves
with adequate prescriptions, a lot of people on Medicare choose
every month between medicine and food.  But they wind up getting
care when it's too late, too expensive and they're in the hospital.
And it adds costs to the whole system.
	     
	     There are millions of Americans who have disabilities;
that if they were able to have some in-home care would save us
money.  They would be able to get health insurance and millions of
them would be able to work who cannot work today.
	     
	     So our whole system, because we don't cover everybody,
because we are willing to spend too much on paperwork and,
therefore, too little on things that keep people well, like primary
and preventive health care, cost too much and does too little.
	     
	     You might ask, well, if it's all that simple why
haven't we fixed it?  Well, because it's not all that simple.  And
I'll explain why.
	     
	     There are all kinds of improvements going on now all
the time.  I just got a wonderful demonstration -- you all heard
about it already -- from the Wisconsin Health Information Network.
And Marsha, the lady who showed me, was terrific; I learned a lot
and I was -- if I hadn't been late I would still be out there
fiddling with the computer to prove that even I could do it -- a
total computer illiterate.  (Laughter.)
	     
	     There are some things we can do.  But I believe with
all my heart, having studied this now for years and years, that we
cannot fix these problems unless we have a national response.  Not
a national health care system run by the government, but a national
response.  The government of the United States needs to reorganize
the health care system to keep what's best and fix what's wrong.
(Applause.)  And make no mistake about it, there are a lot of
things that are great about our system -- the doctors, the nurses,
the medical research, the technology, the advances.
	     
	     I have a friend from Wisconsin here -- Brianne
Schwantes.  Stand up and wave to the crowd here.  (Applause.)  She
was born with a problem -- her bones were prone to break easily,
and she comes to the National Institutes of Health on a regular
basis and gets world-class care.  And so here she is; and you know
where I found her?  Working with the flood victims in the Middle
West, risking her brittle bones to help other people who were in
trouble.  (Applause.)
	     
	     If it weren't for the miracles of our system, she
would not be able to do that.  And we don't have to mess that up.
But we do have to make some hard decisions.  We're going to have to
either cover everybody, or not.  If we don't cover everybody, your
wages are still going to be stressed by paying too much for health
care because other people won't cover their own.  You're still
going to have horror story after horror story of people who can't
get coverage, or who are terrified of losing it.  And we will
continue to pay more than we should.
	     
	     If we do want to cover everybody, we only have two
choices.  You look all around the world -- there are only two
options.  You either have to do it through a government-funded
program, like Medicare for everybody -- abolish all insurance,
charge everybody a tax and fund it -- or you have to have insurance
for everybody.  And if you have insurance for everybody, then
either the employers have to pay it, or the employees and employers
together have to pay it, or the employees have to pay it for those
who are working, and the government's got to help for those who
aren't working who don't have insurance.  Now, you can look all
around the world.  I don't think there are any other options if you
believe that the only way to fix this is to make sure that we have
health security.
	     
	     Here's my plan.  First, guarantee everybody private
health insurance.  Why do it that way?  Because that's a system we
have now, and just apply it to everybody.  Nine out of ten
Americans who have health insurance buy it at work, and eight out
of ten Americans who aren't insured have someone in their family
who works.  So the simplest way is just to extend the system we
have now.
	     
	     Second, make sure the benefits are adequate -- not
just catastrophic health care, but primary and preventive health
care, too -- mammographies for women in the appropriate age group;
cholesterol tests for people.  Do the primary and preventive stuff
that will hold down the cost of health care and keep us well, as
well as take care of us when we're sick.
	     
	     Next, permit people to choose their own doctors and
health plans.  Less than half the American people today who are
insured at work have a choice of the health plan they're a part of.
Now, is that because there's somebody bad in the system?  No, it's
because that's all the employers and the insurance companies can
afford under the present system.  But if everyone were insured
properly, then the employees and their families could choose what
kind of plan they want.  And, under our plan, every employee in
America and their families would get at least three choices every
year.  If you didn't like the choice you had, next year you could
make another choice.  I think that's very important.
	     
	     Third, have insurance reforms -- don't permit
insurance companies who issue health insurance to pick and choose
whom to cover.  When insurance was started for health care by Blue
Cross, that's the way it was -- everybody paid more or less the
same thing and we were all insured in huge pools.  And insurance
companies then made money the way grocery stores do -- they made a
little bit of money on a lot of people.  Today in America, there
are 1,500 different health insurance companies writing thousands of
different policies and the reason is, as Mr.  Notebaert noted, that
25 percent of our money goes to health care paperwork.  You think
about it -- 1,500 companies, thousands of different polices,
everybody with a different deal.  Think about how many people you
have to hire in insurance offices and doctors' offices and clinics
just to figure out what's not covered; just to figure out what not
to pay for.
	     
	     And when you put on top of that the cost control
pressures so that doctors all over America are going crazy, even as
we talk, because they have to call some distant insurance company
employee to get credit to perform a procedure or practice medicine
in a way that to them is perfectly self-evident; and when you add
to that a separate government system for the poor -- Medicaid --
and for the elderly -- Medicare -- you have a paperwork nightmare.
	     
	     And it's really tough.  So we have got to reform
insurance.  We've got to say, you can't kick somebody off and you
can't charge them more just because one of their children has been
sick.  You shouldn't charge an older worker more than a younger
worker when the average worker is changing jobs six, seven times in
a lifetime.  You've got people losing jobs in defense industries
that are in their late 50s and early 60s who must find new jobs and
who cannot find them because their employers can't afford to
provide health insurance for them.  It's not right.  So we've got
to have insurance reform.
	     
	     Fourth, I think we ought to protect Medicare, as I
said.  Leave it the way it is, it's working, but extend the
benefits to elderly people to include a benefit of prescription
drugs, which will save money, and for help for the elderly and the
disabled for long-term care in the home and in the community.
(Applause.)
	     
	     I think these benefits ought to be provided at work.
Why?  Because it's the system we have.  Now, you need to know that
this is at the center of the political debate.  And in Washington,
a long way from Milwaukee, here's what they're saying.  They're
saying, well, that's all very well for Ameritech.  They can talk
about that; they're a successful company, they have a strong union,
they pay good wages, they've got a great future.  But what about
all these small businesses in America?  What about the poor guys
with 10 or 20 employees who have a very narrow profit margin?  They
shouldn't have to do this.
	     
	     Well -- and the argument is that they can't afford to
do this.  They're going to lose jobs, and most new jobs are being
created in the small business sector, and it's a terrible thing --
you shouldn't do it.
	     
	     Now, what's my answer to that?  First of all, there
are a lot of small businesses in America who are providing health
insurance to their employees today and they are at an unfair
competitive disadvantage to those who don't.  I met a woman in
Columbus, Ohio, running a restaurant and a deli, with 20 people --
20 full-time employees, 20 part-time employees.  She says to me --
this is a typical story.  She says, "I'm in the worst of all
worlds.  I insure my full-time employees, I don't insure my
part-time employees and we pay too much for insurance because I had
cancer five years ago."
	     
	     She said, "I got it coming and going.  I pay more than
I should.  I feel guilty that I don't insure my part-time
employees.  And I get punished for insuring my full-time employees
because my competitors don't even do that.  I would gladly pay a
little more if you made all my competitors do the same thing.  That
would be all right; I'd be on a fair basis with them."
	     
	     I have a friend who is a car dealer at home in
Arkansas -- in a little town.  Said to me the other day, said, "You
know, I've been feeling sorry for myself for 20 years because I
always covered my employees and none of my competitors ever did.
And I just went around feeling sorry for myself.  And then I
realized that three of my competitors had gone out of business and
I made more money last year than I ever have.  And I think it's
because I never lost an employee because I gave them decent health
care."  Interesting, right?  (Applause.)
	     
	     Today, as I was shaking hands leaving the White House,
a small businessman came up to me and says, "I have got 80
employees, and I implore you to pass this health care.  I am tired
of these lobbies I pay my membership dues to, telling you that
small business doesn't want this.  A lot of us cover our employees.
I cover my 80 employees.  It costs me 20 percent of payroll.  Under
your plan my bills would go to 7.9 percent, because all my
competitors would have to do what I do."  The guy just stopped me
in the line today on the way out to the helicopter.
	     
	     Not only that, under our plan, we give discounts to
small businesses.  If you've got under 70 employees and an average
payroll of under $24,000, you get a discount.  And some of these
businesses will only have to pay 3.5 percent of payroll for their
insurance.  The average business has about a third of their cost of
doing business in labor costs.  So if you pay 3.5 percent, and
that's only a third of your cost of doing business, then it's only
going to cost you a little more than one percent of the cost of
doing business to insure your employees.
	     
	     I would submit to you that that much, if all your
competitors are doing it, can either be passed along or the
employees themselves will absorb it.  It will only take one year to
lower the raise they were going to get by one percent, and then it
will all be in there.  But that's what these Congressmen are
hearing, and they're saying, if you do this, small business in
America will come to an end.  Now, the truth is, most small
business people are paying 35 percent more than most big businesses
for the same insurance.
	     
	     The other thing they're telling them is, this is a
government-run program and government would mess up a one-car
parade.  (Laughter.)  That's the other thing they're saying.  And
we have all felt that at one time or another.  Right?  Especially
now, it's so close to tax day.  But that's what they're saying.
That's not true.
	     
	     Here's what the federal government does in our program
-- the federal government says, everybody's got to have insurance.
The federal government says, there must be insurance reforms so
that people can be insured in large pools.  And the federal
government organizes small- and medium-sized businesses so they can
get buying power to get the same competitive rates that people in
big business and government have.  And we have some basic quality
controls which are an extension of what we have now.  That's what
we do.
	     
	     We also leave to the states, then, the ability to
decide exactly how these mechanisms will be carried out.  This is
not a government run program.  It is private health insurance and
private medical providers just like we have today except now the
worst abuses of the present system will be erased.  Now, that is
what we are trying to do.  And I think it is worth doing.  I think
it needs to be done.
	     
	     Let me say to you that you will have to decide whether
you agree.  You'll also have to decide whether you think you can
persuade your members of Congress without regard to party that they
can do this and be reelected.  Every time I go into a congressional
district, there are these furious radio campaigns run to send a
message to your local congressman not to bankrupt all the small
businesses in the area.  But we had several hundred small
businesses in Washington the other day all asking us to do this so
they could get a fair deal, so they could buy insurance on a
competitive basis.
	     
	     Now, what's behind this?  Somebody's got to lose,
right?  There will be some changes.  What will they be?  If you
endorse this program, fewer Americans will work in the clerical
departments of hospitals, clinics and insurance offices.  And the
small insurance companies will not be able to write policies for
hundreds of thousands of people.  So in order for them to keep
writing health insurance, they'll either have to write specialty
policies, like many do today for extra cancer coverage or something
like that, or somehow find a way to pool with other companies or
they won't all make it.  That's true.  That is true.
	     
	     You have to decide whether you think it's worth it.
Is it worth it for every American to have the same health care
security that you have and to stop your wages from being depressed
and your profits from being depressed by paying too much for health
care, and to provide some sort of security to the working people of
this country I think it is.
	     
	     We will also create more jobs in the health care
industry in providing long-term care.  There will not be a net loss
of jobs, but there will be a shift of jobs.  You need to know that.
This is not a free thing.  But is it a good swap?  I think it is a
lay-down clear choice, the right thing for the country.  But we
have got to decide that.  (Applause.)
	     
	     And let me close by just -- I don't know if these
folks are here.  I had three letter writers.  People who wrote --
we had a million people who have written to my wife or to me on
health care, and I think they're here.  Are Sheryl Brown, Tammy
Stagman and Susan Millard here?  Are you all here anywhere?  Stand
up there.  (Applause.)
	     
	     Now, I want you to -- now these are not abstract
theories.  These are three citizens of your state.  Sheryl Brown
from Madison wrote a letter to Hillary about her health insurance,
and her husband came down with a serious illness.  He lost his
insurance.  She had to leave her job because she couldn't insure
her husband, and go on public assistance to get the benefits she
needed.  Then when she got herself off welfare and went back to
work, her family lost their benefits.  That's the system we have
today.
	     
	     If you go on welfare -- this is a big state for
welfare reform, right?  I've bragged on Wisconsin until I was blue
in the face about welfare reform all over the country.  In our
country today, if you go on welfare, you get health care.  If you
get off of welfare and go to work and start paying taxes, if you
live in a family with a preexisting condition, or you take a
minimum wage job, then all of a sudden you are paying taxes to pay
for the people on welfare to have health care and you don't have it
anymore.  So if you want welfare reform, you've got to pay for the
health care of the working people because the people on welfare
have got it.  (Applause.)
	     
	     Susan Millard wrote me because she's had a lot of
health problems, and she's got a job which doesn't provide health
benefits.  Should she just quit and give it up?  Aren't we proud of
her?  Wouldn't we rather her work?  Isn't it better for us that she
works instead of going on public assistance?  (Applause.)
	     
	     And, Tammy Stagman from Lancaster -- in a way the most
interesting letter of all.  She wrote me because she had some
serious health problems, but she had a good health insurance policy
because of her husband's job.  So she's thinking, what if my
husband ever loses his job?  What if he ever wants to change his
job?  And what about everybody just like me who doesn't have the
same policy I have?
	     
	     We can fix this, folks.  We can fix this if we
remember that there are real Americans out there who are doing
their very best to contribute to this country and to move us
forward and who deserve to have this fixed.  It is in our common
interest to do it, and I think we're going to do it this year.
	     
	     Thank you very much.  Bless you.  Thank you.
(Applause.)

			       END
12:20 P.M. CDT

