State of the Union Addresses. Bill Clinton

to stay on welfare. No wonder people leave work and go back to welfare, to get health care coverage. We've got to solve the health care problem to have real welfare reform.

      Health Care Reform

      So this year we will make history by reforming the health care system. And I would say to you, all of you my fellow public servants, this is another issue where the people are way ahead of the politicians.

      That may not be popular with either party, but it happens to be the truth.

      You know, the first lady has received now almost a million letters from people all across America and from all walks of life. I'd like to share just one of them with you. Richard Anderson of Reno, Nevada, lost his job and, with it, his health insurance. Two weeks later, his wife, Judy, suffered a cerebral aneurysm. He rushed her to the hospital, where she stayed in intensive care for 21 days. The Anderson's bills were over $120,000. Although Judy recovered and Richard went back to work at $8 an hour, the bills were too much for them and they were literally forced into bankruptcy.

      "Mrs. Clinton," he wrote to Hillary, "no one in the United States of America should have to lose everything they've worked for all their lives because they were unfortunate enough to become ill." It was to help the Richard and Judy Andersons of America that the first lady and so many others have worked so hard and so long on this health care reform issue. We owe them our thanks and our action.

      I know there are people here who say there's no health care crisis. Tell it to Richard and Judy Anderson. Tell it to the 58 million Americans who have no coverage at all for some time each year. Tell it to the 81 million Americans with those preexisting conditions; those folks are paying more or they can't get insurance at all or they can't ever change their jobs because they or someone in their family has one of those preexisting conditions. Tell it to the small businesses burdened by skyrocketing costs of insurance. Most small businesses cover their employers, and they pay on average 35 percent more in premiums than big businesses or government. Or tell it to the 76 percent of insured Americans, three out of four whose policies have lifetime limits, and that means they can find themselves without any coverage at all just when they need it the most.

      So, if any of you believe there's no crisis, you tell it to those people, because I can't.

      There are some people who literally do not understand the impact of this problem on people's lives, but all you have to do is go out and listen to them. Just go talk to them anywhere, in any congressional district in this country. They're Republicans and Democrats and independents. It doesn't have a lick to do with party. They think we don't get it, and it's time we show that we do get it.

      From the day we began, our health care initiative has been designed to strengthen what is good about our health care system--the world's best health care professionals, cutting edge research, and wonderful research institutions, Medicare for older Americans. None of this--none of it should be put at risk. But we're paying more and more money for less and less care. Every year, fewer and fewer Americans even get to choose their doctors. Every year, doctors and nurses spend more time on paperwork and less time with patients because of the absolute bureaucratic nightmare the present system has become.

      This system is riddled with inefficiency, with abuse, with fraud, and everybody knows it. In today's health care system, insurance companies call the shots. They pick whom they cover and how they cover them. They can cut off your benefits when you need your coverage the most. They are in charge.

      What does it mean? It means every night millions of well-insured Americans go to bed just an illness, an accident, or a pink slip away from having no coverage or financial ruin. It means every morning millions of Americans go to work without any health insurance at all--something the workers in no other advanced country in the world do. It means that every year more and more hard working people are told to pick a new doctor because their boss has had to pick a new plan. And countless others turndown better jobs because they know, if they take the better job, they'll lose their health insurance.

      If we just let the health care system continue to drift, our country will have people with less care, fewer choices, and higher bill.

      Now, our approach protects the quality of care and people's choices. It builds on what works today in the private sector, to expand employer based coverage, to guarantee private insurance for every American. And I might say, employer based private insurance for every American was proposed 20 years ago by President Richard Nixon to the United States Congress. It was a good idea then, and it's a better idea today.

      Why do we want guaranteed private insurance? Because right now, nine out of ten people who have insurance get it through their employers--and that should continue. And if your employer is providing good benefits at reasonable prices, that should continue too. And that ought to make the Congress and the president feel better. Our goal is health insurance everybody can depend on--comprehensive benefits that cover preventive care and prescription drugs, health premiums that don't just explode when you get sick or you get older, the power--no matter how small your business is --to choose dependable insurance at the same competitive rates that governments and big business get today, one simple form for people who are sick, and most of all, the freedom to choose a plan and the right to choose your own doctor.

      Our approach protects older Americans. Every plan before the Congress proposes to slow the growth of Medicare. The difference is this. We believe those savings should be used to improve health care for senior citizens. Medicare must be protected, and it should cover prescription drugs, and we should take the first steps in covering long-term care.

      To those who would cut Medicare without protecting seniors, I say the solution to today's squeeze on middle class working people's health care is not to put the squeeze on middle class retired people's health care. We can do better than that. When it's all said and done, it's pretty simple to me. Insurance ought to mean what it used to mean. You pay a fair price for security, and when you get sick, health care is always there--no matter what.

      Along with the guarantee of health security, we all have to admit, too, there must be more responsibility on the part of all of us in how we use this system. People have to take their kids to get immunized. We should all take advantage of preventive care. We must all work together to stop the violence that explodes our emergency rooms. We have to practice better health habits, and we can't abuse the system. And those who don't have insurance under our approach will get coverage, but they will have to pay something for it, too. The minority of businesses that provide no insurance at all, and in so doing, shift the cost of the care of their employees to others, should contribute something. People who smoke should pay more for a pack of cigarettes. Everybody can contribute something if we want to solve the health care crisis. There can't be anymore something for nothing. It will not be easy, but it can be done. Now in the coming months I hope very much to work with both Democrats and Republicans to reform a health care system by using the market to bring down costs and to achieve lasting health security. But if you look at history, we see that for 60 years this country has tried to reform health care. President Roosevelt tried, President Truman tried, President Nixon tried, President Carter tried. Every time the special interests were powerful enough to defeat them, but not this time.

      Campaign Finance Reform

      I know that facing up to these interests will require courage. It will raise critical questions about the way we finance our campaigns and how lobbyists yield their influence. The work of change, frankly, will never get any easier until we limit the influence of well financed interests who profit from this current system. So I also must now call on you to finish the job both houses began last year, by passing tough and meaningful campaign finance reform and lobby reform legislation this year.

      You know, my fellow Americans, this is really a test for all of us. The American people provide those of us in government service with terrific health care benefits at reasonable costs. We have health care that's always there. I think we need to give every hard working, taxpaying American the same health care security they have already given to us.

      I want to make this very clear: I am open, as I have said repeatedly, to the best ideas of concerned members of both parties. I have no special brief for any specific approach, even in our own bill, except this: if you send me legislation that does not guarantee