Remarks to the American Nurses Association

Thank you so much. You've made me feel welcome today. You've got my day off to a great start. And you have been a wonderful, wonderful friend and supporter of this administration in all the things we've tried to do to improve the health and welfare of the American people.

I want to begin by saying a special word of thanks to your president, Ginna Trotter Betts, for her 4 wonderful years as president of the American Nurses Association. [Applause] Thank you. I'll never forget the first time we met and talked about this. Al Gore said, you know, the president of the American Nurses Association is from Tennessee. He's shameless about things like that. [Laughter] And then we met, and I thought it was especially wonderful because she did not speak with an accent. [Laughter]

I want every American today to join with me in saluting your leadership on this 100th anniversary celebration. Our country has the finest health care system in the world, and nurses are the heart of that system.

As Ginna said, because of my dear mother, I know the hard work and the sacrifice that goes into your work. I want to thank you again for honoring my mother in 1994 with a special award in her name and for everything that you do. I learned from her, and America learns from nurses every day, the basic values that make this a great country. We know that the mission of our country should be to offer opportunity to every American, to demand in turn that every American take responsibility for making the most of that opportunity. That's the basic bargain of this democracy.

We know, too, that all of us have an obligation to see that we treat all responsible Americans with respect and with tolerance, to build a community out of all of our diversity. Today I ask for your prayers for the people who go to church in those churches that have been burned in the last year and a half and for your support for their right to worship and live.

I also want to thank you for the support you've given us in our attempt to change the course of affairs here in America and to deal with the real issues that affect the lives of real people. I sometimes wonder when people like you, who work and live every day all across America in the heartland and get up and try to make something good happen every day, when you come to Washington, it must be like visiting a foreign country from time to time. [Laughter] I think it would do more good if the people who work and write here in Washington had to go out and visit you more often. I think it would change their attitude about what really matters in life.

We've been at this business of trying to create opportunity and increase responsibility and strengthen our national community for 3 1/2 years now. There was a lot to be done 3 1/2 years ago. We had to get our economic house in order. We had to reduce this terrible deficit and do it in a way that continued to invest in our people and their future. And when we passed that economic plan in 1993, there are those who said, "Well, this is a terrible thing. It will plunge the economy into recession. It's the worst thing in the world." It was a bitterly partisan fight; we prevailed by the narrowest of margins.

Well, 3 1/2 years later we now can see whether they were right or we were right. In 3 1/2 years our economy has produced 9.7 million new jobs, 3.7 million new homeowners, 3 years of record increases in the number of small businesses, and the lowest combined rate of inflation and unemployment in 28 years. I believe we were right.

In 1994 we asked the Congress to take a serious approach to the crime problem, to get beyond rhetoric and partisan division and tough talk and to do something smart as well as tough on crime. We put 100,000 police on the streets, passed the Brady bill, passed the assault weapon ban, passed the Violence Against Women Act. There was a lot of bitter partisan rancor about it all, but we've now had a chance to see whether it works.

We are halfway through, almost, putting the police on the street. Almost 60,000 people with criminal records have been denied the right to buy handguns under the Brady bill, which is a health issue, by the way, and an emergency room issue. We're enforcing the Violence Against Women Act, the "three strikes and you're out" act. We see that the assault weapon ban has worked to ban assault weapons but not take any sporting weapons away from the hunters and other sportsmen who were told that they were going to lose their weapons. We can see it now. We have had 3 years of declining crime in a row. We were right, and they were wrong. We did the right thing to pass the crime bill in 1994.

We have had 3 years now to evaluate the work of expanding Head Start and making college loans more affordable and passing the national service program. And we know that the more people we educate in America, the stronger our country will be and the more people will be able to find good jobs and find other good jobs if they lose the ones they have. And we know enough now to say that we ought to do more. We ought to give families a tax deduction for the cost of college education. And we ought to make 2 years of education free after high school, through tax credits for every American to go to community college.

Today I want to talk with you about two other issues, about how we can reward opportunities— increase opportunities and reward responsibility and build a stronger country by improving health care and by strengthening the requirements that parents be responsible in the support of their children. For 3 1/2 years we have worked on these things as well. And even though we did not prevail in doing everything we've tried to do, I want you to know that I will never forget as long as I live the way the American nurses worked with the First Lady to try to give health care to all Americans. She is grateful for it, and so am I. [Applause] Thank you.

I thank you for standing with us when this administration became the first in American history to take on the tough issue of tobacco and the marketing of tobacco to young people. But we know—we know—notwithstanding some political voices who say this is no big deal and some people can deal with it and some can't— we know it is illegal to sell cigarettes to children in every State in the country. But every day 3,000 underage Americans start to smoke, and 1,000 of them will have their lives ended prematurely because of it. That is something we know.

If we want to improve health care in America, why don't all those people who say that's what they want to do stand up and be counted and do what we need to do to restrict the advertising and marketing and sales of tobacco products to young people in this country? That's what we ought to do.

Let's not forget what has been done. As Ginna said, we did pass the Family and Medical Leave Act to say if you take a little time off to care for a sick child or a sick parent, you won't lose your job. It's amazing to me there are still some of the people who voted against the family and medical leave law defending their vote and saying they did the right thing to oppose it. Well, I think it was right to pass it, and a lot of American families think so too. I never go into a big crowd of families very rarely that somebody doesn't come up to me and say, "I took advantage of the family and medical leave law."

The other day we had in the White House 50 families from 50 States who are participating in the Children's Miracle television network with all the children's hospitals in the country, these desperately ill children and their hard-working parents, almost all of them middle class people. And two families came up to me on the way out of the room and said, "I do not know what I would have done if the family and medical leave law had not been passed. I kept my job and took care of my child."

There's also some things that we have stopped from happening that you deserve a lot of credit for. I sometimes think that the majority in this Congress has forgotten the first rule of health care: first, do no harm. We have fought to slow the rate of inflation in Medicaid while preserving its fundamental guarantees. For three decades the United States has guaranteed that poor children and pregnant women, people with disabilities, and older Americans will not be denied health care simply because they cannot afford it. That is the right thing to do. The majority in Congress is actually insisting that we repeal this guarantee. I have said and I believe this would amount to child neglect for a whole generation. That's why I vetoed that plan last year. If they send it to me again, I will veto it again.

Working with you, we have fought to balance the budget in a way that protects Medicare and honors our duty to our parents. Let me remind you that we have cut the deficit by more than half. We added time to the Medicare Trust Fund, and we're attacked by the now congressional majority for doing it. But their proposal for Medicare would undermine our ability to hire and train nurses, would close down more hospital wings in cities and rural communities. Of course, we have to slow the rate of inflation in Medicare. My plan will secure the Medicare Trust Fund for a decade without imposing unduly high premiums on low-income seniors and without wrecking the delivery system. That is, after all, what we have to preserve if we want people to have good health care in the first place.

And while we're doing no harm, why don't we do a little good? [Laughter] We are working with you to improve health care access to as many as 25 million Americans by fighting for the Kassebaum-Kennedy health care bill. No worker should have to worry about losing health care if he or she loses a job. And no one should be denied health care simply because they or someone in their family has a preexisting condition. I am working hard with the Congress, and I do want to say that I am encouraged that there are people in both parties who support the Kassebaum-Kennedy bill. In its purest form, it passed the Senate 100 to 0. All we have to do now is to get together and pass the bill, pass a good bill. I believe we can do it. I am working with the leadership in both parties to do it. But I want you to leave this town only after you have given a clear signal to Congress: Pass this bill now. [Applause] Thank you.

And while we're at it, one other thing we could do that would really help millions of working families is to raise the minimum wage now. And I hope we will do that. I am doing everything I can to increase opportunity for the American people, but as I said, we all know that the basic bargain in America is opportunity in return for responsibility.

We also know that where our children are concerned, the most important of America's building blocks is not a strong Government but a strong family. It is parents who must love their children and take responsibility for them. That has been the driving principle behind my efforts to reform welfare as we know it. I believe the present system perpetuates a cycle of dependency and irresponsible behavior. But I also know, having spent time in welfare offices as a Governor, that nobody wants to reform this system more than the people who are trapped in it. I want a system that promotes work, strengthens families, and encourages independence. That's why I have proposed time limits and work requirements but also child care and health care to help people move from welfare to work.

The majority in Congress often criticizes me for vetoing a bill they called welfare reform. Well, I did. I did it because it was too tough on kids and too light on work. I asked them to do better. And if they'll do better, I'll be happy to sign welfare reform legislation.

Meanwhile, we will continue to reform welfare with or without congressional action. We have worked to cut redtape for 40 of the 50 States by approving 63 welfare reform experiments. Just today we approved a waiver for a welfare reform effort in New Hampshire which combines strong work requirements with incentives to move people from welfare to work. I have received an intriguing proposal from Wisconsin which has tough time limits but actually gives assurances—assurances—of a job and health care and child care to people on welfare. And I expect to approve that request soon.

What you need to know, all of you, is that for three out of four Americans on welfare, the rules have already changed. Seventy-five percent of the families in this country on welfare are already under welfare reform experiments approved by our administration and devised at the State and local level. That is one big reason that today there are 1.3 million fewer people on welfare than the day I took the oath of office as President of the United States.

The food stamp rolls are also down. The poverty rate is down. Teen pregnancy rates have leveled off and are actually dropping some. Work and training among welfare recipients are up. Child support collections have reached a record high. But we must do more to insist on more parental responsibility. Our proposals are about giving people more opportunity and demanding more responsibility.

And I reject the idea that when it comes to welfare it is only the mother who has to act responsibly. That is a false statement. For too long we have let the men off the hook. We must insist that they do their part to support the children that they help to bring into this world. I wonder how many times nurses in this audience have seen a frightened young girl give birth to a baby alone in a hospital with the father nowhere to be seen. How many times has the hospital and the Government been left to pay the cost not only for the delivery but for the continuing care of the child? Well, two people are required to bring a child into this world, and two should help to raise the child.

Last year I signed an Executive order that cracked down on the requirements for Federal employees to pay their child support. Three years ago I signed a law requiring States to establish hospital-based programs to determine the father of a newborn child. Based on our first reports, more than 200,000 fathers have been identified through these voluntary hospital paternity identification programs. That's 200,000 children whose fathers can't just up and walk away. And child support collections and paternity establishments have increased by 40 percent since 1992. I am proud of that, and you should be as well.

But we have to do more. That's why earlier today I took executive action to strengthen child support enforcement and promote parental responsibility. First, we're putting in place a new national program to help States track parents who owe child support across State lines. Today, too many parents get out of paying child support by moving from job to job, from State to State. This must stop.

Currently, 25 of our States require that when a person is hired for a job a check be made to see if he owes child support. Under this new program, we will check that information against our national database to catch deadbeats who have crossed State lines. I want every State in the country, the other 25, to give us this information so that these people who do not pay their child support have nowhere to hide.

Today I also directed the Department of Health and Human Services to require mothers who apply for welfare to provide the name of the father and other identifying information when they apply for assistance and before they get the benefits. Of course, there must be goodcause exceptions, such as those required to protect mothers from the dangers of violence against women. And we will require the welfare office to contact child support authorities within 2 days, once we get this information, to begin legal proceedings to hold fathers responsible for support.

This is important. Our system should say to mothers, if you want our help, help us to identify and locate the father so he can be held accountable as well. And it should say to fathers, we're not going to let you just walk away from your children and stick the taxpayers with the tab. The Government did not bring the child into the world, you did. Our people will help to take responsibility for those children, but you have to do your part as well. We have to make responsibility a way of life, not an option, when it comes to raising children in the United States.

So let me say again to you, I thank you for the giving, nurturing work you do. We would not have a health care system without you. America wouldn't be what it is without you. I thank you for demonstrating responsibility at work and, for most of you, at home as well throughout your lifetime. I ask for your continued support as we try to not only protect but to advance the cause of health care in this country. We must not rest until we have made health care accessible and affordable to every single American citizen. But we must also say to every American citizen, you ought to be as responsible in your life every day as the nurses of America are in their lives.

This country works with opportunity and responsibility; we cannot have one without the other. And if we're going to build an America that will be the world's leading source of peace and freedom and prosperity in the 21st century, if we're going to keep the American dream alive for all of us, we have to have both those things. You embody it in your life. We're trying to embody it in the policies we advocate. And I ask for your continued support. You've made me very happy, personally, here today, but you make me very proud to be President of an America with people like you. Let's keep fighting to make it better.

Thank you, and God bless you all.