Remarks to the White House Conference on Aging
Thank you so much. Thank you, Mr. Vice President. Thank you for your remarks, and thank you for doing such a good job for America. Thank you, Secretary Shalala, Secretary Brown, Mr. Flemming, Mr. Blancato, Fernando Torres-Gil. Hugh Downs, thank you for being master of ceremonies. I wish I could sit here and watch you work the whole time. I'm delighted to see you. To Congressman Martinez and Congresswoman Morella; the former Members of Congress who are here; the Senators who have gone because they have to vote. I want to say a special word of thanks to the Conference Chair and one of the best friends I ever had in my life, David Pryor. I think he is a wonderful man.
As all of you know, Senator Pryor is now retiring from the Senate. I can remember when, as a young Congressman, he once volunteered as an orderly in Washington area nursing homes to document the conditions under which seniors were then living. And when he couldn't get the Members of Congress to listen, he conducted hearings out of a trailer in a parking lot. The trailer led to the creation of Claude Pepper's House Aging Committee. And as chairman of the Senate's Special Committee on Aging, David Pryor has led fight after fight after fight for the interests of the seniors in this country, especially in his efforts to expand the availability and limit the cost of prescription drugs. We will miss him, and we should be grateful to him.
I'm glad to see all of you in such good spirits. I hope you will stay that way. [Laughter] I hope you'll stay that way because I am identifying more and more with you and—[laughter]—and I understand Secretary Shalala read the letter we got from the child that said old people are smart and Bill Clinton is old. [Laughter]
I remember very clearly about 6 or 7 years ago when I had 2 events occur within 2 days, when I knew I was getting older. My hair had begun to gray, but I thought I was still in reasonably good shape. I felt fairly chipper. And I was making the rounds in my State, and this beautiful young girl, whose parents were very close friends of mine, and therefore I felt that I'd almost had a hand in her upbringing from the time she was born—she was 18 or 19 years old and she was nearly 6 feet tall. And she was just beautiful. And she came up to me— I was so pleased to see her—she came up to me and threw her arm around me, looked me straight in the eye, and she said, "Governor, you look so good for a man your age." [Laughter]
And then, the very next day I was in a different part of the State, and I saw this wonderful retired schoolteacher, who was then 80 years old, who had worked in every single campaign I had ever run. And I was so happy to see her. And she said, "Governor, I'm so glad to see you. You're aging gracefully." [Laughter]
But I think the right thing about this, you know, is to have a good attitude about it. All of you have a good attitude. That's a big part of this.
I just want to tell you one more story that illustrates the right attitude. It's a true story. We had a man in north Arkansas in a little rural county who ran a tiny phone company back when there were lots of these little phone companies. And he was about 92 years old. And they decided to give—actually, he was 96. And the people in the town decided they'd give him a banquet. And everybody got up and said nice things about him, you know, and the time came for him to speak. And he said, "The very first thing I want to do is to thank my secretary." And he introduced her, and she was 72. He introduced her and said, "I want to thank my secretary. She has been with me for 40 years. She has been wonderful. I don't know what I'm going to do when she passes on." [Laughter] So you've got to have the right attitude. Now, if you're all in the right attitude, let's get after it.
I am proud to convene this 1995 White House Conference on Aging. This is the fourth of these Conferences in the history of our country, the first to be held since 1981, the last of the 20th century. I thank the Members of Congress and the citizens of this country from both parties who have supported this endeavor. These Conferences have a productive history, from the establishment of Medicare, Medicaid, and the Older Americans Act, as a result of the 1961 Conference, to the creation of the House Select Committee on Aging, coming out of the 1971 Conference.
But this Conference must be about looking forward, not looking back. All across our country we have seen a dramatic reversal in the way we think about older Americans. We have, after all, twice as many older Americans as we had 30 years ago. And 30 years from now, we'll have twice as many again. People over 55 are younger, healthier, better educated than ever before, and beginning entirely new careers and endeavors in life as they grow older.
Your job here, more than anything else, is to help determine how to use the accumulated experience and judgment of older Americans to make all of our country stronger in the future. That is the purpose of our National Senior Corps, which works with AmeriCorps, our national service initiative in which—[applause]— thank you. The Ameri- Corps program is a national service program in which young people earn money for their education by doing community service. And not all of them are young. I've met retired naval officers in Texas doing work in AmeriCorps and intending to go back to college.
But the Senior Corps, like the AmeriCorps volunteers, are a new source of energy for American social problems and challenges. And they make sure that, as the poet said, the best is yet to be. Your conference agenda confirms your concern with the future. Issues such as crime, ethics, and ways to inspire a renewed sense of community affect all Americans, regardless of their age. To be honest, seniors are in a better position than ever before to help us address these concerns.
I want to mention just a couple of things that have happened since 1981 that are very important with reference to your agenda. First, briefly, since 1981, you and your generation won the cold war and the battle against communism, and you can be very proud of that. And we are now trying to finish that work so that for the first time since the dawn of the nuclear age there are no Russian missiles pointing at the American people.
But we know there are still threats to our security, and we were reminded of it very painfully in the last few days. So I ask all of you as you focus on crime to remember that we need to continue the fight to lower the crime rate. And with a strategy of punishment, police, and prevention, we can do that. But we must focus on the special problems of terrorism to which all open societies are vulnerable. I have sent legislation to the Congress to address this terrorism problem. It has broad bipartisan support. The leaders of the Congress are working with me on it. We must pass it and pass it this month. And I urge you to take a stand for that on behalf of all Americans.
The other truly remarkable thing that's happened since 1981 affects you particularly. Just one year after the last Conference in 1982, for the first time in the history of the United States, older Americans were less likely to be poor than Americans under 65. In the full span of our country's history, that is a stunning change and a remarkable achievement. We have seen it happening over the course of the past several decades. Since 1960, the poverty rate among elderly people has declined by 65 percent. It did not happen by accident. It happened because the American people kept faith with the social compact first forged 60 years ago when President Roosevelt signed the Social Security Act.
That compact has then been strengthened over the last three decades with Medicare, with Medicaid, with the cost-of-living adjustments to Social Security, with community-based services under the Older Americans Act like Meals on Wheels, transportation, and with efforts to prevent abuse of the elderly. This is a remarkable record, and you should be proud of it. It happened because people understood that their Government could be made to work for them in a positive and strong way. And it is something our country should be very proud of.
Now, our administration is committed to continuing that work—first, to the core principles that have made Social Security work. America has a solemn commitment to every person still working, no matter what their age, that Social Security will be there for them and their families when they need it.
We have also worked to strengthen retirement and to make it safer through strengthening private pensions. The Retirement Protection Act signed late last year reformed the Pension Benefit Guaranty Corporation and secured 8 1/2 million pensions that were at risk in this country, stabilizing 40 million others. It was a remarkable bipartisan achievement.
So every American should be proud that we have completely altered the way our people live their lives as they grow older, providing new hope for an entire lifetime of purpose and dignity. But we must remember that with this kind of opportunity in a democracy goes continued responsibility. Our job today is to preserve this progress not only for you during your lifetimes but for all generations of Americans to come.
You are here to look ahead to the next 10 years and beyond, and not just to the past or to your personal concerns. We know that with regard to seniors, our country has been moving in the right direction. But the truth is, we know that too many younger Americans are not. We have to think about this: How are we going to pass along the next century with the American dream alive and well for our children and grandchildren?
From the year I was born, right after the war, well into the seventies, almost to the end of the decade, people at all levels of our country grew economically, and they grew together. Prosperity was unprecedented. Without regard to income groups, people's incomes rose. Today, we have to face the hard fact that 60 percent of working Americans today are working for the same or lower wages than they were making 15 years ago, while working, on average, a longer work week.
We also have a new class of poor people, mostly unmarried, uneducated young women and their little children. We must do more to discourage the things that create poverty, especially teen pregnancy, and to require more education and efforts to enter the work force for those who are dependent upon welfare.
But the real problem facing this country is the problem of the middle class and stagnant earnings, and the insecurity of the American dream that so many people feel, and the gnawing worry so many working people have when they come home at night that they won't be able to give their children a better life than they enjoyed.
The new split in the middle class is caused by the global economy and the technology revolution. And it is rooted, more than anything else, in one word: education. We know that those who have it and continue to get it and learn for a lifetime do well, and those who don't, tend not to do very well.
So as we look ahead to the next 10 years, the question is: How can we preserve the gains and enhance the quality of life further and enhance opportunities to serve and to live and to grow and to thrive for seniors, while reversing the economic fortunes of those who are stuck and being driven away from the American dream, who are younger, and dealing with the fundamental problems of this country, which include the education deficit and also the budget deficit? It exploded in the 12 years before I became President. It too is undermining our ability to give your children a better future and to build opportunity.
For the past 2 years, our administration has made great strides in dealing with that deficit. We've passed two budgets—[applause]—we've passed two budgets that cut it by $600 billion over 5 years. I want you to hear this very carefully. When you hear that we have not cut spending, that we have not reduced the deficit, we have reduced the deficit by $600 billion over 5 years. And this is the more important fact: If it were not for the interest we must pay this year on the debt run up between 1981 and the end of 1992, the budget would be in balance today.
We have also worked to strengthen the Medicare trust fund. It still has problems, but it's stronger than it was on the day I became President.
Despite all that, we know we have to do more. I have been consistently saying for 3 years, beginning with my first address to the Congress and, indeed, all during my campaign in 1992, that we will never fundamentally solve the deficit problem and have the funds we need to invest in education and the future growth in earnings of our people until we are able to moderate the growth of health care spending.
Ask any Member of Congress here present today. All defense and domestic spending are either frozen or declining. Social Security and other retirement income is increasing, but only at the rate of inflation. We have to pay interest on the debt, and we're driving that down, but that changes as interest rates change. The only thing that is going up by more than the rate of inflation and the increased population growth in the programs are the health care programs. Over the next 5 years alone, almost 40 percent of the growth in Federal spending will come from the rise in Federal health care costs— more than our economy is growing, more than inflation is going up, faster than other items of Government spending.
So let us not pretend that there is not a challenge here for us to face, and let us face the challenge with good spirits. You and I know that there is a right way to face this challenge and a wrong way to face the challenge. But not facing the challenge is not an option.
I believe it is wrong simply to slash Medicare and Medicaid to pay for tax cuts for people who are well-off. Beyond that, reducing the deficit is terribly important. But it is also important that Congress protect programs for seniors like Medicare. We must have a sense of what our obligations are. Some proposals would increase the out-of-pocket costs on Medicare by up to $3,500 for our seniors.
I also think it's wrong to cut Medicaid over $150 billion in ways that threaten long-term care for seniors. Let me just say in parentheses here, I hope that if nothing else comes out of this Conference, the American people will come to understand that Medicaid is not simply a program for poor people. Yes, it provides health coverage to people on welfare and their children. But two-thirds of the Medicaid budget goes to care for the seniors and the disabled in this country, two thirds of the Medicaid budget. To give you a stark example, if Medicaid were not there, middle class people all across this country struggling to raise and educate their children would face nursing home bills for their parents that would average $38,000 a year. Medicaid is primarily a program for the elderly and the disabled.
It is wrong in my judgment to reduce coverage under the Medicare program, or to undermine health services in rural and urban areas that are already underserved, or to make changes that just simply coerce beneficiaries into managed care. We can't save Medicare and Medicaid by using savings to fund tax cuts for people who are already well-off or other purposes. That is the wrong way to approach this problem. But we must approach the problem. The right way is to start from the perspective of the people the system is intended to serve, to ask, what does it take to preserve and strengthen it, and what is fair to expect of everyone to do that, to preserve and strengthen it.
For 3 years I have said that the right way is to strengthen Medicare and Medicaid by containing costs as part of a sensible overall health care reform proposal that works for everyone.
If you want to hold down costs, expand coverage, and reduce the deficit, you must reform the health care system. You have to expand long-term care, for example, in terms of the options for seniors, not restrict it. Look at the growth in the population. Look at what's going to happen in the next 30 years. If you don't provide for people to get more long-term care in their homes and in other less expensive settings, if you don't provide—[applause]—thank you. If you don't provide for alternatives to more expensive hospital care, if you don't provide, in other words, for the problem in the least costly way, given what you know is going to happen to our population, then we will have greater costs, not lower costs.
So let's look at this in the right way. I do want to work with the Congress. But we must do it in the right way. I have said all along that I will evaluate proposals to change Medicare and Medicaid based on the issues of coverage, choice, quality, affordability, and costs.
We ought to have some simple tests. For example, does a proposed change reduce health care coverage by eliminating services or by charging seniors with modest incomes more than they can possibly be expected to pay? Does it deal with this long-term care problem in a way that will lower costs per person in long-term care but recognize that we have to have more options? Does it restrict choice by forcing seniors to give up their doctors and enter into managed care programs whether they're good ones or not? Or does it instead increase choice by giving people incentives and options to enter into managed care programs and other less costly options that might be made more attractive to them? Does it reform Medicare and Medicaid to lower the rate of cost increases without threatening the quality of care? Does it keep health care affordable for seniors, and does it help to control costs for the Government?
Many people say, well, all these things are mutually inconsistent. But that cannot be. We are spending over 14 percent of our income as Americans on health care. No other country is over 10 percent. We know that there are changes that we can make that will improve coverage, broaden services, control costs, and help us with the deficit. But we can only do it if we start from the point of view of what it takes to have a health care system with integrity that can be fairly paid for, in a fair manner.
So, while I will not support proposals to slash these programs, to undermine their integrity, to pay for tax cuts for people who are well-off or to pay for—all by themselves to pay for these kinds of arbitrary targets on the budget, I cannot support the status quo. And neither can you.
We must find a way to make this system work better that deals with the internal issues of the system, your health care issues and those that are coming behind you, and that deals with the genuine problems the Congress faces with our budgetary situation. That's why I have said repeatedly that when the Republicans present their budget as required by law, we will evaluate where they are in terms of their commitments and what they want to do, where we are, and then we will do our best to work through this. I will not walk away from this issue.
I watched from afar, when I was a Governor and a citizen, for 12 years while people here walked away from problem after problem. And I sustained, as President, an agonizing experience when large numbers of people walked away from problems that I asked them to face for short-term political gain. I will not do that. The status quo is not an option.
But in order for us to have discussions, we have to know where everyone stands. I have presented a budget. I have said for 3 years where I stand. As soon as we see the budget that is legally mandated from the Members of Congress who are in the majority, we will then talk about where we go from there and what we can do, so that I can make sure that your interests and the interests of people coming behind you are protected but that no one pretends that the status quo is an option. We can pursue both those goals and do it in the right way.
Now, let me also say there are other right ways to address this problem that we in the executive branch can be doing right now. You know, waste, fraud, and abuse has become a tired phrase in politics. But the truth is there's a lot of it in the health care system, and you know it as well as I do. With all the problems we have today with income for citizens and with the budget for the Government, people who rip this system off jeopardize the health of beneficiaries and the stability of our Government and our economy.
Since the beginning of this administration, Secretary Shalala and Attorney General Reno have worked hard to crack down on fraud and abuse. And I am pleased to announce today that, as a part of phase two of the Vice President's outstanding reinventing Government initiative, we are taking an additional strong measure. We are forming a multistate effort to identify, prosecute, and punish those who willingly defraud the Government and who victimize the public.
In five States, with nearly 40 percent of all the Medicare and Medicaid beneficiaries—New York, Florida, Illinois, Texas, and California— we will have an unprecedented partnership of Federal, State, and private agencies. For every dollar we spend, we will save you $6 to $8 in the Government's health care programs to stabilize what we need to be doing. This is a win-win situation for everybody except the perpetrators of fraud. And it's about time they lost one.
Let me close with this thought. This should be an exciting time for you. You should welcome this challenge. You should know that I will be there, with you and for you, to protect the legitimate interests of the senior citizens of this country and not to see us trade the long-term welfare and health of the American people for anybody's short-term gain. But you should also know that we need you to be here for us. We need for you to say, "These are changes that make sense. These are changes that don't. These are things that will make us all stronger. These are things that will help you guarantee higher incomes and better wages and a better future for our children and our grandchildren. These are things that will bring us together." This country is always strongest when we are together.
We are always strongest when we are together. I'll bet you more than half of the people in this room wept in the aftermath of that terrible tragedy in Oklahoma City. We were for a moment once again one family, outraged and heartbroken. And you saw what happened when people gave up their lives and came from all over the country to go there to help with the rescue effort, to help to deal with the families who are grieving, to help with all the efforts that were going on. That's when we're strong.
The theme of this conference is "Generations Aging Together." You know when we're together we're strong. And so many forces in America today are trying to turn us all into consumers of goods or politics or other things, so that we're all divided up in little markets and segmented and we fight with each other all the time. And the people that provoke the fights make a lot of money or votes or whatever out of us when we do that. But that's not when we're strong.
I saw the end of the film, when you quoted my speech at Normandy. I don't know that I have ever or ever will have a greater honor than to go and honor the generation of my parents for winning the Second World War. We were one, because of what you did, because of your sacrifice.
And I just want to say to you today, we can win the challenges of today and tomorrow. We can make the 21st century an American century. We can continue the progress in expanding the quality of life for our seniors. We can solve the health care crisis. We can do it if we will do it together. Lead us there. Help us there. And I will stay with you.
Thank you, and God bless you all.
NOTE: The President spoke at 11:52 a.m. at the Washington Hilton. In his remarks, he referred to Arthur Flemming, Chairman, and Robert B. Blancato, Executive Director, White House Conference on Aging; and Hugh Downs, co-anchor, ABC News' television program "20/20."
William J. Clinton, Remarks to the White House Conference on Aging Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/221053