Hillary Clinton photo

Remarks in Waukee, Iowa on Long-Term Care Insurance

August 15, 2007

Thank you, thank you all so much, and I would like to thank Becky for being here and for chairing the democratic party in Dallas County, its was wonderful Becky, thank you so much.

We have a full house, some of you know, we were originally planning to do this in a slightly smaller setting, so there are one or two chairs left, but not very many, there are a couple up here for people standing in the back. I see three here, it is not like church where we are going to call you forward, we want to try to give you a char to sit in.

I am thrilled to be here and there are a number of people who are with is that I would like to recognize starting with my great friends and your former governor and first lady Tom and Christie Vilsack who are here.

Another great friend of mine who has been active in Iowa and active on so many issues in Washington for so many years on your behalf is Ruth Harkin, Senator Tom Harkin's wife.

I want to welcome the mayor, Mayor Peard, thank you very much for being here; I really appreciate you coming,

I saw the State Senator, Staci Apple come in, thank you so much Staci for coming, and in a few minutes I'm going to introduce you to our very, very special guests who will talk about their own experiences concerning some of the issues that I want to raise today. So you will be hearing in a moment from Pat Twerpy, and Mary Rose Brown, and I am very happy they are here because what they will talk about are issues that are affecting seniors and their families.

But I want to start this morning by asking a few questions:

How many of you are caring for an aging relative or know someone who is? You can raise your hand.

And how many of you have every worried about whether social security and Medicare will still exist when your children and your children and your grandchildren may need it.

I think every hand went up on that one

How many of you do not want to be a burden on your children either emotionally or financially when you retire or if you have already retired.

Yea lots of hands, my mother is 88 and let me tell you that is how she feels.

Now, I know that behind me we have got, you know ready to change, and ready to lead. Well I think we're ready for changes when it comes to helping take care of our seniors but to recognize, as all of the hands just did, that we are not talking only about issues that effect seniors these are family issues.

These are issues that effect all generations together. There're really American issues and we've had in the past leader who have called on us as a nation to make smart choices about what needs to be done.

Yesterday I was in Dubuque talking about some of the issues that I think are important on this campaign and I mention that it was 72 years ago yesterday, that president Roosevelt singed the social security act.

And when he signed the social security act he made it very clear that it was just a corner stone in a structure that was being built, but was by no means complete. And certainly President Johnson 30 years later knew that we had to do something in order to help, seniors who didn't have the resources, as they aged to be able to deal with the health problems that do come, the older you get. You know that old story, the good news is, that you wake up in the morning, and the good news is you know that because you hurt everywhere.

And so I think everybody knows as we get a little older, and things start to break down a little and you need some more help. And so President Johnson recognized that and when he signed the Medicare bill, he said no longer will this nation refuse to hand the justice to those who have given a lifetime of service, and wisdom, and labor, to the progress of this progressive country.

Well I consider myself a modern progressive. I am proud of all of the progress, we've made as a nation. But it didn't happen by accident, I didn't happen by wishing for it, it happened because people came together, and worked to achieve them. And sometimes over great odds, to reach what we saw as goals for our county.

Well today we face a new set of challenges. In part because of the very success of programs like social security and Medicare. The good news is, we are living longer, and we are living healthier lives. But we still have to figure out, how we are going to get our system to catch up, with what is the reality of life today. Long term costs already consume 40 percent of what we spent on Medicaid, and is estimated by 2040, that's going to grow by more than 250 percent.

The average cost of a private room in a nursing home today is more than 70,000 dollars a year. The average hourly rate for home health aids has gone up 13 percent over this past year.

Medicare also faces significant financial challenges they are driven by the spiraling cost of health care. And unfortunately we are not addressing any of these issues and planning for the future. Our current president hasn't called on us to make a national commitment to saving social security and Medicare and in fact he's tried to privatize social security and instead of focusing on Medicare he has given tax cuts to billionaires and contracts to companies like Halliburton and his answer to the prescription drug needs of our seniors is a plan that takes a PHD in bureaucracy to figure out and as you'll hear in a minute, it is not working for a lot of people, Medicare part D.

Now this is all consistent with how this president sees our country. He wants to leave everything up to the individual. He believes in the "you're on your own" society. And if you look at you're on your own and you take the first letters, that's the yo-yo society. (Applause, describes the up and down)

Well I think its time that we talked about and confronted a lot of these issues because for too many people, its like they're invisible to the president, we don't see what's happening in the lives of people here in Iowa, and across the country from this White House, and I think that's outrageous because so many people have worked hard their entire lives and they realize they cant afford to retire.

I was in Las Vegas two days ago, and I was in a super market, and I was shaking hands with everybody working in the super market, and I met a man, and he looked to be elderly. He looked to be probably in his 80's, but ha had a staff badge on, so I greeted him, and I said, "Are you working here?"

He said "I have to; I don't have enough money for my wife and me to live on." So what do they have you do? He said, "well you know I kind of help around and greet people and try to guide people to where they need to go but I don't know what I would do if they didn't give me a job. In his 80's

If you're a senior who has diligently paid your long term care insurance premiums for years, only to have the insurance companies turn around and deny you benefits because of some technicality buried in the fine print of your policy, well you're invisible to.

And if you are a mother or father trying to raise your children and care for your aging relatives you're at your wits end trying to juggle it all. And you are invisible as well.

And if you are that grandmother or grandfather struggling to make ends meet and heartsick at the thought of burdening your children and your grandchildren, it turns out you are invisible as well.

Well I want you to know that you are not invisible to me. And you certainly are not going to be invisible to the next president of the United States. Because when we take back the White House, we are going to start seeing our fellow Americans again. (Applause)

I have a very different vision of our country; it's more in line with Franklin Roosevelt, Harry Truman and Lyndon Johnson, than George W. Bush. Because I reject the idea of a "on your own" society, the yo-yo society, I think it is far better if it's a we're "all in this together society" where we're helping each other. You know, I wrote a book called it takes a village to raise a child; well it also takes a Village to care for your aging relatives.

You need these people to be there for you, to back you up. To provide some respite care and we're going to try and create support for people to do the most important work any of us will ever do and that's taking care of each other. Whether it's our children, or our parents, or our spouses.

I don't think long term care is a burden, I think it is a fundamental obligation. And I think if we work hard together, we can get policy that will help us all do what we should do as members of families.

First, when I am president, I am going to take immediate steps, to address the growing problem of fraud and abuse committed against our seniors.

And I am going to start with the long term care market. You know in recent years, millions of Americans have done what they thought was the right thing. They have done out and they have purchased long term care insurance policies, they see the adds on TV, they get the phone calls at home, you know, they are talking for their neighbors, maybe a church somewhere people are saying, we got to prepare for the future, so guess what, millions of American have done that, including 128,000 right here in Iowa. And they though they were being responsible, that if they ever needed long term care, it was paid for.

Only to find out when they actually needed the coverage the company denied it for no good reason. Or they increase the premiums, or they withheld payments for months and even though people have been paying the premiums for years, they were stuck with the bill.

Now the bill can run into 10's of thousands of dollars pretty quick. And many of you probably read the heartbreaking series in the des Moines Register over the last week or two and it describes what the means for families here in Iowa. Well, I became concerned about this, and back in march I wrote a letter to the government accountability office demanding an investigation into these practices, what was going on. Because I was starting to hear these long term care policies are kind of new so it's only now that people are really starting to try and collect on them and get the help that they need from them. So in my office in New York, and people around the country are starting to hear these stories and I want to know what is really gong on.

Now as president, I will require all insurance companies that benefit from federal tax advantages or that want to market their products, through the federal employees' health benefit plan, which is all of them, they're going to have to meet new consumer protection standards. That will be the fastest way to begin to regulate this market, because the federal employees' health benefit program covers 9 million federal employees to compete for the business. So if they want to compete for the federal employees business, as well as Mary Rose's or Pat's business, they are going to have to meet standards that will protect against fraud and abuse. They're going to have to disclose their average rate increases over the past 10 years so that seniors know which companies inflate their prices. We are going to put all of that in an easily accessible format, so that people can get the information they need before they make a choice.

We're going to require that they put all of their fine print into easy to understand English. People are going to be able to read it, know exactly what it says, and what they are purchasing. No more hiding behind, loopholes and traps that they spring on seniors when the seniors need the help.

We are going to require that insurers offer inflation protection, because many seniors don't realize that a nursing home facility that costs 150 dollars a day in 2007 could cost 400 dollars a day in 20 years.

So we have to protect against the cost going up and let seniors know what they are buying when they actually give that check over.

In addition, I will require that companies be more careful in setting their rates in the first place. So they will be less likely to hit seniors with ballooning premiums later.

If a company decides it wants to increase premiums, they are going to have to put a larger share of their increases into paying claims instead of building up their profits. And I will require insurers to sit down with potential buyers and assess whether long term care coverage is really right for them, because Medicaid already covers long term care for low income Americans. I don't think it's right that some companies are tricking customers into buying double coverage which they do not need.

And the way I see it, I don't think anybody should have to worry about some clause buried in 700 pages of fine print. Or having some insurance company make them feel that they're going to be secure, and when affect what they are doing is just pulling the wool over their eyes.

And we are going to put an end to that. We are going to change the regulations we are going to force them and then when seniors do have to move into assisted living or long term care facilities we want to do everything we can to protect them from abuse and neglect. You know, there are thousands of professionals and paraprofessionals who are providing excellent care for our seniors every single day. But sadly, senior abuse cases are on the rise. They jumped 20 percent in the last 4 years. I co-sponsored legislation called the patient safety and abuse prevention act.

We need a nation wide system of criminal background checks not only for long term care workers, but home health care workers as well. When someone comes into your home, you need to have confidence that that person will not hurt you, or rob you, or in some other way take advantage of you.

But you know elderly fraud and abuse, isn't limited to long term care, or home health care. For many of our seniors, it's on the other end of their telephone line. Today, 85 percent of the victims of telemarketing fraud are over 65. Fraudsters pray on seniors, offer prizes and sweepstakes, and lotteries that lure people, into a web of deception. I have seen things in what's happening in the mortgage market. A lot of seniors were talked into taking out home equity loans allegedly at low interest, and the interest was raised on them. And there are seniors across our country that are in danger of losing the home that they have purchased had paid off, until they bought into a home equity scam.

So it's not only on long-term care, we have got to send out the alarm, seniors should be extremely careful in buying anything somebody tries to sell you, over the telephone. And once someone has responded to any of these scams, their personal information is often added to a so-called "suckers list", which is sold to other fraudsters, making them prime targets for identity theft as well. That's why I'm proposing we give seniors and other victims, the right to sue companies that misuse their personal data to perpetuate fraud.

I also think, we need to have a center for telecommunications record privacy, because we've got to stay ahead of the fraudsters, they are a step ahead of us. You know, it started with people calling from I think Nigeria or somewhere years ago, saying that if you just sent me money, somebody will be saved from a terrible persecution and its gotten much more sophisticated than that, so we need people to be up to date about what is going on and we need one person in the government in charge of developing a coordinated strategy to protect personal phone records.

And years ago, about 4 years ago I think, I proposed legislation that you could not export people's private information unless they agreed to it. Because you know what happens with all these call stations, and other things that are going on in foreign countries, they have no laws protecting privacies so we've got to get smarter about how we are going to protect privacy and particularly protect our seniors

Second, when I am president we are going to offer a renewed commitment to social security. We have fought the president on his ill advised scheme to privatize social security, that was a terrible idea, and thankfully we beat him back and we are not going to have to face that.

But the problem is that the President has two big priorities, tax cuts for the wealthiest Americans and the Iraq war, and he hasn't paid for either one of them. He has put them on the giant credit card. (Applause)

And where has he gotten the money for tax cuts for the wealthy and the Iraq war? Two Sources: Borrowing from the social security trust fund, and borrowing from foreign countries like China.

We have got to get back to fiscal responsibility and shore up the social security trust fund. When my husband left office in 2001, because we had a balanced budget with a surplus, the social security trust fund was totally solvent and safe until 2055.

Six and a half years later with George Bush's reckless fiscal policies, its lost 14 years, its down to 2041. So we have to get back to fiscal responsibility and use those surpluses to shore up the social security trust fund, and I will do that.

Third we have got to get seniors a real prescription drug benefit that is truly there whenever they need it. Right now, American seniors pay 35 to 55 percent more for the very same drugs that seniors in Europe and Canada pay. And some pay hundreds, some even pay thousands of dollars a month for their medication. I did not vote for the Medicare part D plan. Because I thought it was a plan for drug companies and not a plan for our seniors. [Applause] And we are going to work, to reform and change that plan.

We're going to let our seniors through Medicare negotiate for lower prices with these drug companies, something that the bush administration has forbidden, now this makes no sense at all, why wouldn't you want to negotiate for a lower price if you were really on the side of seniors. You're on the side of drug companies, you don't want to negotiate for a lower price, well we're going to do that. We are also going to keep our fight up to allow the re-importation of American drugs back from Canada so people can by them safely. [Applause] As a lot of people have done over the years over the years.

And I know, I bet there are people, we are going to hear from them in a minute, from Mary Rose, I bet there are more people here who have fallen into the so called doughnut hole under part D of the prescription drug benefit. You know, you spend more than 2500 dollars and get no help until you spend more than 5000 dollars, that just doesn't make any sense at all, and we are going to hear a very specific example of that.

Fourth, here's an issue I care deeply about that nobody ever talks much about and that is we have to support the growing number of grandparents who are raising children. You know it's not an issue you hear much about, is it. But believe it or not four and a half million American children are living in grandparent headed households. Nearly 25,000

Of them here in Iowa. Many of these grandparents, and it is mostly grandmothers, find themselves in a very unexpected position. They are living on fixed incomes, they are not as strong and healthy as they used to be and all of a sudden they have to figure our school enrollment forms and health care and keeping up with small children again. I have been working on smoothing I call the kinship caregiver support act, its bipartisan; I introduced it several years ago to give more help to grandparents who are raising children later in life.

Programs like the Muscatine community Y here in Iowa provides support groups here in Iowa provide support groups and counseling and educational seminars and recreational activates.

I helped to start a housing complex in New York City for grandparents raising children so they can be safe together. They didn't want to life in apartments where there were people they did not want to trust with their grandchildren so it's all grandparents raising children and they support each other. We have to start thinking about how we are going to do more of that.

And finally as President I will continue the work I started in the senate to help seniors keep their independence and live in their won homes and communities. The work starts with our caregivers. The ones who are juggling the needs of sometimes growing children and aging parents. And maybe having to work full time as well. And if everybody who is giving care stopped today it would cost 300 billion dollars to replace [cut off]

This is not only the right thing to do; this is an economic service being done to care for people who cannot totally care for themselves. But just because family care giving is unpaid does not mean it doesn't cost. And obviously it's very rewarding and important but it can be exhausting and expensive. And I was proud to finally pass legislation I introduced called the lifespan respite act, to give temporary relief to those caring for their loved ones. [Cut off]

I also think we should consider tax credits for individuals and caregivers, tax deductions for long term care insurance. And now there is a new phenomenon where people are banding together themselves to help buy services that they will need in order from them to stay in their own homes.

So I am very hopeful that we can really focus [cut off] on the issues that seniors talk to me about. You know my 88 year old mother who has always been very independent, after my father died in 1993 she did not want to give up her home; she didn't want to move in with any of her children, so she held on as long as she could. But it got to be difficult driving and that's what really convinced her that she could no longer live on her own because she couldn't see well at night to drive and see needed [cut off]

Hillary Clinton, Remarks in Waukee, Iowa on Long-Term Care Insurance Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/277597

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