pd08ja01 Memorandum on Keeping the Heating Fuel Distribution System Open...

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will be unable to pay for health care that will dramatically improve or 
even save their lives.
    Everybody who knows anything about this disease knows this delay can 
be fatal, literally. And still, too many uninsured women face a curious 
patchwork of care or inadequate care or no care at all. We know that 
women who are uninsured--listen to this--are 40 percent more likely to 
die from breast cancer than women with insurance. I know the worst 
licking I took in the last 8 years was when I tried to provide health 
insurance to everybody. But when I hear a statistic like that, I still 
think we need to keep going until everybody's got health insurance.
    Now, there's more than one way to do it. The Children's Health 
Insurance Program--when we tried in '94, the budget was in deficit and 
the economy was still not fully recovered. We could neither raise the 
money nor require employers to come up with it. That's fundamentally 
what happened. We didn't have the economic circumstances to create a 
comprehensive network. But the Children's Health Insurance Program, 
alone, as it's being implemented, has led us to the first reduction in 
the number of people without health insurance in a dozen years, and 
that's good.
    Now, the Breast and Cervical Cancer Treatment Act, which built on 
the previous work we did to provide preventive screenings under Medicare 
and to include more women in clinical trials, both of which were also 
quite important for the long run issues--this allows States to extend 
full Medicaid benefits to women who are diagnosed with these cancers but 
don't have insurance. Every year it will help to get prompt and quality 
care to thousands who might otherwise not receive care or be bankrupted 
by the cost of it.
    Today we're taking two new steps to help bring down these barriers 
earlier. First, we are releasing new guidelines for States to explain 
their options under the Breast and Cervical Treatment Act. I don't want 
to have the same kind of take-up time with this we had with the 
Children's Health Insurance Program. We need to move on this in a hurry, 
and you can help with that.
    These guidelines will explain how to get Federal matching dollars to 
fund care. When women are diagnosed with cancer through federally funded 
screening programs, States may now enroll them in Medicaid right away. 
Doctors and hospitals may start providing care immediately, even before 
the paperwork is processed. It's very important. And we hope that these 
guidelines will free more State funds for breast cancer screening. If 
all this happens and it happens in a hurry, we will save a lot of lives 
every year.
    Second, because we want the Federal Government to be a model 
employer, I'm directing every agency to help every employee have the 
time to get checked for cancer and other preventable diseases every 
year. This is an important step for everyone and particularly for women. 
To take just one example, for women ages 50 to 69, regular mammograms 
reduce the risk of death by breast cancer by 30 percent. From now on, 
every one of our 1.8 million Federal employees who need it will have up 
to 4 hours of leave available every year for preventive

[[Page 10]]

screenings. I hope this will spur other employers to take similar 
actions.
    With these steps, as well as the Children's Health Act of 2000 that 
Hillary mentioned, we've built a strong foundation of research and 
treatment for those who suffer today, and we've done what we could to 
ensure that cancer and other diseases will claim fewer victims tomorrow.
    But before I close, I just want to remind you, there's a lot of work 
ahead--a lot. And all the best stuff is still out there. We have to 
build on what we have accomplished, and we should not retreat from the 
advances we've made in reproductive health and family planning. We want 
to see healthy mothers and healthy fathers raising healthy children in 
the United States and all across the world.
    We have to recognize that we have a unique situation today where 
we've gone from record deficits to record surpluses, where we can 
actually invest in health care and education and the other things we 
need to invest in, have an affordable tax cut, and continue to pay down 
the debt to keep interest rates low.
    If anybody doubts the psychological and financial impact of lower 
interest rates, all you have to do is look what happened when the 
Federal Reserve acted yesterday. [Laughter] And the Government--those of 
us in political life, or those of you, now that I'm leaving--
[laughter]--you've got to remember that. If you keep the interest rates 
low, it's a big old tax cut to everybody, and it keeps the budget in 
balance, and it provides the funds necessary to invest in these things.
    But let me just say again--and this is particularly important to 
women, because women still have a longer life expectancy than men, and 
Americans who live to be 65 have the longest life expectancy of any 
people in the world, so we have got to modernize and upgrade Medicare 
and add a prescription drug benefit to it.
    And another thing I think is very important, we ought to pass that 
tax credit for long-term care. More and more people are providing direct 
health care to their parents or otherwise having to pay for it. And this 
is going to become a bigger issue. Anybody who lives to be 65 in America 
today has a life expectancy of nearly 83 years. And it's only going to 
go up.
    I think it is profoundly important to pass the Patients' Bill of 
Rights. If you look at the reaction you had to Tonia today and the 
reaction you had to sort of congratulating yourselves--as well you 
should have--for the passage of the law that we celebrate and then you 
imagine every other person in this country today who has got some other 
kind of cancer or some other kind of health problem or is going to have 
an accident that requires some kind of serious health care, we must 
rededicate ourselves now, when we are financially solvent, to the 
proposition that we're going to do more to expand health care coverage 
for the millions of people who still don't have it. And again, we've 
learned over the last 6 years that if we focus on discrete populations 
and build bipartisan support, we can get this done.
    And I still believe the biggest numbers out there and the greatest 
need are the parents of the children who are in this Children's Health 
Insurance Program, because a lot of them are getting their kids insured 
now, but they don't have health insurance, and they're not insured at 
work; they're working for modest wages. And we can afford to do that. 
That would take about--if we did it right, we'd get rid of about 25 
percent of the uninsured population, including those least able to pay.
    Then I think we should focus on the people who quit work at 55 and 
can't get Medicare until 65. And with a tax credit, we can enable them 
to buy into Medicare without bankrupting Medicare, without taking down 
the Trust Fund at all--it's at a 25-year high now. And we'd really be 
taking some of the most generally vulnerable populations. So I hope you 
will continue to work on that.
    And let me just say, looking ahead, we have roughly doubled spending 
on medical research in the last 6 years or so. We have announced this 
year the sequencing of the human genome. A little over a year ago, the 
two genetic variations that are high predictors of breast cancer were 
identified.
    Now, what all this means is, first of all, that we're going to be 
able to prevent more diseases; secondly, we're going to have quicker 
treatment. I am convinced that the development of so-called 
nanotechnology,

[[Page 11]]

which will enable us to have, for example, computer storage capacity on 
things the size of a teardrop that are bigger than supercomputers today 
and will, within a matter of a few years, allow us to go after cancers 
when they are only a few cells large. Our idea today about identifying a 
cancer early will seem like, within 5 years, identifying a cancer in 
very late stages.
    All this is going to change everything for the better. But I will 
say again, we had to put these privacy rules out that we put out. We've 
got to pass this antidiscrimination legislation, and we have to make 
sure that we continue to invest in not only the research but then the 
distribution of the wonders through adequate care coverage.
    It won't be long before the average young mother will come home with 
a little gene map of their baby. [Laughter] And some of them will have 
really scary things on there, and it will be a burden for some people. 
But they will also have a list of things that, if the mothers and 
fathers will do these things, the kids will dramatically increase their 
chances of living a long and healthy life. And it won't be long until 
the average mother will bring home a baby with a life expectancy of 90 
years or more. Our bodies are actually built to last more than 100 
years, if we didn't have all the problems that get in our way along 
life's way.
    But that means we have to reimagine all this. And it means that the 
role of citizen lobbyists and citizen activists will become more and 
more important, because we are literally just at the beginning of 
building the kind of health care system that will be adequate to the 
21st century.
    And I'm telling you, most of it is going to be really good. But it's 
going to change the practice of medicine. It's going to change the way 
the health care delivery system is organized. It's going to provide all 
kinds of new challenges. And we're going to have to figure out how to 
get people who need to know it all this stuff that's out there without 
letting somebody else take advantage of them, financially or otherwise.
    I can hardly think of a more exciting time in the entire history of 
the health sciences. And I believe that in the lifetime of people in 
this room, the cure rate for breast and cervical cancer will go through 
the roof; the prevention rate will escalate for all kinds of major 
cancers; the cure rate for prostate cancer will go through the roof. And 
once we get the technology down, when we merge the human genome with the 
microtechnology necessary to identify and zap cancers when they're just 
in infant stages that are presently unidentifiable, the whole world will 
be very different.
    You can all participate in that. But these decisions do not happen 
by accident. People who have other things to think about have to make 
decisions about how to allocate public funds for research. People who 
are under all different kinds of pressures have to make decisions about 
which bills will pass and which won't, in terms of extending coverage. 
And you have to enter this fray with the same energy that you brought to 
this fight. And just remember, all the best stuff is still out there. Go 
get it.
    Thank you, and God bless you.

Note: The President spoke at 3:15 p.m. in the East Room at the White 
House. In his remarks, he referred to breast cancer survivor Tonia 
Conine, who introduced the President. H.R. 4386, approved October 24, 
2000, was assigned Public Law No. 106-354. The transcript released by 
the Office of the Press Secretary also included the remarks of Senator 
Hillary Clinton.


<DOC>
[Weekly Compilation of Presidential Documents]
 [frwais.access.gpo.gov]
                         

[Page 11-12]
 
Monday, January 8, 2001
 
Volume 37--Number 1
Pages 1-16
 
Week Ending Friday, January 5, 2001
 
Memorandum on Preventive Health Services at the Federal Workplace

January 4, 2001

Memorandum for the Heads of Executive Departments and Agencies

Subject: Preventive Health Services at the Federal Workplace

    Today, as we celebrate the enactment of the Breast and Cervical 
Cancer Prevention and Treatment Act that I signed into law in October of 
last year, I am heartened by the progress being made in expanding access 
to preventive care for cancer and other serious diseases. We know a 
great deal about screening procedures that can detect diseases early, 
and about behaviors, such as smoking cessation and sun avoidance, that 
can greatly reduce a person's risk of disease. The challenge that 
remains is to ensure that all Americans

[[Page 12]]

not only take advantage of the screening programs and other effective 
preventive measures that are available and appropriate, but that they 
make positive changes in their lifestyles before disease develops.
    The workplace is a logical place to provide employees with health 
information and services to help them learn about preventive health. The 
Federal Government, the Nation's largest employer, has already developed 
many programs to encourage preventive health care for its employees. 
These measures, available to Federal employees through the Federal 
Employee Health Benefits Program, cover a broad range of preventive 
health services, including screening for prostate, cervical, colorectal, 
and breast cancer, and screening for sickle cell anemia, blood lead 
level, and blood cholesterol level. The programs also provide for all 
recommended childhood immunizations, well child care, and adult 
preventive care visits. In addition, the Federal personnel system 
provides employees with considerable flexibility in scheduling their 
hours of work and taking time off for medical needs, including routine 
examinations and preventive screenings. Many agencies offer creative, 
effective employee health programs that provide opportunities for 
employees to take advantage of preventive health screenings at the 
worksite.
    There is still room for progress. Therefore, I am today directing 
Federal departments and agencies to review their policies and make 
maximum use of existing work schedule and leave flexibilities to allow 
Federal employees to take advantage of screening programs and other 
effective preventive health measures. Each department and agency should 
also inform its employees of the various work schedule and leave 
flexibilities available to them to participate in these preventive 
screenings and examinations. Such flexibilities include promoting 
alternative work schedules (flexible and compressed work schedules), 
which allow for a variety of working arrangements tailored to fit the 
needs of individual employees, granting leave under the Federal 
Government's sick and annual leave programs, and granting excused 
absence to employees to participate in agency-sponsored preventive 
health activities. In the case of employees with fewer than 80 hours 
(two weeks) of accrued sick leave, I am directing each department and 
agency to establish a policy that provides up to 4 hours of excused 
absence each year, without loss of pay or charge to leave, for 
participation in preventive health screenings.
    I am also directing agencies to develop or expand programs offered 
at the worksite to help employees understand their risks for disease, 
obtain preventive health services, and make healthy lifestyle choices, 
and to share these initiatives with the Office of Personnel Management 
(OPM) within 120 days. The OPM will use this information to identify 
agency best practices. Finally, I direct the OPM to prepare guidance to 
assist agencies in carrying out this directive.
    Agencies will carry out this policy within available appropriations, 
and to the extent permitted by law and consistent with the 
Administration's budget priorities.
    I want the Federal Government to serve as a model for the rest of 
the country. While Federal agencies have led the way in many instances, 
I want to go even further in demonstrating that preventive health care 
for all employees is not only desirable, but also very practical and 
sensible.
                                            William J. Clinton

Note: An original was not available for verification of the content of 
this memorandum.


<DOC>
[Weekly Compilation of Presidential Documents]
 [frwais.access.gpo.gov]
                         

[Page 12-13]
 
Monday, January 8, 2001
 
Volume 37--Number 1
Pages 1-16
 
Week Ending Friday, January 5, 2001
 
Statement on the Report on the National Drug Control Strategy

January 4, 2001

    The 2001 Annual Report on our National Drug Control Strategy issued 
today by National Drug Policy Director Barry McCaffrey shows that 
America is making real progress in the fight against illegal drugs but 
that we must never give up on making our children's futures safe and 
drug-free. The most recent National Household Survey on Drug Abuse found 
that drug use by youths aged 12 to 17 has declined 21 percent since 
1997.

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