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REMARKS BY:	DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES
PLACE:		Women's Equality Summit, Washington, D.C.
DATE:		March 15, 1999

For this Administration-since day one-the question we've been trying to answer is how do we address the needs of every woman, every day, everywhere? As the First Lady and Secretary Herman discussed, we're working to do just that on a number of fronts. We've invested in women's education and training by providing Hope Scholarships, Lifetime Learning Tax Credits, and an increase in Pell Grants. We're helping working women care for their kids by extending health insurance to millions of children. And we've expanded women's economic opportunities by passing the Family & Medical Leave Act, extending the Earned Income Tax Credit, and raising the minimum wage. These are all great accomplishments for women.Accomplishments that also underscore this Administration's aim to help working families.And accomplishments to be proud of.

But today I want to focus on two specific priorities of ours-child care and Medicare. These two issues may seem completely unrelated. But they demonstrate our firm commitment to address the needs of women across the entire arc of life-From the young mother struggling to care for her children-to the elderly grandmother whose children may need to take care of her.

When it comes to addressing the needs of many working women, we have to start with child care. Because whenever I talk with working mothers-and fathers-who are struggling to balance the demands of work and family, the conversation inevitably turns to their child care concerns. That's why I'm proud of what this Administration has done for child care. We've helped states establish health and safety standards. We've promoted partnerships between child care and health care agencies. We've brought the public and private sectors together to offer more child care that families can depend on. And in 1997, the President- and First Lady-hosted the nation's very first White House child care conference.

We've done a lot to ease the child care concerns of millions of working families. But these are steps to build on-not to rest on. And we still have much to do. As the President said when he proclaimed March as "Women's History Month": "We must promote policies and programs-including affordable, high quality child care-that enable working women to succeed both on the job and in their homes."

The President knows that child care needs a giant booster shot. And that's exactly why he proposed his Child Care Initiative-the largest single investment in child care in our nation's history. The initiative will help relieve what today's working parents always tell me are the three biggest child care headaches: Can I find it? Can I afford it? Can I trust it? It will help families find child care by creating more care, particularly after-school care for up to half a million children per year.

It will help families afford child care by doubling the number of children receiving child care subsidies. And by providing greater tax relief to help working parents pay for child care-or to support those parents who choose to stay at home and care for their children.

Finally, this initiative will help families trust child care by providing 3 billion dollars over 5 years to improve the quality of care.to train providers.and to help states enforce their own health and safety standards.

The President's initiative isn't only an investment in child care. It's an investment in America's working families. It's an investment in America's future. It's an investment in the possibility and potential of every child. And it will help ensure that no one will ever have to choose between being a good worker and a good parent. I'm glad to report that-tomorrow-we expect representatives Cardin of Maryland and Tauscher of California to introduce comprehensive child care bills in Congress that reflect the President's initiative. Quality child care is a promise we need to keep for every working mother.

But for those women who have already watched their children, and they're grandchildren, grow up.for those women who are at the other end of life's arc.we have a very different promise to keep-the promise of Medicare.

The difference that this single program has made in the lives of our older Americans reminds me of a story about the famous writer, Somerset Maugham. Maugham was asked to address a group on his 80th birthday. When the author was introduced, he slowly rose. He thanked his hosts. He took a few sips from his glass of water. He then began by saying, "Old age has many benefits." And he suddenly stopped. Maugham looked around. He fidgeted. He sipped some more water. At last, he said dryly and slowly, "Old age has many benefits-I'm just trying to think of some."

Maugham, of course, was trying to be funny. But when he made that remark a half century ago, there was a sad ring of truth in his words. At the time, growing old meant poverty. Growing old meant disability. And growing old meant going without health insurance. As late as 1956, only 56 percent of America's seniors had insurance for hospital care. They often had to choose between saving their health-or spending all they had saved. But when President Johnson signed Medicare into law, he changed what it meant to grow old in America. Today, Americans are living 20 percent longer-and the poverty rate among senior citizens has dropped in half-since the 1960's.

Medicare promised the best health care in the world for older Americans. And for nearly 35 years, our nation has recognized that we must keep this promise-especially for our older women. Women have longer life spans than men. Elderly women are nearly twice as likely to be poor as other seniors. They comprise the majority of our nursing home population. They are more likely to suffer from a severe disability or have a crippling disease- like osteoporosis or arthritis-than elderly men. And nearly three- quarters of all Medicare beneficiaries over age 85 are women.

For older women, Medicare isn't just a support system-it's a lifeline. From the very beginning, this Administration has worked to ensure that the lifeline isn't broken. That growing old in America is never again synonymous with poverty and disability. And that we keep the promise of Medicare not only for ourselves-but for our daughters and granddaughters. That's why we've extended the life of the Trust Fund for 10 years and formed a Bipartisan Commission to address Medicare's long-term challenges. That's why we've cracked down on Medicare fraud, waste and abuse-increasing the number of fraud convictions by 240 percent. That's why we've added new benefits-including mammograms, pap smears and bone density screenings-to prevent and detect diseases in women. And that's why we've made Medicare more efficient through market-oriented reforms-reforms such as new plan choices, prudent purchasing provisions and payment system improvements. All of these actions will help reform and transform Medicare into a more efficient and responsive program.

But if we really want to keep the promise of Medicare for generations to come, to paraphrase the poet, we still have miles to go. In fact, we face two paramount challenges-we must secure and strengthen the program.

Our first challenge is to secure Medicare. As I'm sure you're aware, President Clinton is proposing to use one in six dollars of the budget surplus for Medicare for the next 15 years. That will keep the Trust Fund solvent for two decades while we work out an even longer-term solution. And we have to do this now- because the program is facing a demographic time bomb. As the President pointed out, the Baby Boom is about to become a Senior Boom-with the number of elderly Americans doubling by the year 2030. We must guarantee that Medicare will be there not only for the Baby Boom generation, but for generation "X", generation "Next", and every generation.

But it isn't enough to just secure Medicare-we must also strengthen the program. And that's our second challenge. We must make Medicare more competitive by adopting the best management, payment, clinical and competitive practices used by private industry. And we must guarantee a defined set of benefits without excessive new costs to beneficiaries.

We've also proposed that uninsured workers ages 62 to 65-and all other Americans ages 55 to 62 who have lost their jobs and health insurance through no fault of their own-be allowed to buy into Medicare.

To complement our Medicare reform efforts, the President has proposed the first long-term care strategy in our nation's history. The crux of our five year, six billion dollar initiative, is a targeted 1000 dollar long- term tax credit-paid for as part of our balanced budget-for people with long-term care needs or their caregivers. The initiative would also include an effort to inform all Medicare beneficiaries about long-term care options-since they may know very little about their choices.

Of course, when we discuss Medicare beneficiaries, we must ensure that the concerns and interests of women are not consigned to the backwater or the back burner. And that's where all of you come in. I'm reminded of a story involving the great Casey Stengal. When asked about winning the 1958 World Series, Stengal simply replied, "I couldn't have done it without my players."

Whether its Medicare, child care, health care, long-term care-or any other issue- we need each of you, and your organizations, to step up to the plate and help ensure that women's special needs are never overlooked. We need you to hold our feet to the fire. We need you to give us input and ideas. We need you to continue to stand up and speak out. And we need you to help remind everyone that women's issues are really family issues-and they're really national issues. It's thanks to organizations like yours that women's issues, women's interests, and women's rights have come so far. So I'm sure that, working together, we can help address the needs of every woman, every day, everywhere.