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REMARKS BY: DONNA E. SHALALA, SECRETARY OF HEALTH AND HUMAN SERVICES PLACE: City Club of Cleveland, Cleveland Ohio DATE: November 6, 1998
When I think about the pride, pluck and progress of Cleveland, I think about the story of two young brothers from the Outhwaite Homes public housing complex over on the East Side. Two boys known to family and friends as "Billy and Brother." Their circumstances were all too common. Fatherless since childhood. Rough neighborhood. Danger around every corner. Friends headed for jail or an early grave.
But these brothers were lucky. Their mother was hard on them. With a big heart. But they also made their own luck. They studied hard in school, worked hard at odd jobs, and then joined the Army. When they came home, the older brother pushed his sibling to finish high school at age 21. Both went on to college, and then law school. In fact, my mother went to Cleveland Marshall Law School with the older brother. Before long, my mother's classmate would argue a landmark civil rights case before the U.S. Supreme Court. Eventually, Cleveland sent him to Washington, the first African American from Ohio to serve in Congress. And his little brother would appear on the cover of Time Magazine as the first African American elected mayor of a major American city.
Of course you know I'm talking about our local heroes, Carl and Louis Stokes. At Carl Stokes' memorial two years ago, I read a letter from the President who said, "He taught us that it was possible for America to rise above prejudice and find visionary leaders of all races, beliefs and backgrounds." And when his brother Louis retires from Congress, our nation will miss Congressman Stokes' voice, views and vision, particularly his commitment to minority health. We heard his voice just last week at the White House, when Congressman Stokes joined President Clinton, me and many others to launch a crisis response to the epidemic of HIV/AIDS in minority communities. As the President said, AIDS is like many other epidemics -- it picks on the most vulnerable among us, where knowledge is scarce and poverty is high.
The Stokes Brothers are more than home-town heroes. They were history-makers, agents of change. And the example they set -- the path they chose -- points the way for progress today.
Progress means serving the real needs of real people. Being a voice for the voiceless, a defender of the defenseless. But progress also means reaching across the old boundaries and barriers -- racial, geographical, political, even psychological. The history of American progress is the story of people reaching out and coming together when the need is great and the cause is just. It's written on every dollar: e pluribus unim -- "out of many, one."
Sometimes we seem in danger of losing that tradition. Four years ago, when Republicans took over Congress, some predicted fiercely divided government, open partisan warfare and political gridlock. Some even called for it. What the cynics ignore is the sea-change in the role of government during this decade, especially since this Administration took office. We agreed that the era of big government was over. The age of ideological rigidity has ended. The comfortable assumptions of both the left and the right were discarded. A tacit understanding developed that neither party had a monopoly on good ideas.
These were the right choices for political leaders to make. But they were also the only choices to make. The American people no longer accepted the notion that government has the answer to every problem. But they also no longer accepted that government's proper response to the weak and vulnerable is: Tough luck. So we found a middle ground. But I think of it as a pragmatic strategy born of real experience with social and economic policies -- experience accumulated over three decades. In short, we know now that Washington alone is not the answer. That more money alone is not the answer. Through that understanding, we found better answers. And even though Washington has bifurcated along party lines, we have reached bipartisan answers to national questions.
Together, we rewrote legislation to reform the welfare system. We gave the states resources and flexibility to help people move from welfare to work. We also made work pay by raising the minimum wage, by expanding the Earned Income Tax Credit, and by passing Family and Medical Leave, so working adults can take time off to care for a sick child or aging parent. And to help working families raise healthy children, we adopted the Children's Health Insurance Program, also known as CHIP. CHIP is now bringing health care coverage to 5 million uninsured children of working families in this country -- more than 130,000 in Ohio alone. We're also making an historic national investment in scientific research. In the new federal budget Congress just adopted, the National Institutes of Health will get their largest single budget increase ever -- two-billion dollars, a 15 percent increase. This will give modern science new hope of defeating our leading killers -- cancer, AIDS, diabetes, Parkinson's, Alzheimer's and others. As we made all of these national investments, we also balanced the federal budget for first time since 1969 -- the year that Louis Stokes arrived in Congress. Today, we have the first surplus and the smallest government in three decades, and genuine optimism about the future.
We saw that optimism at the polls on Tuesday. The problem is, it showed up in the number of voters who did not show up. For better or worse, a happy electorate tends to be a sleepy electorate. The political pundits didn't know what to make of this election. Some suggested it was a "Seinfeld" election -- a show about nothing -- with no national issues to bend the races or divisive issues to distinguish the candidates. Others declared it would be determined by a hot new political swing group: "Waitress Moms." Women with the least amount of time and energy to get to the polls. More likely, the truth was in between all of the above, and none of the above.
But we do know what the `98 election was not about. It was not about scandal. And it was not about shallow partisanship, free-lunch-ism or zero-sum-gaming. And it certainly was not about doing nothing. The people know, as a nation, we still have many great questions to answer -- and much work to do. They know in good times we must plan with an eye toward future lean years. Like the old fable about the ant and the grasshopper, we must sweat today for security tomorrow.
That's why this new Congress -- the 106th Congress -- has a big job to do. We regret they'll have to do it without Louis Stokes from Ohio. But we hope they'll do it in the spirit of consensus, compromise and teamwork that the Stokes brothers brought to Washington and Cleveland, because there are significant national needs that Congress set aside in the last session. Needs that will not fade away, like the proverbial old soldiers. Retirement needs. Family needs. Health care needs. The needs of children.
The new Congress we chose on Tuesday will take us to the new millennium. The test for Congress is not unlike the test for our computer systems -- will they take us into the future? When it comes to the health and well being of American families, I believe this test involves four key questions; four questions that will demand that Congress stand up for progress over partisanship.
Question number one involves everyone who wants to be secure in old age. Will Congress put Social Security first? As we look back on this century, few of our achievements match the enduring legacy of Social Security. Together with Medicare, Social Security helped to change what it means to grow old -- to be disabled -- in America. It brought dignity to those who fought our wars at home and abroad. It honors our parents and grandparents by safeguarding their independence. It takes away the fear of poverty for millions of our most vulnerable citizens. More than any other government programs in our history, Social Security and Medicare remind us that this a great and good and decent nation.
Certainly, like any landmark institution, we must modernize them. We began with the Medicare reforms in the Balanced Budget Act of 1997, which extended the solvency of the Medicare Trust Fund for another decade. Perhaps there is no greater tribute to the man who helped launch the Medicare program, the former Cleveland mayor and one of my predecessors, Judge Anthony Celebrezze, who passed away last week.
Now we must also preserve the security of Social Security. This past year, we held a series of bipartisan forums around the country on how to reform Social Security to absorb and serve the tidal wave of retirees. Next month, the White House will hold a national conference to share those ideas. But we don't need a conference to know we must make new investments in Social Security, to keep it solvent. That means Social Security must be first in line for any budget surplus. We say Social Security First. And we will hold the line.
The second test for the new Congress comes from a younger generation -- our children. Four-hundred and twenty days from now, at the stroke of midnight, the first child of the new millennium will be born. And before you know it, that infant will be a child with a mind of her own. Recently, somebody asked a group of young children what they've learned most in life. One, age 6, said, "I've learned that you can't hide a piece of broccoli in a glass of milk." Another, age 7, said, "I've learned that when I wave to people in the country, they stop what they're doing and wave back." And another, age 9, said, "I've learned that just when I get my room just the way I like it, Mom makes me clean it up."
Every generation of children is wise beyond its years. But as our knowledge and science advance, the children of the millennium have a chance to develop and grow up healthier than any generation, ever. But scientists can only do so much. It's up to all of us -- families, coaches, teachers, clergy, communities and government -- to help raise the children of the millennium and keep them safe, happy and whole. That leads to the second question for the new Congress: Will it help protect children from the number-one preventable cause of disease and death -- tobacco?
We've all heard the heart-breaking statistics. Every day, 3,000 children become regular smokers. Some day, 1,000 of them will die from tobacco-related illness. Every time a child lights up, we're looking at a future cancer patient or lung disease victim just waiting to happen. We're watching a healthy future go up in smoke. We know why children smoke. And we know what it takes to help children resist the lure of tobacco and the hook of nicotine. But the question is, What will it take for Congress to take action?
Last year, Congress failed to act on the President's challenge to protect children from tobacco. For all the wrong reasons. There's a word in politics for this kind of issue. It's called a "no-brainer." There is no constituency in favor of children smoking. On Tuesday, California voters approved Proposition 10, a measure to increase cigarette taxes by 50 cents a pack and devote the money for youth anti-smoking programs. It's time for Congress to do the right thing. The children counting on them.
The parents of these children are posing the third question for the new Congress: Will it help to ease the child care crisis facing too many homes, businesses and eventually, our economy? Today, three out of five mothers with children under 6 work outside the home. At least 5 million school-aged children are left unsupervised during those critical after-school hours. They need somebody asking them where the broccoli went.
When you talk to businesses that help their employees with child care, their reason usually boil down to four competitive advantages: It boosts recruiting. It boosts morale. It cuts down on absenteeism. And it boosts productivity because workers can focus their full attentions on the job at hand. But when you talk to parents who need child care, their concerns usually boil down to three important questions: Can I get it? Can I afford it? Can I trust it?
If a young parent stops me in the street and asks, "Secretary Shalala, what can I do to make sure my child gets quality child care?" I always say: "Join the Army." That's because the Army takes protecting and nurturing the children of its soldiers seriously. They have a high-quality child care system that includes surprise inspections four times a year. Frankly, all children deserve the same kind of protection that military families have. Parents shouldn't have to choose between being a good employee, and a good parent. And business shouldn't have to shoulder the entire burden of helping employees with child care. Last year, Congress failed to act on the President's Child Care Initiative, a package of measures to help working parents find and afford child care they can trust. But we're not giving up. When the new Congress convenes next year, we will reintroduce our Child Care Initiative. It really is a comprehensive early learning -- early education -- program. And we'll make sure the child care concerns of parents and employers are heard in every office on Capitol Hill. Finally today, the fourth question for the new Congress is one they know won't go away -- Will Congress deal with access to health care, to insurance, to quality health care? We know our health care system is the best in the world. But we also know it isn't always "as good as it gets" for everyone. Especially for the 43 million Americans who have no health insurance today. We know who they are. Mostly children. Poor families. Minorities. The partly employed. This problem is only getting worse. There are 6 million more uninsured people today than in 1994, when this Administration put the problem on the national table. What a bitter irony: As the economy has grown, so has the number of uninsured.
We've kept this number from going even higher by extending coverage to some of the most vulnerable, including children. Last year, we also asked Congress to give seniors short of retirement age a chance to buy into Medicare if they lose their private health insurance. And we asked Congress to allow the disabled to keep their Medicaid coverage if they go to work. On both counts, Congress failed to act. But America is not the kind of country that ignores the health of vulnerable people. Neither will we, and neither should Congress. Together, we should find ways to allow participation in existing health care programs -- public and private -- to cover those who need coverage the most.
For everybody who does have health insurance, Congress knows it cannot ignore the public demand for patients' rights and quality. People have a right to the highest quality care. They have a right to see a specialist when needed. They have a right to know all their medical options. They have a right to expect their health plan to keep its promise and not leave them stranded when they're sick or injured. And if the health care system does not guarantee these rights, they have a right to expect Washington to take action. Earlier this year, with the stroke of his pen, the President guaranteed a Patients' Bill of Rights to everybody in a federal insurance plan. That's about 80 million Americans -- one third of all insured. It covered all federal employees, military families, veterans, and Medicare and Medicaid beneficiaries. It even covers Members of Congress. To ensure fairness and equity to the rest of the nation, the President challenged Congress all year to pass a Patients' Bill of Rights for everyone in private health plans. In the end, the House did pass a very weak Patients' Rights bill. It was partisan and riddled with loopholes -- more of a placebo than a cure. The Senate bill was even weaker. It left out 100 million people. It didn't guarantee access to specialists. It wouldn't even prevent a health plan from dropping you in the middle of chemotherapy. Neither the House nor the Senate bills would have guaranteed any recourse if you were maimed or killed because a gatekeeper overruled a doctor's call.
Somebody once asked the comedian Joey Bishop why he loved his doctor so much. He replied, "when I couldn't afford an operation, he just touched up the X-rays." Well, real doctors never fake a remedy. And when it comes to patients' rights, Congress can't fake it either. Next year, the pressure will be on Congress to guarantee real patients' rights for all Americans. And there is a simple test to distinguish between the real thing and a placebo: Does it gives every American the patients' rights -- the access and quality guarantees -- that Congress enjoys today?
Two years from now, when we take stock of the new Congress --- the last Congress of this century -- we'll ask whether it prepared us for the new century. And I believe our answer will be, "yes it did," if the new Congress takes a page from the story of Congressman Stokes. Not long ago, Congressman Stokes gave a speech over at East Tech. He talked about the lives that he and his brother had made for themselves. How they built a ladder out of school and work, and used it to climb out of the projects and up through their lives of public service and personal success. When he finished speaking, a young man walked right up to the Congressman, and declared: "Mr. Stokes, me and my brother live in the projects. And me and my brother are going to be just like you and your brother."
There's wisdom in there for all of us, including those in our nation's capital. If those two boys can climb over all their difficulties and dangers to be like Louis Stokes and Tony Celebrezze, why can't we in Washington? If we could all be like the distinguished public officials that Cleveland has contributed to our country, our country will be in very good hands with a very bright future. Thank you.