For Immediate Release
Office of the Press Secretary
June 27, 2001
Press Briefing by Ari Fleischer
The James S. Brady Briefing Room
Listen to the
Briefing
- Personnel announcements
- Faith-based initiative
- Patients' bill of rights
- Global warming
- House vote on Mexican trucks
- Osama bin Laden
- Middle East/Secretary Powell visit
1:15 P.M. EDT
MR. FLEISCHER: Good
afternoon. I have a personnel announcement and then two
policy items I want to discuss. One, the President intends
to nominate Donald Schregardus to be Assistant Administrator of the
Environmental Protection Agency for Enforcement and Compliance
Assurance. The President intends to nominate H.T. Johnson to be
Assistant Secretary of the Navy for Installations and
Environment. And the President intends to nominate the
following individuals to be commissioners of the United States Parole
Commission for a term of six years: Gilbert Gallegos, Henry
Hart, Cranston J. Miller, Marie Ragghianti. Those are the
individuals for the Parole Commission.
Two
other items -- number one, the House Judiciary Committee tomorrow will
take action on the President's faith-based initiative. The
President is very pleased that action is beginning in the Congress on
one of his defining policy objectives to help some 15 million children
who are at risk in this country, 2 million children are prisoners, so
they have more opportunities and more hope for a brighter
future. The faith-based initiative is aimed squarely at
bringing help to those who are often left behind in society, and an
agreement has been reached with House leaders on the terms of the
language. The legislation will start moving tomorrow; it
will move in the Ways and Means Committee immediately following the
recess. And the President is very pleased with this
action. It's a sign of good things to come in the House, in
his opinion.
Also, on the patients' bill of
rights, earlier today the President issued a statement in support of
the Fletcher-Peterson, Thomas-Hastert patients' bill of rights
proposal. And if that bill is sent to the President he will
sign it. Again, a sign from the President that he would like
the Congress to work productively in a fashion that allows a patients'
bill of rights to be signed into law this year. The
President believes very strongly in putting progress before
politics. This bill puts progress before politics, and the
President will sign it if it sent to him.
And
with that, I'm more than pleased to take any questions you have.
Helen.
Q I assume the
President thinks this religious office and religious funding is
constitutional.
MR.
FLEISCHER: There is no question about its constitutionality
in the opinion of the lawyers who looked at and the people we have
worked with on the Hill.
Q What people have looked at it?
MR. FLEISCHER: The Department of
Justice attorneys who are responsible for this area of
law. And as the President indicated in a speech he gave just
the other day, there are already -- for example, under Medicaid, there
are Jewish hospitals, there are Catholic hospitals that receive
Medicaid funding. Yet these hospitals were originally
started for the purpose -- they are Catholic hospitals, they are Jewish
hospitals. They are not non-denominational.
Q But the money goes to the patient, doesn't
it? MR. FLEISCHER: In the case of
Medicaid, it often goes directly to the service provider, the hospital
or the doctor -- or the hospital. It reimburses hospitals
for their costs. So it costs the government -- Habitat for
Humanity receives federal funding in some cases. The
Salvation Army. There are a host of groups in our society
that are faith-based that do good deeds that bring help to people who
otherwise would be left out --
Q Why is he so against the government doing
these things?
MR. FLEISCHER: He
believes that both are necessary. The President believes
there must be a continued role for the government in these
matters. But even with the government having spent trillions
since the War on Poverty began in the early '60s, there have been
millions of Americans who have been left behind. The
government proposals, no matter how effective and how well-intentioned,
have not been able to find everybody in our society who needs
help. Very often the answer is --
Q Well, isn't it Congress' fault?
MR. FLEISCHER: I think it's a
reflection of how intractable some of the social problems
are. And the President does not want to give up on anyone
who has been left behind after the government does everything it can
do. And often the solution is found in the Salvation Armies
of the world, in the faith-based organizations of the
world. And the President wants to empower them to do more to
bring help to those in need.
Q Ari, in the patients' bill of rights, there
are Democrats who see this House approach, especially on, yes, you can
sue in state court, but the way you get there creates something of a
maze before you can get there. What's -- in their view. To
the President's mind, what's the road map here for some kind of
compromise that allows patients to do something that Republicans have
not heretofore supported, which is suing in state court and also
satisfying him?
MR. FLEISCHER: Let
me begin with a basic building block. And that is why, in
the President's opinion, it's important to protect people's rights and
access to health insurance by keeping these cases primarily in federal
courts. And the reason is relatively simple.
President Bush believes that these suits are
best handled in federal court because people typically receive their
insurance through their employee. And those employees
provide the same type of insurance to the residents who live in Maine
as they do to the residents who live in southern
California. In other words, there is a universal health care
plan that is offered throughout these companies.
And one of the reasons that plan can be
uniform and universal and therefore available to so many tens of
millions of Americans who get their insurance through their employer is
because they know they can offer one package to all their employees and
not have to design 50 packages to conform with 50 laws in 50 states.
If all of a sudden for the first time, these
employees had to revise all their health care plans to have 50 plans in
50 states subject to 50 different suits, millions of Americans could be
at risk of losing their insurance. It makes it very hard and
very complicated for people to get their insurance. And
that's the benefit of a federal system that has brought health care to
so many workers. And I dare say, many people in this
room. You all work for corporations. The reason
you are able to have this insurance, whether you are stationed here in
Washington or whether you worked out of a bureau somewhere else, you
would still have the same insurance policy. And that's
because of the federal nature of insurance regulations.
If you, for the first time in this
legislation, say it's better to have suits heard in the state court
than the federal court, you begin to undermine the uniformity that has
allowed the package of benefits to be delivered to so many millions of
workers. That's the building block. That's why the
President believes these cases are best heard in federal
court. If you put them in state court, as the McCain-Kennedy
approach does, then you have no caps, in essence, on suits, on damages,
and you'll have 50 different provisions for how people can get their
insurance. And that's going to put people's ability to get
insurance at risk. That's why the President believes it's
best in federal court.
He has, in the case of
the Fletcher bill, indicated some flexibility on that, and that would
apply to what you would call "bad actors," and that is, if an HMO,
having lost a case before an independent review organization, still
denies care to someone who needs the care, in that case, the President
would say, you've been a bad actor, you have not listened to the
independent review organization, you have bucked their will, an
independent review organization should be listened to; therefore, as a
punitive step to give you an incentive to comply with an independent
review organization, those cases can be heard in state
court. And that's a compromise the President is willing to
make. The President hopes that the Congress also will be
willing to compromise.
Q Ari, who is coming to the meeting today, and
what is the purpose of the meeting?
MR.
FLEISCHER: The purpose of the meeting is to discuss with
many members of the House who have shown a willingness to work toward
an agreement on a patients' bill of rights, have an opportunity for
them to hear the President's point of view on how strongly he feels
that legislation can be signed into law if the Congress is willing to
compromise. So you're going to see many people who have
worked very closely with Congressman Norwood, with Congressman Dingell,
who are part -- Congresswoman Nancy Johnson, for example, who are part
of what we view as an emerging compromise -- are the people who will be
invited down. And we will have that list of people for
you. I just want to again make certain that those who have
been invited will actually be here.
Q Do you have a few names? I mean,
has anybody --
MR.
FLEISCHER: Again, we'll put that out as soon as we're able
to confirm actual attendance.
Q -- Norwood or Dingell --
MR. FLEISCHER: You'll know soon
enough, as soon as people are here. What I always hesitate to do on
member meetings is indicate who is invited because, if somebody gets
caught up on the Hill in another meeting or in another vote, out of
respect for the members, we don't like to indicate they were not able
to make a meeting.
Q Hastert?
MR.
FLEISCHER: The Speaker is not coming. It is more
rank and file membership.
Q How are these people being
chosen? Is it people who supported Norwood-Dingell or who
seem willing to support something now?
MR.
FLEISCHER: Many of the people are people who have supported
the Norwood-Dingell approach.
Q But do you have an indication they may move
and support something closer to the Fletcher bill or --
MR. FLEISCHER: The purpose of the
meeting is to continue to look for ways to put together compromises and
to work with people who are willing to get a patient bill of rights
signed into law.
Q Are
those who supported the Fletcher bill also who are coming?
MR. FLEISCHER: There will be some
who support the Fletcher bill coming, too.
Q Let's move the debate question from the front
of liability to these independent review boards. Democrats
argue that the Senate vehicle the White House has supported, and even
in this emerging Thomas Fletcher bill, HMOs are in the driver's seat as
to who sits on these review boards and, in some cases, provide the
financial backing for the review boards themselves. Their
accusation is that they are truly not independent but much more
beholden to the HMOs than would outwardly appear.
What is the White House position on how these
independent review boards should be created, who should finance them,
and what role, if any, the HMO should play in their membership?
MR. FLEISCHER: The independent
review boards must be independent. They cannot be controlled by the
HMOs, otherwise they would lose that independence. The
purpose of an independent review board is to give consumers a right to
an external appeal if they file a claim with their HMO and the HMO
denies the appeal. It must be independent to be effective,
in the President's opinion, and he will support legislation that makes
them independent.
What's interesting here is
if there is a dividing line between the President and some in Congress
who would prefer to have health care matters settled in court, as
opposed to have health care matters settled before a panel of
independent doctors, is that people don't want to go to court. They
would much rather get quick adjudication and settlement through an
independent review board.
The problem the
President has with the approach of some of the democrats on patient
bill of rights is that they will immediately try to get people into
court, where the first thing somebody has to do is pay for and hire a
lawyer. And health care should not have to be administered
through lawyers. Health care, in the President's opinion,
should be administered through health care professionals and
providers. The Democrats' solution is to right away go to
court. The President's solution is to right away get people
care.
Q Are you saying
that if the President is persuaded that these independent review
boards, in whatever legislation finally emerges, are not truly
independent and that the HMOs, in fact, do have a broad say in either
financing or makeup, he will veto the legislation?
MR. FLEISCHER: I'm saying they have
to be independent. The President supports independent review
boards.
Q Does that
mean that the HMOs can -- How do you pick the board
members? How do you pick the board members? Who?
MR. FLEISCHER: That's all part of
the specifics of the legislation, in terms of who gets to serve on an
independent review board.
Q How does the White House see it?
MR. FLEISCHER: It's typically done
by a combination of factors that bring outsiders into the organizations
that are done in concert with the health care professionals and with
the consumers.
Q Would
this review board be made up of medical professionals, or would they be
accountants?
MR. FLEISCHER: Yes,
medical professionals.
Q Moving on to the Senate, can you share with us
the President's views on the Snowe amendment and a little bit of their
conversation, recent conversation, prospects for it over there?
MR. FLEISCHER: The President views
the Snowe amendment as one of several steps that need to be taken in
the right direction. But the President supports a
comprehensive fix of the liability problems that are presented in the
legislation currently before the Senate. The Snowe bill is
one step in that direction. More need to be taken.
Q I have a couple
global warming questions. When the President meets with the
Prime Minister of Japan this weekend, will he seek to get Japan to join
the United States in some alternative way of dealing with this outside
the Kyoto process?
MR.
FLEISCHER: Ron, I think we will have a little bit more
closer to the meeting on the agenda with Japan. I anticipate
that the topic of global warming can come up and I think that you will
hear the President indicate what he has indicated publicly before about
his desire to find a way to reduce greenhouse gases, and he will share
that with the Japanese Prime Minister.
Q And the other question is, when the next round
of global warming talks in Bonn next month -- which the President
agreed the U.S. would participate -- will the representatives there
flesh out in any way what the U.S. alternative approach is?
MR. FLEISCHER: I will have a little
bit more on that closer to the event. I don't want to
predict this far in advance of it.
Q Could I follow that, Ari,
just a moment on global warming? The Kyoto -- it was actually the Rio agreement
called for a sharing of a billion-dollar fund between many of the principal
countries involved, and the United States had committed $400 million to that
fund under President Clinton. Is President Bush going to live up to that
commitment, or is he going to rescind it? Because if he were to pull out, that
could defeat the entire Kyoto protocol right there.
MR. FLEISCHER: Let me take that question and get back to you.
Q Ari, back to
the state court versus federal court issue. It takes a long,
long time in federal court for civil cases to come to trial. There
just aren't that many federal courthouses compared to state
courthouses. There is a big civil case
backlog. And it's more expensive, generally, because getting
a lawyer who practices in federal court tends to cost
more. Is the President comfortable with making people wait
years before they come to adjudicate their health care claims and make
them pay a lot more --
MR.
FLEISCHER: State courts are not exactly known for their
swiftness. There is a whole problem with having courts
resolve these problems. The President believes very strongly
that individual health care consumers who are denied the health care
that they are entitled to, as determined by independent review
organizations, have a right to sue the HMO.
The question is, is that suit best handled in a federal court or in a
state court? And as I explained earlier, there are real
problems and you are going to damage people's ability to get health
insurance if all those cases are heard in 50 different state
courts. It begins to undermine the whole pattern of people
receiving their insurance through their employers. And that puts
people's health care at risk.
Q It will take longer and cost more to send them
to federal court.
MR.
FLEISCHER: I'm not aware of the statistics that you're
citing, Terry. I know that it's always expensive to go to
court. Any time somebody sues, they make a determination to
go into court, and nobody is satisfied with a court system in which the
contingency fees give a lot of the rewards to the attorneys and not
very much to the consumers. And the President, again,
believes that when people are denied services, they want to quickly be
able to get the health care they need from a medical provider, and not
have to go and hire a lawyer and go to court and wait years for
adjudication of a court claim. The best system --
Q It will happen in
federal court --
MR. FLEISCHER: But
it will happen immediately. Under the Democrat proposal, you
will immediately go to court. There is such a loose system
set up for the independent review organization under the Kennedy-McCain
approach, that if you're under their approach, lawyers are going to be
able to find people to just take HMOs to court in 50 different states,
and we'll have a whole new system of insurance set up across the
country that's going to limit people's ability to get their insurance
coverage.
Q One more
on this. Chief Justice Rehnquist in the judicial conference
has said repeatedly that there should not be additional enormous causes
of action shifted into the federal court system. And they
don't like this. Does the President believe the Chief
Justice is wrong?
MR.
FLEISCHER: The President believes that a patients' bill of
rights should give people health care, and that if there is an
independent review organization set up properly, that health care will
then be delivered as a result of the rulings of the independent review
organization, so that if you are denied the care that you think you are
entitled to from your HMO, the HMO won't pay your claim, you go to an
independent review organization. The President believes the
independent review organization should be empowered to settle the
matter. And if they are empowered to settle the matter, the
fact of the matter is very few people will need or want to go to court,
whether it's state or federal.
And that is
the experience of the states. There are states where you are
entitled to go to court -- Texas is one of the states that has a very
powerful patients' bill of rights, but it also has a very effective
independent review organization. As a result of the power of
the independent review organization, there have not been a lot of
people who have felt the need to still go to court. And
after all, a patients' bill of rights is about getting people health
care, not getting people lawyers.
Q What happens now? The President suffered a setback yesterday in the
House of Representatives, the very overwhelming vote against allowing Mexican
trucks to come into the country. What can the President do to change the thing,
having such a large difference against him?
MR.
FLEISCHER: The President believes very strongly that what the House did
yesterday is wrong. And let me review the facts on this matter. In the vote in
the House of Representatives yesterday, they struck the President's request to
hire additional inspectors on the border so that trucks can be inspected to make
sure that they are safe. The President proposed more than doubling the number
of inspectors along the borders to inspect trucks to ensure they're safe. Yet
the House has eliminated the President's request to hire more inspectors.
The House also -- and I want to read this -- the amendment that was agreed to
says, none of the funds of this act may be used to process applications by
Mexico-domiciled motor carriers. They won't even allow applications to be
filled out. The House action had nothing to do with safety, it has to do with
banning trucks because they happen to be operated by our friends to the
south. And the President thinks that's wrong.
So the
President is going to work diligently in the conference to reverse that
action. Through the Department of Transportation, the
federal government has already issued rules to make certain that all
trucks that operate within the United States are operated
safely. By doubling the number of inspectors along the
border, as the President has proposed, the Congress can show its
commitment to truck safety. But the House, in the
President's opinion, should not ban trucks because they're operated by
our Mexican friends to the south.
Under the
DOT rule, individual trucks would be subject to inspection, exactly as
American trucks are subject to inspection. Same standards,
same rules. But the House just said, if you're operated by
Mexicans, no funds can be used to process
applications. That's not safety; that's
wrong. And that's why the President disagrees so strongly
with it.
Q But why are
you saying -- if it's not safety, are you saying it's racism?
MR. FLEISCHER: I'm saying -- I'm
going to read again from the amendment: None of the funds
from this act may be used to process applications by Mexican-domiciled
motor carriers. And then it continues and it has a little
bit of language about different zones, et cetera. But the
House action just says it's not allowed. The House action
was not tied to safety; in fact, the House action went in the opposite
direction on safety by striking the President's request to more than
double the number of inspectors. And this also raises real
complications for NAFTA and for free trade. And therefore,
the President objects to it on those grounds.
Q Can I follow up on that? The
government of Mexico has just announced that they are planning to close
the border of Mexico and close the roads for American
trucks. And also some Mexican legislator have said that
they're planning to go to the WTO to deal with this issue. My question is, is
the President planning to call the Mexican government, to plan some talks, or
other members of the government to try to deal with this issue?
MR. FLEISCHER: The place the issue needs to be
dealt with is in the United States Congress. And that's going to be the focus
of the President's efforts. And he's going to work hard to reverse this, and he
thinks it's the right thing to do.
Q You lost a lot of
Republicans on that vote. And you lost a lot of Republicans
on the off-shore drilling-monument issue. What's going on
over there?
MR. FLEISCHER: Well,
again, this is not final, and the President will have this conversation
in a couple of weeks before this gets final and you will judge whether
the President was successful in his efforts on this. He's going to
work hard on this issue.
Q Will he bring it up at the meeting today,
Ari?
MR. FLEISCHER: No, the
meeting today is about patients' bill of rights.
Q Does the President
think he's losing ground with his own party in the Congress?
MR. FLEISCHER: No, I think you're
seeing a President who has, frankly, been very successful on
legislative matters. The tax cut, as you know, passed with a
very large, overwhelming margin. The education bill passed
with a rather large margin in the House, large margin in the Senate.
And what you are talking about here are amendments on broader
appropriation issues. It is not unusual for Congress to
speak its mind on amendments and for that process to change several
times.
That's one of the reasons that in the
House, appropriation bills are one of the few bills that are subject to
amendment. Not every bill that moves through the House is
subject to wide-ranging amendment. So it's not at all
unusual for the House to express itself, and for the House then to take
additional or corrective action when it gets to conference.
Q Ari, does the
President believe Mexican trucks are as safe as American trucks?
MR. FLEISCHER: The President
believes that all trucks operating in the United States have to be
operated safely, regardless of who is at the wheel.
Q You said that the
House action was not about safety --
MR.
FLEISCHER: The one standard should apply to all, and that
is, are the trucks safe. And under the rules as announced by
President Bush's Department of Transportation, all trucks are subject
to the same safety requirements. And that should be the
factor. And by doubling the number of inspectors, it helps
guarantee the safety of all trucks traveling on American roads.
Q How do you know the
House action is not about safety? If they're banning Mexican
trucks and if they're assuming that Mexican trucks aren't as safe, then
isn't it about safety?
MR.
FLEISCHER: Well, there was a report that I saw this morning
-- this is why I addressed this -- there was a report this morning that
was erroneous, saying that the House voted to make certain that trucks
from Mexico are subject to the same safety requirements as trucks from
the United States. That was not what the vote
did. And so I'm saying that -- actually addressing that
interpretation of the House vote, because there was nothing to do with
that in the House vote.
Q Ari, how long was the discussion with Tom
Daschle this morning?
MR.
FLEISCHER: I didn't ask the President how long it was.
Q Back on this question of the appropriations
vote yesterday. Republicans I've talked to said the White House was caught
completely flat-footed, the legislative shop had not engaged on this issue. The
Teamsters had been working it for three and four weeks very hard -- the
Republicans who voted against the White House position on it, many of them are
strong labor Republicans, and that you were simply out-foxed and out-worked on
the floor dealing with an issue that, as you already identified, violates the
President's position on three key issues -- free trade, NAFTA and the safety of
trucks operating --
MR. FLEISCHER: As you know,
there are very often amendments that are agreed to shortly before they're voted
on, and there is not a long lead time before the votes take place. The vote was
what it was and the President has said what he has said.
Q Any message for the
President from the Indian-American Association of Physicians from
India? They are having a convention this afternoon in
Washington, D.C., and they do support the President's patient bill of
rights, number one.
Number two, Sonia Ghandi
will be in the White House today and tomorrow, the opposition leader in
India, and President of Indian National Congress. Is the
President going to drop in or is he going to meet with her?
MR. FLEISCHER: I am so focused on
answering your questions today, I have not looked at his schedule for
tomorrow. I don't know. I'll have to take a look
at that later today and let you know.
Q And just to follow that, the Indian government
have arrested a number of terrorists in connection with Osama bin Laden
and his activities, also in Saudi Arabia now. Osama Bin
Laden has called on India, that he will destroy all the U.S.
installations and all the U.S. interests in India. So what
is the U.S. government doing? Has the President spoken with
the Prime Minister of India or anybody there?
MR. FLEISCHER: The President is always concerned about
extremism and terrorism and that is particularly the case with Osama
Bin Laden. And the United States, working with our allies
around the world, will remain vigilant in making certain that all steps
are taken to prevent terrorist acts from taking place.
Q Ari, about global
warming issues, is there any possibility whatsoever of the President
changing his well-known position on the Kyoto Protocol as a result of
his meeting with Prime Minister Koizumi Saturday, or would you totally
rule it out?
MR. FLEISCHER: I
think you have heard what the President has said about global
warming. He is committed to reducing greenhouse gases and
his position is consistent.
Q A number of the President's presidential
predecessors have been called upon in their constitutional requirement
to see that the laws are enforced, to take decisive action to back up
the rulings of the United States Supreme Court. And my
question, the first of two: Since the D.C. Human Rights
Commission has been reported on page 1 as having defined the U.S.
Supreme Court in the case of Boy Scouts of America versus Dale, by
ordering two homosexual troop leaders restored to their former post.
President Bush won't allow this, will he,
Ari? Or will he?
MR.
FLEISCHER: I'm not familiar with that issue, Les.
Q It was page 1 of The
Washington Times, Ari. Is the President going to allow this
local thing to defy the Supreme Court?
MR.
FLEISCHER: I have not talked to the President about it and
he does not get involved in these local matters.
Q The top of page one
of this morning's Washington Times, which I'm sure you and the
President read, reports that U.S. Commission on Civil Rights Chair Mary
Frances Barry is being charged by Florida Secretary of State Harris
with conducting a bogus investigation because she was a supporter of Al
Gore. And since, there have been a number of similar charges
against Barry. The President isn't going to remain aloof,
and let her continue in this office indefinitely, and not -- he won't
-- not support Secretary of State Harris, will he Ari? Or
will the President leave this to what might be called an
Ari-illusive? (Laughter.)
MR.
FLEISCHER: Les, for some questions, that is deserved and
redundant. First, the President is always concerned about
any matter dealing with any allegation of any racial problems in any
elections. And he is very cognizant and careful to make
certain that all the laws of our country are followed, so that everyone
has the right to vote and that that right is honored.
In the case of this specific report that you
site, there have been many questions raised about whether that report
was accurate, and whether the motives for that report were
political. That report was not shared with all members of
the panel before it was offered publicly. So there are
important issues that need to be looked at.
Q When's he going to take action on this very --
I mean, it was a Harvard Law researcher that did a huge article on a
number of things. He's done this all over. And
when is he going to --
MR.
FLEISCHER: I think I've addressed the question.
Q Is he going to leave
her in office forever?
MR.
FLEISCHER: I've addressed the question as fully as I can.
Q On the Senate side,
the patients' bill of rights is silent on the issue of suing in federal
courts, or in fact they don't have that as an avenue. When
and if the bill gets to conference, is the White House signaling today
that they want Senators Breaux, Jeffords and Frist to embrace this idea
of having suits --
MR.
FLEISCHER: Which Senate bill are you referring to?
Q Breaux, Frist and
Jeffords. Their view of patients' bill of rights does not
allow for suits at the state level.
MR.
FLEISCHER: Well, there bill represents what the President
believes in, as I explained earlier, that it's best for the health care
consumers if cases are brought to federal court. That's what
the President believes, and that's why the President supports that
approach.
Q They have
no avenue in their state court suits, even on a limited circumstance,
such as in a bill by Fletcher and Hastert. So are you saying
in conference --
MR. FLEISCHER: The
President has indicated that both approaches meet his principles,
because both approaches allow patients the right to sue, but mostly in
federal court or entirely in federal court. And let me --
because you brought this up, let me talk a second about the other bill
that is moving in the Senate, which is the Kennedy-McCain bill, in
terms of what that does in terms of the venue of court cases.
That bill creates a $5 million punitive cap
for federal court only. That bill creates no caps for suits that are
brought in state court, and it has no non-economic damages in state
court. The McCain-Kennedy bill has one very narrow provision
allowing a small number of cases to be heard in federal
court. But under it, most cases would be brought in state
court.
So the problem is not only the level
of the cap at $5 million for those few cases that would be brought in
federal court, but under the McCain-Kennedy approach, it would funnel
most cases to state courts, which will undermine people's ability to
get health care insurance.
Q There's also -- the Senate is working on a
compromise plan that would have a $750,000 cap for non-economic damages. Would
that be acceptable?
MR. FLEISCHER: Again, I'm not going to negotiate
for the President through the press. But the President does think a $5 million
cap is too high, and the President thinks that there would be too many cases
brought to state court, where the cases should be properly heard in federal
court, under the approach that you just cited.
Q There is an
argument, Ari, that any patients' bill of rights bill, no matter what
the approach, is bound to fail. This argument was put forth
most recently by Marcia Angel, who's a former head of the New England
Journal of Medicine in a New York Times column a couple days ago, A
Wrong Turn on Patients' Rights. And she argues as follows:
She says it's becoming apparent to nearly
everyone that our experiment with private managed care has
failed. The system is imploding in the patients bill by
increasing costs will accelerate its demise. And then she
says, the answer is a single-payer system that covers everyone and more
efficiently uses the resources we allocate to health
care. This is tantamount to extending Medicare to all
Americans. Two questions: One, do you believe
that this private system has failed? And why not Medicare
for all?
MR. FLEISCHER: The
President believes very strongly that people should have the right to
have choices in the health care marketplace and, for some people, they
will voluntarily want to have managed care. For other
people, they will want to have fee-for-service care. There
are other people who want to have PPOs, provider-sponsored organization
care. For some people, medical savings accounts made sense.
But the point is, health care should be in the
hands of the consumers and they should be empowered to enter the
marketplace and get the insurance and the health care that they think
is best for them and their families. And many people in this room
wrote extensively about senior citizens who lost their HMOs because
HMOs did not have sufficient reimbursement rates, which Congress fixed
and President Clinton signed into law late last year, to increase
reimbursements for HMOs. And many seniors said thank you to
President Clinton and to the federal government because it preserved
the option that they themselves chose.
And
through HMOs, many seniors have access to drugs, for example, that they
do not get under typical Medicare. So the President believes
the answer is empowering consumers with choices.
Q But just to follow
up, if in fact that's the argument, why not just repeal Medicare and
give seniors choice, total choice?
MR.
FLEISCHER: Seniors are increasingly receiving
choices. As a result of some of the reforms that were
created in 1997 that President Clinton signed into law, seniors did for
the first time have choices available to them under
Medicare. Seniors, for example, for the first time can have
medical savings accounts. Seniors, as you indicate, are in
HMOs if they want to be in HMOs. Seniors have to pay
Medigap, however. Medigap is very expensive. So
there are a series of options available to seniors --
Q But why not repeal
Medicare?
MR. FLEISCHER: The
President believes very deeply that we need to have Medicare, and he
believes so deeply in it that he wants to make sure that the system is
there for younger workers, young people. And that's why he
proposes to save Medicare, because Medicare, like Social Security, is
going bankrupt.
Q Two
quick questions. First, has the White House been in touch
with Secretary Powell since he arrived over there?
MR. FLEISCHER: The President has
not talked with the Secretary since his arrival. The
Secretary is in the middle -- actually at the very beginning of his
meetings. The President will be talking with him, but has
not done so yet.
Q And
then a second question is, was the administration taken by surprise
yesterday by Prime Minister Sharon's insistence on a 10-day period of
complete peace for Israeli citizens?
MR.
FLEISCHER: I think what the Prime Minister said privately in
the Oval Office are very similar to things he had said publicly up in
New York and in other places, about that he wants to reduce the
violence to zero and that he had an approach that he shared with the
President.
Q Specifically on a 10-day period, that seemed
to be new. And I wondered if the administration had heard
that before from him or not?
MR.
FLEISCHER: I would have to check with Condi or check with
the President. But I don't think there were any surprises
there.
Thank you.
END 1:50
P.M. EDT
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