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i New York: 2'J230'9•1400 RADIO Chicago: 312•541-2020 ' I Defro;t 3'13-344-1177 i VREP(D RTS 6os Angeks: 2J3!466-6124' Washingfonj D:Cs 301a656-A068' Boston: 617,536'•2232 _. _Nl1'~OWA4 MIARK~T;C®V'.ERi{1GE Philadslphia: 215-56'7 76'00 San Franciscx 213-466.6124 TRANSCRIPT' FOR PHILIP MORRIS STATION WABC/TV Mami: 3053583358' PROGRAM' NIGHT LIIr1E' SPECIAL EDITION CITY NEW YORK DATE 9/23/93 10:00 P.M. AUDIENCE SUBJECT HEALTH CARE REFO'RM/PRESIIDENT CLINTON AT TAMPA, FLA. TOWN MEETING FULL TEXT ANNOUNCER: An ABC News Break. Now from Washington, Carol Simpson. CAROL S IMPSON - ANCHO'R : Good evening ! Pres ident C1 inton and much of his Cabinet were out barn-storming today for The Administration's Health Care Plan. An ABC News Washington Post poll shows the public re'sponding favorably, although Sena~torRepublican Leader, BobDe1le warns ofalong andtorturous road ahead. Coming up next' on a Special Edition of Night Line, The President, pitching the health, plan and answering questions Iive' at a:Town Meeting.. * . . (FILM CLI'P). TED KOPPEL - ANCI3OR: The President arrives in Tampa, Florida. A medium-sized city where one out of five people has no health iznsurance. (FILM CLIP) KOPPEL: There are a hundred different ways it can go wrong. How can you be sure it's going to go right for you? ~ PRESIDENT WILLIAM CLINTON - UNITED STATES': I can't. You O ~ know, somebody may ask me a question that I don't know the answer to, even though I've been studying this health care system O seriously for three and a half years now. Andi I've tried very hard ~ to keep up with the work of the First Lady''s Task Force, not just ~ ~. While Radio iv Repons endwvors b asawe 1he oceuvcr of nwbeial isuqqlied by it; it canrwt be respansible (a misloks or omiasions: lvlalsriol supplied by Radio 1N', Repons may be used 6 file ond r.(sr.nce pwposes onl'y. M moy, nd be repnmduaed; sokd ar, publicly demonstrated or enhibif.d-

- 2 - in general terms, but in the.details. While I've been working, on the budget and the re-inventing government project and all the things we're doing, - you know - I may not know all the answers, so, if someone asks me a question I can`t answer, I brought Mr. (1naudible), and a lot of our crew down here tonight, and during the breaks., I'll try to get the answer. I'll just tell them, I just dbn't know. TOM FRIEDMAN - NEW YQRK TIMES: This is Mr. Clinton's format and - um, - this certainly plays to his strength. That''s for sure. ANN DEVFtOY- WAS'HINGTOU F5OST: I think he knows his faictsf better than any President I've seen on a domestic subject. I think we're going,to have a lot of questions. UNIDE1tiiTIFIED WOMAN #2: It's going to be: a pretty tough, crowd, I' think. KOPPEL: Dolyou think so? LINIDENTIFIED1WOMABi' #2 : Yeah. And I' dilike to ask him, how he sees home care .... UNIDENTIFI'ED, MAN #1: I just wonder what this:is going to do, to his deficit reduction bill. UNIDENTIFIED MAI+d #2: We want to know if' President Clinton's plan will make the temporary job services accountable for their health insurance:. PRESIDENT CLINTON: jWhat I' want people to know tonight is that - that a -- first of' all, this is by far the most comprehensive effort ever undertaken, to study and'resolve the problems of the Americamhealth care system. That we're determined to keep what is right with the system. And that we're taking great care with this to do it right.. (OVERLAPPING VOICES) KOPPEL: All of those comments were recorded jlust minutes before air time. Those were The President, members of The White House Corps, and'members of our audience, here in Tampa. And' now, ladies and gentlemen, here, joining us live in Tampa, The President of the United States. ~ (APPLAUSE/MUSIC)' ~ ~ ANNOUh7CEFt': This is an ABC News Special Edition of Night ~ Line. A Town Meeting. Health Care: The Clinton Prescription. ~ Now, reporting live from the Tampa, Bay Performing Arts Center, Ted ~ ~ ~

- 3 - Koppel. TED KOPPEL - ANCHOR: We11, Mr. President, Welcome. standing ovation. It's got to be down-hill from here on in. ( LAUGHTER). PRESIDENT CLINTON: Oh, ho! Well, a lot of the: work is still to be done. KOPPEL• Indeed. I' m gping to begin with 'what may seem like a, rather trivial thing. Although, it really wasn't trivial to you yesterday. There you were, you were in front of a Joint-Session of Congress. You had the Joint Chiefs of Staff there. You had your Cabinet there. You were talking to tens of millions of people and you step up~to the podium and if you' d be good enough, to take a look at one of those monitors there, we're going to run the video. (APPLAUSE') KOPPEL: What did you see?' Actually you can look at that one over there. What were you seeing as you looked out there? ( APPLAUSIE) . PRESIDENT CLINTON: You can see the teleprompters there!. Can you see it folks, that little plate there? Now watch. ( ;LAUGHTE'R ). PRESIDENT CLINTON: I'm, telling the Vice President how they've got the wrong speech onithe teleprompter. (LAUGHTERJ. PRESIDENT CLINTON: He said, that' s impossible. I said, - "you're not reading it. Read it. Read it." That's what I said to him. (;LAUGHTER/APPLAUSE) PRESIDENT CLINTONi: So, it turned out that we had -- that the people with our communications department haditypedlin the speech for the teleprompter on a disc that had also had my State of the Union Speech in February. And when the disc was called up, it started at the State of the Union, instead of at the Health Care Speech and I thought to myself, that was a pretty good speech, but not good enough to get advice(?). ( LAUGH'TER')

PRESIDENT CLINTON: So, that''s what happened. KOPPEL: When I was looking at The First Lady there, you must've talked to 'her later on, it was almost as though she: was telepathic. She looked worried. She knew there was something wrong. PRESIDENT CLINTON: She knew there: was something: wrong. My daughter, actually, watched at home, told me, she also sensed there was something wrong. And I just decided I was going to give the talk. I mean, I had - you know - I didn''t internalize it, I had workedi on writing it with our folks. The only problem is when you have to go through a lot of points, and you can't just read it, so, I would just look at the first line! and try to recall from memory. I didn't want to miss anything. And the other problem was if the teleprompter goes off, that's one thing, you j'ust look at the aud'ience, just like I' m, looking at you. But imagine if' I've got these teleprompters here and I'm trying to speak and the wrong words are going up on the screen ... ('LAUGHrI'..ER) Pbt'ESIDENT' CLINT.O'N: ...which, is! what we started out to do. So, I had to ignore: all these words and try to look through the words to the people. But about 8/~9~~ minutesi ~ iinto~ the speech, he~~ --~~ they~ --~ a fella figured out what was wrong, pulled up the right speech, andi then whizzed through it, to f'igure out ... 4 (LAUGHTEII). PRESIDENT CLINTON: ...where I was and from then on in, it was reasonably normal.. KOPP'EL:. Well, I've gotta(sic) tell ya!(sic), Mr. President, as a communications specialist, and it may be the last nice thing I say to you, or for you this evening, you had my admiration. I can' t tell ya (sic ) how tough that is when you've got the wrong speechgoing by and you did an extraordinary job. Let us take a look at how the speech played. We've got some phone numbers there. Before the speech, you can see we took a polr-- and 43% approval of your health care plan and 41%, disapproval; Let's take a look at after the speech. Up to 56%, approval, 24%, disapproval. Now, you're too good a political pro ... (APPLAUSE) KOPPEL: ...you're.too good a political pro to put too much

- 5 - faith in that sort of kick that you get right after a speech. How tough is it gping to be to hold on to that? PRESIDENT.' CLINTON: I think it depends upon how good a line of communication we can maintain with the American people. And how open1we can be in working this process through Congress. There will be a lot of people who, will honestly disagree with, cer+..-ain things I have recommended. There'll be a lot of- other people who will not want it to happen because they will make less~ money out of the system that we propose or because it will require them to change. And they will all be heard. So, that thet important thing i.s that everyone u'nderstand that this is an extremely complicated thing. You've interviewed me before and I saw your show tonig,ht. I've been working on this issue seriously for three and a half years. And I've been dealing with health care as a Governor, Attorney General, asi a citizen for a long time, but really workirng on the systematic problems for three and a half years. And talking to hundlreds of doctors and other experts all around the country. It's a complex thing. But I think if the American people know that Hililary and I andd our Administration, that we're listening to people and that we're really shooting, them straight, then I think we can maintain support for change because the reason there's so much support for change among Republicans and Democrats and all the people in the healthh care system, is that those who know, the most, know we cannot afford to continue with the system we have. It's bankrupting. the country andinot helping people. KOPPEL: Mr. President, we've got an awful lot of people here, who I know want to ask questions. II just want to show you one! more poll result. Take a, look. I worry my future health care costs won't be taken care of. hTow, look at how many people agree with that statement. That's after hearing your speech. PRESIDENT CLIhTTI'..OTiT': They should worry about that. KOPPEL: Why do you think it's still so high? Two-thirds of the.American public still worry that their future health care costs won't be.taken care!of. PRESIDENT CLINTON: Because health care costs have been going ~ up at twice the rate of inflation or more. For people insured'in ~. small businesses, more than twice the rate of inflation,. Because ~ at any given two year period, almost one in four Americans don't 4.i have any health insurance. Because about a hundred thousand 0' Americans a month lose their insurance! permanently. So, how could FAi people not? And even if that hasn't- happened to you, almost )-Pb everyone.of'usknows someone that it's happened to,. ~ . ~'

- 6 - KOPPEL. Let me ask you a favor, Mr. President, I''ve.already talked to the audience outhere: andas~ked'themtbesamefavor. They're going to introduce themselves to you, tell you their names,, and! who they are. We've got so; many people who want to talk to you, to the degree that we can, let's zip~ through as many ques.tions and answers as we can. Ma'am(?), you've got the kick-off'question. Goo ahead. KATHY BLOUNCE - HOME'-MAI+CER : Hi. My name is Kathy Blounce (? )l and I'm a homemaker. I have a 4!-year-old son, who three years agoo had a near drowning accident and just barely survived,. Drowning. Due to neurological brain damage, he requires physical, occupational and speech therapy three times a week, every week, forr the past three years. I'm very concerned that, number one, he won't be able to continue this long-term therapy. Number two, that he won't be able to d6 it at a, specialized children's therapy center. And number three, we already pay for the most expensive coverage we can through, my husband's work in order to just get this coverage. And I'm afraid that, if it costs:any more, we won't be able to continue the therapy for him, that he needs. PRESIDENT CLINTON: Well, first of all, it won't get any worse.. That is, if you' re paying for it now and you have coverage that covers that, there's notihingito prevent that from continuing in our system. Anybody, for example, who's got a situation at work where your employer's payiing 100!s of your premiums, that can continue. So, you shouldn't worry about that. But in alll probability, because of'the changes in our plan, you will have more secure coverage. That is, if' this plan passes, you will know that the coverage you have can never be taken away from you and that we will cover primary and preventive services and those kindls of long- term care services for children are very important. A1so, what we want to do, that is very impo,rtant,, especially in the event that, if your husband has to change.jobs, we're going to rate all families in America under a broad-based community rating system so that peopl~e go into: big pools. Insurance companies make money like grocery stores do, a little bit of money on allot of people., instead of a lot on a few. And we all share the risks in ways that will guarantee that you'll always be ab1.e to get insurance at lower rates, than would otherwise be the case. KOPPEL:~ All right. Let know that none of you~ is going me move right on andlforgiive me,, I to be satisfied and would like to ask follow-up questions, but we are gping to try and move around. All right. Go ahead, sir. -- -- -N DR. ERIC'KAPIAN - PSYCHIAT RIST: Hi. My name''s Doctor Eric ~ Kaplan. I'm alpsychiatrist in Tampa. First of all, on behalf of ~, my patientS and their families, I'd like to thank you for including ~ mental health benefits as part of the~comprehensive health package. ~.a ~ ~

My question for you is for out-patient services for the mentally ill, will they be paid at a cost that is equal to: other medical illnesses or will they be paid at a lesser rate; such as Medicare, which is, many of us feel, is discriminatory? PRESIDENT CLIh7TOU: It depends. The reimbursement rate will depend upon what plan the person joins, who wants the mental health care. For example, each individual will choose what health plan they belong to. If you chose, for example, a preferred provider organization where a lot of doctors get together andi offer to give services, they will prescribe what the reimbursernent rate will be and what the cost of'the plan will be. If you -- if a person joins a fee for service plan, then the reimbursement rate will be published!on the front and it will be agreed to by the doctors, in the beginning. But the government won't set the rate. So there will be some more flexibility there. And let me also say, because I don't want to over-promise in this thing. I really believe it's important for us to cover mental health benefits. But we're not going to be able to cover the full range of'mental health benefits because we don't know how to cost them out very well. As much as I think we should'until the year 2000. So, there won't be unlimited visits, for example:, until the year 20!00. But we'll start with some hospitalization that's significant and a, number of visits per year andl then build up to full coverage over the rest of the decade. KOPPEL: Mr. President, we also have our financing, plan here. We have to take some commercial breaks and we'll take the first of them right now~. We' 11 be back with President. Clinton and with our audience here in Tampa, in just a moment. w . . (FILM CLIP - iJhiIDENTIFIED~ DOCTOR: I'm concernedi that we're gping to try to fix some things and in, the process, we're going to break things more. UNIDENTIFIED MAN: We need to do some reform and he's headed ~ in the right direction, trying to do something. And I'd like to ... ~ UNIDENTIFIED DOCTOR #2: Bring in a system in which,, we have ~ such a, tiered system, people who receive no health care, some ~ people who receive opulent health care is an embarrassment. ~j N ' -4 Q

8'. END OF FILM CLIP) I+COPPEL : Now, if you' 11 take a look at the po:l l, I don''t know if you can readi -- your eyes are probably better than mine:. I can't read'i those results from here. Can we put it up on the big screen? Can we see the poll up:there? PRESIDENT CLINTON: I see it. KOPPEL:! Can you read it? Well, would you be -- there we go!. They think your plan: versus the present system - 64% think it's better, 17% think it's worse, 3% think it's the same:. Again, - that's~pretty good. I mean, you can't expect it to do much better. PRES IDENT' CLIhJTON!: And 64 % are right. (LAUGHTER /P.P P LAUS E ) PRESIDENT CLII+ITONl: They're right about that. Yeah. KOPPEL,: Just to keep things fromigetting too dull, let's see if we can get a question fromi one of the 17%. All right? Goo ahead. JEAN PARKER - HOME-MAKER': Mr. President, I'm Jean Parker, a homemaker, retired. I' m, a, caregiver for two Alzheimer victims. I represent the Alzheimer Association in Tampa and I' have my mother who is 85, been in a care facility for five and a half years. My husiband, 66 years old~, is in a, care facility, nine months. Whatt will your health care program do, for me? And these! other caregivers? PRESIDENT CLINTON: It will do three things. First of' all,, for people with Alzheimer's, and other problems~ that require institutional care, we will continue to cover that. And we will cover it, at least as well, or better, as now. But secondly, over a period of years, now we can't do all this at once because we haveo to phase.in the coverage as we realize more savings from the wastef of the existing system. But over a, period of years,, we will alsoo reimburse people for in-home care. Because oftiezn, times, it's less~ expense to maintain people in-homes than in nursing homes. So, we! will, for the first time, have a, system, by which, people can actually have coverage for in-home care. And that will include respite care too. If for example, you are: taking care of a parent or a spouse, you're doing an incredible: service for our society. You're keeping your family together. And you're saving money for the system, but youl're entitled to a little: time off, and so under this system, over a period of years, we'd actually set up a reimbursement system so you could be reimbursed

- g - or covered to bring,in a nurse. For example, if you wanted to take a 4-day, week-end or something, just to get away from the pressure of your duties.. And over the longirun, this will enable.more people to keep their families together, lower the cost of care by keeping moree people out of institutions and make for, I think, a better quality of life in our country. KOPPEL: To the degree that you can, Mr. President, can youu give a sense of what the progression of years is going to be? In other words, you keep saying, we're.not going, to be able to do all of this right away. PRESIDENT: Sure! Yeah, I can. Let me say, first of all, we assume that it willl take a period of several months for The Congress to work through this. But I must tell you, this is the best spirit I have ever seen in The Congress, at least in modern times, among Democrats and Republicans. First to learn everything they can and second to,, work together. We're in Florida tonight, we have six members of the Florida delegation up here, three Democrats and three Republicans who came down here with me tonight and that's sort of the attitude that's going on. So, let's~assume we pass a bill sometime next year. The first and! most important thing, we have to do is to lock in basic security for everyone. So, we want to get that done by 1996. That is, everybody's~covered with comprehensive benefits and then between 1996 and the year 2000, we want to phase-in, each year more of these long-term care benefits. . So, it'll be about a 5-year period after the!basic benefits come in. KOPPEL: You, have got to be concerned. There's a little thing called re-election that has to kick in before you can be sure that you're gping to be able to continue doing these things into a second term. You must feel tremendous, pressure to get a lot of' this done by the end of'your first term. . PRESIDENT CLINTOhi:! Well, what I feel the pressure to do, is to, at least, pass the legislation and get the: security in. I' waant everybody to have their health security card sio they'll know they have comprehensive benefits they can't be taken away. They can't lose. If that happens, I believe that the public feeling for this will sweep across America without regard as to party, to region, to age That the American people will see'this as a descent humane thing that we have waited too long to do,. And that it will then be a tide that no one can turn back. And no one will really want to turn back.

- 10 - KOPPEL: Let me ask you to swivel around'and I know you wanted to acknowledge! the Attorney General, who's sitting out there. So, if we can jlust db that, ... PRESIDENT CLINTONi: Say hello to Attorney General Reno... (APPLAUSE) PRESIDENT CLINTONi: She's here with me, in Florida. (APPLAUSE) PRESIDENT CLTNTON!: She wanted to come home with me, you know. Janet Reno is from Florida, for two, reasons!. First of all, we're going to do an event tomorrow dealing with young people andd crime and the cost that that imposes on our health care system andd because she also, is! deeply concerned about what she can do~to help deal with some of the issues.here. The Attorney General must enforce the Americans with Disabilities Act, for example. Attorney General has the power to reach and deal with our young people in ways that can have a direct impact on the quality of their lives and health care in this country. So I -- she came diown here, and I'm glad she's here. KOPPEL: Swivel your attention over to the! left. The gentleman up there at the microphone. Go ahead, sir. FRANK: Yes sir. Good evening,, Mr. President. PRESIDENT CLINTON:~ Good evening, sir. a FRANK: My name is Frank (Inaudible)~, and I'm a retired school teacher. An educator for the last 15 years~. I've! been forced to retire because I'm a person with AIDS. In two months, I look forward to having absolutely no medical insurance in my life other than Medicaid. I'm actively involved in the AIDS'community and in the medical community here in Tampa. And my concern is the concern of the Medicaid program in terms of health care reform. Presently many of'the physicians - some, not all, - but many of the physicians and health care providers including pharmaciess are openly refusingi medical care to patients who are either Medicaid patients or who are H.I.V. Positive/AIDS patients. A ~ friend of ours is in the hospital as we speak. He has a severe ~ dermatological problem. He's in a non-for-profit hospital. ~ None: of the doctors in the hospital, none of' the! doctors in 0 the Medicaid-Provider book, nor any of the doctors in the phone ,~ book who are dermatologists, will see this person. Not because of ~ 'Q G?