For Immediate Release
Office of the Press Secretary
June 27, 2001
Office of the Press Secretary
10:09 A.M. EDT
Good morning. The President had his usual round
intelligence briefings this morning. He
had other briefings on domestic and economic policy matters, which I
want to talk about in just a second.
The President at 2:45
p.m. today will host a meeting with a group of
moderate House Republicans to talk
about patients' bill of rights. The President continues to
work closely with the Senate and the House trying to
secure an agreement so that
the bill that Congress passes can indeed be signed into law, and so
that patients can get the protections they deserve. We will provide
you a list of who is coming as soon as we get a little more
finality to it. But by and large,
it's going to be a group of moderates from the House who are very
committed to getting something done.
Q Is the Speaker among
MR. FLEISCHER: No, the Speaker will
not be one of the atteendees.
Q About how many, Ari?
MR. FLEISCHER: About
16. And the reason I want to wait on the list
is because it always depends on congressional
schedules. I don't want to
indicate somebody's coming until they're definite and
confirmed. But moderates --
Q What do you mean --
Moderates? A lot of people who are
Norwood-Dingell, who are supportive of the Hastert-Fletcher
approach, people who want to work for compromise to get things done.
Q Will Norwood be
MR. FLEISCHER: Again, I want to
take a look at the list and get it to you in final form.
Q Was he invited?
MR. FLEISCHER: I'm going to get you
the list in final form.
Q You say people who
are supportive of both bills?
MR. FLEISCHER: Hang
on. I have a ritual here. I have to finish the
schedule. And then the President will depart this evening
at 6:00 p.m. or
6:10 p.m. depart for the President's Dinner
at the Convention Center. Shoot, I heard it was black tie and
boots. I forgot my boots.
Also the President spoke to Leader Daschle
this morning, called him to thank him for agreeing to schedule the
defense supplemental bill this week.
As you know, that's something that I discussed in
here yesterday, and the President is pleased because this is
necessary to get the funding done and
agreed to, so it can be signed into
law, so it makes a difference to the men and women of the military, so
that the benefits of the supplemental can be received this fiscal
Finally, the President is disappointed in the
action that was taken in the House yesterday concerning Mexico and
trucking. The President believes
that we can have safe transportation
of Mexican trucks within the United States, in accordance with the
NAFTA agreement. He thinks the action taken
yesterday was wrong, and he looks forward to
working with members of Congress in the conference committee to reverse
Q Will he veto, in case
MR. FLEISCHER: There is no
discussion of that. This is one amendment to a larger
appropriation bill. The President thinks the action was
wrong, and he's going to work to reverse it.
Q Would he be amenable
to tougher requirements for Mexican trucks, as has been talked about --
MR. FLEISCHER: Well, the Department
of Transportation has announced a
series of steps to ensure that the transportation
issues are handled safely. And he's confident that we can
have Mexican trucking in the United States in a safe manner.
Q Ari, should the
transportation bill come down with that amendment attached to it, will
he veto the overall bill?
MR. FLEISCHER: Why
don't you ask me after the conference. Let's see what the results are.
Q Has this come up with
MR. FLEISCHER: That's the -- that's
been the longstanding view of the President.
The President articulated that
position in the campaign, he
articulated it earlier this year,
when the Department of Transportation
announced their regulations, and he was
disappointed in the action the House took. So the
President's view on this has been long known.
Q What effects would
not having it --
MR. FLEISCHER: It's also
inconsistent with NAFTA.
What effect would not having it have on NAFTA, or have on
trade relations with Mexico?
MR. FLEISCHER: Would not having
Q Of not allowing the
MR. FLEISCHER: You mean if the
House action prevails?
MR. FLEISCHER: That it's
inconsistent with NAFTA.
Q But what
effect will this have with trade -- on trade relations with Mexico?
Well, anything that's inconsistent with NAFTA would present
a trade problem with Mexico.
Q Would the
Mexicans have some recourse in terms of being able to impose
MR. FLEISCHER: You'd have to go to
the USTR for any of those specific
But the President thinks that should
be averted. The
President thinks that we can welcome our neighbors to
the south, in accordance with our agreements, and that it can be done
in a manner that is -- protects the travelers within our country.
Q Are you confident you
can overturn this move by the House?
MR. FLEISCHER: Well,
the President's going to work -- the President
is going to work hard to do so. He
thinks that this is a matter of right or wrong, and this action was
wrong. Q Will he be
calling Fox, the President that is?
MR. FLEISCHER: No. Go
-- appropriations bill. There are over 1,000
earmarks in there
for highways, aviation and transit, and they've earmarked
all of the discretionary money that DOT would
have had to use for airport congestion
around the country. And I'm just
wondering if the administration really cares about that?
MR. FLEISCHER: Yes,
there's a SEP that has been circulated on that. I'd refer you to the
Q Ari, the meeting this
afternoon, is this an acknowledgment by the White House that
if you really do want to compromise, both sides are going to have to
move toward the center?
There's no question about it. When it comes to
the patients' bill of rights, you have
some who want to turn our health care system into a system in which
people have less coverage, and attorneys have more fees. You
have some who don't want a patients' bill of rights at all.
And you have the President who is in
the middle, who is trying to bridge that gap, who
is trying to make people come together, so a compromise can be
If you look at the patients' bill of rights,
there are two sections to it.
One deals with real people patients' protections.
There is no
question in anybody's mind --
in most people's minds, that those can be
signed into law.
There are some Republicans who oppose
those. The President differs with those Republicans.
There's another section of the
bill that deals with liability, and
you'll see a series of amendments in the
Senate now on the liability questions, that can address the
concerns that the President has. If those
concerns can be addressed, than the meat
of the bill, which is giving
patients protections in their dealings
with HMOs, can and will be signed into law.
And that's the good news that the
Congress should concentrate on, and that's the message that the
President is going to give to the House members
who come up here today, that there is so much
that they agree on, why let
these provisions dealing with legal
liability go too far, and therefore
derail the chances of an agreement and the
chances of compromise? And be very careful, the
President will say, because you risk letting -- throwing
people off of their insurance if
you go too far on the legal liability side.
And there's an area in the middle, and the
President occupies it. And
his goal is to bring people
together. And Senator Breaux is a part of
this, and several others, so that the bill can
get signed into law. Congress has a golden opportunity, if
they would only compromise. And the President hopes Congress
will not loose that opportunity.
Q Part of what you're
suggesting would seem to indicate a lessening
or a reduction of the possible
penalties for HMOs that don't treat their
If you back-peddle it that much,
aren't you in effect eliminating the possibility of
penalties, and giving the HMOs no incentive to take care of their
MR. FLEISCHER: The
current bill penalizes people who have insurance, particularly
companies where they will loose their insurance if lawyers can
collect $5 million fees by suing
indiscriminately and in a manner that subverts the real meaning of
patient protections into lawyer protections.
Q Five million dollar
fees, or --
MR. FLEISCHER: Five million dollar
Q What about the
incentives for HMOs to take care -- to give their
customers the medical care that they're entitled
to? What's the incentive for an HMO if there's no penalty?
The penalty doesn't go against the HMO. It's a
fee and it's a reward that goes to lawyers. That's the whole
part of the bill.
HMOs under the bill are required
to cover, in certain instances -- for example, if you wanted to go a --
if you needed to go to an emergency room,
under the bill that the President
supports, and under all legislation, there's universal
agreement that you should not have to automatically call an 800 number
before going to an emergency room.
What's holding that up from becoming
law? These legal provisions that
don't have to do with
patients, they have more to do with lawyers. Why
shouldn't that become law? Now
that's what you're talking about. Those are the protections
Q There are lots of
laws that make --
MR. FLEISCHER: The President is
calling for a lower cap.
Q In punitive?
MR. FLEISCHER: Non-economic
Q No, but punitive is
different, and you know that. And your bill
doesn't want any punitive. What about
lower than $5 million? Is there a compromise
there, something between, say, 500,000 which I know is
non-economic. But would the White House accept punitive
damages in a final bill if it were lower than $5 million?
The White House -- the President wants to work with members
of Congress to set that at the appropriate level.
Well, Ari, you're saying that the President's in the
middle. I mean, what do you mean by that? Does
that mean that he would go beyond the caps that on the --
MR. FLEISCHER: Just like I said,
there are some people who don't want a patients' bill of
rights at all, and have worked for years to defeat it.
Q Republicans -- would
it have to be Republicans --
There are others. Yes, they're
Republicans. There are others who are less
interested in an agreement, and more interested in
a political veto strategy. And it's an
interesting test of the leadership
in the Senate. And the President hopes
that the Senate and others in the Senate, the rank and file
members of the Senate, will be willing to find a way to get an
agreement so that the bill can be signed into law.
Q -- the Daschle
MR. FLEISCHER: No, the
Daschle conversation really did focus on the defense stuff, and some
Q What other matters?
MR. FLEISCHER: We're going to leave
it as a private conversation, but patients' bill of rights was not a
prominent part of the call.
Q Ari, has there been a
decision on the Yugoslav donors conference,
if the U.S. will attend, and if there has been --
or when do we expect it to be announced?
MR. FLEISCHER: Mary Ellen, do you
have anything on that? MS.
COUNTRYMAN: I'm sorry, one more time?
MR. FLEISCHER: Yugoslav donors
MS. COUNTRYMAN: Oh,
State Department may have some announcement for you today.
Q On patients' bill of
rights, one more question. Is the President
showing any more openness to the possibility of patients
being able to sue in state court? Is
that something we're seeing a little more openness on the President's
MR. FLEISCHER: The Fletcher-Hastert
approach provides some measure of flexibility.
Appropriately so, when it comes to state court
and federal court. And, as I
indicated yesterday, there are several provisions that honor the
President's principles and there are several bills that honor the
President's principles and that bill is one of them.
Q So you would identify
the ability to sue in state court as one of those platforms on which
the President was willing to compromise?
MR. FLEISCHER: The
President is willing to work with the Congress on
these liability issues. The question
is, is the Congress willing to work with the President?
Ari, that provision does say that as long
as external and internal full process has been
exhausted, then in certain instances, it's okay to go to the state
Well, the President wants to avert --
and this is where this becomes either a lawyers' bill or a bill that
can be signed into law -- is a situation in which the independent
review organization does not really exist, that people go right from
denial of care to court.
And the problem with that is, if you go right
from denial of care into court, you don't get
your care. No court settles matters that
fast. The first thing you have to do
is hire a lawyer. It takes months and months, if not years
and years. And that's not health care; that's lawyer care.
But if you have an independent review
organization first set up, so that the system focuses on, after denial
of care, an immediate system where you don't have
to hire a lawyer but you have a prompt, independent review
of a decision made by an
HMO to deny care, and the people who make that review are
medical professionals, that's the best way to reverse the HMO's
action and get people the health care they
need. Going right to court is
the wrong solution and that's the problem the
President has with the lawyers' bill.
What is the HMO's incentive to do what
the -- what either the bill says or what the independent
review says, if there is no penalty that faces them --
The penalty would be -- this is why
differs with some Republicans --
the President does believe that people
should have the right to go to court after an independent review
organization completes its review if the care, the order of the IRO, is
not accepted by the HMO, if they refuse to provide the
service required. Then the President believes that person
should be entitled to go to court --
Q State court?
MR. FLEISCHER: --
because, in this case the HMO did wrong. Federal court.
Q The Fletcher one is
for state. The entire process --
MR. FLEISCHER: As I
indicated, the President -- the Fletcher-Hastert
provision is much more complicated than just
state. It is a state-federal approach, it's a combined
approach, and it's very complicated.
The President believes the federal
court is the preferred approach
because the provision under law that has allowed
insurers to provide insurance to so many tens of millions of
people through the private sector
is a federal statute,
ERISA. And by having a federal statute that gives
employers the tax advantages and the protections to offer
insurance, which is what is an incentive that got people their
insurance in the first place, to subvert that
through a system of 50 different state suits will make it
harder for employers to offer
insurance, not easier. That's the core of the President's
you pointed out, there is flexibility here, as the
Hastert-Fletcher approach indicates. Is there equal
flexibility offered to the President in the
Congress? There are some people in the Congress who
want a veto.
They are not interested in a solution. They
interested in getting patient protections. They
are more interested in politics than progress.
And if the Congress puts
progress before politics, this bill can get
signed into law. But if the Congress
puts politics before progress, then patients will get denied their
Ari, isn't it true, though, that the reason you could sign
onto Hastert-Fletcher is because it puts enough hurdles in the way that
very few people will get into state court?
MR. FLEISCHER: Actually,
John, if you look at the states where there is independent review
organization review and then a legal remedy, very few
people do go to court because the IRO works. It
should not be the purpose
of a health care bill to put
people into court. Court takes forever. Court means you
have to hire a lawyer, not a doctor.
It should not be the purpose of any
health care legislation to set up
a shortcut to the
courthouse. A shortcut to the courthouse means people
get bogged down and mired in lengthy
legal reviews where the first thing they have to do is hire a lawyer.
Q But it
has also historically provided the incentive for HMOs to
cease and desist from the kinds of
practices that got them into court in the first place?
MR. FLEISCHER: This is
exactly why the preferred approach should be IRO. And if
the HMO does not honor the obligations imposed on them by the IRO, the
person shall have the right to go to court.
There are a couple of cases
in California where the level of
damages was a disincentive for
the HMO to continue along those lines of practices that it had engaged
And there are millions of cases across
the nation where the costs of court have driven up premiums,
have driven up insurance and therefore make it harder for
people to get insurance. It's a question
of balance and the President
is seeking to strike that balance. Is the Congress?
What's to say that the IROs aren't going to -- if
law, then you'll have a whole lot of people
doing these independent
reviews, and that will take up a lot,
a lot, a lot of time, just like it would have in the court.
MR. FLEISCHER: Nothing
is like in the court. Nothing is like hiring an attorney and
having juries and judges.
Q Maybe this should be
an opportunity for someone to discuss maybe
fixing the court system, or some sort of balance
in the court system that it takes forever --
We'll be happy to take that one
up next. Last question.
Jacob had his hand up before.
Thank you. All I want to know is, do you say the
President is going to fight to try to reverse the vote in
the House. But that vote was
massively against, two to one. And I
know the Senate hasn't taken up the vote yet. But how can
the President reverse such a large margin?
MR. FLEISCHER: Keep your eye on
it. The President believes in it and
we will see what happens. But you know
where the President stands and we will have this conversation again in
a matter of weeks.
Q Ari, do
you want to try the Middle East? There is a perception
today that Israel and the U.S. are
a little further apart, are not as
close, after the meeting between the President
and Mr. Sharon than before that meeting. What is the view of
the White House?
MR. FLEISCHER: Secretary
Powell is in the region now. There will be
additional conversations had. And the
President remains committed to the Mitchell Committee report which has
also been accepted by the parties. And so, as always, the
issues involving peace in the Middle East are not simple and the
President is going to continue his efforts.
The Mitchell Report -- for instance, doesn't
speak about a pre-cooling off period, which Mr. Sharon insisted on
MR. FLEISCHER: But it does talk
about an unconditional cease-fire.
Thank you very much, everybody.
10:29 A.M. EDT