For Immediate Release
Office of the Press Secretary
June 27, 2001
Press Briefing by
By Ari Fleischer
Patients' Bill of Rights......................1, 3-9, 15-17
Global Warming......................................7-8, 13
House Vote on Mexican Trucks...........................9-12
Osama Bin Laden..........................................13
Middle East/Secretary Powell Visit.......................17
the White House
Office of the Press Secretary
for Immediate Release June 27, 2001
Press Briefing By
the James S. Brady Briefing Room
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
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
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.
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
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
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
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
Q Does that mean that
the HMOs can --
Q How do you pick the
board members? How do you pick the board
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
Q Would this review
board be made up of medical professionals, or would they be
MR. FLEISCHER: Yes, medical
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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.