Remarks at a town meeting in Nashua, New Hampshire

Weekly Compilation of Presidential Documents, March 21, 1994

But I don't want to kid you. The employer would still have the option to pick an HMO, and that would still be a less expensive option than the fee-for-service. But you would be able to get the fee-for-service, and your employer would have to make the same contribution to that plan as he or she would to the HMO. So you would have much more choice than you have now.

Right now--I think it's important that everybody understand this--right now, most people who have insurance are insured in the workplace, and only about half, actually slightly fewer than half have any real choice of providers today who are insured through the workplace. So the amount of choice is going down.

Now, as I said, there are some very, very good HMO's. New England has some very good HMO's that have done a terrific job. But a lot of people want to have the choices. Under our plan, we will promote and facilitate the growth of good HMO's because there will be economic incentives for people to compete for lower cost but higher quality medicine. But we will protect the choices people have, which are vanishing at a very rapid rate today. We're really trying to work out the specialist problem, because that's the thing people are most traumatized about. Someone has been taking care of a family member with a special problem and have to give it up; it's really tough on them.

Q. I come from a town called Amherst, where I'm a distinct minority, I'm a Democrat. |Laughter~ And my husband and I have just become editors of a small news letter, and we sent you a copy to the White House, as a matter of fact. I'm concerned about health care because I'm one of those people with lots of preexisting conditions and my husband is a contract engineer and insurance doesn't come with his job. I'm afraid when I hear news reports of you having to compromise to get this bill through Congress. I'm afraid that one of the things you may have to compromise on is people like me. Is that so?

The President. No, there will be no compromise on everybody being covered. There's no point in doing it if we're not going to cover everybody. There is no point in doing it if we're not going to cover everybody. But what I want you to understand, I want every one of you to understand that there are consequences to all human behavior, including inaction. We all know that, but sometimes we forget it.

If we do not act, certain things will happen. Some of you will go into HMO's and you'll be very well satisfied and you'll get good health care at lower costs. Some of you will go into HMO's and you'll lose your choices of doctors and you'll feel that quality has suffered and you'll be frustrated and angry. Some of you will lose health coverage because every year we lose about 100,000 people a month in the United States who lose their health insurance permanently. And every year, at some point during the year, there are over 50 million of us who don't have any health insurance.

So what I want you to understand is I won't pretend to have all the answers; I don't pretend that we're right about everything. This is a complicated subject. But there are consequences to every course of action, including doing nothing. And they are quite significant, the consequences of doing nothing.