Al Gore Addresses Students at Keene State College (New Hampshire) on Healthcare

The honorable Jeanne Shaheen. Yes it's a campaign season now so we have to get in the great state. And the great governor. You know you have to bring a little levity. It's really wonderful for me to be able to be here this morning with the vice president. To join all of you from Keene State College and from the college community in talking about health care. And I want to thank Dr. Y for hosting us today and for all of you for joining us. Health care issues are something that I've been involved in since I was first elected to the state Senate. I recognize that people can't feel.

Good and secure in their lives. If they're worried about whether they're going to have the kind of health care when they need it. So it's something that I've worked very hard on both from the side of trying to make sure that insurance is available to people that it's affordable and also to make sure that we expand coverage for people who need it. And I'm very excited that this week we were able to announce that the 20000 children who are currently uninsured in New Hampshire are now going to be able to get affordable health insurance. We announced a new New Hampshire Children's Health Insurance Program. It's going to be funded through monies that were made available through the budget agreement last year. And certainly we thank the vice president for all of his efforts in getting that agreement passed that provides that federal those federal dollars that are available to help states like New Hampshire cover children

who can't get health insurance. And the really exciting thing about this program is that we know that about two thirds of those 20000 uninsured children live in working families whose parents make too much money to qualify for Medicaid but not enough money to be able to afford private health insurance. And this program is going to be structured right at those families. It's going to be operated through the Healthy Kids Foundation. And it's going to be funded through a matching premium that those families are going to provide. But it's going to be subsidized with the federal dollars that are available. And with the state match that's available through a private foundation set up when Matthew Thornton was bought by Blue Cross so they're going to be state dollars involved to bet the majority of those state dollars at this point are going to be used for outreach and for working on an administration of the program that has one of the things that we

know is that there are a lot of people who qualify for Medicaid but who have not enrolled their children for one reason or another. So we're trying to do a couple of things we're trying to reach out to those families to let them know what's available to reach out and let them know that now we're going to have affordable insurance coverage for children in the state and also to make it easier for them to sign up. From now on families are going to be able to fill out what used to be about a six page application we've cut it down to two pages. They're going to be able to mail it in. And we think it's going to be much easier for families to sign up. So I'm very excited because I think that kind of an investment in children in New Hampshire makes so much sense because we know that kids who get a healthy start have a much better chance of success in life. So

we're also working on some efforts to expand coverage for small businesses to do a small business purchasing cooperatives so that businesses can band together because we know that a lot of people who are in small businesses can't afford the expensive costs of premiums. We're also working to provide some protections more protections for people who are covered by their HMO. And we're going to talk about both of those. I think a little later in the program. So let me stop at this point and introduce the real special guest for today's event. As I said he was very involved in the efforts to get the agreement last summer that provided those funds for children's help around the country. And we very much appreciate all of the vice

president's efforts to do that has been very involved in putting issues around HMO protections on the forefront with the patients bill of rights. And I'm very pleased that he's here helping us in New Hampshire today. Mr. Vice President Al Gore it's great to be back in Keene. And thank you so much for the warm hospitality it was wonderful. Just driving up here and seeing the kids from the elementary school there the students from Jean stay here it's great to be back at Keene State and I want to I want to thank Dr. Jaro Savic Dr. Y for his hospitality.

I'm going to say a few more words about Governor Shaheen in just a moment but right off the bat here I'd like to say that what she did in working out the intricate financial details of this federal state partnership in the unique circumstances in which every state's budget finds itself. But but especially here for reasons that are that are well-known having to do with the whole history of the tax base here the way she worked out all of the details here and made it possible to bring health insurance to 20000 children who didn't have it before I think is a remarkable feat. And I want to offer my congratulations. I want to also recognize the governor's husband Billy Shaheen who is here

thank you very much. Some of my colleagues in the administration are here with me today and they may have a chance to say something during this townhall meeting a little bit later on but I want to introduce to you the administrator of the Social Security Administration Ken Apfel and the director of the Office of Personnel Management Janice La Chance. His home is not too far from here and her. Her mom and dad Charlie and Rachel Chanslor are here. Awfully glad to see them. Now Mayor Pat Russell of Keene is a great friend and Mayor Russell I don't know where you got where you are. Thank you for

all your work on welfare reform also. We have a number of state representatives here represent just a representative. Jim believe it is going to be speaking a little bit later. And here he is a doctor and is going to be talking about some of these issues. Representative Benjamin Peko Representative Richard Doucette representative Margaret Lynch. Representative Margaret Leonato And also there are a number of local government officials here as well. And I thank all of you for coming here. Now ladies and gentlemen we're here today in a state that has done so much to advance access to health care for all its citizens to talk about how we can make a good health care system even better and how we can prepare this state and the rest of our country for a 21st century in which the American people are healthier and more prosperous than than ever in American history.

You know these days when I think about health care I'm reminded of a story about three neighbors who one day met their final reward and went to heaven. I'm sure some of you heard this. They got to the gates and St. Peter asked them one by one what they did on earth to get into heaven and the first said well I was a teacher I help children learn how to read. St. Peter said Well come right on and haven't. Asked a second what did you do. He said Well I was a doctor I healed people and restore their health. Well come right on in to heaven. Yes the third night were what did you do. So I ran an HMO. St. Peter said well you can certainly go right on into heaven but you can only stay for three days. The truth is we're living in a time when medical miracles are

available to those who can afford them. And to those who can gain access to them in other ways and for all of our progress we really cannot rest until we can find out how to ensure that all Americans have access to the quality health care that they need. And may I say that I feel very privileged to serve in an administration that is led by a person who understands this challenge better than anyone. President Bill Clinton and also first over the past five and a half years nobody has done more to improve the health and well-being of America's families. We're not here to talk about the fact that the unemployment rate here has gone down from seven

and a half percent to two and a half percent or to talk about the crime rate dropping or the unemployment or the all the new jobs or all the other success. But just in the area of health care. Make no mistake about it. President Bill Clinton's policies are good for New Hampshire and good for the United States of America. His leadership is making a tremendous positive difference for the children and the families of this country in that area of health care. Several related issues here today and we've worked on a lot of challenges we've raised the immunisation rates for children to the highest level ever. We've passed legislation that makes sure that no one loses health insurance just because he or she loses his job or is in transition from one job to another we've taken the first steps toward parity for those with mental health

problems and we've taken other steps. And last year we passed the single largest investment in children's health since 1965 to help states that have the the the kind of leadership that is needed at the state level to provide health care coverage nationwide to 5 million children who don't have it today. And in fact today the Department of Health and Human Services is releasing a progress report on how that nationwide effort is going. And the report shows that in the last year 38 states have taken up the call and have participated in this initiative and just because of the efforts achieved so far. 2.3 million American children will be getting coverage who did not have it before so we're making good progress. And of course as I mentioned just this past Tuesday Governor Shaheen made the dramatic announcement that

she had to cut the Gordian knot and figured out a way to get approval for a plan that extends health insurance to so many thousands of New Hampshire children who don't have it today. And I was inspired by the governor's words when she pointed out the what has long been obvious to many people and that is that no parent should be forced to choose between buying groceries and taking a sick child to the doctor. The New Hampshire healthy kids plan is a great victory for New Hampshire's children and a great example for the nation. So again congratulations on that and we're here to build on that announcement and to talk about what we can do to make New Hampshire's children and families even healthier and safer. I believe that there are three great unconquered health care challenges that we must meet in this state and all across the nation. First Governor Sheehan's progress this week underscores an important point we

must do more to get children the health care they need to grow up healthy and strong. Even those who are reluctant to have a comprehensive program for absolutely every citizen are willing. In most cases to give their support to an approach that makes sure that at least children are completely covered. And thank goodness that that we are making progress on that. But now we have to make sure that those children actually get the health care that they have been made eligible to receive. There's a big difference between those two things because nationwide right now the studies show that there are up to 4 million children. Who are legally entitled to health care but who are not receiving it because their parents don't know they're eligible for it. They haven't signed up for it. They don't know how to get into the programs and

pass the red tape and the bureaucracy. And that's just that's a waste of good health and it has to change. Today I'm proud to announce that we are expanding the efforts of the federal government through agencies that serve the citizens of New Hampshire like the Department of Labor the Small Business Administration and the Department of Housing and Urban Development to help spread the word and sign those children up. And this expands upon a national initiative that my wife Tipper and I launched at our annual family conference last summer in Nashville and we've we have seen more agencies get involved now and this expansion I think is going to make it a lot more effective. Now secondly while we do a better job of reaching out to children we have to also do a better job of reaching out to others who for a variety of reasons have been left out in the past. I mentioned financial access and other problems of access.

Think about geography a lot of people in rural areas have historically had a hard time gaining Geographic access to health care. People in the disability community have had problems getting access to health care people with mental health problems have had have had difficulties gaining access. And that's why we are making special efforts to bring quality health care to those who have often been left out in the past. And I'd like to talk specifically about those with disabilities and those with severe mental illnesses. Today I'm especially pleased to announce that as part of awards that we're making today to nine states across the country were formally granting to New Hampshire a half a million dollars to help people with disabilities and severe mental illnesses to return to jobs and take their place as full members of the American family on this grant will help New Hampshire

develop innovative new one stop shops to help people with disabilities get all of the services that they need in one place and that includes long term health services vocational training and rehabilitation in the same place they'll also be able to find jobs and figure out how to retain jobs. And as as we're going forward with this we're also working with the Congress to pass to try and pass bipartisan legislation that will help even more people with disabilities to get good health care and we're going to be talking about these challenges a little bit here today also. Incidentally we know that every time someone with a mental illness or a physical disability. And actually I should catch myself. My wife Tipper who's the president's adviser on a mental health care always points out that that dividing line is really artificial because

almost all mental health problems are rooted in the brain which is a part of the body that these illnesses are now much better understood. And we know that there is a physical tangible cause for them and they should not be treated differently from diseases that occur in the in the heart or the liver or some other part of the body just because they occur in the brain. And I think now. Third as we work to reach out to children and to groups of Americans that have been left out and left behind in the past we also have to take steps to make a good health care system work even better for all Americans. That is why we are working so hard to pass a health care patients

bill of rights. And I admire what Governor Shaheen is doing here to try to get these protections in New Hampshire. Today there are 160 million Americans enrolled in managed care plans in part because of the savings they offer and those savings are a good thing. But when you have a health problem the doctor's first question should be where does it hurt or exactly what is wrong not. Will your health care plan pay. And today too frequently the first questions are financial in nature and that really has to change. We need to do more to ensure that when it comes to medical decisions that affect you or members of your family those decisions are made by doctors and not by accountants or budgetary bean counters with lawyers working for HMO or insurance companies. We need a law to give every American in an HMO the right to see a specialist when that American needs to see a

specialist. We need a law that will give to give every American the right to appeal. If an HMO denies them the care that they need and that's why we do need a patients bill of rights in this country. We have seen the congressional majority's version of the so-called Bill of Rights. You need to know this. That so-called Bill of Rights does not guarantee access to specialists. It does not insure that your care will not be changed abruptly. It rolls back your medical privacy letting your health plan freely share your private medical records with outsiders even without your consent. That's about the worst thing that we could do in the field of privacy and health care. So there is a big difference. They they claim it's the same it's not the same. You've heard the old story about that that Noreen and the taxidermists went into business together and they put a sign

out front that said either way you get your dog back. Well there's a big difference between the Bill of Rights and the bill of goods. So I urge all of you to join me and say to Congress pass the patients bill of rights. Now finally before we open up this discussion I want to make one more important point. It is important for the federal government to get its own house in order because the patients bill of rights ought to apply to federal health care plans as well. There are 85 million Americans in federal health plans and the federal government ought to be a leader in this regard. Today I'm pleased to announce that we're making these protections available to a full nine million Americans covered by the federal employee health benefit program and I'm going to thank Janice low chance for her efforts in this regard.

We began last February the work of extending all of the rights of the patients bill of rights to every federal health plan. And today's announcement means that we're making tremendous progress and it's time for Congress to follow our lead and pass the law that will guarantee these rights to every American family. Now these three initiatives that I've announced here today will build on the children's health plan that Governor Shaheen announced earlier this week and working together will make New Hampshire's families even stronger. And there's a simple principle behind all of these initiatives today on the eve of the 21st century in the nation that leads the entire world in quality health care. We cannot rest until every American has full access to affordable health care. It's not just a question of public policy it's a question of public responsibility.

And it is in that spirit that I'm eager to hear today from the doctors and business owners and educators and parents and students who are with us here today. More than most you understand the value of bipartisan cooperation on health care. You have seen the benefits here in New Hampshire and I know that Washington D.C. can learn a lot from this example. So thank you very much. And let's open up the town hall now it's his wife. He is over here. Now correct me if I'm wrong you have you have four children. And they have been up until Governor Shaheen so.

No health insurance at all what have you been doing. So you pray that they'll stay in good health. But you've had some problems that you've had to take care of. Yes. And we manage to pay out of pocket and do the best we can but we have not been able to have the luxury of well health checkups and things. How old are your children ages 3 to 14. My 14 year old haunts me. Well what is it what does it mean to you to have the governor work this out. And know that your four children now are covered with health insurance. It means that we're we're not going to be gambling with their health we're going to be able to get regular checkups and keep them up to date on their immunizations and make sure they're growing and healthy and we're not going to have to make choices between

food a mortgage payment doctor's visit and we've had to make those choices. You haven't been they haven't been getting regular checkups Now until now because you can't have it. The only thing you can afford for now you have been able to afford is this crisis intervention when something's terribly wrong. Then you dig into your family budget and take care of that. But in terms of preventive activities and checkups you haven't been able to immortally. Well. I'm glad that your family is now. They were very happy with this new program. Is there anything you'd like to say to Governor Fein about that. Thank you very much. My children thank you. My husband and I thank you. Yes think it's a big relief. Thank you. And now obviously one of the things that we still have to do is to work on the

implementation of the program and make sure that families like yours Judy has the information that we can do the outreach through schools and through hospitals and through doctors and community centers so that families know what's available and consign their children up. Now that it's affordable we've got to make sure that it's accessible to. That's an excellent point and I think Governor we have some people here today who are actually working on the task of enrolling families and signing children up or would any of you like to speak yes. Could you give them. Tell us what your night that are Center to New Hampshire. This is when the work director and our center Kim Hayward who's a family support visit her were unique in the state of New Hampshire that we have a social worker that works with us during which clinics. It's not a part of the federal funding it's funded by the county in which you live which is Grafton County. We're very appreciative of that. We have the

social worker is a part of the we visit. It's nonintrusive it's very user friendly. We're from a very small town about 6000 people in northern New Hampshire. There's stigma associated with going into the Medicaid office big stigma and unfortunately bad news travels much faster than good news. You hear one story of someone who's had a bad experience in the Health and Human Services office and no one wants to go in. So we can expedite the Medicaid New Hampshire law request that we ask every week participant if they are on Medicaid and at amnesic not only do we ask but we act upon their answer if they're not we enrolled in there in our work facility in Medicaid. Well let me hear a little bit. You're the Wicca coordinator the work director the week director I'm sorry and not the women infants and children program right which is designed for nutrition. Yes. And yet when you are implementing this program if you notice that a family may not have the children covered then now you are able to sit down right then and there and fill out that helped and fill out the application for

Medicaid. And what kind of response are you getting an excellent response. Well we have about 15 applications a month. Now if you go in the home or or just you. You're at your own up you're in the office. OK. And how many homes do you visit each week. We visit and we all there's forwork is in the office and we each have a case of about 15 families. Part of the process is we do Medicaid applications with them. But I I had also held the social work position for four years. And that's what I did most of my Medicaid application work. It's a question that when they get to see the social worker you ask that question if they have health insurance. If not do they have Medicaid. If not then we find out if they qualify and do the application on the spot. Have you seen some of our stories have you seen some situations where it's obvious to you that. Children are suffering because they haven't had this access.

Yes we have. Can you give me some examples. Without the names of names. I guess one that I can think of is a failing that a person of mine laid off is not having the coverage to take the child to the doctor and when they do take the children to a family of four they find out that there is a double ear infection. So what they do is they get the antibiotics and assume that that's what the rest of the sick children have in Shia the any biotics and also children. So they get what they can was you know to start treating them in some way but they are not able to take all four to the doctor. Of course doctors always warn against that because if they don't get the right dosage of antibiotics they're not curing the infection. And in fact they're making things worse because they're giving them just enough to. To put the the the germs on steroids so they can get past the treatments. Next time it

comes back even worse. What does it mean to you to be able to assign these families up if you have you. I'm sure you have. You've made a lot of good friends among the families that you work with and have you. Have you felt a personal joy in seeing these children get signed up. Yes I have. And it's great to get the feedback of the parents again. I mean it was mentioned the stigmatism was going into the health and human services office whereas when they came into work they feel very comfortable they're willing to sit down and fill out the application knowing that once we get everything together as workers we will drop the application off to the office. And then what happens is their card is mailed to them. So they never even have to step into an office. Well thank you very much and thanks for the job you're doing every single day for this. My name is Laurie Greer and I'm a parent. I have one four year old and I have three

stepchildren. Recently in May my oldest step child passed away. My husband is a friend and counselor and he was out of work for two months. His psychiatrist prescribed a medication for him an anti-depressant that the HMO. Refused to pay for. He had to the psychiatrist had to call and get special permission. But. My concern is what right does the HMO have to tell the doctor what they'll pay for and what they won't. I mean it is the doctors job to care for the patient and what right does the HMO say you know to have that control over the doctor. I ran into another situation with my 4 year old son who had to have oral surgery. He spent two hours in the O.R. and I had the HMO who said we'll pay for this but get a referral from my primary care physician which they refused to do because it was the dentist who was doing it was out of the service area so I had the HMO say it will pay for it. And my primary care physicians

and now we're going to tell you how they're going to spend their money. So I had two relatively difficult cases where my husband needed a medication over the loss of his child that the HMO said I'm not going to pay for this. And the psychiatrist had to literally say please please please. And yet I also had a situation where my child needed surgery and. The PCP he said now we're going to tell the age of my how I think it is how where they get to spend their money which I found to be incredibly frustrating because the doctors are the ones who are supposed to be in control of the patient care not the insurance company for the dollars and cents. And that's my frustration. Understandable. Good point. First of all I'm sorry about your family's loss. Let me let's call on Dr. Jim Hill here. He's a state representative a Republican worked on this issue for a long time he illustrates the bipartisan nature of the

concerns that we're that we're facing here in response to this mother's concerns and deep frustration. Of President Clinton and are proposing a patients bill of rights. The AMAA supports it. Governor Shaheen as you know is fighting extremely hard to get a new hampshire patients bill of rights. We thought this ought to be beyond partisanship. And I know you've worked on healthcare issues for a long time. Doctor I'd like to hear your views on this. Thank you very much. First of all I appreciate your problem. We do and the AMAA those two. I think we've seen two pieces of work come forth in the last month. One was the governor's effort to promote this state state policy and then the federal the problem with the federal. For people who don't realize that there are four bills at the moment all essentially claiming they say the same thing but they don't.

As was pointed out there are 125 million Americans. Who are insured by employer insurance for example. This is just one example. Those folks who are aggrieved somehow do not have the right to access to the plans that govern these things because they're protected under a risk. And without going into what Arisa means basically their employer employee health plans. Now the deshabille. Which is number one and approved I think supported by the president and vice president. Eliminates that exemption. That's the bill when you say Patient Protection Act don't just simply say patient action and say that Desch shall give heart Bill thirty six or five of those to be exact because that takes away this exemption and says all health plans will be treated soon and can implement the governor's plan which says if all else fails

you can go to court. And claim there is some accountability and maybe liability. We've tried to stay away from liability by the way why we do not want to produce 401k plans for lawyers. What we want to do is make people have access to courts if necessary. And if all else fails. So from that's too much like a few dozen other things. But that's the main. Well thank you very much doctor and thank you for. Thank you Jim and Jim's been very involved as a legislator of course and as a doctor and trying to make sure people get good health care. And I wanted to point out that one of the things that my HMO Accountability Act as is say that if all else fails patients should have the right to sue their HMO just as they have the right to sue their provider.

But it does several other things that I think are equally important. It says that there should be some independent review if you don't like the decision that your HMO has given you relative to what can be covered. So Lori there would be an external grievance procedure that would have an independent panel that could look at whether the HMO should provide that medicine that your husband your doctor said Your husband should have. It also has a disclosure provision that says that you should know ask consumers what kind of arrangements exist between your doctor and the HMO. That might be an incentive to deny you care. I think making sure that people know those kinds of provisions that exist as one of the best things that we can do to make sure that people have access to the kind of care they need. We also think that medical directors who are making the decisions for HMO about what kind of care you get

should be governed by the same rules as doctors are so that they should be under the medical review board in this state just like doctors because they are making life and death decisions just like other doctors are. And finally is that provision that would say if all else fails if you have gone through that external grievance if you still can't get satisfaction then you should have the right to sue. Just as you have the right to sue in all other areas. So hopefully you will help us as we bring this bill forward in the legislature this upcoming session and see that it's passed. Thank you. Thank you. Somebody else give us a clear example of why health care patients bill of rights is just right here. My name is Susan Fetzer and I'm a registered nurse. I've been a nurse for 23 years a member of the New Hampshire Nurses Association in the agency. My particular area of practice is the

recovery room I take care of folks after surgery before they go home. In the past when a patient had surgery that it was a little a little more than expected maybe they had more pain a little more nausia couldn't eat before they go home. It was my recommendation that they stay overnight in the hospital as a very experienced professional I've seen 23 years of how patients react to surgery nowadays. What happens if that patient was supposed to go home. We need to call the HMO. If you ever tried to get an HMO on a Friday night at 6 o'clock you're going to get to answer one no answer and two no we're going to deny you because for that particular surgery overnight they are not needed. Why does the patient to do on Friday night. What am I going to do with the nurse to provide nursing care when I believe that the best nursing care is available in the hospital. I think we need some checks and balances on an HMO. And I think that a patient bill of rights must have a timely appeal mechanism.

Good for you. When. I come back. When you when you finally do get them on the phone is a person that you are talking to a doctor rarely a doctor rarely a nurse. Typically what happens is the patient has to make a very bad choice. Either I go home perhaps in New Hampshire that 40 or 50 miles away away from a health care and I take the risk of maybe not having good pain control or maybe being nauseous and having to come all the way back or I take the risk of having to be admitted to the hospital pay a $600 bill out of pocket. But here's the situation you've described this very clear illustration of why this. Legislation is about twenty three years experience. You're on the telephone talking to basically an accountant who has no medical training.

Talking to the accountant who is reading off the policy. They were talking two languages and you're trying to describe the pain and the medical condition of the patient who's on the bed in your recovery room. And you're saying look I'm a medical professional and I'm telling you the correct medical treatment is to keep this person in the hospital. And that accounting who is reading from the form. Isn't really listening to that correct. Well not only does he not listening but he couldn't understand if he was listening do they do do they feel badly when you when you explain what the human problem is. I don't think they feel. Well you know maybe they do but they are in a situation where very difficult tracking like machines and they're just giving on an automatic no answer according to two financial considerations. Well thank you I appreciate that. Ladies and gentlemen I don't think

we can have a clear example of why we need this new law. And as the doctor pointed out when the country gets to the point where the vast majority come to a decision we need this law we have to have a patients bill of rights. Then you've got to be on your guard. That somebody doesn't slip in a bill of goods at the last minute and say this is what you want and it's actually not the genuine item. And that's why we're we're fighting and actually the the majority leader of the Senate shut down the Senate. Night before last for four hours completely shut it down in order to prevent Senator Kennedy from bringing this legislation to a vote because they don't want to vote on it because the people understand that this is their recovery room nurse is all over the country are doctors all over the country their patients and mothers and fathers all over the country who are outraged by this. You want to make a comment on the same subject right

that we hear. Here we go. Tell us your name first. My name's Andrew Salzberg. I'm a senior here at Quincy and also Myracle remember. And a couple of weeks before I came back to school I was involved in a motor vehicle accident and I'm still suffering neck and back pain and I'm wondering what can be done for students to get health care they need when they're attending a school that's out of the network. I'm a resident of Connecticut and I'm still trying to talk to my insurance company and they're saying all right now you can only go to emergency room or a clinic and they keep telling them we need to see a specialist in this scene. They're working on it. Well God bless you and that's this law is designed to try to address that problem. First of all at the time of your accident. If this law is passed then no matter where your accident takes place. You will have a legal right to be taken to the nearest emergency room where you can get the best treatment. Now a days.

Unbelievably active accident victims are sometimes taken many miles away from the nearest emergency room because of some financial arrangement worked out in advance between the health care policy or the HMO and a set of particular clinics or hospitals. But you needed you needed the care right there. The second thing is that it guarantees that when your care continues if you need a specialist they cannot deny you the right to see the specialist that you need. So your case really illustrates this very clearly. I want to ask you Janice last chance to tell us from the standpoint of the federal government you're trying to make the federal health care plans models for everybody else in the country.

Why is this so important and what does it mean to people who are in these plans. Well the Federal Employees Health Benefits Plan is the world's largest employer sponsored health insurance program and it covers some 9 million people all across this country. And when we took a look at the protections provided by the patient bill of rights we realized that our enrollees very much needed those as do all Americans and we were actually once we took a look at the process were able to add these protections on for virtually no additional cost. So for example starting in 1999 a federal enrollee will be able to access a women's health care provider for routine and preventive medical care. If you need a specialist if you're sick if you're injured you will have direct access to one. Our health insurance plans that we work with have been actually very co-operative in working with us on this are going to institute a reasonable person standard for any sort of emergency room care so that you're not going to be second guessed by an accountant or

somebody who's not in the medical field. And finally we have banned gag orders which now means that doctors are going to be able to communicate completely and thoroughly with their patients about the full range of medical treatments available for their condition. And remarkably we were able to do this for each and for a cost of 25 cents per year per enrollee so others should have no excuse for not doing well figured out how to do it. What very reason what we're trying to do is show Congress that for the cost less than the cost of this quarter that I'm holding in my hand they could expand these benefits to all Americans. Very good. I think you know some people here in New Hampshire who had similar problems I do and when we announced our HMO Accountability Act we had with us

talking about some of the circumstances the tragic circumstances they faced in trying to get the kind of care that they needed for their son through their HMO where Steve and Janice McNeil who are here someplace there they are and. They're from us. And the story that they have to tell is the kind of story that no one else should ever have to deal with. So Steve thank you very much Governor. I'll be on when we get both story I'll try to keep it as simple as I can. Our son Aaron was only four years old when he died suddenly in our kitchen Halas from a cardiac arrhythmia something that we now believe to have been avoidable. We've all seen it time and time again in the headlines when managed care means management of the bottom line patients being under-served. It's parents of two other children. We noticed something was wrong before Aaron was to our HMO wouldn't take us seriously and after several weeks of waiting for services we were referred

to a specialist who determine that Aaron was autistic. The specialists recommended that Aaron have a battery of physical and psychological testing to determine the current treatment plan. The proper mix of medications for his initial diagnosis. Our HMO denied that evaluation as well as other services along the way to save money and comply with internal spending limits and evaluation by the way Governor that the Hollow school department found to be so critical to our educational plan. That they offered to pay for it. Just three weeks before he died. We always question the diagnosis of autism and continue to request additional testing. Finally after demanding an MRI it was determined that Aaron had a brain tumor. Something we uncovered not our age. Mom Aaron survived that that alone would have outraged most people but it didn't stop there. The coroner concluded that Aaron died as a result of medication used to treat him for an uncertain diagnosis. Aaron didn't have to die and his diagnosis didn't have to be

uncertain. In fact he received more diagnostics after he died than before he died. Aaron was under served by a system doing the minimum. I'm here today as I was with Governor Shaheen a month ago. Joe applied you for your efforts both on the federal and state level with regard to HMO accountability patients rights. Excuse me. One child can save my trouble to show a picture because I think when we talk about autism I found this with my HMO. People tend to give up. They kind of think that autism is the end of the road. Well I'm a therapist and I work with developmentally disabled children. This is a picture of my little bunny in this all different types of autism. He had a life and we valued it. RH emoted. And he's worth the investment and I think if all your efforts save even one child like Aaron it'll certainly be well worth it. God bless. Thank you for.

Asking. We are. So. This is something that needs to be done. The American Medical Association supports nurses supported parents and families who've been through this nightmarish kind of experience are telling the rest of us it has to be done. The federal plans are showing that it can be done at a very low cost and in fact when preventive

care is routinely used you will avoid all of that a lot of unnecessary treatments cost money and don't do any good and often do harm instead. So this is the time and I just want to say that in New Hampshire under Governor chicanes leadership and in the United States of America under Bill Clinton's leadership it is time to pass a health care patients bill of rights that have the medical decisions made by doctors and not by accountants for HMO. And let's get the. I'd like to I'd like to talk for a short time about the issues related to disability and mental health problems because that's another aspect of the announcements that we're making here today and I'd like to call on Clyde Terry who helped to design new Hampshire's new grants that will assist people with the with disabilities doubt

they'll bring him the microphone. Governor. Very good. Bring it on up this way would you. Clyde I know that to instill this coming Tuesday in Manchester you have a big expo coming up don't you. That's right. Several disability organizations in the state including Granite State Independent Living Foundation and many others are sponsoring a three state Expo featuring technology and other age and appliances that make folks with disabilities to live independent and productive lives and don't have to rely on. It can live independently. Now that's a clear example of an outreach effort that we know is going to be meaningful to a lot of people. But you've worked very hard to make this possible. And I was proud to make the announcement today of this grant in New Hampshire. Tell us exactly what this is going to mean for people with disability who who are touched by this program the grant in particular.

Before I get into it I just want to say it's ironic that the administration's announcements today to expand the patients bill of rights to all federal programs will offer protections to the same Congress and send congressmen and senators that weren't afforded to the rest of the American population. You have a way with words. One more directly on the point a lot of disability organizations in the state have been working for years to find ways to improve employment opportunities for people with disabilities. We have advances in technology advances in health care in medical care so that people with disabilities can no longer be put on the back shelf or in the back room that they're ready to join the forefront of the American workforce and be productive contributing taxpaying members of our society. But oddly enough we have a system that's antiquated it was built on a time when it was thought that if someone got injured at work or they're born with a disability that they could no longer be productive that let's just pay them to stay home. And so now we have folks trained educated

where they can go to college and they go to school or go to college they're ready to enter the workforce. And all of a sudden. They earn more than $500 in a month. They lose the very same health care that gets them out of bed in the morning. They lose the benefits that help them pay for their housing and so forth. And we have a council member for example from Lebanon just north of here just last week told me of a story she's working in a school which can only work 15 hours a week. The school came with her. They wanted to extend her hours for a full day and she had to say no for fear that if she did it she would not be able to get the personal care attendant she needs to get herself out of bed in the morning so she go to that job in the first place. That seems contradictory. And we're losing a valuable member of our workforce so I think it's time to let's get the policy to catch up with the technology and the attitudes of the American population for the next century. So we have a new economy where more and more jobs are replacing Brawne with brain and muscle power with thinking and

more and more people who in the past were just considered disable and therefore not be able to participate in the work force are really very productive. But many of them do not have access to to the health care and to the technology in some cases that they need to fill these jobs. And there are new approaches that ask people not what's wrong but what works and how can we connect you to productive employment. And what this this program is designed to do is to reach those people and to make sure that they have access to the new opportunities that are available and that you want to add one thing quite well I think just clearly it's the point is that if someone finally can get a job where they can make more than $500 a month we certainly want to make sure they can still keep their health care which gets them there in the first place. Whether it's a prescription drugs or the personal care attendants or whatever it takes.

Well thank you very much for your. You're fine. I want to I want to ask Can I ask how to speak. We're honored to have the administrator of the Social Security Administration and as you know the disability program is a major part of our social security program in America and Canada. You've done great work in this area and I'd like you to tell us why this new approach is so important. Well it is so important that many people when they think of Social Security think of retirement and clearly retirement is a very important part of our foundation of support. But disability is there also just as the retirement benefit is in Social Security and it should be to provide help to individuals who become fully disabled who engage and work in New Hampshire. Now 30000 individuals receiving disability as part of the foundation that we have and support in this country. But the reality is that we have a system that doesn't give people the opportunities to be able to

return to work. Some of those 30000 people will never get to be a more severe severe disability but many could. So how do we transform a system that now provides just income support to one that would enable people to be able to take the risk to go back to work. Do you go back to work and not lose their health care coverage is as was so eloquently pointed out here to be able to get contact with with work centers in one stop centers to provide the support systems that are needed to enable people to be able to return to work and keep their health care coverage. Governor Shaheen you're receiving this grant because you're just about the best in business here in New Hampshire on this issue. You're clearly one of the best states in the country in this which is why we selected you to work on this because you have gone so far today. And Mr. Vice President what we're doing here is consistent with your whole message which is how do we make government work better for people. How do we make the systems work better so that individuals can

maximize themselves in America. So we hope this was an important step for the country and. We really thank you for everything you're going to be doing. Thanks for your doing Kim. We appreciate that. We're very excited to be one of the nine states that's getting one of these grants. As Clive pointed out what we've got right now is a system that provides the wrong incentives for people. And what this will allow us to do is to help us figure out how to do an even better job than we're doing. And I think one of the things that is particularly important for us in New Hampshire about this right now is that as you all pointed out that we've got a lot of people with disabilities who really have something to contribute to the workforce. And with an unemployment rate that is below 3 percent and has been since I took office almost where everywhere I go I hear businesses

saying we can't find the skilled workers that we need. And we can't keep them to be able to bring another whole segment of people into the workforce who have talent who can get the skills to do the jobs that we need is. You know one of the whole unexplored areas in the state so I think this Grant will give us a tremendous opportunity to begin to look at how we can bring those folks into the workforce in a way that allows them to be more productive and provides a very valuable service to what we need in the state's economy. I want to ask someone who can add to this from the standpoint of family dealing with mental health. Disability Yes. Right here. Tell us your name. My name is Brenda hanc. My story begins with my 15 year old daughter who met a very undesirable young man and tried to run away with him. She was placed by the police in protective custody. She

threatened suicide if she could not be with this young man and the police took her to the Concord Hospital in handcuffs after they wrestled him to the floor. I called my primary care physician who said she's in the best hands. Don't worry about it. Call them mental health. They've taken her to Concord Hospital it's within network. I went there. I called. At the time I that mental health people who told me their computer was down. But I gave them all of the information. And they told me I didn't hear from them within 24 to 48 hours that everything would be fine don't worry about it. So they evaluated my daughter they sent her to Philbrick mental hospital in Concord to have her observe and hold her in protective custody. What I didn't know is that my HMO had called Philbrick hospital and said they weren't

going to cover this but they never told me. So I had to go to the hospital my husband on and sign financial responsibility because we were not being covered that we still had not been told that I received the registered letter. 21 days later date the date that they had denied it. It was a cost of over $13000. By the time we finished with Philbrick the psychiatrist psychologist at the hospital my husband and I paid them out of pocket. And it took me 10 and a half months to be reimbursed by the HMO. And my biggest concern here is I'm happy to say that my daughter is fine but my concern is what about the parents who don't have over $10000 to lay out. Any child who threatened suicide needs to be taken seriously. If I could not have said I would pay that bill they would have to cut her loose and my

daughter and me. So I'm all for better mental health and protecting rights. Thank you. Given me they've given me several notes here that we've run we've run out of time and run over time. There are so many people who have stories to share and explain so clearly why these measures are needed. I want to thank all of you for being here. But because we've run out of time I'd like to just summarize briefly. We need a health care patients bill of rights for all of the reasons that people have eloquently stated here. I congratulate Governor Sheehy for making this a priority in New Hampshire and I know all of you are fighting along with her to get this passed. We need it on a national basis and we need the right bill and we need to pass

it this year and it should also deal with people who have mental health problems and people with mental health problems should also be included in the outreach to those who are in the disabled community because we we don't have a person to waste. You've heard that phrase before. It is a it's it is a truism about this country. We have to make our healthcare system work for everyone and we have to provide opportunity for everyone the people to start with in ensuring. Access to health care. Or the children. And because of what Governor Shaheen has done. To capture children previously uninsured so many of them 20000 of them will now have health insurance. And as the study released today shows in 38 states all over America almost two and a half million children who didn't have health insurance are now going to have it. But we've got a long way to go to provide health

insurance to all children. We have this new expanded partnership to reach out and sign them all to provide access to health care for everyone in this country. We're going to continue to pass this health care bill of rights and to provide opportunity for everyone regardless of disability physical mental condition. We're going to reach out to make sure that they have access to the new opportunities that are making all the difference to so many millions of Americans. I want to thank all of you for hosting me here today. Thank you very much and once again Governor Shaheen. Congratulations on your great achievement. Check Check out this page.

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