# Press Briefing by Press Secretary Ari Fleischer, July 26, 2001

The James S. Brady Briefing Room
12:45 P.M. EDT
MR. FLEISCHER: Good afternoon. The President intends to appoint Richard J. Warren to be a member of the Roosevelt Campobello International Park Commission. And I have a readout on a phone call the President made early this morning.
President Bush had a cordial 10-minute phone conversation with President Megawati of Indonesia this morning. The President called and congratulated her and Indonesia on the peaceful transfer of power, emphasized the importance of Indonesia's unity, prosperity and continued democratic development. He reaffirmed the United States' commitment to working with Indonesia to address its many challenges.
I'm pleased to take questions.

## Q Is the President any closer on the stem cell research?

    MR. FLEISCHER: Nothing new to report, Helen.

## Q Ari, what progress has been made on the patients' bill of rights? The President said there are serious conversations today. What area of compromise would he accept?

    MR. FLEISCHER: The President today sees progress on two fronts involving a patients' bill of rights. One is the number of members of Congress who are indicating they are switching positions and supporting legislation sponsored by Congressman Ernie Fletcher; and two, his conversation this morning in the Oval Office with Congressman Charlie Norwood. The President sees reasons for optimism and progress on both fronts.

## Q Can you be more specific?

    MR. FLEISCHER: As you know, the President has been meeting now for several weeks with members of Congress of both parties, principally in the House of Representatives, on patients' bill of rights legislation, urging members to pass a patients' bill of rights that can be signed into law because it protects patients in their dealings with HMOs without driving up the cost of health insurance. Toward that point, in these meetings, the President has spoken with many members who have previously voted for the Norwood legislation, who this year are indicating a willingness to support the Fletcher bill. And there is continued progress on that front in the course of these private meetings. The President just concluded a meeting in the Oval Office.
    This morning, at 8:30 a.m., the President met privately with Congressman Norwood, which is a follow-up to several meetings that have been taking place on the staff level with Congressman Norwood. And the President was encouraged by the meeting. They are talking about ways to get a patients' bill of rights passed into law that meets the President's principles -- principally, that it does not drive up the cost of health insurance because there's no point in enacting a patients' bill of rights into law that means that people are going to lose the very insurance that it is designed to be protecting.
    And discussions will continue with Congressman Norwood and with many other members. The point is the President is going to continue to reach out and talk to members of Congress as hard as he can, because he is committed to getting a patients' bill of rights that protects patients signed into law this year.

## Q Is he seeking a compromise? I mean, he's talking to all these people -- are they making any impression on him?

    MR. FLEISCHER: Oh, certainly. And he's making an impression on them, they're making an impression on him.

## Q Is he changing his mind about anything?

    MR. FLEISCHER: The President wants to work with the Congress on the specific terms of the patients' bill of rights so that one can be signed that keeps in mind his focus on enacting a patients' bill of rights into law that gives patients the protections they need such as access to emergency room care, a woman's right to go visit her OB/GYN without first going through a gatekeeper. To afford patients those types of protections, without creating such a new system of lawsuits that the cost of health care is driven up to the point where people lose their health insurance coverage. And that's the balance the President is working with members of Congress to reach, and members of Congress are working with the President.

## Q Why do you assume lawsuits if there's going to be good care and so forth?

    MR. FLEISCHER: Because there is no question about it, that if you make lawsuits such a preeminent part of health care, the cost to people who provide health insurance in the first place will go up, and therefore, people will lose their insurance. After all, this whole debate about a patients' bill of rights is about giving people health insurance that protects them in their dealings with HMOs. What good does it do a patient if they lose the very insurance that they need in the first place to get health care?

## Q Why are they going to lose it?

    MR. FLEISCHER: And to the degree that these lawsuits drive up costs, employers will be less likely to offer insurance to their employees, and that is one of the greatest ways Americans get their insurance is, thanks to employer-provided insurance.

## Q But why do you say that the lawsuits are preeminent in this legislation?

    MR. FLEISCHER: Because in the Norwood approach, to a certain degree there are no caps at all on the amount that can be recovered in damages and lawsuits brought in state court. The President wants to give people the right to sue if they've been wronged. It's just a question of what reasonable limits can be put on the right to sue so that the bill does not become one that enriches the trial lawyers at the expense of people being able to afford health insurance in the first place.

## Q Ari, two questions. First, what was the crux, the central core of the conversations, specifically between Norwood and the President on the patients' bill of rights? Two, the Speaker said today that he still has hopes this can be dealt with before Congress leaves for the August recess. Does it matter to the White House whether this is voted on before the recess, or after? Tactically, does it make any difference?

    MR. FLEISCHER: Let me take your second question first. Getting a patients' bill of rights signed into law has been a 10-year battle in the United States Congress. It's languished; it has not gotten done. Whether the President was a Republican or the President was a Democrat, it just hasn't gotten done. Whether Congress was a Democrat or Congress was Republican-controlled, it didn't get done.
    From the President's point of view, whether this measure gets voted on today, tomorrow, next week, or next month, is not as important as that it gets done and signed into law. The President believes the American people have waited too long for a patients' bill of rights, and what's most important is to get an agreement so it can get signed into law this year in a way that protects patients and their dealings with HMOs without driving up the costs of health care.
    Specifically, on the meeting this morning, they discussed several substantive areas of the legislation, which I'm not prepared to get into, but they both have a willingness to work with each other to get the job done. And that's another encouraging sign of progress.
    It's also a sign of how hard the President works this issue, how he reaches out to people who don't always share his exact approach to legislation. And the President is hopeful that at the end of the day, enough fruitful conversations will take place that enables millions of Americans to have better protection in their dealings with their HMOs.

## Q But there's more to compromise than back-slapping and hand-shaking. What specifically has he said he would do, policy-wise, in the way of compromising?

    MR. FLEISCHER: As I just indicated to Major, there were substantive discussions in the course of the meeting with Congressman Norwood.

## Q Beyond just that meeting. If you don't want to talk about that meeting, can you tell us an example of where he's willing to compromise?

    MR. FLEISCHER: What do you think takes place at all these meetings with members of Congress when they come down and sit around a table and talk about patients' bill of rights with the President? If you think the only thing that takes place --

## Q We don't know. Apparently, they had substantive conversations, but what we're trying to figure out --

    MR. FLEISCHER: That's exactly right.

## Q -- is what exactly is the substance of that conversation. Like where is the President willing to compromise? Can you give us an example?

    MR. FLEISCHER: There is a series of discussions -- take legal liability, for example. There is no question there is 90 percent agreement on so many of the key protections in this bill that afford patients what they need when they deal with HMOs, such as access to emergency rooms, a woman's right to go see her OB/GYN, a parent's right to have their child see a pediatrician. There is widespread agreement. If Congress would send President Bush that bill, a patients' bill of rights could be enacted into law today.
    But Congress instead is focusing on a bill that contains poison pills. And those poison pills are much of the conversation. They involve legal liability issues that drive up the cost of health care. Those issues include venues for court cases, state and federal. They include limits on damages, non-economic, economic, punitive. All those are measures that are under discussion.
    When it comes to the things that people most relate to, going to see their doctor and getting good care, there's widespread agreement. When it comes to things that involve trial lawyers and the cost of health insurance, as a result of excessive legal fees, that's where the differences lie. And that's where it's very hard to move Democrats off of those provisions that help the trial lawyers. The problem with helping the trial lawyers, in this case, is they drive up the cost of health care to consumers and to the companies that provide health insurance in the first place.

## Q Is the President willing to move -- you keep talking about moving Democrats away from their position. Are you willing to change your position on the venue or on the cap size of the lawsuit?

    MR. FLEISCHER: Let me give you an example where the President has indicated flexibility that still conforms to his principles. And that was in a speech in Florida. The President said that he believed that the best way to protect people's right to keep their health insurance was to have all legal matters brought in federal court, because companies are able to provide insurance on the basis of a federal law that provides a one nation standard for health insurance.
    There is a bill moving in the House, sponsored by Congressman Ernie Fletcher, that has a mixed system of state and federal action on lawsuits. The President thought that the mix was right in the Fletcher bill and he indicated a willingness to -- he has supported the Fletcher approach. That's a bit of a dual track about state and federal. There's a perfect example. If others demonstrate the same flexibility the President has demonstrated, a patients' bill of rights can be signed into law this year.

## Q Is the concept of a cap part of all of this discussion? A cap on the size --

    MR. FLEISCHER: Certainly. As the President made clear from the very beginning of this debate in the speech he made in Florida in the winter, the President believes there can and should be a cap on the amount of damages somebody can collect. That way the cost, again, is not driven out of control by outrageous and excessive lawsuits.
    The cap in the state of Texas was set at a level of $750,000, which is a level the President has cited. The cap in the Fletcher bill is set at approximately $500,000. The cap under discussion in the proposal of Congressman Norwood and Senator Kennedy is at a level of $5 million. That's an area that the President believes is way too excessive.

## Q Are the discussions ongoing then haggling about the precise size of the cap, and is there some point between $250,000 and $5 million --

    MR. FLEISCHER: I'm not going to do the President's negotiating through the press. There are serious conversations underway that give the President encouragement, and that's what you would hope and expect toward the end of a legislative process. That's how Congress and the President work together to get the people's business done.

## Q Two questions, Ari. Can you elaborate in any way on the President's statement this morning that he's open-minded in considering other countries in the immigration reforms being considered by the working group?

    MR. FLEISCHER: What the President indicated is that he has not made any decisions yet, but that matter is under review. And he cited, of course, the reason for much of his focus is because of the impending visit of his good friend, President Fox of Mexico for the state visit in September.

## Q He indicated a willingness to include other countries.

    MR. FLEISCHER: Certainly. All along -- the White House has said that all along, that the President had made no decisions about the exact groups that may be liable for more humane and legal treatment as a part of an expanded or improved guest worker program. But no decisions have been made. The President is considering various ideas about how to apply changes in the guest worker program and to whom those changes should apply to.

## Q And one other area. The House, as you know, yesterday voted to lift travel restrictions to Cuba. What's the President's position on that?

    MR. FLEISCHER: The President does not support that. The President thinks it's important to send a strong message of standing strong against oppression in Cuba, and that is not a measure that the President would support.

## Q Would you kill it?

    MR. FLEISCHER: It's a little early in the process to get into that. This, after all, just took place. The legislative process concerning this action is just beginning.

## Q Why doesn't he support it?

    MR. FLEISCHER: Because the President thinks it's very important to stand strong against oppression in Cuba and to keep a strict economic embargo in place against Cuba.

## Q But there is a lot of travel now, and it's growing.

    MR. FLEISCHER: That's the President's position.

## Q Ari, usually when the President wants to talk to lawmakers about legislation, they come to the White House. And all of the meetings on the patients' bill of rights have been here. This afternoon, he's going up there, he's going to go to Speaker Hastert's office, sit down with members. Doesn't this sort of create the impression or look like he's going hat in hand to members who sort of -- almost begging for votes?

    MR. FLEISCHER: With all due respect, I think this is an indication that sometimes with the press, no matter what a President does, it doesn't matter what the party is -- the press will find a reason to oppose it. It used to be that the President was not engaged. Now, all of a sudden, the President is very heavily engaged. The press says, why is he engaged.
    I don't think it matters what venue the President uses to convince members of Congress that the nation needs a strong patients' bill of rights. The President is pleased to have meetings with members of Congress to discuss his initiatives and his ideas to build support so that patients around America can have protections in their dealings with HMOs. So the President is honored and pleased to go to Capitol Hill and meet with members of Congress.

## Q Did the idea for this come from the White House, or did Hastert say that this would be a good thing to do?

    MR. FLEISCHER: I haven't -- this is so routine, I haven't looked into the origins of it. Get used to the fact that you have a President who was governor of Texas, working very hard and very well with members of the legislature, and often did so by surprise drop-ins on their offices.
    In the federal system, as President, it's a little harder to have a surprise with that motorcade that has to be taken up there. But it's a sign of how the President believes it's important to reach out and talk to members of Congress, to listen to their concerns, to hear them, and it's a perfect continuation of what he did as governor of Texas very successfully.
    There obviously are upcoming votes that will take place in the patients' bill of rights, which will be the best indication of whether the President's effort was successful. But make no mistake -- because he wants to give patients protections, he's sparing no effort at working with members of Congress to make progress and get an agreement.

## Q Ari, does the fact that you've intensified these discussions with Norwood mean that there's an understanding here that if you do get the Fletcher bill, it won't exactly be the Fletcher bill, it's going to have to be some modified version of it?

    MR. FLEISCHER: Keith, it's an indication, as the President said in his remarks from the Oval Office, that he wants to get an agreement on patients' bill of rights, and that conforms with his principles. And those principles are that patients get the protections they need, without forcing the cost of health care up. So there are a series of vehicles moving on the Hill, the Fletcher bill, the Norwood bill. And what you see here is a President willing to work with various parties to get the job done.

## Q But just a follow-up. You wouldn't be talking to Norwood if you were doing so well on the Fletcher bill, would you?

    MR. FLEISCHER: It's an indication that it's important to work several fronts at the same time. Both conversations help with each other.

## Q Based on the arguments you've been giving, it seems like the crux of the matter rests in an assurance that whatever reaches the President's desk has some form of independent review process, where everything's exhausted first, and then, and only then, would you go to federal court. Excuse me if I'm getting that right or wrong -- state court. You know what I mean. If you were able to reach some sort of agreement with Norwood on this independent review process, that would sort of eliminate your fear of all this explosion of litigation. So if you could -- if Norwood would agree with the Fletcher mixed review system, would the administration then be willing to show some flexibility on the liability limits?

    MR. FLEISCHER: The purpose of a strong independent review is to give patients recourse to reverse a decision an HMO makes if they don't like the HMO decision. Patients don't want to end up in court, they want health care. You don't get health care from in a court room. You get legal liability, you get a damage award. Patients are less interested in that -- lawyers are more interested in damage awards.
    Patients are more interested in getting health care from their doctor. Patients would much rather see a doctor than a lawyer, and that's what a good independent review is about. It means that if an HMO denies a patient treatment, because the insurance policy won't allow the doctor to do what the doctor says is right, the patient should be able to go to independent review and then the doctor should do what the independent review tells the doctor to do. It should be used as a vehicle to get health care to patients. It should not be used, primarily, as a vehicle to get lawyers into courtrooms, which drives up the cost of health care. And that's the way the President views independent review organization, and that's an important substantive part of everybody's legislation.

## Q Would it be accurate to say that the independent review process, the Fletcher provision on this area, is non-negotiable, but if you can get Norwood and company to agree to that, then the administration would be willing to negotiate on the caps between $500,000 and $5 million, because --

    MR. FLEISCHER: I'm just not going to get into the sustenance of what the President and Congressman Norwood are discussing, as well as the staff discussions with Congressman Norwood. Just suffice it to say, the President is pleased with the meetings, pleased with the progress, and he's dedicated to it.

## Q Ari, in any of the meetings with the Republicans, does the President talk about the political impact on the party of having to veto a bill, what it would mean if he has to tell the public he can't sign this bill?

    MR. FLEISCHER: The President has just said directly, in response to one question a member of Congress asked him yesterday, the member said, will you veto Ganske if it's sent to you? And the President gave him a one word answer, yes.

## Q But have you talked about the political impact that would have, and have you also discussed --

    MR. FLEISCHER: The President has not.

## Q Are there discussions about -- I know a lot of the members of Congress came out to the microphones roundabout, saying that the Democrats are going to use this in the elections if there is a veto, so we're trying to find a solution this year, and that's sort of the impetus. How much of that has been discussed in the White House, in the Oval Office --

    MR. FLEISCHER: Well, the discussions are entirely substantive. They are focused on the provisions of the legislation, and the President is making his case to members and the members are listening.

## Q And you're not worried about the political impact if there is a veto?

    MR. FLEISCHER: The President has told members of Congress directly that his job as President is to protect the American people so they get health care, and that he will not support a bill that would hurt the American people's ability to have health care coverage. He's talked to members of Congress about the huge problem in this country of the uninsured, and he's asked the members of Congress not to make it worse. By passing a patients' bill of rights that drives up the cost of health care so that people lose their health care coverage, that adds to the number of uninsured in America. And that's the President's message to members of Congress.

## Q On another point, when Norwood was leaving he said, "we aren't changing anything." So where does the President see progress?

    MR. FLEISCHER: I'm not aware of what Congressman Norwood said as far as that's concerned, but again, I'm not going to talk about the substance of their discussions. But there's a reason the President is heartened.

## Q Ari, why did the Bush administration pull the plug on the gun buy-back program?

    MR. FLEISCHER: On the gun buy-back program, that was a program operated by the Department of Housing and Urban Development whose mission is to provide housing for American citizens who are low-income and in need. There are other departments in the government whose mission is to protect people within that public housing and to make certain that the laws of our country are being obeyed.
    And toward that point, the administration has made millions -- hundreds of millions of dollars available this year to support Project Safe Neighborhoods, for example -- that's one program -- $558.8 million is in the Bush budget for Project Safe Neighborhoods, and that provides $15.3 million for 113 new U.S. attorneys to serve as full-time gun prosecutors; $75 million to fund 600 new state and local gun prosecutors to work in partnership with federal law enforcement to reduce gun violence. So there are a series of actions being taken by this administration to reduce gun violence; that includes public housing projects. But the mission of HUD is a different mission and HUD has been racked in previous years by the inability to carry out their core mission. And this is a focus on their core mission.

## Q But the point of this program was to take 20,000 guns off the street. It's great that you have lawyers that can help out, but what about the fact that there's going to still be 20,000 guns on the street? The point was to get them off the street --

    MR. FLEISCHER: And that's why the President has ordered these initiatives that provide hundreds of millions of dollars of new funding, to make certain that whatever guns are on the street are not in the hands of criminals.

## Q Would he be willing to move it to a different agency or department in law enforcement? The program -- he just doesn't like the program.

    MR. FLEISCHER: No, it's much more a jurisdictional issue here, that this is not part of the core mission of HUD. HUD's core mission, which it's had a lot of trouble with in recent years --

## Q Okay, so you put it in Justice --

    MR. FLEISCHER: I could walk through the entire list of programs that Justice is working on, but I think you may want to talk to Justice about whether that's in their plans.

## Q Does the President think this was a successful program, or not?

    MR. FLEISCHER: It's not a topic I've discussed specifically with the President. I can just walk through with you the reasons why this is not under HUDs core mission.

## Q We know that's your position. Would you be willing to move it to another department?

    MR. FLEISCHER: As I said, this is a matter that's not under HUD's jurisdiction. Whether it's the jurisdiction of another department such as the Attorney General, you may want to address that to the Attorney General's office.

## Q No, I'm addressing it here --

    MR. FLEISCHER: Well, I just indicated, it's not a topic that I've talked to the President about.

## Q Ari, the President today was very clear in saying he does not support blanket amnesty. And you keep talking of a temporary worker permit or a guest worker -- or whatever they're called. In other words, for anybody to be able to -- the President said today an employee has to want to work for that employer and he said there must be a mechanism, a way of making both ends match. So all this talk about amnesty, all it is is a worker program, that's all. You've got to have the worker and the guy who wants to hire him, right?

    MR. FLEISCHER: I would hesitate to say "all it is." That's a lot. There's an important need to help immigrants come to this country and have the legal protections they're entitled to, as well as a humane, safe, and legal way for them to enter into our nation's borders.
    One of the biggest problems with people coming to this country from Mexico is they have been entering in ways that have led to tragedies, human tragedies, with people dying on the borders trying to get through. And if we can create a new guest worker program that addresses some of those concerns, we can protect the lives of people who come to this country for opportunity. And that's why the President is focused on this.
    I would just remind you that nobody in this administration talked about amnesty. You heard the President's position on it. It's always been a guest worker program, as was accurately reported in the first story on this topic.

## Q How about the people who are already here? There are millions of them that are already here; they're probably working illegally, and the workers would probably like to retain them. Would they be eligible --

    MR. FLEISCHER: This applies to the people who are already here.

## Q Even if they're here illegally?

    MR. FLEISCHER: That's correct. This applies to people who are already here.

## Q As long as both sides --

    MR. FLEISCHER: This applies to people who are already in this country, and it, of course, would have implications for how people arrive in this country beyond that.

## Q Which leads to the central question. If the President is not in favor of blanket amnesty, but nevertheless, this guest worker system as it has been described to me would be a transitional bridge to full legal status, don't you eventually achieve amnesty, or something very close to it, for the people who are already here? It's not just a guest worker program that has a date certain where they have to go back. It's a bridge to becoming a full-fledged legal resident.

    MR. FLEISCHER: Only after they avail themselves of their legal rights to apply for citizenship, which takes a considerable period of time, of course.

## Q But citizenship is different from being able to permanently work in the United States.

    MR. FLEISCHER: Major, I think until the President makes his determination about what steps to take, you're jumping ahead. You don't know what the President is going to decide. But what you know is that the President is indicated that we need to be a country that welcomes immigrants to our shores. And there are millions of people here who are here illegally, who came here for opportunity, and there are millions -- there are many people who risked their lives coming here. The President would like to set up a system that is humane, that is legal, that is safe, so that immigrants can come here and be welcomed with the opportunities that this nation presents.

## Q I'm jumping ahead, it's only because I have been lead there by people I've talked to within this administration who say what is currently contemplated is something where guest worker is a transitional phase to legal status. So isn't this much closer to amnesty than the President is actually conceding?

    MR. FLEISCHER: No, because as the President indicated, he opposes a blanket amnesty. There is a difference between that and the guest worker program, which as the President and Jacobo just indicated, matches employers' needs with employees presence here.

## Q Ari, the White House has expressed its pleasure at the release of Gao Zhan; the President even suggesting a bit of pride, suggesting that it came as a result or after his talks with Jiang Zemin. Is the U.S. pursuing any remedy for the illegal detention of a U.S. citizen, in this case, Gao Zhan's son, either in terms of a monetary remedy or some other sanction on the part of China?

    MR. FLEISCHER: Wendell, there's nothing that I'm aware of when it pertains to that.

## Q Why not?

    MR. FLEISCHER: Well, the point here is the President has repeatedly spoken out against China and their violations of human rights. And he will continue to do so, just as he did today. The President is heartened by the result of these two releases in this case. And they did follow the President's call and personal message to President Jiang Zemin. This has been a contentious issue with China, and as the President said, it's very important for China to understand that as they modernize and become a part of the developed world, human rights is a key component of development. And the President will be looking to China on that score.

## Q Do we have any indication, Ari -- if I could follow -- do we have any indication this is something that China might not repeat next week, next month?

    MR. FLEISCHER: That's a question you need to ask Chinese authorities. It's not in the hands of the United States.

## Q Can you address the pending legislation on religious charities and the conversation the President had this morning with Senator Lieberman and Senator Santorum, and especially their indication that there was some possibility, they had thought, on Title VII of the discrimination provisions?

    MR. FLEISCHER: The President had a very constructive meeting today with Senator Lieberman and Senator Santorum, in which progress was made and having the Senate take up a key initiative, which is helping people who have some of the most difficult problems in our society through faith-based initiatives.
    Senator Lieberman was very powerful -- his support for the overall program. The President is looking forward to working with the Senate on the exact details of the program, and doing so in a way that comports fully with the nation's existing civil rights laws.
    And I've got to go catch a vehicle to get up to the Hill for the next series of meetings so I can answer more of your questions. Thank you, everybody.
THE PRESS: Thank you.
END