Hartford, Connecticut Remarks and a Question-and-Answer Session at the National Issue Forum of the National Retired Teachers Association and the American Association of Retired People.

President Johnson, President Hughes, Governor Grasso, Senator Weicker, Congressmen Cotter, Dodd, and Ratchford:

It is a distinct honor for me to be here with these two combined distinguished groups of retired Americans. As much as I admire you as retired Americans, I must admit that I'm not yet tempted to join your ranks anytime soon. [Laughter]

For much of this century, you've seen our Nation through its major crises—two World Wars, a great depression, severe shortages, tragic assassinations, political scandals, embarrassments to our Government, and social upheavals changing the racial interrelationship of our country. You've helped to bring us through all of that, and you've helped to build the most powerful, free society in history, with both material power and also with spiritual power.

These are achievements of which all of you can be very proud, and I as President am deeply grateful to you for this wonderful achievement for all of us. Thank you very much.

But there are some things that trouble us about the future of our great Nation. And I cannot think of any group more qualified to discuss our Nation's future than you who have so positively shaped its past and its present.

My greatest responsibility, above everything else as President of the United States of America, is to protect the security of the United States. Excessive imports of foreign oil—listen very carefully threaten the security of our country. We not only import about one-half of all the oil we use, but with that oil, we also import excessive inflation and unemployment.

Listen to this: Without including energy, the inflation rate would only have gone up this year about one-fourth of 1 percent—without energy. Energy prices, however, have forced up the consumer price index, because they have increased 60 percent this year.

You know that our country has had severe problems with gasoline this summer. But throughout that difficult period of shortage, which bothered motorists, when tempers ran even higher than the gas tanks ran low, my top concern was to prepare for this winter.

The morning after my Sunday night address about the crisis of confidence in our country, I flew out to Kansas City, where I set forth the specifics of our energy plan for the Nation. And I said then, and I quote, "We must have adequate heating fuel to prevent suffering next winter." Today, I am pleased to tell you that we will have necessary fuel to see us through this winter. You need not doubt that any longer.

Our heating oil stocks will reach 240 million barrels in October. At this moment, we are 2 million barrels ahead of where we were last year at this time, and we are now producing 330,000 barrels every day more than we were producing this time a year ago.

Another of the actions that I pledged to you was better management of the supplies that we have. It won't be enough to have 240 million barrels of oil in storage somewhere if there is an emergency shortage where you live. Therefore, I've created a special heating oil management group to assure steady and predictable deliveries throughout this winter. The group will involve the Departments of Energy and Agriculture, Transportation—and even the Coast Guard and the Army Corps of Engineers, in case we have severe transportation problems because of excessive icing or excessive snow. And they'll work closely with the industry and with State and local governments. Special emphasis will be placed on coordination with Governors. The headquarters of this group will be in Boston, and the team will go into action on September 15.

With OPEC jacking up its prices by more than 60 percent just since last December, we know all too well that the price of heating oil has gone up all too much. As a nation, we simply must face up to the true cost of energy. And I cannot mislead you; there is no prospect of any reduction in energy prices anytime in the foreseeable future.

You can understand when it's time for this country to face hard realities, because you yourselves, in the past, led us to face hard realities and to overcome them. Given this hard reality of high prices, we're going to reduce the burden of these increased costs on those Americans, many of them the elderly, who are least able to bear them. We will reduce those burdens from the shoulders of those for whom you have deep concern.

Last week, one of the major oil companies, Texaco, announced that it would hold the line on home heating oil prices, that they would provide emergency supplies of heating oil to needy households, and that they would improve credit terms for wholesalers and for retail customers. I'm asking the other 27 major oil companies to act in a similarly responsible manner, to freeze prices and to give adequate credit to help us through this winter with heating oil.

I've launched a continuing major investigation to make sure that no oil companies profiteer from our energy problem. If one inescapable truth has emerged from the whole energy crisis, it is that all of us—oil executives, gas station owners, farmers, renters, homeowners, truckers, retirees, Members of the Congress, Governors, and Presidents—all of us share this problem together, and we must all pull together to beat this problem so it will not beat us all.

There is so much more that we can do if we are ever again to have an adequate energy security for our Nation, on which our own well-being depends. All of us must save energy, stop wasting energy, to hold down the total amount we use and to minimize competition for available supplies and, therefore, hold down the price.

Tax credits are now available to every family in our country for insulating of homes. And we have seen through observation that the simple matter of spending a few hundred dollars on better insulation of homes will cut consumption of fuel by as much as 50 percent. And, obviously, everyone can set your own thermostats to either save energy or to waste energy. We must, however, in addition to this, give special help to the elderly and others who live on low incomes.

I'm today asking the Congress to provide $1.6 billion this winter and $2.4 billion next year and thereafter to ease the burden of rising energy costs on people who most need assistance. This financial help will be for everyone in our country who's the most needy. I know you'll appreciate that. The Congress must act, and you must help me induce the Congress to act.

The program has two basic propositions, and I'll be very brief.

First, a special program which will make cash assistance available to all low income households. The average benefits nationwide will be about $200, but, of course, there will be higher payments for parts of the country like New England, where the coldest weather prevails. And there will be a second crisis assistance program, that we've had in the last 2 years since I've been in office, that will be greatly expanded to help the States give needy households, in energy emergencies that are dangerous to health, extra help.

I'm asking the Congress to take $400 million for the crisis assistance program this winter out of general revenues—that's out of existing tax programs now—to prevent tragedies and to avoid delays.

The Congress must also act quickly on the windfall profits tax on the oil companies' unearned profits to pay for the special program for over 7 million needy households in our country.

In structuring this program, we've done several things to ensure that the elderly benefit as much as possible. For example, States will be required to take special steps, which Governor Grasso is already taking, to ensure help for the nearly 2 million elderly who are expected to participate in the special program this winter.

The price rise of heating oil is a perfect example of why this Nation must have a windfall profits tax now. Once we have it—and I predict that we will have it this year—then 50 percent of any increase in the price of oil will be recaptured for low income assistance, for conservation, for mass transportation, and for developing alternative fuels to reduce our dependence on uncertain crude oil supplies from overseas.

I'll be working also with the Congress to explore every additional way possible to help Americans meet this energy challenge.

The simple truth is that this country is going through a hard transition—from energy so cheap that we didn't even have to think about it, to fuel so dear that it's hard to think about anything else.

Year after year, we have put off the tough decisions on energy. This summer, it became clear to many Americans, who were previously doubtful, that we no longer have a choice, that we have a real energy problem. This winter we must be prepared to face this truth together.

To summarize, we've built up our fuel stocks; we're preparing for emergency distribution of available fuel supplies; we have assistance for needy families; we have an adequate, financial, encouraging program to insulate your homes; we are shifting from oil to more available fuels-natural gas in some instances up here. The most important thing we must do now is to ensure that the windfall profits tax passes, so that it can give us energy security. We can put the era of gas lines and precarious winters behind us.

Of all the groups in this country, you are the best equipped to teach America how to endure and bow to prevail. You're the best trained troops we have for winning the energy war.

Look just for a moment, in closing, at the victories we've already won together. Before I became President, as I traveled around our country, the main concern expressed to me by elderly Americans was the fear that the social security system was in danger of bankruptcy, the Disability Insurance Trust Fund was to be depleted, bankrupt in 1979, and the Old Age and Survivors Insurance Trust Fund would be bankrupt by 1983.

With Nelson Cruikshank's¹ help and with your strong support in the Congress, we now have legislation which assures the soundness of the social security system, and we will keep the social security system secure. You can depend on that.

¹ Counselor to the President on Aging.

This is a fight we've won together. It was not easy. Members of the Congress who voted for this program have suffered politically, but it was the right thing to do; it was the courageous thing to do.

This is not the only victory we've won. We've won protection against unwarranted mandatory retirement when I signed last year the Age Discrimination in Employment Act. We have won better and more efficient Government services when I signed last year the Comprehensive Older Americans Act, a landmark piece of legislation that helps every retired person in our country. And we've also won important victories in pension reform, housing for the elderly, rural clinics, mental health care, food stamps, and helping the elderly handicapped. This is a good record. We can be proud of it. And today I want to pledge that together we're going to add two more vital victories to that record in the field of health care.

The first victory which you and I are going to win together is to establish in this country a comprehensive national health insurance plan for which this country has been waiting all our lives. Ever since Harry Truman was President, we've been talking about it; now's the time to do it.

Under this health care program, the 24 million older Americans now receiving Medicare will, for the first time, have a limit on out-of-pocket expenses. After the very first day of hospitalization, senior citizens will be entitled to an unlimited number of fully subsidized hospital days.

There will also be doctor fees publicly set for physicians for both Medicare and Medicaid, for health services rendered. Senior citizens will not face doctors' bills beyond those covered by Medicare.

In addition, over 10 million poor Americans will be given health coverage for the first time. Pregnant mothers, newborn children will be covered. Catastrophic medical bills will be covered for all Americans. We are ready to enter a new era in the United States in health care. If you'll help me, we'll implement this program in the Congress.

And finally, I'm absolutely determined to get hospital cost containment passed through the Congress. The key votes are going to come in the next few days. I hope every one of you will help in every way possible. My proposal to control the sky-rocketing increases in hospital costs, increases that fall so heavily on older Americans with fixed incomes, is a crucial part of the health program and the program to control inflation. The States represented here in New England already have such plans, and they're working well.

I'd like to remind you that in the year 2000, the Americans born in the first year of social security will turn 65. They will owe a great debt to you. It's not too much to ask the rest of us that we repay some of this debt now. You who have strengthened this country, changed our society, and have yourselves endured, know that we still live in the greatest and most free democracy in the world. Your will can be made our Nation's will if you make it known to your elected representatives.

I trust you to do that now, as you always have done in the past. I trust you to fight for a just distribution of the resources of this great country, from windfall profits to social security. And, above all, I trust you to help me prove that this land is big enough, rich enough, and humane enough for it to be both free and fair.

To summarize, we must carry forward our vision of a greater America. We must work together for a rebirth of the American spirit. We must restore confidence in ourselves, our neighbors, and in our country. We must revitalize basic human values, which do not change. We must regenerate a sense of unity among the different people in this country. And we must define new and exciting goals for America. Together, that's the kind of nation we will continue to build. Together, that's the kind of land we will leave our children.

Your courage and your commitment, your experience and your wisdom will help to see this dream of a greater America come true. As we have in the past, our Nation will still depend on you.

God bless you. And now, I'd like to answer some questions.

QUESTIONS

NATIONAL HEALTH PLAN

Q. Mr. President.

THE PRESIDENT. Yes, sir.

Q. I'm Jim Peace from Cape Cod in Massachusetts. Your hospital cost containment bill is having a difficult time; we will help you get that through. However, why introduce piecemeal legislation that is inflationary, rather than the entire package as contained in the Kennedy bill?

THE PRESIDENT. For the last 20 or 30 years, the Congress has been assessing, with frequent proposals, how to get passed a comprehensive, nationwide health insurance program. We have assessed the possible means of implementing this nationwide insurance program in every possible way.

I've spent hours with Senator Kennedy, with Senator Long, with Senator Ribicoif, and others. There's no doubt in my mind that the proposal we put forward will not only be less costly but has enough support in the Congress finally to pass. Its ultimate results will be equal to at least the coverage described in any health insurance program. And it's focused upon a phased implementation, which will meet the most urgent needs that I've outlined this morning.

First, both proposals, mine and Senator Kennedy's, have a lot in common. Both will be first implemented in 1983. The difference, in my opinion, is that mine can pass. And as the propositions go through the Congress, I have no doubt that there'll be negotiations, decisions by subcommittees in the House and Senate, and that we'll eventually come out with a plan that I support, that previous Presidents have advocated—none have been able to get through—and that the Congress and the House and Senate, including Senator Kennedy, will be proud to see implemented in our country.

We're working together. There are a few differences. Both plans are good. I believe mine can and will pass.

HEALTH INSURANCE

Q. Mr. President, my name is John J. Stevens of Amherst, New Hampshire. We've had reports that you had a meeting this morning with a number of insurance executives in this insurance city. Are we to understand that you assured them that any national health plan which you plan to propose to Congress will not interfere with their business? [Laughter]

THE PRESIDENT. I have not met with any insurance executives. I will meet with them after this meeting, and I will not give them that assurance.

Q. Thank you, Mr. President. [Laughter]

NATIONAL HEALTH PLAN

Q. Mr. President, I'm Delbert Smith. I'm from central New York, a little town named Eaton. Would it not be less expensive and more practical, less costly, to have a complete coverage, such as they have in some of the other nations, than to try to bolster up the present system, which I understand your present plan calls for?

THE PRESIDENT. Our plan is a complete one. It is phased to be implemented step by step. It's the kind of proposal that has already aroused substantial support from people who in the past have blocked the passage of any health legislation, as I said, since the time of President Truman.

The final plan, which we have presented to the public and to the Congress, is nationwide. It is comprehensive, it is adequately all-inclusive, it's fiscally sound. And it has an excellent chance to pass though the Congress. I have no doubt that the judgment that I've made on it is the proper one for you, for me, and for the country.

NURSING HOME CARE; SCOPE OF COVERAGE

Q. I'm Patricia ; from Windsor, Connecticut. And I would like to ask if the national insurance plan would cover elderly patients in nursing homes and, also, to ask, why is it so difficult now for the patients to obtain hospital coverage? Thank you.

THE PRESIDENT. No, none of the comprehensive national health insurance plans include the long-term care in nursing homes, neither mine, Senator Kennedy's, nor any others, so far as I know. We all agreed that the best way to handle that is through a more comprehensive proposal dealing with different facets of financing, the licensing of nursing homes, and the Medicaid-Medicare extension to chronic care, including drug programs.

As far as the coverage of persons-that's a difficulty that you described—I believe that the program that we've put forward to the Congress will be all-inclusive for certain categories and, obviously, will include all Medicaid and Medicare patients in the future. There would be no exclusion at all.

Let me pause to ask Nelson Cruikshank if there's a special consideration that I need to describe.

MR. CRUIKSHANK. No, that's correct, Mr. President.

THE PRESIDENT. Nelson says that my answer's correct. I'm glad to hear it.

Q. Thank you, Mr. President.

THE PRESIDENT. He's my expert on the subject.

MEDICARE

Q. Mr. President, I'm Marcella Spigelmire, president of the Maryland Retired Teachers Association. I'm from Baltimore, Maryland. Having filed many Medicare forms for myself and my relatives, and always wishing afterward that I had the foresight to select a doctor who would accept the assignment and whose fees met the requirements of being not greater than reasonable and proper, I wonder if you have anything in your plan to alleviate the redtape and rigidity of the present requirements.

THE PRESIDENT. Yes. The whole plan is designed to minimize the redtape and rigidity, because now there are so many different, nonrelated facets of health care. Each person, almost, in our country, each small group of people in our country are in a separate category, and much of that paperwork is designed to identify or to define a person's right for coverage.

The reason that we put forward this comprehensive plan to the Congress is so that as it's phased in, each broad class of people would be completely covered. There would be a minimum amount of paperwork—I would hope no more than you experience with your social security, routine payments. And this is what we hope for, and I believe that we can achieve that.

Q. Thank you, Mr. President.

THE PRESIDENT. Thank you. The comprehensive nature will help to decrease the paperwork.

INFLATION RATE

Q. President Carter, my name is Thomas Canzillo from Monroe, Connecticut. The rate of inflation has been increasing in the last month or so. From all our economic indicators, do you expect the rate of inflation to go up or go down?

THE PRESIDENT. I expect the rate of inflation to go down the rest of this year. As I pointed out earlier, the 60-percent increase in fuel costs imposed on the rest of the world by OPEC is a prime cause of the rapid growth in the inflation rate this year.

Yesterday, I had my economic advisers give me a summary of what the inflation rate would be without energy. And as I said earlier, throughout this whole year the inflation rate would only have changed about one-fourth of 1 percent without energy. With energy included, the inflation rate has changed 4 or 5 percent, because energy has gone up at an annual rate of about 100 percent.

We do not anticipate although I cannot control this—we do not anticipate any further increases by OPEC this year. So, the rate of increase, even in energy, is likely to level off. And that's why we're working so closely with Texaco and, hopefully, with other oil companies, to get them now to level off their price increases so that we can have a decrease in the inflation rate by the end of this year. I predict that that will happen.

NATIONAL HEALTH PLAN

Q. Mr. President, Bernard Hartspak, Campbell Hall, New York. We have come here from all over this great Nation to listen and also to be listened to. I was told to make my presentation short for lack of time. All one needs to do is look at the seniors in this room to see there is not much time. [Laughter] If you'll bear with me, I would like to make part of this presentation, and I'll leave the full text with you.

THE PRESIDENT. I don't agree with that last statement you made. It looks to me like they have a lot of time.

Q. A comprehensive national health plan must and should be put into operation with all due haste. Some of the reasons are: When a nation spends over a hundred billion dollars a year for medical expense—excuse me, I can't see too well with my age— [laughter] —we'll get to the question, relax—for medical expenses, still, the American people cannot afford medical attention without the fear of additional expense, is a national disgrace. When a President talks about fair and equal treatment for all, is it fair and equal when the President, Senator, Congressmen, diplomats, heads of state, heads of foreign states, members of their family receive medical treatment at the taxpayers' expense? It would be fair and equal treatment only when all people receive the same treatment.

When a nation serves the medical needs of welfare recipients, drug addicts, alcoholics, prisoners, at the taxpayers' expense, fair and equal treatment for all Americans will apply only when all people are included, when illness strikes.

Now, the question, because time is- [laughter] —relax. How much longer will the American people have to wait for a complete national health plan for all Americans?

Thank you very much.

THE PRESIDENT. Thank you. It depends as much on all of you assembled in this room as it does on me.

We have evolved and presented to the Congress, worked closely with the chairman of the Ways and Means Committee, Al Ullman, closely with the chairman of the Finance Committee in the Senate, Russell Long, and with Senator Kennedy and with Jim Corman and others, to propose a comprehensive, nationwide health insurance program. The Congress passing of that program will be dependent on how much they are convinced of your interest in it and the need of the country for it.

I'm convinced that your interest in it is acute and that you will work on it. And I'm convinced that the Nation needs it. And I'm determined to make sure that it comes into being. The implementing date of the health insurance program that we put forward and also, coincidentally, the one that Senator Kennedy put forward, is 1983. If the Congress acts this year or early next year, that's the earliest that a complicated program like this can be implemented.

So, your answer is—I agree with your basic concerns and your basic purposes. If we can get the Congress to act, this program will start to be implemented in 1983. And it will be comprehensive, allinclusive, and adequate to meet your needs.

HOSPITAL COST CONTAINMENT

Q. President Jimmy, I'm Frank Pezzick from Nutley, New Jersey. I'm going to try to make my question shorter than the preceding speaker, because I'm a Jerseyite and all these other speakers have been New Englanders. [Laughter]

Every homemaker in this country knows that when she goes to the store, the price on a can of beans or the price on a steak is higher today than it was yesterday, and it'll be higher tomorrow than it was today, and so on. You and Governor Grasso have pointed out that the price of fuel is going up constantly. We know-and Senator Weicker's drug company can substantiate this—that the price of medicines goes up constantly.

Now, you say that you're going to contain hospital costs. Every delivery a hospital gets of food for its patients is up higher than it was the day before. Every jar of intravenous solution is up, constantly—

AUDIENCE MEMBERS. Question!

Q. The question—quiet, you listened to the other one, now you can listen to me. [Laughter]

THE PRESIDENT. But you promised to be briefer. Right?

Q. The question is, simply, what are you going to do to contain hospital costs in view of circumstances like I just mentioned?

THE PRESIDENT. Okay. Let me point out that our system of economy is based on the free enterprise system, where competition helps to control prices even in times of inflation. In the last few years, where hospital cost containment did not exist, hospital costs have gone up about twice the rate of inflation, because there is not adequate competition in hospital care.

Quite often, a person pays hospital insurance for years, if they are fortunate and are well. All of a sudden they feel badly. Their inclination is to go into the hospital, to stay a few days, if possible, to get a good physical examination, to get at least as much care as they need, and partially to recoup what hospital insurance premiums they've paid.

The hospital administrators quite often are very eager to keep the beds full, because the more beds are full, the more profits are made. It's more convenient for a doctor to treat a group of patients in the hospital than a group of patients outside the hospital. In many cases, the doctors are the ones that own the hospitals and derive a profit when the hospitals are full.

Quite often, patients can be treated much more cheaply with generic drugs and much more cheaply in their own homes and with out-patient care than they can incarcerated in a hospital. And what we're trying to do is to make sure that hospitals don't profit from the absence of competition that I've described for you, and that they do be given an adequate means to pass on the inflation rate that prevails in the rest of the society, but not to continue to have excessive charges above and beyond what the inflation rate would normally warrant. That's the reason for hospital cost containment.

In the States that have it, it has worked. The quality of hospital care has not gone down. The profits are still there, and the patients and the whole society profits.

This hospital cost containment proposal, if passed, would save the American people $56 billion in the next few years; the Federal Government, ,$22 billion; local and State governments, $6 billion. And the hospital care would still be adequate; the profits for the hospitals would still be adequate. I think we need it; I'm going to fight for it and get it if we possibly can.

Q. A lot of the things you've said are wrong, but we'll talk about that some other time.

THE PRESIDENT. Thank you. This will have to be the last question.

NATIONAL HEALTH PLAN

Q. Mr. President, I'm Bonnie Berstein, director of senior services for West Hartford, Connecticut. When you spoke about your national health plan, you said that doctors' fees will be publicly set, that elderly will not face doctors' bills not covered by Medicare. Who will pick up that tab of the bills that are higher than those "publicly set"?

THE PRESIDENT. Well, we'll do several things in that. One, of course, is that the fees charged by the doctors will be publicly posted; and insurance companies and the general public, the President's Advisory Committees and others, the Health, Education, and Welfare Department will monitor those fees.

If doctors charge different fees under the health care program than they do private patients, say, higher or more abusive, they would be revealed. And that doctor will either be prohibited from participating in the plan or castigated in public as someone who's trying to cheat his patients or her patients.

Let me say this in closing: I'm very proud to have a chance to come and be with you. In almost every forum of this kind we spend our time—mine in my opening speech, yours in asking questions, mine in answering questions—talking about the problems that we face, the differences that exist among us, the disappointments, the challenges, the debates, the controversial issues—that's part of our system, and I wouldn't want to change it.

But as President, I'd like to remind you of this: The problems that we face, compared to the blessings that we have, are very few and far between. God has given us in this great country uncounted, sometimes unremembered opportunities and blessings. We are free, we can be individuals, we can speak our mind, we can criticize the President, we can let our Congress know what we want and demand, we can shape our own government. We can sustain ethical and moral standards and commitments in a time of transient, fast-changing, technological progress. We can repair a nation when it's injured; we can unite if we choose when a nation's in danger. We've got ideals and commitments we can spread around the world.

So, I'd just like to remind you not to forget that our country, in spite of its problems—and they're here, they are manageable—in spite of its problems, it's still the strongest and greatest nation on Earth. Militarily, economically, politically, morally, spiritually—we still live in the greatest nation on Earth. And with your help as free human beings, we can make it even greater in the future.

Thank you very much.