[Congressional Record Volume 149, Number 16 (Wednesday, January 29, 2003)]
[Senate]
[Pages S1694-S1696]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        REFLECTING ON THE PRESIDENT'S STATE OF THE UNION ADDRESS

  Mr. FRIST. Mr. President, I rise to very briefly comment on the 
President's message last night and to initiate my own reflection, which 
I hope to have the opportunity to continue over the next several days 
and weeks as we respond to the vision that he painted for us in a very 
eloquent, very direct, and very focused way last night.
  Last night, the President said we will not deny or ignore or pass 
along today's problems to future leaders and future generations. He 
said we will confront them head on, we will confront them directly, we 
will do it with clarity, and we will do it with courage.
  He is right. We have much to do. And our success in this body very 
much depends on our own focus and our own clarity and our own courage.
  Let me begin with health care--specifically, this whole issue of 
Medicare, strengthening and improving Medicare and prescription drugs.
  Last night, the President made it clear that if seniors and 
individuals with disabilities are satisfied, if they like and are 
pleased with the Medicare coverage they have today--the way the 
Medicare system works for them today--that they will, in this vision 
that he paints, have the option of not changing anything, for keeping 
it just the way it is. Remember, about two out of three of our seniors 
and individuals with disabilities today do have some prescription drug 
coverage. Many of those individuals may say: I don't want to change 
anything.
  He also made it clear--and this is what is exciting to me as a 
physician and as one who has taken care of thousands of Medicare 
patients--that seniors and individuals with disabilities should have 
another option, another alternative. That is best understood by saying 
they will have an opportunity to choose from among a menu of options, 
much like Bill Frist does as a Senator or Senator Kit Bond from 
Missouri does or Senator Hagel or others.
  We hear from the other side of forcing people into HMOs. Let's make 
it very clear that the option the President began to spell out last 
night--that I believe in heartily--is that we should give seniors the 
same options we have to choose from among a variety of plans, not just 
HMOs, as the other side of the aisle comes back to because they know 
HMOs are demonized today, but an option of coordinated plans which 
include prescription drugs.
  Nine million Federal employees have this option for a type of care 
that we all consider very good, that does allow us to choose our own 
doctors, if you choose such a plan. And those are the sort of options 
that will be made for seniors. It works for us. It works for 9 million 
employees. It works for our staffs. So don't seniors deserve the same 
opportunities?
  It is going to take real courage for anyone to tell Americans they 
should not have the same options that we have, which is the President's 
proposal: to give those same opportunities to seniors and individuals 
with disabilities.
  Opponents of choice in health care for seniors are saying the 
President's plan forces individuals to give up their doctors, their 
family doctors, or forces them to use a particular physician. Indeed, 
if a senior so chooses to go that route, maybe for larger benefits, 
higher prescription drug coverage, that may be one route to going in, 
but that is not what we necessarily have to do. We have that broader 
choice. To say that people are going to be forced into plans where they 
have to give up their physicians, that is not what happens to 9 million 
Federal employees unless that is what they choose to do. I am in the 
same program, and I choose my own doctor.
  What we are hearing is a lot of the same old, tired rhetoric. And it 
really comes down to scare tactics. When we last talked about Medicare, 
improving Medicare, in the Senate, this word, ``Mediscare,'' became 
popularized because that is what people saw, that is what the rhetoric 
resulted in.
  Indeed, some people are using these ``Mediscare'' tactics to frighten 
seniors and to create anxiety and insecurity. It is time for us to pull 
together, in a bipartisan way, to elevate the discussion well above 
that.
  The pursuit of these scare tactics results in nothing but fear and 
anxiety. Our seniors simply deserve better.
  The President talked about the Federal employees' health care program 
as one model. Under that model, there is a strong public-private 
partnership where you get the very best out of the

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private models combined with the very best oversight and, yes, 
regulation in terms of the Government model, and you marry the two of 
those together in a way that you can best--in a coordinated way--take 
care of prevention, diagnosis, and treatment of seniors and individuals 
with disabilities.
  Many of those plans, as I implied earlier, have an unlimited choice 
of physicians. In my particular plan, that I chose in the Federal 
Employees Health Benefits Program, I can go to any physician I would 
like. So to say it takes away choice is, to me, not being entirely 
honest with what is being proposed.
  To do the right thing for our seniors and individuals with 
disabilities is going to take a lot of the focus and the clarity that 
the President spoke about last night in his address. It is going to 
take a lot of courage in this body to focus on the policy itself--on 
the policy itself--and not on the politics and the ``Mediscare'' 
tactics, to really get down to the substance of the issue itself. 
Politics and policy each have their time and their place, but when we 
are talking about the health care for 40 million Americans now and in 
the future--in essence, all Americans--we really do need to put 
politics aside. Politics has no place when we are talking about the 
health of Americans.
  My first priority--from medical school, internship, residency, 
fellowship, and in the practice of medicine--has been to improve access 
to the best, most affordable health care. As majority leader, in 
working with the Republican caucus and the Democratic caucus, I want to 
continue that lifelong commitment to improved access.
  It is clear the current Medicare system, the 2003 system, has not 
kept up with the advances that have been made in preventive health 
care--in terms of prescription drugs, in terms of chronic care 
management--because the system has become too rigid.
  We are essentially operating with a system designed in 1965, which 
has been slow to change because the system worked well through the late 
1960s, 1970s, and even into the early 1980s. However, we have now 
gotten to a point where the current Medicare system is limiting choice, 
where our seniors don't even have a choice of prescription drugs. 
Prescription drugs has become equally powerful to the operating rooms, 
where I spent my career using the surgeon's knife.
  A survey this month by the AMA tells us that nearly half, 50 percent, 
of all physicians today are considering either reducing their Medicare 
patients--the number of patients they will see--or they are leaving the 
Medicare Program. Why? Because of reduced Medicare reimbursement year 
after year--a 5-percent reduction last year and another 5 percent this 
year, they see continued reimbursement below their cost, and they 
simply cannot stay in business.
  The President mentioned medical liability insurance last night. I 
think it is important to address it head on because we are reaching a 
threshold where we are about to see catastrophe. It comes down to 
frivolous lawsuits. Can we tolerate the lawsuits when the escalation 
and number of lawsuits, and the money entailed, takes money away from 
health care and drives people from the practice of medicine to the 
point that we are having trauma centers close down--most notably in 
Nevada last year. And 6 weeks ago, we saw the doctors in West 
Virginia--it hurts me to even think about going on strike in terms of 
what physicians are doing. When you cannot stay in business, physicians 
really have no choice. We saw what happened in West Virginia.
  The President said frivolous lawsuits have not cured one patient. He 
is exactly right. I can tell you what will cure patients, and that is 
changing our medical liability system so doctors can afford to heal, so 
they can be allowed to heal.
  Again, as a doctor, I will fight for the right of any patient to sue 
and receive fair and just compensation if they have been a legitimate 
victim of a medical malpractice incident or an error. That is critical 
and that is right. What is not right, and what I will continue to fight 
against, is the reduction of access to good health care because doctors 
and hospitals can no longer afford to continue doing what they do 
best--diagnose, treat, and heal, provide care--because of these 
skyrocketing costs that are associated with frivolous, illegitimate 
lawsuits.
  It comes down to the fact that family doctors are having a hard time 
staying in business and keeping the doors open; trauma units are 
shutting down; pregnant women in rural America are having a hard time 
finding an obstetrician because they are having to leave that 
particular area because of the exorbitant rates they are forced to pay, 
not because they are bad doctors but because of these skyrocketing 
lawsuits. It is going to take laser-like focus to fix this, and I agree 
with the President that we have no option but to fix it now.
  The President introduced many positive policies last night. I want to 
comment on one that means a great deal to me that I think we will be 
able to address in this body early in the session, and that is the 
international pandemic of the HIV/AIDS virus. What the President said 
last night was truly historic, truly unprecedented in the history of 
the world, addressing head on a problem that has killed 23 million 
people in the last 20 years--a virus nobody knew anything about in 1981 
and that, in the best of all worlds, will kill, for every one person in 
the last 20, two in the next 20, or almost 45 million people. I cannot 
begin to say how important this is and how impressed I am that the 
President is taking bold action, demonstrating bold leadership, by 
making the United States of America a courier of medical care, of 
education, and thereby making the United States of America a courier 
for international hope, in the sense that it is addressing what is 
destroying a nation, a continent, and now spreading throughout the 
world.

  I also commend the President for his commitment to the protection of 
all Americans from this whole threat of bioterrorism. The threat is 
real and these biological agents are in the hands of our enemy. These 
agents are deadly. When you talk about anthrax and Ebola, which the 
President mentioned last night, and you talk about plague, you are 
talking about agents that are more powerful than nuclear weapons. These 
weapons of mass destruction--now in the hands of terrorists--are more 
powerful than nuclear weapons. A biological agent is a tiny 
microorganism that can be transported in a little vial in your pocket, 
unlike most nuclear weapons. They are cheap, they are easily 
transportable, and they are more deadly than nuclear weapons.
  My closing point is on this particular facet of weapons of mass 
destruction. We know our enemies--I speak now of Saddam Hussein and his 
henchmen--have in their possession quantities that serve no purpose but 
that of weapons of mass murder. Saddam Hussein, we know, is a serial 
killer. He has used chemical weapons--they are not biological weapons. 
There are chemical, biological, and nuclear weapons. Chemical weapons 
are similar to biological but a little bit different. Saddam Hussein 
has used chemical weapons and, in 1 day, killed 5,000 of his own 
people, and 10,000 people in addition to those who were injured, and 
tens of thousands between 1983 and 1988 were killed by these chemical 
weapons. We know he has these weapons; we know he harbors terrorists. 
Why in the world would a rational person believe he would hesitate to 
help others terrorize the United States or Europe or Asia or Israel, 
wherever anyone has an agenda of hate?
  Some question the wisdom of a preemptive attack against Saddam. It is 
akin to being against preventive health care, against these deadly 
microorganisms which are used as weapons of mass destruction, for which 
there is no cure. We have no cure or vaccine. The Ebola virus kills, 
and we have no vaccine right now. We have no treatment for the Ebola 
virus today. It was overlooked, but the President introduced a $6 
billion program last night to best protect us from these biological 
agents, which we know other countries have developed in the past as 
offensive weapons of mass destruction.
  I look forward to Secretary Powell's presentation at the United 
Nations next week, as this President continues to use every diplomatic 
means to force Saddam Hussein to fulfill his responsibilities to the 
world community. I am proud this Congress voted overwhelmingly to 
endorse the ability of our President to do whatever is necessary to 
protect America, including force, if

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it is necessary, and we pray that it doesn't come to that.
  Our President has shown courage. He has shown clarity. He has shown 
focus in his efforts to rid the world of terrorists and others who are 
threats to freedom. I hope all of us in this body show the same 
courage, clarity, and focus. The health of our Nation depends on it.
  I yield the floor.
  The PRESIDING OFFICER (Mr. Sununu). The Senator from Missouri is 
recognized.
  Mr. BOND. Mr. President, I appreciate the thoughtful discussion our 
majority leader has given on health issues, on combating AIDS, and on 
the need to prepare vaccines and protection against the biological 
weapons that terrorists may use. It was a very important part of the 
President's speech last night, and certainly there is no one more 
qualified in this body, or elsewhere, than the distinguished majority 
leader, the Senator from Tennessee, to speak about these matters.
  Following on the State of the Union Message, some commentators were 
saying today they wish the President had spoken more about the economy. 
He did speak about the economy. He made it clear that his goal is to 
see that every American who wants a job and needs a job can find one, 
and he proposed tax relief to make sure that the money is there for 
small businesses to expand and grow and hire more people.
  Money for working families, for child care and health deductions on 
their tax returns, and putting a thousand dollars in the pocket of 
every American family is going to make the economy move.

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