    [Public Papers of the Presidents of the United States: William J. Clinton (1999, Book I)]
    [March 16, 1999]
    [Pages 388-389]
    [From the U.S. Government Publishing Office www.gpo.gov]

    [[Page 388]]

    Remarks on Medicare Reform and an Exchange With Reporters
    March 16, 1999

    Amtrak Crash in Illinois

        The President. Good afternoon. I would like to begin by saying that
    our thoughts and prayers are with all those people who were involved in
    this morning's Amtrak crash in Illinois. We've dispatched safety
    officials from the National Transportation Safety Board and other
    Federal investigators to the site to lead the investigation. I want you
    to know that we will do everything we can to help the victims and their
    families and to ensure that the investigation moves forward with great
    care and speed.

    Medicare Reform

        Now, before I leave for Florida, I would also like to comment on an
    issue of vital importance to our future: how to strengthen the Medicare
    program for the 21st century.
        Today Senator Breaux and Representative
    Thomas will hold a final meeting of their
    Medicare Commission. Although it did not achieve consensus, the
    Commission has helped to focus long overdue attention on the need to
    modernize and prepare the program for the retirement of the baby boom
    generation and for the present stresses it faces. The Commission has
    done valuable work, work that we can and must build on to craft Medicare
    reform.
        Make no mistake, we must modernize and strengthen Medicare. For more
    than three decades, it has been more than a program. It has been a way
    to honor our parents and grandparents, to protect our families. It has
    been literally lifesaving for many, many seniors with whom I have
    personally talked.
        In my 1993 economic plan that put our country on the path to fiscal
    responsibility, we took the first steps to strengthen Medicare. In 1997,
    in the bipartisan balanced budget agreement, we took even more
    significant actions to improve benefits; expand choices for recipients;
    to fight waste, fraud, and abuse; and to lengthen the life of the Trust
    Fund.
        But as the baby boomers retire and medical science extends the lives
    of millions, we must do more; we must take some strong and perhaps
    difficult steps to modernize Medicare so that it can fully meet the
    needs of our country in the new century. If we don't act, it will run
    out of funds. That would represent a broken promise to generations of
    Americans, and we cannot allow it to happen.
        As I said in January, we must act, and when we do our actions should
    be grounded in some firm principles. We must seize the opportunity
    created by our balanced budget and surplus to devote 15 percent of the
    surplus to strengthen the Trust Fund. We must modernize Medicare and
    make it more competitive, adopting the best practices from the private
    sector and maintaining high quality services. We must ensure that it
    continues to provide every citizen with a guaranteed set of benefits.
    And we must make prescription drugs more accessible and affordable to
    Medicare beneficiaries.
        The plan offered by Senator Breaux and
    his colleagues included some very strong elements, which should be
    seriously considered by Congress. However, I believe their approach
    falls short in several respects. First, it would raise the age of
    eligibility for Medicare from 65 to 67, without a policy to guard
    against increasing numbers of uninsured Americans.
        I know that back in 1983, the Commission voted in Social Security
    and the Congress ratified a decision to slowly raise the Social Security
    age to 67. But there is a profound difference here. Perhaps the fastest
    growing number of uninsured people are those between the ages of 55 and
    65. We cannot simply raise the age to 67 without knowing how we're going
    to provide for health insurance options for those who are already left
    out in the cold between the ages of 55 and 65. It is simply not the
    right thing to do.
        Also, the proposal has the potential to increase premiums for those
    in the traditional Medicare program beyond the ordinary inflation
    premiums that keep the percentage paid by the beneficiaries the same. It
    does not provide for an adequate affordable prescription drug benefit.
        But most important of all, it fails to make a solid commitment of 15
    percent of the surplus to the Medicare Trust Fund. That is the biggest
    problem. Even if all the changes recommended by the commission were
    adopted, because of the projected inflation rates in health care costs,

    [[Page 389]]

    it would not be sufficient to stabilize the fund. Only by making this
    kind of commitment can we keep the program on firm financial ground well
    into the next century.
        Every independent expert agrees that Medicare cannot provide for the
    baby boom generation without substantial new revenues. Beyond that, it
    is clear that it will also require us to make difficult political and
    policy choices. Devoting 15 percent of the surplus to Medicare would
    stabilize the program and improve our ability to modernize and improve
    its services and to make those hard choices.
        I want to thank the members of the Medicare Commission for their
    hard work and for their recommendations. Today I am instructing my
    advisers to draft a plan to strengthen Medicare for the 21st century,
    which I will present to this Congress. I look forward to a good and
    healthy debate about how best to strengthen this essential program. We
    must find agreement this year. Medicare is too important to let partisan
    politics stand in the way of vital progress. I believe if we make the
    hard choices, if we work together, if we act this year, we can secure
    Medicare into the future.
        Thank you very much.
        Q. Mr. President, your critics are suggesting that by not endorsing
    the Breaux plan you're simply assuring that there will be a campaign
    issue, something the Democrats can run on.
        The President. I want an agreement this year. I have given my best
    assessment of where we are now, of what my objections are. I think it is
    now incumbent upon me to present an alternative proposal, and I will do
    that.
        But I want to make it clear that I believe we owe it to the American
    people to make an agreement this year, and I'm going to do my dead-
    level-best to get it done.
        Thank you.

    Note: The President spoke at 3:55 p.m. outside the Oval Office at the
    White House, prior to his departure for Palm Beach, FL. In his remarks,
    he referred to the derailment of Amtrak's City of New Orleans train in
    Bourbonnais, IL.