[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.