[Public Papers of the Presidents of the United States: GEORGE W. BUSH (2001, Book I)]
[March 21, 2001]
[Pages 270-274]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks at the American College of Cardiology Convention in Orlando, 
Florida
March 21, 2001

    Thank you all. Thank you very much. George, thank you very much for your kind introduction. Doctor. 
Doctor. [Laughter] I'm honored to be here, and it's an honor to be your 
President.
    I thought about inviting Vice President Cheney to travel with me today. [Laughter] He said he's seen 
enough cardiologists lately. [Laughter] I'm pleased to report that he's 
feeling great, and you'll be happy to know that when it comes to 
following doctor's orders, he's a model patient.
    I appreciate so very much the leadership of this august organization 
having me here, and I appreciate the fact that they invited my bigger 
little brother. [Laughter] I can't tell you how 
proud I am of Jeb. He is a really fine Governor of this important State.
    I'm also pleased to be traveling with Members of the United States 
Congress from the State of Florida, John Mica, 
Ric Keller, and Dave Weldon. Thank you all for coming with me. Weldon informed me 
he's a doctor. He's representing your interests in the Halls of 
Congress.
    And today we're in the hometown of the new Secretary of Housing, Mel 
Martinez.

[[Page 271]]

I'm proud that Mel is the first Cuban American to serve in a President's 
Cabinet. Mr. Secretary, welcome home, but don't stay too long. 
[Laughter] You're going back to Washington with me; we've got a lot of 
work to do.
    You know, I haven't been in front of so many people who poke and 
prod and examine since my last press conference. [Laughter] And I 
appreciate the chance to visit with so many distinguished doctors and 
their families. So many Americans live longer, healthier, and happier 
lives because of the important work you all do every single day. And I'm 
glad to have an opportunity to thank you in person.
    Modern medicine continues to bring a revolution of hope and dignity 
into countless lives. The average life* expectancy in America today is 
29 years longer than it was just a century ago. And those added years 
now have added vigor. Many forms of cancer, once incurable, are 
routinely treated and often cured. Diseases that grow more common with 
age, such as arthritis and osteoporosis, can be less debilitating than 
they once were. And heart disease, though still the leading cause of 
death in America for both men and women, is claiming fewer lives than 
ever before. Just 40 years ago, when patients were diagnosed with 
serious heart disease, treatment meant putting them in a hospital bed 
and trying to make them comfortable. Today, thanks to new surgeries, 
devices, and drugs, and thanks to doctors and researchers behind them, 
millions of Americans with heart disease live vigorous, productive 
lives. And Dick Cheney serves his country 
as Vice President of the United States.
---------------------------------------------------------------------------
    *White House correction.
---------------------------------------------------------------------------
    This ongoing revolution in medicine is centered in America, and for 
good reason: Medical advances depend on innovation, and innovation 
depends on freedom. America has wisely resisted efforts to place 
medicine and health care into the hands of central planners. Government-
controlled health care may spring from the best of motives, but a 
cumbersome bureaucracy and one-size-fits-all approach stifle innovation 
and do not produce the best of results. There is an appropriate role for 
Government in funding medical research, protecting consumers, and 
providing health care for our senior citizens.
    Our health care system is strong, and it can be stronger. And as we 
improve and reform it, we must always respect the freedom that makes 
America's health care system the best in the world.
    This year we have a real opportunity to improve health care. Today I 
want to talk about protecting the doctor-patient relationships with a 
Patients' Bill of Rights. But first, I can't resist putting in a plug 
for my budget and for tax relief.
    My budget funds our Nation's important priorities, including many 
health care priorities. We increase funding for education and for 
military pay and benefits. We set aside $2.6 trillion of payroll taxes 
over the next 10 years for Social Security and for only Social Security. 
We double funding for Medicare over the next 10 years and make sure that 
every dime that comes in for Medicare is spent only on Medicare.
    And as you know better than most, Medicare urgently needs reform. At 
a time when prescription drugs are often the treatment of choice for 
heart disease and many other illnesses, 99 percent of employer-provided 
health care plans offer some form of prescription drug coverage; yet, 
Medicare does not. Often, Medicare does not cover new treatments and 
innovative technologies. The Medicare bureaucracy is rigid and difficult 
and too often treats doctors as if you have nothing better to do than 
fill out forms. To offer our seniors better coverage and better health 
care, Medicare needs new life and new vitality.
    One of the leaders in the effort to modernize Medicare is a heart 
surgeon, Senator Bill Frist of Tennessee. He's 
joined with Democrat Senator John Breaux and 
Republican Congressman Bill Thomas to set 
out

[[Page 272]]

a framework for reform. And I'm committed to working with Congress to 
reform Medicare and to make sure that every senior has access to 
affordable prescription drug coverage.
    My budget also proposes refundable tax credits to make health 
insurance more affordable for working families. I propose making it 
easier for small businesses to join together so that they can purchase 
better and more affordable health coverage for their workers. And we 
increase funding for community and migrant health centers, so that over 
the next 5 years we double the number of people served at community 
centers in rural and low-income neighborhoods.
    I've also asked Congress to increase funding for medical research, 
which gives hope to many who struggle with serious disease. My budget 
for next year requests an additional $2.8 billion for the National 
Institutes of Health, an important step toward our goal of doubling the 
budget for the NIH by the year 2003.
    We've increased discretionary spending by 4 percent, greater than 
the rate of inflation. And after we fund important priorities in the 
ongoing operations of our Government, I believe we ought to pay down 
national debt. And so my budget pays down a record 2 trillion in debt 
over the next 10 years. And that sets up a $1 trillion contingency fund 
for emergencies or additional expenses. After funding priorities, after 
paying down debt, after setting up a contingency fund, we still have 
money left over.
    And the fundamental question is, what do we do with it? Well, some 
in Congress want to spend it. They want to increase the size and scope 
of the Federal Government. That's not my vision. You see, I understand 
the surplus is not the Government's money; the surplus is the people's 
money. And I believe after meeting priorities, we need to send it back 
to the people who earned it in the first place. Not only are we not 
going to send it back; we don't need to take it in the first place.
    This debate in Washington has moved beyond whether we should have 
tax relief, to how much it should be and who should get it. Now, to put 
it bluntly, some folks in Washington think all of the doctors in this 
room make too much money, and you shouldn't get any of your money back. 
That's a fact. I know you've worked hard to get to where you are. You 
spent long hours in training and school. You do important, life-saving 
work. You also pay a lot of taxes. And I think everybody, everyone who 
pay taxes, from the schoolteacher to the truck driver to the doctor, 
should get tax relief.
    Be wary of those who talk about targeted tax cuts in Washington, 
those who want to pick the winners and losers. That's not my vision for 
Government. I don't believe the Government is to try to pick winners and 
losers in the Tax Code. The only fair way to do it is to say, ``If you 
pay taxes, you ought to get relief.''
    My plan helps those at the bottom end of the economic scale. It 
lowers the rate to 10 percent and doubles the child credit. In fact, the 
greatest percentage benefits in my plan go to those at the lowest end of 
the economic ladder. But my plan also drops the top rate from 39.6 to 33 
percent, because I believe on principle that nobody in America, nobody 
in this room, should pay more than a third of his or her income to the 
Federal Government.
    I hope you'll join me in making the case to Congress to enact a 
fiscally responsible budget and provide meaningful tax relief. It is 
necessary, and we can afford it. Don't be afraid of contacting a Senator 
of yours or a Member of the Congress. I'm sure they'd like to hear from 
you. [Laughter]
    And there is another issue I hope you'll join me on, persuading 
those very same Members of both parties to work together to pass a 
comprehensive and meaningful Patients' Bill of Rights. I'm very familiar 
with this issue. When I was Governor of

[[Page 273]]

Texas, I had to veto a bad patients' bill of rights, and then I signed 
some good ones. First, I was presented a bill that gave special interest 
treatment to selected HMO's. So I vetoed it and then worked with our 
insurance commissioner to write new patient protections that I proudly 
signed into law the next legislative session. I don't want that to 
happen again. This time I hope we can get it right the first time.
    Doctors and their patients should be in charge of medical decisions. 
I want to sign a Patients' Bill of Rights this year, but I will not sign 
a bad one. And I cannot sign any one that is now before the Congress. So 
enacting a Patients' Bill of Rights this year is going to require some 
different thinking, a new approach, based on sound principles.
    First, a Federal Patients' Bill of Rights must cover everyone, all 
patients in all private health plans. The standard should be strong 
enough to protect everyone, yet flexible enough to preserve the good 
work that has already been done in many States.
    Second, we must guarantee all patients important rights: the right 
to get emergency treatment at the nearest emergency room; the right to 
see a specialist when they need one--say, just for an example, the right 
to see a cardiologist for a heart problem. Women should be able to visit 
their gynecologist, and parents their children's pediatrician, without 
going through a gatekeeper. All patients should have the right to 
participate in potentially life-saving clinical trials when standard 
treatment is not effective.
    Third, if medical care is denied, patients should have the right to 
a fair and immediate review. People want health care quickly. They don't 
want to have to go through a legal, lengthy process to get it. I want to 
sign a bill that protects patients' rights with a strong, binding, 
independent review process. If your health plan denies you care, you 
should be able to appeal immediately to an independent, impartial review 
panel of medical doctors. And if they say you need the care, your health 
care plan must provide it. An effective medical review is the key to 
protecting patients' rights and the key to maintaining the doctor-
patient relationship you work so hard to develop and preserve.
    Fourth, a Patients' Bill of Rights should offer patients who have 
been harmed a meaningful remedy without inviting frivolous lawsuits. 
After independent review, if you have been harmed by your HMO's refusal 
to provide care, you have a legitimate complaint, and you should have 
recourse in court. With a strong, independent review process, most 
disagreements should not wind up in court. Our Federal legislation must 
allow the review process to work, not short-circuit it by inviting 
unnecessary lawsuits. With strong independent review, doctors make 
medical decisions, not the lawyers.
    The fifth guideline for a Patients' Bill of Rights ensures that 
Americans will have access to affordable health care coverage. I want to 
sign protections that improve medical care, not make it impossible for 
patients to afford it or employers to provide coverage. Excess and 
frivolous litigation does harm to our health care system. It clogs the 
courts and consumes time and money. It undermines the trust between 
doctor and patient. It drives up insurance premiums for everyone.
    We've enacted civil justice reforms in Texas to guard against 
frivolous litigation and excessive awards. To make sure health care 
coverage remains affordable, I will insist any Federal bill have 
reasonable caps on damage awards. And the caps in proposed legislation 
before Congress are too high and will drive up the costs of health care 
in America.
    To encourage employers to continue to provide health care insurance 
for their employees, we must protect them from unnecessary litigation. 
Some proposals now before Congress fail to adequately address this 
problem and would even make it worse. Employers who decide up front they

[[Page 274]]

will not make medical decisions should not be required to go to court 
all the time to prove they were not involved in those decisions. And I 
will not support a Federal law that subjects employers to new multiple 
lawsuits in 50 different States.
    With these principles as our guide, I believe we can enact a 
Patients' Bill of Rights in the Congress this year. This issue has been 
debated in Washington time and time again. Over the years, alliances 
have been formed, and divisions have deepened. I hope Members of 
Congress will join me in advancing this debate beyond the arguments of 
the past.
    Just as doctors no longer treat heart disease with bed rest, we 
should not approach this year's Patients' Bill of Rights stuck in last 
year's rut. Just as innovative approaches in medicine spur new 
breakthroughs, a new approach in Washington offers the hope that we will 
share the credit for success. Americans deserve comprehensive patient 
protections, and a new, commonsense approach may be just what the doctor 
ordered.
    On this issue, the rewards are far greater than shared political 
success. The real reward will be knowing that we have helped put the 
healing powers of modern medicine within the reach of all who need them. 
Each of you holds that incredible power and upholds a great trust.
    I appreciate the important work you do. You have my gratitude and my 
respect. And in the days ahead, I hope my plans for reform will have 
your support. Thank you for having me.
    God bless. God bless America. Thank you all.

Note: The President spoke at 10:24 a.m. in the Orange County Convention 
Center. In his remarks, he referred to George A. Beller, immediate past 
president, American College of Cardiology; and Gov. Jeb Bush of Florida.