    [Public Papers of the Presidents of the United States: George W. Bush (2001, Book II)]
    [July 12, 2001]
    [Pages 842-845]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on Medicare Reform
    July 12, 2001

        Thank you all very much. Today I'm here to talk about our most
    important commitment to our seniors, the health of our seniors and how
    we can modernize and strengthen Medicare. I'm also here to announce an
    exciting new plan to provide every senior on Medicare an opportunity to
    better afford prescription drugs by the beginning of next year.
        I want to thank the members of both political parties--of all three
    political parties--[laughter]--who are here today. It shows us firm
    commitment to make sure our Nation fulfills a solemn pledge to our
    seniors and that is that our seniors have the best possible health care
    available for them. So thank you all for coming. We've got many Members
    of the House and the Senate, most notably Senators Breaux and Thomas--I mean, Senators Breaux and Frist and Congressman Thomas,
    all three Members who worked hard on Medicare reform in the past and who
    are joining with the administration to promote Medicare reform this
    year.
        Thirty-six years ago this month--and thank you, as well, Mr.
    Secretary, for being here--36 years ago
    this month President Lyndon Johnson flew to Independence, Missouri, to
    sign Medicare into law and to present the first Medicare registration
    card to former President Harry Truman. President Johnson spoke that day
    about what Medicare would mean for our country, and here is what he
    said: ``No longer would older Americans be denied the healing miracle of
    modern medicine. No longer would illness crush and destroy the savings
    that they have so carefully put away over a lifetime, so that they may
    enjoy dignity in their later years.'' He went on to say that ``no longer
    will young families see their own incomes and their own hopes eaten away
    simply because they are carrying out their deep moral obligations to
    their parents and to their uncles and to their aunts.''
        Medicare has lived up to President Johnson's vision. It has improved
    the health of America's seniors, and it's eased the financial anxieties
    of retirement, reduced the burden on younger generations, and fulfilled
    our Nation's commitment.
        Medicare is a binding commitment. The Medicare promise we made in
    1965 will never change. And as medicine advances and the needs of our
    seniors change, Medicare, too, must advance, and it, too, must change.
    This generation of leaders must honor and renew the promise of Medicare
    by strengthening Medicare for the future.
        In 1965 health care usually meant hospital care. Today, we
    understand how important it is to prevent people from getting sick in
    the first place. Yet, Medicare does not fully cover preventative
    medicine.
        In 1965 prescription drugs meant antibiotics. Today, illnesses that
    could once only be treated by invasive surgery are treated instead with
    effective new drugs. But these new drugs can be very expensive, and
    under the current system, Medicare doesn't pay for them.
        In 1965 medicine could offer people diagnosed with cancer and other
    dangerous

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    diseases little hope. Today, we can defeat many once incurable diseases,
    but too often at a costly price that Medicare will not pay in full.
        In 1965 the pace of medical progress was relatively slow. Today,
    hardly a day goes by without news of an exciting advance to extend life
    or improve health. Yet, Medicare takes way too long to authorize new
    treatments.
        We must act now to ensure that the next generation of medical
    technology is readily available to America's seniors, from medicines
    tailored exactly to an individual's disease to Internet diagnosis that
    will allow patients to be treated by experts on the other side of their
    continent without the patients having to leave their living rooms.
        In 1965 Medicare's finances were based on assumptions that quickly
    proved wrong. This has had enduring consequences. Medicare has too many
    limits on coverage. Seniors enrolled in Medicare are responsible for a
    nearly $800 deductible every time they visit a hospital. And they find
    themselves responsible for paying thousands more if they are seriously
    ill.
        Medicare's funding structure doesn't make sense--two different
    parts, one of which appears to have a surplus, even though the other has
    a much bigger shortfall. And Medicare's costs are rising too fast, which
    creates anxieties about the program's stability.
        It may be that cars don't get any better than the 1965 Mustang. But
    even the '65 Mustang didn't have power windows or anti-lock brakes. When
    it comes to cars and when it comes to health care, 1965 is not the state
    of the art. We need to bring Medicare into the 21st century, to expand
    its coverage, improve its services, strengthen its financing, and give
    seniors more control over the health care they receive.
        Medicare's most pressing challenge is the lack of coverage for
    prescription drugs. Several people here with us this morning know from
    personal experience what that means. Frank Van der Linden was a newspaper reporter, and a good one; now
    he's being squeezed behind Medicare premiums and drug costs. Or Bobby
    Cherry, he's a senior coordinator at the
    Florida Avenue Baptist Church right here in Washington; he pays close to
    40 percent of his income for prescription drugs and Medicare copayments.
    Or Gwendolyn Black, who spends $2,400 a year
    to put four healing drops a day into each of her eyes.
        Today I announce the first step toward helping American seniors get
    the prescription drugs they need and deserve, a new national drug
    discount program for seniors that will begin early next year. Every
    senior on Medicare can receive a new drug discount card. It won't cost
    much, at most a dollar or two a month, and will work like the cards you
    already have for, say, your groceries. Present the card at a
    participating pharmacy, and you receive a substantial discount. It's as
    simple as that, and it's convenient.
        The new drug discount plan combines the purchasing clout of millions
    of seniors to negotiate lower prices than under the current system. And
    under my plan, participating pharmacies will get new customers, and
    seniors will get high-quality drugs at a lower price.
        It's a plan similar to the plan that brings discounts to many
    Americans who have private insurance. And the leaders of the companies
    that have been so successful in providing drug discounts in private
    plans are here with us today and will brief the press on the savings
    about our strategy.
        The drug discount plan is the first necessary step to provide
    immediate help to seniors without destabilizing Medicare's finances. It
    is the first step, but it is not a substitute for a drug benefit and for
    strengthening Medicare. And that's why my administration has developed,
    with a bipartisan group of legislators, a framework for strengthening
    and expanding Medicare for the long term. This framework will guide us
    as Congress takes up Medicare in the

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    coming months, and here are its main elements:
        First, seniors already enrolled in Medicare and those near
    retirement must have the option of keeping their Medicare exactly the
    way it is today. No senior will see any change that he or she does not
    want or does not seek. If you like things the way they are, that's just
    the way they'll stay.
        Second, all seniors today and tomorrow will be offered a range of
    new Medicare plans, including an improved and updated Government plan,
    as well as others offered by nongovernment insurance plans. All the
    Medicare plans must offer benefits at least as comprehensive as the
    Government plan. All will be regulated by the Federal Government, and
    all of them must offer prescription drug coverage.
        Third, everyone enrolled in Medicare will have the power to choose--
    power to choose--which plan works best for him or her. The plans will
    compete with each other, forcing them to offer better service, extra
    benefits, and lower premiums. All seniors in America should enjoy the
    same freedoms that Federal employees have today when it comes to
    choosing their health care plans. We must trust seniors to make the
    right decisions for themselves.
        Fourth, Medicare must become more responsive to seniors, especially
    to seniors on low incomes and with unusually high medical costs.
    Sometimes people discover Medicare's gaps when they need Medicare most.
    Under the current system, the sickest Americans pay a higher percentage
    of their bill than others do. And that's not right, and under our
    approach, that will stop. We'll put a stop-loss limit on the amount any
    senior can be asked to pay in any year.
        Too many seniors feel compelled to purchase costly Medigap policies
    to cover what Medicare does not. Take, for example, Mr. Cuyler
    Taylor, who's with us today. The Taylors spend
    more than $10,000 a year on drugs and Medigap insurance. Our framework
    will not only cover drugs, but it will reduce the need for costly extra
    insurance. The gaps in Medicare bear especially hard on low-income
    people, and extra help will be available to them, as well.
        And finally, we must put Medicare on a sustainable financial footing
    for future generations. The two parts of Medicare must be combined into
    one. When popular alternative plans are established, the Government's
    contribution to any one Medicare plan should eventually be tied to the
    average cost of all Medicare plans, preventing any one plan from driving
    up the cost that all Americans must pay.
        So these are the main principles for strengthening and improving
    Medicare: Nobody on Medicare will see any change in Medicare unless he
    or she wants it. There will be new Medicare choices, and all of these
    new choices will offer prescription drugs. Medicare plans will compete
    by offering better service and lower premiums. Medicare will respond
    better to the needs of seniors and, especially, low-income seniors and
    seniors with high medical bills. And Medicare will be put on sound
    financial footing.
        These are principles which will strengthen one of our Nation's most
    sacred obligations, the health of our senior citizens. We'll protect
    seniors now, offering exciting new services and more choices to seniors
    in the future, and guarantee prescription drug coverage. And we will do
    it without overtaxing our children and our grandchildren.
        Medicine is constantly improving. Medicare must keep pace. That's my
    administration's commitment today and its exciting new vision for health
    care in America.
        Thank you all for coming.

    Note: The President spoke at 9:51 a.m. in the Rose Garden at the White
    House.

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