    [Public Papers of the Presidents of the United States: George W. Bush (2002, Book I)]
    [May 17, 2002]
    [Pages 813-818]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks to the Coalition for Medicare Choices
    May 17, 2002

        Well, thanks for that warm welcome, and welcome to the people's
    house, the White House. I am so glad you're here to discuss an
    incredibly important subject, and that is how we can work together to
    strengthen Medicare.
        The most eloquent spokespersons for Medicare are our senior
    citizens. And I share the determination of people in this room to make
    sure that Medicare is--not only works for this generation, the
    generation now on Medicare, but works for generations to come. Our
    Nation has a moral commitment to fulfill Medicare's promise of health
    care security for American seniors and for people with disabilities.
    Yet, we need to do more to meet the commitment, and that's what we're
    here to talk about today.
        Two problems demand immediate action: Medicare must provide
    prescription drug coverage, and all seniors should be able to choose an
    affordable Medicare coverage option that best suits their needs. We're
    going to keep our commitment to senior Americans, and we'll work
    together to make Medicare work better.
        I want to thank Tom Scully from Centers
    for Medicare & Medicaid Services for being here--that used to be called
    HCFA. [Laughter] He joins me in a strong commitment for that which I'm
    about to talk

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    about. You need to know, my administration is committed to trusting
    seniors with more options. We're committed to the programs and the
    principles about which I'm going to speak.
        I want to thank my fellow Americans who have joined us on the stage.
    I want to thank the Salazars; they're from Texas. [Laughter] I want to
    thank Mary Gruenewald for being here as
    well. I want to thank Joe Hotin and Ben
    Oppenheim, Florence Galloway, the Holmes family. Thank you all for coming and
    sharing with me your deep concerns and for sharing with others your
    concern about how to make sure Medicare fulfills its promise.
        I want to thank the docs who are here, one from California and one from
    Florida. I asked him if he'd ever heard of the Governor down there. [Laughter] Dr. Bangasser and Dr. Thompson--I
    want to thank them for being here as well. They're men who are deeply
    concerned about the health and welfare of our seniors, who understand
    firsthand the problems that Medicare faces.
        The health care system that we have in America is unique and strong
    in many ways. After all, we lead the world in dramatic medical advances,
    and that's really positive. It's important, as we think about medical
    policy, that we encourage innovation in our health system. After all,
    live-saving drugs are helping millions of senior citizens--millions of
    senior citizens to live longer and to have healthier lives.
        New drugs are available to treat diabetes, for example, and that's a
    positive development for many of our seniors. New drugs are available to
    prevent serious complications from heart disease or cancer, and that's
    incredibly positive news as well. Yet, as many in this room can testify,
    the costs of these treatments are really high. Because Medicare does not
    cover most prescription drugs, many seniors often pay the highest price
    for drugs, forcing too many to choose with either paying for pills or
    paying for their bills.
        Members of Congress in both House and Senate are working on
    legislation, and that's a positive development, and that's good. They're
    hearing my call and your call to do something about Medicare. In the
    House, the committees and the leadership are drafting legislation to
    help seniors immediately with drug costs and to ensure every senior has
    access to prescription drug coverage. That's a positive development, and
    we're hopeful to get this legislation out of the House very soon. In the
    Senate, there is a tripartisan group working on legislation to provide
    prescription drug coverage and improve Medicare, and I support their
    efforts as well.
        So we've got something to work with. And I urge you all to not only
    pay attention to the process but let your voices be heard as the
    process--the legislative process starts heading down toward, hopefully,
    a conclusion this year.
        My administration is doing some things in the short term that I'd
    like to share with you. We're working for a Medicare-endorsed drug card
    that will allow seniors to get lower prices from drug manufacturers
    right away. I unleashed the idea a while back. It kind of got snagged up
    in the courts. Now we're working to get it unsnagged in the courts for
    the benefit of our seniors. This is a good idea, and this will help.
        We're also working on temporary assistance with drug costs for
    seniors with limited incomes. We're trying to bridge toward the time
    when full prescription drug benefits become available. In other words,
    we want to help people who need help immediately. Those are two ideas
    that we're working with Congress on.
        Medicare also needs to give every senior affordable, up-to-date
    health insurance coverage options to get the most out of Medicare. Right
    now in America, more than 5 million Medicare members have access to a
    valuable program, to a modern health insurance program with modern
    health benefits called Medicare Plus Choice.

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    Medicare Plus Choice is a vital program if we're going to meet our
    commitments to our seniors. And Congress ought to understand how vital
    the program is and how important the program is. They need to listen not
    only to me--of course, I'd like them to listen a little more to me--
    [laughter]--but to the folks here in this room, the people who
    understand.
        Now, let me give you some interesting facts. Many Medicare members,
    including those with limited means, including those with low incomes,
    prefer these private health plans because they provide more benefits
    than traditional Medicare at lower cost. If you find an idea that
    provides better benefits at lower cost, it seems like it makes sense
    that people up on the Hill there would understand that.
        The improved benefits and innovative treatments have given Fred
    Salazar the assistance he needed to get his
    diabetes under control. That's not just theory; that's actually
    happened. Ben Oppenheim improved his arthritis and lowered the amount he
    spends on his arthritis treatment through an exercise program provided
    in his health plan. Florence Galloway got
    the bills paid for the care she needed when she fell and broke a
    backbone in Spain. She got the care she needed. Arina Holmes was hospitalized with a serious illness. She was not
    saddled with hundreds of dollars of deductibles and co-payments for her
    care.
        These are examples, right here, of people who have benefited in a
    real way from the innovative options under Medicare Plus. Some plans in
    Medicare Plus even make it possible for their members to help other
    seniors with transportation or grocery shopping or yardwork or other
    needs. That's also very positive.
        What's important to understand is that almost none of the treatments
    that I described--or programs that can save and improve lives and reduce
    health care costs--are part of Medicare's defined benefits. Many are
    only available through Medicare's private plans, and that's important to
    understand. As we discuss Medicare and it's reform, it's important to
    understand that the defined benefit plan in Medicare limits the capacity
    of seniors to meet their needs. And that doesn't seem right to me.
        Dr. Thompson--Dr. Isaac Thompson said
    this: ``Medicare Plus Choice has served as a safety net for my patients
    and for tens of thousands of beneficiaries, so many of whom are low-
    income and would otherwise not be able to afford the drugs they need.''
    This is Dr. Thompson speaking, a man who makes a living off of helping
    seniors, a person who understands Medicare and Medicare Plus Choice, and
    the differences between the two. You know, as he talks eloquently about
    low-income seniors, the myth is, somehow, that if seniors are given
    choice, low-income seniors will not benefit; that if we provide more
    options for our senior citizens to tailor plans that meet their needs,
    that somehow the low-income will be left behind. That's the opposite of
    what Dr. Thompson has learned, because it is the opposite of what
    happens with Medicare Plus Choice.
        We've got to address this issue straight on. Millions of Medicare
    members don't have the option to choose benefits from private health
    plans, and access to these benefits for everyone in Medicare is
    threatened. Under current law, private health plans cannot compete in
    Medicare in the same way that the Federal Government has long provided
    for people who work for the Federal Government.
        I've always found that to be pretty interesting, that the people who
    make the laws here in Washington--good, fine people from both political
    parties--make sure that the Federal employees have choice. They trust
    the Federal employees with whom they work to be able to go into the
    marketplace and figure out what best suits their needs. And yet, when it
    comes to our seniors, through Medicare, they don't get the same
    benefits. It seems like to me that

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    the Congress ought to be consistent with how they view--[applause].
        You know better than me--or you know as well as I do, at least--that
    the current system hasn't reflected rising costs. The lack of enthusiasm
    for choice for seniors has affected budgets. And therefore, 100 private
    plans have left Medicare, and millions of seniors have lost the valuable
    additional benefits that private plans provide. To be blunt about it, it
    seems like Medicare Plus Choice is getting slowly starved, and we've got
    to change that.
        Part of my message today is, I want to work with you to provide more
    choices and more savings for our seniors. I'm a person who trusts
    people. See, I trust the American people. The American people are
    fantastic, great citizens. We've got to trust people with their own
    choices in life. I'd rather have the American people make choices than
    the Federal Government make choices on their behalf.
        We need a fair system of competition. We need a system that
    guarantees that patient protections and all of Medicare's required
    benefits are included in every choice, a system that encourages
    additional benefits and options for better care at lower cost, including
    improved medical savings accounts. That's what we need to think about,
    and that's where we ought to head here in America.
        The cost savings from competitive reforms are essential. They're
    essential. If you notice, and the people will testify to this, that
    there are lower costs in Medicare Plus Choice. And those cost savings in
    a Medicare Plus Choice plan are very important for the future, for your
    children and your grandchildren to be able to have a Medicare system
    that works. We must this year pass legislation that gives all seniors
    secure access to prescription drugs, along with up-to-date, lower cost
    coverage options in Medicare. That's the goal.
        I believe strongly that we've got to make sure that our seniors
    understand that if you're happy with your current Medicare coverage,
    nothing changes. There are a lot of our citizens who worry that any kind
    of strengthening of the system will maybe disrupt their current health
    plans. And I can understand that. I can understand someone who is
    perhaps content with the way things are and shouldn't be forced to
    change, particularly at this point in somebody's life. And I respect
    that, and any reform must honor that. We've got to make sure, however,
    that the promise of prescription drugs is a part of any plan and that we
    recognize that as treatments change, as the ability to treat a disease
    changes with modern times, that the people we're trying to help are able
    to realize those benefits.
        You see, Medicare was written awhile ago, in such a way that it
    doesn't have the ability to change. And so all of a sudden, technology
    is heading here, and Medicare is stuck back here. And Medicare Plus
    Choice has provided seniors with the ability to stay up with technology.
    That's why you're so supportive of it, and that's why I am as well. But
    we've got to make sure that the whole system moves with the
    technological change, so we can benefit--all of us, not just the young
    but all of us can benefit from the new technologies available to help
    save lives.
        I believe that when we trust people with their--trust their
    decisions and trust their judgment about how best to care for
    themselves, a better plan evolves, a much better plan than one designed
    by some green eye-shades up on Capitol Hill, because it will be a plan
    designed by the consumers, not by the planners. It's a plan that evolves
    as a result of the collective decisions of people we're trying to help,
    not by some who aren't even in the plan.
        And so what we're talking about today is recognizing the importance
    of Medicare Plus Choice, what it means to people's lives in real terms,
    how it can positively affect people that we have a moral obligation to
    help, but also how best to incorporate the principles of the plan to
    expand it, to make it work for more seniors and, at the same

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    time, make sure Medicare works for people like me, when it's my time--to
    make sure that it's not only healthy today but healthy tomorrow, that it
    can exist and be available.
        I believe we can make good progress, but we need your help. To be
    frank with you, there are some up there that really don't like this
    plan, and I understand that. I mean, what the heck, that's the great
    thing about democracy; not everybody agrees 100 percent of the time. We
    all agree we need to help the seniors, and that's important. But to the
    extent that you can help influence opinion, it's really important; it
    is. People listen--people listen--people around here listen to opinion,
    and they listen to people such as yourself, who understand what you're
    talking about. And we need your help to get this done.
        There's a reluctance, but it's okay. It's--you've seen reluctance in
    your life before. You've lived a good, strong, full life in the service
    of your country, many of you, and now is your chance to provide a unique
    service, an important service not only for yourself but future
    generations that are coming up, by spreading the word, by contacting
    your Congressman or your Senator. Let them know. Let them know the
    importance of this program and this idea.
        I also want to thank you for your service to the country. You know,
    you know better than me that--you've see a lot of America in your day,
    and it's a fabulous country that we're able to call home. It's a--what a
    remarkable land, where we share common values. People from all walks of
    life come into--underneath this unique experiment called America. Our
    spirit is strong. It's never been more needed these days, of course, as
    we make it clear to the world and to an enemy that we'll defend our
    freedoms at any cost.
        You know, I like to remind people, those that attacked, they must
    have thought that we were so selfish and so weak and so materialistic
    that we might file a couple of lawsuits or two, but that's all we were
    going to do. [Laughter] They found out we think a little differently
    here in America when it comes to our freedom. And that when it comes to
    our freedoms that we love--the freedom to worship the way each of us
    sees fit, the freedom to raise our family the way we think is necessary,
    the freedom to speak out, freedom of the press--the freedoms that we
    hold dear, if anybody attacks those freedoms, we'll defend them. We'll
    defend them.
        You need to know about me that I am as resolved as I was the day
    after the attack, today. I know my duty, and my duty is to protect
    America in the best way. And as we do so, I believe we'll make the world
    safer. I long for peace. I just want you to know and assure you that the
    actions my administration takes has a lofty goal in mind, and that's
    peace, peace for our country, peace around the world. That's why we do
    what we do.
        But we need to make the world not only safer but better, a better
    place. And one way we can make the world a better place is to make sure
    our seniors are treated with dignity, by starting with a health care
    plan that provides options.
        So I want to thank you all for coming to this magnificent house, the
    White House. It's--as you can imagine, it's an honor to be here, and
    it's an honor to welcome you here.
        May God bless you all, and may God bless America.

    Note: The President spoke at 1:11 p.m. in the East Room at the White
    House. In his remarks, he referred to Dr. Ronald Paul Bangasser, family
    physician, Redlands, CA; and Gov. Jeb Bush of Florida.

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