[Public Papers of the Presidents of the United States: George W. Bush (2002, Book I)]
[February 11, 2002]
[Pages 205-212]
[From the U.S. Government Publishing Office www.gpo.gov]



Remarks at the Medical College of Wisconsin in Milwaukee, Wisconsin
February 11, 2002

    Well, thank you very much, Tommy; I 
appreciate your introduction. Your heart may be in Wisconsin, but you've 
got to keep your address where it is right now. [Laughter] I'm counting 
on you. He's doing a fabulous job. I love Wisconsin for a lot of 
reasons. One, you produced Thompson. I love you so much I even come in 
the winter, which is hard for a Texan. [Laughter]
    It is an honor to visit this distinguished place of learning which 
trains so many outstanding physicians. I happen to know something about 
Wisconsin doctors. I'm pretty familiar with them. After all, the White 
House physician is Colonel Richard Tubb, raised 
right here in Wisconsin. He's not only a fine doctor; he fortunately got

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special instructions on pretzel-related conditions. [Laughter] My advice 
is, swallow after you chew. [Laughter]
    But the Medical College of Wisconsin represents the future of health 
care, here and throughout our country. It's a fitting place to address 
the great opportunities and challenges that the future will bring our 
country. Our health care system is in need of important reform and on 
the verge of amazing discovery. We must seize the moment for the benefit 
of all Americans.
    And that's why I want to thank Scott McCallum for welcoming me here, and I appreciate his leadership 
for the State of Wisconsin. I want to thank the members of the 
congressional delegation, Barrett, 
Petri, Ryan, 
Sensenbrenner, for coming, as 
well. It's good to see all of you. I'm looking forward to working with 
you to do what's right for the citizens in terms of health care.
    I appreciate Michael, his leadership, 
and his hospitality. I want to thank the docs who gave me a briefing. 
And I want to thank all of you for your warm welcome.
    I want to talk about two things, and they both have to do with the 
challenges we face. I briefly want to talk a little bit about the 
challenge we face abroad. And then I want to talk about the challenge we 
face at home, particularly with health care.
    First, the enemy made a bad mistake. They don't understand us. Let 
me rephrase that--they didn't understand us. They do now. We are 
patient. We're resolved people. But we are absolutely determined to 
defend freedom.
    I'm pleased to report that out of the evil have come some good, one 
of which is that in Washington, there is no difference between 
Republicans and Democrats as to who is the most patriotic or who wants 
to win the most. All of us want to win the war against terror, for which 
I am grateful.
    But I want to tell you all that we're just beginning, that I see 
this as a unique moment in history. And this Nation must seize the 
moment. And it's this: Either we defend freedom, so that our children 
and grandchildren can grow up in a peaceful world, or we blink. And if 
we blink, the rest of the world will blink as well. I don't believe we 
have that luxury. I believe we must find terror wherever it hides and 
bring it to justice.
    And so the Afghan theater is the first theater in the war against 
terror, and we've done a lot in a quick period of time. I laid out a 
doctrine that said, if you harbor a terrorist, if you feed a terrorist, 
if you hide a terrorist, you're just as guilty as the terrorists. And 
the Taliban found out what I meant. Not only have we thrown them out, 
but in doing so, we liberated--we liberated women and children from the 
clutches of one of the most barbaric regimes in the history of mankind.
    I'm proud of our military. And for those of you who have got a 
relative in the military, thank you, and I know you're proud of that 
relative, as well.
    There's a lot of focus on one individual in this war on terror, but 
this is much bigger than one person. Oh, the guy, he can hide, and he 
can run, but there's no cave deep enough for the arm of justice of the 
American people. And it's just a matter of time. I have no artificial 
date deadlines. I really don't care if it's tomorrow or a month from now 
or a year or a couple of years. But Mr. bin Laden is going to meet his fate.
    And in the meantime, the United States of America will continue to 
rally our coalition, to continue to cut off money from terrorist 
organizations, continue to share intelligence so we can react better, 
continue to defend our homeland, and continue to insist that freedom-
loving nations find, incarcerate, and bring to justice anybody who would 
harm America, our allies, and our friends.
    There was some concern amongst some that the farther we got away 
from the horrible day of September 11th, America would waver in our 
determination. They

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don't need to be concerned. We are determined. We are patient. We are 
tough. We're compassionate. We will not yield to terror.
    There are a lot of challenges we face. We fight a recession. I'm 
optimistic we'll recover. But one of the big challenges is our health 
care system. I like to put it this way: We face a huge challenge of 
making sure that we're still the world's greatest health care system. 
That's our challenge. How do we maintain our edge? How do we make sure 
the American people get the best health care in the world?
    And it starts by making sure that we attract the best and brightest 
to the medical profession. And that can start with the President saying, 
thank you for dedicating your lives to such a great calling. America 
appreciates the fact that you've chosen a profession that is so profound 
and so important. It's a model of service and excellence. And the 
achievements of our medical professionals set the standards for the 
entire world.
    Life expectancy in America today is 8 years longer than it was in 
1950 and 29 years longer than it was in 1900. That's a lot of progress. 
And for millions, those extra years are more active and more healthy 
than anybody could have imagined. We're making great progress against 
many diseases, such as breast cancer and colon cancer and childhood 
leukemia. The death rate from coronary disease is down 40 percent since 
1980. Our country leads the world in Nobel Prizes for science and 
medicine and in the invention of new drugs and medical devices.
    I truly believe that this progress is one of America's greatest 
contributions to mankind. It is a tribute to the outstanding efforts of 
the medical profession and to a system of private medicine that 
encourages innovation and rewards hard work.
    Yet our doctors and patients know that our system is far from 
perfect. Too many patients feel trapped by the system, with decisions 
about their health dictated by HMOs or Government bureaucracies. Too 
many doctors feel buried in paperwork. I've heard it said that some 
doctors feel they don't practice medicine, they practice insurance. At 
the same time, health care costs are rising sharply, and many people 
worry they won't be able to afford the treatments they need. Some 
procedures are overused, often as defensive measures to avoid 
litigation. And about 40 million Americans still have no health 
insurance at all.
    We must reform health care in America. We must build a modern, 
innovative health care system that gives patients more options and fewer 
orders and strengthens the doctor-patient relationship.
    Government has got to take an active role in reform. Yet it's 
important that Government's role is not to centralize, nor is 
Government's role to control the delivery of medicine. Other nations 
have tried this route, and it has led to long waits for treatment, low-
quality care, and lagging technologies. And for many patients, their 
experience with centralized Government-controlled medicine leads them 
somewhere else, often right here to America, where they can get the 
treatment and care they need.
    The role of Government in health reform is to fix the system where 
it's failing, while preserving the quality and innovation of a private, 
patient-centered medical system. All reform should be guided by some 
goals.
    The first goal: All Americans should be able to choose a health care 
plan that meets their needs at affordable prices. When people have good 
choices, when people are given different options, health plans have to 
compete for business, which means higher quality and better coverage.
    Most Americans get their health care coverage at work. Yet, higher 
costs are causing some employers to cut back on benefits or insist that 
the employee pay more, especially if they want to choose their own 
doctor or to avoid the complications of managed care. Many families end

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up in a health plan whose monthly premium puts a strain on their budget, 
and when they require care, they find what they need really isn't fully 
covered.
    So here's what I propose: I propose we give workers more choice. I 
propose we reform the system to make the system more individualized by 
creating personal health accounts. Instead of paying a large premium 
every month for services you may not use, I believe we ought to have an 
account that allows a person to pay a much smaller premium for major 
medical coverage and then put the savings into a health account, tax 
free.
    The money is your money. It's your money in the health account, not 
the Government's money. And you can use it for whatever health care need 
that arises. If you don't use it, it's yours to keep. And the more 
affordable--and for the more affordable premium, you also get 
catastrophic care, protection in case of serious illness.
    The tendency for Government is one size fits all. If part of reform 
is to restore the patient-doctor relation and to give patients more 
choices, we have to change the tax system, too, and allow for patients 
to make decisions that is in their best interests.
    I also propose to help workers get better and more affordable 
choices in health plans at work. Now, some large companies are--you're 
okay; you've got some choice. But many small businesses are unable to 
afford health insurance. And so--and that's because there's not much 
purchasing power. A stand-alone small business does not have purchasing 
power in the marketplace. Either they can't afford to cover, or they 
have to allow their employees to settle on a high premium, high-dollar 
single plan.
    And so what I propose is that we ought to allow employers to pool 
together, through an industry association or perhaps the Chamber of 
Commerce, so that they can get the best deal for their workers, just as 
large corporations are allowed to do.
    Too many workers get no coverage at all through their jobs. This is 
especially true among minorities, part-time employees, and seasonal 
workers. For those with limited means, my budget will provide new 
credits to afford health coverage, up to $1,000 for an individual or 
$3,000 per family. And they won't have to wait for tax time to get these 
health credits. We'll make them immediately available for qualifying 
families, giving them the help they need when they need it. And at the 
same time, we'll work with our Nation's Governors to create purchasing 
groups to negotiate with insurers for the people who use these health 
credits.
    In other words, people who don't have insurance must be given 
incentive to purchase insurance; the States can help them pool, in order 
to get decent--decent coverage; but it's not a Government program. In 
other words, we trust the people. The Government incents individuals to 
make decisions in the marketplace. If the goal is to increase quality 
care by encouraging individual choice and a doctor-patient relationship, 
health credits is one way to help the uninsured do so.
    I also strongly believe that the legislation that I proposed to help 
unemployed workers makes a lot of sense. And it's this: As soon as a 
person qualifies for unemployment benefits, the Government would cover 
60 percent of the cost of continuing their health care. That's a proper 
role for the Federal Government. The role of the Federal Government is 
to help people who have been unemployed, not only with benefits but also 
with their health care costs.
    And the same principle of encouraging choice and helping people help 
themselves must apply as well to two Government-sponsored programs, 
Medicaid and Medicare.
    Medicaid and the SCHIP program provide essential coverage for low-
income families and seniors and persons with disabilities. These 
Americans also deserve more

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choices. My budget gives States more flexibility to provide better 
options in Medicaid and SCHIP and makes additional funds available for 
States to improve the coverage.
    And the Medicare program is a source of security and dignity for 
tens of millions of our seniors. It is an incredibly important 
commitment that our Federal Government has made. I strongly support 
Medicare because it is so crucial in the lives of older Americans, but I 
understand that Medicare is antiquated. It has not kept pace with 
advances in medicine. For instance, when Medicare was established 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 preventive medicine.
    In the past 37 years, many new medicines have arrived to replace 
invasive treatments and surgeries. These drugs can be more effective 
than surgery and are far less expensive. A serious stomach ulcer, for 
instance, once required a lengthy stay in the hospital and many 
thousands of dollars in medical bills. Today, the ulcer can be cured 
with prescriptions costing only hundreds of dollars. Yet Medicare would 
only cover the surgery, not the prescription.
    We must bring Medicare into the 21st century, to expand its 
coverage, to improve its services, to strengthen its financing, and to 
give seniors more control over the health care they receive. I think 
we're making progress in Washington, progress toward convincing the 
Congress that all wisdom doesn't exist in Washington bureaucracies when 
it comes to health care for the elderly. We've got Republicans and 
Democrats and an independent from the United States Senate working on 
Medicare reform.
    Seniors who are happy with the current system should be able to keep 
the coverage just the way it is. In other words, if there is a senior 
living in America who says, ``I love Medicare just the way it is,'' 
nothing changes, and that's an important--it's important for a lot of 
Americans to hear that. But all seniors should be offered different 
options, a range of options from which to choose, in both the private 
sector and private markets, as well as a better Government plan with 
better Medigap options. And all of these choices--all of them, however, 
must include prescription drug coverage.
    The second goal of reform is quality, the ability for a patient to 
get the best care from the doctor of our choice.
    Managed care plans have done a lot to make health care more 
affordable for many people. They can also unfairly deny coverage and 
step between the doctor and the patient. When such basic rights are 
lost, they've got to be restored by law. And that's why I urge Congress 
to get a Patients' Bill of Rights to my desk.
    We're close to an agreement on this issue. I've given a message to 
Congress: Please send me a bill that protects all patients, not just a 
fortunate few. Send me a bill with comprehensive patient protections. No 
one should be charged extra, for example, for simply visiting the 
nearest emergency room. No one should have to run a bureaucratic 
gauntlet before he or she can see a specialist. And if health plans deny 
care, every patient should have the right to a prompt review by an 
impartial panel of doctors.
    Finally, we should be serving the interests of the patients, not the 
self-interest of trial lawyers. There will always be matters that can 
and will be resolved in a courtroom, but with a strong review process, 
most disagreements between patients and health plans will end up in 
medical care, not in the courtroom.
    Needless litigation does not--needless litigation does incredible 
harm to our health care system. It costs everyone time and money, 
especially patients who need care quickly, and can destroy the bond of 
trust between physician and patient. Frivolous lawsuits drive up 
insurance premiums for everybody and discourage employers

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from offering employee coverage at all. It is really important to 
remember that we want to help doctors to heal, not encourage lawyers to 
sue.
    And the hostile legal atmosphere that doctors face is adding to 
costs and undermining the quality of health care in practical ways. At 
some hospitals, for instance, doctors have worked closely with one 
another to cut the rate of infection after surgery by more than half. 
Yet when they discuss that information openly or put it on a paper for 
the benefit of others, they also put themselves at risk of a lawsuit. We 
actually have a system that penalizes doctors for trying to prevent 
errors and avoid complications in patient care. And that doesn't make 
much sense. These good-faith efforts do not deserve the punishment of a 
lawsuit, and Congress needs to do something about that.
    When it helps patients, information must be broadly shared. In the 
Medicare system, we're giving people more information on the quality of 
nursing homes all across the country, and we plan to do the same thing 
throughout the health care system. Increased reliance on information 
technology will not only lower costs, it also holds great promise for 
detection and treatment and the development of new cures for disease. 
Personal medical information, however, must always be strictly 
confidential. A patient's right to privacy must be protected, and we 
will enforce those protections.
    My final goal in health care reform is to make sure Government acts 
where it should, providing a strong health care safety net and promoting 
research on the frontiers of science. The Federal Government has 
accepted these responsibilities, and we must fulfill them.
    Many of the poor and uninsured, including legal immigrants, are 
outside our system of health care entirely. Their neighborhoods often 
have few health care professionals or facilities. They have little or no 
access to preventive care, and most treatment takes place in an 
expensive emergency room.
    Around the country, more than 3,000 community health centers are 
fighting these problems by giving immunizations, providing prenatal 
care, and treating illness before they become medical emergencies. I 
strongly support these community health centers because they're 
compassionate. They are compassionate; they are cost effective; and 
America needs more of them. And so I've set this goal: We need 1,200 
more community health centers over the next 5 years to make sure our 
Government fulfills its commitment to the needy.
    The Federal Government has a large role in medical research, as you 
well know here. And that role is now urgent. In response to the threats 
facing our Nation, we've committed more than $2 billion to develop new 
tests and new treatments for bioterror weapons. This research is not 
only important for the immediate, but it is likely to produce new 
insights into the treatment of diseases such as tuberculosis, malaria, 
HIV/AIDS. Our massive effort to ensure the safety of our people will 
improve the health of our people.
    The National Institutes of Health is one of the most successful 
Government undertakings in our history. The work of the NIH has helped 
us defeat a long list of diseases and dangers to public health. Now, as 
scientists begin to read the codes of life itself, we are nearing 
incredible breakthroughs in the fight against disease. We may, in our 
lifetime, lift from humanity the curse of cancer.
    This is a moment of great national challenge, and the work of the 
NIH has become even more urgent and promising. I'm asking Congress to 
give strong support to the NIH. And my budget achieves the goal I set 
out when I sought the vote, and that is, we will have doubled the NIH 
goal at the end of the year 2003.
    Science is--on the very sources--is closing in on the sources of 
sickness and disease. By 2010, scientists predict, genetic tests will 
allow individuals to know if they

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are predisposed to certain conditions. Within 20 years, targeted drug 
and gene therapies will be available for diabetes and hypertension and 
other diseases.
    As we pursue the promise of these projects, we must also be alert to 
their dangers. Genetic information should be an opportunity to prevent 
and treat disease, not an excuse for discrimination. Just as we 
addressed discrimination based on race, we must now prevent 
discrimination based on genetic information.
    There is another danger to guard against, the use of genetic 
research to threaten the dignity of life itself. The powers of science 
are morally neutral, as easily used for bad purposes as good ones. In 
the excitement of discovery, we must never forget that mankind is 
developed--is defined not by intelligence alone but by conscience. Even 
the most noble ends do not justify every means. Life itself is always to 
be valued and protected. In biomedical research, we're dealing with the 
very makings of life, and the law must be firm and clear in restraining 
the reckless and protecting the voiceless.
    These are the goals of health care reform, principles to make a good 
system even better. We'll put our trust in the choices of patients and 
the decisions of doctors, the surest way to better coverage and better 
care. We'll protect patients and doctors from unfair treatment and 
unreasonable lawsuits. And Government will fulfill its unique 
responsibilities to provide a health care safety net and conduct the 
research that holds such great hope for all of us. With these reforms, 
new breakthroughs in medical research will reach the patients who need 
them, quickly and at the lowest cost possible.
    I believe America can achieve anything it sets its mind to. I 
believe--I don't believe--I know we're going to win the war against 
terror. And I know if we honor our professionals and honor our patients 
and recognize the limited role of Government, if we trust Americans to 
make the right choices for their lives, we'll have the health care 
system that remains the envy of the world. There's no doubt in my mind 
that with the right reforms, the right philosophy, a philosophy of 
trust--trust in people--that America will remain on the cutting edge of 
medicine. And as America remains on the cutting edge of medicine, 
America will be the promised land for all of us.
    It is such an honor to be here. I want to thank the youngsters who 
are going to be docs. I want to thank you for your service. Give them an 
``A'' for attending, for sitting through this lecture. [Laughter] But I 
do appreciate it. And I also appreciate your professors. And I 
appreciate the chance to come and share with my fellow citizens about 
the future of health care in America.
    May God bless you all.

Note: The President spoke at 2:52 p.m. in the Alumni Center. In his 
remarks, he referred to Gov. Scott McCallum of Wisconsin; T. Michael 
Bolger, president and chief executive officer, Medical College of 
Wisconsin; and Usama bin Laden, leader of the Al Qaida terrorist 
organization. The Office of the Press Secretary also released a Spanish 
language transcript of these remarks.


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