    [Public Papers of the Presidents of the United States: George W. Bush (2003, Book I)]
    [June 11, 2003]
    [Pages 621-625]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks to the Illinois State Medical Society in Chicago, Illinois
    June 11, 2003

        Thanks for the warm welcome. It's good to be back in the Windy City.
    I'll try not to be too windy. [Laughter]
        The last time I was here, which was in January, I talked about big
    objectives of my administration and big responsibilities we share, and I
    talked about the need to continue to fight the war on terror. I reminded
    our citizens that this country would uphold the just demands of the
    world and confront the real threat posed to the free world by Saddam
    Hussein. Since I was here, thanks to the
    bravery of our military and to friends and allies, the regime of Saddam
    Hussein is no more; the world is peaceful and free. Thanks to their
    bravery and their sacrifice, the world is more peaceful, America is more
    secure, and the Iraqi people are now free.
        We have a lot more work to do in Iraq, and we'll stay the course.
    And we've got a lot more work to do to make sure our country is secure,
    because the war on terror goes on. There are still terrorist networks
    which hate America because of what we love. They hate us because we love
    our freedoms. And since we're not going to change, we're going to have
    to deal with them. We will be strong; we will be diligent; and we will
    win.
        I also talked about economic security when I was here last. I laid
    out a plan, what I called a growth-and-jobs plan, that recognized that
    so long as any of our fellow citizens are looking for work, that we've
    got to be concerned about the fact they can't find a job. We need a--I
    reminded the country that we needed to grow our economy so people could
    find work.
        The crux of the plan I laid out said that if a person has more money
    in their pocket, they're likely to demand an additional good or a
    service. In our type of economy, when you demand a good or a service,
    somebody

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    is going to produce the good or a service. And when somebody produces
    that good or a service, it's more likely a fellow citizen will find
    work. And the Congress acted, and they passed substantial tax relief,
    which will give more Americans their own money.
        Today I've returned to Chicago to discuss another issue relating to
    our security, and that's the need for us to improve the health security
    of the American citizens. We have an unprecedented opportunity to give
    America's seniors an up-to-date Medicare system that includes more
    choices and better benefits like prescription drug coverage. And for the
    sake of health care for all Americans, we must reform the medical
    liability system. For years, leaders of both political parties have
    talked about these reforms. Now is the time to get the job done.
        I am very grateful for the Illinois State Medical Society for
    hosting me today. This distinguished organization was founded in 1840 in
    Springfield, the same time that Abraham Lincoln was practicing law in
    that city on North 5th Street. Lincoln was a lawyer who believed in
    discouraging unnecessary litigation. I want to thank Dr. Ron
    Ruecker for his hospitality, his
    introduction.
        I want to thank Tommy Thompson. Tommy
    used to be in this neighborhood. [Laughter] But he's doing a fantastic
    job as our Secretary of Health and Human Services. When we talk about
    tort reform in this administration, Tommy is the point man up on Capitol
    Hill, working hard with Senators and Members of the United States
    Congress, some of whom traveled with us today. Senator Peter
    Fitzgerald is with us today, and I want
    to thank the Senator for joining us. Congressmen Bobby Rush and Luis Gutierrez, Rahm
    Emanuel, Danny Davis, Phil Crane, Mark Kirk, and Congresswoman Judy Biggert
    also traveled, and I want to thank the Members of Congress for your
    interest and for joining us.
        We have just had a roundtable discussion with fellow citizens, some
    docs, some people on Medicare. I want to thank them for joining me today
    and sharing their stories and their concerns about the future of health
    care in our country.
        One thing is for certain about health care in our country, is that
    we've got the best health care system in the world, and we need to keep
    it that way. We've got great docs in America. We're really good at
    research. We're developing technologies and medicines which are
    extending lives not only in our country but all across the world.
        To make sure we've got a good health care system today and tomorrow,
    we've got to make sure that no policy of the Federal Government will
    undermine the system of private care in America. As folks who deliver
    that care, you know that we've got challenges in our system. We must
    address the challenges while not undermining the strengths of American
    medicine.
        There are some hard-working folks in our country who do not qualify
    for Medicaid and cannot afford to buy health insurance. So I sent a
    proposal to Congress for refundable tax credits to help low-income
    people purchase their own insurance. There are too many needy Americans
    who use emergency rooms as their main source of health care. So I worked
    with Congress, and I want to thank Congress for increased funding, for
    more community and migrant health care centers all across America.
        And we've got another challenge that we're now dealing with in
    America, and that's Medicare. It's an essential commitment of this
    Government, yet the system is not keeping pace. The system is not
    adjusting to the advances of modern medicine. This year we have an
    opportunity to seize and strengthen and--to strengthen and improve
    Medicare for the sake of all our seniors. I'm here to urge Congress not
    to miss the opportunity. I'm here to ask for your help in making sure
    that Congress does not miss the opportunity.
        Four decades--over four decades, the Government has made some
    improvements in Medicare. Notice I said ``the Government'' has made
    improvements in Medicare. Therein lies part of the problem.

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    [Laughter] We've expanded the program to cover persons with
    disabilities, to cover kidney dialysis, to cover more home-based
    services to the bedridden, to cover some cancer screenings and vaccines.
    Yet, health care moves faster than bureaucracy. Health care is being
    transformed by drug therapies and active prevention. These are an
    increasingly important part of how docs treat their patients, yet
    seniors with Medicare must pay for those treatments out of their own
    pocket or go without them.
        Medicine is changing; Medicare is not. As many as one-third of
    seniors on Medicare have no drug coverage at all. It's about 900,000--
    90,000 seniors in Chicago without any drug coverage. Because seniors
    don't have drug coverage for prescription drugs and preventative care,
    we are creating a health care system that is more expensive and less
    effective.
        Let me give you two examples. Prolonged hospital stays for ulcers
    can cost up to $28,000, which Medicare pays. But Medicare does not pay
    the annual bill of $500 for drugs that can eliminate the cause of most
    ulcers. Medicare would pay many of the costs to treat a serious stroke,
    including bills from the hospital and the rehab center, doctors, home
    health aides, and outpatient care. And those costs can total upwards of
    $100,000. Medicare will not pay for a year's worth of treatment with
    blood-thinning drugs that can prevent stroke, drugs which cost less than
    $1,000.
        Time and time again, Medicare's failure to pay for drugs means our
    seniors risk serious illnesses, disease, and injuries, all of which
    Medicare would pay to treat after the fact. America's seniors deserve a
    modern system of health care, instead of a bureaucracy that covers the
    latest medical treatments slowly and sporadically. Our seniors should
    have choices under Medicare, so that affordable health care plans
    compete for their business and, at the same time, give them the coverage
    they need.
        This principle of choice, of trusting people to make their own
    health care decisions, is behind the health plan enjoyed by every person
    on the Federal payroll, including every Member of Congress. All Federal
    employees get to choose their health care plan. Health plans compete for
    their business by offering good services and better choices at lower
    costs. It seems logical to me that if Members of Congress and staffs get
    good choices and good service, so should the seniors of America.
        Here are the principles of the plan that I have submitted to
    Congress. Seniors who want to stay in the current Medicare system should
    have that option plus a prescription drug benefit. Seniors who want
    enhanced benefits, such as more coverage for preventative care and other
    services, should have that choice as well. Seniors who like managed care
    plans should have that option as well. And all low-income seniors should
    receive extra help, so that all seniors will have the ability to choose
    a Medicare option that includes a prescription drug benefit.
        That's what we discussed at our roundtable, the need for seniors to
    have a prescription drug benefit. Dan and Barbara
    Lee are with us today. He has leukemia, which is
    now under control, but he's worried about the future. He has affordable
    prescription drug coverage through a previous employer, but he knows
    he's eventually going to lose it. And then he will have a monthly
    prescription drug bill of more than $300, and the current Medicare
    system will not help him. Dan describes Medicare this way: ``There isn't
    a lot of choice, and I think people ought to have choice.'' Congress
    needs to listen to Dan.
        We also heard from Gene Preston. He and his
    wife, Dorothy, live on a tight budget and do
    not have prescription drug coverage. To the Prestons, a full drug
    benefit would help a lot because they now spend $300 a month on drugs.
    He says, ``Everything is going up in price. Before, we could save a
    couple of bucks at the end of the month. But right now, we're just
    holding even, if not going below even.'' Gene says

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    it's important to have good health care coverage, and he's right. And
    that's exactly what the plan I submitted to Congress will provide to
    Gene and his wife and a lot of seniors around our country that need
    help.
        The need for Medicare reform is absolutely clear to me, and the
    opportunity for Medicare reform is real. We've got a chance to get it
    done. We have set aside the necessary resources to make reform work. The
    budget I proposed, which Congress passed, provides 400 billion
    additional dollars to modernize Medicare and provide a prescription drug
    benefit--$400 billion. We've also got a growing consensus in both Houses
    of Congress and in both political parties, a consensus that our seniors
    need more choices and better benefits including prescription drugs. And
    the time is right to make progress.
        The House of Representatives will take up this issue in the coming
    weeks under the leadership of a man from Illinois, a guy who I've got a
    lot of respect from, Speaker Denny Hastert.
    Dennis And I appreciate the leadership of Chairman Bill
    Thomas and Chairman Billy Tauzin. J.
    ``Billy'' And in the Senate, Republican Senator Chuck
    Grassley of Iowa and Democrat Senator
    Max Baucus of Montana are working closely to add
    momentum for Medicare reform. With the right spirit, I am confident that
    both the House and the Senate can act on historic Medicare improvements
    before the Fourth of July recess.
        In a strengthened and modernized Medicare system, every senior in
    America would enjoy better benefits than they have today, no matter what
    plan they choose. And all seniors would continue to benefit from the
    most fundamental choice of all, the ability to choose your own doctor.
        It is that relationship between patient and doctor which is the
    significant strength of American health care. Everything we do to
    improve Medicare should honor this relationship. And that relationship
    is being hurt by junk lawsuits filed against many doctors. It is
    important for our fellow citizens to understand the effects of junk
    lawsuits. It means that doctors and their insurance companies must fight
    every single case, regardless of how frivolous. And therefore, liability
    premiums go up, and that's got two effects. One, it causes price to
    patients to go up, and in some cases, drives docs out of business.
        If one of the goals of health care is to have affordable and
    available health care, it makes no sense to have a system--because of
    junk lawsuits--which drives up the costs and, in many States, makes
    health care less available. As well, it's important for our fellow
    citizens to understand that because of the threat of lawsuit, docs
    practice defensive medicine, ordering more tests, doing more procedures
    than are necessary, in order to avoid a lawsuit or in order to prepare a
    case for a potential lawsuit. And that causes costs to go up in America
    as well. Both higher premiums and defensive medicine drives up the cost
    to patients all across America, in every State. And both are hurting
    health care in this country, and we need to do something about it now.
        Dr. Andrew Roth is with us today. Our
    citizens must listen to the story of Andrew Roth because it's a--
    unfortunately, it's a typical story all around America. He went to high
    school at Hinsdale Central High. He stayed in Chicago for college and
    medical school. He and his practice deliver about 200 babies a year. His
    insurance premiums are going up 50 percent next month, to $170,000. And
    next January, he expects another 40-percent increase.
        The interesting thing about his career is that he has never spent a day in court as a defendant in a
    liability case, and he has never settled a case. But because this State
    has no medical liability reform, the cost of him staying as a baby doc
    is getting out of sight. And he is now considering leaving this vital
    State. And that hurts the patients in this State, and it must hurt him
    as well. He was raised here, educated here,

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    loves the Cubs. [Laughter] And yet, a flawed system is not only making
    it hard for him to practice medicine; it's making it hard for him to
    stay in an area he loves. He said, ``We're all at the breaking point.
    Liability premiums are keeping us from doing what we love or forcing us
    to leave our homes.''
        We have got a problem in America that we must deal with. And this is
    not only a local problem, but because lawsuits and premium increases and
    preventative medicine drive up the cost in Medicaid and Medicare and
    veterans health benefits, medical liability is a national issue that
    requires a national solution.
        Every person with a legitimate claim deserves a day in court. Junk
    lawsuits make it hard to get into court. And bad doctors must be held to
    account. I'm confident that's what the Illinois Medical Society believes
    as well. Yet, for the sake of affordable and available health care, we
    need a cap on non-economic damages, of $250,000. Punitive damages should
    be limited to reasonable limits.
        This health care system needs liability reform now. No one has ever
    been healed by a frivolous lawsuit. This past March, the House of
    Representatives passed medical liability reform. The Senate has not
    acted. I urge all of you to talk to your Senators. I know one of them is
    okay.
        You can make a difference. Not only should the people of Illinois
    who care about medical liability reform get involved, people all over
    this country--if you want a health care system that is available and
    affordable--need to get involved. You need to let your Senators know how
    you feel on this key issue.
        I'll be right there with you getting involved. I want to sign this
    into law. I want to sign Medicare reform into law, and I want to sign
    medical liability reform into law, so that we can look the American
    people in the eye and say, ``We have done our job; we saw a problem and
    we fixed it.''
        There are challenges in the health care system. We understand that
    in Washington. And we can answer those challenges with practical,
    sensible, compassionate reforms. That is the charge before us, and that
    is the charge we must keep on behalf of the American people.
        May God bless your work, and may God continue to bless America.

    Note: The President spoke at 10:32 a.m. in the ballroom at the Chicago
    Hilton. In his remarks, he referred to former President Saddam Hussein
    of Iraq; and Ronald L. Ruecker, M.D., chair, board of trustees, Illinois
    State Medical Society. The Office of the Press Secretary also released a
    Spanish language transcript of these remarks.