    [Public Papers of the Presidents of the United States: George W. Bush (2003, Book I)]
    [June 30, 2003]
    [Pages 713-718]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks to Senior Citizens in Miami, Florida
    June 30, 2003

        Thank you very much. Thanks for coming. Sientese, por favor. Muchas
    gracias. I'm honored to be here. Thank you for letting me come by to
    talk about a subject that is, I know, important to many, and that is the
    opportunities and the chances of modernizing Medicare. I am really glad
    to have the invitation to come to the Little Havana Activities and
    Nutrition Centers. After all, it gives me a chance to check

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    up on El Gobernador--[laughter]--mi hermanito, mi
    grande hermanito. [Laughter]
        I'm really proud of Jeb. He's--as you know,
    we've got a very close family, and any chance we have to get together to
    visit and compare notes about the latest thing Mother has told us to do, it gives us--it's a great
    opportunity. So--but thanks for letting me come.
        I--as Tommy mentioned, that we're
    making historic progress in Washington. It's really a matter of will.
    It's a matter of putting aside politics and focusing on what we're
    supposed to be focusing on, that is, the people. And so today I want to
    spend some time talking about the historic opportunity we have to
    modernize Medicare on behalf of America's seniors.
        There's some differences between the two bills. The Senate had one
    version. The House of Representatives had another. But there's a lot of
    commonality between them. And I'm confident that the Members, when they
    get back from their Fourth of July breaks, will get to work, iron out
    the differences in a constructive way, and get a good bill to my desk so
    that I can then say and all of us can say we've done our jobs on behalf
    of America's seniors.
        Tommy has--Tommy Thompson has been the
    point person for the administration on Capitol Hill, working this issue
    hard. He has done a really good job. He was my friend when he was the
    Governor of Wisconsin, so I saw that he was a good, hard worker and a
    productive person as the Governor of Wisconsin. He was a reformer, and
    he was on the leading edge of change in a lot of areas. And I was really
    happy to be able to convince him to serve in the incredibly important
    position of Secretary of HHS. And he hasn't let me down, and he's not
    letting the American people down, Tommy, and I want to thank you for
    your service.
        And I'm glad that Josefina came. I
    understand she used to be the president and CEO of this--of the Little
    Havana Activities and Nutrition Centers. She is--she did such a good job
    here that we spirited her up to Washington, DC, to serve our country. I
    want to thank Josefina, and I also want to wish her a happy birthday.
        Toni Jennings, the Lieutenant Governor, is
    with us today, and I'm honored that the Lieutenant Governor would be
    here. Thank you, Toni.
        I see that the Diaz-Balart boys for joining us today. Congressman, thank you for being
    here. I'm honored you're here. I appreciate your time. Terry
    White is here, the secretary of the Florida
    Department of Elder Affairs. Terry, thank you for coming, Senor Blanco.
    I--Dr. Rhonda Medows is with us today. I'm
    honored that the doc is here.
        We've got el alcalde de Miami. Thank you, Senor. Thank you very
    much, Alex, for coming, and as well--I mean,
    Manny, for coming. And Alex Penelas is here
    as well, the mayor of--donde? Okay. [Laughter] At least he got his name
    mentioned; that's a smart move. I appreciate Rene Rodriguez, the director of the Miami-Dade Housing Authority, for
    being here. Berta, donde esta Berta? Berta
    Ruano, thank you very much, Berta, for letting us come.
        And finally, when I landed at the airport on Air Force One, I was
    honored to walk off, and after I saw Brother and
    others that were there, I met a lady named Ana Cooper. Ana is right
    here. Thank you for coming, Ana. Let me tell you
    about Ana.

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    Stand up, please. So you're wondering who Ana is. You're wondering who
    Ana Cooper is; she is a volunteer. She volunteers to help seniors have a
    better life. She spends time comforting seniors. She takes time out of
    her day to help somebody in need. And that's an important part of
    America. It's a really important part of our system. It's a part of a
    compassionate tomorrow when a fellow citizen is willing to dedicate time
    to help somebody who needs help.
        And I want to thank Ana. She's a--what I call
    a USA Freedom Corps greeter. Everywhere I go in America, I try to
    recognize an individual who is serving something greater than themselves
    in life. If you're such an individual, I want to thank you for that.
        If you're interested in helping, you can get on the Internet and
    look up usafreedomcorps.gov. It's an opportunity for young and old alike
    to serve your community. The strength of our country is more than just
    military might. The strength of our country is the heart and soul of our
    fellow citizens, people like Ana who are willing to help somebody in
    need. Ana, thank you for the example you've set, and I appreciate you
    coming.
        I mentioned our love for freedom in America. We love it. We love it
    for people of Cuba. We love it for the people of Iraq. We love it for
    the people of Afghanistan. We also know that a free society is more
    likely to be a peaceful society. And so when you hear me talk about
    freedom, you must also know that I talk about peace, that our deep
    desire in America is for the world to be more free and more peaceful.
    And we'll stay the course.
        We have made great progress at freeing people from barbaric regimes,
    which also means that America is more secure. We will stay on guard in
    America because we understand there are still enemies of freedom,
    enemies for what we stand for. And I want to thank the local authorities
    and the State authorities and our Federal authorities, who are all
    working closely together to keep the homeland more secure. But in order
    to make sure the homeland is more secure, we must hunt down enemies
    wherever they hide. The best way to make America secure is to find the
    enemy before the enemy comes to us. And that's what we will do.
        We must also worry about the economic security of our fellow
    citizens. And I want to thank the Members of Congress who have worked
    closely with the administration to create the environment for additional
    job growth. Your Governor and the good people down
    here have led the Nation in new job creation. And I want to thank the
    people of Florida for setting the pace for job recovery. But so long as
    anybody is looking for work and who wants to work and can't find a job,
    we will worry about it. And we will create the conditions necessary for
    economic vitality, including, most importantly, to make sure our small
    businesses are strong and vibrant all across the United States of
    America.
        And then we're worried in Washington, DC, and we're doing something
    about it, about the health security of the American people. And one of
    the things we finally recognized in Washington, well, we recognized it--
    actually get something done about it--is that medicine is becoming more
    modern, yet the systems dealing with medicine, like Medicare, aren't. In
    other words, there have been great advancement in medicine, and yet the
    Medicare system is stuck in the past. And so we decided to do something
    about it.
        We decided to make sure that prescription medicines, which
    oftentimes replace surgeries and long hospital stays, become an integral
    part of a modern medical system available for our seniors and everybody
    else; in other words, that we now focus on prevention as opposed to
    reaction as an integral part of a modern medical system.
        One of the things that we've got to always worry about and work on
    in Washington is to make sure that pharmaceutical

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    drugs are more affordable and more available. And I took some strong
    action to help that be the case by making sure that generic drugs are
    not delayed in making it to the marketplace.
        In our system today, if a pharmaceutical company invents a new kind
    of medicine, they're given patent protection for a period of time. And
    that's okay. It makes sense. After all, we want a--we want new medicines
    coming on the market, and patents provide incentives for people to
    reinvest and to take research and development risks. But what we can't
    afford is to have generic drugs delayed because of loopholes in the laws
    and regulations. We cannot allow drug companies to block generics, which
    are cheaper at the counter for our citizens--``less expensive'' is a
    better way to put that, still of high quality but of less expense--
    because of arguments over minor features.
        In other words, the generic gets ready to come on the market, and
    the initial company will say, ``Wait a minute. You're--you know, you've
    got the pill bottle--the color of the pill bottle looks like that you're
    infringing on the patent,'' and delays take place. And we can't allow
    these excuse-making delays to take place. So the Federal Drug
    Administration has taken strong action which will get generics quicker
    to the markets, which will save our seniors and all people relying upon
    pharmaceuticals savings.
        We anticipate the savings will be up to $35 billion over a 10-year
    period. And that's a good, positive step on behalf of making sure our
    drugs are more affordable.
        But the other thing we've done is we made sure that Medicare is
    heading toward reform. And a reform in Medicare means a couple of
    things. It means seniors get to have choices, and all choices will
    include prescription drug benefits. The Medicare system of today does
    not have prescription drug benefits, as you know. We've got to change
    that. If medicine is changing, we want Medicare to change with it, on
    behalf of the senior citizens all across the country.
        And so, as Tommy mentioned, we've had
    a debate up in Washington, and that is how best to provide a modern
    system to our seniors. One of the things I reminded people of and will
    continue to do so until I get a bill on my desk, that Members of the
    United States Congress and their staffs get a choice about what kind of
    plan--health care plan best suits their needs. In other words, Congress
    said, ``Let us have a consumer-friendly system.'' A consumer-friendly
    system is one that says we trust the consumers to make the best choice.
    Senior citizens are consumers, and therefore, the plan ought to match
    your needs, not the needs designed by a bureaucrat--not your needs as
    decided by a bureaucrat in Washington, DC. If choice is good enough for
    Congress, it ought to be good enough for the seniors in America, was my
    point.
        I appreciate these men--I appreciate their consistency. They
    understood that, and that's a vital part of the bill which came out of
    the House of Representatives and the Senate. And basically it says this:
    It says that if you like your current Medicare system, you like the way
    the Medicare system is today, you should have the option of staying in
    that system, plus an additional benefit, and that would be prescription
    drugs. In other words, if you're happy where you are, we're going to add
    a prescription drug benefit.
        Now, as well, if you enhanced benefits or--such as more coverage for
    preventative care or other services, you ought to have that choice as
    well. In other words, you take what the Government provides, and if you
    want to make it better, you ought to have that choice--your choice to
    make. That ought to be available part of the program. As well, if you
    like the affordability of managed care plans--Medicare+Choice--if you
    like that and you're in the plan, that ought to be a part of your
    option. In other words, there's three opportunities. The plans ought to
    be tailored to your demands.

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        Low-income seniors will receive extra help. We want to help those
    who are--who need help. So that ought to be a part of our Government
    policy so that seniors will have the ability to choose a Medicare plan
    which best fits their needs. And all the plans will mean there is a
    prescription drug benefit available. So we're modernizing Medicare, and
    it's important that we do.
        I talked to Myrtle Ball today--I had the
    honor of meeting with some of your fellow citizens prior to coming out
    here to talk, and I heard their stories. It's a good opportunity for
    Jeb and me and Tommy
    to listen to what people--what's on their mind. And pretty much common
    story--Myrtle is diabetic. She takes eight medications, and those cost
    her at least $700 a month, which is nearly half her income. And that
    bothers her, and it worries her. So she's cutting down, cutting the
    pills in half in some cases, to try to make those--stretch those
    dollars. The bill we passed--both bills we passed, and the combined bill
    we passed, Tommy and I concluded, will help somebody like Myrtle, help
    her meet the needs so that she doesn't feel stressed in later years of
    life.
        Teresa Tibble is here, and she takes care
    of her mom, Betty, at home. And Teresa, I want
    to thank you very much for doing that. She is a dutiful daughter. Her
    mom has got Alzheimer's. And Teresa wants to live with her mom so her
    mom feels comfortable. I think Jeb and I were
    touched by what it means to be sitting at a table with a daughter who
    has said, ``I've got a responsibility to my mom.'' And I want to
    appreciate Teresa for doing that. The extra money that will come from
    the benefit that's going to end up in the bill will help Teresa take
    care of her mom at home.
        I also met the Gensels. They're here, Judy
    and Jerry. And they--now, they're typical of a
    lot--because of Jerry's previous job, he was--had some benefits, some
    benefits as a retiree, but in his case, they run out in a couple of
    years. And so in the--from a private-sector plan--so he's concerned,
    obviously. When the benefits expire as a result of the retirement
    package he had earlier, what's going to happen to Judy and Jerry? And
    this bill will help. This bill will make a difference.
        In other words, this bill is more important for people to realize,
    instead of the rhetoric, that it actually is going to affect people's
    lives in a positive way. And here are some people's lives that will be
    affected, and I'm sure a lot of your lives will be affected as well.
    We've just got to get the job done now. We've got to make sure that the
    bills are reconciled and get them to my desk. And I look forward to
    signing a good Medicare bill.
        Finally, there's one other issue I want to talk about. I mean, if
    we're concerned about health care which is accessible and affordable, we
    better be concerned about the number of lawsuits that are taking place
    all across America. You see, it's one thing for somebody to be able to
    sue a bad doctor. We're for that. But the problem is, we've got a lot of
    lawyers filing suits against any doctor. And let me tell you the effect
    of frivolous lawsuits, the effect it's having all across America.
        It means that doctors are practicing what they call preventative
    medicine. In other words, if you think somebody's going to sue you, if
    you're in a litigious society, then you'll take extra care by
    prescribing more and more either procedures or whatever it may be. And
    that runs the cost of medicine up. It makes it more likely your bill is
    going to go up.
        And secondly, lawsuit after lawsuit after lawsuit that oftentimes--
    you know, that people just settle in order to get it off the docket
    cause premiums to go up, which also makes medicine more costly. In a lot
    of cases around the country, docs have just had it. They said their
    premiums have gone up so high that they can't practice medicine anymore.
    So you know what they do? They take the shingle down, which makes it--

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    there's less doctors available. We've got a problem.
        I met with docs all across our country. The premiums are just going
    out of sight because of frivolous lawsuits are running up the cost of
    doing business, and it costs you more money. It just does. And people
    say, ``Well, you know, that's not a Federal issue. It's a State issue.''
    And I want to applaud my brother, working hard on this issue. And I hope
    the legislature responds positively so that people all across this State
    are going to have affordable and accessible health care. But it also
    runs up the cost of the Federal bills.
        I mean, if somebody is practicing preventative medicine, it's going
    to mean Medicare costs go up. Medicaid costs will go up. Veterans health
    benefits go up. I've looked at the cost of all these frivolous lawsuits
    to the Federal Government and have come to the conclusion we have a
    Federal problem as well, which requires a Federal solution. In order to
    make sure health care is vibrant and viable, we need medical liability
    reform all across America, and we need a Federal medical liability
    reform.
        I want to thank you all for--I want to thank you for giving me a
    chance to come by and visit with you. Let me conclude by telling you
    something that I know is true. We are fortunate to be Americans. We live
    in a great country. We live in a great country that has got the best
    health care system in the world, and we need to keep it that way. We
    live in a great country because we believe in serving concepts greater
    than ourselves. We live in a great country because we believe in values
    and ideals from which we will not vary. We believe strongly in freedom.
    We believe in peace. We believe in human dignity. We believe in the
    worth of each individual. We are a great country, and I'm proud to be
    the President of this great country.
        Thank you all for coming. May God bless.

    Note: The President spoke at 11:19 a.m. at the Metropolitan Senior
    Center, Little Havana Activities and Nutrition Centers. In his remarks,
    he referred to Gov. Jeb Bush and Lt. Gov. Toni Jennings of Florida;
    Josefina Carbonell, Assistant Secretary for Aging, Department of Health
    and Human Services; Representatives Lincoln and Mario Diaz-Balart of
    Florida; Dr. Rhonda Medows, secretary, Florida Agency for Health Care
    Administration; Mayor Manuel A. Diaz of Miami; Mayor Alex Penelas of
    Miami-Dade County; and Berta Ruano, assistant to Ramon Perez-Dorrbecker,
    president, Little Havana Activities and Nutrition Centers. The Office of
    the Press Secretary also released a Spanish language transcript of these
    remarks.