[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.