    [Public Papers of the Presidents of the United States: George W. Bush (2003, Book II)]
    [July 30, 2003]
    [Pages 966-971]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on the 38th Anniversary of Medicare
    July 30, 2003

        Thank you all for coming. Welcome to the people's house. We're
    thrilled you're here. Tommy is right; 38
    years ago, Lyndon Johnson signed the Medicare Act. What I found
    interesting was that he had the ceremony in Independence, Missouri, so
    that former President Harry Truman could be there, because Truman had
    set out the vision of Medicare many years before that. A few minutes
    after 3 o'clock, Medicare

    [[Page 967]]

    became law, and President Johnson handed the first Medicare card to
    Harry Truman.
        Health insurance for elderly and disabled Americans was one of the
    greatest, most compassionate legislative achievements of the 20th
    century. It spared millions of seniors from needless worry and hardship.
    Since 1965, every President and every Congress has had the
    responsibility to uphold the promise of Medicare, and we will uphold our
    promise. We will do our duty.
        The 38th anniversary of Medicare is a time for action. The purpose
    of the Medicare system is to deliver modern medicine to America's
    seniors. That's the purpose. And in the 21st century, delivering modern
    medicine requires coverage for prescription drugs.
        Both Houses of Congress have passed Medicare improvements that
    include prescription coverage. Now the House and Senate must iron out
    the remaining differences and send me a bill. For the sake of our
    seniors, for the sake of future retirees, we must strengthen and
    modernize Medicare this year.
        I appreciate Tommy Thompson taking the
    lead on this issue for this administration. He--I knew him when he was a
    Governor. I figured he'd make a pretty good Cabinet Secretary--
    [laughter]--and he proved me right. He's doing a fabulous job. He is the
    point man on the Hill on this complex, important legislation.
        And we've got two of the Members from the Senate who have worked
    really hard to see to it that the legislation came to fruition and
    passed the Senate and are working hard to get a good bill out of the
    conference, and that's--starting with the majority leader of the United
    States Senate, Bill Frist from Tennessee; the
    ranking member on the Finance Committee from the State of Montana, that
    would be Max Baucus, Senator Baucus. For those of
    you who don't follow politics--[laughter]--Frist is a Republican--
    [laughter]--Baucus is a Democrat--[laughter]--both of them willing to
    put aside party to focus on what's doing right for the seniors. And I
    appreciate their leadership of both these Senators. Thank you all for
    coming. You set a good example for the body you represent.
        I appreciate Tom Scully, who is with
    us. He is the Administrator for the Centers for Medicare and Medicaid
    Services. That is a long title for a very tough job. And I appreciate
    Scully's knowledge on this issue. He too, along with Secretary
    Thompson, is working the Hill, along with
    members of my staff, working hard with Senators and Congressmen from
    both parties to come up with a bill that will stand the test of time.
        I want to thank top docs in my administration who are traveling the
    country to talk about the benefits of Medicare reform. Rich
    Carmona is the Surgeon General of the
    United States. Thank you for coming, Doc. Dr. Julie
    Gerberding directs the Center for Disease
    Control and Prevention. It's a tough and important job. Mark
    McClellan is the Commissioner of the FDA,
    the Food and Drug Administration. Elias Zerhouni is the Director of the National Institute of Health--all
    four great Americans, all four fine doctors, all four doing a really
    good job on behalf of the American citizens.
        On a piece of legislation like this, there's a--it obviously
    attracts the attention of advocates, people who are willing to get
    involved in the process, people who work hard on behalf of the
    constituents they represent. Today we've got Jim Parkel and Bill Novelli. Jim is
    the president, Bill Novelli is the director and CEO of AARP. I'm honored
    you all are here. Thanks. Thanks for providing such good leadership for
    all.
        There's a group involved in the process called United Seniors
    Association. It's headed by Charlie Jarvis. He's the chairman and CEO, and Charlie is with us today.
    Thank you for coming, Charlie. Representing the 60 Plus Association is
    my long-time friend, Jim Martin. Thank you
    for coming. I'm glad you're here.

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        I want to thank those of you who are here today for your interest. I
    want to thank our fellow citizens who may be watching this on C-SPAN, if
    it happens to be on C-SPAN--seems like everything is on C-SPAN these
    days--[laughter]--for your interest in this very important issue.
        You know, for a long time Medicare was called ``Medi-scare,'' and it
    meant that political people weren't supposed to touch it for fear of
    losing an election, that when you talked about reforming Medicare, then
    all of a sudden you were supposed to lose because people would bang you
    over the head on the issue. I think we're beyond that, and that's a very
    positive development. A lot of you in this room have helped us get
    beyond that, and I want to thank you for that. Now we've got hard work
    to do to get this process across the line.
        I'm joined onstage, by the way, by some of our fellow citizens, who
    I'll talk about in a little bit about how the current Medicare plan as
    envisioned by a lot of us will help in their daily lives. But let me
    start by telling you this: For four decades, it's important for our
    citizens to know that Medicare has done exactly what it was created to
    do, which is pretty unusual for an act of Congress--[laughter]--in all
    due respect. [Laughter] Under Medicare, older Americans have access to
    good quality health care in a system of private medicine. That what it
    was intended to do, and that's what it has done. Seniors and people with
    disabilities have greater peace of mind knowing that Medicare will
    always be there. It was the initial intent of the law, and that's what
    it has done.
        Medicare coverage has helped protect the savings of our seniors and
    shielded their families from costs they may not be able to afford.
    Medicare is an important national achievement, and it is a continuing
    moral responsibility of our Federal Government. Americans are proud of
    our Medicare program. We must make sure that Medicare fits the needs of
    our seniors today. It has done what it was supposed to do. Our task is
    to make sure it continues to do what it was supposed to do.
        It was created at a time when medicine consisted mostly of house
    calls and surgery and long hospital stays. Now modern medicine includes
    preventative care, outpatient procedures, and at-home care. Medicine is
    changing. Many invasive surgeries are now unnecessary because of the
    miraculous new prescription drugs being developed. Most Americans have
    coverage for all this new medicine, yet seniors relying exclusively on
    Medicare do not have coverage for most prescription drugs.
        No one intended for Medicare to develop these major gaps in
    coverage. That was not the initial intent of the law. There are gaps in
    coverage now. Medicine has changed. Medicare hadn't. We must fill those
    gaps. Medicare must be modernized.
        Let me give you a couple of examples by what I mean when I talk
    about modernization. Medicare today will pay for extended hospital stays
    for ulcer surgery at a cost of up to $28,000 per patient. This is
    important coverage. Yet Medicare will not pay for drugs that eliminate
    the cause of most ulcers, drugs that cost about $500 a year. Medicare
    will pay for the cost to treat a stroke, including bills from the
    hospital and rehab center, doctors, home health aides, and outpatient
    care. That's what Medicare pays for. Those costs can total up to
    $100,000. This is essential coverage; it's vital coverage. Yet Medicare
    does not cover the blood-thinning drugs that prevent strokes in the
    first place, drugs that cost less than $1,000 a year.
        The Medicare system has got a lot of strengths, no question about
    it. Yet it is often slow to respond to the dramatic changes in medicine,
    and that's what we've got to address. That's what we are addressing.
        The best way to provide our seniors with prescription drug coverage
    and better preventative care is to give them better choices under
    Medicare. If seniors have choices, health plans will compete for their
    business

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    by offering better coverage at affordable prices.
        Both Houses of Congress have passed bills that follow the framework
    of reform that I suggested and others have suggested. Under either bill,
    seniors who want to stay in current Medicare have that option plus a new
    prescription drug benefit. Seniors who want enhanced benefits, such as
    coverage for extended hospital stays and protection against high out-of-
    pocket expenses, will have that choice as well. Seniors who like
    managed-care plans will have that option as well. All low-income seniors
    will receive extra help so that all seniors will have the ability to
    choose a Medicare option that includes a prescription drug benefit.
        Many retirees depend on employer-sponsored health plans for their
    prescription drug coverage. That's a reality in today's society.
    Medicare legislation--the legislation that these two good Senators are
    working hard on--should encourage employers to continue to provide those
    benefits while extending drug coverage to millions of Medicare
    beneficiaries who now lack it. It's important that those who have
    assumed the responsibility--corporate responsibility of providing
    prescription drugs for their retirees keep providing that benefit. And I
    know the Senators are working on that important part of the Medicare
    legislation.
        Every Member of Congress gets to choose a health coverage plan that
    makes the most sense for them, and so does their staff. So does every
    Federal employee, and so should every senior have that choice. See,
    choice is good. It makes sense. I can understand why Members of Congress
    have said, ``Well, look, give me more than one option, if you don't
    mind. I'm plenty capable of choosing for myself. I'd like to see what's
    available. As a matter of fact, I'd like to have my demand be listened
    to. I'd like to have plans begin to tailor their services to what I
    think is necessary for me.'' And seniors should have that same option,
    it seems like to me. Seniors are plenty capable of making decisions for
    what's best for them.
        For seniors without any drug coverage now, these reforms will help a
    lot. Let me tell you what I mean by that. In return for a monthly
    premium of about $35 or about a dollar a day, seniors now without
    coverage will see their drug bills cut roughly in half. That's the good
    work that these Senators have done. They've heard the call, and they're
    responding with a piece of legislation that will help seniors save
    money.
        A senior with a monthly drug cost of $200 will save between $1,300
    and $1,800 on drug costs each year. That's under the bills that have
    been passed now. A senior with a monthly drug cost of $800--monthly cost
    of $800 would save between $5,700 a year and $6,100 each year on drug
    costs. That's some pretty good change.
        The House and the Senate have got to work out their differences, and
    they're going to. This is--I believe that there's a spirit of
    cooperation and a can-do attitude amongst the conferees. But in either
    version of their bills, seniors who currently lack drug coverage will
    see real savings, and that's a positive reform for a lot of our fellow
    citizens.
        As we move toward this system, we will provide seniors with a drug
    discount card that saves them 10 to 25 percent off the cost of all
    drugs, so they'll start seeing savings immediately as well. The
    conferees, I know, are working on the drug discount card now to make
    sure we can iron out any differences, and I was briefed on that today by
    our staffers who are working close with the conferees.
        We have some seniors, as I mentioned, with us today--some citizens
    with us today that would like to see the legislation move forward for
    practical reasons. A lot of times in Washington we talk about statistics
    and laws and hearings, and I always like to bring the human element to
    the front so people get to see how these bills will actually affect
    people's lives in a positive way.

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        Mary Jane Jones from Midlothian,
    Virginia, is with us today. She's a Medicare recipient. She's 69 years
    old. She'd like to be retired for good. [Laughter] But she has to work
    20 hours a week just to make sure she can afford her nearly $500-a-month
    bill for prescription drugs and insulin. Sometimes, she says, she uses
    her insulin needles 3 or 4 times to save money. That's a story I'm
    confident that those who have held hearings in Congress or members of
    groups up here hear from their members.
        Mary Jane says that getting about half
    her drug cost covered would be a big help. That way, she says, she
    wouldn't have to work constantly. Seniors like Mary Jane have made their
    plans. This bill will help them enjoy their retirement.
        Refa Ryan is with us from Warrenton, Virginia.
    She has Medicare. She doesn't have drug coverage, and she pays $120 to
    $200 a month for medicine. Three years ago, when she was having a hard
    time making payments on her drugs, rather than asking someone for help,
    she was ready to sell her engagement ring. Fortunately, Denise found out about it and bought the ring so it stayed in
    the family. Refa says she appreciates what Congress is trying to do to
    add drug coverage to Medicare.
        ``I wouldn't be anxious all the time,'' she said. ``I wouldn't have
    to worry all the time.'' See, this bill will help our seniors not have
    to worry all the time. And that's why there's momentum toward getting
    something done.
        I also fully recognize that there are some that are beginning to
    think about what Medicare means when they retire. I might be one of
    them. [Laughter] There's some baby boomers that are beginning to look
    out and say, ``Medicare isn't going to be there. Is it going to be
    modern when we get ready?''
        In support of what I know the Senators are doing and Members of the
    House are doing, the conferees are doing, is that they're thinking not
    only to make sure the system works for our seniors today but make sure
    that seniors--I mean, that the seniors-to-be have got a plan available
    for them and that most of us in the baby boomer era, we like the idea of
    choices. We want to be able to pick and choose to help meet our needs.
    We want to make sure that the system is--kind of listens to the demand
    of the citizen.
        Richard Kamenitzer is with us.
    Richard and I are of the same generation. It says in here he and his
    wife, Rose Marie, are in their
    fifties. Well, Laura and I are in our fifties
    too. He's from Stroudsburg, Pennsylvania. He's a self-employed guy. He's
    a part of the entrepreneurial class here in America. He's a small-
    business man, and he and his wife take about seven medications a day
    right now. Now, he's probably beginning to wonder, after he retires, how
    can he afford seven medications--he and his wife--a day? Who's going to
    pay for it?
        He said--here's what he says, with
    drug coverage and Medicare, about the new plans that we're trying to get
    done. He said, ``I'd have a fighting chance''--that is, ``I would have a
    fighting chance to enjoy retirement. Without it, I don't know what I'd
    do. Retirement, in a sense, may be out of the question, because I won't
    be able to afford the prescriptions I desperately need.''
        See, not only are we talking about helping the seniors today who are
    on Medicare; we're talking about the ones getting ready to get on
    Medicare too. And that's why these folks are thinking beyond just the
    immediate. We want a plan that stands the test of time. Remember, the
    plan that Lyndon Johnson signed was pretty effective for four decades.
    We have a chance to do the same thing here in Washington, DC.
        I know that Congress is listening to the voices of the retired and
    near-retired. And I appreciate that very much. I appreciate the
    willingness throughout all the Federal Government to give our seniors
    and those living with disabilities the kind of options

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    they deserve, the kind of hearing that they want. We should not let
    another Medicare anniversary go by without modernizing the system,
    without giving our seniors--[applause].
        The Senate, I think, is getting ready to go out on the August
    vacation. We're certainly pulling for you to go out. [Laughter] The
    House is already gone. They're in their districts. They'll be listening
    to the people, and I know Americans who are concerned about this issue
    will want to make their voices heard. And we, of course, urge you to do
    so. We urge you to contact your Member of your House and your Senators
    and let them know your thoughts on Medicare reform. Let them know that
    we expect to plow through the doubts and the obstacles and get a good
    bill to the President's desk. My pen is ready. I'm ready to sign a good
    bill.
        I know that this August, staff members of the conference will be
    working. And for those staff members who are here, I want to thank you
    for grinding through a complex piece of legislation and working out your
    differences. And then when the Members come back, we'll have some heavy
    lifting to do. But I want to be there to help you carry the load.
        We've all come to Washington, those of us who have been elected to
    office, to serve something greater than ourself. And we have a duty and
    a call to not only describe a problem but to address it. And in this
    case, when we do, the lives of our fellow citizens will be improved.
        I want to thank you for your interest in this really important
    subject, thank the two Senators who have joined us today. I want to
    thank the members of my Cabinet who are here.
        May God bless you all, and may God continue to bless the United
    States of America.

    Note: The President spoke at 2:45 p.m. in the East Room at the White
    House. The Office of the Press Secretary also released a Spanish
    language transcript of these remarks.