    [Public Papers of the Presidents of the United States: George W. Bush (2003, Book II)]
    [October 29, 2003]
    [Pages 1410-1413]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on Medicare Reform Legislation
    October 29, 2003

        The President. Thank you all for coming. Good morning. Welcome to
    the White House. I'm glad you're here. We're meeting at an historic
    time, and the reason why is, after years of debate and deadlock, the
    Congress is on the verge of Medicare reform. And that's important.
    Prescription drug coverage for our seniors is within reach. Expanded
    coverage for preventive medicine and therapy is within our reach. More
    health care choices for seniors are within our reach.
        Though a few difficult issues remain, the Congress has made
    tremendous progress. And now is the time to finish the work. The
    Congress needs to finalize legislation that brings our seniors the best
    of modern medicine. I want to sign the legislation into law before the
    year is out.
        And the point person for this administration in working with the
    Congress to move the legislation along is Tommy Thompson, our Secretary. He has done a fabulous job. If he
    looks tired, it's because he's showing up early--[laughter]--and going
    to bed late, working for the seniors of America.
        I want to thank Tom Scully, who is the
    Administrator--Scully is the Administrator of the Centers for Medicare
    and Medicaid Services. I appreciate you coming.
        We've got other members of my administration who are concerned about
    the health of all Americans, including our seniors: Rich
    Carmona, the Surgeon General--thank you,
    General; the head of the Centers for Disease Control and Prevention,
    Julie Gerberding. Thank you, Julie, for
    being here. It's good to see you. The Director of the National
    Institutes of Health, Elias Zerhouni--Dr.
    Zerhouni is with us.
        We've got a lot of other important people here, too many to name.
    But I have just come from a roundtable discussion with some seniors and
    some people involved in the process, a corporate executive who is from
    Caterpillar, who assures me that corporations have no intention of--if
    there's a Medicare reform bill signed by me, corporations have no
    intention to what they call dump retirees into a system they don't want
    to be dumped into. And I appreciate that commitment by Rich
    Lavin. Thank you for bringing that up.
        I want to thank Jim Parkel from
    Fairfield, Connecticut, who is the president of the AARP, for being
    here. I appreciate my friend Jim ``Buddha'' Martin for being here today. He's very much concerned about the
    health of our citizens. And thank you all for coming. This is an
    important moment, as I said.

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        You see, the stories we heard remind Tommy and me that seniors depend upon Medicare and that the
    Medicare program is a basic trust that must be upheld throughout the
    generations. What we're talking about is trust, can people trust their
    Government to bring a modern system of health to our seniors. We made a
    commitment at the Federal level to provide good health care for seniors,
    and we must uphold that commitment. That's what we're here to discuss
    today, how best to do that.
        Each of the seniors that we talked about--talked to understands that
    the system needs improvement, that Medicare needs to be modernized. I'm
    determined to meet this responsibility.
        And let me share some of the stories we heard right quick. Neil
    LaGrow is with us. Neil, thank you. He takes 10
    medications, about $525 a month he spends. He pays for it all. Because
    of these costs, he continues to work, although I must say he didn't
    complain about it. [Laughter] He likes to work. We need our seniors
    working, by the way, in terms of making contributions to our society.
    I'm not talking about being on the factory floor for 8 hours, but I am
    talking about passing on values from one generation to the next or
    helping in different community activities as you see fit. It's a really
    important contribution to our country. Neil does that. If he gets some
    help with his prescription drug costs, it's going to make his retirement
    a little easier. [Laughter] Isn't that right?
        Mr. LaGrow. That's very right.
        The President. Seniors should be able to plan their retirement
    better. The best way to do so is to make sure that they can afford the
    medicines necessary to keep them healthy. That's what we're talking
    about in this bill.
        Joan Fogg is with us, from Richmond. She and
    her husband, Walter, are on Medicare, and they
    pay a goodly portion for drugs right out of their own pocket. ``When we
    think we're getting down on money, we go ahead and cut the medication in
    half.'' That's what she said. ``That's not the way it should be, but we
    deal with it. We have to.'' Joan is right, that's not the way it should
    be. That's why we want to modernize the system. That's why we want to
    work better for all seniors.
        Most American seniors and people with disabilities are grateful for
    the current Medicare system. Yet they understand the system has
    problems. Our job is to address those problems. We should carefully
    correct the problems. That's what we're elected to do. Medicare 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. Life is
    changing. Medicare is not.
        Many invasive surgeries are now unnecessary because of miraculous
    new prescription drugs. Most Americans have coverage for this new
    medicine. Three-quarters of seniors have some kind of drug coverage. But
    seniors relying exclusively on Medicare do not have coverage for most
    prescription drugs and many forms of preventative care. This is not
    good. It's not cost-effective medicine.
        Medicare today will pay for extended hospital stays for ulcer
    surgery, at a cost of about $28,000 per patient, and that's important
    coverage. Yet Medicare will not pay for the drugs that eliminate the
    cause of ulcers, drugs that cost about $500 a year. So we're going to be
    talking about cost savings; there's an example of cost savings.
        Medicare will pay many of the costs to treat a stroke, including
    bills from hospital and rehab center, doctors, home health aides, and
    outpatient care. Those costs can run more than $100,000, and this is
    essential coverage. Yet Medicare does not cover the blood-thinning drugs
    that could prevent strokes, drugs that cost less than $1,000 a year.
        The Medicare system has many strengths. Yet it is often slow to
    respond to dramatic changes in medicine. It took

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    more than a decade and an act of Congress to get Medicare to cover
    preventative breast cancer screenings. It took 10 years and then an act
    of Congress to change the system. That's not a good system. Our seniors
    should not have to wait for an act of Congress for improvements in their
    health care.
        The best way to provide our seniors with modern medicine, including
    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 by offering better coverage at more
    affordable prices.
        The choices we support include the choice of making no change at
    all. I understand some seniors don't want to change, and that's
    perfectly sensible. If you're a senior who wants to stay in the current
    Medicare system, you'll have that option, and you'll gain a prescription
    drug benefit. That's what the reform does.
        If you're a senior who wants enhanced benefits, such as coverage for
    extended hospital stays or protection against high out-of-pocket
    expenses, you'll have that choice. If you liked managed care plans, that
    option will be there. If you're a low-income senior, you will receive
    extra help each month and more generous coverage, so you can afford a
    Medicare option that includes prescription drug benefits.
        We're applying a basic principle: Seniors should be able to choose
    the kind of coverage that works best for them, instead of having that
    choice made by the Government. Every Member of Congress gets to choose a
    health coverage plan that makes the most sense for them. So does every
    Federal employee. If this kind of coverage is good enough for the United
    States Congress, it's good enough for America's seniors.
        For seniors without any drug coverage now, these reforms will make a
    big difference in their lives. In return for a monthly premium of about
    $35, or a dollar a day, those seniors now without coverage would see
    their drug bills cut roughly in half. A senior who has no drug coverage
    now and monthly drug costs of $200 a month would save more than $1,700
    on drug costs each year. A senior with monthly drug costs of $800 would
    save nearly $5,900 on drug costs each year. Those are important savings,
    help change people's lives in a positive way.
        I'm optimistic the House and the Senate negotiators will produce a
    bill that brings real savings to millions of seniors and real reform to
    Medicare. Once the legislation is passed, it will take some time to put
    into place. During this period, we'll provide all seniors with a
    Medicare-approved drug discount card that saves between 10 to 25 percent
    off the cost of their medicines. So they'll have a start to see savings
    immediately.
        Low-income beneficiaries will receive a $600 subsidy along with
    their discount card to help them purchase their prescription medicines.
    The legislation Congress passes must make sure that the prescription
    drug coverage provided to many retirees by their employers is not
    undermined. That's what Rick and I just
    discussed. Medicare legislation should encourage employers to continue
    benefits, while also extending drug coverage to the millions of Medicare
    beneficiaries who now lack it.
        These steps will strengthen Medicare, not only for today's seniors
    but for tomorrow's retirees. Many workers are counting on Medicare to
    provide good health care coverage in their retirement. That's what
    people are counting on. These reforms will give our workers confidence
    that Medicare will serve them with the very best of modern medicine.
        The budget I submitted earlier this year commits an additional $400
    billion over 10 years to implement this vision of a stronger Medicare
    system. We're keeping our commitments to the seniors of today. We must
    pursue these reforms so that our Medicare system can serve future
    generations of Americans.

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        The time to improve our Medicare system has come. Now is the time. I
    urge America's seniors to speak up, to call and write your
    representatives to urge them to work out a final bill. Speak up for
    prescription drug coverage. Speak up for health care choices. Speak up
    for a modern Medicare system that puts patients and doctors in charge.
        I urge the Congress to act quickly, to act this year, not to push
    this responsibility to the future. We have the opportunity--we have the
    obligation to give seniors more choices and better benefits. We have
    come far, and now is the time to finish the job.
        Thank you for coming. Appreciate it. Good to see you all. Thank you
    all.

    Note: The President spoke at 11:06 a.m. in Room 450 in the Dwight D.
    Eisenhower Executive Office Building. In his remarks, he referred to
    Richard P. Lavin, vice president, Human Services Division, Caterpillar
    Inc.; and Jim Martin, president, 60 Plus Association. The Office of the
    Press Secretary also released a Spanish language transcript of these
    remarks.