    [Public Papers of the Presidents of the United States: George W. Bush (2003, Book II)]
    [December 8, 2003]
    [Pages 1694-1698]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks on Signing the Medicare Prescription Drug, Improvement, and
    Modernization Act of 2003
    December 8, 2003

        Good morning. Thanks for the warm welcome. In a few moments I will
    have the honor of signing an historic act of Congress into law. I'm
    pleased that all of you are here to witness the greatest advance in
    health care coverage for America's seniors since the founding of
    Medicare.
        With the Medicare Act of 2003, our Government is finally bringing
    prescription drug coverage to the seniors of America. With this law,
    we're giving older Americans better choices and more control over their
    health care, so they can receive the modern medical care they deserve.
    With this law, we are providing more access to comprehensive exams,
    disease screenings, and other preventative care, so that seniors across
    this land can live better and healthier lives. With this law, we are
    creating Health Savings Accounts. We do so so that all Americans can put
    money away for their health care tax-free.
        Our Nation has the best health care system in the world, and we want
    our seniors to share in the benefits of that system. Our Nation has made
    a promise, a solemn promise to America's seniors. We have pledged to
    help our citizens find affordable medical care in the later years of
    life. Lyndon Johnson established that commitment by signing the Medicare
    Act of 1965. And today, by reforming and modernizing this vital program,
    we are honoring the commitments of Medicare to all our seniors.
        The point man in my administration on this issue was Secretary Tommy
    Thompson, and he and his team did a
    fabulous job of working with the Congress to get this important piece of
    legislation passed. Tommy, I want to thank you for your leadership.
        This bill passed the Congress because of the strong leadership of a
    handful of Members, starting with the Speaker of the House, Denny
    Hastert. Mr. Speaker was joined by Senator
    Bill Frist, the Senate majority leader of the
    Senate, in providing the leadership necessary to get this bill done. I
    want to thank you both.
        I appreciate the hard work of the House majority leader, Tom
    DeLay, in seeing that this bill was passed. I also
    appreciate the hard work of the chairman of the Ways and Means
    Committee, Chairman Bill Thomas, for his
    good work. The chairman of the Finance Committee in the Senate, Senator
    Chuck Grassley, did a noble job, and he
    was joined in this task by the ranking member of the Finance Committee,
    Senator Max Baucus of Montana.

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        And the entire Senate effort was boosted by the efforts of a man
    from Louisiana, Senator John Breaux. And
    speaking about Louisiana, Billy Tauzin
    of the House of Representatives did great work on this bill. Senator
    Orrin Hatch from Utah made a significant
    contribution. Nancy Johnson, the House
    Member from Connecticut, did a great job. Mike Bilirakis from Florida worked hard on this piece of
    legislation. I want to thank all the other Members of the Congress and
    the Senate who have joined us. Thank you all for taking time out of your
    busy schedules to share in this historic moment.
        I appreciate Tom Scully, the
    Administrator of the Centers for Medicare & Medicaid Services, for his
    good work. The Director of the CDC, Julie Gerberding, is with us today. Julie, thank you for coming. The Food
    and Drug Administration Commissioner, Mark McClellan, is here. Jo Anne Barnhart,
    the Commissioner of the Social Security Administration, is with us.
    Thank you for coming, Jo Anne. Kay James,
    who is the Director of the Office of Personnel Management, is with us.
    Thank you for coming, Kay.
        A lot of this happened--this bill happened because of grassroots
    work. A lot of our fellow citizens took it upon themselves to agitate
    for change, to lobby on behalf of what's right. We had some Governor
    support around the country. Governor Craig Benson from New Hampshire is with us today. Governor, thank
    you for coming.
        But the groups that speak for the elderly did fantastic work on this
    legislation. See, there was a lot of pressure not to get something
    done--for the wrong reasons, I might add. But Bill Novelli, the CEO of AARP, stood strong in representing the
    people he was supposed to represent and worked hard to get this
    legislation passed. And Bill, I want to
    thank you for your leadership. And you were joined by Jim
    Parkel, who is the president of the AARP.
    Jim, I want to thank you as well for doing what was right, for focusing
    on the needs of the seniors of our country.
        Jim Martin, the president of 60 Plus
    Association, worked hard. Charlie Jarvis,
    the chairman and CEO of United Seniors Association, worked hard. Mike
    Maves, the executive vice president and CEO
    of the AMA, worked hard on this piece of legislation. Mary
    Martin, the chairman of the board of the Seniors
    Coalition, worked hard. The truth of the matter is, a lot of good people
    worked hard to get this important legislation done, and I thank you for
    your work.
        Medicare is a great achievement of a compassionate Government, and
    it is a basic trust we honor. Medicare has spared millions of seniors
    from needless hardship. Each generation benefits from Medicare. Each
    generation has a duty to strengthen Medicare, and this generation is
    fulfilling our duty.
        First and foremost, this new law will provide Medicare coverage for
    prescription drugs. Medicare was enacted to provide seniors with the
    latest in modern medicine. In 1965, that usually meant house calls or
    operations or long hospital stays. Today, modern medicine includes
    outpatient care, disease screenings, and prescription drugs. Medicine
    has changed, but Medicare has not--until today.
        Medicare today will pay for extended hospital stays for ulcer
    surgery; that's at a cost of about $28,000 per patient. Yet Medicare
    will not pay for the drugs that eliminate the cause of most ulcers,
    drugs that cost about $500 a year. It's a good thing that Medicare pays
    when seniors get sick. Now, you see, we're taking this a step further:
    Medicare will pay for the prescription drugs so that fewer seniors will
    get sick in the first place.
        Drug coverage under Medicare will allow seniors to replace more
    expensive surgeries and hospitalizations with less expensive
    prescription medicine. And even more important, drug coverage under
    Medicare will save our seniors from a lot of worry. Some

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    older Americans spend much of their Social Security checks just on their
    medications. Some cut down on the dosage to make a bottle of pills last
    longer. Elderly Americans should not have to live with those kinds of
    fears and hard choices. This new law will ease the burden on seniors and
    will give them the extra help they need.
        Seniors will start seeing help quickly. During the transition to the
    full prescription benefit, seniors will receive a drug discount card.
    This Medicare-approved card will deliver savings of 10 to 25 percent off
    the retail price of most medicines. Low-income seniors will receive the
    same savings plus a $600 credit on their cards to help them pay for the
    medications they need.
        In about 2 years, full prescription coverage under Medicare will
    begin. In return for a monthly premium of about $35, most seniors
    without any prescription drug coverage can now expect to see their
    current drug bills cut roughly in half. This new law will provide 95-
    percent coverage for out-of-pocket drug spending that exceeds $3,600 a
    year. For the first time, we're giving seniors peace of mind that they
    will not have to face unlimited expenses for their medicine.
        The new law offers special help to one-third of older Americans with
    low incomes, such as a senior couple with low savings and an annual
    income of about $18,000 or less. These seniors will pay little or no
    premium for full drug coverage. Their deductible will be no higher than
    $50 per year, and their copayment on each prescription will be as little
    as $1. Seniors in the greatest need will have the greatest help under
    the modernized Medicare system.
        I visited with seniors around the country and heard many of their
    stories. I'm proud that this legislation will give them practical and
    much needed help. Mary Jane Jones from
    Midlothian, Virginia, has a modest income. Her drug bills total nearly
    $500 a month. Things got so tight for a while she had to use needles
    twice or 3 times for her insulin shots. With this law, Mary Jane won't
    have to go to such extremes. In exchange for a monthly premium of about
    $35, Mary Jane Jones would save nearly $2,700 in annual prescription
    drug spending.
        Hugh Iverson from West Des Moines, Iowa,
    just got his Medicare membership. And that's a good thing, because he
    hasn't had health insurance for more than 3 years. His drug bills total
    at least $400 a month. Within 2 years, with the $35-a-month coverage, he
    will be able to cut those bills nearly in half, saving him about $2,400
    a year.
        Neil LaGrow from Culpeper, Virginia, takes
    15 medications, costing him at least $700 a month. To afford all those
    medications, Neil has to stay working. And thanks to this law, once he
    is enrolled in the drug benefit, he will be able to cut back his work
    hours and enjoy his retirement more because he'll have coverage that
    saves him about $4,700 a year.
        I promised these seniors when I met with them that we would work
    hard to give them the help they need. They are all here today. So I am
    happy to report to them in person: Mary Jane, Hugh, and Neil, we are keeping our promise.
        In addition to providing coverage for prescription drugs, this
    legislation achieves a second great goal. We're giving our seniors more
    health care choices, so they can get the coverage and care that meets
    their needs. Every senior needs to know, if you don't want to change
    your current coverage, you don't have to change. You're the one in
    charge. If you want to keep your Medicare the way it is, along with the
    new prescription benefit, that is your right. If you want to improve
    benefits, maybe dental coverage or eyeglass coverage or managed care
    plans that reduce out-of-pocket costs, you'll be free to make those
    choices as well.
        And when seniors have the ability to make choices, health care plans
    within

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    Medicare will have to compete for their business by offering higher
    quality service. For the seniors of America, more choices and more
    control will mean better health care. These are the kinds of health care
    options we give to the Members of Congress and Federal employees. They
    have the ability to pick plans to--that are right for their own needs.
    What's good for Members of Congress is also good for seniors. Our
    seniors are fully capable of making health care choices, and this bill
    allows them to do just that.
        A third purpose achieved by this legislation is smarter medicine
    within the Medicare system. For years, our seniors have been denied
    Medicare coverage--have been denied Medicare coverage for a basic
    physical exam. Beginning in 2005, all newly enrolled Medicare
    beneficiaries will be covered for a complete physical.
        The Medicare system will now help seniors and their doctors diagnose
    health problems early, so they can treat them early and our seniors can
    have a better quality life. For example, starting next year, all people
    on Medicare will be covered for blood tests that can diagnose heart
    diseases. Those at high risk for diabetes will be covered for blood
    sugar screening tests. Modern health care is not complete without
    prevention, so we are expanding preventive services under Medicare.
        Fourth, the new law will help all Americans pay for out-of-pocket
    health costs. This legislation will create health savings accounts,
    effective January 1, 2004, so Americans can set aside up to $4,500 every
    year, tax-free, to save for medical expenses. Depending on your tax
    bracket, that means you'll save between 10 to 35 percent on any costs
    covered by money in your account. Our laws encourage people to plan for
    retirement and to save for education. Now the law will make it easier
    for Americans to save for their future health care as well.
        A health savings account is a good deal, and all Americans should
    consider it. Every year, the money not spent would stay in the account
    and gain interest tax-free, just like an IRA. And people will have an
    incentive to live more healthy lifestyles because they want to see their
    health savings account grow. These accounts will be good for small-
    business owners and employees. More businesses can focus on covering
    workers for major medical problems such as hospitalization for an injury
    or illness. And at the same time, employees and their families will use
    these accounts to cover doctors visits or lab tests or other smaller
    costs. Some employers will contribute to employee health accounts. This
    will help more American families get the health care they need at the
    price they can afford.
        The legislation I'm about to sign will set in motion a series of
    improvements in the care available to all America's senior citizens. And
    as we begin, it is important for seniors and those approaching
    retirement to understand their new benefits. This coming spring, seniors
    will receive a letter to explain the drug discount card. In June, these
    cards, including the $600 annual drug credit for low-income seniors,
    will be activated. This drug card can be used through the end of 2005.
    In the fall of that year, seniors will receive an information booklet
    giving simple guidance on changes in the program and the new choices
    they will have. Then in January of 2006, seniors will have their new
    coverage, including permanent coverage for prescription drugs.
        These reforms are the act of a vibrant and compassionate Government.
    We show our concern for the dignity of our seniors by giving them
    quality health care. We show our respect for seniors by giving them more
    choices and more control over their decisionmaking. We're putting
    individuals in charge of their health care decisions. And as we move to
    modernize and reform other programs of this Government, we will always
    trust individuals and their decisions and put personal choice at the
    heart of our efforts.

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        The challenges facing seniors on Medicare were apparent for many
    years, and those years passed with much debate and a lot of politics and
    little reform to show for it. And that changed with the 108th Congress.
    This year we met our challenge with focus and perseverance. We
    confronted problems, instead of passing them along to future
    administrations and future Congresses. We overcame old partisan
    differences. We kept our promise and found a way to get the job done.
    This legislation is the achievement of Members in both political
    parties. And this legislation is a victory for all of America's seniors.
        Now I'm honored and pleased to sign this historic piece of
    legislation, the Medicare Prescription Drug, Improvement, and
    Modernization Act of 2003.

    Note: The President spoke at 11:10 a.m. at DAR Constitution Hall. H.R.
    1, approved December 8, was assigned Public Law No. 108-173. The Office
    of the Press Secretary also released a Spanish language transcript of
    these remarks.