[Public Papers of the Presidents of the United States: George W. Bush (2003, Book II)]
[November 25, 2003]
[Pages 1625-1631]
[From the U.S. Government Publishing Office www.gpo.gov]


[[Page 1625]]


Remarks at the Los Olivos Senior Center in Phoenix, Arizona
November 25, 2003

    Thanks for coming. I'm thrilled to be at Los Olivos Center. You're 
kind to have me. And I'm here to talk about some issues facing our 
Nation, probably an issue you'd like to hear about, which is Medicare. I 
think you probably have heard of Medicare. [Laughter] I think you 
probably recognize that Medicare needs to be modernized and reformed so 
it works better for you.
    The United States House of Representatives, the United States Senate 
recently took historic action to modernize and to strengthen the 
Medicare system so it works for you. I'm here to tell you, I look 
forward to signing a good piece of legislation which says that our 
country will keep our commitment to today's seniors and prepare to 
receive tomorrow's seniors into Medicare--people like me--[laughter]--
with a system that's modern and strong.
    You know, our job in Washington is to tackle problems when we see 
them, not to pass them on to future Congresses or future Presidents or 
future generations. I want to thank the Members of Congress for taking 
on this very difficult issue. I appreciate them for their hard work. 
Medicare has worked for many people. It got a little old. It got a 
little tired. It needed to be changed. We changed it, and the system is 
better for it.
    The Members of Congress who are here, I appreciate them coming. 
Senator Jon Kyl is one of the fine Members of the 
United States Senate. Congressman Rick Renzi, 
he's from the north; Trent Franks is from the 
north--Congressman Franks, and Josie, his 
wife, is with him; J.D. Hayworth--I don't know 
if you've ever heard of J.D., but--[applause]. They're fixing to call 
J.D. ``Slim,'' ``Slim'' Hayworth. [Laughter] Jeff Flake is with us. Jeff, I'm honored you're here. Congressman 
Jim Kolbe from Tucson, Arizona, is with us. I'm 
honored. These are all fine Members of the United States Congress. I've 
enjoyed working with them all. They're good, honest men who care deeply 
about the citizens of the State of Arizona.
    I appreciate Jan Brewer, who is the 
secretary of state of the great State of Arizona, with us. Your mayor is 
with us, Skip Rimsza. I'm honored, Mr. Mayor, 
that you're here. My only advice to the mayor is to make sure you fill 
the potholes. [Laughter] He's been doing a great job of filling the 
potholes for the people of Phoenix, Arizona. It's a--I know he's fixing 
to leave office, but I--the people of this city owe him a debt of 
gratitude for nearly 10 years of great service, great honest public 
service.
    I want to thank Cindy McCabe, who is the 
executive director of this fine center. I really appreciate you and your 
staff putting on this event. It's not easy to have the President come. 
You know, these entourages are quite big--[laughter]--a lot of people 
roaming around when the President is here. But the center has done a 
fabulous job of welcoming us, and I'm really glad I came.
    Mark McClellan is with me. He's a 
Texan, kind of like I am. And he's the Commissioner of the Food and Drug 
Administration, the FDA. He's got a huge responsibility, and he's doing 
a really good job. I appreciate you coming, Commissioner. I'm honored 
you're here.
    You know, a lot of times people talk about the strength of America, 
and they think in terms of the number of airplanes we might have or, you 
know, look, the number of soldiers in uniform or the size of our 
wallets, but that's really not the strength of our country. The strength 
of America is the hearts and souls of the American people. You think 
about it. That's what makes this country incredibly strong. It's the 
fact that people are willing to reach

[[Page 1626]]

out to a neighbor in need. I call them soldiers in the army of 
compassion. That's the most important army here in America, in many 
ways, when you think about it.
    I met a soldier. She's probably a general, although she would call 
herself a simple private. That would be Maybelle Harris. Maybelle, where are you? There she is, Maybelle. 
She's a Sunshine Lady for AARP. She sends cards to people who are 
celebrating and/or mourning the loss of a loved one. In other words, she 
understands that there's a special responsibility for those of us who 
are fortunate in this country to help people who might have a hurt in 
their heart.
    Maybelle is, since '82--has been a 
member of the Gold Star Wives club. This is an organization dedicated to 
assisting widows of military servicemen. Maybelle, I want to thank you 
for your compassion. I want to thank you for the example you have set. 
You make it clear that America can change, one heart, one soul, one 
conscience at a time. And you set a fine example for--particularly 
people coming up here in America--that in order to be a solid citizen, 
love your neighbor just like you'd like to be loved yourself. I 
appreciate your example, Maybelle.
    We've got the world's greatest health care system. I hope you 
understand that. I say that with certainty. We've got the best docs in 
the world. We've got fabulous nurses. We've got wonderful facilities for 
people to go to. We've got wonderful research in America. I mean, if you 
really think about the research we do in this country, the lifesaving 
research, the pharmaceutical drugs that change people's lives in a 
positive way, it is--you understand when I say we've got the best health 
care system in the world.
    And we need to keep it that way. We need to make sure it continues 
to be the best health care system in the world. A lot of that has to do 
with honoring our obligation to our seniors and to make sure the 
Medicare system works well. Some it has to do with making sure that we 
don't have too many lawsuits in our society, which runs good doctors out 
of practice and runs up the cost of medicine, that makes it hard for 
people to get good health care.
    I believe we need medical liability reform at the Federal level, 
medical liability reform which will say, ``If you get harmed by a bad 
doctor, you ought to have your day in court.'' Of course you ought to be 
able to sue. But we've got to get rid of these frivolous lawsuits that 
cause our docs to practice defensive medicine, which runs up your cost 
of medicine and runs some doctors out of practice. This country needs 
national medical liability reform.
    I want to thank Kyl and the Members of the House 
for supporting these measures. We got a good bill out of the House. It's 
stuck in the Senate. [Laughter] Some Members of the Senate must 
understand--and by the way, your Senators don't need this message, but 
some--maybe in some neighboring States they need it. No one has ever 
been healed by a frivolous lawsuit in our society. For the sake of good 
health care, for the sake of keeping our docs in practice, and for the 
sake of making sure our customers, the patients of America, have health 
care that's available and affordable, we need medical liability reform 
at the Federal level.
    We need to make sure we've got a Medicare system that works. It's 
first important to recognize that Medicare is a basic trust between our 
Federal Government and our citizens. The Federal Government said, 
starting in 1965, this is our responsibility to make sure our seniors 
get a health care system that works. And therefore, we have a Federal 
responsibility to make sure that the health care system is the best we 
can possibly come up with through law for our seniors.
    Part of making sure American health care works is to make sure 
Medicare is modern, and that's what the bill I am going to sign does. It 
changes the Medicare system,

[[Page 1627]]

which needed to be changed. Medicare has not kept up with the advances 
of modern medicine. That's a fact. And we have a choice in Washington to 
ignore that fact or to deal with that fact.
    When Medicare was passed in '65, health care meant house calls, 
surgery, and long hospital stays. And that's how the Medicare system was 
designed, to deal with that type of medicine. Medicine has changed. 
Modern medicine now means preventative care, which is not a part of 
Medicare, outpatient procedures, at-home care. In other words, medicine 
changed. Invasive surgeries are now unnecessary because of miraculous 
new prescription drugs that have been developed. Think about how much 
medicine changed since 1965. Medicare didn't change with it.
    You know, most Americans have coverage for new forms of health care. 
That's the fact. But seniors who rely exclusively on Medicare do not, 
and that's why we needed to change the system. Medicine changed. 
Medicare hadn't. The Congress dealt with it, and now we can say Medicare 
is modern. And that's important change for the health care and for 
quality of life for our citizens.
    I'm sure you've heard some question the need to change the system. I 
will give you an example of why we needed to change it. It's a clear 
example of why we need to change it. Medicare will pay $28,000 for a 
needed hospital stay for ulcer surgery. Yet it will not pay for the $500 
for the anti-ulcer drugs that would keep the senior out of the hospital 
in the first place. Now, that doesn't make any sense to me. See, we'll 
pay the $28,000, but we won't pay the $500 to keep from having to pay 
the $28,000 in the first place, see. We needed to change the system. 
Medicare ought to cover medications that will keep our seniors from 
getting sick in the first place. And yet it doesn't for those who rely 
exclusively on Medicare.
    Medicare was not quick to change as medicine changed. After all, 
there was a bureaucracy that had to make the decisions. Bureaucracies 
don't move very fast; they're slow. Bureaucracies are cumbersome. Many 
times, it took a law from the Congress to change what was covered under 
Medicare, and getting laws out of Congress sometimes aren't easy either. 
It's a cumbersome process. It's not a very good system. Private plans 
were able to adjust quickly. Private plans were able to meet a 
consumer's demand. Medicare was stuck, see. It just wouldn't change.
    And so one of the things we've done in this new bill and this new 
system is we recognize that seniors are plenty capable of making 
choices, that a senior is able to choose. A senior is plenty capable of 
being able to say, ``Here are the pros and cons of these very plans, and 
I want to take this plan that matches my needs.''
    One way to get Medicare to change is to give seniors choices. See, 
Congress has got choices. If you've got a health care plan for the 
Congress, you can say, ``I like this plan,'' or ``I like that plan,'' or 
``I might want this.'' But in Medicare, the old Medicare system, you 
didn't have that choice. And therefore, the delivery of certain 
procedures and technologies were slow in coming, and that's not right. 
The system was stuck in the past, and we needed to do something about 
it.
    And our job in Washington is to solve problems, not pass them on. 
And that's what we did. This is a good piece of legislation, important 
reform. It will take about 2 years to get the reforms in place. It's a 
complex--listen, when you change something that's been in effect since 
1965 by legislation, it's--there's a lot of print, a lot of pages. It 
was a hard piece of work, don't get me wrong. And so it's going to--
there's going to be a transition period.
    But Congress wisely said, ``We've got to do something during the 
transition period,'' and what that is, is that seniors will be given a 
health care card, a prescription drug card that you'll be able to use 
and be able to get a discount of up to 10 to

[[Page 1628]]

25 percent on the drugs you now currently take. That's a positive 
development. You will get a card within 6 months, a discount card that 
will allow you to take it to where you're buying your drugs, and you'll 
get a discount. Plus, if you're a low-income senior, you'll get $600 a 
year as a credit on that card to help you buy drugs.
    Congress was wise in helping with the transition. Congress was smart 
to enable people to better afford prescription drugs, since prescription 
drugs is the newest form of medicine relative to the past. When the full 
drug benefit arises in 2006, all seniors will be eligible for 
prescription drug coverage for a monthly premium of about $35. The 
result is that for most seniors without coverage today, the Medicare 
drug plan will cut their annual drug bills roughly in half. That's 
positive for our seniors who are relying upon prescription drugs. 
Seniors with the highest drug bills, of course, will save the most. 
Seniors with the greatest need will get the most help.
    Low-income seniors will pay a reduced premium or no premium at all 
and lower or no copayments for their medicines. Congress wisely said, 
``We want to help the lowest-of-income seniors have a modern Medicare 
system with no premium and no copayments in certain cases.'' And I 
appreciate Congress for the compassion.
    John Bajusz is with us. He's on the stage. I 
just had a--by the way, some of these people here and I had a wonderful 
visit about their current desires and needs and frustrations and worries 
about their status, particularly with health care. John has high 
prescription drug costs. He's on a Medicare HMO that provides about $100 
in drug coverage a month. But he spends about $500 to $600 a month. That 
probably sounds familiar to some of you all. You're on a program that 
helps a little bit. Under the law that I'm going to sign, he will save 
up to about $2,000 a year in his drug costs. That helps John, at least 
that's what John told me. [Laughter] I take his word for it.
    See, we're helping John. We're helping John 
with a modern Medicare system. He's out of pocket $500 to $600 a month. 
If you say he spends 6 and nets 100, it's about $500 a month. He's going 
to save $2,000. That will come in plenty handy. There's a lot of Johns 
around America who this bill will help in a very positive way.
    Under the new reforms, as I told you, seniors will have choices. 
That's an important part of the bill. We want you to have choices. 
Earlier today I was in Las Vegas, and I met with a couple. The man said, 
``You know, my wife and I, before we chose our Medicare+Choice plan''--
maybe some of you are on that plan--``before we chose that plan, we 
weighed out the pros and the cons. I listed the pros and the cons for a 
variety of policies, and we picked Medicare+Choice.'' My point to you 
is, is that he spent a lot of time trying to figure out what was best 
for him and his wife. I'm sure some of you do that as well. That's what 
we want. We want people to be able to have that choice.
    Now, I fully understand some on Medicare don't want to choose at 
all. Some people that are on the current system like where they are, and 
they're frightened by change. And that's realistic. That's reasonable. I 
can understand that. And so could the Congress. And so we said that if 
you want to stay on Medicare, you can, traditional Medicare. But now 
we'll have a prescription drug benefit for the first time. And that's 
important. It's important to recognize that change sometimes isn't a 
part of somebody's future.
    But a lot of people want to choose. And choice is important. See, 
some people will want expanded coverage for hospital stays or protection 
against high out-of-pocket medical expenses. People ought to be able to 
pick a plan. And when people pick a plan and they start choice, then 
it's amazing what happens. The plans start meeting the needs of the 
consumer, not the whims of somebody in Washington, DC, who gets to

[[Page 1629]]

make the decision for you. That's an important part of this bill. This 
bill introduces choice for our seniors.
    I met with the Weavers today, Glenn and Marjorie, from Sun City. They are on 
Medicare+Choice. They like the plan. See, they picked it out. They said, 
``This plan meets our needs.'' They want to stay on it. The Government 
was starving Medicare+Choice for awhile. One of the positive aspects 
about the bill I'm going to sign funds Medicare+Choice so people like 
the Weavers have got this plan available for them.
    I met with Dick and Willa 
Key. They were here. They are not retired. They are near retired. They 
want prescription drug coverage. They want choices. See, they like the 
way this bill is modeled, because their view is--and I share this view--
the more choices available for our American citizens, the more likely it 
is the health care system will meet their needs, and this bill provides 
that. Make no mistake about it, it recognizes that the decisionmaker in 
this process should be you, the American consumer.
    There are other reforms I want to mention briefly. Under the new 
law, when seniors sign up for Medicare, they will get a complete health 
examination so doctors can know their health needs right from the start. 
That was very practical by Congress to do that. It seems like to make 
sense to me that it's very important to diagnose problems early so you 
can solve them. And so Medicare now, for the first time, will have a 
complete health examination available for people who sign up. There's 
obviously an emphasis on preventative care, and that's important.
    The bill provides incentives for companies to keep existing coverage 
for their retirees. I'm sure some of you have worked hard and worked for 
a private concern, and you've got a health care plan now. And the bill 
makes sure that that's a health care plan is still available for you, as 
best as we possibly can. We don't want people saying, ``Well, gosh, the 
Federal Government has now modernized Medicare; we don't have an 
obligation any more. Go to the Government.'' So Congress did a good job 
of addressing this issue, and I appreciate that.
    Every American, old and young, will be able to have what's called a 
health savings account. That makes a lot of sense. People ought to be 
able to put money aside tax-free to help their families with medical 
expenses, not only current medical expenses but future medical expenses. 
The health savings accounts will be set up to encourage people to choose 
healthy lifestyle choices. When you've got your own money out there for 
your health care that you can see on a daily basis, all of a sudden, you 
start making better choices with your life.
    And these health savings accounts are not only important for 
seniors, but they're also important for younger workers as well to be 
able to utilize. Congress wisely put these in place. Health savings 
accounts not only will encourage people to make right choices but will 
make--will help maintain the doctor-patient relationship, which is a 
vital part of a effective and excellent health care system.
    The bill helps rural hospitals. Hospitals in Phoenix don't qualify 
as rural--[laughter]--but some of these Congressmen represent rural 
hospitals. And this bill wisely helps them continue to be a vital part--
to serve the vital part of our country, which is the good folks living 
in rural America. The bill sets up fair reimbursement rates for doctors 
serving Medicare patients. This is a good bill, is what I'm telling you. 
It's an historic achievement. It's a bipartisan achievement.
    See, year after year, the problems in the Medicare system were 
studied and debated, and then nothing ever got done. As a matter of 
fact, Medicare in the political parlance wasn't ``Medicare''; it's 
called ``Medi-scare.'' [Laughter] People were scared to talk about 
Medicare for fear of a political backlash. And so the problems just 
festered, and the system got out of date, and

[[Page 1630]]

people weren't getting the health care that they deserved. And the 
Federal Government was not fulfilling its obligation to our seniors, and 
that was wrong.
    And so we moved. We moved in spite of the fact that some up there in 
Washington said that nothing could get done, that it was impossible to 
make reforms. But we acted. And we acted on some solid principles, 
providing new treatments and choices for our seniors, provide 
prescription drug coverage, keep the commitment of Medicare to better 
the lives of America's seniors for not only this generation but 
generations to come.
    That's what we're doing in Washington, DC, and it was hard work. It 
really was. It was a lot of debate and sharp elbows and a lot of 
political dialog. But the Members focused on the most important job of 
all, and that was working for the people, working to make sure that we 
fulfilled our promise. I'm honored to sign this bill. I'm looking 
forward to it. It's a historic piece of legislation. It wasn't perfect, 
but I haven't found a piece of legislation that's perfect yet. 
[Laughter] But we're improving the system, and I can say to the Members, 
``Job well done.''
    I also want to talk a little bit about our national defense. My job 
is to address problems at home, whether it be the economy or health 
care, whether it be medical liability reform, and to work with the 
Congress to get things done. My job as well is to protect the American 
people. It's a solemn responsibility, and I accept it. And I want to 
thank the Members of Congress for joining me in this important task. 
See, I'm not going to forget the lessons of September the 11th, 2001. 
Our life changed that day, didn't it? It really did.
    When we were growing up--when old Senator Kyl 
and I were growing up, we used to think oceans could protect us. We used 
to think America could pick or choose where we--how to deal with a 
gathering threat. You know, if we saw a threat here, we may choose to 
deal with it or ignore it, because we felt pretty safe here at home. We 
felt like the enemy could never get to us. They tried on--they hit us 
pretty hard on Pearl Harbor, but kind of--in our own mind, if the truth 
be known, we thought that it isn't going to happen again.
    And September the 11th, 2001, came, and it happened. It happened in 
one of our great cities. Thousands of people lost their life. I vowed 
that day to never forget the lessons. We will do everything we can to 
protect our people at home, but the best way to protect our people is to 
chase these killers down and to bring them to justice. The best way to 
protect our homeland is to deny them sanctuary in countries that might 
allow them to train or provide them with weapons or training. The best 
way to protect our homeland is to work with allies and friends who 
understand the call to history and to share intelligence and to find 
them.
    And that's what we're doing. Yesterday I went to Fort Carson, 
Colorado. I had the honor of addressing about 6,000 members of our 
military and their families. The military spirit is high. They 
understand their responsibilities. I had the chance to thank them for 
their service to our country, to stand in harm's way. I appreciated so 
very much their sacrifices in Afghanistan and Iraq.
    You see, the issue in Iraq is not only our own security short-term. 
By removing Saddam Hussein, America is safer. 
So is the neighborhood. But the long-term issue is to make sure, in the 
heart of the Middle East, democracy and freedom reign. And that's 
important for peace. It's essential for peace in the world. Free 
countries are peaceful countries. People who live in freedom are people 
that are peaceful people. Free countries don't develop weapons to hurt 
their neighbors. Free countries focus on the aspirations of their 
citizens, the hopes of their citizens.
    And so we've got a hard task ahead of us in Iraq. But I just want to 
assure you that we will stay the course; we will do

[[Page 1631]]

the job; we will not be intimidated by thugs and killers who will kill 
innocent Iraqis or try to kill our coalition troops to force us out, 
because I truly believe that when we succeed, we will leave behind a 
more peaceful world.
    Many of you have served our country, and you can understand what I'm 
about to tell you: Freedom is precious. Freedom is inherent in our soul. 
Freedom is not America's gift to the world; freedom is the Almighty's--
Almighty God's gift to every person who lives in this world. We will 
work to protect ourselves, but we'll also work to free people who have 
been enslaved by tyranny, free those who live in a country where they 
get tortured if they speak out. We love freedom in America. We will 
never forget our love for freedom. Our foreign policy is based upon 
freedom and peace, and we'll succeed.
    Thank you all very much. God bless.

Note: The President spoke at 4:33 p.m. In his remarks, he referred to 
Mayor Skip Rimsza of Phoenix, AZ; and former President Saddam Hussein of 
Iraq.