[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

[[Page 1412]]

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.