[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.

[[Page 968]]

    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

[[Page 969]]

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.

[[Page 970]]

    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

[[Page 971]]

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.