    [Public Papers of the Presidents of the United States: George W. Bush (2004, Book I)]
    [June 14, 2004]
    [Pages 1038-1044]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks in a Discussion at the Liberty Community Center in Liberty
    June 14, 2004

        The President. Thank you very much. Thanks for coming. We're glad to
    be in Liberty, aren't we? What a great town. Gosh, I want to thank the
    citizens for lining the street and waving to us coming in. [Laughter] I
    really appreciate it. Mr. Mayor--I know the mayor is here, Steve
    Hawkins. Mayor, thank you for--please
    thank the citizens of your city for being so kind, and it's really great
    to be here.
        You're wondering why I'm on stage with some local citizens,
    important Washington, DC-type personalities--[laughter]--it's because
    we're going to talk about something really important that's happening in
    the country, and that is, we're going to talk about how to make sure our
    seniors get the best health care possible. That's what we're here to
    talk about. We've got some--this is going to be a very interesting
    discussion, one that I think you'll find to be educational, one that
    will help illuminate what's going on with a good piece of law in a
    practical way.
        Before I do, I want to say something about my friend Sam
    Graves. Congressman Graves, thank you for coming.
    I asked him what he did to lose weight. [Laughter] He looks a lot
    prettier now than he used to. [Laughter] He said he quit eating sugar.
    But he is a fine Congressman. I really enjoy working with him. And I
    appreciate you being here, Sam. He's from a farming background. He's
    plenty capable and plenty smart. And I'm saying that because I want him
    to feel good as he gets back in the limousine. I'm giving him a ride on
    Air Force One back to Washington. [Laughter]
        I'm with my friend Mark McClellan.
    I'll tell you about him in a minute.
        Today when I landed, I met a lady named Ruth Blake. Where are you, Ruth? Yes, there she is. Ruth, thank you
    for coming. You're probably wondering why I'm introducing Ruth. The
    reason why is she's from Shepherd's Center, which is a--[applause]--
    sounds like you brought your family. [Laughter] Ruth is a volunteer. She
    manages the adult education program that educates and empowers seniors.
    And the reason I bring that up is I just want our fellow citizens here
    in Liberty, Missouri, to understand that I know the great strength of
    the country is the heart and souls of the American people, that our
    greatest strength--[applause].
        I see some of our military folks here. That's a strength of America.
    We'll keep the military strong. And we've got to keep the military
    strong to make the world--to help the world be a peaceful world. It's
    incumbent upon America to lead and work with other nations to spread
    freedom. Free countries are peaceful countries. And I believe we have an
    obligation to work toward freedom and peace, not only for our own
    security, not only because we must never forget the lessons of September
    the 11th but because, in this Nation, we understand that freedom is not
    America's gift to the world. Freedom is the Almighty God's gift to each
    man and woman in this world.
        Another strength of America is the fact that we're a wealthy nation,
    and that's important. It's important that we stay that way, so people
    can find work; they can put food on the table; people can do their duty
    as a mom or a dad.
        But our true strength is the fact that we've got loving citizens who
    are willing to volunteer to help change America, one heart and one soul
    at a time. My call to our fellow citizens is to join the army of
    compassion, which exists in every neighborhood in every city of our
    great land. Make a difference by teaching a child or an adult to read,
    by providing food to the hungry, shelter to the homeless, and together,
    we can make sure the great promise and hope

    [[Page 1039]]

    of America is extended to every corner of our great country.
        I'm honored you're here. Thanks for coming. Thanks for representing
    the best of America.
        Nearly 39 years ago, not far from here, President Lyndon Baines
    Johnson signed the Medicare law, the first Medicare law. And
    interestingly enough, the first Medicare card was handed to Harry
    Truman. You might remember him--[laughter]--a fine President, I might
    add. But Medicare, which had done a great job for many years, got stuck
    in the past. In other words, medicine began to change, but Medicare
    wouldn't change with it.
        For years, politicians talked about modernizing Medicare. Nothing
    got done, though. As a matter of fact, as you might remember, it became,
    in political parlance, ``Medi-scare.'' In other words, somebody would
    talk about it, and they'd use it against him as a political weapon. And
    it was time to get rid of that kind of talk because Medicare is too
    important a program for our seniors.
        We were willing to provide money for operations, but we weren't
    willing to pay for the drugs that would prevent the operation from
    needing to happen in the first place. See, it was stuck in the past. The
    procedures were too old, and it required bureaucratic action to make
    sure that the modern medicine was available to our seniors. It kind of
    crept along. It wasn't doing its job. So we called Congress to task--I
    called Congress to task. I said, ``Let's do our duty as elected
    officials to make the system work better on behalf of our senior
    citizens.'' Congress passed the law. I proudly signed it, and it's going
    to make a positive difference, a big difference in the lives of our
    seniors.
        We're really in a three-stage process. We're going to talk about the
    first stage of Medicare modernization today, which is the issuance of
    drug discount cards. The second stage is what happens next year when
    Medicare begins to pay for preventative medicine, maintenance, and
    screenings for seniors. In other words, for the first time in Medicare's
    history, we're now going to diagnose problems before they become acute.
    That seems to make sense, particularly if you're worried about
    taxpayers' money. In other words, if you act early to prevent problems
    from happening in the first place, it's good for the taxpayers. Medicare
    didn't do that in the past. We're going to do it now.
        And starting in '06, for the first time ever, there will be a
    prescription drug benefit available for people in Medicare. It's a--by
    the way, one of the things I insisted on was that somebody who is happy
    with the current Medicare system doesn't need to change. I mean, I fully
    understand there's a lot of seniors who don't want to change. I know
    that. We needed to change the system to make sure there was a
    prescription drug benefit available. But for seniors who are happy with
    Medicare, plus the prescription drug benefit, you're in great shape. As
    a matter of fact, the program just got better in 2006. And if you're a
    poorer senior, the Government will help you afford the cost of doing--
    the cost of medicine.
        For other seniors, there's going to be more choices--for all seniors
    there's more choices. I mean, if you're happy with Medicare, fine. If
    you like the current Medicare+Choice, which will be called Medicare
    Advantage, that's going to be more robust, more available. If you want
    other options available to you, I always felt it was best to trust
    people, not Government, in order to--in the decisionmaking process.
        And so we're moving down the road to make sure the system is modern
    and to make sure the system works. But today we're going to talk about
    the issuance of cards, drug discount cards that are now available to our
    seniors. And we've got some problems. One problem is there's
    misinformation about these cards. Another problem is, is that people--
    they feel like

    [[Page 1040]]

    it may be too complicated, the procedures may be too complicated to get
    a drug discount card. Some of them say, ``Well, it's not going to matter
    anyway.'' They've heard political promises before, and a lot of times
    they fall empty. So today we're going to talk about how to make sure our
    seniors understand that the drug discount card works.
        We're going to talk to two folks who have used their card. As a
    matter of fact, I witnessed Wanda going to
    the pharmacy, local pharmacy here, and putting her card down, and her
    drugs--I think which would have cost her $19, cost her $1.70, something
    like that, just about the range we're talking about. I may not have the
    numbers exact.
        Wanda Blackmore. That's about right.
        The President. Yes, I didn't pay for it. [Laughter] The receipt is
    in her purse, I know. [Laughter] It was
    something like that.
        And that's what we're here to talk about. I want our seniors to
    understand--and this will be repeated several times--that if you have
    any questions about the drug discount card, there is a way to get
    information that will help you, or there's a way for your son or
    daughter to get information to help you, and that is to call 1-800-
    MEDICARE. That's all you've got to do: Pick up the phone, 1-800-
    MEDICARE. And people will answer the phone--is it 24/7--24/7. In other
    words, that means 24 hours a day, 7 days a week, somebody will be there
    to help and answer questions.
        You're going to hear Mark talk about
    what the Federal Government is trying to do to make sure that you
    understand this information is available. There's other ways to--you can
    log on, if you happen to be a high-tech person, and use the Internet.
    You can go to www.medicare.gov. It's not all that hard, and there will
    be all kinds of information available to you.
        And you're going to hear that there's a lot of different choices.
    You bet. That's what we want. We want there to be choices, different
    cards available. That's how you meet different needs. We don't want a
    ``one size fits all.'' That's not a consumer-driven system. That's a
    Government-driven system. A consumer-driven system is one that allows
    consumers to make the choices on what's best for them.
        So there's different cards, is what I'm telling you, to meet your
    needs. And I understand, for some that's going to be--it's going to be
    complicated, and some people just don't want their lives complicated.
    And--but you've got to know there's help. And just because it may seem
    complicated, that's not a good--I think people should not use that as an
    excuse to participate, because you're going to find there's good
    discounts; there's good savings. Fifteen percent on brand-name drugs,
    minimum. Isn't that right? Is ``minimum'' the right word to use--
    minimum? Thirty percent on generic drugs. Those are the drugs that,
    after a patent has expired, that do the exact same thing as the brand-
    name drug but at a much cheaper cost.
        And by the way, he was the head of the
    FDA before I put him in this position, and his job was to speed up
    generic drugs to the markets. People shouldn't be afraid of using
    generic drugs. They accomplish the same thing, and you're going to save
    a lot of money. They asked Wanda--they said,
    ``This is a generic drug, Wanda.'' She said, ``Fine, let me have the
    generic drug. I know it's going to do the same thing as the brand-name
    drug, but it's going to cost me a heck of a lot less.''
        In other words, this discount card is going to save our seniors a
    lot of money. And I'm just about running out of air--[laughter]--you'll
    be happy to hear. [Laughter] Want me to keep talking? Okay. [Laughter]
    But she can tell it better than me.
        But first, I want to start off with my friend Mark
    McClellan. He is a doctor and a Ph.D. He's
    from Texas. [Laughter] And he is the Administrator of the Centers for
    Medicare and Medicaid Services. That's his

    [[Page 1041]]

    job. His job is to make sure the Medicare system works well and that as
    the law kicks in--in other words, as the system becomes more modern, his
    job is to make sure it happens for the benefit of our seniors. I picked
    a smart guy to do this. He understands health care, and he understands
    the task. And the task is to make sure our seniors get the best health
    care possible and our taxpayers get the best deal possible as our
    seniors get the best health care possible.
        And so, Mark, welcome. Thanks for
    coming. As I mentioned to you, he at one time was the head of the FDA,
    and he did such a fine job there that I gave him a tougher job. And so,
    Mark, thanks for coming. Share some stuff with us. Tell us what's on
    your mind. Tell us how our seniors can benefit from this program.
        Mark B. McClellan. Thank you, Mr.
    President. It's a real pleasure to be here with you, with all of you
    here in Liberty, and especially to be working with Medicare at such a
    critical time. It's just 6 months since this new Medicare law was
    passed, and we already are having the opportunity to get drug costs down
    for seniors that need help right now and who have been waiting too long.
    There's been a lot of talk for a long time. We're actually implementing
    steps right now that are getting those costs down.
        And that's coming about through a couple means. The cards is a
    start, but with the cards, you get a chance to band together, to stick
    together to get lower prices on your drugs, just like people who have
    had insurance for their drugs have been able to do for a while. That
    gets negotiated prices down from manufacturers, and that leads to
    savings. And on top of that, we're giving people more information on
    where they can get the best prices so they can comparison shop more
    easily.
        You talked about the fact that consumers can really help us find
    better deals for Americans in many areas, but that's been tough in
    drugs. It's been hard to get prices and hard to know exactly what you
    can--what kind of deal you can get at different pharmacies and through
    different means available, through mail order, through other options
    like that. And we're going to put all that information in front of you
    with this program.
        And as you said, Mr. President, what we're seeing through the drug
    card program is now savings of, very often, 15 to 30 percent or more off
    the list prices for brand-name drugs and much larger savings for generic
    drugs. And we'll also tell you about the generics when they're
    available, so you can find out about more ways to save through using
    generics, whenever they are available.
        And some seniors have been able to get a little bit of help. They've
    been trying hard to find good deals. But often when you go to your
    neighborhood pharmacy, the best you can get is a pharmacy discount card
    that may give you a few percent off the drug store prices but don't let
    you negotiate to get those much lower prices. And that's where these
    real savings are coming from.
        And the most important thing is, for people who are having drug
    costs that are causing them trouble right now or they're struggling with
    their costs, is to find out about this program. As you said, Mr.
    President, there's some easy ways to do that. You can call us at 1-800-
    MEDICARE, any time, day or night. You can go to the web site,
    www.medicare.gov.
        And we've also made help available for the first time ever through
    some expanded programs in local areas. Joe is going to talk about this
    in a few minutes. But you can get face-to-face help. If you don't think
    you can follow through with a phone call, if you really want to talk to
    somebody face to face about this program, you can do that. Right here in
    Missouri, we're working with CLAIM. It's a State health insurance
    assistance plan that provides this personalized help for seniors, often
    working through volunteers who know this program well. So

    [[Page 1042]]

    those are some simple ways that you can find out about what's in this
    program for you.
        And the people who need help the most get the most help right away
    with this program. If you're struggling with drug costs today because
    you don't have good drug coverage, you should find out about it. But
    especially if you've got a limited income, below about $1,400 a month
    for a couple, about $1,040 a month for a single senior--about 7 million
    Medicare beneficiaries who are in that category, below those income
    levels, they can get not only the discounts but some direct financial
    help on their card--$600 this year, $600 next year, and there's some
    additional discounts coming from the drug manufacturers for them as
    well. So it amounts to literally thousands of dollars in savings. And
    you can find out about it right now just by calling us at 1-800-
    MEDICARE, and we'll put you in touch with a face-to-face person if you
    want to get help that way.
        The President. Good job, thanks. Do we have the program up and
    running where somebody can actually dial up--put in their ZIP Code, the
    pharmacies come up, they show the different prices for drugs in their
    neighborhood?
        Dr. McClellan. That's exactly right.
        The President. In other words, it's kind of a virtual market. It's
    kind of an interesting concept, isn't it? One of the things I believe is
    that markets have got a fantastic way of rewarding consumers with better
    quality and better price. And you can get on your web page or you can
    get on the computer, and you can shop--price shop right now in your
    particular ZIP Code. And that's a way, also, to make sure that better
    price is available for our seniors.
        Dr. McClellan. That's right. And if
    you don't want to go on the web, we can help you over the phone and send
    you something, a personalized brochure, that gives you as much or as
    little detail as you want about the best options for your own personal
    needs at the pharmacies that you want to use.
        The President. Joe Tilghman is with
    us. Joe is the Administrator. He works with Mark. Don't worry about all
    the cameras. [Laughter] He is the Regional Administrator. He has been
    charged with helping people in this area understand the benefits of the
    drug discount card. He will then, once he completes that task here this
    year, he'll then be in charge of the '05 modernization of information,
    and then in '06 will be in charge with helping Mark implement the brand
    new law. And it's good. I'm telling you, it's going to make a big
    difference in our seniors' lives.
        Joe, thanks. Welcome.

    [Joe Tilghman, Regional Administrator, Centers for Medicare and Medicaid
    Services, Department of Health and Human Services, Kansas City Regional
    Office, Kansas City, MO, made brief remarks.]

        The President. See, what you're hearing is, is that Mark has asked his team to go out and educate people.
    People need to understand the truth and the facts and what's available.
    That's what we're trying to get done here. And that's what we're trying
    to get done all around the country. And you're doing a fine job at it.
    Thank you.
        Mr. Tilghman. Thank you, sir.
        The President. Just keep putting the word out. This is a program
    that helps people. If you've got a mom or a dad out there that may be
    nervous about hearing the change in Medicare, talk to them. Call the
    number because this will help. And look, you're probably saying,
    ``Another guy is showing up from Washington, laying out something that's
    just not true.'' Well, it's true.
        And I'll tell you, who best to testify is Wanda, Wanda
    Blackmore. She and I, as I told you, we just
    went to a pharmacy. She--I was going to say, you whipped out your card,
    but you left your card there before, right? Anyway, they had her card,
    and

    [[Page 1043]]

    she bought some drugs that is a blood thinner, right?
        Wanda Blackmore. Right.
        The President. Yes. Okay, talk into the mic. [Laughter]
        Ms. Blackmore. Yes, sir. [Laughter] I
    was afraid you would try to over talk me if----
        The President. That's right. [Applause] Are your grandkids here?
        Ms. Blackmore. I can't see them.
        The President. Yes, your grandkids are here. She's talking to me like she does her grandkids. That's okay.
    [Laughter] I'm used to strong women. [Laughter]
        Ms. Blackmore. I'm old enough to be your
    grandmother too.
        The President. Okay. Let's get to work, will you? [Laughter]

    [Ms. Blackmore, senior citizen, Kansas City, MO, made brief remarks.]

        The President. So here's the thing. Let me see if I can distill it,
    summarize what she just said. She got her
    card. The first time she used it was June 7th. On a prescription that
    usually cost $10, she paid $1.14. That's called savings. It looks like--
    we kind of did some rough math, didn't we, and it looks like you're
    going to save about $750 this year. And that's a lot. That's an awful
    lot for some people in this country, and I'm telling, you this thing is
    working. And I appreciate you coming to testify.
        Ms. Blackmore. Yes, sir.
        The President. There you go. She drove
    in with the limo--we're a little familiar with each other because she
    was in the limousine from the airport to here. [Laughter]
        Ms. Blackmore. I got him lined out.
    [Laughter]
        The President. That's right. All right, you're not the only person
    on the stage here. [Laughter]
        Ms. Blackmore. I will be, if you keep
    talking like that. [Laughter]
        The President. That's right.
        Ms. Blackmore. I'll throw him out.
        The President. All right, here we go. [Laughter] Yes, ma'am.
    [Laughter]
        Ms. Blackmore. Thank you, sir.
        The President. Gladys Cole.
        Gladys Cole. Mr. President, I can tell you
    that your drug card is working.
        The President. Okay, why can you say that?
        Ms. Cole. Well, because I went and got my
    medicine that I had to give $120 for, and when I got through, I gave
    $20-something for that same medicine. So there's no doubt in my mind
    that it is working and working quite well.
        The President. All right, how did you find out about the card? See,
    people are wondering out there how these two
    ladies found out about the card, and they may
    not have heard about it.
        Ms. Cole. Well, my pharmacist knew that I
    had no prescription card, and so he knew what a price I'd been paying
    for my medicine. So when the leaflets come in for us to fill out, he
    asked me, would I take them home and fill it out. And he said, ``I'll
    fax them in if you'll just fill them out.'' So I thought, ``Oh, well,
    maybe 5 or 10 dollars,'' but 5 and 10 dollars looked awful good to me.
    So I said, ``All right.'' And when he got my medicine card and I took it
    in and he told me what the savings was, I about dropped my false teeth.
    [Laughter]
        The President. We're talking about teeth up here. [Laughter] Now
    that you've recovered your false teeth--[laughter].
        Ms. Cole. So I'm sold on it, and anytime I
    can tell you people out there that are of our age, try it out. See if it
    fits for you. And then if it don't, well, fine. But you need to at least
    try it and see.
        The President. There you go. I appreciate you, Gladys. Thanks very much for sharing that.
        It's estimated that over the next 7 months, she's going to save $700 for the year. That's good. Yes,
    that's a lot of money. These ladies qualify for the $600 subsidy. At a certain income
    level, people can qualify for additional help, not only

    [[Page 1044]]

    get the card. If you don't qualify, you use the card anyway, because
    you're going to get your discounts. But you get $600 additional a year
    help.
        Ms. Blackmore. This is the only time
    I've been glad to be poor. [Laughter]
        The President. Who's writing your material for you? [Laughter]
        Ms. Blackmore. I'm not going to tell.
        The President. We didn't have enough room on the stage--well, we
    have plenty of room. Anyway--[laughter]--Roberta Sims and Betty Sten is with us too.
    Where are you? There you go. Thanks for coming, ladies. I appreciate you
    all being here. She got her--Roberta got her card, and she used it at
    Liberty Wal-Mart on June the 5th. She purchased over $300 in
    prescriptions and paid 22.62. That's a fact. It better be a fact.
    [Laughter] Betty got her card recently too and is going to save a lot of
    money, $500.
        In other words, this is important. The reason we're here is to share
    information. We're trying to fight through the clutter, the noise, so
    that people can understand that there is a great opportunity to take
    advantage of a good piece of legislation. That's what we're here to talk
    about.
        We want our seniors to be able to have the benefits of modern
    medicine in a way that is best affordable. That's what we're here to
    talk about, and if you don't believe me, just listen to the two ladies
    here on the stage. They go to their pharmacies; they put down their
    money; and they've seen the difference between what they had been
    charged and what they're paying now. And it's a real savings, and it's
    important savings. And I want to thank them for coming to share their
    stories. You have made the day much more credible--[laughter]--much more
    lively too.
        Let me conclude by telling you this: I--you know, our country has
    been challenged. We're challenged to make sure that we're defended from
    an enemy that can't stand what we believe in. We're challenged because
    the economy has been through quite a bit. It's now getting better, I
    might add. We've been challenged in a lot of ways. Our hearts are
    challenged every day when we realize amidst our plenty there are people
    who hurt.
        The thing I want to share with you and remind you about, that this
    great country can overcome any challenge we face. This is a great
    country because of the values we believe in. It's a great country
    because of the citizens who inhabit her. And there's nothing--there's
    not one thing we can't do together to make sure the world is more free,
    the country is secure, and America is the best possible place it can be
    for all our citizens to call home.
        Thanks for greeting us today. I'm so honored you came. May God bless
    you all.

    Note: The President spoke at 3:32 p.m. In his remarks, he referred to
    Mayor Stephen P. Hawkins of Liberty, MO.