    [Public Papers of the Presidents of the United States: George W. Bush (2006, Book I)]
    [May 10, 2006]
    [Pages 908-916]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks in a Discussion on the Medicare Prescription Drug Benefit in
    Orlando, Florida
    May 10, 2006

        The President. Please be seated. Thank you. Thanks for letting me
    come by to say hello. I'm thrilled to be back in the State of Florida.
    Yesterday I checked in with my brother--
    [laughter]--to make sure everything is going all right. I'm real proud
    of Jeb. He's a good, decent man, and I love him dearly.
        I also checked in with Laura this morning, to
    see how she's doing. She sends her best to all of you all. She's doing
    just great, by the way.
        I'm here to talk about Medicare. We've got an exciting program and
    an exciting opportunity for people to improve their lives. So this is an
    educational forum. This is a chance not only to speak to the folks here
    but to those who may be watching on TV about a really interesting
    opportunity for the seniors all around our country to

    [[Page 909]]

    really improve their lives by signing up for a new opportunity in
    Medicare.
        But before I do--and by the way, I've got some interesting helpers
    here to make the case. I thought it would be better to have others
    describe what the Medicare program means than me sitting up here just
    giving a long speech. [Laughter] You probably agree with that, but
    you're too polite to say so. [Laughter]
        I want to thank Tommy Martinez for
    welcoming us here. Tommy, thank you. I thank all the good folks who work
    here. Thanks for helping our seniors to improve their lives. You know,
    one of the great things about America is there's a lot of citizens who
    have heard a call to help a neighbor, and there's a lot of people that
    are willing to, kind of, help educate somebody or help somebody find
    help. That's what we're really here to honor today, in many ways. We're
    not only here to talk about a new program for Medicare, but we're here
    to thank people that have taken time out of their lives to help a senior
    improve their lives.
        I want to thank Sylvia Caceres. She is
    the central Florida regional director. Thank you, Sylvia. Ramon
    Ojeda is the president of the Hispanic
    Chamber of Metro Orlando. Ramon, thank you. Finally, old Rich
    Crotty, he's here somewhere. Hey, Rich,
    good to see you, buddy. I was thinking about Rich. You might remember,
    his son made him famous--[laughter]--made me
    famous too. [Laughter] The lad went to sleep in the middle of one of my
    stemwinders. [Laughter] Give him my best, Crotty.
        Let me talk real quick about Medicare. First of all, my
    administration views Medicare as a vital--that Medicare is a vital
    program. It's an important program that has worked well for many years.
    And therefore, when I got into office, I said, we're going to not only
    commit ourselves to Medicare, but we're going to make it better. See,
    the Federal Government has said to our seniors, ``We're going to provide
    a good health care system for you.'' And so we started looking at
    whether or not the Medicare system was delivering as good a health care
    system as possible. And I determined it wasn't. I said it was good, but
    it could be better.
        And the reason why it wasn't as good as it could be is because the
    system was not helping seniors with prescription drugs. In other words,
    medicine had changed a lot since the sixties, obviously--that's an
    obvious statement--but Medicare itself hasn't changed along with the
    modernization of medicine. I'll give you a good example. Medicare would
    pay for ulcer surgery, a surgery which might cost upwards of $25,000,
    but it would not pay for the prescription drugs that could have
    prevented the ulcer from happening in the first place. And that didn't
    make any sense. It didn't make any sense for our seniors, and it didn't
    make any sense for the taxpayers. And so it seemed like it made sense to
    me to modernize the system, which we did.
        And so we created what's called Part D, and basically Part D is a
    prescription drug benefit for not only our seniors but those who
    qualified who are disabled as well. Part D says this: It says that
    seniors have now got a prescription drug plan available to them. It's
    your choice to make. One of the interesting things about the strategy
    we've employed is seniors now have over 40 choices to choose from in
    Florida. Now, that in itself created a slight problem, because 40
    choices can create a sense of uncertainty among people. You know, people
    say, ``I don't think I want all those choices.'' After all, there had
    been very little choice up to now. And so the idea of saying, ``Well,
    here are 40 different plans to choose from,'' I knew was going to create
    the need to encourage people to get involved to help people make the
    right choice for them.
        I strongly believe that giving seniors choices is important to a
    good health care system. After all, not everybody's needs are the same.
    And therefore, the more opportunity there is to pick a program that
    meets

    [[Page 910]]

    your needs, the better off the health care system will be. That's why
    choice matters.
        It also means there are people actually competing for your business.
    They're saying, ``I want your business; therefore, I'm going to try to
    make it attractive for you.'' And the idea of giving choice to people
    has affected the cost of the plan. When we first got in there, we
    anticipated the cost for the average senior was going to be $37 a month;
    now it's down to $25 a month for the average plan. That's positive news.
    It's positive for our seniors, and it's positive for the taxpayers.
        We also believe that peace of mind is important for our seniors. And
    so inherent in this reform plan is the notion of the Government stepping
    in after a certain level of expenditures have been made by the average
    senior. In other words, anything over $3,600 in prescription drug
    coverage, the Government will pick up 95 percent of it. That's a
    catastrophic plan. It says that we recognize that we've got to help
    seniors after a certain level of expenditures, so as to help peace of
    mind.
        That wasn't the case in the old plan, as you might remember. The new
    plan has got stop-loss; it's got catastrophic care. And that's a very
    important part of helping make sure the system was modern. The other
    thing that's important for people to understand is that this program is
    very generous for low-income seniors. About a third of the seniors
    qualify for extra help. And that's the way it should be in America, in
    my judgment. We want to help people who cannot help themselves. And so
    if you're a low-income senior, this plan will pay nearly 95 percent of
    all your drug costs, and that's important for our seniors to understand.
        We've had good success at signing people up. There's about 42--a
    little more than 42 million people who are eligible for Medicare in the
    United States. Up to this point, a little over 31 million have signed up
    for the new Part D plan. There's about 6 million seniors who don't feel
    the need to sign up because they're adequately covered elsewhere, and
    that's okay; I understand that. So there's about 37, more or less,
    million people have so far signed up since January for this new benefit.
    And our mission is to reach out for the final 6-plus million, is to
    encourage people to, at the minimum, take a look at what's available.
        There is a May 15th deadline, unless you're a low-income senior, in
    which case you can sign up after May 15th without any penalty. And
    that's important for our seniors to understand as well.
        And so we're here today to talk about a Medicare plan that I believe
    is a good deal for America's seniors. It's very important for people to
    understand that there are significant savings for you involved in this
    plan. There's--the average senior saves about one-half on his or her
    drug bills, and that's good news. This is a plan that helps people when
    there's a catastrophe in their lives, and this is a plan that means our
    low-income folks won't have to choose between food and medicine. And
    that's good for America.
        Now, we're reaching out to people from all walks of life. First of
    all, if you're interested in finding out about the program, call 1-800-
    MEDICARE, and somebody will be there at the other end of the line
    explaining it to you. If you're computer-literate, call up medicare.gov,
    and you'll find a program that will help you--it will help explain to
    you what is available for you.
        If you've got a--if you're a son or a daughter, and you've got a
    mother or dad who is eligible for Medicare and hasn't looked at this
    program, you have a duty, in my judgment, to be a good son or a daughter
    and help your mom or dad. You know, some of our seniors aren't that
    comfortable with using a computer, and I understand that. But your sons
    and daughters are comfortable, or your grandchildren are comfortable.
    Get them to help you. Get them to take a look at what's available.

    [[Page 911]]

    A son or a daughter owes it to their mom and dad to do that. If you're a
    member of a church group and you've got seniors in your congregation,
    find help for them. If you're a member of AARP, an active member of
    AARP, help a friend see what's available. If you're a part of an
    outreach group such as this, continue doing your duty to give people
    knowledge.
        And that's what we're here to do. We're working with the National
    Alliance for Hispanic Health, the Hispanic Business Roundtable, the
    National Coalition of Latino Clergy and Christian Leaders. I mean, we're
    talking to a lot of groups. We've reached out through Univision and
    Telemundo and Spanish radio. My point is, is that we're reaching out to
    all people in all societies. We're working with the NAACP, AARP. There
    are a lot of people trying to help. And for those of you here who are
    helping, thank you for doing what you're doing. I hope it makes you feel
    better. It makes me feel good to know there are millions of Americans
    who are willing to help a neighbor understand what's available in this
    important program.
        So you're watching the President be Educator in Chief today.
    [Laughter] My job is to go around America and explain that which is
    available, but I can't do it alone. Yesterday, down in South Florida,
    Mike Leavitt was with me. He's the
    Secretary of Health and Human Services. He's doing a fine job. Josefina
    Carbonell works with Mike. Her title is
    Assistant Secretary for Aging, Administration on Aging, Department of
    Health and Human Services--a long title for a fine person. Josefina,
    tell us what's happening in the Department. Welcome.
        Assistant Secretary Josefina Carbonell. Thank you, Mr. President. Yes, I'm known as the
    Assistant Secretary of Aging, but I've got the great honor to also have
    been coined in this campaign as ``Senora Medicare.'' [Laughter] And
    we've gone across the country.
        It's indeed a wonderful honor to serve you as the Assistant
    Secretary for Aging, but having worked in the aging field for over 35
    years right here in the State of Florida, it is so gratifying and so
    historic for me personally to see the fine work of individuals and
    volunteers across this country that have made such a difference. And
    you'll meet--some of them are with us today, and many in the audience--
    how important the benefits are.
        We've held over 47,000 events like this, assistance and enrollment
    events and information events. And we've ridden in buses, in our
    Medicare buses across this country and visited with people in towns
    small and big, rural and urban communities, in limited English-speaking
    communities. And we are so proud of the work that our inner-city and our
    community-based organizations and our volunteers in both the private
    non-profit sector, civic organizations, the business community, and our
    municipalities, and most importantly, our volunteers.
        We've had a wonderful opportunity to have over 40,000 dedicated
    volunteers that have served to assist people on one-on-one as a backup
    to our 1-800-MEDICARE, to, of course, our web site, and our area
    agencies on aging, our senior centers, our Meals on Wheels programs, our
    home care agencies. But those 40,000 volunteers have made such a
    difference. I've been in communities where we've sat around somebody's
    dining room table in the middle of a little church hall--and being able
    to assist them one-on-one making that choice.
        And that's so important. I know that having worked with seniors for
    so many years, it is so gratifying to see the difference that this new
    benefit takes on, not only in cost savings, but the most important thing
    for me, in many of the minority communities, have been the ability for
    them to access new preventive benefits--and cardiovascular and diabetes
    and other chronic conditions that are so prevalent in our minority
    communities. So that's another very important feature.

    [[Page 912]]

        But help is there. Those that might still be afraid and have not set
    out--the 1-800-MEDICARE, we've staffed that Medicare line up with 6,000
    operators, trained people. We've got volunteers like Sandra, 40,000
    across this country, and the area agencies on aging and the elder help
    lines that are there to assist you. We also have help lines for minority
    communities. We know that in the Hispanic community, in addition to the
    1-800-MEDICARE, we have the 1-800-SU-FAMILIA [1-866-SU-FAMILIA],* run by
    the National Hispanic Council, the National Hispanic Alliance for
    Health, which is manned by grassroots organizations across this country,
    and many, many more that are there to help you.
    ---------------------------------------------------------------------------
        *White House correction.
    ---------------------------------------------------------------------------
        So seek help. The 15th is the deadline. Don't stay without that very
    important benefit that not only will give you the prescription drug
    benefits that you need but, most importantly, will be a lifesaving
    effort for many, many of our at-risk individuals.
        The President. Yes, I knew one of the real challenges, once this
    bill had passed, was to convince people that change would be in their
    interests. There's a lot of folks, frankly, at a certain point in their
    lives, where they're just really aren't interested in change. They're
    happy with the way things are, and therefore, it would be hard to get
    people to, kind of, be alert to the new opportunities. And so therefore,
    we knew we'd have to rally a group of folks who were not political
    people, but just concerned about their neighbor, so that there was a
    human touch to convince somebody that change--it's one thing to call a
    phone number; you're talking to somebody you can't see. But the most
    important contact is the one-on-one contact that many in this audience
    have helped others with. And for those of you doing that, I want to
    thank you.
        Josefina also talked about an
    important part of the reform, and that is that there's now a wellness
    exam for people entering Medicare finally. It makes sense to detect
    problems early so it makes it easier to solve problems. That old
    Medicare system didn't have, kind of, this sense of prevention as a part
    of our strategy to help our seniors, and now it does.
        But for a senior who hasn't signed up, call but also reach out to
    somebody. They'll help you. This program is not as complicated as one
    would initially think. And there's a lot of people that will help you,
    help you walk through the steps necessary to determine what is best for
    you.
        Now, we've got some folks here who are being served. Pete, Pete Navarro, welcome; thank you for coming.
        Peter Navarro. Good morning, Mr.
    President.
        The President. You got to speak into the mike.
        Mr. Navarro. Good morning, Mr. President.
        The President. Where do you live?
        Mr. Navarro. I live in Tavares, Florida.
        The President. Very good--right around the corner.
        Mr. Navarro. About 45 minutes.
        The President. Well, it's a large corner. [Laughter] Give people
    your circumstances, please.

    [At this point, Mr. Navarro, retiree, made brief remarks.]

        The President. One of the things people have got to understand--
    Pete, by the way, is not eligible for Medicare
    yet, just in terms of age.
        Mr. Navarro. That's correct.
        The President. You're 59?
        Mr. Navarro. Fifty-nine, yes.
        The President. So am I. [Laughter] I blame my gray hair on my
    mother. [Laughter] I don't know who you blame
    yours on. [Laughter] I used to think 60 was old, didn't you?
        Mr. Navarro. When I was young, I thought
    that was way out.
        The President. Now I think it's young, don't you?

    [[Page 913]]

        Mr. Navarro. I think so. [Laughter]
        The President. Yes. Anyway, people on disability can apply for this
    program as well. You have done so.
        Mr. Navarro. I have done so.
        The President. You're taking eight different medications a day.
        Mr. Navarro. Eight different medications a
    day.
        The President. So you're worried, obviously, about the cost.
        Mr. Navarro. I was, and since I have it, I
    only pay a $2 copay for generics and a $5 copay for the regular drugs.
        The President. Right. Are you able to estimate your monthly savings
    now?
        Mr. Navarro. I'm saving between 500 and
    600 dollars a month.
        The President. I'm not surprised. We hear stories like this all the
    time, where this program is helping people. The average senior is going
    to save half on their drug bills. Here's a fellow who is saving a lot more than half.
        Mr. Navarro. That's a lot of money.
        The President. Yes. And that helps you, obviously--500 or 600
    dollars a month gives you a little breathing room.
        Mr. Navarro. Oh, yes. It really does. It
    eliminates that stress that you live when you don't know if you can get
    it or not.
        The President. Yes. Well, I appreciate you sharing your story with
    us. It's--so, when are you turning 60?
        Mr. Navarro. Next January.
        The President. Oh, January. You're a lot younger than I am.
    [Laughter] We're baby boomers--[laughter]--which really leads to another
    issue, and that is whether or not the Congress will have the will to
    help restructure Social Security and Medicare so a young generation,
    your grandchildren who are going to be paying people like me to retire--
    whether or not the system is solvent for them. You're fine. I mean, the
    seniors are in great shape when it comes to Medicare and Social
    Security. The truth of the matter is baby boomers like old Pete and I here, we're in good shape. It's just those who
    are going to be paying for us need to make sure the system is solvent.
        It's not exactly the issue, but it is an issue that is of major
    importance. And, look, I'll work with Congress. Look, we need to just
    get rid of all the politics in Washington and focus on what's best for
    the country and do what's right.
        All right, Pete, thank you very much.
        Gloria Lavergne. Gloria, where do you
    live?
        Gloria S. Lavergne. Good morning, Mr.
    President.
        The President. Yes ma'am, thank you.
        Ms. Lavergne. I live here in Orlando.
        The President. Fantastic.
        Ms. Lavergne. I was born and raised
    in Puerto Rico.
        The President. Que bueno.
        Ms. Lavergne. Que bueno. And I moved
    to Florida in 1982 with my family. I work as a legal assistant for 20
    years, and unfortunately, on 2002, I became disabled. And like you, I
    suffer from that time until 2 months that I'm going to be able to get my
    supplemental, because I'm paying right now $265 with an insurance. And I
    would say, when I heard about Medicare Part D, I start my own search. I
    look at different companies that I receive in the mail and compare,
    start calling. Don't be afraid to call; get the name of the medication
    that you are taking--I'm taking six medicines every day. One of them is
    Lidoderm--it's a patch--that cost me at regular price $175 per month,
    and I'm paying $28 is my deductible.
        The President. Let's slow down for a minute. You're doing great. I
    just want to make sure everybody understands: This good woman is paying for six different medicines, one of which
    costs 175--speak in the mike, please--175. You signed up for Medicare
    Part D, and now it costs you 28?
        Ms. Lavergne. My premium is $26.60;
    my deductibles are $28; and I'm saving $550 per month. That's amazing.

    [[Page 914]]

        The President. Yes. Now, I know it sounds too good to be true; like,
    if I had said it, everybody would have said, ``Well, I think he's just--
    you know--just talking.'' [Laughter] So I asked Gloria to be here. It's interesting what she said. She said she
    took the initiative to see what was available.
        Was it that difficult?
        Ms. Lavergne. No, it wasn't
    difficult. I look at the brochures, check with the medication that I was
    taking, and I enrolled in AARP--for me is one of the best. And I'm very
    happy. I encourage everybody to join the program.
        The President. See, she said--what
    you just heard her say is, she took the initiative, took a look, and
    found a program that met her needs. And that's why choice is important.
    In other words, the Government didn't say, ``Here's the program that
    meets your needs.'' The Government said, ``Here's programs available.
    You pick the one that meets your needs.'' It's a little change of
    attitude, when you think about it--basically empowers the customers.
        Now, there are some people, I readily concede, that aren't that
    confident about picking a program that meets their needs. But there are
    people out there who are willing to help you. So therefore, please call
    in and let us know who you are. We're trying to make sure that every
    senior has a chance to sign up for this program. And there's going to be
    some people in society that are nervous about the program. They hear all
    the talk, and they hear this program, and they hear the advertisements,
    and I know they're nervous. I know they're concerned. But I assure you,
    it is worth your time to listen to somebody who wants to at least
    explain what's available for you.
        If you're--I repeat, if you're a son or a daughter and your mom
    hasn't signed up or your dad hasn't signed up, do your duty and--to find
    out what's available and explain. You just heard the testimony of
    Gloria; she's saving $500 a month.
        Ms. Lavergne. ----$550.
        The President. ----$550 a month. Well, that's a lot. And one of the
    things we want is the program to work, and it works well when people
    take advantage of the program.
        So thank you both for sharing your--you got something else to say?
    You're welcome--you're through?
        Ms. Lavergne. Thank you so much.
        The President. Gracias. Good job. Very good job. I told you you'd do
    a good job. You were great.
        We got an interesting fellow here named Ramon Ortiz. Ramon is a pharmacist, as you can see. One of the most
    important groups of people who are helping our seniors realize what is
    available are our pharmacists. You can understand why. They're the point
    of contact for a lot of our seniors.
        How long have you been a pharmacist?
        Ramon Ortiz. Well, 15 years. I've been 15
    years--3 years which I served in the United States Air Force. I was
    stationed here at Patrick Air Force Base.

    [Mr. Ortiz, pharmacist, CVS Pharmacy, made brief remarks.]

        The President. One of the things he said
    that's interesting is--CVS took corporate responsibility and said, we
    now understand--once President George W. signed the bill, we understand
    that a lot of our customers are now going to be wondering whether or not
    it makes sense for them to look at it. And the company became a part of
    the educational outreach by educating first the educators, who happened
    to be the pharmacists; that's what you're saying.
        And then now--so you've got people coming, and saying, hey,
    Ramon, what's up? Maybe they don't put it that
    way--[laughter]--but they're----
        Mr. Ortiz. We knew it was going to be big.
    And also, we knew that we were going to be providers; we were going to
    be instrumental in their choices.

    [Mr. Ortiz made further remarks.]

    [[Page 915]]

        The President. It's hard for some Americans to believe, but there
    were seniors who were going out--without their drugs in the past. People
    had to choose, and that's not right. And this program really helps a lot
    of low-income seniors. It helps all low-income seniors. We don't want
    people making that choice between food and medicine. We want the health
    care system to be modern; we want it to work. If you're going to say to
    your seniors, ``Let's have a good health care system,'' we need to make
    it good, and we've done that. And so--keep going; you're on a roll.
    [Laughter] Your mother?
        Mr. Ortiz. I also--perhaps one of the most
    difficult patients that I had was my mom.
        The President. Yes, I know the feeling. Does she tell you what to
    do?
        Mr. Ortiz. Yes. For her, I'm the baby; I'm
    not a pharmacist.
        The President. Yes, well, I know the feeling as well. Join the
    ``aggressive mothers club.'' [Laughter]
        Mr. Ortiz. So being a pharmacist, seeing how
    much this program had helped seniors, and I knew, because I was paying
    for my mom's prescriptions sometimes, and I knew that she was taking--
    paying over $280 for prescriptions. Recently I called her, yesterday.
    She told me that she was not even taking some of the medications doctor
    prescribed because she could not afford it. I said, ``Mom, why didn't
    you call me? I would have paid for your prescriptions.''
        Finally, I convince her--she's down in Puerto Rico in a small town,
    Ceiba; she enrolled. And she asked me, tell President Bush--[laughter]--
    this is the greatest thing ever happened. Now my father, at the age of
    73, he's looking for retirement. He was working 40 hours just to pay----
        The President. To help your mom.
        Mr. Ortiz. ----for the prescriptions. Now he
    can look into retirement. I'm not sure if my mom will allow him to
    retire. [Laughter] They cannot be in the same house. [Laughter] True
    story.
        The President. Let's leave it at that, you know? [Laughter]
        Mr. Ortiz. So I mean, I know there's a lot
    of complication, and I asked Anna, the first lady that I told you,
    ``Anna, do you really need to understand the Medicare Plan D?'' She
    said, ``No, I don't have to; I'm saving money.'' [Laughter] That's what
    it's all about.
        The President. Yes, it is. You know what I come away with? One, I
    want to thank you for your compassion. There's a lot of people who
    deeply care--a lot of people who care about our fellow citizens. We
    really are a compassionate country, aren't we? Here's Ramon. You know, he speaks with passion about people who come
    to his place of business worried about their health care and worried
    about their future. Thanks.
        The other good lesson is, here's a good son. You know, he takes time
    to worry about his mom--and dad, by the way. Sons and daughters owe that
    to their parents. They have received a lifetime of love from a mother or
    father, and they need to repay it by helping understand what's available
    in this new program. So if you're--I keep saying this, I know, but I
    strongly believe it. I believe there's personal responsibility in
    society, and sons and daughters have a personal responsibility to help
    their mom or dad, just like Ramon did.
        You did a fine job. Thank you. Gracias.
        Mr. Ortiz. Gracias.
        The President. Sandra Johnson. Now,
    Sandra Johnson works for the Serving Health Insurance Needs of Elders,
    known as SHINE. Is that right? Explain SHINE.

    [Sandra Johnson, local coordinator, Serving Health Insurance Needs of
    Elders, made brief remarks.]

        The President. You know what's a blessing? We got people like you in
    this country, like Sandra. She comes down
    here, she says, ``What can I do to help. How can I help somebody?''

    [[Page 916]]

        I love your spirit. Thanks for helping. She represents a lot of other people in this area and
    around the country who are volunteering.
        Ms. Bryan.  [Inaudible]--$22 a month.
        The President. There you go. [Laughter] From 350 to 22?
        Ms. Bryan.  Twenty-two.
        The President. Testify. [Laughter]
        Ms. Bryan.  [Inaudible]
        The President. There you go. We're glad you're here, Ms.
    Bryan. Thank you for coming.
        Listen, I hope you've enjoyed this experience. I've asked these good
    folks to join us to help make the case: One, take a look at what's
    available; two, help somebody take a look at what's available. That's
    all we can ask. There's a May 15th deadline coming up, unless you
    qualify for extra help, in which case you can sign up after May 15th
    with no penalty. If you don't quality for extra help, sign up now. Now's
    the time. This is a good deal. It's the Government doing its duty to
    provide modern medicine for our seniors.
        I want to thank our panelists. You all did a fantastic job. God
    bless you all, and God bless our country.

    Note: The President spoke at 9:47 a.m. in the Asociacion Borinquena de
    Florida Central, Inc. In his remarks, he referred to Gov. Jeb Bush of
    Florida; Tommy Martinez, president, Asociacion Borinquena de Florida
    Central, Inc.; Sylvia T. Caceres, southern States regional director,
    Puerto Rico Federal Affairs Administration; and Mayor Richard T. Crotty
    of Orange County, FL, and his son, Tyler.