    [Public Papers of the Presidents of the United States: George W. Bush (2006, Book I)]
    [March 14, 2006]
    [Pages 471-478]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks in a Discussion on Medicare Prescription Drug Benefits in
    Canandaigua, New York
    March 14, 2006

        The President. Thank you all. Be seated. Thank you all very much.
    Thanks for coming. Thanks for the warm welcome. Thanks for giving me a
    chance to come and talk to you about an important issue for our seniors.
        Before I get started, though, I do want to thank the folks here at
    Canandaigua Academy for letting me come by to say hello. The assistant
    principal, John LaFave, kindly greeted me
    behind stage here. As I understand, some of the students are here in the
    room, and some are watching. I'm glad to provide you a convenient excuse
    to get out of class. [Laughter] I want to thank the superintendent,
    Steve Uebbing, for greeting me as well.
        For all the teachers who are here and are paying attention to this,
    thanks for being a teacher. It's a noble profession. It's an important--
    it's really important. And speaking about teachers, I married one.
    [Laughter] She sends her love. Laura W. Bush is a
    unique woman who is obviously a patient woman. [Laughter] When I married
    her, she was a public school librarian who wasn't that much interested
    in politics. Now she's the First Lady of the United States. And I'm
    proud to call her First Lady, and I love to call her wife. And she sends
    her love too.
        I want to thank Randy Kuhl;
    he served with distinction in the United States Congress. He said,
    ``Look, you've been in my district before; come back up here if you want
    to be with some just good, down-to-earth people that care about the
    future of the country.'' And one of the reasons I'm here is because of
    Randy's invitation.
        I also want to thank Congressman Sherry Boehlert, right next door. I appreciate you being here. Mighty New
    York Yankee fan, I want you to know--[laughter]--fierce baseball--
    advocate for baseball. Plus, he's a good Congressman.
        I want to thank Antonia Novello. Dr.
    Novello, where are you? She's here--oh, there you are. Good to see you.
    Appreciate you coming. She's the commissioner of health for the State of
    New York. I'm honored you're here. I'll tell old 41 I saw you. That's the number for my dad. See, he's the
    41st President; I'm the 43d President, so--I'll tell him I saw you.

    [[Page 472]]

        I want to thank the mayor, who is here--
    Madam Mayor, where are you? Thanks for coming. Yes, I appreciate you
    coming. Thanks for your hospitality. It's great to be in your city. I
    want to thank all the other folks who are State government and local
    government.
        Most of all, I want to thank our panelists. There are different ways
    to describe an issue that's of concern to the American people. And so
    one way to describe the issue is to have others help describe it for
    you, and that's what we're doing. This is a opportunity for me and
    others to share thoughts about Medicare.
        The role of government is to provide good health care for our
    seniors. We made that commitment, interestingly enough, when Lyndon
    Baines Johnson was the President. When I got to Washington, I took a
    look at the Medicare system to determine whether or not Medicare was
    providing excellent health coverage. If you're going to provide health
    coverage for somebody, you want to make sure it works. I found a system
    that was old and stale. It really wasn't a modern health care system.
    Medicine had changed; Medicare had not changed.
        For example, the Government would pay $28,000 for an ulcer surgery
    for a senior on Medicare but not a dime for the prescription drugs to
    prevent the ulcer surgery from being needed in the first place. There
    was a lot of times the cures for disease would lag behind the Government
    saying it's okay to provide that as a benefit. In other words, it was an
    old system.
        So I worked with the Congress, and we've modernized Medicare. And
    for the first time, seniors can now get a prescription drug benefit
    under Medicare. And that's what we're here to talk about--the benefits
    of such a program; the need for people to, at the very minimum, take a
    look to see whether or not that program makes sense, and if it does make
    sense, to sign up on it. You'll hear me make the case: It's a good deal.
    Now, don't take my word for it. I would hope people would seek advice,
    seniors seek advice as to whether or not it's a good deal. Twenty-six
    million seniors so far have taken a look and said, ``I think it's
    worthwhile to sign up.''
        And so part of the--the main reason I'm here is to talk about the
    Medicare reform plan, the prescription drug benefit, all aiming to
    convince people to the very minimum to take a look. I think you're going
    to like what you see.
        One of the things that was necessary in Medicare to make it work
    better was to have--was to start exercising preventative medicine, to
    analyze and diagnose disease early, before they become acute.
    Interestingly enough, in the new Medicare reform law that I signed, for
    the first time, we're beginning to screen--offer screenings and a free
    physical for seniors when they sign up for the program. And that's
    important. Part of making sure health care is modern is to recognize
    that if you catch disease early, it makes it much easier to cure the
    problem.
        And so not only are we talking about a prescription drug benefit
    that's important to make sure Medicare and medicine is modern, but we've
    now got screenings and preventative care--annual screenings and a
    ``Welcome to Medicare'' physical. So if you're thinking about signing
    up, think about having an additional benefit of having a screening or a
    physical. And that's an important part of making sure that our systems
    are modern and Government is fulfilling its responsibility to provide
    good, quality health care for our seniors.
        The benefit is really important because it makes sure that seniors
    have choices as well. See, I've always believed that the consumer has
    got more options from which to choose, it provides higher quality. I'm
    one of these people that we ought to--that says, ``We ought to trust
    people; we ought to trust their judgment.'' So one of the things about
    the reform plan that went

    [[Page 473]]

    forward is, not only does it provide a prescription drug benefit, but it
    says seniors ought to have a menu of opportunity, different options from
    which to choose to meet their needs.
        And that created some confusion initially. And I knew it would, as a
    matter of fact. I knew some seniors on Medicare really didn't want to be
    confronted with any choice, and that the myriad of options would create
    a little confusion to begin with. But when people have taken time to
    look at the options and have sought help--whether it be a son or a
    daughter, or a community-based organization, or a faith-based
    organization, or 1-800-MEDICARE--they begin to realize that maybe the
    system is geared toward them. The more options a senior has to choose
    from, the more likely it is that the benefit is going to be tailored to
    his or her needs. And that's important for people to understand.
        If you're a low-income senior, the Government is going to pay over
    95 percent of your costs. Low-income seniors must take a look at this
    deal. I'm telling you, it's a good opportunity for you. You know, there
    was a period of time when seniors had to choose between rent and
    prescription drugs, and that wasn't right in our country. And this bill
    I signed is taking care of that problem, so people don't have to make
    the zero-sum choice. Prescription drugs has become an integral part of
    health care for a lot of folks, as you know.
        The competition is good for consumers; it happens to be good for our
    taxpayers too. One of the interesting things that has happened is, is
    that because there are people saying, ``I can do a better job for you,''
    if you're a senior, the anticipated premiums for the drug benefit has
    dropped from $36--$37 a month to $25 a month in a 6-month period of
    time. In other words, people looked at the bill, and they said, ``Well,
    this is what we think it's going to cost a senior for drug benefits, 37
    bucks a month--not low-income seniors but seniors.'' And instead, the
    cost is $25 a month.
        The anticipated--in Washington, you know, we spend a lot of time
    guessing what something is going to cost. And the anticipated cost to
    the taxpayers for this drug benefit is 20 percent lower in the first
    year than anticipated. In other words, it matters when people have
    choice. It matters not only for quality but for price. The average
    senior on Medicare will get a--will see their prescription drug bills
    cut in half. If you're a low-income senior, the Government is going to
    pick up a significant portion of your tab. If you're an average senior--
    income senior, you're going to see your drug bills cut in half. If
    you're a taxpayer, the anticipated costs are significantly lower than we
    thought. It's working. It makes a lot of sense.
        Part of my mission here, as I said earlier, was to convince people
    to find out about the program. If you haven't looked at the new
    prescription drug benefit, do so. Call 1-800-MEDICARE, or go to
    medicare.gov on the Internet. We're beginning to see some surveys from
    people who are actually using the program, and what's interesting is a
    lot of the seniors are getting information from the Internet. There's--
    and you'll see it's user-friendly. It's been designed to make it easy
    for the senior to take advantage of this new program.
        If you're interested in the program, get your son or daughter to
    help you. And if you're a son or daughter and your mom or dad is
    eligible for Medicare, make sure you at least take time to give your
    parent the benefit of finding out what's available. If you're an
    average-income senior, you're going to get one-half of your prescription
    drugs cut. If you're a poor senior, this Government is going to pay over
    95 percent of the cost of your prescription drugs. It makes a lot of
    sense.
        I called upon a fellow named Dr. Mark McClellan to join me in this effort. He's here. That's him right
    there. He is a--

    [[Page 474]]

    he's a Ph.D., see. I'm a C student. [Laughter] Look who's the President
    and who's the adviser. [Laughter]
        Dr. Mark is in charge of what's called
    CMS. He'll tell you what that means. We use a lot of initials in
    Washington. The way I like to describe it to you is, he is in charge of
    making sure the Medicare reform plan is explained, rolled out, and
    administered properly.
        And so, Mark, thanks for coming.
    Welcome.
        Mark B. McClellan. Mr. President, it's
    great to be here. CMS is----
        The President. Ph.D. in what?
        Dr. McClellan. In economics, and I'm a
    physician as well.
        The President. See, he spent a lot of
    time in the classroom. [Laughter]
        Dr. McClellan. It's great to be part
    of the team, sir.
        The President. We're glad you're here. Tell people what CMS stands
    for, and tell them what your job description is.
        Dr. McClellan. CMS is the Center for
    Medicare and Medicaid Services. It's the Agency that oversees the
    Medicare program and also Medicaid. Overall, we're providing health
    insurance for more than 90 million people. And this is a very important
    year for us, as the President said. We're making some major improvements
    in the Medicare program so that seniors will not just think of us as the
    program that's going to pay the bills when they get sick but the program
    that's going to help them stay well and live a longer and healthier
    life. And we're working with States like New York to improve the
    Medicaid program for people with limited incomes as well.
        The President. So we just cranked up. Anytime Washington passes a
    new law, sometimes the transition period can be interesting. And so we
    had some early challenges.
        Dr. McClellan. That's right. In fact,
    I was just talking with Diane about this beforehand. Diane is a
    pharmacist. You're going to hear from her in a minute.
        The President. No, I'm the emcee. [Laughter] You're the explainer.
    [Laughter] You know how these Ph.D.s are. You know, they kind of--
    [laughter].

    [At this point, Dr. McClellan made further remarks.]

        The President. How about the phone lines? People have----
        Dr. McClellan. The phone lines are
    much better wait times. If you call 1-800-MEDICARE, that 24/7 help line
    that we make available so seniors can find out exactly what this program
    means for them, your wait time now is an average of two minutes or less.
    So you can get through very quickly and find out what this program means
    for you.
        The President. So would you recommend people--a loaded question--
    kind of leading the witness, and I'm not even a lawyer. [Laughter] Why
    would--why should people sign up for this?
        Dr. McClellan. Well, now is a really
    good time to find out about it. We've got hundreds of thousands of
    people enrolling each week now, and we're ahead of what I think is going
    to be a rush towards the end of April and the first part of May as we
    approach the enrollment deadline. It's a 6-month period that people have
    to make a decision about the new coverage.
        People are finding that they can save typically 50 percent on their
    prescriptions--or more--compared to not having coverage. And Consumer
    Reports pointed out recently that if you're willing to look at generic
    drugs, or other drugs that work in a very similar way to the ones you're
    taking now, you can save 70 or 80 percent. And if you call 1-800-
    MEDICARE, go to medicare.gov, or go to one of the many events happening
    all over the country, including right here in Canandaigua, there are
    places to go to get face-to-face help right here to find out about what
    this means for you. You can save literally thousands of dollars

    [[Page 475]]

    on your drug costs, and you can be protected for the rest of your life
    against high prescription drug costs in the future.
        The President. Yes, describe that--the catastrophic care component
    of Medicare.
        Dr. McClellan. Well, the drug benefit
    will, in most cases, start paying right off the bat. Most seniors who
    have signed up are already saying they're saving money with the program
    just 2 months into the benefit. There is what's called catastrophic
    protection as well. So if you have very high drug expenses, your
    coverage is never going to run out. For people who have higher--
    relatively high incomes, if they spend $3,600, Medicare will then pick
    up as much as 95 percent of all their subsequent drug costs. So no
    matter what your drug needs are for the rest of your life, you're going
    to be protected against very high expenses.
        And, Mr. President, as you said, for people with limited means,
    about one in three seniors is living just on a fixed income--they get
    extra help, so they pay, typically, just a few dollars for each
    prescription. It's very important help.
        The President. People need to take a look. I get out of Washington,
    people say, ``Well, I'm not so sure we can trust the Government all that
    much.'' Take a look. One of the reasons I have come is to ask people who
    are eligible for Medicare just to explore the options. It's a good deal.
        For the taxpayers who are here as well, we're doing an--we're
    providing an important service for our seniors. I repeat to you: The
    Federal Government has made the commitment to our seniors for good,
    modern health care. I happen to believe if that's the commitment, we
    ought to keep it. And the bill that I had the honor of signing keeps
    that commitment.
        And so, Mark, thanks for coming. Stay
    on it. I'm a results-oriented guy. When I heard that it took a while for
    people to get on that--call that number and somebody wouldn't answer, I
    started asking, why? And they're solving it. We're making sure this
    opportunity for our seniors is done in a cost-effective, efficient way.
    We want it to be user-friendly for our seniors.
        Again, I repeat: I fully understand some people are perfectly
    content with life the way it is, and they're not interested in looking
    at forms and opportunities and choices. I would urge you to get somebody
    to help you take a look at the opportunities available for you.
        Somebody who is helping people understand the opportunities is Susan
    Wilber. Susan, what do you do? [Laughter]
        Susan Wilber. Well, I'm an A student,
    always was, so I became a health care professional. [Laughter]
        The President. Look, you don't need to rub it in, you know.

    [Ms. Wilber, director, The Brighter Day, made brief remarks.]

        The President. That's good. If you're a church or community-based
    group or a synagogue, talk to your folks who go to your facility and
    encourage them to contact 1-800-MEDICARE, medicare.gov, Susan. I mean, there's all kinds of people like Susan.
        What have you found to be the response initially, today? Give us a
    sense for----
        Ms. Wilber. Initially, there was a lot of
    panic and confusion, a lot of new information coming from all
    directions--the newspaper, the television, the mailings. I think that
    we're a strong health care system in this community and that we're all
    well-connected as a health care network, so people were very willing to
    bring their concerns to us and to ask for help. And that's certainly a
    confidence that we've instilled in people. And I'm very grateful for
    that opportunity.
        But we've set up individual meetings; we've set up situations where
    we meet with family members; we've done conference calls with families
    out of State to help their loved one here. So it's really been quite a
    collaborative effort to get people signed up.
        The President. Thanks. Thirty--26 million people have signed up.
    That requires

    [[Page 476]]

    a lot of community effort around the country. And I want to thank
    Susan and others who just make sure the
    opportunity is at least presented in a way that people can make a
    choice. And the amazing thing about our country is we've got a lot of
    really decent souls, like Susan, at the community level who are very
    concerned about somebody else, that they want to help somebody. And one
    way to help somebody is to let seniors know about the opportunities
    available in this Medicare reform.
        And you're signing up quite a few people, I understand.
        Ms. Wilber. We've had quite a few people
    sign up initially.
        The President. Good. How's it going?
        Ms. Wilber. It's going well. There was a
    little bit of confusion at first, but----
        The President. But, I mean, you don't want to recommend somebody to
    sign up and they say, ``Why did you get me to sign up for this?''
        Ms. Wilber. For the most part, it's worked
    very well. We've gotten some excellent feedback from our customers.
        The President. Good. Thanks for being here.
        Ms. Wilber. Thanks for having me.
        The President. My call is, please help. I really hope a son or a
    daughter takes time on behalf of their mother or father and get on the
    Internet, medicare.gov, and take a look. You ought to do it. I think it
    happens to be a duty. If your mother or father is not that interested in
    getting on the Internet, get on with them. Walk through the steps and
    take a look at what's available.
        We've got with us Diane Lawatsch.
    Welcome.
        Diane Lawatsch. Thank you, Mr. President.
    I'm happy to be here.
        The President. You're gainfully employed?
        Ms. Lawatsch. I am gainfully employed.
        The President. How? [Laughter]
        Ms. Lawatsch. Uh-oh. [Laughter] I am a
    pharmacy operations manager for Wegmans Food Markets. I've been a
    registered pharmacist for almost 18 years. And a pharmacy operations
    manager helps to oversee the operations in pharmacy. And I have four
    stores in this region, and the Canandaigua store is one of them.
        The President. Good. So give us a feel for how you view the Medicare
    bill, how it came to be, your reaction. Obviously, you're very much
    involved in prescription drugs.

    [Ms. Lawatsch made brief remarks.]

        The President. Obviously, pharmacists have got a stake in this. I
    mean, people show up at the counter, and there's a lot of pharmacists
    around the country who are saying, ``Can we help you?'' It's, frankly,
    in the interest of the pharmacist to give people the opportunity to get
    a very generous prescription drug benefit from the Government. I don't
    know if you've seen attitudinal changes yet amongst the people using the
    program.
        Ms. Lawatsch. Well, absolutely. We
    definitely see customers come in that say, ``Gee, I've never had
    coverage before,'' and now they have the coverage. One of the things,
    too, that we did at Wegmans was we started over a year ago preparing and
    investing in our people and putting our pharmacists and our technicians
    through training programs. We had four different online training courses
    so that they were prepared come January, and that helped a great deal.
        The President. Good. Thanks. You're on the frontline.
        Ms. Lawatsch. Yes, we are.
        The President. So we've got Bob and
    Eleanor with us. Isn't that right?
        Bob Wisnieff. Yes, we're here.
        The President. So, in my family, the wife starts speaking first.
    [Laughter]
        Eleanor Wisnieff. Okay, I'll go first.

    [Mrs. Wisnieff, retiree, made brief remarks.]

        The President. I like the idea of somebody saying, ``Here are three
    choices from

    [[Page 477]]

    which to choose.'' See, if you give people an opportunity to choose, it
    means they're more likely to be able to find something that meets their
    needs. It's a different approach, isn't it? The older--one approach is,
    ``We'll tell you what you need; the Government probably knows a little
    better than you do, anyway; we'll think on your behalf.'' What this bill
    says is, is that let's have some options available so people get to
    tailor the options to meet their needs. And what ends up happening is,
    is that there's choice. When we trust seniors with judgment, it helps on
    price and it helps on quality.
        Do you have anything to offer, Bob?
        Mr. Wisnieff. Well, I think Eleanor has
    pretty much got the punch line of my whole thing, so I'll have to be a
    bit of a Paul Harvey and say ``the rest of the story.'' [Laughter]
        The President. Pretty good. How long have you all been married?
        Mr. Wisnieff. Fifty-two years.
        The President. Fifty-two years?
        Mr. Wisnieff. Fifty-two happy years. I hope
    you have the same.
        The President. He said 52 happy years, by
    the way. Thanks for setting a good example.

    [Bob Wisnieff, retiree, made brief remarks.]

        The President. The key is saving a little money in retirement.
    They're on a fixed
    income. They've got now a prescription drug benefit. They don't have to
    make the awful choice between food, electricity, and prescription drugs.
    And they're actually putting a little extra money in their pocket. If
    that's true--is that true?
        Mr. Wisnieff. That's true.
        The President. Okay. If it's true, you ought to look at it. Senior
    citizens not only here in upstate New York but all across the country
    ought to look at this plan, ought to look at the opportunities. If you
    like it, sign up. It's a good deal. If you need help, ask for help. If
    you want to find out more about it, call 1-800-MEDICARE or get on the
    Internet, medicare.gov.
        For the students listening here, one of my jobs is to help explain
    things to the American people, explain why we make the decisions we
    make. Today I've tried to explain to you why the Medicare system needed
    to be changed and some of the principles inherent in the change that
    benefits our seniors. Part of explaining something is to have people who
    are actually involved with the program, people that are helping to
    educate, people that know something about the pharmaceutical industry,
    people who are benefiting from the plan, to come and share their
    experience as well. And so I want to thank you all for giving me a
    chance to come.
        One thing I didn't say--I do want to conclude by saying, Dr. Steve
    Uebbing, who is the superintendent of
    schools--when I came through the line, he told me about his son
    Daniel's service in the United States
    military. I meant to thank a good, proud dad, but more importantly, I
    want to thank his son for volunteering to serve his country, for
    volunteering to serve.
        And for the students listening, I urge you to find out a way to
    serve your community. Mentor somebody; help feed the hungry; provide
    shelter for the homeless. If you're interested in volunteering for the
    military, that's one way to serve. Peace Corps is a fantastic
    opportunity to serve your country. Being a teacher is a fantastic way to
    serve your country. The strength of the United States of America is not
    the size of our military or the size of our wallets; the strength of the
    United States of America is found in the hearts and souls of decent,
    honorable, compassionate people who have heard a call to serve something
    greater than themselves.
        Thank you all for giving me a chance to come by. I ask for God's
    blessings on you all and on the United States of America. Thank you.

    [[Page 478]]

    Note: The President spoke at 11:45 a.m. in the Canandaigua Academy
    Theatre. In his remarks, he referred to Stephen J. Uebbing,
    superintendent, Canandaigua City School District; and Mayor Ellen
    Polimeni of Canandaigua, NY.