[Weekly Compilation of Presidential Documents Volume 36, Number 24 (Monday, June 19, 2000)]
[Pages 1354-1356]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks on Medicare Prescription Drug Coverage

June 13, 2000

    Well, Ruth, this is the most laughs we've had in this room in a long 
time. [Laughter] You can come back tomorrow and the next day and the 
next day. [Laughter]
    She made the trip all the way from Idaho here. She had bad weather 
in Chicago last night. This is hard. She went to a lot of trouble to 
come here. Let's give her another hand. Let's thank her very much. 
[Applause]
    I want to thank Secretary Shalala for her work on this. And 
Congressman Strickland, thank you, sir. And I especially want to thank 
Senator Max Baucus who has been on this issue of the particular impact 
of the prescription drug problem on rural seniors for a very long time 
now.
    I'd also like to introduce the other Members of Congress who are 
here from rural America: Behind me, Congressman John Baldacci from 
Maine; Congressman Marion Berry from Arkansas; Congressman Leonard 
Boswell from Iowa; Congressman Chris John from Louisiana; Representative 
Paul Kanjorski from Pennsylvania; Representative David Minge from 
Minnesota; Representative Ciro Rodriguez from Texas; Representative John 
Tanner from Tennessee; Representative Jim Turner from Texas; and 
Representative Bud Cramer from Alabama. I think that's everybody. Let's 
give them a hand. They're all on our side. [Applause]

Patients' Bill of Rights

    We're involved in two or three great health care issues here in this 
millennial year, and I want to talk about, obviously, the one that we 
came to talk about, but there was a very important decision yesterday by 
the Supreme Court on HMO's that I would like to just mention briefly.
    We--those of us that have been pushing a strong Patients' Bill of 
Rights--believe Americans should have the right, even if they're in 
HMO's, to see a specialist, to go to the nearest emergency room, to 
maintain continuity of care if they change jobs--if they're in a cancer 
treatment, for example, or in the process of having a baby--and they 
have a right to hold their health plans accountable.
    But yesterday the Supreme Court--I've got this headline here that's 
in all the papers--``HMO Ruling Passes Debate Back to Congress.'' The 
Supreme Court ruled yesterday, I believe unanimously, what we all knew, 
which is that only Congress can provide to the American people in HMO's 
a comprehensive Patients' Bill of Rights.
    Now, we've been fighting this battle a long time. And there's, 
obviously, I think--there's a clear majority in the House for a good 
bill, and we failed by only one vote in the Senate this week. We think 
there's a majority there, if we can ever get a clean shot. So we're 
going to keep working. But I just want to emphasize, the Supreme Court 
now has removed any doubt that this can be handled anywhere but 
Congress.

Medicare Prescription Drug Coverage

    Now, the same is true about dealing with this prescription drug 
issue. They have become an indispensable part of modern medicine. But 
more than three in five seniors in America on Medicare now lack 
dependable insurance coverage for the drugs that could lengthen and 
enrich their lives. And as the report we're releasing today shows, the 
situation of rural seniors is even worse.
    Now, you heard Ruth talk about her situation. We know that rural 
seniors have a harder time getting to a doctor or a pharmacy. They're 
just further away. We know they're much less likely to have HMO's or 
other insurers willing to offer reasonably priced coverage; they don't 
have economies of scale. Yet, more often they are in poor health and in 
need of prescription drugs than their urban and suburban counterparts.
    As a result, rural seniors and rural people with disabilities spend 
25 percent more out-of-pocket for the prescriptions they need. They are 
60 percent more likely not to get those drugs at all. You remember what 
Ruth said, that she knew people who could not afford to fill the 
prescriptions their doctors

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had ordered them to take. And it is important to emphasize that, 
depending upon the size of the monthly bill, this could be true not only 
for low income seniors but also for middle income seniors.
    This report could not be more timely, because we--you can't go vote 
yet; I'm nearly done. [Laughter] This is amazing to me that we're even 
having this debate. We've got a strong economy. We've got a big 
projected surplus. We know that the surplus will be revised upward by 
some amount in the so-called midsession review that's coming just a few 
days from now. Now, there is no excuse not to do this right, not to 
provide prescription drug coverage under Medicare.
    If we were starting Medicare all over again, everybody knows we'd do 
it. It's just that it was created in 1965 as basically a problem for 
serious medical emergencies and for doctors, for hospitals. In the last 
35 years there's been a sea change in what pharmaceuticals can do to 
keep people healthy, to keep people living, to keep people out of the 
hospital. So the real question is, are we going to do now what we would 
have done in 1965 if we'd have the tools then that we have now, and are 
we going to do it in the right way and provide it as an optional benefit 
to all the people on Medicare? That's what we think we ought to do.
    And I believe it's very important that we not provide a prescription 
drug benefit that is some sort of faint hint at doing what needs to be 
done and that would wind up being nothing more than a broken promise to 
a lot of our seniors. I think we need a bottom-line, simple, 
straightforward plan that all seniors have a chance to buy into. You 
heard Ruth say she didn't mind paying a little bit of a co-pay, making a 
contribution. But people like her need access to this plan.
    Now, my budget proposal would extend the lifeline of optional 
prescription drug coverage to all seniors by allowing them to sign up 
for drug coverage through Medicare. No matter where they live, how sick 
they are, they would pay the same premiums. The plan would use price 
competition, not price controls, to give seniors everywhere the best 
prescription prices. It would help cover the expenses of seniors who 
face catastrophic costs and is part of an overall plan that would 
strengthen and modernize Medicare to keep it efficient and solvent, to 
add more years to the Trust Fund so that we can begin to absorb the baby 
boom generation.
    There's growing bipartisan support for prescription drug action this 
year, and that's good. But I'm quite concerned that the proposals the 
House Republicans intend to put forward today won't help the Americans 
who need it the most. Today--and let me just describe why, and think 
about the story you just heard Ruth Westfall tell. Today's report on the 
special needs of rural seniors makes it clear that we need a benefit 
that's available for all older Americans. My understanding is that the 
latest Republican proposal relies on a private insurance model that has 
already failed rural Americans.
    You just heard her say that she couldn't afford Medigap. And there 
are tons of people in this country who can't afford the Medigap 
insurance policy. Most people with gray hair out in this audience are 
now nodding their head vigorously--I hope the press has picked that up. 
Rural Americans, by and large, can't afford Medigap insurance. It makes 
no sense to use something that's failing today as our model for 
tomorrow, especially when we do not have to do it.
    We ought to ensure that any plan benefits the people who need 
prescription drugs as much as it benefits the companies who sell the 
drugs. We have reached across party lines before. We passed the Kennedy-
Kassebaum bill to allow people to take their health insurance with them 
when they change jobs. We passed the Children's Health Insurance Program 
as part of the 1997 Balanced Budget Act, which has provided millions of 
children in lower income working families access to health insurance. We 
can do this.
    But there's no point in telling the American people we're doing 
something that turns out to be a fraud. And there's no point in 
pretending that only poor seniors need this help. That is not true. This 
is a need that's out there for people, based on the size of their 
medical bills as much as on the size of their monthly income check. And 
to say, ``Well, we're going to spend a little bit of money and take care 
of the very poorest seniors, but anybody else we're going to put in some 
private insurance market that is already

[[Page 1356]]

a proven failure''--that the insurance companies themselves, to their 
credit, say will not work--is a bad mistake.
    I think we ought to be helping people like Ruth Westfall. I sat 
there listening to her talk. She said she was proud of the life that she 
and her husband built. They worked hard so that they wouldn't have to 
depend on other people, so they wouldn't be a burden on other people. I 
can tell you that that story is a story that the baby boom generation 
wants to tell when we all get retired. And as the oldest of the baby 
boomers, I can tell you it's a story that we worry about all the time 
not being able to tell, because there are so many of us.
    Now, there's no point in letting politics or ideology get in the way 
of the manifest need of the seniors of this country and the disabled 
Americans who have access to Medicare to get these prescription drugs. 
And we're not broke now. I've worked real hard for 7\1/2\ years to make 
sure I didn't leave us broke when I finished. We've got a good surplus. 
And if we were in deficit and trying to do this, I could understand why 
we would say, ``Well, we can't help everybody, so we'll just help a 
few.'' But that's not the situation. We can afford to do this right. And 
we must not pass a plan that claims to offer something to everybody and 
is a false hope to most and, therefore, inadequate.
    So I want to ask you all to remember this fine woman that hauled 
herself all the way here from Idaho. And she's still vigorous. She's 
still got a lot to give, and there's millions like her out there, and we 
owe it to them to do the right thing. And I want you to stick with these 
Members of Congress behind me. I thank them for being here. Let's get 
this done this year.
    Thank you very much.

 Note:  The President spoke at 10:15 a.m. in Presidential Hall in the 
Dwight D. Eisenhower Executive Office Building. In his remarks, he 
referred to Medicare recipient Ruth Westfall, who introduced the 
President.