[Weekly Compilation of Presidential Documents Volume 39, Number 31 (Monday, August 4, 2003)]
[Pages 1015-1019]
[Online from the Government Publishing Office, www.gpo.gov]
<R04>
Remarks on the 38th Anniversary of Medicare
July 30, 2003
Thank you all for coming. Welcome to the people's house. We're
thrilled you're here. Tommy is right; 38 years ago, Lyndon Johnson
signed the Medicare Act. What I found interesting was that he had the
ceremony in Independence, Missouri, so that former President Harry
Truman could be there, because Truman had set out the vision of Medicare
many years before that. A few minutes after 3 o'clock, Medicare became
law, and President Johnson handed the first Medicare card to Harry
Truman.
Health insurance for elderly and disabled Americans was one of the
greatest, most compassionate legislative achievements of the 20th
century. It spared millions of seniors from needless worry and hardship.
Since 1965, every President and every Congress has had the
responsibility to uphold the promise of Medicare, and we will uphold our
promise. We will do our duty.
The 38th anniversary of Medicare is a time for action. The purpose
of the Medicare system is to deliver modern medicine to America's
seniors. That's the purpose. And in the 21st century, delivering modern
medicine requires coverage for prescription drugs.
Both Houses of Congress have passed Medicare improvements that
include prescription coverage. Now the House and Senate must iron out
the remaining differences and send me a bill. For the sake of our
seniors, for the sake of future retirees, we must strengthen and
modernize Medicare this year.
I appreciate Tommy Thompson taking the lead on this issue for this
administration. He--I knew him when he was a Governor. I figured he'd
make a pretty good Cabinet Secretary--[laughter]--and he proved me
right. He's doing a fabulous job. He is the point man on the Hill on
this complex, important legislation.
And we've got two of the Members from the Senate who have worked
really hard to see to it that the legislation came to fruition and
passed the Senate and are working hard to get a good bill out of the
conference, and that's--starting with the majority leader of the United
States Senate, Bill Frist from Tennessee; the ranking member on the
Finance Committee from the State of Montana, that would be Max Baucus,
Senator Baucus. For those of you who don't follow politics--[laughter]--
Frist is a Republican--[laughter]--Baucus is a Democrat--[laughter]--
both of them willing to put aside party to focus on what's doing right
for the seniors. And I appreciate their leadership of both these
Senators. Thank you all for coming. You set a good example for the body
you represent.
I appreciate Tom Scully, who is with us. He is the Administrator for
the Centers for Medicare and Medicaid Services. That is a long title for
a very tough job. And I appreciate Scully's knowledge on this issue. He
too, along with Secretary Thompson, is working the Hill, along with
members of my staff, working hard with Senators and Congressmen from
both parties to come up with a bill that will stand the test of time.
I want to thank top docs in my administration who are traveling the
country to talk about the benefits of Medicare reform. Rich Carmona is
the Surgeon General of the United States. Thank you for coming, Doc. Dr.
Julie Gerberding directs the Center for Disease Control and Prevention.
It's a tough and important job. Mark McClellan is the Commissioner of
the FDA, the Food and Drug Administration. Elias Zerhouni is the
Director of the National Institute of Health--all four great Americans,
all four fine doctors, all four doing a really good job on behalf of the
American citizens.
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On a piece of legislation like this, there's a--it obviously
attracts the attention of advocates, people who are willing to get
involved in the process, people who work hard on behalf of the
constituents they represent. Today we've got Jim Parkel and Bill
Novelli. Jim is the president, Bill Novelli is the director and CEO of
AARP. I'm honored you all are here. Thanks. Thanks for providing such
good leadership for all.
There's a group involved in the process called United Seniors
Association. It's headed by Charlie Jarvis. He's the chairman and CEO,
and Charlie is with us today. Thank you for coming, Charlie.
Representing the 60 Plus Association is my long-time friend, Jim Martin.
Thank you for coming. I'm glad you're here.
I want to thank those of you who are here today for your interest. I
want to thank our fellow citizens who may be watching this on C-SPAN, if
it happens to be on C-SPAN--seems like everything is on C-SPAN these
days--[laughter]--for your interest in this very important issue.
You know, for a long time Medicare was called ``Mediscare,'' and it
meant that political people weren't supposed to touch it for fear of
losing an election, that when you talked about reforming Medicare, then
all of a sudden you were supposed to lose because people would bang you
over the head on the issue. I think we're beyond that, and that's a very
positive development. A lot of you in this room have helped us get
beyond that, and I want to thank you for that. Now we've got hard work
to do to get this process across the line.
I'm joined onstage, by the way, by some of our fellow citizens, who
I'll talk about in a little bit about how the current Medicare plan as
envisioned by a lot of us will help in their daily lives. But let me
start by telling you this: For four decades, it's important for our
citizens to know that Medicare has done exactly what it was created to
do, which is pretty unusual for an act of Congress--[laughter]--in all
due respect. [Laughter] Under Medicare, older Americans have access to
good quality health care in a system of private medicine. That what it
was intended to do, and that's what it has done. Seniors and people with
disabilities have greater peace of mind knowing that Medicare will
always be there. It was the initial intent of the law, and that's what
it has done.
Medicare coverage has helped protect the savings of our seniors and
shielded their families from costs they may not be able to afford.
Medicare is an important national achievement, and it is a continuing
moral responsibility of our Federal Government. Americans are proud of
our Medicare program. We must make sure that Medicare fits the needs of
our seniors today. It has done what it was supposed to do. Our task is
to make sure it continues to do what it was supposed to do.
It was created at a time when medicine consisted mostly of house
calls and surgery and long hospital stays. Now modern medicine includes
preventative care, outpatient procedures, and at-home care. Medicine is
changing. Many invasive surgeries are now unnecessary because of the
miraculous new prescription drugs being developed. Most Americans have
coverage for all this new medicine, yet seniors relying exclusively on
Medicare do not have coverage for most prescription drugs.
No one intended for Medicare to develop these major gaps in
coverage. That was not the initial intent of the law. There are gaps in
coverage now. Medicine has changed. Medicare hadn't. We must fill those
gaps. Medicare must be modernized.
Let me give you a couple of examples by what I mean when I talk
about modernization. Medicare today will pay for extended hospital stays
for ulcer surgery at a cost of up to $28,000 per patient. This is
important coverage. Yet Medicare will not pay for drugs that eliminate
the cause of most ulcers, drugs that cost about $500 a year. Medicare
will pay for the cost to treat a stroke, including bills from the
hospital and rehab center, doctors, home health aides, and outpatient
care. That's what Medicare pays for. Those costs can total up to
$100,000. This is essential coverage; it's vital coverage. Yet Medicare
does not cover the blood-thinning drugs that prevent strokes in the
first place, drugs that cost less than $1,000 a year.
The Medicare system has got a lot of strengths, no question about
it. Yet it is often slow to respond to the dramatic changes in
[[Page 1017]]
medicine, and that's what we've got to address. That's what we are
addressing.
The best way to provide our seniors with prescription drug coverage
and better preventative care is to give them better choices under
Medicare. If seniors have choices, health plans will compete for their
business by offering better coverage at affordable prices.
Both Houses of Congress have passed bills that follow the framework
of reform that I suggested and others have suggested. Under either bill,
seniors who want to stay in current Medicare have that option plus a new
prescription drug benefit. Seniors who want enhanced benefits, such as
coverage for extended hospital stays and protection against high out-of-
pocket expenses, will have that choice as well. Seniors who like
managed-care plans will have that option as well. All low-income seniors
will receive extra help so that all seniors will have the ability to
choose a Medicare option that includes a prescription drug benefit.
Many retirees depend on employer-sponsored health plans for their
prescription drug coverage. That's a reality in today's society.
Medicare legislation--the legislation that these two good Senators are
working hard on--should encourage employers to continue to provide those
benefits while extending drug coverage to millions of Medicare
beneficiaries who now lack it. It's important that those who have
assumed the responsibility--corporate responsibility of providing
prescription drugs for their retirees keep providing that benefit. And I
know the Senators are working on that important part of the Medicare
legislation.
Every Member of Congress gets to choose a health coverage plan that
makes the most sense for them, and so does their staff. So does every
Federal employee, and so should every senior have that choice. See,
choice is good. It makes sense. I can understand why Members of Congress
have said, ``Well, look, give me more than one option if you don't mind.
I'm plenty capable of choosing for myself. I'd like to see what's
available. As a matter of fact, I'd like to have my demand be listened
to. I'd like to have plans begin to tailor their services to what I
think is necessary for me.'' And seniors should have that same option,
it seems like to me. Seniors are plenty capable of making decisions for
what's best for them.
For seniors without any drug coverage now, these reforms will help a
lot. Let me tell you what I mean by that. In return for a monthly
premium of about $35 or about a dollar a day, seniors now without
coverage will see their drug bills cut roughly in half. That's the good
work that these Senators have done. They've heard the call and they're
responding with a piece of legislation that will help seniors save
money.
A senior with a monthly drug cost of $200 will save between $1,300
and $1,800 on drug costs each year. That's under the bills that have
been passed now. A senior with a monthly drug cost of $800--monthly cost
of $800 would save between $5,700 a year and $6,100 each year on drug
costs. That's some pretty good change.
The House and the Senate have got to work out their differences, and
they're going to. This is--I believe that there's a spirit of
cooperation and a can-do attitude amongst the conferees. But in either
version of their bills, seniors who currently lack drug coverage will
see real savings, and that's a positive reform for a lot of our fellow
citizens.
As we move toward this system, we will provide seniors with a drug
discount card that saves them 10 to 25 percent off the cost of all
drugs, so they'll start seeing savings immediately as well. The
conferees, I know, are working on the drug discount card now to make
sure we can iron out any differences, and I was briefed on that today by
our staffers who are working close with the conferees.
We have some seniors, as I mentioned, with us today--some citizens
with us today that would like to see the legislation move forward for
practical reasons. A lot of times in Washington we talk about statistics
and laws and hearings, and I always like to bring the human element to
the front so people get to see how these bills will actually affect
people's lives in a positive way.
Mary Jane Jones from Midlothian, Virginia, is with us today. She's a
Medicare recipient. She's 69 years old. She'd like to be retired for
good. [Laughter] But she has to work 20 hours a week just to make sure
she can afford her nearly $500-a-month bill for
[[Page 1018]]
prescription drugs and insulin. Sometimes, she says, she uses her
insulin needles 3 or 4 times to save money. That's a story I'm confident
that those who have held hearings in Congress or members of groups up
here hear from their members.
Mary Jane says that getting about half her drug cost covered would
be a big help. That way, she says, she wouldn't have to work constantly.
Seniors like Mary Jane have made their plans. This bill will help them
enjoy their retirement.
Refa Ryan is with us from Warrenton, Virginia. She has Medicare. She
doesn't have drug coverage, and she pays $120 to $200 a month for
medicine. Three years ago, when she was having a hard time making
payments on her drugs, rather than asking someone for help, she was
ready to sell her engagement ring. Fortunately, Denise found out about
it and bought the ring so it stayed in the family. Refa says she
appreciates what Congress is trying to do to add drug coverage to
Medicare.
``I wouldn't be anxious all the time,'' she said. ``I wouldn't have
to worry all the time.'' See, this bill will help our seniors not have
to worry all the time. And that's why there's momentum toward getting
something done.
I also fully recognize that there are some that are beginning to
think about what Medicare means when they retire. I might be one of
them. [Laughter] There's some baby boomers that are beginning to look
out and say, ``Medicare isn't going to be there. Is it going to be
modern when we get ready?''
In support of what I know the Senators are doing and Members of the
House are doing, the conferees are doing, is that they're thinking not
only to make sure the system works for our seniors today but make sure
that seniors--I mean, that the seniors-to-be have got a plan available
for them and that most of us in the baby boomer era, we like the idea of
choices. We want to be able to pick and choose to help meet our needs.
We want to make sure that the system is--kind of listens to the demand
of the citizen.
Richard Kamenitzer is with us. Richard and I are of the same
generation. It says in here he and his wife, Rose Marie, are in their
fifties. Well, Laura and I are in our fifties too. He's from
Stroudsburg, Pennsylvania. He's a self-employed guy. He's a part of the
entrepreneurial class here in America. He's a small-business man, and he
and his wife take about seven medications a day right now. Now, he's
probably beginning to wonder, after he retires, how can he afford seven
medications--he and his wife--a day? Who's going to pay for it?
He said--here's what he says, with drug coverage and Medicare, about
the new plans that we're trying to get done. He said, ``I'd have a
fighting chance''--that is, ``I would have a fighting chance to enjoy
retirement. Without it, I don't know what I'd do. Retirement, in a
sense, may be out of the question, because I won't be able to afford the
prescriptions I desperately need.''
See, not only are we talking about helping the seniors today who are
on Medicare; we're talking about the ones getting ready to get on
Medicare too. And that's why these folks are thinking beyond just the
immediate. We want a plan that stands the test of time. Remember, the
plan that Lyndon Johnson signed was pretty effective for four decades.
We have a chance to do the same thing here in Washington, DC.
I know that Congress is listening to the voices of the retired and
near-retired. And I appreciate that very much. I appreciate the
willingness throughout all the Federal Government to give our seniors
and those living with disabilities the kind of options they deserve, the
kind of hearing that they want. We should not let another Medicare
anniversary go by without modernizing the system, without giving our
seniors--[applause].
The Senate, I think, is getting ready to go out on the August
vacation. We're certainly pulling for you to go out. [Laughter] The
House is already gone. They're in their districts. They'll be listening
to the people, and I know Americans who are concerned about this issue
will want to make their voices heard. And we, of course, urge you to do
so. We urge you to contact your Member of your House and your Senators
and let them know your thoughts on Medicare reform. Let them know that
we expect to plow through the doubts and the obstacles and get a good
bill to the President's desk. My pen is ready. I'm ready to sign a good
bill.
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I know that this August, staff members of the conference will be
working. And for those staff members who are here, I want to thank you
for grinding through a complex piece of legislation and working out your
differences. And then when the Members come back, we'll have some heavy
lifting to do. But I want to be there to help you carry the load.
We've all come to Washington, those of us who have been elected to
office, to serve something greater than ourself. And we have a duty and
a call to not only describe a problem but to address it. And in this
case, when we do, the lives of our fellow citizens will be improved.
I want to thank you for your interest in this really important
subject, thank the two Senators who have joined us today. I want to
thank the members of my Cabinet who are here.
May God bless you all, and may God continue to bless the United
States of America.
Note: The President spoke at 2:45 p.m. in the East Room at the White
House. The Office of the Press Secretary also released a Spanish
language transcript of these remarks.