[Weekly Compilation of Presidential Documents Volume 39, Number 48 (Monday, December 1, 2003)]
[Pages 1698-1704]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks at the Los Olivos Senior Center in Phoenix, Arizona

November 25, 2003

    Thanks for coming. I'm thrilled to be at Los Olivos Center. You're 
kind to have me. And I'm here to talk about some issues facing our 
Nation, probably an issue you'd like to hear about, which is Medicare. I 
think you probably have heard of Medicare. [Laughter] I think you 
probably recognize that Medicare needs to be modernized and reformed so 
it works better for you.
    The United States House of Representatives, the United States Senate 
recently took historic action to modernize and to strengthen the 
Medicare system so it works for you. I'm here to tell you, I look 
forward to signing a good piece of legislation which says that our 
country will keep our commitment to today's seniors and prepare to 
receive tomorrow's seniors into Medicare--people like me--[laughter]--
with a system that's modern and strong.
    You know, our job in Washington is to tackle problems when we see 
them, not to pass them on to future Congresses or future Presidents or 
future generations. I want to thank the Members of Congress for taking 
on this very difficult issue. I appreciate them for their hard work. 
Medicare has worked for many people. It got a little old. It got a 
little tired. It needed to be changed. We changed it, and the system is 
better for it.
    The Members of Congress who are here, I appreciate them coming. 
Senator Jon Kyl is one of the fine Members of the United States Senate. 
Congressman Rick Renzi, he's from the north; Trent Franks is from the 
north--Congressman Franks, and Josie, his wife, is with him; J.D. 
Hayworth--I don't know if you've ever heard of J.D., but--[applause]. 
They're fixing to call J.D. ``Slim,'' ``Slim'' Hayworth. [Laughter] Jeff 
Flake is with us. Jeff, I'm honored you're here. Congressman Jim Kolbe 
from Tucson, Arizona, is with us. I'm honored. These are all fine 
Members of the United States Congress. I've enjoyed working with them 
all. They're good,

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honest men who care deeply about the citizens of the State of Arizona.
    I appreciate Jan Brewer, who is the secretary of state of the great 
State of Arizona, with us. Your mayor is with us, Skip Rimsza. I'm 
honored, Mr. Mayor, that you're here. My only advice to the mayor is to 
make sure you fill the potholes. [Laughter] He's been doing a great job 
of filling the potholes for the people of Phoenix, Arizona. It's a--I 
know he's fixing to leave office, but I--the people of this city owe him 
a debt of gratitude for nearly 10 years of great service, great honest 
public service.
    I want to thank Cindy McCabe, who is the executive director of this 
fine center. I really appreciate you and your staff putting on this 
event. It's not easy to have the President come. You know, these 
entourages are quite big--[laughter]--a lot of people roaming around 
when the President is here. But the center has done a fabulous job of 
welcoming us, and I'm really glad I came.
    Mark McClellan is with me. He's a Texan, kind of like I am. And he's 
the Commissioner of the Food and Drug Administration, the FDA. He's got 
a huge responsibility, and he's doing a really good job. I appreciate 
you coming, Commissioner. I'm honored you're here.
    You know, a lot of times people talk about the strength of America, 
and they think in terms of the number of airplanes we might have or, you 
know, look, the number of soldiers in uniform or the size of our 
wallets, but that's really not the strength of our country. The strength 
of America is the hearts and souls of the American people. You think 
about it. That's what makes this country incredibly strong. It's the 
fact that people are willing to reach out to a neighbor in need. I call 
them soldiers in the army of compassion. That's the most important army 
here in America, in many ways, when you think about it.
    I met a soldier. She's probably a general, although she would call 
herself a simple private. That would be Maybelle Harris. Maybelle, where 
are you? There she is, Maybelle. She's a Sunshine Lady for AARP. She 
sends cards to people who are celebrating and/or mourning the loss of a 
loved one. In other words, she understands that there's a special 
responsibility for those of us who are fortunate in this country to help 
people who might have a hurt in their heart.
    Maybelle is, since '82--has been a member of the Gold Star Wives 
club. This is an organization dedicated to assisting widows of military 
servicemen. Maybelle, I want to thank you for your compassion. I want to 
thank you for the example you have set. You make it clear that America 
can change, one heart, one soul, one conscience at a time. And you set a 
fine example for--particularly people coming up here in America--that in 
order to be a solid citizen, love your neighbor just like you'd like to 
be loved yourself. I appreciate your example, Maybelle.
    We've got the world's greatest health care system. I hope you 
understand that. I say that with certainty. We've got the best docs in 
the world. We've got fabulous nurses. We've got wonderful facilities for 
people to go to. We've got wonderful research in America. I mean, if you 
really think about the research we do in this country, the lifesaving 
research, the pharmaceutical drugs that change people's lives in a 
positive way, it is--you understand when I say we've got the best health 
care system in the world.
    And we need to keep it that way. We need to make sure it continues 
to be the best health care system in the world. A lot of that has to do 
with honoring our obligation to our seniors and to make sure the 
Medicare system works well. Some it has to do with making sure that we 
don't have too many lawsuits in our society, which runs good doctors out 
of practice and runs up the cost of medicine, that makes it hard for 
people to get good health care.
    I believe we need medical liability reform at the Federal level, 
medical liability reform which will say, ``If you get harmed by a bad 
doctor, you ought to have your day in court.'' Of course you ought to be 
able to sue. But we've got to get rid of these frivolous lawsuits that 
cause our docs to practice defensive medicine, which runs up your cost 
of medicine and runs some doctors out of practice. This country needs 
national medical liability reform.
    I want to thank Kyl and the Members of the House for supporting 
these measures. We got a good bill out of the House. It's

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stuck in the Senate. [Laughter] Some Members of the Senate must 
understand--and by the way, your Senators don't need this message, but 
some--maybe in some neighboring States they need it. No one has ever 
been healed by a frivolous lawsuit in our society. For the sake of good 
health care, for the sake of keeping our docs in practice, and for the 
sake of making sure our customers, the patients of America, have health 
care that's available and affordable, we need medical liability reform 
at the Federal level.
    We need to make sure we've got a Medicare system that works. It's 
first important to recognize that Medicare is a basic trust between our 
Federal Government and our citizens. The Federal Government said, 
starting in 1965, this is our responsibility to make sure our seniors 
get a health care system that works. And therefore, we have a Federal 
responsibility to make sure that the health care system is the best we 
can possibly come up with through law for our seniors.
    Part of making sure American health care works is to make sure 
Medicare is modern, and that's what the bill I am going to sign does. It 
changes the Medicare system, which needed to be changed. Medicare has 
not kept up with the advances of modern medicine. That's a fact. And we 
have a choice in Washington to ignore that fact or to deal with that 
fact.
    When Medicare was passed in '65, health care meant house calls, 
surgery, and long hospital stays. And that's how the Medicare system was 
designed, to deal with that type of medicine. Medicine has changed. 
Modern medicine now means preventative care, which is not a part of 
Medicare, outpatient procedures, at-home care. In other words, medicine 
changed. Invasive surgeries are now unnecessary because of miraculous 
new prescription drugs that have been developed. Think about how much 
medicine changed since 1965. Medicare didn't change with it.
    You know, most Americans have coverage for new forms of health care. 
That's the fact. But seniors who rely exclusively on Medicare do not, 
and that's why we needed to change the system. Medicine changed. 
Medicare hadn't. The Congress dealt with it, and now we can say Medicare 
is modern. And that's important change for the health care and for 
quality of life for our citizens.
    I'm sure you've heard some question the need to change the system. I 
will give you an example of why we needed to change it. It's a clear 
example of why we need to change it. Medicare will pay $28,000 for a 
needed hospital stay for ulcer surgery. Yet it will not pay for the $500 
for the anti-ulcer drugs that would keep the senior out of the hospital 
in the first place. Now, that doesn't make any sense to me. See, we'll 
pay the $28,000, but we won't pay the $500 to keep from having to pay 
the $28,000 in the first place, see.
    We needed to change the system. Medicare ought to cover medications 
that will keep our seniors from getting sick in the first place. And yet 
it doesn't for those who rely exclusively on Medicare. Medicare was not 
quick to change as medicine changed. After all, there was a bureaucracy 
that had to make the decisions. Bureaucracies don't move very fast; 
they're slow. Bureaucracies are cumbersome.
    Many times, it took a law from the Congress to change what was 
covered under Medicare. And getting laws out of Congress sometimes 
aren't easy either. It's a cumbersome process. It's not a very good 
system. Private plans were able to adjust quickly. Private plans were 
able to meet a consumer's demand. Medicare was stuck, see. It just 
wouldn't change.
    And so one of the things we've done in this new bill and this new 
system is we recognize that seniors are plenty capable of making 
choices, that a senior is able to choose. A senior is plenty capable of 
being able to say, ``Here are the pros and cons of these very plans, and 
I want to take this plan that matches my needs.''
    One way to get Medicare to change is to give seniors choices. See, 
Congress has got choices. If you've got a health care plan for the 
Congress, you can say, ``I like this plan,'' or ``I like that plan,'' or 
``I might want this.'' But in Medicare, the old Medicare system, you 
didn't have that choice. And therefore, the delivery of certain 
procedures and technologies were slow in coming, and that's not right. 
The system was stuck in the past, and we needed to do something about 
it.

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    And our job in Washington is to solve problems, not pass them on. 
And that's what we did. This is a good piece of legislation, important 
reform. It will take about 2 years to get the reforms in place. It's a 
complex--listen, when you change something that's been in effect since 
1965 by legislation, it's--there's a lot of print, a lot of pages. It 
was a hard piece of work, don't get me wrong. And so it's going to--
there's going to be a transition period.
    But Congress wisely said, ``We've got to do something during the 
transition period,'' and what that is, is that seniors will be given a 
health care card, a prescription drug card that you'll be able to use 
and be able to get a discount of up to 10 to 25 percent on the drugs you 
now currently take. That's a positive development. You will get a card 
within 6 months, a discount card that will allow you to take it to where 
you're buying your drugs, and you'll get a discount. Plus, if you're a 
low-income senior, you'll get $600 a year as a credit on that card to 
help you buy drugs.
    Congress was wise in helping with the transition. Congress was smart 
to enable people to better afford prescription drugs, since prescription 
drugs is the newest form of medicine relative to the past. When the full 
drug benefit arises in 2006, all seniors will be eligible for 
prescription drug coverage for a monthly premium of about $35. The 
result is that for most seniors without coverage today, the Medicare 
drug plan will cut their annual drug bills roughly in half. That's 
positive for our seniors who are relying upon prescription drugs. 
Seniors with the highest drug bills, of course, will save the most. 
Seniors with the greatest need will get the most help.
    Low-income seniors will pay a reduced premium or no premium at all 
and lower or no copayments for their medicines. Congress wisely said, 
``We want to help the lowest-of-income seniors have a modern Medicare 
system with no premium and no copayments in certain cases.'' And I 
appreciate Congress for the compassion.
    John Bajusz is with us. He's on the stage. I just had a--by the way, 
some of these people here and I had a wonderful visit about their 
current desires and needs and frustrations and worries about their 
status, particularly with health care. John has high prescription drug 
costs. He's on a Medicare HMO that provides about $100 in drug coverage 
a month. But he spends about $500 to $600 a month. That probably sounds 
familiar to some of you all. You're on a program that helps a little 
bit. Under the law that I'm going to sign, he will save up to about 
$2,000 a year in his drug costs. That helps John, at least that's what 
John told me. [Laughter] I take his word for it.
    See, we're helping John. We're helping John with a modern Medicare 
system. He's out of pocket $500 to $600 a month. If you say he spends 
six and nets 100, it's about $500 a month. He's going to save $2,000. 
That will come in plenty handy. There's a lot of Johns around America 
who this bill will help in a very positive way. Under the new reforms, 
as I told you, seniors will have choices. That's an important part of 
the bill. We want you to have choices.
    Earlier today I was in Las Vegas, and I met with a couple. The man 
said, ``You know, my wife and I, before we chose our Medicare+Choice 
plan''--maybe some of you are on that plan--``before we chose that plan, 
we weighed out the pros and the cons. I listed the pros and the cons for 
a variety of policies, and we picked Medicare+Choice.'' My point to you 
is, is that he spent a lot of time trying to figure out what was best 
for him and his wife. I'm sure some of you do that as well. That's what 
we want. We want people to be able to have that choice.
    Now, I fully understand some on Medicare don't want to choose at 
all. Some people that are on the current system like where they are, and 
they're frightened by change. And that's realistic. That's reasonable. I 
can understand that. And so could the Congress.
    And so we said that if you want to stay on Medicare, you can, 
traditional Medicare. But now we'll have a prescription drug benefit for 
the first time. And that's important. It's important to recognize that 
change sometimes isn't a part of somebody's future. But a lot of people 
want to choose. And choice is important. See, some people will want 
expanded coverage for hospital stays or protection against high out-of-
pocket medical expenses. People ought to be able to pick a plan. And 
when people pick a plan and they

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start choice, then it's amazing what happens. The plans start meeting 
the needs of the consumer, not the whims of somebody in Washington, DC, 
who gets to make the decision for you. That's an important part of this 
bill. This bill introduces choice for our seniors.
    I met with the Weavers today, Glenn and Marjorie, from Sun City. 
They are on Medicare+Choice. They like the plan. See, they picked it 
out. They said, this plan meets our needs. They want to stay on it. The 
Government was starving Medicare+Choice for awhile. One of the positive 
aspects about the bill I'm going to sign funds Medicare+Choice so people 
like the Weavers have got this plan available for them.
    I met with Dick and Willa Key. They were here. They are not retired. 
They are near retired. They want prescription drug coverage. They want 
choices. See, they like the way this bill is modeled, because their view 
is--and I share this view--the more choices available for our American 
citizens, the more likely it is the health care system will meet their 
needs, and this bill provides that. Make no mistake about it, it 
recognizes that the decisionmaker in this process should be you, the 
American consumer.
    There are other reforms I want to mention briefly. Under the new 
law, when seniors sign up for Medicare, they will get a complete health 
examination so doctors can know their health needs right from the start. 
That was very practical by Congress to do that. It seems like to make 
sense to me that it's very important to diagnose problems early so you 
can solve them. And so Medicare now, for the first time, will have a 
complete health examination available for people who sign up. There's 
obviously an emphasis on preventative care, and that's important.
    The bill provides incentives for companies to keep existing coverage 
for their retirees. I'm sure some of you have worked hard and worked for 
a private concern, and you've got a health care plan now. And the bill 
makes sure that that's a health care plan is still available for you, as 
best as we possibly can. We don't want people saying, ``Well, gosh, the 
Federal Government has now modernized Medicare; we don't have an 
obligation any more. Go to the Government.''
    So Congress did a good job of addressing this issue, and I 
appreciate that. Every American, old and young, will be able to have 
what's called a health savings account. That makes a lot of sense. 
People ought to be able to put money aside tax-free to help their 
families with medical expenses, not only current medical expenses but 
future medical expenses. The health savings accounts will be set up to 
encourage people to choose healthy lifestyle choices. When you've got 
your own money out there for your health care that you can see on a 
daily basis, all of a sudden, you start making better choices with your 
life.
    And these health savings accounts are not only important for 
seniors, but they're also important for younger workers as well to be 
able to utilize. Congress wisely put these in place. Health savings 
accounts not only will encourage people to make right choices but will 
make--will help maintain the doctor-patient relationship, which is a 
vital part of a effective and excellent health care system.
    The bill helps rural hospitals. Hospitals in Phoenix don't qualify 
as rural--[laughter]--but some of these Congressmen represent rural 
hospitals. And this bill wisely helps them continue to be a vital part--
to serve the vital part of our country, which is the good folks living 
in rural America. The bill sets up fair reimbursement rates for doctors 
serving Medicare patients. This is a good bill, is what I'm telling you. 
It's an historic achievement. It's a bipartisan achievement.
    See, year after year, the problems in the Medicare system were 
studied and debated, and then nothing ever got done. As a matter of 
fact, Medicare in the political parlance wasn't ``Medicare''; it's 
called ``Mediscare.'' [Laughter] People were scared to talk about 
Medicare for fear of a political backlash.
    And so the problems just festered, and the system got out of date, 
and people weren't getting the health care that they deserved. And the 
Federal Government was not fulfilling its obligation to our seniors, and 
that was wrong.
    And so we moved. We moved in spite of the fact that some up there in 
Washington said that nothing could get done, that it was impossible to 
make reforms. But we acted. And we acted on some solid principles, 
providing new treatments and choices for our

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seniors, provide prescription drug coverage, keep the commitment of 
Medicare to better the lives of America's seniors for not only this 
generation but generations to come.
    That's what we're doing in Washington, DC, and it was hard work. It 
really was. It was a lot of debate and sharp elbows and a lot of 
political dialog. But the Members focused on the most important job of 
all, and that was working for the people, working to make sure that we 
fulfilled our promise. I'm honored to sign this bill. I'm looking 
forward to it. It's a historic piece of legislation. It wasn't perfect, 
but I haven't found a piece of legislation that's perfect yet. 
[Laughter] But we're improving the system, and I can say to the Members, 
job well done.
    I also want to talk a little bit about our national defense. My job 
is to address problems at home, whether it be the economy or health 
care, whether it be medical liability reform, and to work with the 
Congress to get things done. My job as well is to protect the American 
people. It's a solemn responsibility, and I accept it. And I want to 
thank the Members of Congress for joining me in this important task. 
See, I'm not going to forget the lessons of September the 11th, 2001. 
Our life changed that day, didn't it? It really did.
    When we were growing up--when old Senator Kyl and I were growing up, 
we used to think oceans could protect us. We used to think America could 
pick or choose where we--how to deal with a gathering threat. You know, 
if we saw a threat here, we may choose to deal with it or ignore it, 
because we felt pretty safe here at home. We felt like the enemy could 
never get to us. They tried on--they hit us pretty hard on Pearl Harbor, 
but kind of--in our own mind, if the truth be known, we thought that it 
isn't going to happen again.
    And September the 11th, 2001, came, and it happened. It happened in 
one of our great cities. Thousands of people lost their life. I vowed 
that day to never forget the lessons. We will do everything we can to 
protect our people at home, but the best way to protect our people is to 
chase these killers down and to bring them to justice. The best way to 
protect our homeland is to deny them sanctuary in countries that might 
allow them to train or provide them with weapons or training. The best 
way to protect our homeland is to work with allies and friends who 
understand the call to history and to share intelligence and to find 
them.
    And that's what we're doing. Yesterday I went to Fort Carson, 
Colorado. I had the honor of addressing about 6,000 members of our 
military and their families. The military spirit is high. They 
understand their responsibilities. I had the chance to thank them for 
their service to our country, to stand in harm's way. I appreciated so 
very much their sacrifices in Afghanistan and Iraq.
    You see, the issue in Iraq is not only our own security short-term. 
By removing Saddam Hussein, America is safer. So is the neighborhood. 
But the long-term issue is to make sure, in the heart of the Middle 
East, democracy and freedom reign. And that's important for peace. It's 
essential for peace in the world. Free countries are peaceful countries. 
People who live in freedom are people that are peaceful people. Free 
countries don't develop weapons to hurt their neighbors. Free countries 
focus on the aspirations of their citizens, the hopes of their citizens.
    And so we've got a hard task ahead of us in Iraq. But I just want to 
assure you that we will stay the course; we will do the job; we will not 
be intimidated by thugs and killers who will kill innocent Iraqis or try 
to kill our coalition troops to force us out, because I truly believe 
that when we succeed, we will leave behind a more peaceful world.
    Many of you have served our country, and you can understand what I'm 
about to tell you: Freedom is precious. Freedom is inherent in our soul. 
Freedom is not America's gift to the world; freedom is the Almighty's--
Almighty God's gift to every person who lives in this world. We will 
work to protect ourselves, but we'll also work to free people who have 
been enslaved by tyranny, free those who live in a country where they 
get tortured if they speak out. We love freedom in America. We will 
never forget our love for freedom. Our foreign policy is based upon 
freedom and peace, and we'll succeed.
    Thank you all very much. God bless.

Note: The President spoke at 4:33 p.m. In his remarks, he referred to 
Mayor Skip Rimsza of

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Phoenix; and former President Saddam Hussein of Iraq.