[Weekly Compilation of Presidential Documents Volume 40, Number 25 (Monday, June 21, 2004)]
[Pages 1064-1070]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks in a Discussion at the Liberty Community Center in Liberty

June 14, 2004

    The President. Thank you very much. Thanks for coming. We're glad to 
be in Liberty, aren't we? What a great town. Gosh, I want to thank the 
citizens for lining the street and waving to us coming in. [Laughter] I 
really appreciate it. Mr. Mayor--I know the mayor is here, Steve 
Hawkins. Mayor, thank you for--please thank the citizens of your city 
for being so kind, and it's really great to be here.
    You're wondering why I'm on stage with some local citizens, 
important Washington, DC-type personalities--[laughter]--it's because 
we're going to talk about something really important that's happening in 
the country, and that is, we're going to talk about how to make sure our 
seniors get the best health care possible. That's what we're here to 
talk about. We've got some--this is going to be a very interesting 
discussion, one that I think you'll find to be educational, one that 
will help illuminate what's going on with a good piece of law in a 
practical way. Before I do, I want to say something about my friend Sam 
Graves. Congressman Graves, thank you for coming. I asked him what he 
did to lose weight. [Laughter] He looks a lot prettier now than he used 
to. [Laughter] He said he quit eating sugar. But he is a fine 
Congressman. I really enjoy working with him. And I appreciate you being 
here, Sam. He's from a farming background. He's plenty capable and 
plenty smart. And I'm saying that because I want him to feel good as he 
gets back in the limousine. I'm giving him a ride on Air Force One back 
to Washington. [Laughter]
    I'm with my friend Mark McClellan. I'll tell you about him in a 
minute.
    Today when I landed, I met a lady named Ruth Blake. Where are you, 
Ruth? Yes, there she is. Ruth, thank you for coming. You're probably 
wondering why I'm introducing Ruth. The reason why is she's from 
Shepherd's Center, which is a--[applause]--sounds like you brought your 
family. [Laughter] Ruth is a volunteer. She manages the adult education 
program that educates and empowers seniors. And the reason I bring that 
up is I just want our fellow citizens here in Liberty, Missouri, to 
understand that I know the great strength of the country is the heart 
and souls of the American people--that our greatest strength--
[applause].
    I see some of our military folks here. That's a strength of America. 
We'll keep the military strong. And we've got to keep the military 
strong to make the world--to help the world be a peaceful world. It's 
incumbent upon America to lead and work with other nations to spread 
freedom. Free countries are peaceful countries. And I believe we have an 
obligation to work toward freedom and peace, not only for our own 
security, not only because we must never forget the lessons of

[[Page 1065]]

September the 11th, but because, in this Nation, we understand that 
freedom is not America's gift to the world. Freedom is the Almighty 
God's gift to each man and woman in this world.
    Another strength of America is the fact that we're a wealthy nation, 
and that's important. It's important that we stay that way, so people 
can find work; they can put food on the table; people can do their duty 
as a mom or a dad.
    But our true strength is the fact that we've got loving citizens who 
are willing to volunteer to help change America, one heart and one soul 
at a time. My call to our fellow citizens is to join the army of 
compassion, which exists in every neighborhood in every city of our 
great land. Make a difference by teaching a child or an adult to read, 
by providing food to the hungry, shelter to the homeless, and together, 
we can make sure the great promise and hope of America is extended to 
every corner of our great country.
    I'm honored you're here. Thanks for coming. Thanks for representing 
the best of America.
    Nearly 39 years ago, not far from here, President Lyndon Baines 
Johnson signed the Medicare law, the first Medicare law. And 
interestingly enough, the first Medicare card was handed to Harry 
Truman. You might remember him--[laughter]--a fine President, I might 
add. But Medicare, which had done a great job for many years, got stuck 
in the past. In other words, medicine began to change, but Medicare 
wouldn't change with it.
    For years, politicians talked about modernizing Medicare. Nothing 
got done, though. As a matter of fact, as you might remember, it became, 
in political parlance, ``Mediscare.'' In other words, somebody would 
talk about it, and they'd use it against him as a political weapon. And 
it was time to get rid of that kind of talk because Medicare is too 
important a program for our seniors.
    We were willing to provide money for operations, but we weren't 
willing to pay for the drugs that would prevent the operation from 
needing to happen in the first place. See, it was stuck in the past. The 
procedures were too old, and it required bureaucratic action to make 
sure that the modern medicine was available to our seniors. It kind of 
crept along. It wasn't doing its job. So we called Congress to task--I 
called Congress to task. I said, ``Let's do our duty as elected 
officials to make the system work better on behalf of our senior 
citizens.'' Congress passed the law. I proudly signed it, and it's going 
to make a positive difference, a big difference in the lives of our 
seniors.
    We're really in a three-stage process. We're going to talk about the 
first stage of Medicare modernization today, which is the issuance of 
drug discount cards. The second stage is what happens next year when 
Medicare begins to pay for preventative medicine, maintenance, and 
screenings for seniors. In other words, for the first time in Medicare's 
history, we're now going to diagnose problems before they become acute. 
That seems to make sense, particularly if you're worried about 
taxpayers' money. In other words, if you act early to prevent problems 
from happening in the first place, it's good for the taxpayers. Medicare 
didn't do that in the past. We're going to do it now.
    And starting in '06, for the first time ever, there will be a 
prescription drug benefit available for people in Medicare. It's a--by 
the way, one of the things I insisted on was that somebody who is happy 
with the current Medicare system doesn't need to change. I mean, I fully 
understand there's a lot of seniors who don't want to change. I know 
that. We needed to change the system to make sure there was a 
prescription drug benefit available. But for seniors who are happy with 
Medicare, plus the prescription drug benefit, you're in great shape. As 
a matter of fact, the program just got better in 2006. And if you're a 
poorer senior, the Government will help you afford the cost of doing--
the cost of medicine.
    For other seniors, there's going to be more choices--for all seniors 
there's more choices. I mean, if you're happy with Medicare, fine. If 
you like the current Medicare + Choice, which will be called Medicare 
Advantage, that's going to be more robust, more available. If you want 
other options available to you, I always felt it was best to trust 
people, not Government, in order to--in the decisionmaking process.

[[Page 1066]]

    And so we're moving down the road to make sure the system is modern 
and to make sure the system works. But today we're going to talk about 
the issuance of cards, drug discount cards that are now available to our 
seniors. And we've got some problems. One problem is there's 
misinformation about these cards. Another problem is, is that people--
they feel like it may be too complicated, the procedures may be too 
complicated to get a drug discount card. Some of them say, ``Well, it's 
not going to matter anyway.'' They've heard political promises before, 
and a lot of times they fall empty. So today we're going to talk about 
how to make sure our seniors understand that the drug discount card 
works.
    We're going to talk to two folks who have used their card. As a 
matter of fact, I witnessed Wanda going to the pharmacy, local pharmacy 
here, and putting her card down, and her drugs--I think which would have 
cost her $19, cost her $1.70, something like that, just about the range 
we're talking about. I may not have the numbers exact.
    Wanda Blackmore. That's about right.
    The President. Yes, I didn't pay for it. [Laughter] The receipt is 
in her purse, I know. [Laughter] It was something like that.
    And that's what we're here to talk about. I want our seniors to 
understand--and this will be repeated several times--that if you have 
any questions about the drug discount card, there is a way to get 
information that will help you, or there's a way for your son or 
daughter to get information to help you, and that is to call 1-800-
MEDICARE. That's all you've got to do: pick up the phone, 1-800-
MEDICARE. And people will answer the phone--is it 24/7--24/7. In other 
words, that means 24 hours a day, 7 days a week, somebody will be there 
to help and answer questions.
    You're going to hear Mark talk about what the Federal Government is 
trying to do to make sure that you understand this information is 
available. There's other ways to--you can log on, if you happen to be a 
high-tech person, and use the Internet. You can go to www.medicare.gov. 
It's not all that hard, and there will be all kinds of information 
available to you.
    And you're going to hear that there's a lot of different choices. 
You bet. That's what we want. We want there to be choices, different 
cards available. That's how you meet different needs. We don't want a 
``one size fits all.'' That's not a consumer-driven system. That's a 
Government-driven system. A consumer-driven system is one that allows 
consumers to make the choices on what's best for them.
    So there's different cards, is what I'm telling you, to meet your 
needs. And I understand, for some that's going to be--it's going to be 
complicated, and some people just don't want their lives complicated. 
And--but you've got to know there's help. And just because it may seem 
complicated, that's not a good--I think people should not use that as an 
excuse to participate, because you're going to find there's good 
discounts; there's good savings. Fifteen percent on brand-name drugs, 
minimum. Isn't that right? Is ``minimum'' the right word to use--
minimum? Thirty percent on generic drugs. Those are the drugs that after 
a patent has expired, they do the exact same thing as the brand-name 
drug but at a much cheaper cost.
    And by the way, he was the head of the FDA before I put him in this 
position. And his job was to speed up generic drugs to the markets. 
People shouldn't be afraid of using generic drugs. They accomplish the 
same thing; you're going to save a lot of money. They asked Wanda--they 
said, ``This is a generic drug, Wanda.'' She said, ``Fine, let me have 
the generic drug. I know it's going to do the same thing as the brand-
name drug, but it's going to cost me a heck of a lot less.''
    In other words, this discount card is going to save our seniors a 
lot of money. And I'm just about running out of air--[laughter]--you'll 
be happy to hear. [Laughter] Want me to keep talking? Okay. [Laughter] 
But she can tell it better than me.
    But first, I want to start off with my friend Mark McClellan. He is 
a doctor and a Ph.D. He's from Texas. [Laughter] And he is the 
Administrator of the Centers for Medicare and Medicaid Services. That's 
his job. His job is to make sure the Medicare system works well and that 
as the law kicks in--in other words, as the system becomes more modern, 
his job is to make sure it happens

[[Page 1067]]

for the benefit of our seniors. I picked a smart guy to do this. He 
understands health care, and he understands the task. And the task is to 
make sure our seniors get the best health care possible, and our 
taxpayers get the best deal possible, as our seniors get the best health 
care possible.
    And so, Mark, welcome. Thanks for coming. As I mentioned to you, he 
at one time was the head of the FDA, and he did such a fine job there 
that I gave him a tougher job. And so, Mark, thanks for coming. Share 
some stuff with us. Tell us what's on your mind. Tell us how our seniors 
can benefit from this program.
    Mark McClellan. Thank you, Mr. President. It's a real pleasure to be 
here with you, with all of you here in Liberty, and especially to be 
working with Medicare at such a critical time. It's just 6 months since 
this new Medicare law was passed, and we already are having the 
opportunity to get drug cost down for seniors that need help right now 
and who have been waiting too long. There's been a lot of talk for a 
long time. We're actually implementing steps right now that are getting 
those costs down.
    And that's coming about through a couple means. The cards is a 
start, but with the cards, you get a chance to band together, to stick 
together to get lower prices on your drugs, just like people who have 
had insurance for their drugs have been able to do for a while. That 
gets negotiated prices down from manufacturers, and that leads to 
savings. And on top of that, we're giving people more information on 
where they can get the best prices so they can comparison shop more 
easily.
    You talked about the fact that consumers can really help us find 
better deals for Americans in many areas, but that's been tough in 
drugs. It's been hard to get prices and hard to know exactly what you 
can--what kind of deal you can get at different pharmacies and through 
different means available, through mail order, through other options 
like that. And we're going to put all that information in front of you 
with this program.
    And as you said, Mr. President, what we're seeing through the drug 
card program is now savings of, very often, 15 to 30 percent or more off 
the list prices for brand-name drugs and much larger savings for generic 
drugs. And we'll also tell you about the generics when they're 
available, so you can find out about more ways to save through using 
generics, whenever they are available.
    And some seniors have been able to get a little bit of help. They've 
been trying hard to find good deals. But often when you go to your 
neighborhood pharmacy, the best you can get is a pharmacy discount card 
that may give you a few percent off the drug store prices but don't let 
you negotiate to get those much lower prices. And that's where these 
real savings are coming from.
    And the most important thing is for people who are having drug costs 
that are causing them trouble right now, or they're struggling with 
their costs, is to find out about this program. As you said, Mr. 
President, there's some easy ways to do that. You can call us at 1-800-
MEDICARE, any time, day or night. You can go to the web site, 
www.medicare.gov.
    And we've also made help available for the first time ever through 
some expanded programs in local areas. Joe is going to talk about this 
in a few minutes. But you can get face-to-face help. If you don't think 
you can follow through with a phone call, if you really want to talk to 
somebody face to face about this program, you can do that. Right here in 
Missouri, we're working with CLAIM. It's a State health insurance 
assistance plan that provides this personalized help for seniors, often 
working through volunteers who know this program well. So those are some 
simple ways that you can find out about what's in this program for you.
    And the people who need help the most get the most help right away 
with this program. If you're struggling with drug costs today because 
you don't have good drug coverage, you should find out about it. But 
especially if you've got a limited income, below about $1,400 a month 
for a couple, about $1,040 a month for a single senior--about 7 million 
Medicare beneficiaries who are in that category, below those income 
levels, they can get not only the discounts but some direct financial 
help on their card--$600 this year, $600 next year, and there's some 
additional discounts coming from the drug manufacturers for them as 
well. So it amounts to

[[Page 1068]]

literally thousands of dollars in savings. And you can find out about it 
right now just by calling us at 1-800-MEDICARE, and we'll put you in 
touch with a face-to-face person if you want to get help that way.
    The President. Good job, thanks. Do we have the program up and 
running where somebody can actually dial up--put in their ZIP Code, the 
pharmacies come up, they show the different prices for drugs in their 
neighborhood?
    Dr. McClellan. That's exactly right.
    The President. In other words, it's kind of a virtual market. It's 
kind of an interesting concept, isn't it? One of the things I believe is 
that markets have got a fantastic way of rewarding consumers with better 
quality and better price. And you can get on your web page or you can 
get on the computer, and you can shop--price shop right now in your 
particular ZIP Code. And that's a way, also, to make sure that better 
price available for our seniors.
    Dr. McClellan. That's right. And if you don't want to go on the web, 
we can help you over the phone and send you something, a personalized 
brochure, that gives you as much or as little detail as you want about 
the best options for your own personal needs at the pharmacies that you 
want to use.
    The President. Joe Tilghman is with us. Joe is the Administrator. He 
works with Mark. Don't worry about all the cameras. [Laughter] He is the 
Regional Administrator. He has been charged with helping people in this 
area understand the benefits of the drug discount card. He will then, 
once he completes that task here this year, he'll then be in charge of 
the '05 modernization of information, and then in '06 will be in charge 
with helping Mark implement the brand new law. And it's good. I'm 
telling you, it's going to make a big difference in our seniors' lives.
    Joe, thanks. Welcome.

[Joe Tilghman, Regional Administrator, Centers for Medicare and Medicaid 
Services (CMS), Department of Health and Human Services, Kansas City 
Regional Office, Kansas City, MO, made brief remarks.]

    The President. See, what you're hearing is, is that Mark has asked 
his team to go out and educate people. People need to understand the 
truth and the facts and what's available. That's what we're trying to 
get done here. And that's what we're trying to get done all around the 
country. And you're doing a fine job at it. Thank you.
    Mr. Tilghman. Thank you, sir.
    The President. Just keep putting the word out. This is a program 
that helps people. If you've got a mom or a dad out there that may be 
nervous about hearing the change in Medicare, talk to them. Call the 
number because this will help. And look, you're probably saying, 
``Another guy is showing up from Washington, laying out something that's 
just not true.'' Well, it's true.
    And I'll tell you, who best to testify is Wanda--Wanda Blackmore. 
She and I, as I told you, we just went to a pharmacy. She--I was going 
to say, you whipped out your card, but you left your card there before, 
right? Anyway, they had her card, and she bought some drugs that is a 
blood thinner, right?
    Ms. Blackmore. Right.
    The President. Yes. Okay, talk into the mike. [Laughter]
    Ms. Blackmore. Yes, sir. I was afraid you would try to over talk me 
if----
    The President. That's right. [Laughter] Yes, your grandkids are 
here. She's talking to me like she does her grandkids. That's okay. 
[Laughter] I'm used to strong women. [Laughter].
    Ms. Blackmore. I'm old enough to be your grandmother too.
    The President. Okay. Let's get to work, will you? [Laughter]

[Ms. Blackmore, senior, Kansas City, MO, made brief remarks.]

    The President. So here's the thing. Let me see if I can distill it, 
summarize what she just said. She got her card. The first time she used 
it was June 7th. On a prescription that usually cost $10, she paid 
$1.14. That's called savings. It looks like--we kind of did some rough 
math, didn't we, and it looks like you're going to save about $750 this 
year. And that's a lot. That's an awful lot for some people in this 
country, and I'm telling you this thing is working.
    And I appreciate you coming to testify.
    Ms. Blackmore. Yes, sir.

[[Page 1069]]

    The President. There you go. She drove in with the limo--we're a 
little familiar with each other because she was in the limousine from 
the airport to here. [Laughter]
    Ms. Blackmore. I got him lined out. [Laughter]
    The President. That's right. All right, you're not the only person 
on the stage here. [Laughter]
    Ms. Blackmore. I will be, if you keep talking like that. [Laughter]
    The President. That's right.
    Ms. Blackmore. I'll throw him out.
    The President. All right, here we go. [Laughter] Yes, ma'am. 
[Laughter]
    Ms. Blackmore. Thank you, sir.
    The President. Gladys Cole.
    Gladys Cole. Mr. President, I can tell you that your drug card is 
working.
    The President. Okay, why can you say that?
    Ms. Cole. Well, because I went and got my medicine that I had to 
give $120 for, and when I got through, I gave $20-something for that 
same medicine. So there's no doubt in my mind that it is working and 
working quite well.
    The President. All right, how did you find out about the card? See, 
people are wondering out there how these two ladies found out about the 
card, and they may not have heard about it.
    Ms. Cole. Well, my pharmacist knew that I had no prescription card, 
and so he knew what a price I'd been paying for my medicine. So when the 
leaflets come in for us to fill out, he asked me, would I take them home 
and fill it out. And he said, ``I'll fax them in if you'll just fill 
them out.'' So I thought, ``Oh, well, maybe 5 or $10,'' but 5 and $10 
looked awful good to me. So I said, ``All right.'' And when he got my 
medicine card, and I took it in, and he told me what the savings was, I 
about dropped my false teeth. [Laughter]
    The President. We're talking about teeth up here. [Laughter] Now 
that you've recovered your false teeth--[laughter].
    Ms. Cole. So I'm sold on it, and anytime I can tell you people out 
there that are of our age, try it out. See if it fits for you. And then 
if it don't, well, fine. But you need to at least try it and see.
    The President. There you go. I appreciate you, Gladys. Thanks very 
much for sharing that.
    It's estimated that over the next 7 months, she's going to save $700 
for the year. That's good. Yes, that's a lot of money. These ladies 
qualify for the $600 subsidy. At a certain income level, people can 
qualify for additional help, not only get the card. If you don't 
qualify, you use the card anyway, because you're going to get your 
discounts. But you get $600 additional a year help.
    Ms. Blackmore. This is the only time I've been glad to be poor. 
[Laughter]
    The President. Who's writing your material for you? [Laughter]
    Ms. Blackmore. I'm not going to tell.
    The President. We didn't have enough room on the stage--well, we 
have plenty of room. Anyway--[laughter]--Roberta Sims and Betty Sten is 
with us too. Where are you? There you go. Thanks for coming, ladies. I 
appreciate you all being here. She got her--Roberta got her card, and 
she used it at Liberty Wal-Mart on June the 5th. She purchased over $300 
in prescriptions and paid 22.62. That's a fact. It better be a fact. 
[Laughter] Betty got her card recently too and is going to save a lot of 
money, $500.
    In other words, this is important. The reason we're here is to share 
information. We're trying to fight through the clutter, the noise, so 
that people can understand that there is a great opportunity to take 
advantage of a good piece of legislation. That's what we're here to talk 
about.
    We want our seniors to be able to have the benefits of modern 
medicine in a way that is best affordable. That's what we're here to 
talk about, and if you don't believe me, just listen to the two ladies 
here on the stage. They go to their pharmacies; they put down their 
money; and they've seen the difference between what they had been 
charged and what they're paying now. And it's a real savings, and it's 
important savings. And I want to thank them for coming to share their 
stories. You have made the day much more credible--[laughter]--much more 
lively too.
    Let me conclude by telling you this: I--you know, our country has 
been challenged. We're challenged to make sure that we're defended from 
an enemy that can't stand what

[[Page 1070]]

we believe in. We're challenged because the economy has been through 
quite a bit. It's now getting better, I might add. We've been challenged 
in a lot of ways. Our hearts are challenged every day when we realize 
amidst our plenty there are people who hurt.
    The thing I want to share with you and remind you about, that this 
great country can overcome any challenge we face. This is a great 
country because of the values we believe in. It's a great country 
because of the citizens who inhabit her. And there's nothing, there's 
not one thing we can't do together to make sure the world is more free, 
the country is secure, and America is the best possible place it can be 
for all our citizens to call home.
    Thanks for greeting us today. I'm so honored you came. May God bless 
you all.

Note: The President spoke at 3:32 p.m. In his remarks, he referred to 
Mayor Stephen P. Hawkins of Liberty, MO.