[Weekly Compilation of Presidential Documents Volume 42, Number 11 (Monday, March 20, 2006)]
[Pages 472-481]
[Online from the Government Publishing Office, www.gpo.gov]

<R04>
Remarks on the Medicare Prescription Drug Benefits and a Question-and-
Answer Session in Silver Spring, Maryland

March 15, 2006

    The President. Listen, thank you all for coming. First of all, I'm 
proud to be traveling with a Cabinet Secretary. He runs Health and Human 
Services. His job is to make sure that the Medicare plan works the way 
it was designed to work.
    We've come to answer some questions, if you have any--about any 
subject. [Laughter] But before I begin, I do want to share some thoughts 
with you.
    First, speaking about Cabinet Secretaries, I know Mary Hill is here. 
Where's Mary? Oh, hi, Mary. The reason I bring her up is that her 
daughter is married to one of my Cabinet Secretaries, and she is a fine 
woman--so is the Cabinet Secretary--[laughter]--Norm Mineta, Norm and 
Deni Mineta.
    I want to thank the folks who run this fine facility. Thanks for 
letting us come by and talk about good health; that's what we're here to 
talk about. By the way, Laura sends her best. You might remember her; 
she's the most patient woman in America. I don't know why she didn't 
come; I should have asked her. I'll ask her. You wanted her to come? 
Well, listen, that happens to me a lot--[laughter]--``You stay home; let 
Laura come.''
    But I'm here to talk about Medicare. First of all, when I got to 
Washington I took a look at the Medicare system and thought it needed to 
be improved. When the Government makes a commitment, it ought to make 
good on its commitment, and it ought to do--make sure we deliver 
excellence when we say we're going to do something. Lyndon Johnson--nice 
Texan--signed the Medicare bill, and it was a commitment by the Federal 
Government to provide health care for our seniors. And my attitude is, 
if we're going to provide health care for the seniors, let's provide a 
good system, a modern system.
    And so I took a look at it and said that Medicare is doing a lot of 
good stuff, you know; it really is. It's an important system. But I 
asked the question, couldn't we do it better? And for example, just to 
give you an idea, you know, Medicare would pay $28,000 for the surgery 
for ulcers but wouldn't pay a dime for the medicine to prevent the 
surgery from being needed in the first place. That didn't sound like a 
very good system to me. In other words, what had happened was, medicine 
started to change. You all know what I'm talking about. Pharmaceuticals 
became a really important part of the delivery of good health care. But 
Medicare did not change with medicine.
    And so one of the things that we did, we worked with Republicans and 
worked with Democrats and said, ``Let's provide a prescription drug 
benefit for our seniors to make sure that Medicare is a modern system.'' 
Now, I understood that when we began to change Medicare, modernize 
Medicare, it could create some confusion with people. You know, some 
people just don't want to change. Some people thought things were just 
fine and that giving different options or giving people an opportunity 
to make different decisions could create some confusion.
    Now, I understood that. But I also felt it was worth the risk of 
creating confusion to

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give people different options from which to choose. And so the Medicare 
bill--the new Medicare bill does something different. It says there is a 
prescription drug benefit available for all Americans, special help for 
the lower income Americans, that seniors have also got the opportunity 
to make a choice, to design a health care plan that best suits their 
needs.
    And so we started the program. Congress passed the bill. It did 
provide really good help for low-income seniors. It did provide choices. 
It did provide a medical examination for people who enroll in Medicare. 
It does provide for annual screenings. That makes sense, doesn't it? Why 
don't you--if we screen for disease, it might make it easier for us to 
solve problems before they become acute.
    And so we started saying to the people, ``This bill has passed; take 
a look at it.'' And so people got on the computers and saw a lot of 
different options, and said, ``Whoa, this may be a little more than I 
bargained for.'' And so recognizing that people might need some 
explanations, we rallied people. We got the churches and the synagogues, 
and we got the community groups; we got the AARP--we got people all 
around the country--facilities just like this, as a matter of fact--to 
start explaining options available to our seniors, so seniors can make 
the right choice for them.
    Since the program got going, 26 million seniors have signed up. 
That's a lot. Pretty quick period of time--26 million people take a look 
and signed up for the program. They're signing up by the thousands every 
week. And so one of the reasons I've come is to encourage people who 
have not signed up to take a look at Medicare, the new Medicare, take a 
look at what's available. If you like what you see, sign up. If it 
doesn't meet your needs, that's fine. But I think you're going to like 
what you see. Drug bills have been cut in half for the average--for the 
typical senior. I'm not making it up. I'm just telling you what people 
who've signed up--realize what the plans available--what it has meant to 
them.
    Drug costs have been cut in half. That's positive news if you're a 
senior. I was with some folks yesterday in upstate New York, and old Bob 
got up at a deal like this, and he said in the microphone, he said, ``I 
thought it was too good to be true; it was one of these typical 
Government deals, you know, where they kind of say something is going to 
happen, and it doesn't.'' He said, ``My drug bills have been cut in 
half.'' I think if you--if people pay attention to this program and take 
a look at it, you'll find that there are some significant cost savings 
for you.
    The other thing that's happened, the taxpayers have got to know is 
that it's anticipated--the cost of this is 20 percent lower than 
anticipated in the first year. In other words, it turns out when people 
have choices, they get better quality and they get better price. And 
that's what you're seeing in the Medicare bill.
    If you haven't signed up--by the way, I'm not only speaking to you, 
I'm speaking to the cameras, too, by the way--[laughter]--because I want 
people to hear this; it's important. If you haven't signed up, call 1-
800-MEDICARE. If you're a--if you've got--if you're a son or a daughter 
of a citizen on Medicare, do your parent a favor and get on the Internet 
and take a look at what's available and help your mom or dad take a look 
at this new Medicare benefit structure. There are some choices to choose 
from, no doubt about it. But with more choices to choose from, you can 
better design a program that meets your needs.
    People are signing up by the thousands. There's a May 15th deadline. 
And so what Mike and I are going to do is travel around the country and 
hold seminars like this and continue to remind people there's a good 
opportunity. And I really urge you to take a look. It's a program that 
does modernize the system. It's a program that says, we trust seniors to 
make the right choice. It's a program that I think you're going to like 
a lot.
    And that's what I've come to do. Part of my job is to educate the 
American people about what's available. It's called the Educator in 
Chief. [Laughter] This is a new program, and it requires a lot of work.
    Yesterday I met with a group of concerned citizens from different 
walks of life--you know, the NAACP and the--some Latino groups, business 
groups, pharmaceutical

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groups. I said, look--and they're there for a reason; they wanted to 
hear my commitment to the program and my encouraging them to go out and 
find people and encourage them to take a look and sign up.
    And so that's what I'm doing here today, and I want to thank you all 
for giving me a chance to come by and visit with you. If you've got any 
questions for me, I'll answer them. If they're too hard, I'll turn them 
over to the Secretary and let him answer them. [Laughter] But I'll be 
glad to answer any questions you've got on any subject on your mind. If 
you've got something you want to ask about Medicare, you can--any other 
subject that you care about.
    Yes, ma'am.

Private Sector Health Insurance

    Q. [Inaudible]--subject. First, welcome to the Blue State of 
Maryland.
    The President. Thank you. It's good to be here.
    Q. Secondly, I am a member of Medicare, of course. I'm also a member 
of Kaiser Permanente. My medical bills are absolute nothing--90 days or 
$8. Why does Kaiser have more of a means of putting forth these 
medications than does the Government of the United States?
    The President. See, she is a part of a private program that has 
provided a benefit that you like, and you don't want to change, and you 
don't have to change. And that's what we're trying to do. We're trying 
to give people different options, like the option you have got.
    In the old system, they didn't have those options. Matter of fact, 
they didn't have a prescription drug benefit in the old Medicare system. 
Now the Medicare system has invited a series of providers--I think 
there's 34 different providers here in the State of Maryland, if I'm not 
mistaken--that say, now, I want to give you a chance to be able to come 
up and have the same satisfaction with the program that you do.
    Look, if you're happy with where you are--and it sounds like you're 
pretty happy about it--don't change.
    Q. I'm not going to.
    The President. You shouldn't. [Laughter] And I don't blame you; I 
wouldn't either. But if you're--but you ought to take a look. See, 
people ought to take a look and see. That's all I'm saying. Nobody is 
making you do anything. I'm just traveling around saying to people, take 
a look at what's available for you. There's people on this staff here at 
this facility that will help you. That's all--believe me, it's worth 
taking a look. It's free.
    Yes, ma'am.

Medicare Prescription Drug Benefits

    Q. First off, as a resident, I wish to tell you how pleased we are 
that you took time out to come to Riderwood, because Riderwood beside 
has a wonderful--you look around at these vibrant, elderly people; you 
know we have very good health care. And we're looking for good health 
care.
    Now, we have the Advantage--Erickson Advantage is here, which covers 
Medicare and Part D, which is what you're sponsoring. So we're glad that 
you're here to explain, even though this is Erickson's health plan. But 
that doesn't eliminate your Part D.
    The President. No, that's right. Yes, I mean, in other words, 
Erickson is a part of the menu of opportunity.
    Q. Right.
    The President. Well, I appreciate you bringing it up. You sound like 
you know a lot on the subject. You ought to be up here speaking. 
[Laughter] No, I appreciate that. Thanks.
    Part D--when they hear Part D, that's talking about the prescription 
drug benefit that's now available. It was not available in Medicare. I 
signed the bill; it is now available.
    Q. Right.
    The President. And again, I repeat, if you're a low-income senior, 
there's a lot of help for you. The Government pays over 95 percent of 
anything coming your way. And that's important. So you ought to look. 
That's all we're saying.
    Yes, sir. Thanks for wearing the Texas shirt. [Laughter]

Health Care for Veterans

    Q. I have a grandson here from Houston. He brought it. He gave it to 
me last Christmas, and I had to wear it today.

[[Page 475]]

    The President. I'm honored. Thanks. Yes, kind of reminds me of home. 
[Laughter]
    Q. Mr. President, I'm happy to be here at Riderwood. I'm retired 
military, retired from the Veterans Administration also, and I can get 
treatment from VA. What is the best thing for a man like me to do? There 
are many retired military people here who are in the same situation.
    The President. Well, I think the Veterans Affairs benefits are a 
very good package. And Veterans Affairs, one of their major 
responsibilities is to honor the commitment they've made to you, sir. 
And they intend to honor it. Again, I don't know all the details of your 
Veterans Affairs benefit package, but you ought to take a look at all 
options. It's just a free look. Get your son to get on the Internet with 
you, and just see whether or not it makes any sense. But I'll bet you'll 
find the Veterans' benefits are pretty good.
    Yes, sir. Thanks for serving, by the way. Appreciate the example 
you've set.
    Yes, sir.

Electronic Medical Records

    Q. The people who live here are fortunate to have their health 
records in a computer--in electronic medical records. Could you talk a 
little bit about that?
    The President. Thank you, sir. [Laughter] Yes, well, it's a very 
good question because part of the issue we face in America is the cost 
of health care, the rising cost of health care. Part of the rising cost 
of health care is the result of a really important industry not being a 
part of the 21st century technology. He asked about medical records, 
electronic medical records. That means that everybody will have their 
medical records on a--digitized in a way that can be used over the 
Internet, for example.
    You might remember the old days--and a lot of hospitals are still 
that way, by the way, or most doctors' offices are that way, when they 
actually write your prescription or write your procedure on a piece of 
paper. That's pretty inefficient. One reason is doctors can't write to 
begin with. [Laughter] Are you a doc? Sorry. [Laughter]
    But carrying your files from one office to the next is not an 
efficient way to run a system. Files can get lost; people cannot 
necessarily read what is written; prescriptions can sometimes not be 
written properly because the handwriting isn't legible. You might--you 
know, a person transfers from one jurisdiction to the next, and the 
files may get lost, or the doctor may not exactly understand what the 
other doctor had talked about in the handwritten files. And that leads 
to medical errors and a costly health care system.
    And so what the good doc is asking is, are we in the process of 
trying to have medical records like you have here at this facility so 
that your health care is better delivered and there aren't mistakes? And 
the answer is, absolutely. I've tasked the Secretary of Health and Human 
Services to start working on a variety of fronts when it comes to 
information technology in health care, starting with a common language. 
The data of medicine is complicated. You can describe different ailments 
and different diseases in different ways. And so what Mike is doing 
through his department is coming up with a common language.
    And the idea is--I'll give you a practical example of why this is--
having medical records is important. When Hurricane Katrina hit, a lot 
of veterans were displaced. Now, the Veterans Administration has got 
medical records for people that they're serving. And so you have a 
person go from New Orleans to Houston and, fortunately, the electronic 
medical record could go with that person, which then meant the doc in 
Houston would see a new patient, but the medical records would lay out 
exactly what needed to be done to take care of the patient.
    And that's precisely the kind of vision that we're talking about so 
that, ultimately, America is using information technology to lower the 
cost of medicine, but to provide higher quality of medicine for people 
through medical records. And Mike is in charge of that, and his 
department is making good progress. Thanks for bringing it up.
    The other thing that's really important about medical records, and 
something my administration is going to be a stickler for, is to make 
sure that the records are private. We don't want people looking at your 
medical record if you don't want them looking at your medical record. In 
other words, it's

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your record, and there's got to be a certain amount of privacy to that 
record. And so just because I talk about having electronic medical 
records, you've just got to understand that there's going to be an 
important privacy component to making sure that others can't look at 
your record if you don't want them to.
    Good question.
    Yes, ma'am.

Medicare Prescription Drug Benefits

    Q. Mr. President, I told my mother last night that I was going to be 
covering the President of the United States on the health--[inaudible].
    The President. Okay, here you go. She started off saying she talked 
to her mom last night.
    Q. Yes. And you may have some experience with instructions from a 
forceful mother, sir. [Laughter] I got some from mine. [Laughter]
    The President. Well-spoken.
    Q. My mom is 75; she is sick; she's back in New Jersey alone. She 
didn't know anything about the Part D drug plan until I told her in 
February, with all the publicity and everything. I'm trying to walk her 
through it, but she doesn't know what to tell me. I don't know how to 
help her. I've punched her stuff into medicare.gov. I've got the basics, 
but it's still too much for her to afford. And I don't know where to 
tell her to go and get help. She wants to know if you guys will roll 
back the May 15th deadline.
    The President. No. And the reason why is, there's got to be a fixed 
time for people to sign up. And we want people to realize there is--now 
is the time. And I'm not exactly sure about your mom's situation. I do 
want to thank you for helping her. Daughters ought to help their mothers 
realize what's available.
    Now, again, there is a--I'm not sure what the plan--the structure 
looks like in New Jersey, but rolling back deadlines is not going to 
help your mom make a good decision. You're going to have to help her 
make the decision. And a lot of people like your mom were in the same 
situation--they took a look, said it looks confusing. But there's a lot 
of help. That's what--one of the reasons I'm here to talk about----
    Q. The thing I'm trying to find out is--this is a great system where 
you have a group like Riderwood--it's a great system in Riderwood, where 
people can come together, or the church groups. But what do you do with 
the people who are just sick enough, they can't go out, they don't have 
help, you know? Do we have a system to knock on doors, to walk----
    The President. Absolutely. And that's exactly what our----
    Q. Where can I send her?
    The President. Well, first of all, I happen to think--and I don't 
want--look, I'm not going to tell you your business, but I think it's 
your responsibility to help your mom. And I think a lot of parents--a 
lot of children should help their moms. And I think you really ought to 
take a look at the different options for her. I mean, the best 
grassroots outreach is child to parent. There's other outreach; you're 
right. The church is outreaching. Again, I don't know the particulars in 
the neighborhood. I can--if you can get us the area in which she lives, 
we can find a group that's very much involved in helping people like 
your mom. I appreciate it.
    But that's the whole--her--she's got a great point. In order to--
we've got to explain this to as many people as we can. And I fully 
understand that it's confusing. That's why I started off the talk, ``It 
can be confusing to people.'' But when you work through the different 
options and look at the steps and have somebody explain it to you, in 
the end, it is a really good deal.
    Now, if she doesn't choose to be a part of Part D, that's a choice 
that you and she and others will make. But it is--it has proven to be a 
cost-effective decision for our seniors. The typical senior has their 
drug bill cut in half. That's across America. If your mom qualifies, she 
will get more than 95 percent of her drug bills paid by the Government.
    And so thanks for bringing it up.

Health Care Reform

    Q. Back here.
    The President. Oh, yes.

[[Page 477]]

    Q. We still have millions of underinsured or uninsured citizens in 
the United States, and what are you going to do about that?
    The President. Right. No, there's no question that's an issue. And 
one of the reasons why is because health care costs are going up, and 
there are ways to address health care costs. One of them is information 
technology. Another one is legal reform. A lot of doctors are getting 
sued. And when they get sued, they practice defensive medicine in order 
to protect them in the courts. And by practicing defensive medicine, it 
causes costs to go up. Transparency in pricing is another way to make 
sure consumers have got the capacity to make rational decisions for 
themselves.
    Some of the people who are not insured are younger Americans who 
choose not to be insured. It's like, I kind of remember that period of 
time. I thought I was never going to get sick, and so I thought I'd save 
some money.
    A lot of people who are insured--or uninsured are working uninsured, 
and they tend to work for small businesses. And small businesses have 
trouble being able to purchase insurance--so they get the insurance. And 
one idea to help small businesses is to allow them to pool risk across 
jurisdictional boundaries. In other words, let the restauranteur in 
Texas and the restauranteur in Maryland join in a risk pool so as to 
make insurance more affordable for small businesses. Health savings 
accounts are a way to help small businesses be able to afford insurance.
    Now, if you're poor, you're going to get help through Medicaid. 
There is an insurance plan. If you're a--if you're somebody in this 
country who needs primary care, we've got community health centers all 
across America, places where people can get good health care, not in the 
emergency rooms of our hospitals.
    So there is a variety of ways to deal with a very difficult issue. 
And you're right; it's an issue that the country must address. Thanks 
for bringing it up.
    Yes, sir.

Medicare Prescription Drug Benefits

    Q. No one's quite said this, this way, I don't think, sir. Speaking 
as one resident here, among a very diverse group, that it is an honor 
and a privilege to be visited by the President of all 300 million of us 
and the leader of the free world.
    The President. Thank you, sir.
    Q. Welcome.
    The President. Thank you.
    Q. I do have a question. When this law was passed with your 
encouragement--almost immediately after the bill was enacted by 
Congress, the chief auditor at Medicare came out and spoke on TV and 
said that he had compiled a projected cost significantly higher than 
what Congress had been told. And he was threatened with immediate 
dismissal if he allowed that information to come out. Is that--did that 
man speak the truth? And if so, why would you not want facts like that 
to come out to the American people?
    The President. Actually, what's happened, sir, is that the estimated 
cost is 20 percent lower than bodies that tried to estimate the cost. 
And the reason why is, is because the program has worked better than 
anticipated, and it has been better than anticipated. And I think you'll 
be reflected in our budgets.
    Well, they estimated, for example, the average premium was going to 
cost $37 a month, and it's down to $25 a month. In other words, it's 
working. And I think that's important for people to understand. And 
there's been a lot of estimates about the cost of the program, but what 
really matters is the actual costs. And it looks like the dollars are 
going to be lower than we thought, which is good news--good news--and 
more importantly, lower to the seniors than we thought. And that's the 
most important news of all. The most important news to you is, this is a 
good deal for you, the consumer, the person we're trying to help. And we 
think it is. And people ought to look at it. I don't know if you've 
looked at, but you ought to, if you haven't. Thank you.
    Yes, ma'am.

Electronic Medical Records

    Q. Yes, you mentioned a little while ago about chips--I mean about 
medical records. Today in The Post, they were talking about people 
getting chips implanted with their medical records. And it sounded good 
to me.

[[Page 478]]

My dog has one. [Laughter] And I bet your dogs have them.
    The President. Now, I don't know if our dogs--I don't think--we're 
not quite that sophisticated yet. Barney might not like it. [Laughter]
    Q. I guess my question is, in the future, if we want people to have 
this, would it be possible, or thinking that far ahead, that when a 
child is born, a chip is implanted and you keep feeding information into 
it through----
    The President. I don't know. That's an interesting question. I, 
frankly, haven't heard of that. Do you have any--maybe the Secretary--
maybe it's time for the Secretary to step in. [Laughter]
    I think the point is this--I think the point is, is that there is 
the capacity to carry in a very small object a lot of data that can be 
downloaded in other medical facilities in order to facilitate a flow of 
information that enables people to get good health care in a cost-
effective way. I don't know about implantations or not. But 
nevertheless, I do think that the idea of having a medical chip that is 
on a card, or it can be anywhere--you got one, doc? No, I thought you 
were searching for--[laughter].
    Q. We have one at Erickson.
    The President. Yes, sir.

India

    Q. Mr. President, I just want to take the opportunity to thank you 
for your farsighted policy in India, of assisting them in their civilian 
nuclear program.
    The President. Oh, thank you, sir.
    Q. I was at Tarapur 40 years ago, when General Electric inaugurated 
the first nuclear plant in India. And I think it's going to go a long 
way towards keeping our friendship with that important country in Asia. 
Thank you very much.
    The President. Well, thanks for bringing that up. He's referring to 
a trip I just took to India and Pakistan and Afghanistan. And we were 
working on an agreement with India to encourage India and help India 
develop its civilian nuclear power industry. And one--a couple of 
reasons why one would do that: One, when India's demand for fossil fuels 
goes up, it causes the price of our fossil fuels to go up. And so, 
therefore, to encourage them to use a renewable source of energy that 
doesn't create greenhouse gas, this makes a lot of sense.
    Secondly, India has been a--is a nonproliferator, has proven to be a 
nonproliferator for the past 30 years. In other words, they've got a 
record that, in my judgment, should cause the Congress to pass old law 
to treat them as a new partner. Thirdly, India wants to be a part of 
international agreements that will help deal with proliferation.
    And so I thank you for your comments. I appreciate you saying that.
    Yes, sir.

Pakistan

    Q. It was particularly courageous, in view of the fact that Pakistan 
is one of our allies in the war on terrorism, and of course, it's going 
to affect their attitude to some extent.
    The President. Well, I appreciate you saying that. The good news is 
that, as I said in the speech there in India, we now--I think Indians 
understand it's good for the United States to be friendly with Pakistan, 
and the Pakistanis understand it's good for the United States to be 
friendly with India--which is, as you know, a change of, kind of, the 
relationship of the United States with those two countries.
    I had a good visit with President Musharraf, who is dedicated to 
routing out Al Qaida if they hide in his country, and we really 
appreciate his dedication. And at the same time, he's dedicated toward 
advancing democracy. So it was a great visit. Thanks for bringing it up.
    Yes, ma'am--oop, you again. [Laughter]

Electronic Medical Records

    Q. You mentioned about privacy, Mr. President.
    The President. Yes.
    Q. It's very well to say privacy on our electronics. You know 
there's no such a thing as real privacy. Something leaks out all the 
time somewhere.
    The President. I'd say that. [Laughter]
    Q. Did you ever think, or think in your bill some way that the 
insurance companies cannot use it against us? Because that's the

[[Page 479]]

fear--that's the fear, that an insurance company will say, ``Uh-oh, we 
won't touch you,'' and you know----
    The President. Preexisting conditions----
    Q. That's right--or something that you developed along the way.
    The President. I think there's laws that protect you on that. It's a 
different issue from them looking at your records. One is to say, 
``Well, you've got a preexisting condition; therefore, we won't insure 
you.'' That's different from them taking a look at your records.
    Q. Because you get these conditions later on as you go along in 
life.
    The President. Right. I understand. The good news about the current 
Medicare program is that they'll take care of you as you are.
    Q. Here's an electronic card.
    The President. Let's see that card. I don't see very well. 
[Laughter]
    Q. [Inaudible]
    The President. They did? Great. Thanks. That's what--the card, yes.
    Yes, sir. The mic disappeared on you. Sorry.

Energy/Environment

    Q. Thank you. Since we're talking about health care, I wonder if we 
couldn't address the health care of the world--in particular, the issue 
of greenhouse gases.
    The President. Sure.
    Q. The entire--well, I'm one of the scientists who believes that--
and many of us do--that the greenhouse gases have been caused by us, and 
that it's about time that the United States took serious actions on the 
prevention of further greenhouse gases.
    The President. I exactly agree with you, sir, and that's exactly 
what we're doing. I think you're right. I thought the prescription to 
the Kyoto plan was the wrong way to go. On the other hand, I do know we 
can use technologies to achieve exactly that objective.
    For example, second-generation nuclear power. It's a renewable 
resource. It doesn't emit, as you know, greenhouse gases. It's one of 
the reasons why I work with India and trying to help China, as well, to 
be able to develop a civilian nuclear power industry without--with 
guarantees against proliferation, in order to protect the environment.
    The other day, in the State of the Union address, I said, we're too 
addicted to oil, and we need to get off oil. There are alternative ways 
to do that. Plug-in hybrid batteries is a new technology that's coming, 
and I think will help deal with emissions. The use of ethanol--ethanol 
made from sugar, of course, is a technology that works. But hopefully, 
we'll be able to have some breakthroughs to be able to use saw grass or 
wood chips to manufacture ethanol in order to be able to not only make 
us less dependent on foreign sources of energy but also to be good 
stewards of the environment.
    Ultimately, hydrogen-powered automobiles will help make a huge 
difference. We're spending about a billion--$200 million or so to 
research that. Solar technology is another area where there's some great 
potential breakthroughs. I went to a plant in Michigan the other day and 
saw these new roofing materials that got photovoltaic cells, a part of 
them.
    And so I agree with you. I think it's very important for us to use 
technology to help protect the environment and, at the same time, 
achieve an important economic and national security objective, which is 
no dependence on oil.
    It's a--all right. Yes, sir.

Transparency of Health Costs

    Q. Mr. President.
    The President. Thank you, sir.
    Q. Glad to have you here.
    The President. Thanks.
    Q. Thank you very much. I have two questions. The first question 
deals with a resident that's here--was unable to be here, but she's 
having--the resident is having a problem trying to get enrolled in 
Medicare B. And all of the time that she's had problems, the person has 
had a problem getting on the computer, getting anything resolved, and so 
on and so forth.
    The President. Okay.
    Q. And that's----
    Secretary of Health and Human Services Michael O. Leavitt. I'll get 
the name, and we'll take care of it.
    Q. Okay. The second question----

[[Page 480]]

    The President. That's easy. [Laughter]
    Q. The second question deals with what are we doing at the Federal 
level to get some uniformity in terms of the billing in hospitals so 
that we don't have the wide dispersion between hospital billing as a 
result of someone having insurance and someone who does not have 
insurance and the whole bit. And that's been going on for years, because 
I was in a hospital, ran a part of it, and I know that there's a great 
dispersion in that.
    The President. No, I appreciate that. Do you want to take that on, 
Mike?
    Secretary Leavitt. Sure. Last night I was in a hotel, and on the 
back of the hotel door, there was a price: $449 a night. Now, you'll be 
pleased to know, Mr. President, that I didn't pay that--[laughter]--and 
we didn't pay that because the Government had created a Government rate. 
It was only $130 a night, and they slid the bill under the door.
    A lot of insurance companies do the same thing and create special 
prices for the people that are insured with them. What the President has 
recently done is, he's told every insurance company, every employer, and 
every provider in the country, ``You ought to tell people what you're 
charging.'' People deserve, people have a right to know what they're 
being charged and the kind of quality they're getting. And that's an 
initiative of the President. And very shortly, I believe you'll start to 
see that kind of disclosure.
    Q. Thank you.
    The President. This guy has got a great question because really what 
he's talking about is transparency in pricing. When you go buy a car, 
you know exactly what they're going to charge you. [Laughter] Well, 
sometimes you don't know. [Laughter] Well, you negotiate with them. 
[Laughter] Well, they put something on the window that says price. 
[Laughter] His point is, is that the more you know about price, the 
better you can make better decisions, and I appreciate that.
    Listen, you're paying me a lot of money to work, and so I think I'm 
going to have to head back home. But I'm honored. Got any more 
questions, I'll be glad to answer them.

Electronic Medical Records

    Q. I have one.
    The President. Okay, yes, please. Thank you.
    Q. I'd like to ask you about the medical records. They're not 
infallible, and we like to have paper backup. Recently had an experience 
here in Riderwood; went for a blood check. Records were down because the 
power was down, and they couldn't connect to the computer. They need--
most places have paper backup, and I think if you don't have a complete 
record, it's not going to work as greatly as it does.
    The President. No, that's really a kind of redundancy in the process 
to make sure that if there's a power outage, that there's not an 
emergency caused by that. No, that's a really good point. Thanks.
    Q. Thank you.
    The President. I guess, is there a----
    Secretary Leavitt. Working on it. [Laughter]
    The President. Working on it. [Laughter] Yes, sir. Working on it. 
[Laughter]

India/Nuclear Technology

    Q. Mr. President, there are some--and I guess I would include 
myself--who have different views about the Indian agreement, because 
they're concerned about the effect that the agreement will have on the 
capacity of India to stimulate its own production of nuclear weapons----
    The President. No, I understand.
    Q. ----by helping them. But I would go beyond that and ask you, 
while you're still President, to consider one aspect of this whole 
nuclear question. I guess I'm one of the three standing--left standing 
Americans who helped--who did the negotiation of the nonproliferation 
treaty. And the basic bargain there was that other countries would give 
up their nuclear weapons if we, the nuclear powers, would engage in a 
program of nuclear disarmament.
    Now, I'm aware of all of the agreements that have taken place. I'm 
aware of the negotiations that you had with Mr. Putin. The point is that 
we cannot expect that agreement, that basic agreement to hold if the 
United States, particularly, goes on acting as--and has the position 
that we might initiate a nuclear war if it is necessary.

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    And I would ask you just to think about the time--while you're still 
President, taking the one position that only one American President has 
taken, and that is President Johnson, to consider a ``no first-use'' 
policy to help the prospect of nuclear proliferation in the long run.
    The President. Well, thank you. Thank you very much. Thanks for your 
contribution, by the way. I appreciate it.
    Part of the Indian deal is to actually get them to formally join 
some of the institutions that you helped--your work created. And you're 
right. I did do an agreement with President Putin--thanks for noticing--
where we're--both of us are reducing nuclear stockpiles. But I'll take 
your words to heart and think about it. Thank you. No commitment 
standing right here, of course. [Laughter]
    Well, I'm thrilled to be here. Thank you all for your time. I would 
hope that people would take a look--just take a look. And if you need 
help, there are people here who will help you. And if you're watching on 
TV, ask your son or daughter or ask your neighbor or ask a person that 
has signed up whether or not it's worthwhile. And I think you'll find 
this is a program that's--it's a good program.
    I appreciate you letting me have a chance to come by and visit with 
you. Thanks for the town hall meeting. Thanks for the good questions. 
God bless you all.

Note: The President spoke at 1:50 p.m. at Riderwood retirement 
community. In his remarks, he referred to Richard S. Foster, Chief 
Actuary, Centers for Medicare & Medicaid Services; President Pervez 
Musharraf of Pakistan; and President Vladimir Putin of Russia.