George W. Bush photo

Remarks to the Coalition for Medicare Choices

May 17, 2002

Well, thanks for that warm welcome, and welcome to the people's house, the White House. I am so glad you're here to discuss an incredibly important subject, and that is how we can work together to strengthen Medicare.

The most eloquent spokespersons for Medicare are our senior citizens. And I share the determination of people in this room to make sure that Medicare is—not only works for this generation, the generation now on Medicare, but works for generations to come. Our Nation has a moral commitment to fulfill Medicare's promise of health care security for American seniors and for people with disabilities. Yet, we need to do more to meet the commitment, and that's what we're here to talk about today.

Two problems demand immediate action: Medicare must provide prescription drug coverage, and all seniors should be able to choose an affordable Medicare coverage option that best suits their needs. We're going to keep our commitment to senior Americans, and we'll work together to make Medicare work better.

I want to thank Tom Scully from Centers for Medicare & Medicaid Services for being here—that used to be called HCFA. [Laughter] He joins me in a strong commitment for that which I'm about to talk about. You need to know, my administration is committed to trusting seniors with more options. We're committed to the programs and the principles about which I'm going to speak.

I want to thank my fellow Americans who have joined us on the stage. I want to thank the Salazars; they're from Texas. [Laughter] I want to thank Mary Gruenewald for being here as well. I want to thank Joe Hotin and Ben Oppenheim, Florence Galloway, the Holmes family. Thank you all for coming and sharing with me your deep concerns and for sharing with others your concern about how to make sure Medicare fulfills its promise.

I want to thank the docs who are here, one from California and one from Florida. I asked him if he'd ever heard of the Governor down there. [Laughter] Dr. Bangasser and Dr. Thompson—I want to thank them for being here as well. They're men who are deeply concerned about the health and welfare of our seniors, who understand firsthand the problems that Medicare faces.

The health care system that we have in America is unique and strong in many ways. After all, we lead the world in dramatic medical advances, and that's really positive. It's important, as we think about medical policy, that we encourage innovation in our health system. After all, live-saving drugs are helping millions of senior citizens—millions of senior citizens to live longer and to have healthier lives.

New drugs are available to treat diabetes, for example, and that's a positive development for many of our seniors. New drugs are available to prevent serious complications from heart disease or cancer, and that's incredibly positive news as well. Yet, as many in this room can testify, the costs of these treatments are really high. Because Medicare does not cover most prescription drugs, many seniors often pay the highest price for drugs, forcing too many to choose with either paying for pills or paying for their bills.

Members of Congress in both House and Senate are working on legislation, and that's a positive development, and that's good. They're hearing my call and your call to do something about Medicare. In the House, the committees and the leadership are drafting legislation to help seniors immediately with drug costs and to ensure every senior has access to prescription drug coverage. That's a positive development, and we're hopeful to get this legislation out of the House very soon. In the Senate, there is a tripartisan group working on legislation to provide prescription drug coverage and improve Medicare, and I support their efforts as well.

So we've got something to work with. And I urge you all to not only pay attention to the process but let your voices be heard as the process—the legislative process starts heading down toward, hopefully, a conclusion this year.

My administration is doing some things in the short term that I'd like to share with you. We're working for a Medicare-endorsed drug card that will allow seniors to get lower prices from drug manufacturers right away. I unleashed the idea a while back. It kind of got snagged up in the courts. Now we're working to get it unsnagged in the courts for the benefit of our seniors. This is a good idea, and this will help.

We're also working on temporary assistance with drug costs for seniors with limited incomes. We're trying to bridge toward the time when full prescription drug benefits become available. In other words, we want to help people who need help immediately. Those are two ideas that we're working with Congress on.

Medicare also needs to give every senior affordable, up-to-date health insurance coverage options to get the most out of Medicare. Right now in America, more than 5 million Medicare members have access to a valuable program, to a modern health insurance program with modern health benefits called Medicare Plus Choice. Medicare Plus Choice is a vital program if we're going to meet our commitments to our seniors. And Congress ought to understand how vital the program is and how important the program is. They need to listen not only to me—of course, I'd like them to listen a little more to me—[laughter]—but to the folks here in this room, the people who understand.

Now, let me give you some interesting facts. Many Medicare members, including those with limited means, including those with low incomes, prefer these private health plans because they provide more benefits than traditional Medicare at lower cost. If you find an idea that provides better benefits at lower cost, it seems like it makes sense that people up on the Hill there would understand that.

The improved benefits and innovative treatments have given Fred Salazar the assistance he needed to get his diabetes under control. That's not just theory; that's actually happened. Ben Oppenheim improved his arthritis and lowered the amount he spends on his arthritis treatment through an exercise program provided in his health plan. Florence Galloway got the bills paid for the care she needed when she fell and broke a backbone in Spain. She got the care she needed. Arina Holmes was hospitalized with a serious illness. She was not saddled with hundreds of dollars of deductibles and co-payments for her care.

These are examples, right here, of people who have benefited in a real way from the innovative options under Medicare Plus. Some plans in Medicare Plus even make it possible for their members to help other seniors with transportation or grocery shopping or yardwork or other needs. That's also very positive.

What's important to understand is that almost none of the treatments that I described—or programs that can save and improve lives and reduce health care costs— are part of Medicare's defined benefits. Many are only available through Medicare's private plans, and that's important to understand. As we discuss Medicare and it's reform, it's important to understand that the defined benefit plan in Medicare limits the capacity of seniors to meet their needs. And that doesn't seem right to me.

Dr. Thompson—Dr. Isaac Thompson said this: "Medicare Plus Choice has served as a safety net for my patients and for tens of thousands of beneficiaries, so many of whom are low-income and would otherwise not be able to afford the drugs they need." This is Dr. Thompson speaking, a man who makes a living off of helping seniors, a person who understands Medicare and Medicare Plus Choice, and the differences between the two. You know, as he talks eloquently about low-income seniors, the myth is, somehow, that if seniors are given choice, low-income seniors will not benefit; that if we provide more options for our senior citizens to tailor plans that meet their needs, that somehow the low-income will be left behind. That's the opposite of what Dr. Thompson has learned, because it is the opposite of what happens with Medicare Plus Choice.

We've got to address this issue straight on. Millions of Medicare members don't have the option to choose benefits from private health plans, and access to these benefits for everyone in Medicare is threatened. Under current law, private health plans cannot compete in Medicare in the same way that the Federal Government has long provided for people who work for the Federal Government.

I've always found that to be pretty interesting, that the people who make the laws here in Washington—good, fine people from both political parties—make sure that the Federal employees have choice. They trust the Federal employees with whom they work to be able to go into the marketplace and figure out what best suits their needs. And yet, when it comes to our seniors, through Medicare, they don't get the same benefits. It seems like to me that the Congress ought to be consistent with how they view—[applause].

You know better than me—or you know as well as I do, at least—that the current system hasn't reflected rising costs. The lack of enthusiasm for choice for seniors has affected budgets. And therefore, 100 private plans have left Medicare, and millions of seniors have lost the valuable additional benefits that private plans provide. To be blunt about it, it seems like Medicare Plus Choice is getting slowly starved, and we've got to change that.

Part of my message today is, I want to work with you to provide more choices and more savings for our seniors. I'm a person who trusts people. See, I trust the American people. The American people are fantastic, great citizens. We've got to trust people with their own choices in life. I'd rather have the American people make choices than the Federal Government make choices on their behalf.

We need a fair system of competition. We need a system that guarantees that patient protections and all of Medicare's required benefits are included in every choice, a system that encourages additional benefits and options for better care at lower cost, including improved medical savings accounts. That's what we need to think about, and that's where we ought to head here in America.

The cost savings from competitive reforms are essential. They're essential. If you notice, and the people will testify to this, that there are lower costs in Medicare Plus Choice. And those cost savings in a Medicare Plus Choice plan are very important for the future, for your children and your grandchildren to be able to have a Medicare system that works. We must this year pass legislation that gives all seniors secure access to prescription drugs, along with up-to-date, lower cost coverage options in Medicare. That's the goal.

I believe strongly that we've got to make sure that our seniors understand that if you're happy with your current Medicare coverage, nothing changes. There are a lot of our citizens who worry that any kind of strengthening of the system will maybe disrupt their current health plans. And I can understand that. I can understand someone who is perhaps content with the way things are and shouldn't be forced to change, particularly at this point in somebody's life. And I respect that, and any reform must honor that. We've got to make sure, however, that the promise of prescription drugs is a part of any plan and that we recognize that as treatments change, as the ability to treat a disease changes with modern times, that the people we're trying to help are able to realize those benefits.

You see, Medicare was written awhile ago, in such a way that it doesn't have the ability to change. And so all of a sudden, technology is heading here, and Medicare is stuck back here. And Medicare Plus Choice has provided seniors with the ability to stay up with technology. That's why you're so supportive of it, and that's why I am as well. But we've got to make sure that the whole system moves with the technological change, so we can benefit—all of us, not just the young but all of us can benefit from the new technologies available to help save lives.

I believe that when we trust people with their—trust their decisions and trust their judgment about how best to care for themselves, a better plan evolves, a much better plan than one designed by some green eye-shades up on Capitol Hill, because it will be a plan designed by the consumers, not by the planners. It's a plan that evolves as a result of the collective decisions of people we're trying to help, not by some who aren't even in the plan.

And so what we're talking about today is recognizing the importance of Medicare Plus Choice, what it means to people's lives in real terms, how it can positively affect people that we have a moral obligation to help, but also how best to incorporate the principles of the plan to expand it, to make it work for more seniors and, at the same time, make sure Medicare works for people like me, when it's my time—to make sure that it's not only healthy today but healthy tomorrow, that it can exist and be available.

I believe we can make good progress, but we need your help. To be frank with you, there are some up there that really don't like this plan, and I understand that. I mean, what the heck, that's the great thing about democracy; not everybody agrees 100 percent of the time. We all agree we need to help the seniors, and that's important. But to the extent that you can help influence opinion, it's really important; it is. People listen—people listen— people around here listen to opinion, and they listen to people such as yourself, who understand what you're talking about. And we need your help to get this done.

There's a reluctance, but it's okay. It's— you've seen reluctance in your life before. You've lived a good, strong, full life in the service of your country, many of you, and now is your chance to provide a unique service, an important service not only for yourself but future generations that are coming up, by spreading the word, by contacting your Congressman or your Senator. Let them know. Let them know the importance of this program and this idea.

I also want to thank you for your service to the country. You know, you know better than me that—you've see a lot of America in your day, and it's a fabulous country that we're able to call home. It's a—what a remarkable land, where we share common values. People from all walks of life come into—underneath this unique experiment called America. Our spirit is strong. It's never been more needed these days, of course, as we make it clear to the world and to an enemy that we'll defend our freedoms at any cost.

You know, I like to remind people, those that attacked, they must have thought that we were so selfish and so weak and so materialistic that we might file a couple of lawsuits or two, but that's all we were going to do. [Laughter] They found out we think a little differently here in America when it comes to our freedom. And that when it comes to our freedoms that we love—the freedom to worship the way each of us sees fit, the freedom to raise our family the way we think is necessary, the freedom to speak out, freedom of the press—the freedoms that we hold dear, if anybody attacks those freedoms, we'll defend them. We'll defend them.

You need to know about me that I am as resolved as I was the day after the attack, today. I know my duty, and my duty is to protect America in the best way. And as we do so, I believe we'll make the world safer. I long for peace. I just want you to know and assure you that the actions my administration takes has a lofty goal in mind, and that's peace, peace for our country, peace around the world. That's why we do what we do.

But we need to make the world not only safer but better, a better place. And one way we can make the world a better place is to make sure our seniors are treated with dignity, by starting with a health care plan that provides options.

So I want to thank you all for coming to this magnificent house, the White House. It's—as you can imagine, it's an honor to be here, and it's an honor to welcome you here.

May God bless you all, and may God bless America.

NOTE: The President spoke at 1:11 p.m. in the East Room at the White House. In his remarks, he referred to Dr. Ronald Paul Bangasser, family physician, Redlands, CA; and Gov. Jeb Bush of Florida.

George W. Bush, Remarks to the Coalition for Medicare Choices Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/212763

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