George W. Bush photo

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, 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 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.

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 6 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 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 "Medi-scare." [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 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 Phoenix, AZ; and former President Saddam Hussein of Iraq.

George W. Bush, Remarks at the Los Olivos Senior Center in Phoenix, Arizona Online by Gerhard Peters and John T. Woolley, The American Presidency Project

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