Delivers "State of the Union"
January 28, 2003
The U.S. Capitol
9:01 P.M. EST
White House photo
White House photo
THE PRESIDENT: Mr. Speaker, Vice President Cheney, members of Congress,
distinguished citizens and fellow citizens: Every year, by law and
by custom, we meet here to consider the state of the union. This
year, we gather in this chamber deeply aware of decisive days that
You and I serve our country in a time of great consequence. During
this session of Congress, we have the duty to reform domestic programs
vital to our country; we have the opportunity to save millions of
lives abroad from a terrible disease. We will work for a prosperity
that is broadly shared, and we will answer every danger and every
enemy that threatens the American people. (Applause.)
In all these days of promise and days of reckoning, we can be confident.
In a whirlwind of change and hope and peril, our faith is sure,
our resolve is firm, and our union is strong. (Applause.)
This country has many challenges. We will not deny, we will not
ignore, we will not pass along our problems to other Congresses,
to other presidents, and other generations. (Applause.) We will
confront them with focus and clarity and courage.
During the last two years, we have seen what can be accomplished
when we work together. To lift the standards of our public schools,
we achieved historic education reform -- which must now be carried
out in every school and in every classroom, so that every child
in America can read and learn and succeed in life. (Applause.) To
protect our country, we reorganized our government and created the
Department of Homeland Security, which is mobilizing against the
threats of a new era. To bring our economy out of recession, we
delivered the largest tax relief in a generation. (Applause.) To
insist on integrity in American business we passed tough reforms,
and we are holding corporate criminals to account. (Applause.)
Some might call this a good record; I call it a good start. Tonight
I ask the House and Senate to join me in the next bold steps to
serve our fellow citizens.
Our first goal is clear: We must have an economy that grows fast
enough to employ every man and woman who seeks a job. (Applause.)
After recession, terrorist attacks, corporate scandals and stock
market declines, our economy is recovering -- yet it's not growing
fast enough, or strongly enough. With unemployment rising, our nation
needs more small businesses to open, more companies to invest and
expand, more employers to put up the sign that says, "Help
Jobs are created when the economy grows; the economy grows when
Americans have more money to spend and invest; and the best and
fairest way to make sure Americans have that money is not to tax
it away in the first place. (Applause.)
I am proposing that all the income tax reductions set for 2004
and 2006 be made permanent and effective this year. (Applause.)
And under my plan, as soon as I sign the bill, this extra money
will start showing up in workers' paychecks. Instead of gradually
reducing the marriage penalty, we should do it now. (Applause.)
Instead of slowly raising the child credit to $1,000, we should
send the checks to American families now. (Applause.)
The tax relief is for everyone who pays income taxes -- and it
will help our economy immediately: 92 million Americans will keep,
this year, an average of almost $1,000 more of their own money.
A family of four with an income of $40,000 would see their federal
income taxes fall from $1,178 to $45 per year. (Applause.) Our plan
will improve the bottom line for more than 23 million small businesses.
You, the Congress, have already passed all these reductions, and
promised them for future years. If this tax relief is good for Americans
three, or five, or seven years from now, it is even better for Americans
We should also strengthen the economy by treating investors equally
in our tax laws. It's fair to tax a company's profits. It is not
fair to again tax the shareholder on the same profits. (Applause.)
To boost investor confidence, and to help the nearly 10 million
senior who receive dividend income, I ask you to end the unfair
double taxation of dividends. (Applause.)
Lower taxes and greater investment will help this economy expand.
More jobs mean more taxpayers, and higher revenues to our government.
The best way to address the deficit and move toward a balanced budget
is to encourage economic growth, and to show some spending discipline
in Washington, D.C. (Applause.)
We must work together to fund only our most important priorities.
I will send you a budget that increases discretionary spending by
4 percent next year -- about as much as the average family's income
is expected to grow. And that is a good benchmark for us. Federal
spending should not rise any faster than the paychecks of American
A growing economy and a focus on essential priorities will also
be crucial to the future of Social Security. As we continue to work
together to keep Social Security sound and reliable, we must offer
younger workers a chance to invest in retirement accounts that they
will control and they will own. (Applause.)
Our second goal is high quality, affordable health care for all
Americans. (Applause.) The American system of medicine is a model
of skill and innovation, with a pace of discovery that is adding
good years to our lives. Yet for many people, medical care costs
too much -- and many have no coverage at all. These problems will
not be solved with a nationalized health care system that dictates
coverage and rations care. (Applause.)
Instead, we must work toward a system in which all Americans have
a good insurance policy, choose their own doctors, and seniors and
low-income Americans receive the help they need. (Applause.) Instead
of bureaucrats and trial lawyers and HMOs, we must put doctors and
nurses and patients back in charge of American medicine. (Applause.)
Health care reform must begin with Medicare; Medicare is the binding
commitment of a caring society. (Applause.) We must renew that commitment
by giving seniors access to preventive medicine and new drugs that
are transforming health care in America.
Seniors happy with the current Medicare system should be able to
keep their coverage just the way it is. (Applause.) And just like
you -- the members of Congress, and your staffs, and other federal
employees -- all seniors should have the choice of a health care
plan that provides prescription drugs. (Applause.)
My budget will commit an additional $400 billion over the next
decade to reform and strengthen Medicare. Leaders of both political
parties have talked for years about strengthening Medicare. I urge
the members of this new Congress to act this year. (Applause.)
To improve our health care system, we must address one of the prime
causes of higher cost, the constant threat that physicians and hospitals
will be unfairly sued. (Applause.) Because of excessive litigation,
everybody pays more for health care, and many parts of America are
losing fine doctors. No one has ever been healed by a frivolous
lawsuit. I urge the Congress to pass medical liability reform. (Applause.)
Our third goal is to promote energy independence for our country,
while dramatically improving the environment. (Applause.) I have
sent you a comprehensive energy plan to promote energy efficiency
and conservation, to develop cleaner technology, and to produce
more energy at home. (Applause.) I have sent you Clear Skies legislation
that mandates a 70-percent cut in air pollution from power plants
over the next 15 years. (Applause.) I have sent you a Healthy Forests
Initiative, to help prevent the catastrophic fires that devastate
communities, kill wildlife, and burn away millions of acres of treasured
I urge you to pass these measures, for the good of both our environment
and our economy. (Applause.) Even more, I ask you to take a crucial
step and protect our environment in ways that generations before
us could not have imagined.
In this century, the greatest environmental progress will come
about not through endless lawsuits or command-and-control regulations,
but through technology and innovation. Tonight I'm proposing $1.2
billion in research funding so that America can lead the world in
developing clean, hydrogen-powered automobiles. (Applause.)
A single chemical reaction between hydrogen and oxygen generates
energy, which can be used to power a car -- producing only water,
not exhaust fumes. With a new national commitment, our scientists
and engineers will overcome obstacles to taking these cars from
laboratory to showroom, so that the first car driven by a child
born today could be powered by hydrogen, and pollution-free. (Applause.)
Join me in this important innovation to make our air significantly
cleaner, and our country much less dependent on foreign sources
of energy. (Applause.)
Our fourth goal is to apply the compassion of America to the deepest
problems of America. For so many in our country -- the homeless
and the fatherless, the addicted -- the need is great. Yet there's
power, wonder-working power, in the goodness and idealism and faith
of the American people.
Americans are doing the work of compassion every day -- visiting
prisoners, providing shelter for battered women, bringing companionship
to lonely seniors. These good works deserve our praise; they deserve
our personal support; and when appropriate, they deserve the assistance
of the federal government. (Applause.)
I urge you to pass both my faith-based initiative and the Citizen
Service Act, to encourage acts of compassion that can transform
America, one heart and one soul at a time. (Applause.)
Last year, I called on my fellow citizens to participate in the
USA Freedom Corps, which is enlisting tens of thousands of new volunteers
across America. Tonight I ask Congress and the American people to
focus the spirit of service and the resources of government on the
needs of some of our most vulnerable citizens -- boys and girls
trying to grow up without guidance and attention, and children who
have to go through a prison gate to be hugged by their mom or dad.
I propose a $450-million initiative to bring mentors to more than
a million disadvantaged junior high students and children of prisoners.
Government will support the training and recruiting of mentors;
yet it is the men and women of America who will fill the need. One
mentor, one person can change a life forever. And I urge you to
be that one person. (Applause.)
Another cause of hopelessness is addiction to drugs. Addiction
crowds out friendship, ambition, moral conviction, and reduces all
the richness of life to a single destructive desire. As a government,
we are fighting illegal drugs by cutting off supplies and reducing
demand through anti-drug education programs. Yet for those already
addicted, the fight against drugs is a fight for their own lives.
Too many Americans in search of treatment cannot get it. So tonight
I propose a new $600-million program to help an additional 300,000
Americans receive treatment over the next three years. (Applause.)
Our nation is blessed with recovery programs that do amazing work.
One of them is found at the Healing Place Church in Baton Rouge,
Louisiana. A man in the program said, "God does miracles in
people's lives, and you never think it could be you." Tonight,
let us bring to all Americans who struggle with drug addiction this
message of hope: The miracle of recovery is possible, and it could
be you. (Applause.)
By caring for children who need mentors, and for addicted men and
women who need treatment, we are building a more welcoming society
-- a culture that values every life. And in this work we must not
overlook the weakest among us. I ask you to protect infants at the
very hour of their birth and end the practice of partial-birth abortion.
(Applause.) And because no human life should be started or ended
as the object of an experiment, I ask you to set a high standard
for humanity, and pass a law against all human cloning. (Applause.)
The qualities of courage and compassion that we strive for in America
also determine our conduct abroad. The American flag stands for
more than our power and our interests. Our founders dedicated this
country to the cause of human dignity, the rights of every person,
and the possibilities of every life. This conviction leads us into
the world to help the afflicted, and defend the peace, and confound
the designs of evil men.
In Afghanistan, we helped liberate an oppressed people. And we
will continue helping them secure their country, rebuild their society,
and educate all their children -- boys and girls. (Applause.) In
the Middle East, we will continue to seek peace between a secure
Israel and a democratic Palestine. (Applause.) Across the Earth,
America is feeding the hungry -- more than 60 percent of international
food aid comes as a gift from the people of the United States. As
our nation moves troops and builds alliances to make our world safer,
we must also remember our calling as a blessed country is to make
this world better.
Today, on the continent of Africa, nearly 30 million people have
the AIDS virus -- including 3 million children under the age 15.
There are whole countries in Africa where more than one-third of
the adult population carries the infection. More than 4 million
require immediate drug treatment. Yet across that continent, only
50,000 AIDS victims -- only 50,000 -- are receiving the medicine
Because the AIDS diagnosis is considered a death sentence, many
do not seek treatment. Almost all who do are turned away. A doctor
in rural South Africa describes his frustration. He says, "We
have no medicines. Many hospitals tell people, you've got AIDS,
we can't help you. Go home and die." In an age of miraculous
medicines, no person should have to hear those words. (Applause.)
AIDS can be prevented. Anti-retroviral drugs can extend life for
many years. And the cost of those drugs has dropped from $12,000
a year to under $300 a year -- which places a tremendous possibility
within our grasp. Ladies and gentlemen, seldom has history offered
a greater opportunity to do so much for so many.
We have confronted, and will continue to confront, HIV/AIDS in
our own country. And to meet a severe and urgent crisis abroad,
tonight I propose the Emergency Plan for AIDS Relief -- a work of
mercy beyond all current international efforts to help the people
of Africa. This comprehensive plan will prevent 7 million new AIDS
infections, treat at least 2 million people with life-extending
drugs, and provide humane care for millions of people suffering
from AIDS, and for children orphaned by AIDS. (Applause.)
I ask the Congress to commit $15 billion over the next five years,
including nearly $10 billion in new money, to turn the tide against
AIDS in the most afflicted nations of Africa and the Caribbean.
This nation can lead the world in sparing innocent people from
a plague of nature. And this nation is leading the world in confronting
and defeating the man-made evil of international terrorism. (Applause.)
There are days when our fellow citizens do not hear news about
the war on terror. There's never a day when I do not learn of another
threat, or receive reports of operations in progress, or give an
order in this global war against a scattered network of killers.
The war goes on, and we are winning. (Applause.)
To date, we've arrested or otherwise dealt with many key commanders
of al Qaeda. They include a man who directed logistics and funding
for the September the 11th attacks; the chief of al Qaeda operations
in the Persian Gulf, who planned the bombings of our embassies in
East Africa and the USS Cole; an al Qaeda operations chief from
Southeast Asia; a former director of al Qaeda's training camps in
Afghanistan; a key al Qaeda operative in Europe; a major al Qaeda
leader in Yemen. All told, more than 3,000 suspected terrorists
have been arrested in many countries. Many others have met a different
fate. Let's put it this way -- they are no longer a problem to the
United States and our friends and allies. (Applause.)
We are working closely with other nations to prevent further attacks.
America and coalition countries have uncovered and stopped terrorist
conspiracies targeting the American embassy in Yemen, the American
embassy in Singapore, a Saudi military base, ships in the Straits
of Hormuz and the Straits the Gibraltar. We've broken al Qaeda cells
in Hamburg, Milan, Madrid, London, Paris, as well as, Buffalo, New
We have the terrorists on the run. We're keeping them on the run.
One by one, the terrorists are learning the meaning of American
As we fight this war, we will remember where it began -- here,
in our own country. This government is taking unprecedented measures
to protect our people and defend our homeland. We've intensified
security at the borders and ports of entry, posted more than 50,000
newly-trained federal screeners in airports, begun inoculating troops
and first responders against smallpox, and are deploying the nation's
first early warning network of sensors to detect biological attack.
And this year, for the first time, we are beginning to field a defense
to protect this nation against ballistic missiles. (Applause.)
I thank the Congress for supporting these measures. I ask you tonight
to add to our future security with a major research and production
effort to guard our people against bioterrorism, called Project
Bioshield. The budget I send you will propose almost $6 billion
to quickly make available effective vaccines and treatments against
agents like anthrax, botulinum toxin, Ebola, and plague. We must
assume that our enemies would use these diseases as weapons, and
we must act before the dangers are upon us. (Applause.)
Since September the 11th, our intelligence and law enforcement
agencies have worked more closely than ever to track and disrupt
the terrorists. The FBI is improving its ability to analyze intelligence,
and is transforming itself to meet new threats. Tonight, I am instructing
the leaders of the FBI, the CIA, the Homeland Security, and the
Department of Defense to develop a Terrorist Threat Integration
Center, to merge and analyze all threat information in a single
location. Our government must have the very best information possible,
and we will use it to make sure the right people are in the right
places to protect all our citizens. (Applause.)
Our war against terror is a contest of will in which perseverance
is power. In the ruins of two towers, at the western wall of the
Pentagon, on a field in Pennsylvania, this nation made a pledge,
and we renew that pledge tonight: Whatever the duration of this
struggle, and whatever the difficulties, we will not permit the
triumph of violence in the affairs of men -- free people will set
the course of history. (Applause.)
Today, the gravest danger in the war on terror, the gravest danger
facing America and the world, is outlaw regimes that seek and possess
nuclear, chemical, and biological weapons. These regimes could use
such weapons for blackmail, terror, and mass murder. They could
also give or sell those weapons to terrorist allies, who would use
them without the least hesitation.
This threat is new; America's duty is familiar. Throughout the
20th century, small groups of men seized control of great nations,
built armies and arsenals, and set out to dominate the weak and
intimidate the world. In each case, their ambitions of cruelty and
murder had no limit. In each case, the ambitions of Hitlerism, militarism,
and communism were defeated by the will of free peoples, by the
strength of great alliances, and by the might of the United States
of America. (Applause.)
Now, in this century, the ideology of power and domination has
appeared again, and seeks to gain the ultimate weapons of terror.
Once again, this nation and all our friends are all that stand between
a world at peace, and a world of chaos and constant alarm. Once
again, we are called to defend the safety of our people, and the
hopes of all mankind. And we accept this responsibility. (Applause.)
America is making a broad and determined effort to confront these
dangers. We have called on the United Nations to fulfill its charter
and stand by its demand that Iraq disarm. We're strongly supporting
the International Atomic Energy Agency in its mission to track and
control nuclear materials around the world. We're working with other
governments to secure nuclear materials in the former Soviet Union,
and to strengthen global treaties banning the production and shipment
of missile technologies and weapons of mass destruction.
In all these efforts, however, America's purpose is more than to
follow a process -- it is to achieve a result: the end of terrible
threats to the civilized world. All free nations have a stake in
preventing sudden and catastrophic attacks. And we're asking them
to join us, and many are doing so. Yet the course of this nation
does not depend on the decisions of others. (Applause.) Whatever
action is required, whenever action is necessary, I will defend
the freedom and security of the American people. (Applause.)
Different threats require different strategies. In Iran, we continue
to see a government that represses its people, pursues weapons of
mass destruction, and supports terror. We also see Iranian citizens
risking intimidation and death as they speak out for liberty and
human rights and democracy. Iranians, like all people, have a right
to choose their own government and determine their own destiny --
and the United States supports their aspirations to live in freedom.
On the Korean Peninsula, an oppressive regime rules a people living
in fear and starvation. Throughout the 1990s, the United States
relied on a negotiated framework to keep North Korea from gaining
nuclear weapons. We now know that that regime was deceiving the
world, and developing those weapons all along. And today the North
Korean regime is using its nuclear program to incite fear and seek
concessions. America and the world will not be blackmailed. (Applause.)
America is working with the countries of the region -- South Korea,
Japan, China, and Russia -- to find a peaceful solution, and to
show the North Korean government that nuclear weapons will bring
only isolation, economic stagnation, and continued hardship. (Applause.)
The North Korean regime will find respect in the world and revival
for its people only when it turns away from its nuclear ambitions.
Our nation and the world must learn the lessons of the Korean Peninsula
and not allow an even greater threat to rise up in Iraq. A brutal
dictator, with a history of reckless aggression, with ties to terrorism,
with great potential wealth, will not be permitted to dominate a
vital region and threaten the United States. (Applause.)
Twelve years ago, Saddam Hussein faced the prospect of being the
last casualty in a war he had started and lost. To spare himself,
he agreed to disarm of all weapons of mass destruction. For the
next 12 years, he systematically violated that agreement. He pursued
chemical, biological, and nuclear weapons, even while inspectors
were in his country. Nothing to date has restrained him from his
pursuit of these weapons -- not economic sanctions, not isolation
from the civilized world, not even cruise missile strikes on his
Almost three months ago, the United Nations Security Council gave
Saddam Hussein his final chance to disarm. He has shown instead
utter contempt for the United Nations, and for the opinion of the
world. The 108 U.N. inspectors were sent to conduct -- were not
sent to conduct a scavenger hunt for hidden materials across a country
the size of California. The job of the inspectors is to verify that
Iraq's regime is disarming. It is up to Iraq to show exactly where
it is hiding its banned weapons, lay those weapons out for the world
to see, and destroy them as directed. Nothing like this has happened.
The United Nations concluded in 1999 that Saddam Hussein had biological
weapons sufficient to produce over 25,000 liters of anthrax -- enough
doses to kill several million people. He hasn't accounted for that
material. He's given no evidence that he has destroyed it.
The United Nations concluded that Saddam Hussein had materials
sufficient to produce more than 38,000 liters of botulinum toxin
-- enough to subject millions of people to death by respiratory
failure. He hadn't accounted for that material. He's given no evidence
that he has destroyed it.
Our intelligence officials estimate that Saddam Hussein had the
materials to produce as much as 500 tons of sarin, mustard and VX
nerve agent. In such quantities, these chemical agents could also
kill untold thousands. He's not accounted for these materials. He
has given no evidence that he has destroyed them.
U.S. intelligence indicates that Saddam Hussein had upwards of
30,000 munitions capable of delivering chemical agents. Inspectors
recently turned up 16 of them -- despite Iraq's recent declaration
denying their existence. Saddam Hussein has not accounted for the
remaining 29,984 of these prohibited munitions. He's given no evidence
that he has destroyed them.
From three Iraqi defectors we know that Iraq, in the late 1990s,
had several mobile biological weapons labs. These are designed to
produce germ warfare agents, and can be moved from place to a place
to evade inspectors. Saddam Hussein has not disclosed these facilities.
He's given no evidence that he has destroyed them.
The International Atomic Energy Agency confirmed in the 1990s that
Saddam Hussein had an advanced nuclear weapons development program,
had a design for a nuclear weapon and was working on five different
methods of enriching uranium for a bomb. The British government
has learned that Saddam Hussein recently sought significant quantities
of uranium from Africa. Our intelligence sources tell us that he
has attempted to purchase high-strength aluminum tubes suitable
for nuclear weapons production. Saddam Hussein has not credibly
explained these activities. He clearly has much to hide.
The dictator of Iraq is not disarming. To the contrary; he is deceiving.
From intelligence sources we know, for instance, that thousands
of Iraqi security personnel are at work hiding documents and materials
from the U.N. inspectors, sanitizing inspection sites and monitoring
the inspectors themselves. Iraqi officials accompany the inspectors
in order to intimidate witnesses.
Iraq is blocking U-2 surveillance flights requested by the United
Nations. Iraqi intelligence officers are posing as the scientists
inspectors are supposed to interview. Real scientists have been
coached by Iraqi officials on what to say. Intelligence sources
indicate that Saddam Hussein has ordered that scientists who cooperate
with U.N. inspectors in disarming Iraq will be killed, along with
Year after year, Saddam Hussein has gone to elaborate lengths,
spent enormous sums, taken great risks to build and keep weapons
of mass destruction. But why? The only possible explanation, the
only possible use he could have for those weapons, is to dominate,
intimidate, or attack.
With nuclear arms or a full arsenal of chemical and biological
weapons, Saddam Hussein could resume his ambitions of conquest in
the Middle East and create deadly havoc in that region. And this
Congress and the America people must recognize another threat. Evidence
from intelligence sources, secret communications, and statements
by people now in custody reveal that Saddam Hussein aids and protects
terrorists, including members of al Qaeda. Secretly, and without
fingerprints, he could provide one of his hidden weapons to terrorists,
or help them develop their own.
Before September the 11th, many in the world believed that Saddam
Hussein could be contained. But chemical agents, lethal viruses
and shadowy terrorist networks are not easily contained. Imagine
those 19 hijackers with other weapons and other plans -- this time
armed by Saddam Hussein. It would take one vial, one canister, one
crate slipped into this country to bring a day of horror like none
we have ever known. We will do everything in our power to make sure
that that day never comes. (Applause.)
Some have said we must not act until the threat is imminent. Since
when have terrorists and tyrants announced their intentions, politely
putting us on notice before they strike? If this threat is permitted
to fully and suddenly emerge, all actions, all words, and all recriminations
would come too late. Trusting in the sanity and restraint of Saddam
Hussein is not a strategy, and it is not an option. (Applause.)
The dictator who is assembling the world's most dangerous weapons
has already used them on whole villages -- leaving thousands of
his own citizens dead, blind, or disfigured. Iraqi refugees tell
us how forced confessions are obtained -- by torturing children
while their parents are made to watch. International human rights
groups have catalogued other methods used in the torture chambers
of Iraq: electric shock, burning with hot irons, dripping acid on
the skin, mutilation with electric drills, cutting out tongues,
and rape. If this is not evil, then evil has no meaning. (Applause.)
And tonight I have a message for the brave and oppressed people
of Iraq: Your enemy is not surrounding your country -- your enemy
is ruling your country. (Applause.) And the day he and his regime
are removed from power will be the day of your liberation. (Applause.)
The world has waited 12 years for Iraq to disarm. America will
not accept a serious and mounting threat to our country, and our
friends and our allies. The United States will ask the U.N. Security
Council to convene on February the 5th to consider the facts of
Iraq's ongoing defiance of the world. Secretary of State Powell
will present information and intelligence about Iraqi's legal --
Iraq's illegal weapons programs, its attempt to hide those weapons
from inspectors, and its links to terrorist groups.
We will consult. But let there be no misunderstanding: If Saddam
Hussein does not fully disarm, for the safety of our people and
for the peace of the world, we will lead a coalition to disarm him.
Tonight I have a message for the men and women who will keep the
peace, members of the American Armed Forces: Many of you are assembling
in or near the Middle East, and some crucial hours may lay ahead.
In those hours, the success of our cause will depend on you. Your
training has prepared you. Your honor will guide you. You believe
in America, and America believes in you. (Applause.)
Sending Americans into battle is the most profound decision a President
can make. The technologies of war have changed; the risks and suffering
of war have not. For the brave Americans who bear the risk, no victory
is free from sorrow. This nation fights reluctantly, because we
know the cost and we dread the days of mourning that always come.
We seek peace. We strive for peace. And sometimes peace must be
defended. A future lived at the mercy of terrible threats is no
peace at all. If war is forced upon us, we will fight in a just
cause and by just means -- sparing, in every way we can, the innocent.
And if war is forced upon us, we will fight with the full force
and might of the United States military -- and we will prevail.
And as we and our coalition partners are doing in Afghanistan,
we will bring to the Iraqi people food and medicines and supplies
-- and freedom. (Applause.)
Many challenges, abroad and at home, have arrived in a single season.
In two years, America has gone from a sense of invulnerability to
an awareness of peril; from bitter division in small matters to
calm unity in great causes. And we go forward with confidence, because
this call of history has come to the right country.
Americans are a resolute people who have risen to every test of
our time. Adversity has revealed the character of our country, to
the world and to ourselves. America is a strong nation, and honorable
in the use of our strength. We exercise power without conquest,
and we sacrifice for the liberty of strangers.
Americans are a free people, who know that freedom is the right
of every person and the future of every nation. The liberty we prize
is not America's gift to the world, it is God's gift to humanity.
We Americans have faith in ourselves, but not in ourselves alone.
We do not know -- we do not claim to know all the ways of Providence,
yet we can trust in them, placing our confidence in the loving God
behind all of life, and all of history.
May He guide us now. And may God continue to bless the United States
of America. (Applause.)
END 10:08 P.M. EST
President Calls for Strengthened and
Reformed Medicare Program
Devos Performance Hall
Grand Rapids, Michigan
January 29, 2003
12:40 P.M. EST
THE PRESIDENT: Thank you all. I'm anxious to get started. (Laughter.)
So I woke up this morning, and Laura said, "Where are you going?
I said, "Grand Rapids, thankfully." (Applause.) And she said, "Home
of a great American, Gerald Ford." (Applause.) And home to many
I want to thank you for your hospitality. She said, "I've got a
suggestion for you, shorten your speech." (Laughter.) I want to
share some of my thoughts about that speech I gave last night. It's
important for me to come to parts of our country and explain why
I said what I said, so that you and others around our country clearly
understand some things about the country and the problems we face.
First thing I want you to know is that there's no doubt in my mind
that we can accomplish our objectives, because we're the finest nation,
full of the greatest people on the face of this Earth. (Applause.)
Thanks for coming. I also want to thank my friend, Tommy Thompson,
who is the Secretary of Health and Human Services, for leaving a
comfortable life and serving our nation. You may remember, he was
the governor of Wisconsin. Don't hold it against him, here in Michigan.
(Laughter.) He's a great governor and he's a great Secretary of
Health and Human Service. And I'm honored Tommy is serving with
And I want to thank your Governor and Attorney General and Secretary
of State for joining us today. I'm honored you all are here. Thanks
for taking time out of your schedules to come and greet the President
and hear what I have to say.
I travel today from Washington
with members of the mighty Michigan congressional delegation --
your Congressman, Vern Ehlers. (Applause.) Neighboring Congressman
Peter Hoekstra. (Applause.) Dave Camp and Nick Smith, also of the
congressional delegation. (Applause.) I appreciate these members
traveling with me. I was honored to speak in their chamber last
night. I talked about things that mattered to the future of this
Today, before I came here, I had the honor of going to Spectrum
Hospital, where I visited with docs and hospital administrators
and Medicare -- folks on Medicare, people who hurt -- and heard
their stories. I will share some of that with you, because I believe
part of making sure that we've got a great country is we've got
a great health care system that addresses the needs of all our citizens.
Our biggest need at home, seems like to me, is to make sure that
anybody who wants a job and can't find one -- and if they can't
find a job, we've got a problem. We've got to make sure this economy
is as strong as it possibly can be.
My philosophy is the role of government is not to create wealth,
but an environment in which the small business owner can grow to
be a big business owner; in which the entrepreneur feels confident
about the future; in which people are willing to take risk and invest,
which will equal jobs. And that's why I feel so strongly about making
sure that people get to keep more of their own money. (Applause.)
We've come out of a recession. We've withstood terrorist attacks.
We had some of our fellow citizens think they could fudge the books,
and we're routing them out and bringing them to justice, because
we believe in honesty in America. And our economy is still kind
of nudging along, in spite of those setbacks. But there's more we
need to do.
When a fellow American has more money in his or her pocket, they're
more likely to demand a good or a service. And in the marketplace
which we have in America, when somebody demands a good or a service,
somebody is more likely willing to produce that good or a service.
And when somebody produces a good or a service, it means somebody
is more likely to find work. That's why tax relief is such an important
component about creating the environment for economic growth. It
is important for the people of Michigan and America to know that
when I talk about tax relief, it equals jobs. (Applause.)
You hear a lot of rhetoric in Washington, D.C. about tax relief.
You hear a lot of rhetoric about tax relief in Washington, D.C.,
the old rhetoric of class warfare. My attitude is, if you pay taxes,
you ought to get relief; the government ought not to try to pick
and choose. (Applause.)
Seventy percent of new jobs in America are created by small business
owners. It makes sense to try to create an environment in which
the small business owner feels confident about the future, is willing
to take risks and expand jobs. It just so happens that most small
businesses in America pay taxes at the income tax level because
they're sole proprietorships or limited partnerships or sub-chapter
So when you hear me talk about tax relief, I want you to know that
that will help stimulate small business growth in America. More
money in the pockets of our small business owners means it's more
likely somebody in western Michigan is able to find work. (Applause.)
We're trying to get rid of the effects of the marriage penalty.
It doesn't make any sense to me that we tax marriage. (Laughter
and applause.) It seems like we ought to encourage marriage in America.
(Applause.) We ought to accelerate the increase of the child credit
from $600 to $1,000 as quickly as possible. (Applause.) We ought
to drop that lowest rate from 15 percent to 10 percent. (Applause.)
All these measures have been passed. You see, what I'm talking about
today is what I argued for to Congress two years ago. They're all
law. Congress decided these were good measures. It's just that they
phased them in over three or five or seven years. We need some life
in this economy. We've got people looking for jobs who can't find
them. If the tax relief is good five years from now, it makes a
lot of sense to put the tax relief in today. For the sake of our
economic vitality, Congress must act. (Applause.)
Ten million seniors receive dividends. It's a part of their retirement
package. It's a part of making sure the quality of life is high.
A dividend is a part of a dollar that has gone through our system
that has been taxed twice. A company first pays taxes on profits,
and that's right. And then they distribute the money out to a shareholder,
somebody who has invested in that company, and then the shareholder
gets to pay it again. The double taxation of dividends is not fair,
it hurts our seniors. Congress needs to end the double taxation
of dividends, for the sake of capital formation and for the sake
of the quality of life for the seniors in America. (Applause.)
These measures will help our economy grow, and that's important
for the federal budget. It's important for state budgets. If you're
worried about budgets, which we should be worried about budgets,
the first question you ask is, how do you create growth in the economy?
The more growth there is, the more likely it is you'll have tax
revenues. Policies that stimulate growth ought to be the centerplace
of public policy, not policies which discourage growth. And the
growth packages I talk about will encourage economic vitality, means
more tax revenues at the federal level.
But there's two equations when it comes to deficits and balanced
budgets. There's the revenue side, and then there's the spending
side. I call upon the United States Congress to set clear and important
priorities and not overspend the people's money. (Applause.)
And we have some important priorities that's reflected in my budget,
not only the budget this year, but the budget the last couple of
years. A significant, important, vital priority is education. Our
federal government has substantially increased the amount of federal
money we have spent on education, particularly over the last two
years. We've increased it by another 6 percent in the budget I've
submitted to Congress.
Spending money is important for education, but so is making sure
that every child gets educated. It's important to spend money on
priorities. It is essential that we set high standards for our children;
that we challenge the soft bigotry of low expectations; that we
insist that states measure so we can determine whether programs
are working, so we know whether or not children are learning to
read and write and add and subtract. And equally important, it is
essential that when we find children trapped in schools which will
not teach and will not change, we give parents different opportunities
for their children. (Applause.)
Yesterday, I talked about an immeasurable part of America's strength,
and that is our hearts. Compassion in this country runs deep. It's
one of the really great blessings to be the President of a country
where people love their neighbor like they'd like to be loved themselves
-- and it doesn't even require a government program. (Laughter and
I do think there's a role of government, though, when it comes
to helping people in need. The government ought to help people who
cannot help themselves. And we need to recognize in Washington that
there are pockets of despair and hopelessness all around our country;
that in this land of plenty there are those who hurt, there are
neighborhoods where the concept of the American Dream just doesn't
exist. There are people who need love and affection and direction.
There are people who are hopelessly addicted to drugs.
The government can spend money, and should. But government cannot
put hope in people's hearts or a sense of purpose in people's lives.
That happens when a fellow neighbor puts their arm around somebody
who hurts and says, I love you, can I help you, what can I do to
help you, young lady or young man, understand that this country
belongs to you and its future if you make the right decisions, and
I'm here to help you make those right decisions.
Yesterday, I talked about the need to rally the great compassion
of America to focus on those who hurt. Think about what it must
be to be a child whose mother or dad is in prison. Imagine what
kind of life that would be, growing up in this society. I have hope
for those citizens because I know there is somebody there in our
society who can provide the love and direction and guidance to make
sure that child has a chance to succeed.
Today, I came out -- when I landed here at the Ford Airport, I
had the honor of meeting Jerry Nienhuis. He works for Kids Hope
USA. I want my fellow -- (applause.) Hi, Jerry. This program, as
Vern Ehlers was telling me, is an inspiration to many here in Grand
Rapids, Michigan. I think Vern said it started right here. It shows
the great social entrepreneurial spirit of our country. It's a faith-based
program. It's a program -- a call went out to churches in the area;
they said, if you truly love the Almighty, help somebody who hurts,
mentor a child. Mentor a child.
I said last night that we can save our society one heart, one soul,
one conscience at a time. Each of can be somebody helping. I urge
you to mentor, just like Jerry has done. I urge those who are addicted
to find a program that will help heal your heart. People care about
you in our society. A better America is a compassionate America,
where we save our country, one person at a time. And I'm confident
it will happen. (Applause.)
A better America is one in which our health care systems work.
One of the commitments we have made to our seniors is that they
get good health care. This system is called Medicare. Medicare has
been used as a political football, however. It's old -- it's important
-- but it hadn't changed. I like to remind people, medicine has
changed, and Medicare hadn't. It's stuck in the past. It requires
all kinds of bureaucracies to allow new medicines to come forth
so our seniors can take advantage of the technologies and changes
I urged the Congress last night to put aside all the politics and
to make sure the Medicare system fulfills its promise to our seniors.
I believe that seniors, if they're happy with the current Medicare
system, should stay on the current Medicare system. That makes sense.
If you like the way things are, you shouldn't change. However, Medicare
must be more flexible. Medicare must include prescription drugs.
Medicare must be available to seniors in a variety of forms.
The Congress has got a good health care system for themselves and
their employees, and other federal employees, which is fine. It's
based upon trusting each member of Congress to make decisions for
his or her family. There's a variety of plans from which to choose.
I believe it's very important for seniors to be given the same opportunities
that members of the Congress, members of the Senate have. They ought
to be able to choose their own health care plan, including fee-for-service
plans. If it's good enough for the Congress, it's good enough for
the senior citizens of America. (Applause.)
Any good plan provides options, and any good plan makes sure seniors
who cannot afford help receive help from the federal government.
I proposed a budget where the discretionary spending grew at 4 percent.
Within that budget I proposed last night is a substantial increase
in Medicare funding of $400 billion on top of what we already spend,
over the next 10 years. This is a commitment that America must make
to our seniors. A reformed and strengthened Medicare system, plus
a healthy dosage of Medicare spending in the budget, will make us
say firmly, we fulfilled our promise to the seniors of America.
We want health care to be affordable and accessible for our all
our citizens, of course. One of the problems we have in our society
is we've got too many junk lawsuits. (Applause.) Too many lawsuits
against docs and hospitals; too many frivolous lawsuits which cause
people to practice preventative medicine. Procedure after procedure,
just in case they get sued. Too many people being forced to settle
out of court just to get rid of the lawsuits, which drives up your
cost, and drives doctors and nurses out of the practice of medicine.
And it's a problem. I visited states where it's a real problem,
where I've had docs come and see me and say, I can't practice medicine
anymore. I remember a baby doc that came to see me when I was in
Pennsylvania. She had tears in her eyes. She said, I love to deliver
babies, I can't do it anymore. I'm being sued so much, my premiums
are out of sight.
It is essential, it is essential that Congress understand what
excessive litigation is doing to patients. It's driving up the cost.
It makes it hard for people to get access to care, because there's
I've come to the conclusion that this is a federal issue, because
excessive lawsuits are driving up the cost of health care at the
federal level. Medicare costs more, Medicaid costs more, veterans
benefits cost more. We need a national, federal medical liability
We can get one, but I need your help. The trial lawyers are powerful.
They don't see the problem the way we see it. You need to write
your senators and make it clear to them that you, like me, expect
people who have had injury to be able to have their day in court.
And that's what we want. We want a judicial system that works.
If somebody is hurt, they ought to have their day in court. But
we need reasonable caps. We need to make sure that this lottery,
this lawsuit lottery doesn't ruin the health care for citizens all
across our country. It's an important piece of legislation, to help
get control of costs that are running out of sight here in the medical
Domestic policy is incredibly important, and I'll spend a lot of
time on it. But there's nothing more important than protecting the
American people from harm. (Applause.) I knew one my challenges
was going to be to make sure people understood that distance between
September the 11th, 2001, did not necessarily mean war had ended
and your government can relax. War has not ended. The war that people
brought to our soil still goes on.
We're doing everything we can in Washington to protect our soil.
We've got a new Department of Homeland Security that will be up
and running here pretty quickly. It's a better way to coordinate
all the assets at our disposal, to protect our borders and protect
our airports, protect our infrastructure -- if need be, respond
in an efficient way on your behalf.
Our intelligence services, FBI, are working a lot better than ever
before. The FBI's whole culture has changed from one that, we will
haul you in, to one that says, we'll prevent a danger from happening
in the first place as best we can. In other words, we're on alert.
We know that there is still an enemy which lurks -- and there is;
there is. And they're nothing but a bunch of cold-blooded killers,
by the way. (Applause.) You know, they just don't value life like
we do. The great thing about America is we say every life is precious,
everybody counts. (Applause.) Everybody has worth. And they just
don't view it that way. They kill in a name of a false ideology
based upon hatred.
And as I told the Congress last night, and the country, we're winning
this war. We're chasing them down one by one and bringing them to
justice. (Applause.) Make no mistake about it, we are slowly but
surely dismantling their organization.
Yesterday, some of them bunched up in parts of Afghanistan. They,
unfortunately, met the United States military head on. (Applause.)
Unfortunately for them. (Laughter.) The reason I bring that up is
our troops are still in Afghanistan, and they're doing a great job.
The country needs our presence and will have our presence -- needs
our presence to help make sure that those remnants of al Qaeda that
still lurk around the area are brought to justice. And they will
be, they will be.
Our coalition is still strong. The doctrine says that either you're
with us, or you're with the enemy, that still exists. (Applause.)
And there are a lot of good people working hard all across the world
to bring these people to justice. The Brits hauled in a bunch the
other day. You'll see the Spanish. We're sharing intelligence, and
we're watching them. And when they pop their heads up, we're getting
them, one by one. (Applause.)
And it doesn't matter how long it's going to take. It just doesn't
matter. Slowly but surely, we will bring them to justice. Because
this country understands and this generation understands, we have
an obligation to protect our land. That's our most important thing
And by the way, in Afghanistan, we're not leaving for another reason.
We didn't go into Afghanistan as conquerors, we went in as liberators.
(Applause.) We liberated people from the clutches of one of the
most barbaric regimes imaginable. And we're helping to build schools
and health care centers. Tommy was telling me they're fixing to
open one up in a couple of months in Afghanistan. And we're building
highways. We're helping these good people get back on their feet.
That's the great compassion about our country. We're strong in
our might, we're compassionate in our vision. Everybody matters.
Everybody has worth in the eyes of the American people. It doesn't
matter where you're from, the nature of your religion, everybody
Including the millions who suffer from AIDS in Africa. This is
a moral nation, we're a great nation. We have a chance to use our
wealth and our abilities to help cure that epidemic that plagues
a group of people. I call upon the generosity of the American people,
at this time of tragedy, where thousands are dying, where thousands
of children are being orphaned, to join in a great cause, a great
humanitarian cause, a cause beyond all imaginable -- a cause to
solve unimaginable problems, to help the people who are needlessly
dying. We can make a huge difference, a significant difference in
the lives of thousands of our fellow human beings. I want people
to step back at some point in time and say, thank God for America
and our generosity as lives were saved. (Applause.)
My point is, our presence in the world is more than just our might;
but our might is needed in the world right now to make the world
a more peaceful place. The war on terror is not confined strictly
to the al Qaeda that we're chasing. The war on terror extends beyond
just a shadowy terrorist network. The war on terror involves Saddam
Hussein because of the nature of Saddam Hussein, the history of
Saddam Hussein and his willingness to terrorize himself.
Saddam Hussein has terrorized his own people. He's terrorized his
own neighborhood. He is a danger not only to countries in the region,
but as I explained last night, because of al Qaeda connections,
because of his history, he's a danger to the American people. And
we've got to deal with him. We've got to deal with him before it
is too late. (Applause.)
Before September the 11th, during a period when a lot of us thought
oceans would protect us forever from gathering threats far from
our land, the thought of containing somebody like Saddam Hussein
made sense -- so we could step back in America and say, gosh, well,
don't worry, he's only a threat to somebody in the neighborhood,
and we might pick or choose whether or not we're going to help in
But, see, our fellow citizens must understand that September the
11th, 2001 changed the equation. It's changed the strategic outlook
of this country, because we're not protected by oceans. The battlefield
is here. And therefore, we must address threats today as they gather,
before they become acute.
There's a reason why the world asked Saddam Hussein to disarm --
for 12 years. (Laughter.) And the reason why is because he's dangerous.
He's used them. He tortures his own people. He's gassed his own
people. He's attacked people in the neighborhood.
What's changed for America -- besides the fact that he's still
dangerous and can create havoc with friends in the neighborhood
-- is that there's now a shadowy terrorist network which he could
use as a forward army, attacking his worst enemy and never leave
a fingerprint behind, with deadly, deadly weapons. And that's what's
We're having an honest debate in this country, and we should, about
peace and how to achieve the peace. It should be clear to you now,
though, that in my judgment you don't contain Saddam Hussein. You
don't hope that therapy will somehow change his evil mind -- (laughter)
-- that you deal with Saddam Hussein. I hope we can do this peacefully.
I went to the United Nations for a reason. One, I wanted the United
Nations to be something other than an empty debating society. (Applause.)
I wanted it to address this threat. By a 15-0 vote in the Security
Council, they said, yes, it's a problem and he must disarm. But
the fundamental question is, when. There's a lot of focus on the
inspectors, and we wish them well. But the role of the inspectors
is not to play hide-and-seek with Saddam Hussein in a country the
size of California. There's 108 inspectors running around a country
trying to stumble into something; 108 people who are being misled
by a person who's made a history of fooling inspectors.
See, the role of the inspectors are not to play "gotcha." He's
better at playing "gotcha," obviously -- for 12 years he's played
"gotcha." The role of the inspectors are to watch Iraq disarm. That's
the role of the inspectors. They're to report back and say, gosh,
he's started getting rid of all his mustard gas or sarin gas. He
started getting rid of these weapons of mass destruction. He's now
getting rid of the biological laboratories. That's the role of the
And it's clear he's not disarming. I'm convinced that this still
can be done peacefully. I certainly hope so. The idea of committing
troops is my last option, not my first. I understand the terrible
price of war. I understand what it means to put somebody into combat.
I know what it means to hug mothers and wives. But I've got to tell
you something. I've thought long and hard about this. The risks
of doing nothing, the risks of assuming the best from Saddam Hussein,
it's just not a risk worth taking.
So I call upon the world to come together and insist that this
dangerous man disarm. But should they choose not to continue to
pressure Saddam, and should he continue to defy the world, for the
sake of our peace, for the sake of the security, this country will
lead a coalition of other willing nations and we will disarm Saddam
Hussein. If need be, if war is brought upon us like I said last
night, I want to assure you, particularly those who wear the uniform
and those who have a loved one in the military, we will commit the
full force and might of the United States military. And for the
name of peace, we will prevail. (Applause.)
We will free people. This great, powerful nation is motivated not
by power for power's sake, but because of our values. If everybody
matters, if every life counts, then we should hope everybody has
the great God's gift of freedom. We go into Iraq to disarm the country.
We will also go in to make sure that those who are hungry are fed,
those who need health care will have health care, those youngsters
who need education will get education. But most of all, we will
uphold our values. And the biggest value we hold dear is the value
of freedom. (Applause.) As I said last night, freedom and liberty,
they are not America's gifts to the world. They are God's gift to
humanity. We hold that thought dear to our hearts.
This is a great nation. America is a strong nation. America is
a nation full of people who are compassionate. America is a nation
that is willing to serve causes greater than ourselves. There's
no question we face challenges ahead of us -- challenges at home,
challenges abroad. But as I said last night, history has called
the right nation into action. History has called the United States
into action, and we will not let history down.
Thank you all for coming. May God bless. (Applause.)
END 1:22 P.M. EST
by the President On the 2003 Report of the Social Security Trustees
March 17, 2003
I commend the Social Security Board of Trustees for their hard work
on their annual report.
As in last year's report, the Trustees confirmed that benefits
for today's seniors are safe and secure. Promises made can and will
be kept. The Trustees also once again have delivered a sobering
message -- Social Security, in its present form, is unsustainable
for the long term. I share the Trustees' view that we need to explore
new ways to ensure that Social Security remains strong and financially
secure for America's children and grandchildren.
I am encouraged by the unprecedented level of bipartisan interest
in Social Security modernization. Many comprehensive proposals have
been put forward to strengthen Social Security for the long term.
Although these proposals differ in details, they are consistent
in showing that if we give workers the opportunity to invest a portion
of their wages in personal accounts, Social Security will be able
to offer higher benefits than would otherwise be the case.
To repeat what I told Congress in the State of the Union address
this year: "As we continue to work together to keep Social
Security strong and reliable, we must offer younger workers a chance
to invest in retirement accounts that they will control and they
Social Security protects beneficiaries with disabilities, retirees,
widows, and widowers. It also affects the lives of millions of taxpaying
workers, the beneficiaries of tomorrow. As the report makes clear,
Social Security faces long term problems that demand bipartisan
I hope that Members of Congress will join with the Social Security
Administration and other interested parties in a national dialogue
about how best to strengthen and protect Social Security. I look
forward to working with Congress to see that Social Security remains
sound and strong for today's and tomorrow's retirees.
President's Radio Address
June 7, 2003
THE PRESIDENT: Good morning. This week, the House and Senate are
working on one of the most important issues facing Congress: improving
Medicare to offer prescription drug coverage to American seniors.
And on Wednesday, I will travel to Chicago and talk about our responsibility
to give seniors more choices and better benefits, including help
with the rising costs of prescription drugs.
We have a tremendous opportunity to reform Medicare and help our
seniors. The budget I proposed, and which the Congress passed, provides
$400 billion in additional funds over the next 10 years to strengthen
and improve Medicare -- so we have the resources to make reform
work. We're also seeing a growing consensus -- in both houses of
Congress and both parties -- that our seniors need a strengthened
Medicare system that includes prescription drug coverage. The time
is right to make progress.
Our nation has made a binding commitment to bring affordable health
care to our seniors. We must honor that commitment by making sure
Medicare stays current with the needs of today's seniors. When Medicare
was launched 38 years ago, medicine focused on surgery and hospital
stays -- and that is mainly what Medicare covers. Today, doctors routinely
treat their patients with prescription drugs, preventive care, and
ground-breaking medical devices -- but Medicare coverage has not kept
pace with these changes. Our goal is to give seniors the best, most
innovative care. This will require a strong, up-to-date Medicare system
that relies on innovation and competition, not bureaucratic rules
My views on Medicare are clear. First, those who like the Medicare
system as it is should be able to stay just where they are, and
also receive prescription drug benefits.
Second, those who want more coverage for preventive care and other
benefits should be able to choose from multiple health plans under
an enhanced Medicare program. This option would be similar to the
health care coverage available to every federal employee. If that
coverage is good enough for members of Congress and federal employees,
it is good for our seniors.
Third, seniors who want the benefits of managed care plans -- including
prescription drug coverage -- should be able to choose from a range
of plans that best fit their personal needs.
And, fourth, we must provide extra help for low-income seniors,
so that all seniors will have the ability to choose the Medicare
option that serves them best -- and every senior will have the option
of a prescription drug benefit.
In a Medicare system that reflects these principles, every senior
in America would enjoy better benefits than they do today. And they
would continue to benefit from the most important strength of American
medicine: the ability to choose your own doctor. We want seniors
and doctors -- not government bureaucrats -- to be in charge of
the important health care decisions.
Members of Congress are working hard on this issue, and I encourage
their efforts. I also urge Americans to make their voices heard.
If we work together, Congress will pass a strong Medicare bill --
and our seniors will finally get the prescription drug benefits
and choices they need and deserve.
Thank you for listening.
President's Radio Address
June 28, 2003
THE PRESIDENT: Good morning. This week the United States Congress
passed historic legislation to strengthen and modernize Medicare.
Under the House and Senate bills, American seniors would, for the
first time in Medicare's 38-year history, receive prescription drug
We're taking action because Medicare has not kept up with the advances
of modern medicine. The program was designed in the 1960s, a time
when hospital stays were common and drug therapies were rare. Now,
drugs and other treatments can reduce hospital stays while dramatically
improving the quality of care. Because Medicare does not provide
coverage to pay for these drugs, many seniors have to pay for prescriptions
out of pocket, which often forces them to make the difficult choice
of paying for medicine or meeting other expenses.
In January I submitted to Congress a framework for Medicare reform
that insisted on giving seniors access to prescription drug coverage
and offering more choices under Medicare. The centerpiece of this
approach is choice. Seniors should be able to choose the health care
plans that suit their needs. When health care plans compete for their
business, seniors will have better, more affordable options for their
health coverage. Members of Congress and other federal employees already
have the ability to choose among health care plans. If choice is good
enough for lawmakers, it is good enough for America's seniors.
I'm pleased to see that Congress has accepted the principle of
choice for seniors. Under the provisions of both the House and Senate
bills, seniors who want to stay in the current Medicare system will
have that option, plus a new prescription drug benefit. Seniors
who want enhanced benefits, such as coverage for preventative care
and a cap on out-of-pocket costs, will have that choice, as well.
Seniors who like the affordablity of managed care plans will be
able to enroll in such plans. And low-income seniors will receive
extra help so that all seniors will have the ability to choose a
Medicare option that includes prescription drug benefits.
My framework for Medicare reform also called for immediate help
to seniors through a prescription drug discount card. And I'm pleased
that both the House and Senate bills would make a discount card
available to seniors. The card would help senior citizens by reducing
their prescription drug costs, beginning early next year and continuing
until the new prescription drug program under Medicare takes full
effect in 2006.
The Congress must now pass a final bill that makes the Medicare
system work better for America's seniors. This is an issue of vital
importance to senior citizens all across our country. They have
waited years for a modern Medicare system and they should not have
to wait any longer.
Earlier this month in Chicago I met Gene Preston and his wife Dorothy.
They spend about $300 a month on prescription drugs and they do
not have prescription drug coverage. Gene says, "Everything is going
up in price. Before, we could save a couple of bucks at the end
of the month. But right now we're just holding even, if not going
below even." When Congress completes its work, seniors like Gene
and Dorothy Preston can look forward to better health care coverage
and relief from the rising cost of prescription drugs.
I appreciate the hard work of members of Congress who have set
aside partisan differences to do what is best for the American people.
I urge members to seize this opportunity to achieve a great and
compassionate goal. I urge them to finish the job of strengthening
and modernizing Medicare, so that I can sign this crucial reform
Thank you for listening.
President Bush Calls for Action on
38th Anniversary of Medicare
The East Room
July 30, 2003
2:45 P.M. EDT
THE PRESIDENT: Thank you all for coming. Welcome to the people's
house. We're thrilled you're here. Tommy is right, 38 years ago,
Lyndon Johnson signed the Medicare Act. What I found interesting
was that he had the ceremony in Independence, Missouri, so that
former President Harry Truman could be there, because Truman had
set out the vision of Medicare many years before that. A few minutes
after 3:00 p.m., Medicare became law, and President Johnson handed
the first Medicare card to Harry Truman. (Applause.)
Health insurance for elderly and disabled Americans was one of
the greatest, most compassionate legislative achievements of the
20th century. It spared millions of seniors from needless worry
and hardship. Since 1965, every President and every Congress has
had the responsibility to uphold the promise of Medicare, and we
will uphold our promise. We will do our duty.
The 38th anniversary of Medicare is a time for action. The purpose
of the Medicare system is to deliver modern medicine to America's
seniors. That's the purpose. And in the 21st century, delivering
modern medicine requires coverage for prescription drugs. (Applause.)
Both houses of Congress have passed Medicare improvements that
include prescription coverage. Now the House and Senate must iron
out the remaining differences and send me a bill. For the sake of
our seniors, for the sake of future retirees, we must strengthen
and modernize Medicare this year. (Applause.)
I appreciate Tommy Thompson taking the lead on this issue for this
administration. He -- I knew him when he was a governor. I figured
he'd make a pretty good Cabinet Secretary. (Laughter.) And he proved
me right. He's doing a fabulous job. He is the point man on the
Hill on this complex, important legislation.
And we've got two of the members
from the Senate who have worked really hard to see to it that the
legislation came to fruition and passed the Senate, and are working
hard to get a good bill out of the conference. And that's -- starting
with the Majority Leader of the United States Senate, Bill Frist,
from Tennessee. (Applause.) The ranking member on the Finance Committee
from the state of Montana -- that would be Max Baucus, Senator Baucus.
For those of you who don't follow politics -- (laughter) -- Frist
is a Republican -- (laughter) -- Baucus is a Democrat. (Laughter
and applause.) Both of them willing to put aside party to focus
on what's doing right for the seniors. And I appreciate their leadership
of both these Senators. Thank you all for coming. You set a good
example for the body you represent. (Applause.)
I appreciate Tom Scully who is with us. He is the Administrator
for the Centers for Medicare and Medicaid Services. That is a long
title for a very tough job. And I appreciate Scully's knowledge
on this issue. He, too, along with Secretary Thompson, is working
the Hill, along with members of my staff, working hard with senators
and congressman from both parties to come up with a bill that will
stand the test of time.
I want to thank top docs in my administration who are traveling
the country to talk about the benefits of Medicare reform. Rich
Carmona is the Surgeon General of the United States. Thank you for
coming, doc. Dr. Julie Gerberding directs the Center for Disease
Control and Prevention. It's a tough and important job. Mark McClellan
is the Commissioner of the FDA, the Food and Drug Administration.
Elias Zerhouni is the Director of the National Institute of Health.
All four great Americans; all four find doctors; all four doing
a really good job on behalf of the American citizens. (Applause.)
On a piece of legislation like this, it obviously attracts the
attention of advocates, people who are willing to get involved in
the process, people who work hard on behalf of the constituents
they represent. Today we've got Jim Parkel and Bill Novelli. Jim
is the president, Bill Novelli is the director and CEO of AARP.
I'm honored you all are here. Thanks, thanks for providing such
good leadership for all. (Applause.)
There's a group involved in the process called United Seniors Association.
It's headed by Charlie Jarvis. He's the chairman and CEO, and Charlie
is with us today. Thank you for coming, Charlie. (Applause.) Representing
the 60 + Association is my longtime friend, Jim Martin. Thank you
for coming. I'm glad you're here. (Applause.)
I want to thank those of you here today for your interest. I want
to thank fellow citizens who may be watching this on C-SPAN if it
happens to be on C-SPAN -- it seems like everything is on C-SPAN
these days -- (laughter) -- for your interest in this very important
You know, for a long time Medicare was called Mediscare, and it
meant that political people weren't supposed to touch it for fear
of losing an election, that when you talked about reforming Medicare,
then all of a sudden you were supposed to lose, because people would
bang you over the head on the issue. I think we're beyond that,
and that's a very positive development. A lot of you in this room
have helped us get beyond that. And I want to thank you for that.
Now we've got hard work to do to get this process across the line.
I'm joined on stage, by the way, by some of our fellow citizens,
who I'll talk about in a little bit about how the current Medicare
plan as envisioned by a lot of us will help in their daily lives.
But let me start by telling you this. For four decades, it's important
for our citizens to know that Medicare has done exactly what it
was created to do, which is pretty unusual for an act of Congress.
(Laughter.) In all due respect. (Laughter.) Under Medicare older
Americans have access to good quality health care in a system of
private medicine. That what it was intended to do, and that's what
it has done. Seniors and people with disabilities have greater peace
of mind knowing that Medicare will always be there. It was the initial
intent of the law, and that's what it has done.
Medicare coverage has helped protect the savings of our seniors
and shielded their families from costs they may not be able to afford.
Medicare is an important national achievement, and it is a continuing
moral responsibility of our federal government. Americans are proud
of our Medicare program. We must make sure that Medicare fits the
needs of our seniors today. It has done what it was supposed to
do. Our task is to make sure it continues to do what it was supposed
It was created at a time when medicine consisted mostly of house
calls and surgery and long hospital stays. Now modern medicine includes
preventative care, outpatient procedures, and at-home care. Medicine
is changing. Many invasive surgeries are now unnecessary because
of the miraculous new prescription drugs being developed. Most Americans
have coverage for all this new medicine; yet seniors relying exclusively
on Medicare do not have coverage for most prescription drugs.
No one intended for Medicare to develop these major gaps in coverage.
That was not the initial intent of the law. There are gaps in coverage
now. Medicine has changed; Medicare hadn't. We must fill those gaps.
Medicare must be modernized. (Applause.)
Let me give you a couple of examples by what I mean when I talk
about modernization. Medicare today will pay for extended hospital
stays for ulcer surgery, at a cost of up to $28,000 per patient.
This is important coverage. Yet Medicare will not pay for drugs
that eliminate the cause of most ulcers, drugs that cost about $500
a year. Medicare will pay for the cost to treat a stroke, including
bills from the hospital and rehab center, doctors, home health aides
and out-patient care. That's what Medicare pays for. Those costs
can total up to $100,000. This is essential coverage, it's vital
coverage. Yet Medicare does not cover the blood-thinning drugs that
prevent strokes in the first place, drugs that cost less than $1,000
The Medicare system has got a lot of strengths, no question about
it. Yet it is often slow to respond to the dramatic changes in medicine.
And that's what we've got to address. That's what we are addressing.
The best way to provide our seniors with prescription drug coverage
and better preventative care is to give them better choices under
Medicare. If seniors have choices, health plans will compete for
their business, by offering better coverage at affordable prices.
Both houses of Congress have passed bills that follow the framework
of reform that I suggested, and others have suggested. Under either
bill, seniors who want to stay in current Medicare have that option,
plus a new prescription drug benefit. Seniors who want enhanced
benefits, such as coverage for extended hospital stays and protection
against high out-of-pocket expenses will have that choice, as well.
Seniors who like managed care plans will have that option, as well.
All low-income seniors will receive extra help so that all seniors
will have the ability to choose a Medicare option that includes
a prescription drug benefit.
Many retirees depend on employer-sponsored health plans for their
prescription drug coverage. That's a reality in today's society.
Medicare legislation -- the legislation that these two good senators
are working hard on -- should encourage employers to continue to
provide those benefits, while extending drug coverage to millions
of Medicare beneficiaries who now lack it. It's important that those
who have assumed the responsibility -- corporate responsibility
of providing prescription drugs for their retirees keep providing
that benefit. And I know the senators are working on that important
part of the Medicare legislation.
Every member of Congress gets to choose a health coverage plan
that makes the most sense for them, and so does their staff. So
does every federal employee. And so should every senior have that
choice. See, choice is good. It makes sense. I can understand why
members of Congress have said, well, look, give me more than one
option if you don't mind. I'm plenty capable of choosing for myself.
I'd like to see what's available. As a matter of fact, I'd like
to have my demand be listened to. I'd like to have plans begin to
tailor their services to what I think is necessary for me. And seniors
should have that same option, it seems like to me. Seniors are plenty
capable of making decisions for what's best for them.
For seniors without any drug coverage now, these reforms will help
a lot. Let me tell you what I mean by that. In return for a monthly
premium of about $35 or about a dollar a day, seniors now without
coverage will see their drug bills cut roughly in half. That's the
good work that these senators have done. They've heard the call
and they're responding with a piece of legislation that will help
seniors save money.
A senior with a monthly drug cost of $200 will save between $1,300
and $1,800 on drug costs each year. That's under the bills that
have been passed now. A senior with a monthly drug cost of $800
-- monthly cost of $800 would save between $5,700 a year and $6,100
each year on drug costs. That's some pretty good change.
The House and the Senate have got to work out their differences.
And they're going to. That's -- I believe that there's a spirit
of cooperation and a can-do attitude amongst the conferees. But
in either version of their bills, seniors who currently lack drug
coverage will see real savings. And that's a positive reform for
a lot of our fellow citizens.
As we move toward this system, we will provide seniors with a drug
discount card that saves them 10 to 25 percent off the cost of all
drugs, so they'll start seeing savings immediately, as well. The
conferees I know are working on the drug discount card now, to make
sure we can iron out any differences. And I was briefed on that
today by our staffers who are working close with the conferees.
We have some seniors, as I mentioned, with us today -- some citizens
with us today that would like to see the legislation move forward
for practical reasons. A lot of times in Washington we talk about
statistics and laws and hearings, and I always like to bring the
human element to the front, so people get to see how these bills
will actually affect people's lives in a positive way.
Mary Jane Jones from Midlothian, Virginia, is with us today. She's
a Medicare recipient. She's 69 years old. She'd like to be retired
for good. (Laughter.) But she has to work 20 hours a week just to
make sure she can afford her nearly $500-a-month bill for prescription
drugs and insulin. Sometimes, she says, she uses her insulin needles
three or four times to save money. That's a story I'm confident
that those who have held hearings in Congress, or members of groups
here hear from their members.
Mary Jane says that getting about half her drug cost covered would
be a big help. That way, she says, she wouldn't have to work constantly.
Seniors like Mary Jane have made their plans. This bill will help
them enjoy their retirement.
Refa Ryan is with us from Warrenton, Virginia. She has Medicare,
she doesn't have drug coverage, and she pays $120 to $200 a month
for medicine. Three-years-ago, when she was having a hard time making
payments on her drugs, rather than asking someone for help, she
was ready to sell her engagement ring. Fortunately, Denise found
out about it, and bought the ring so it stayed in the family. Refa
says she appreciates what Congress is trying to do, to add drug
coverage to Medicare.
"I wouldn't be anxious all the time," she said. "I wouldn't have
to worry all the time." See, this bill will help our seniors not
have to worry all the time. And that's why there's momentum toward
getting something done.
I also fully recognize that there are some that are beginning to
think about what Medicare means when they retire. I might be one
of them. (Laughter.) There's some baby boomers that are beginning
to look out, and say, Medicare isn't going to be there. Is it going
to be modern when we get ready?
In support of what I know the senators are doing, and members of
the House are doing, the conferees are doing, is they're thinking
not only to make sure the system works for our seniors today, but
make sure that seniors -- I mean, that the seniors to be have got
a plan available for them. And that most of us in the baby boomer
era, we like the idea of choices. We want to be able to pick and
choose to help meet our needs. We want to make sure that the system
kind of listens to the demand of the citizen.
Richard Kamenitzer is with us. Richard and I are of the same generation.
It says in here he and his wife, Rose Marie, are in their 50s. Well,
Laura and I are in our 50s, too. He's from Stroudsburg, Pennsylvania.
He's a self-employed guy. He's a part of the entrepreneurial class
here in America. He's a small business man. And he and his wife
take about seven medications a day, right now. Now, he's probably
beginning to wonder, after he retires, how can he afford seven medications
-- he and his wife -- a day? Who's going to pay for it?
He said -- here's what he says, with drug coverage and Medicare
-- about the new plans that we're trying to get done -- he said,
"I'd have a fighting chance" -- that is, I would have a fighting
chance to enjoy retirement. "Without it, I don't know what I'd do.
Retirement, in a sense, may be out of the question, because I won't
be able to afford the prescriptions I desperately need."
See, not only are we talking about helping the seniors today who
are on Medicare, we're talking about the ones getting ready to get
on Medicare, too. And that's why these folks are thinking beyond
just the immediate. We want a plan that stands the test of time.
Remember, the plan that Lyndon Johnson signed was pretty effective
for four decades. We have a chance to do the same thing here in
I know that Congress is listening to the voices of the retired
and near-retired. And I appreciate that very much. I appreciate
the willingness throughout all the federal government to give our
seniors and those living with disabilities the kind of options they
deserve, the kind of hearing that they want. We should not let another
Medicare anniversary go by without modernizing the system, without
giving our seniors -- (applause.)
The Senate, I think, is getting ready to go out on the August vacation.
We're certainly pulling for you to go out. (Laughter.) The House
is already gone. They're in their districts. They'll be listening
to the people. And I know Americans who are concerned about this
issue will want to make their voices heard. And we, of course, urge
you to do so. We urge you to contact your member of your House and
your senators and let them know your thoughts on Medicare reform.
Let them know that we expect to plow through the doubts and the
obstacles and get a good bill to the President's desk. My pen is
ready. I'm ready to sign a good bill.
I know that this August staff members of the conference will be
working. And for those staff members who are here, I want to thank
you for grinding through a complex piece of legislation and working
out your differences. And then when the members come back, we'll
have some heavy lifting to do. But I want to be there to help you
carry the load.
We've all come to Washington, those of us who have been elected
to office, to serve something greater than ourself. And we have
a duty and a call to not only describe a problem, but to address
it. And in this case when we do, the lives of our fellow citizens
will be improved.
I want to thank you for your interest in this really important
subject -- thank to the two senators who have joined us today. I
want to thank the members of my Cabinet who are here. May God bless
you all, and may God continue to bless the United States of America.
END 3:09 P.M. EDT
President Bush Meets with Medicare Conferees
Remarks by the President After Meeting with Members of the
Congressional Conference on Medicare Modernization
The Cabinet Room
September 25, 2003
3:19 P.M. EDT
THE PRESIDENT: Listen, thank you all for coming. Today we met with
the conferees on Medicare, and had a good and frank discussion about
the need to work together to get a Medicare bill that modernizes
the system, that fulfills the promises to America's seniors, that
uses the latest technology to improve the health care of our elderly.
And in my judgment, the sentiment was optimistic. I believe people
know it's possible to get it done. And there's a lot of work to
get done, but, fortunately, we're surrounded here by conferees that
are plenty capable, plenty smart and care deeply about the future
of the country.
And so I want to thank them for coming, I want to thank you for your
commitment to our seniors and I look forward to working with you to
get a good bill out of both bodies and to my desk before you go home
I'd like to take a couple of questions. Terry.
Q Mr. President, with huge federal budget deficits, do you have
any qualms about spending $400 billion on Medicare prescription
THE PRESIDENT: First of all, no, I don't. I think it's the right
thing to do. We have an obligation to our seniors. Secondly, we've
proposed a plan that reduces the deficit in half by five years --
within five years. I absolutely believe we're doing the right thing.
Q Sir, what did you think of the discovery of traces of weapons
grade uranium --
THE PRESIDENT: Do what now?
Q What did you think of the discovery of weapons grade -- traces
of weapons grade uranium in Iran? And will this be on your agenda
with President Putin this weekend?
THE PRESIDENT: It was on my agenda -- it will be on my agenda with
President Putin this weekend. It was on my agenda with many of the
world leaders I met with in New York. It is very important for the
world to come together to make it very clear to Iran that there
will be universal condemnation if they continue with a nuclear weapons
program. And I will tell you, the response was very positive. People
understand the danger of the Iranians have a nuclear weapons program.
But, you bet, I'll talk to President Putin about it this weekend.
Q Sir, in February of 2001, your Secretary of State said that the
sanctions against Iraq had prevented Saddam from developing any
significant capability with respect to weapons of mass destruction.
A year-and-a-half later, before the U.N., you called Saddam a grave
and gathering danger. And I'm wondering, what changed in that time?
Was it the nature of the threat? Did you get new intelligence? Or
did 9/11 put a new -- set a new playing field for those --
THE PRESIDENT: Yes, the Secretary of State said the same thing,
as well, that Saddam was a threat. Nine-eleven changed my calculation.
It made it really clear we have to deal with threats before they
come on our shore. You know, for a long period of time we thought
oceans could protect us from danger, and we learned a tough lesson
on September the 11th. It's really important for this nation to
continue to chase down and deal with threats before they materialize,
and we learned that on September the 11th.
Q Mr. President?
THE PRESIDENT: Yes.
Q OPEC yesterday announced an agreement to cut oil production by
THE PRESIDENT: Yes.
Q What is your reaction to that; what do you think of it? And what
are the consequences for the U.S. economy?
THE PRESIDENT: My reaction is, is that I would hope our friends
in OPEC don't do things that would hurt our economy.
END 3:23 P.M. EDT
President Calls on Congress to Complete
Work on Medicare Bill
Remarks by the President on Medicare
Dwight D Eisenhower Executive Office Building
October 29, 2003
11:06 A.M. EST
THE PRESIDENT: Thank you all for coming. Good morning. Welcome
to the White House. I'm glad you're here. We're meeting at an historic
time, and the reason why is, after years of debate and deadlock,
the Congress is on the verge of Medicare reform. And that's important.
Prescription drug coverage for our seniors is within reach. Expanded
coverage for preventive medicine and therapy is within our reach.
More health care choices for seniors are within our reach.
Though a few difficult issues remain, the Congress has made tremendous
progress. And now is the time to finish the work. (Applause.) The
Congress needs to finalize legislation that brings our seniors the
best of modern medicine. And I want to sign that legislation into
law before the year is out. (Applause.)
And the point person for this administration in working with the
Congress to move the legislation along is Tommy Thompson, our Secretary.
He's done a fabulous job. (Applause.) If he looks tired, it's because
he's showing up early -- (laughter) -- and going to bed late, working
for the seniors of America.
I want to thank Tom Scully, who is the Administrator -- Scully
is the Administrator of the Centers for Medicare and Medicaid Services.
I appreciate you coming. (Applause.)
We've got other members of my administration who are concerned
about the health of all Americans, including our seniors -- Rich
Carmona, the Surgeon General. Thank you, General. (Applause.) The
Head of the Centers For Disease Control and Prevention, Julie Gerberding.
Thank you, Julie, for being here. It's good to see you. (Applause.)
The Director of the National Institutes of Health, Elias Zerhouni.
Dr. Zerhouni is with us. (Applause.)
We've got a lot of other important
people here, too many to name. But I have just come from a roundtable
discussion with some seniors and some people involved in the process,
a corporate executive who is from Caterpillar, who assures me that
corporations have no intention of -- if there's a Medicare reform
bill signed by me, corporations have no intention to what they call
dump retirees into a system they don't want to be dumped into. And
I appreciate that commitment by Rich Lavin. Thank you for bringing
I want to thank Jim Parkel, from Fairfield, Connecticut, who is
the President of the AARP, for being here. I appreciate my friend
Jim "Budda" Martin for being here today. He's very much concerned
about the health of our citizens. And thank you all, for coming.
This is an important moment, as I said.
You see, the stories we heard remind Tommy and me that seniors
depend upon Medicare, and that the Medicare program is a basic trust
that must be upheld throughout the generations. What we're talking
about is trust, that people trust their government to bring a modern
system of health to our seniors. We made a commitment at the federal
level to provide good health care for seniors, and we must uphold
that commitment. That's what we're here to discuss today -- how
best to do that.
Each of the seniors that we talked about -- talked to understands
that the system needs improvement, that Medicare needs to be modernized.
I'm determined to meet this responsibility.
And let me share some of the stories we heard right quick. Neil
LaGrow is with us. Neil, thank you. He takes 10 medications, about
$525 a month he spends. He pays for it all. Because of these costs,
he continues to work -- although I must say he didn't complain about
it. (Laughter.) He likes to work. We need our seniors working, by
the way, in terms of making contributions to our society. I'm not
talking about being on the factory floor for eight hours, but I
am talking about passing on values from one generation to the next,
or helping in different community activities as you see fit. It's
a really important contribution to our country. Neil does that.
If he gets some help with his prescription drug costs, that's going
to make his retirement a little easier. Isn't that right?
Seniors should be able to plan their retirement better. The best
way to do so is to make sure that they can afford the medicines
necessary to keep them healthy. That's what we're talking about
in this bill.
Joan Fogg is with us, from Richmond. She and her husband, Walter,
are on Medicare and they pay a goodly portion for drugs right out
of their own pocket. "When we think we're getting down on money,
we go ahead and cut the medication in half" -- that's what she said.
"That's not the way it should be, but we deal with it. We have to."
Joan is right, that's not the way it should be. That's why we want
to modernize the system. That's why we want to work better for all
Most American seniors and people with disabilities are grateful
for the current Medicare system. Yet they understand the system
has problems. Our job is to address those problems. We should carefully
correct the problems. That's what we're elected to do. Medicare
was created at a time when medicine consisted mostly of house calls
and surgery and long hospital stays. Now modern medicine includes
preventative care, outpatient procedures, and at-home care. Life
is changing; Medicare is not.
Many invasive surgeries are now unnecessary because of miraculous
new prescription drugs. Most Americans have coverage for this new
medicine. Three-quarters of seniors have some kind of drug coverage.
But seniors relying exclusively on Medicare do not have coverage
for most prescription drugs and many forms of preventative care.
This is not good; it's not cost-effective medicine.
Medicare today will pay for extended hospital stays for ulcer surgery,
at a cost of about $28,000 per patient. And that's important coverage.
Yet Medicare will not pay for the drugs that eliminate the cause
of ulcers -- drugs that cost about $500 a year. So anytime you talk
about cost savings, there's an example of cost savings.
Medicare will pay many of the costs to treat a stroke, including
bills from hospital and rehab center, doctors, home health aides
and out-patient care. Those costs can run more than $100,000. And
this is essential coverage. Yet Medicare does not cover the blood-thinning
drugs that could prevent strokes, drugs that cost less than $1,000
The Medicare system has many strengths. Yet it is often slow to
respond to dramatic changes in medicine. It took more than a decade
and an act of Congress to get Medicare to cover preventative breast
cancer screenings. It took 10 years, and then an act of Congress
to change the system. That's not a good system. Our seniors should
not have to wait for an act of Congress for improvements in their
health care. (Applause.)
The best way to provide our seniors with modern medicine, including
prescription drug coverage and better preventative care, is to give
them better choices under Medicare. If seniors have choices, health
plans will compete for their business by offering better coverage
at more affordable prices.
The choices we support include the choice of making no change at
all. I understand some seniors don't want to change, and that's
perfectly sensible. If you're a senior who wants to stay in the
current Medicare system, you'll have that option. And you'll gain
a prescription drug benefit. That's what the reform does.
If you're a senior who wants enhanced benefits, such as coverage
for extended hospital stays or protection against high out-of-pocket
expenses, you'll have that choice. If you liked managed care plans,
that option will be there. If you're a low-income senior, you will
receive extra help each month and more generous coverage, so you
can afford a Medicare option that includes prescription drug benefits.
We're applying a basic principle: seniors should be able to choose
the kind of coverage that works best for them, instead of having
that choice made by the government. (Applause.) Every member of
Congress gets to choose a health coverage plan that makes the most
sense for them. So does every federal employee. If this kind of
coverage is good enough for the United States Congress, it's good
enough for America's seniors. (Applause.)
For seniors without any drug coverage now, these reforms will make
a big difference in their lives. In return for a monthly premium
of about $35, or a dollar a day, those seniors now without coverage
would see their drug bills cut roughly in half. A senior who has
no drug coverage now and monthly drug costs of $200 a month would
save more than $1,700 on drug costs each year. A senior with monthly
drug costs of $800 would save nearly $5,900 on drug costs each year.
Those are important savings, help change people's lives in a positive
I'm optimistic the House and the Senate negotiators will produce
a bill that brings real savings to millions of seniors, and real
reform to Medicare. Once the legislation is passed, it will take
some time to put into place. During this period, we'll provide all
seniors with a Medicare-approved drug discount card that saves between
10 to 25 percent off the cost of their medicines. So they'll have
a start to see savings immediately.
Low-income beneficiaries will receive a $600 subsidy, along with
their discount card to help them purchase their prescription medicines.
The legislation Congress passes must make sure that the prescription
drug coverage provided to many retirees by their employers is not
undermined. That's what Rick and I just discussed. Medicare legislation
should encourage employers to continue benefits, while also extending
drug coverage to the millions of Medicare beneficiaries who now
These steps will strengthen Medicare, not only for today's seniors,
but for tomorrow's retirees. Many workers are counting on Medicare
to provide good health care coverage in their retirement. That's
what people are counting on. These reforms will give our workers
confidence that Medicare will serve them with the very best of modern
The budget I submitted earlier this year commits an additional
$400 billion over 10 years to implement this vision of a stronger
Medicare system. We're keeping our commitments to the seniors of
today. We must pursue these reforms so that our Medicare system
can serve future generations of Americans.
The time to improve our Medicare system has come. Now is the time.
(Applause.) I urge America's seniors to speak up, to call and write
your representatives to urge them to work out a final bill. Speak
up for prescription drug coverage; speak up for health care choices;
speak up for a modern Medicare system that puts patients and doctors
in charge. (Applause.)
I urge the Congress to act quickly, to act this year, not to push
this responsibility to the future. We have the opportunity; we have
the obligation to give seniors more choices and better benefits.
We have come far, and now is the time to finish the job.
Thank you for coming, appreciate it. (Applause.) Good to see you
all. Thank you all.
END 11:20 A.M. EST
President Bush Meets with Florida Seniors to Discuss Medicare
Remarks by the President in Meeting with Seniors on Medicare
Engelwood Neighborhood Center
November 13, 2003
2:07 P.M. EST
THE PRESIDENT: Thanks for coming.
Thanks for the warm welcome. I want to thank the Engelwood Neighborhood
Center for hosting us. You're awfully kind to have us. Behave yourself.
(Laughter.) I wish I had time for a workout. I saw your facilities.
(Laughter.) One good way to help people maintain their health is
to encourage people to exercise. And I want to thank those of you
who are encouraging people of all ages to get a little exercise
on a daily basis. The best way to make sure you're health is strong
is to prevent disease in the first place. Nothing like going out
for a good stroll to keep yourself healthy.
I also want to thank our friends in my administration and the seniors
who are participating in the discussions in Denver, Philadelphia,
Phoenix, Cleveland and Dallas. I notice that Surgeon General Carmona
is hosting an event on the SMU campus. That kind of warms my heart,
because First Lady Laura Bush went to SMU. I don't know if they
still remember her there -- (laughter) -- but I certainly remember
her here. (Laughter.) And she sends her very best.
I want to thank you all for being here at what I would call an
historic time when it comes to the health of our seniors, because
I believe, with hard work and the right focus and with your help,
we can reform Medicare. We can reform Medicare for the benefit of
people who are on Medicare. And we can reform Medicare for those
of us who are soon to be on Medicare. We have an obligation in this
country. After years of debate and deadlock and delay, both Houses
of Congress are nearing final passage of the biggest improvements
in senior health care in 40 years. (Applause.) We're on the verge
of giving seniors prescription drug coverage, expanded coverage
for preventative maintenance of medicine and therapy, and more health
Members of Congress say they support these Medicare reforms. Now
it's time for a final vote. Members of Congress must resolve their
remaining differences. The House and the Senate must resolve their
differences and get a bill to me. For the sake of America's seniors,
I call on the United States Congress to get the job done. (Applause.)
I appreciate Josefina's service to our nation. As you know, she's
the Assistant Secretary for Aging, U.S. Department of Health. Her
boss, Tommy Thompson, a former governor of Wisconsin, Cabinet Secretary,
is now -- has been on the Hill today working out the differences
between the House and the Senate. He is intricately involved in
making sure we get us a good Medicare bill.
I want to thank my brother, the Governor of this great state, who
cares -- (applause). He's got the right priorities. I know his priorities
because we were both raised by the same mother. (Laughter.) By the
way, she wants there to be a modern Medicare system. (Laughter.)
But Jeb prioritizes his faith and his family and the people of Florida.
He cares deeply about the people here. I'm proud of his leadership.
He's a -- they may say I'm not very objective, but he's a great
I'm honored that five distinguished members of the United States
House of Representatives have joined us here for this discussion.
They are people who are going to help make the decision. I view
them as allies in this important issue, as well as allies in helping
us keep the peace around the world. They are Congressman Rick Keller,
Congressman John Mica, Congressman Adam Putnam, Congressman Katherine
Harris and Congressman -- Congresswoman Katherine Harris -- and
Children Tom Feeney. I'm honored you all are here. (Applause.)
I appreciate so very much your interest in this issue. I want to
thank you for working with us. It's a tough issue. It's a tough
issue because it's a complex issue. But modernizing Medicare is
the right thing to do. We must not miss this opportunity. I ask
the members to go back and take -- share the passion that not only
I share -- have, but the others in the audience have about those
of us in Washington doing our duty, doing what we're called to do,
and that is to tackle tough issues and lead.
I want to thank Rhonda Meadows, who is the Secretary of the Agency
of Health Care Administration. Rhonda, thank you for coming. I want
to thank Terry White for being here. It's good to see you again,
Terry. He's the Secretary of the Florida Department of Elder Affairs.
They know what I'm talking about, for the need for us to have a
modern Medicare system. You know more than they know, because you
live on Medicare, you understand the system needs to be changed
I want to thank the Mayor of Orlando, Buddy Dyer, for coming. Mr.
Mayor, I'm honored you're here. Thank you for taking time. (Applause.)
I appreciate Rich Crotty, who is the Chairman of Orange County,
for being here, as well. Thank you, Rich, for coming. (Applause.)
I appreciate the interest of federal, state and local officials
in this very important subject.
I want to thank -- I just came from a -- what they call a roundtable
discussion. Generally we have roundtable discussions sitting at
square tables. (Laughter.) You know how government works. (Laughter.)
Jeb and I met with Estelle Baker and Loretta De Maintenon; the MacDonalds,
Marge and Mac,; and Beverly and Dick Allred. The reason we did is
because we want to hear firsthand their stories. I'll share some
of their stories with you. But there's nobody -- the best people
to share with us the need to modernize Medicare are those who rely
on Medicare. And they're able to tell the good news about Medicare
and the bad news about Medicare; what works in Medicare and what
doesn't work in Medicare. Both of us like to listen to people who
have had firsthand experiences. And I want to thank the meeting
participants for sharing their stories with us.
Today when I landed -- at your fantastic airport, by the way --
(applause) -- I met Tillie -- Crotty, that's a good sign when people
clap when I mention the airport. (Laughter.) I met a very interesting
women named Tillie Walther. Tillie is here. Tillie is a volunteer
for the Retired and Senior Volunteer Program. It's called RSVP.
She dedicates a lot of time to help other people.
The reason I bring up Tillie is that when people focus on America,
they think about our great military might -- and I'll keep our military
mighty. They think about our pocketbooks --we're working hard to make
sure they're full. The truth of the matter is the great strength of
our country is the heart and souls of our citizens, people who are
willing to take time out of their day to make somebody else's life
And Tillie is such a person. She's leading by example. I love her
spirit. I love the example she sets. My call to people here and
around our country is to love your neighbor just like you'd like
to be loved yourself. Find a way to help somebody in need. Find
a way to help somebody who hurts, and the country will be better
off. Thank you, Tillie. (Applause.) Thanks for coming. I'm really,
really honored you're here.
Many seniors depend upon Medicare. That's what we're here to talk
about. And the Medicare program is a basic trust that must be upheld
throughout the generations. Our government has made a commitment
to our seniors -- the federal government has made a commitment to
our seniors through the Medicare program. We made a commitment to
provide good health care for seniors, and we must uphold that commitment.
Each of the seniors that I talked to today understands that Medicare
needs to be modernized. It needs to be changed. It needs to be brought
into the 21st century. They all want the Medicare system that allows
them to pick the health care coverage that best meets their needs.
And I want to share with you some of the thoughts that we had.
Marge and Mac MacDonald, they take seven different medications
at a cost of about $300 a month, and they have no prescription drug
coverage. That is not exactly how the planners of Medicare envisioned
a senior spending their years of retirement. That's expensive. It's
costly. Marge says she's frustrated that Washington has not delivered
a prescription drug benefit under Medicare. She says, "I'm tired
of the talk." This is her words, not mine. "I'm tired of the talk.
Sooner or later, somebody needs to do something. What is the point
of retiring at all if you're going to worry about whether you have
the money you need to survive?" Marge is right. We've had plenty
of talk in Washington. We've debated this issue for a long time.
Now is the time for action. (Applause.)
Estelle Baker -- I mentioned Estelle earlier -- she, in addition
to her Medicare benefits, she has drug coverage through a supplemental
insurance policy. Perhaps some of you all have this same type of
arrangement. She said, it's time for all seniors to have that kind
of coverage. She said, "Seniors should have the same kind of safety
net -- some kind of safety net, and it should be done as soon as
possible." In other words, that -- what you're hearing from people
is when people retire, they don't want to have to worry. They've
been worrying, probably raising their kids and worrying about their
jobs and worrying about this and worrying about that. We don't want
our seniors worrying about a health care system that is not meeting
Every senior I've talked to are grateful about the Medicare system,
and it's done a lot. In many ways, it's fulfilled the promise, up
until recent history, and therefore, the system needs to be undated.
That's what we're here to discuss. That's what Congress must hear.
They must hear your voice that the system needs to be updated, that
while the system has worked, we can do a better job.
Remember, Medicare was created at a time when medicine consisted
mostly of house calls and surgery and long hospital stays. That
was the nature of medicine when Medicare was created. And therefore,
the Medicare system responded to that. Now modern medicine includes
preventative care, out-patient procedures, at-home care, and miraculous
new prescription drugs. Medicine has changed; Medicare hasn't.
Three-quarters of seniors have some kind of drug coverage, and
that's positive news. Yet seniors relying exclusively on Medicare
do not have coverage for prescription drugs -- for most prescription
drugs, and for many forms of preventative care. That needs to be
fixed. This is not good medicine, it's not cost-effective. Medicare
needs to change.
For example, Medicare will pay -- I want you to hear this example.
Medicare will pay for extended hospital stays for ulcer surgery,
at the cost of about $28,000 per patient. That's important coverage,
particularly if you have an ulcer. Yet, Medicare will not pay for
the drugs that eliminate the cause of most ulcers, drugs that cost
about $500 a year. Willing to pay the $28,000 for the hospital stay,
but not the $500 to try to keep the person out of the hospital in
the first place. To me, that says we've got a system that needs
to updated and modernized. It's not enough for Medicare to pay to
treat our seniors after they get sick. Medicare should be covering
the medications that will be keeping our seniors from getting sick
in the first place. (Applause.)
The best way to provide our seniors with modern medicine, including
prescription drug coverage and better preventative care, is to give
them better choices under Medicare. If seniors have choices, health
care plans will compete for their business by offering better coverage
at affordable prices. That's a fact. With greater choice, we can
give American seniors the very best of modern medicine.
It's very important for people on Medicare to know that one of
the choices that I strongly support, and members of Congress support,
is allowing people to remain in traditional Medicare programs. We
fully understand that some seniors simply do not want to change.
And that's understandable. In any system, modernization must say
to the seniors, if you're happy where you are, you stay there. If
you're a senior who wants to stay in Medicare and you're concerned
about prescription drugs, you should be able to get a Medicare-approved
prescription drug coverage. That's what the bill says. And that's
what we want to happen -- you're not -- there's no reason for you
to leave Medicare, and that the Medicare system needs to be modernized
to include prescription drugs.
If you're a senior who wants enhanced benefits, something a little
different, something better, something that meets your particular
needs, such as a new Medicare-approved private plan that includes
a drug benefit, along with other options, coverage for extended
hospital stays or protection against high out-of- pocket expenses,
you should have that choice, as well. In other words there are --
a variety of choices ought to be available for seniors. If you like
managed care plans, if you're happy with that, that option ought
to be available. And if you're a low-income senior without much
savings, you will receive extra help each month, and more generous
coverage, so you can afford a Medicare option that includes prescription
That's the reform in front of Congress. It's moving forward. We've
just got to make sure it moves forward to completion. That's what
we're here to discuss today. In Medicare reform, we're applying
this basic principle: Seniors should get to choose the kind of coverage
that works best for them, instead of having that choice made solely
by the government. You see, every member of Congress gets to choose
a health care plan that makes the most sense for them. And the same
for federal employees. If choice is good for members of the Congress,
then choice is good for America's seniors. (Applause.)
For seniors without any drug coverage now, the reforms will make
a big difference in their lives. In return for a monthly premium
of about $35, or $1 a day, most seniors now without coverage will
see their drug bills cut roughly in half. A senior who has no drug
coverage now and a monthly drug cost of $200 would save more than
$1,700 on drug costs each year. A senior with monthly drug costs
of $800 would save nearly $5,900 on drug costs each year.
Putting improvements into place are going to take some time, and
so we need to give seniors some immediate savings. We'll provide
all seniors with a Medicare-approved drug discount card that would
save between 10 to 25 percent off the cost of their medicines. So
in other words, when the bill -- as the bill -- when it passes,
and I'm an optimist -- particularly with your help, I will even
be more optimistic -- that in the time the bill transitions between
the old system and the new system, there will be a Medicare-approved
drug discount card for you.
Low-income beneficiaries will receive an annual $600 subsidy, along
with their discount card, to help them purchase their prescription
medicines. And the legislation that Congress passes must make sure
that the prescription drug coverage provided to many retirees by
their employers is not undermined. We don't want the system to undermine
some of the really good plans that you may have received as a result
of your previous employer. Medicare legislation should encourage
employers to continue the benefits, while also extending drug coverage
to the millions of Medicare beneficiaries who now lack it.
Congress should also make sure that Medicare rests on solid accounting.
The current Medicare system accounting does not always give a clear
indication of its long-term financial health. I support the Medicare
system that alerts future congresses and presidents when Medicare's
costs are rising faster than expected so they can address the problem.
The accounting safeguard that we're working on in the bill will
help Medicare stand on a strong financial foundation. We owe that
to the taxpayers of our country. (Applause.)
The important thing we're talking about here is not only will the
steps we're taking strengthen Medicare for today's seniors, but
also for tomorrow's retirees. (Applause.) It seems to be a popular
thought with the baby boomers. Many workers are counting on Medicare
to provide good health care coverage in their retirement. These
reforms will give our workers confidence that Medicare will serve
them with the very best of modern medicine. And that's important
for people to know. The budget I submitted earlier this year commits
an additional $400 billion over 10 years to implement this vision
of a stronger Medicare system. This is enough to meet our commitments
to the seniors today and to future generations of Americans.
I urge the seniors, and all Americans, to speak up and to call
or write your representatives or senators and urge them to get a
final bill that meets the goal I just outlined. I want to -- you
need to speak up for prescription drug coverage. You need to speak
up for health care choices. You need to speak up for a modern Medicare
system that puts patients and doctors in charge. For years, our
seniors have been calling for a prescription drug benefit. For years,
American seniors have been calling for more choices in their health
care coverage, and now we'll see who is really listening in Washington,
The choice is simple: Either we will have more debate, more delay
and more deadlock, or we'll make real progress. I made my choice
-- I want real progress. And I urge the Congress to take the path
of progress and give our seniors a modern Medicare system. (Applause.)
We've come far, let's finish the job.
Thank you for coming. (Applause.) God bless. (Applause.)
END 2:30 P.M. EST
President Urges Congress to "Finish
the Job" on Medicare
November 15, 2003
THE PRESIDENT: Good morning. This week I traveled to Florida to
visit with seniors about an important goal for my administration
and this nation. After years of debate and deadlock, the Congress
is finishing work on the biggest improvements in senior health care
coverage in nearly 40 years.
Some important details of the Medicare legislation have to be worked
out, but leaders in both the House and the Senate have already agreed
to four clear-cut improvements to Medicare.
First: Within six months of Medicare reform law, all seniors would
be eligible for a Medicare-approved drug discount card. This card
would give seniors an immediate 10 to 25 percent savings on the
cost of their medicines. For seniors with typical drug costs of
$1,285 a year, the card would deliver annual savings of up to $300.
And for low-income seniors, the discount card would include a $600
annual credit toward drug costs.
Second: Beginning in 2006, we would establish Medicare prescription
drug coverage for all seniors who want it, at a monthly premium of
about $35. For most seniors without coverage today, the new coverage
would cut their annual drug bills roughly in half.
Third: Seniors with the greatest need will get the most help. Low-income
seniors would pay a reduced premium or no premium at all for the
new drug coverage. And low-income seniors would also have lower
co-payments for their medicines.
Fourth: Our seniors would enjoy more choices in their health coverage,
including the same kind of choices that members of Congress and
other federal employees enjoy. If seniors have more choices, health
plans will compete for their business, by offering better coverage
at affordable prices.
The choices we support include the choice of remaining in the traditional
Medicare program. Some seniors don't want change, and if you're
a senior who wants to stay in the current Medicare system, you will
have that option. And with that option, you will also be able to
get Medicare approved prescription drug coverage.
Some seniors may choose a new Medicare-approved private plan, that
includes a drug benefit, along with other options. Such options
could include coverage for extended hospital stays or protection
against high out-of-pocket medical expenses. Others may prefer managed
care plans. Under the approach I support, seniors would have these
options, as well.
American seniors are calling for these improvements. Among the
seniors I met in Florida was Marge MacDonald. Marge and her husband
Mac do not have prescription drug coverage, and they are frustrated.
Here is what Marge says: "I'm tired of the talk. Sooner or later
somebody needs to do something."
Marge is right. The time for delay and deadlock has passed. Now
is the time for action.
I ask seniors, and all Americans, to speak up, to call and write
your representatives and senators, and urge them to work out a final
bill. Congress has an historic opportunity to give all our seniors
prescription drug coverage, health care choices and a healthier,
more secure retirement. We must make these improvements this year,
during this session of Congress. And with your help, we will get
the job done.
Thank you for listening.
President Bush Meets with Congressional
Leaders on Medicare
Remarks by the President with Congressional Leaders
The Cabinet Room
November 17, 2003
4:20 P.M. EST
THE PRESIDENT: I just had the honor of meeting with the Medicare
Conference Working Group. I first thanked them for their extraordinary
leadership on developing a fine piece of legislation for Medicare.
There are Republican leaders at this table; there are Democrat leaders
at this table. These are Americans who understand we have an obligation
to our seniors to modernize and strengthen the Medicare system.
The bill that will be offered to the House and the Senate modernizes
and strengthens Medicare. There's $400 billion additional dollars
available for our seniors in this bill. There's prescription drug
coverage in the bill for our seniors. This vote will demonstrate
whether the members of the House and the Senate will help keep our
commitment to America's seniors. I look forward to working with
the members around the table to secure passage of this very important
and historic piece of legislation. I urge members of both political
parties to study the legislation, to remember the promise we have
made to America's seniors, and to vote yes for this legislation.
END 4:22 P.M. EST
President's Radio Address
November 22, 2003
THE PRESIDENT: Good morning. This week Congress made significant
progress toward improving the lives of America's senior citizens.
The House of Representatives passed legislation that would bring
prescription drug coverage to Medicare and lead to health care choices
for our seniors. This legislation, if also passed by the Senate,
would represent the greatest improvement in senior health care since
Medicare was enacted in 1965.
When these reforms take full effect, our seniors would see real
savings in their health care costs. Within six months, seniors would
be eligible for a drug discount card that would save them between
10 and 25 percent off the retail price of most drugs. When the full
drug benefit arrives in 2006, all seniors become eligible for drug
coverage for a monthly premium of about $35. For most seniors without
coverage today, the Medicare drug plan would cut their annual drug
bills roughly in half.
Seniors with the highest drug bills would save the most, and seniors
with the greatest need would get the most help. Low-income seniors
would pay a reduced premium, or no premium at all, for the new drug
coverage. And low-income seniors would also have lower co-payments
for their medicines.
Here is an example of how this benefit would work. A senior taking
drugs to treat arthritis, high cholesterol, and migraines has a
typical drug bill of about $250 a month, or $3,000 a year. With
this legislation, this retiree would save $1,680, after paying her
insurance premiums -- more than half her current drug costs.
Under the new reforms, seniors would have more choices of health
care coverage. Should seniors want to stay in traditional Medicare
and receive a prescription drug benefit, they would be able to do
so. Some seniors may want expanded coverage for extended hospital
stays, or protection against high out-of-pocket medical expenses.
Or they may want the coverage that comes with managed care plans.
Under the new law, all those choices would be available. With choice,
seniors would have more control over their health care options and
health plans would compete for the business with better coverage.
We're on the verge of success because of bipartisan leadership,
and because of the support of many advocates for seniors, including
the AARP. Throughout many months of discussion and debate, we've
remained focused on the clear objective -- to modernize and strengthen
the Medicare system. And by working together, we're close to meeting
In the nearly 40 years since Medicare was launched, this is the
most significant opportunity for any Congress to improve health
coverage for our seniors. Now we're down to the final stages. This
Congress will decide whether or not seniors will have prescription
drug coverage under Medicare, and this Congress will decide whether
America's seniors will have better health care choices.
I urge all members of Congress to remember what is at stake, and
to remember the promise we have made to America's seniors. The quality
of their health care, and the future strength of Medicare depends
on the passage of this much needed legislation.
Thank you for listening.
President Signs Medicare Legislation
Remarks by the President at Signing of the Medicare Prescription
Drug, Improvement and Modernization Act of 2003
DAR Constitution Hall
December 8, 2003
11:10 A.M. EST
THE PRESIDENT: Good morning,
thanks for the warm welcome. In a few moments I will have the honor
of signing an historic act of Congress into law. I'm pleased that
all of you are here to witness the greatest advance in health care
coverage for America's seniors since the founding of Medicare. (Applause.)
With the Medicare Act of 2003, our government is finally bringing
prescription drug coverage to the seniors of America. With this
law, we're giving older Americans better choices and more control
over their health care, so they can receive the modern medical care
they deserve. (Applause.) With this law, we are providing more access
to comprehensive exams, disease screenings, and other preventative
care, so that seniors across this land can live better and healthier
lives. With this law, we are creating Health Savings Accounts --
(applause) -- we do so, so that all Americans can put money away
for their health care tax-free.
Our nation has the best health care system in the world. And we
want our seniors to share in the benefits of that system. Our nation
has made a promise, a solemn promise to America's seniors. We have
pledged to help our citizens find affordable medical care in the
later years of life. Lyndon Johnson established that commitment
by signing the Medicare Act of 1965. And today, by reforming and
modernizing this vital program, we are honoring the commitments
of Medicare to all our seniors. (Applause.)
The point man in my administration on this issue was Secretary
Tommy Thompson, and he and his team did a fabulous job of working
with the Congress to get this important piece of legislation passed.
Tommy, I want to thank you for your leadership. (Applause.)
This bill passed the Congress because of the strong leadership
of a handful of members, starting with the Speaker of the House
Denny Hastert. Mr. Speaker -- (applause.) Mr. Speaker was joined
by Senator Bill Frist, the Senate Majority Leader of the Senate,
in providing the leadership necessary to get this bill done. I want
to thank you both. (Applause.)
I appreciate the hard work of the House Majority Leader, Tom DeLay,
in seeing that this bill was passed. I also appreciate the hard
work of the Chairman of the Ways and Means Committee, Chairman Bill
Thomas, for his good work. (Applause.) The Chairman of the Finance
Committee in the Senate, Senator Chuck Grassley, did a noble job.
(Applause.) And he was joined in this task by the Ranking Member
of the Finance Committee, Senator Max Baucus of Montana. (Applause.)
And the entire Senate effort was boosted by the efforts of a man
from Louisiana, Senator John Breaux. (Applause.) And speaking about
Louisiana, Billy Tauzin of the House of Representatives did great
work on this bill. (Applause.) Senator Orrin Hatch from Utah made
a significant contribution. (Applause.) Nancy Johnson, the House
member from Connecticut, did a great job. (Applause.) Mike Bilirakis
from Florida worked hard on this piece of legislation. (Applause.)
I want to thank all the other members of the Congress and the Senate
who have joined us. Thank you all for taking time out of your busy
schedules to share in this historic moment.
I appreciate Tom Scully, the Administrator of the Centers for Medicare
and Medicaid Services, for his good work. (Applause.) The Director
of the CDC, Julie Gerberding, is with us today. Julie, thank you for
coming. (Applause.) The Food and Drug Administration Commissioner
Mark McClellan is here. (Applause.) Jo Anne Barnhart, the Commissioner
of the Social Security Administration, is with us. Thank you for coming,
Jo Anne. (Applause.) Kay James who is the Director of the Office of
Personnel Management, is with us. Thank you for coming, Kay. (Applause.)
A lot of this happened -- this bill happened because of grassroots
work. A lot of our fellow citizens took it upon themselves to agitate
for change, to lobby on behalf of what's right. We had some governor
support around the country -- Governor Craig Benson from New Hampshire
is with us today. Governor, thank you for coming. (Applause.)
But the groups that speak for the elderly did fantastic work on
this legislation. See, there was a lot of pressure not to get something
done -- for the wrong reasons, I might add. But Bill Novelli, the
CEO of AARP, stood strong in representing the people he was supposed
to represent and he worked hard to get this legislation passed.
And, Bill, I want to thank you for your leadership. (Applause.)
You were joined by Jim Parkel, who is the President of the AARP.
Jim, I want to thank you, as well, for doing what was right, for
focusing on the needs of the seniors of our country. (Applause.)
Jim Martin, the President of 60 Plus Association, worked hard.
Charlie Jarvis, the Chairman and CEO of United Seniors Association,
worked hard. Mike Maves, the Executive Vice President and CEO of
the AMA, worked hard on this piece of legislation. (Applause.) Mary
Martin, the Chairman of the Board of The Seniors Coalition, worked
hard. The truth of the matter is, a lot of good people worked hard
to get this important legislation done, and I thank you for your
Medicare is a great achievement of a compassionate government and
it is a basic trust we honor. Medicare has spared millions of seniors
from needless hardship. Each generation benefits from Medicare.
Each generation has a duty to strengthen Medicare. And this generation
is fulfilling our duty.
First and foremost, this new law will provide Medicare coverage
for prescription drugs. Medicare was enacted to provide seniors
with the latest in modern medicine. In 1965, that usually meant
house calls, or operations, or long hospital stays. Today, modern
medicine includes out-patient care, disease screenings, and prescription
Medicine has changed, but Medicare has not -- until today. Medicare
today will pay for extended hospital stays for ulcer surgery. That's
at a cost of about $28,000 per patient. Yet Medicare will not pay
for the drugs that eliminate the cause of most ulcers, drugs that
cost about $500 a year. It's a good thing that Medicare pays when
seniors get sick. Now, you see, we're taking this a step further
-- Medicare will pay for prescription drugs, so that fewer seniors
will get sick in the first place. (Applause.)
Drug coverage under Medicare will allow seniors to replace more
expensive surgeries and hospitalizations with less expensive prescription
medicine. And even more important, drug coverage under Medicare
will save our seniors from a lot of worry. Some older Americans
spend much of their Social Security checks just on their medications.
Some cut down on the dosage, to make a bottle of pills last longer.
Elderly Americans should not have to live with those kinds of fears
and hard choices. This new law will ease the burden on seniors and
will give them the extra help they need.
Seniors will start seeing help quickly. During the transition to
the full prescription benefit, seniors will receive a drug discount
card. This Medicare-approved card will deliver savings of 10 to
25 percent off the retail price of most medicines. Low-income seniors
will receive the same savings, plus a $600 credit on their cards
to help them pay for the medications they need.
In about two years, full prescription coverage under Medicare will
begin. In return for a monthly premium of about $35, most seniors
without any prescription drug coverage can now expect to see their
current drug bills cut roughly in half. This new law will provide
95 percent coverage for out-of-pocket drug spending that exceeds
$3,600 a year. For the first time, we're giving seniors peace of
mind that they will not have to face unlimited expenses for their
The new law offers special help to one-third of older Americans
will low incomes, such as a senior couple with low savings and an
annual income of about $18,000 or less. These seniors will pay little
or no premium for full drug coverage. Their deductible will be no
higher than $50 per year, and their co-payment on each prescription
will be as little as $1. Seniors in the greatest need will have
the greatest help under the modernized Medicare system. (Applause.)
I visited with seniors around the country and heard many of their
stories. I'm proud that this legislation will give them practical
and much needed help. Mary Jane Jones from Midlothian, Virginia,
has a modest income. Her drug bills total nearly $500 a month. Things
got so tight for a while she had to use needles twice or three times
for her insulin shots. With this law, Mary Jane won't have to go
to such extremes. In exchange for a monthly premium of about $35,
Mary Jane Jones would save nearly $2,700 in annual prescription
Hugh Iverson from West Des Moines, Iowa, just got his Medicare
membership. And that's a good thing, because he hasn't had health
insurance for more than three years. His drug bills total at least
$400 a month. Within two years, with the $35 a month coverage, he
will be able to cut those bills nearly in half, saving him about
$2,400 a year.
Neil LeGrow from Culpepper, Virginia, takes 15 medications, costing
him at least $700 a month. To afford all those medications, Neil
has to stay working. And thanks to this law, once he is enrolled
in the drug benefit, he will be able to cut back his work hours
and enjoy his retirement more because he'll have coverage that saves
him about $4,700 a year.
I promised these seniors when I met with them that we would work
hard to give them the help they need. They are all here today. So
I am happy to report to them in person -- Mary Jane, Hugh, and Neil,
we are keeping our promise. (Applause.)
In addition to providing coverage for prescription drugs, this
legislation achieves a second great goal. We're giving our seniors
more health care choices so they can get the coverage and care that
meets their needs. Every senior needs to know if you don't want
to change your current coverage, you don't have to change. You're
the one in charge. If you want to keep your Medicare the way it
is, along with the new prescription benefit, that is your right.
If you want to improve benefits -- maybe dental coverage, or eyeglass
coverage, or managed care plans that reduce out-of-pocket costs
-- you'll be free to make those choices, as well.
And when seniors have the ability to make choices, health care
plans within Medicare will have to compete for their business by
offering higher quality service. For the seniors of America, more
choices and more control will mean better health care. These are
the kinds of health care options we give to the members of Congress
and federal employees. They have the ability to pick plans to --
that are right for their own needs. What's good for members of Congress
is also good for seniors. Our seniors are fully capable of making
health care choices, and this bill allows them to do just that.
A third purpose achieved by this legislation is smarter medicine
within the Medicare system. For years, our seniors have been denied
Medicare coverage -- have been denied Medicare coverage for a basic
physical exam. Beginning in 2005, all newly-enrolled Medicare beneficiaries
will be covered for a complete physical.
The Medicare system will now help seniors and their doctors diagnose
health problems early, so they can treat them early and our seniors
can have a better quality life. For example, starting next year,
all people on Medicare will be covered for blood tests that can
diagnose heart diseases. Those at high risk for diabetes will be
covered for blood sugar screening tests. Modern health care is not
complete without prevention -- so we are expanding preventive services
under Medicare. (Applause.)
Fourth, the new law will help all Americans pay for out-of-pocket
health costs. This legislation will create health savings accounts,
effective January 1, 2004, so Americans can set aside up to $4,500
every year, tax free, to save for medical expenses. Depending on
your tax bracket, that means you'll save between 10 to 35 percent
on any costs covered by money in your account. Our laws encourage
people to plan for retirement and to save for education. Now the
law will make it easier for Americans to save for their future health
care, as well. (Applause.)
A health savings account is a good deal, and all Americans should
consider it. Every year, the money not spent would stay in the account
and gain interest tax-free, just like an IRA. And people will have
an incentive to live more healthy lifestyles because they want to
see their health savings account grow. These accounts will be good
for small business owners, and employees. More businesses can focus
on covering workers for major medical problems, such as hospitalization
for an injury or illness. And at the same time, employees and their
families will use these accounts to cover doctors visits or lab
tests or other smaller costs. Some employers will contribute to
employee health accounts. This will help more American families
get the health care they need at the price they can afford.
The legislation I'm about to sign will set in motion a series of
improvements in the care available to all America's senior citizens.
And as we begin, it is important for seniors and those approaching
retirement to understand their new benefits.
This coming spring, seniors will receive a letter to explain the
drug discount card. In June, these cards, including the $600 annual
drug credit for low-income seniors, will be activated. This drug
card can be used until the end of 2005. In the fall of that year,
seniors will receive an information booklet giving simple guidance
on changes in the program and the new choices they will have. Then
in January of 2006, seniors will have their new coverage, including
permanent coverage for prescription drugs.
These reforms are the act of a vibrant and compassionate government.
We show are concern for the dignity of our seniors by giving them
quality health care. We show our respect for seniors by giving them
more choices and more control over their decision-making. We're
putting individuals in charge of their health care decisions. And
as we move to modernize and reform other programs of this government,
we will always trust individuals and their decisions, and put personal
choice at the heart of our efforts. (Applause.)
The challenges facing seniors on Medicare were apparent for many
years. And those years passed with much debate and a lot of politics,
and little reform to show for it. And that changed with the 108th
Congress. This year we met our challenge with focus and perseverance.
We confronted problems, instead of passing them along to future
administrations and future Congresses. We overcame old partisan
differences. We kept our promise, and found a way to get the job
done. This legislation is the achievement of members in both political
parties. And this legislation is a victory for all of America's
Now I'm honored and pleased to sign this historic piece of legislation:
the Medicare Prescription Drug Improvement and Modernization Act
of 2003. (Applause.)
(The bill is signed.) (Applause.)
END 11:35 A.M. EST