Week Ending Friday, November 14, 2003

Author: George W. Bush  | Date: November 13, 2003

Remarks at the Engelwood Neighborhood Center in Orlando,
November 13, 2003

Thanks for coming. Thanks for the warm welcome. I want to thank the Engelwood Neighborhood Center for hosting us. [Applause] 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 your 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. We’re on the verge of giving seniors prescription drug coverage, expanded coverage for preventative maintenance medicine and therapy, and more health care choices.

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.

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. 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. They may say I’m not very objective, but he’s a great Governor.

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 Ric Keller, Congressman John Mica, Congressman Adam Putnam, Congressman Katherine Harris, and Congressman—Congresswoman Katherine Harris, and Congressman Tom Feeney. I’m honored you all are here.

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 Medows, 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 and modernized.

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. I appreciate Rich Crotty, who is the chairman of Orange County, for being here as well. Thank you, Rich, for coming. I appreciate the interest of Federal, State, and local officials in this very important subject.

I want to thank—I just came from 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 you know, 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—I met Tillie—[applause]. Crotty, that’s a good sign when people clap when I mention the airport. [Laughter] I met a very interesting woman 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 better. 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. 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.

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 the 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 that 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 their needs.

Every senior I’ve talked to is 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, outpatient 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.

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: 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 drug benefits.

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.

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.

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. 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. 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, DC.

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. We’ve come far. Let’s finish the job.

Thank you for coming. God bless.

Note: The President spoke at 2:07 p.m. In his remarks, he referred to Surgeon General Richard Carmona; Josefina Carbonell, Assistant Secretary for Aging, Department of Health and Human Services; Gov. Jeb Bush of Florida; and Rich T. Crotty, chairman, Orange County Governing Board. The Office of the Press Secretary also released a Spanish language transcript of these remarks.


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Chicago: George W. Bush, "Remarks at the Engelwood Neighborhood Center in Orlando, November 13, 2003," Week Ending Friday, November 14, 2003 in United States. Executive Office of the President, Weekly Compilation of Presidential Documents, Week Ending Friday, November 14, 2003 (Washington, D.C.: U.S. Government Printing Office, 2003), 39:1595-1599 1596–1599. Original Sources, accessed July 23, 2024, http://www.originalsources.com/Document.aspx?DocID=PQP9T1XVH7DZ4XP.

MLA: Bush, George W. "Remarks at the Engelwood Neighborhood Center in Orlando, November 13, 2003." Week Ending Friday, November 14, 2003, in United States. Executive Office of the President, Weekly Compilation of Presidential Documents, Week Ending Friday, November 14, 2003 (Washington, D.C.: U.S. Government Printing Office, 2003), 39:1595-1599, pp. 1596–1599. Original Sources. 23 Jul. 2024. http://www.originalsources.com/Document.aspx?DocID=PQP9T1XVH7DZ4XP.

Harvard: Bush, GW, 'Remarks at the Engelwood Neighborhood Center in Orlando, November 13, 2003' in Week Ending Friday, November 14, 2003. cited in , United States. Executive Office of the President, Weekly Compilation of Presidential Documents, Week Ending Friday, November 14, 2003 (Washington, D.C.: U.S. Government Printing Office, 2003), 39:1595-1599, pp.1596–1599. Original Sources, retrieved 23 July 2024, from http://www.originalsources.com/Document.aspx?DocID=PQP9T1XVH7DZ4XP.