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 lie ahead.

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 Wanted." (Applause.)

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 today. (Applause.)

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 families. (Applause.)

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 forest. (Applause.)

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 they need.

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. (Applause.)

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 York.

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 justice. (Applause.)

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. (Applause.)

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. (Applause.)

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 military facilities.

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 their families.

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. (Applause.)

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. (Applause.)

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. (Applause.)

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 great Americans.

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 me. (Applause.)

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 country.

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 S's.

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 applause.)

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 in medicine.

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. (Applause.)

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. (Applause.)

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 fewer providers.

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 policy. (Applause.)

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 industry today.

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 we do.

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 counts. (Applause.)

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 the neighborhood.

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 changed.

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 inspectors.

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

Statement 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 will own."

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 solutions.

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 and regulations.

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.

END

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 coverage.

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 into law.

Thank you for listening.

END

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. (Applause.)

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 issue.

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 to do.

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 a year.

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 Washington, D.C.

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. (Applause.)

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 this fall.

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 drugs?

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 3.5 percent.

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
Presidential Hall
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 that up.

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 seniors.

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 a year.

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 way.

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 lack it.

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 medicine.

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
Orlando, Florida
November 13, 2003

2:07 P.M. EST

President George W. Bush delivers remarks on Medicare reform at the Engelwood Neighborhood Center in Orlando, Fla., Thursday, Nov. 13, 2003. White House photo by Tina Hager. 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 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. (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 governor. (Applause.)

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 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. (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 better. (Applause.)

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 their needs.

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 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. (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, D.C. (Applause.)

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
Radio Address
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.

END

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. Thank you.

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 that goal.

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.

END

President Signs Medicare Legislation
Remarks by the President at Signing of the Medicare Prescription Drug, Improvement and Modernization Act of 2003
DAR Constitution Hall
Washington, D.C.
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 work. (Applause.)

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 drugs.

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 medicine.

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 drug spending.

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. (Applause.)

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 seniors. (Applause.)

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


	Privacy Policy \| Website Policies & Other Important Information \| Site Map	Need Larger Text?