Tommy Thompson
Hello. Good to be here. Looking forward to answering your questions. Lots of things going on in health care these days and looking forward to answering as many as we have time for.

Carol, from Vermont writes:
You euphemistically refer to privatizing Medicare as giving seniors choices in their healthcare. But what if private insurers severely restrict the number of preferred providers available to people on Medicare as what happened with the HMO's under Medicare Choice?

Tommy Thompson
The new law that we hope to pass this session will allow for competition and we believe that we have set it up with enough inducements to get enough private companies to bid so that anybody no matter where you live will have the opportunity to either stay in the current fee for service program or the new competitive model of PPOs or HMOs.

Allison, from Washington, DC writes:
There seems to be a lot of tension and disagreement surrounding the Medicare Conference, and I was hoping you could provide insight on when the Administration is going to get involved to ensure that an agreement is reached and the bill is passed out of converence. Additionally, what is the position of the Administration on the FSA rollover of the Use it or Loose it Rule?

Tommy Thompson
The President and his Administration are involved on a daily basis. In fact, the White House staff and the Department of Health and Human Services staff are meeting with the conferee staffs daily including weekends and the President is meeting on a regular basis with the conferees encouraging them to reach an agreement as soon as possible. And I'm the designated advisor from the White house to the conferees and I'm meeting personally with the conferees on a regular basis. In fact, within the hour the President is having a meeting in the White House with the conferees and hopefully we will be successful in encouraging the conferees to move expeditiously and successfully in completing the Medicare reform proposal

Keith, from Sarasota writes:
Will the Medicare Rx drug card program pay for prescription drugs for those seniors who don't have insurance?

Tommy Thompson
Yes, it will. In fact, the prescription drug card proposal has been agreed upon already on a bipartisan basis with all the conferees and also includes $600 debit or credit for those individuals under 135 percent of poverty and we will have that card for all seniors up and running within six months after the Medicare bill is signed into law by the President.

Allan, from Greensville writes:
Do you stay in touch with your former governors to discuss this issue?

Tommy Thompson
Yes, I do. I have regular interactions with governors around the country and we are hoping to come up with a Medicare reform bill that will also be good for the states as it will be good for our senior citizens. And I'm confident that we can accomplish both objectives.

angel, from Idaho writes:
why doesn't medicare pay for prescription drugs? why doesn't medicare pay for bath benches, commodes, and other needs of this type?

Tommy Thompson
Medicare is a system that takes care of the essential items that people need for good health care. And the cost of the Medicare proposal is very expensive. There has to be some choices and some limitations and as a result of that the Medicare system has to make these difficult decisions and we are doing that with this reform bill by putting a great emphasis on items that will prevent diseases more particularly referred to as prevention therapies and will include drugs so that seniors will be able to have an improved quality of health and not have to make difficult life-changes or decisions on what they can afford in the area of prescription drugs and at the same time structuring it in a financial way that will not break the bank and allow for the continuity of Medicare for current senior but also for future seniors.

Richard, from New Orleans writes:
In your opinion, is the current administration effectively dealing with Medicare fraud? What are you initiativesplans to reduce the amount of Medicare fraud, and what will be the potential savings to the American taxpayers if your execute successfully?

Tommy Thompson
We are aggressively trying to reduce and hopefully eliminate fraud and abuse in the Medicare system, as well as in the Medicaid system. And we have received some of the biggest judgments and forfeitures totaling hundreds of millions of dollars from fraud by providers and companies that have abused the system. Just in the last few weeks, we've cracked down on wheelchair fraud and we closed a huge loophole in the hospital portion of the Medicare program "outlier payments" that will save about 2 1/2 billion dollars a year. And we are instituting changes in contracting, and improving technology that will also prevent fraud, improve efficiencies and save dollars in the future.

Bill, from Bangor writes:
Private health insurance premiums logged a third consecutive year of double-digit increases in 2003, rising 13.9 percent, according to the 2003 Annual Employer Health Benefits Survey released by the Kaiser Family Foundation.

The increase is the largest since 1990. Is this just greed on their part? Cost of medicine is increasing. Is corporate America out of control?

Tommy Thompson
The rise in health costs can't be pinpointed to any one sector of our society, and it certainly isn't a product of greed in the business community. In fact, businesses are footing a significant part of the bill for these rising health costs. We all have a role to play in controlling the costs of health care. If we effectively bring Medicare into the 21st century, and include the benefits of preventive medicine, we can start down a path of controlling health costs not only for Medicare but overall.

And we all have an individual role to play in controlling health costs. There's some personal responsibility at play here. If we don't take care of ourselves, need to visit the doctor more, need more expensive medical tests and procedures, and need to go to the hospital, we're driving the cost of health care up. If we stay healthy, and stay out of the hospital, we're driving down our own personal health care costs but also helping to contain health care costs for all of society.

Again, this is why my department, with the President's leadership, is pushing the prevention message so hard. By taking care of our health, we benefit not only through a better quality of life but through a healthier pocketbook.

Kathy, from California writes:
Do you believe the Medicare choice alternative will become extinct?

Tommy Thompson
If you're referring to Medicare+Choice, we are working so that it doesn't become extinct. We're working to make this choice a more effective one for Medicare and its consumers. A fundamental tenant for the President in pursuing Medicare modernization is to provide seniors with more choices. Medicare+Choice is an option that is popular with those who choose it. It does serve a constituency. What we want to do is work on ways to make it a stronger option, but also one of many options that seniors will have under Medicare.

Rene, from Falls Church writes:
Tommy -- Drug reimportation is a disaster. An absolute disaster. This would do nothing but hurt future medical progress.

Tommy Thompson
The expert scientists at the Food and Drug Administration have real concerns about drug reimportation because they don't believe we can guarantee the safety of the drugs coming into our country this way. This is a position that the FDA and HHS have taken during this administration, but also during the previous administration. Especially given the world we live in today, we need to be cautious about further opening up our borders to medicines coming into this country that our citizens take. The FDA says that it already does allow for imported medicines that meet its standards.

Tracy, from Norwich writes:
Secretary Thompson, The Congressional Budget Office estimates that the drug benefit's 400 billion price tag was wrong and it will actually cost 450 billion over the next decade. Do you agree with this?

Tommy Thompson
The $400 billion price is what the administration is working off and remains behind. Obviously, anyone can find a way to spend more. But we believe the $400 billion strikes the right balance in giving seniors access to the benefits of modern medicine and a prescription drug benefit.

William, from Buffalo, NY writes:
Does it worry you that 13 House conservatives have said they would withdraw their support from the House bill if a compromise is made over key issues such as cost-containment, free market competition, etc.?

Tommy Thompson
We are reaching out and working with lawmakers throughout Congress. Our hope is that everyone will continue to keep in mind the ultimate goal of bringing Medicare into the 21st century and provide our seniors with modern medicine that is delivered in a modern way, including with more choices. If we do that, and put seniors first, I'm confident we can come together.

Rick, from Pittsburgh writes:
Do you side with the Senate or the House bill?

Tommy Thompson
We're working with conferees from the House and Senate to reach a comprehensive piece of legislation that is good policy and can pass both houses and be signed by the President. Actually, we did an analysis of the House and Senate bills. It showed the most seniors without health coverage would see their drug spending cut in half through these pieces of legislation. So while there are differences between the two bills, there is something big that they have in common, and that is substantial savings for seniors. Hopefully, this can be a motivator for both sides to continue working together and get the job done. And I must commend the conferees. They are working very hard and very sincerely to get a good piece of Medicare legislation. They have reached agreement on many important issues. Despite what you might read or hear, they are making progress. We will remain working with them as they seek to finish the job.

Jon, from Nevada writes:
How can we afford a 400-billion, ten year expansion of Medicare to provide prescription drug benefits? What happened to individual responsibility?

Tommy Thompson
We need to bring Medicare into the 21st century, and that means providing access to prescription drugs for seniors. It's a commitment the President has made as well as most members of Congress. And it's the right commitment. Medicare was created, as the President often says, as a commitment by a caring society. What the President is trying to do is strike the right balance between what we need to provide as fair benefits for seniors and be responsible to the taxpayers. The administration's vision for Medicare strikes that balance. And it introduces elements of the free marketplace to help give seniors more choices. We want to create more personal responsibility for Medicare by giving individuals more choices in the benefits they receive. And the individual does pay for a share of the cost. There are many ideas out there on how to add a prescription drug benefit to Medicare, including some ideas that carry a pricetag upwards of $1 trillion. The administration's plan is fair and reasonable.

Steve, from Chandler, AZ writes:
I believe the only thing that is really going to fix Medicare is more citizen involvement in their own health and health care. One impediment to more involvement is the fact that I have to provide the same damn information every time and it is impossible to have historical records in the current environment. When can I see more use of technology so that I can take more control of my own health and health care?

Tommy Thompson
I appreciate your question because it refers to a passion of mine. We are working very hard at HHS on coming up with innovative ways to better use technology to make the health care system more efficient. We want to free up our doctors and nurses to do more caring of patients and less filling out of paperwork. We've taken some ambitious steps already to streamline the system, and we will be producing some new innovative initiatives for better using technology in the health care system. I often say that grocery stores are more technologically advanced than our hospitals. We must continue to bring the operation of our health care system into the 21st century as well, and taking the same advantages of modern technology that we do with modern science and medicine. Citizens do need to be more involved in their health care, beginning with taking care of their own health.

Tommy Thompson
Thanks for all the questions. Looking forward to doing this again soon.