For Immediate Release
November 25, 2003
President Applauds Congress for Passing Historic Medicare Bill
Spring Valley Hospital
Las Vegas, Nevada
10:32 A.M. PST
THE PRESIDENT: Thank you for the warm welcome. It's great to be here in Las Vegas, the great state of Nevada. I'm sorry I don't
spend the night here. (Laughter.) They say the night life is
active. (Laughter.) It's a great part of our country. Thanks for
I also appreciate the Spring Valley Hospital Medical
for hosting us. It's not easy to have the President of the United
States come. It seems like the entourages are quite large these
(Laughter.) So I appreciate the hard work in facilitating my
It's amazing that this facility is not only -- is not yet two
months old, yet it is providing a really good record of care and
compassion. Thanks to the good docs and nurses, CEOs, and aides
work here. I want to thank you for caring about your fellow
with good, decent health care.
Today -- speaking about good, decent, health care, today we had a
major victory to improve the health care system in America.
(Applause.) The United States Senate has joined the House of
Representatives in passing historic reform of Medicare that will
strengthen the system, that will modernize the system, that will
provide high-quality care for the seniors who live in America.
I want to thank and congratulate the members of Congress for their
hard work. You see, we have a responsibility in Washington, D.C.
solve problems, not to pass them on. And today, the United States
Congress met its responsibility. We inherited a good Medicare
It has worked, but it was becoming old and needed help. Because of
actions of the Congress, because of the actions of members of both
political parties, the Medicare system will be modern and it will
I appreciate Karla Perez for hosting us here. She had a very good
visit about health care needs in this community and around our
country. Karla is an impressive CEO and Managing Director, and I'm
really she invited me here. I want to thank Alan Miller, Mike
and Dan McBride for their leadership, as well.
I appreciate so very much your fine Governor, Kenny Guinn, for
showing up today. Governor, it's great to see you. He's a close
friend, as is Dema. The Governor and I both married very well.
(Laughter.) Laura sends her love to both of you. (Laughter.)
Two members of the United States Congress from Nevada are with us
today, Congressman Jim Gibbons and Congressman Jon Porter. They
supported this piece of legislation. They support a lot of good
legislation. And I'm proud of your work, and I appreciate your
in doing the right thing for America's seniors. By the way, not
the seniors today, but those of us who are going to be seniors.
I also want to welcome Trent Franks, from the great state of
Arizona, friend, a man who also supported Medicare reform. He and
wife Josie are here to join us today, and I'm honored that you all
would come over from Arizona to say, "hello." I want to thank the
Nevada Attorney General for joining us, Brian Sandoval. I
members of the statehouse for being here. I'm glad Darlene Ensign
with us, the senator's good wife, for joining us. Most of all, I'm
really glad you all are here, and thanks for letting me come by to
Today when I landed I met
Maria Konold-Soto. She's a -- where is
Maria? Oh, there's Maria. What Maria does is she volunteers in
community on the medical reserve corps. Perhaps you've heard about
it. It is a chance to help our communities prepare for a potential
emergency. Notice I said, "volunteers." A lot of times people
about the strength of the country in terms of our military might or
size of our wallets. The strength of America is the heart and
our fellow citizens who are willing to volunteer to make their
communities a better place.
I know a lot of the docs here provide a lot of care for people who
hurt. That's part of making America a compassionate place. Maria
part of making America a compassionate place. All of you who
volunteer, I want to thank you very much for the job you do. If
interested in being a patriotic American, love a neighbor just like
you'd like to be loved yourself, and you'll make a significant
contribution to our country.
This nation's health care is great. We've got the best health care
in the world, and we need to keep it that way. We've got a great
health care system because of our docs -- well-trained, decent,
people who practice medicine. We've got a great health care system
because of our nurses who work hard to provide compassionate care.
We've got the best research in the world. We're on the leading
change in America.
But we've got to keep the system vibrant. And we must keep it the
best in the world, which we intend to do in Washington, D.C. We
started that by making sure our seniors have got a modern system.
Medicare system, first of all, is an essential commitment of the
federal government. Our federal government has made a commitment
our seniors that we will provide them an up-to-date, decent health
system. It's a basic trust that has been upheld throughout the
And we're keeping that trust by making sure the system works, by
making sure that our seniors are well treated. In recent years,
Medicare has not kept up with the advances of modern medicine. In
other words, it hasn't met the trust that the federal government
promised to our seniors. Remember, when Medicare was passed in
health care meant house calls and surgery and long hospital stays.
the system was designed to meet the health care delivery systems of
day. Modern medicine today now includes preventative care,
procedures, and at home care.
Many invasive surgeries are now unnecessary because of the new
prescription drugs which are being developed. Many Americans have
coverage for these new forms of health care, and that's positive,
we need to keep it that way. Seniors who rely exclusively on
do not have the coverage for many of the new treatments and do not
coverage for prescription drugs -- in other words, medicine changed
Medicare didn't. And as of today, Medicare is changing. Let me give you an example of the need for modernization. The
health care providers here know these examples only too well.
is willing to pay $28,000 for a hospital stay for ulcer surgery.
won't pay the $500 for the anti-ulcer drugs that would keep the
out of the hospital in the first place. Those examples -- or that
example, like many others, says to me, we had a problem with the
Medicare system. It doesn't make any sense to pay $28,000 at the
of the process, but not the $500 up front to keep the $28,000 from
happening in the first place.
Medicare should cover medications to keep our seniors out of
hospitals. The new bill does this. The important part of the
is to recognize that medicine has changed. It will save our
and the taxpayers money by providing prescription drugs early so we
don't have to pay for it in long hospital stays and invasive
Most seniors have got some form of prescription drug coverage from
a private plan, and that's important. It's a fact of life here in
America. Those plans, however, are becoming less available. We've
to make sure the private sector remains vibrant. The bill I'm
describe to you does that.
Medicare was very slow to take advantage of new medical advances,
besides prescription drugs. In other words, you had to go through
bureaucracy in order to get certain procedures covered.
don't move very quickly. They tend not to be very sympathetic
organizations. They're not consumer driven. They're process
They're hidebound by rules and regulations. The docs here know
I'm talking about. You get to deal with bureaucracies. It must be
frustrating experience. Sometimes it's a frustrating experience to
to change bureaucracies.
The Medicare plan that I'm going to sign understands that a lack of
competition meant that there was no real need to provide
And so we're helping to change the system by giving seniors more
options and more choices. See, members of Congress have got
They get to choose from a health care plan. And it works quite
The three congressmen here would tell you they're probably pretty
satisfied with the plan, if they've chosen to be in it. You get to
This new Medicare bill I'm going to sign says seniors are plenty
capable of making choices themselves. I used to say, if it's good
enough for members of Congress to have choice, it ought to be good
enough for the seniors in America to have choice. Now they're
have choice thanks to the bill I'm going to sign. (Applause.)
It's going to take awhile for this piece of legislation to kick
in. It's going to take about two years to get all the reforms in
place. But within six months of the law being signed, our seniors
start to see real savings in health care costs because seniors will
eligible for a drug discount card that will save them between 10 to
percent off their regular drug costs. And low income seniors will
receive up to $600 a year to help them with their drug costs in
addition to the card. Their card will serve as a transition to the
reforms that are inherent in the Medicare legislation.
When the full drug benefit arrives in 2006, all seniors will be
eligible for prescription drug coverage for a monthly premium of
$35. The result is that for most seniors without coverage today,
Medicare drug plan will cut their annual drug bills roughly in
That's positive news for America's seniors.
It's positive news for Joyce and J.C. Pearson. J.C.'s from
Tennessee, by the way, and he reminded me that without Tennessee,
wouldn't have been much. (Laughter.) He reminded more than once,
might add. (Laughter.) The Pearson's are -- live on a tight
They spend about $300 a month for prescription drugs. Under the
Medicare reform bill passed today, they will save $1,800 a year.
said they can use that money. She said, it's going to come in
their retirement years.
Seniors with the highest drug bills will save the most. Seniors
with the greatest need will get the most help. Low-income seniors
pay a reduced premium or no premium at all, and lower or no
for their medications.
Under the new reforms, seniors, as I mentioned, will have choices.
You see, some seniors don't want to choose, and I can understand
In other words, people who are on Medicare just don't want to be
confronted with a choice. And the system in the bill we passed
recognizes that. You can understand why. The person is up in
and it's pretty comfortable. They don't want to have to change.
Change makes some people nervous, and we understand that.
And so should seniors want to stay in traditional Medicare and
receive a prescription drug benefit, they will now be able to do
That's one of the key reforms in the bill. But other seniors want
choose, they want to be able to make a selection based upon their
particular needs. Some might want protection from high
medical expenses. Some might want expanded coverage for hospital
stays. Some might want to be able to pick a plan that better meets
their own individual needs. Under this law, choices will be better
available for our seniors, and that's an important part of reform.
Because, you see, when seniors, or any citizen makes a demand, the
system responds. If there is a demand driven system, it means the
doctor-patient relationship is going to be more firm, and it means
people will have better choices to meet their own particular
Some seniors may want the coverage that comes with managed care
Bob May is with us today. Bob is a World War II veteran. He is
what I would call a solid citizen. Bob said, you know -- his wife,
unfortunately passed away recently, he sat down and analyzed --
choice, weighed the pros and the cons about what health care would
our needs. I want you to hear that carefully.
Bob and his wife sat down and said, here's the pluses and the
minuses. In other words, he's got -- he's plenty capable of making
choice. He didn't need the government telling him how to choose
health care plan best met his needs. And so he chose
Medicare-plus-Choice. And it works, he said. Under the law,
Medicare-plus-Choice will be strengthened, and not starved. It is
viable option for our seniors around the country.
In other words, people will have more control over their health
care options, and health care plans will start competing for their
business, and that's positive -- positive for the consumers,
for the seniors of America.
There are other important reforms in this bill. When seniors sign
up for Medicare, they will get a complete health examination, so
doctors can know their health needs from the start. (Applause.)
finally beginning to focus on preventative care. It makes sense to
include preventative care in any health care reforms. And health
providers here know that better than anybody.
The bill provides incentives for companies to keep the existing
coverage they provide for senior retirees. There was some concern
Washington -- a legitimate concern, as far as I'm concerned -- that
Medicare reform plan would encourage employers to not do their
responsibility to their former retirees. This bill addresses
Two out of every three seniors is now covered by some form of
coverage, and the bill addressed the issue, to make sure that that
coverage is still a viable alternative in the marketplace.
Every American, old and young, will be able to have a health
savings account. They will be able to put money aside tax free to
their families with medical expenses. (Applause.) Medical savings
accounts are an important part of reform. Medical savings account
trust the consumers, provide incentives for people to make wise
choices, and helps to maintain the doctor-patient relationship.
This bill helps rural hospitals. This would not qualify as a rural
hospital here. (Laughter.) But rural hospitals need help to
to serve our country. This bill sets fair reimbursement rates for
doctors serving Medicare patients. (Applause.) This is a good
and I'm looking forward to signing it.
Last Saturday's vote in the House and today's vote in the Senate
marks an historic moment, a bipartisan achievement that all
can be proud of. Year after year, the problems in Medicare system
studied and debated. And yet, nothing was done. As a matter of
they used to call Medicare, "Mediscare" for people in the political
Some said Medicare reform can never be done. For the sake of our
seniors, we've got something done. We're acting. We acted on
principle in Washington, D.C. We'll provide new treatments and new
choices. We'll get prescription drug coverage they deserve. We'll
keep our commitment to Medicare to better the lives of the American
seniors for generations to come.
I appreciate the hard work of the members of the Congress. It's a
tough bill. People worked hard on it. A lot of people searched
soul on this complex and important piece of legislation. But they
stayed after it, stayed focused on the people. A lot of members
politics aside, which we need to do in Washington, D.C. when we're
talking about the people's business.
I appreciate the seniors and the seniors groups, such as the AARP
who lobbied hard on behalf of a modern Medicare system. People
their opinions known. They let the members know where they stand.
it worked, and it helped. And I'm honored to put my signature on
historic piece of legislation. (Applause.)
Another topic of conversation came up at our roundtable discussion,
and that was the effect of junk lawsuits on the delivery of health
in America and in Nevada. You see, one of the things we must work
is a health care system which is affordable and available. Junk
lawsuits, the threat of junk lawsuits drive up the cost of health
and run good docs out of the system. (Applause.)
It's important for our fellow citizens to understand the effect of
junk lawsuits. You see, docs who are threatened and are constantly
sued, even though their practice is a good, strong, excellent
resort to what's called defensive medicine. They order procedures
tests that may not be needed, but are -- provide protection in the
court of law. You see, if you think a lawyer is simply fishing for
rich settlement, is constantly looking over your shoulder, you'll
up practicing what's called defensive medicine.
Docs are afraid to give their patients certain advice. In other
words, the doctor-patient relationship is disrupted for fear that
advice will be used against them in the court of law. This problem
only affects the doctors, it affects the patients, as well. See,
running up the cost of medicine. It affects a person's ability to
deliver good, quality health care.
Donna Miller is an OB/GYN specialist here in Vegas. Doctor Miller
has seen her premiums go up about $28,000 last year, to about
this year. She thinks they're headed to about $100,000 this year.
know what I'm talking about, about premium increases. It's a
that reflects lawsuit after lawsuit after lawsuit. And Doctor
patients pay the price. These junk lawsuits are driving up the
Here's what she says. She says, "You got into medicine to take
care of people and to spend time with your patients. With the
going up the way they are, you can't do that." She told me about
colleagues who have left Nevada. I remember when your trauma
shut down here, it made national news. It's a clear sign that
got an issue here that must be dealt with, because the people who
affected are the people of Nevada.
It means that women who want to have their babies delivered in
Nevada are having a hard time finding a doc -- that's what it
And I met Jill Forte today, a proud mother. She found out she was
pregnant with her second child. She called her doctor. The doctor
told her that because of insurance costs, she could no longer
her baby. So she started calling around. She was told the same
-- I think she told me about five different docs. She considered
to California. Fortunately, she was able to make a connection
a friend for a local doc to take her case.
But you see -- and let me tell you what she said. She said she was
in total shock. She didn't know what was going on until it
Looking for a doctor, worried about finding a doctor when you're
pregnant is a stress that is an unnecessary stress. It's a stress
called -- caused by frivolous and junk lawsuits. It doesn't make
sense to have a society that sues so often that expectant mothers
worried about finding a doctor. We've got to do something about
in America. (Applause.)
There's a cost to the federal government because of the frivolous
and junk lawsuits and the defensive practice of medicine. It is
estimated that the defensive practice of medicine raises the
budget by $28 billion a year. You see that in Medicare, Medicaid,
veteran's health benefits, for example. The junk lawsuits affect
Therefore, I view this as a national problem which requires a
national solution. We need a system where patients who are harmed
their day in court, where they can collect damages to cover their
injuries or recovery or rehabilitation and loss of income. If
been harmed by a bad doc, you deserve your day in court. Frivolous
lawsuits, by the way, that clog the courts, make it very difficult
someone with a legitimate claim to get into the court. When
can prove they were harmed by a doctor's egregious behavior, they
should be able to collect reasonable punitive damages.
There needs to be a $250,000 cap on non-economic damages.
(Applause.) I laid out this proposal to the Congress. The House
Representatives responded in a positive way, and I want to thank
members here for voting the right way. The bill is stuck in the
Senate. You need to contact a senator in the state of Nevada and
them know you're interested in national medical liability reform.
senators must understand that nobody in America has ever been
by a frivolous lawsuit. (Applause.)
For the sake of the patients in this state, and for the doctors in
this state, and for the patients and docs around the country, we
medical liability reform now. (Applause.) And the members of the
Senate must understand, this is a compelling national issue, and I
keep it on the front burner until we get the problem solved.
Finally, yesterday, I was in Fort Carson, Colorado where I had the
honor of addressing men and women who wear the nation's uniform. I
just want to share with you right quick our country's foreign
In a nutshell, it's, we'll do everything we can to keep America
secure. I will not forget the lessons of September the 11th,
duty as the President, obviously, is to deal with domestic issues
to tackle tough problems. My duty as your President, as well, is
keep this country secure. And I had the honor of meeting with men
women who wear the nation's uniform who are doing just that.
We'll protect our homeland as best as we possibly can. But the
best way to protect the homeland is to chase the killers down one
time and bring them to justice, which is exactly what we intend to
Freedom equals peace, as far as I'm concerned. And when you hear
us working for freedom in troubled parts of the world, you've just
to know it will lead to peace. We'll deal with the short-term
needs by staying on the offensive. We'll help our children grow up
a free society by bringing freedom to parts of the world that
desperately need freedom. Our soldiers -- as we head into
Thanksgiving, we need to give thanks to our soldiers for their
sacrifice, for the honor they bring to our country, for the service
they render by bringing freedom to troubled parts of the world.
see, we're bringing freedom in the heart of the Middle East.
Free countries don't develop weapons of mass destruction. Free
countries don't attack their neighbors. Free countries listen to
hopes and aspirations of the people who live in those countries.
America also believes that freedom is not America's gift to the
freedom is the Almighty's gift to every person who lives in this
And this nation will stay the course to bring democracy and freedom to Afghanistan and Iraq. And by doing so, we will not only help the long-suffering people in those countries, we will make America more secure and the world more peaceful.
Thank you for letting me come today. May God bless you all, and may God bless America. (Applause.)
END 11:03 A.M. PST