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Bush Unveils Health Care Plan

Aired September 5, 2000 - 10:24 a.m. ET


BILL HEMMER, CNN ANCHOR: Live to Allentown, Texas Governor George Bush now about to unveil plans for his prescription drug proposal

GOV. GEORGE W. BUSH (R-TX), PRESIDENTIAL CANDIDATE: Thank you very much for your hospitality. And for all the folks here at Gross Towers, it's an honor to be here. It's a particular honor to be here with my great friend, the governor of this state of Pennsylvania, who is doing a fabulous job for all citizens.


I appreciate you very much, Congressman Pat Toomey, being here as well.


Of course, I'm so proud of my running mate. He's a good solid American.


And finally, my wife caught up with me on the campaign trail. I feel like a better candidate when I'm traveling with Laura. I appreciate you coming.


When Medicare was passed in 1965, President Lyndon Johnson said no longer will older Americans be denied the healing miracle of modern medicine, no longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they may enjoy dignity in their later years. Thirty five years later, it is time for our nation to come together and renew that commitment.


My party has often pointed out the limits and flaws of the Great Society, but there were successes as well, and Medicare is one of them. Before 1965, fully half of American seniors lacked health insurance. They were just an illness or an accident away from destitution. Since 1965, more than 80 million American seniors have found a measure of security, a measure of confidence and dignity, in Medicare. By history and by choice, our nation makes a promise. We will honor our fathers and mothers by providing quality health insurance for every senior.


Keeping the promise of Medicare and expanding it to include prescription drug coverage will be a priority of my administration.


Seniors on Medicare know Medicare is showing its age. Its current benefits were modeled on a good, private insurance plan from 35 years ago, in 1965. Back then, the primary concern was hospital costs. Today, many seniors are treated at home or in a doctor's office with drugs and new medical technologies. Back then in 1965, the focus was acute care. Today, there is a greater emphasis on preventative care.

Medicare is an enduring commitment of our country. It must be modernized for our times.


This program is top-heavy with bureaucracy in the federal Health Care Financing Administration, the agency that runs Medicare. Its regulations run over 100,000 pages -- three times more pages of regulations than the Internal Revenue Service Code -- making Medicare rigid and sluggish and slow to change.

In 1994, doctors began using new technology that speeds the healing of bone fractures. Six years later, it has not been approved by the Washington bureaucracy.

The program refuses to cover now standard tests for brain tumors. It actually took an act of Congress to force the Washington bureaucracy to cover prostate screening. When you need a driver's license, bureaucracy can be frustrating. When you need medical care, bureaucracy can be hazardous to your health.

Medicine is changing every day with breakthroughs in arthritis, mood disorders, breast cancer, multiple sclerosis. There's something very wrong when the nation's greatest health care program cannot keep pace with the latest health care progress because of HCFA's bureaucracy.

Medicare also has some long-term budget problems rooted in rising costs and aging population that threaten to make it insolvent by the year 2025.

Medicare is a vital program, too vital to be neglected. It needs preventative care now to provide quality health care and prescription drug coverage for all our seniors.

For eight years, the current administration has had this opportunity and has squandered it. At first, the Clinton-Gore administration proposed an ill-advised government takeover of American medicine. That was wisely rejected by Republicans and Democrats and the American people. Since then, the administration has been too partisan, playing politics at the expense of reform. All the while, our problems have grown deeper.

A combination of added bureaucracy and cost controls have resulted in unprecedented slow-downs in Medicare spending. Hospitals are laying off staff and shutting down needed services. Home care agencies are closing or reducing services. Nursing homes have been placed in financial jeopardy.

And on top of this, in its 2001 budget, the administration proposed cutting Medicare by $70 billion over a 10 year period of time, putting added stress on health care providers.

Just last month we discovered that the administration is planning to deny Medicare payment for anti-cancer drugs given in doctors' offices, affecting chemotherapy for thousands of seniors. And according to one report, Washington bureaucrats had even begun threatening to investigate hospice patients for living too long. When patients survive past six months, the government labels it a negative outcome. Some call this cost savings, I call it a sure sign of bureaucracy grown clumsy and cold.

Yet, this administration has been a roadblock for reform. In 1997, a commission of Republicans and Democrats was appointed to propose ways to modernize Medicare. It outlined a bipartisan direction for fixing this program. But at the last minute, the Clinton-Gore administration turned against the commission and undermined its work. Instead of solving an important problem, they chose to score political points.

Afterwards, the co-chairman of the commission, a United States senator, a Democrat from Louisiana, John Breaux, said this: We are not going to fix Medicare. We're going to be looking for issues to beat each other over the head once again.

That is the old way of doing things; that's old politics. That is the record of the last eight years, old politics causing the same old stalemates, failed leadership and wasted opportunities.

My opponent, Vice President Gore, talks about the people versus the powerful. For eight years, he has been the powerful, and on health care, he has little to show for it.

The vice president said he's been involved with every decision for the past eight years. And after eight years of his active involvement, 8 million more Americans are left without health insurance than in 1993, a 20 percent increase.

Forty-four million Americans have no health insurance; 2.4 million more children have no health insurance; and, of course, nothing has been done to reform Medicare or provide prescription drug coverage.

Now the vice president has adopted the president's prescription drug proposal and has challenged America to compare our plans. I welcome the comparison because there's a lot the vice president isn't telling you.

The vice president calls for a new access fee for prescription drugs. If you make as little as $12,500 a year, you'll pay an additional $24 a month, rising to $50 a month by 2008. This is on top of the premiums, deductibles and co-payments you already pay for Medicare. In return, the government would pay no more than one half of the costs of your prescription drugs.

Now here are the practical problems with his plan: The Gore plan forces seniors into a government-chosen HMO for their drugs. And if you don't like the plan the Washington bureaucracy puts you into, it's too bad, you have no other options. For the majority of seniors, those who use less than $576 in prescription drugs a year, you'll actually lose money on the Gore plan. The combination of additional premiums and high co-pay will force you to pay more than you get back in benefits.

Some seniors may want different options; a higher deductible on drugs, say, in exchange for vision coverage. Under the Gore plan, you're out of luck. You have only one choice, the one the government makes for you.

The Gore plan gives seniors just one chance to buy into drug coverage, at age 64-1/2. If you want coverage at age 67, for example, or you change your mind, you're again out of luck.

It's the Gore plan for life or nothing else.

Even if the Gore plan passes, no one will get full drug benefit for eight years. It's a detail you don't hear much about in his speeches.

By making government agents the largest purchaser of prescription drugs in America, by making Washington the nation's pharmacist, the Gore plan puts us well on the way to price controls for drugs.

As costs rise, the government will be pressured to impose controls, as it already does in other parts of Medicare. A hostile government takeover of the drug industry would actually dry up the supply of new miracle drugs, and this would undermine the health, not just of seniors, but of every single American.

There are about 7,500 new drugs in the research pipeline for seniors. One of them could be a cure for Alzheimer's, one of them could be a cure for Parkinson's. We should not stifle, should not stifle, innovation.

And finally, the Gore plan doesn't modernize the broader Medicare program at all. It doesn't solve its long-term financial problems or save this vital program for the future. It just adds resources without reform.

And that, says Democrat Senator John Breaux, is like putting new gas in an old car. It's still going to run like an old car. Medicare today is running like an 1965 Chevy, he said. Well, it was on the lot when the Al Gore ran in '92.


It's still on the lot when Al Gore ran for re-election in '96. It's still on the lot in the year 2000.

They may have changed the odometer, but it's still not running, and Medicare needs an overhaul.


I support new resources for Medicare. My budget will double funding for Medicare from $216 billion a year to $441 billion a year over the next 10 years. And I support additional spending above that amount that I will detail in just a moment.

Yet, as I announced in May of this year, I want to seize this moment to modernize the Medicare system, to increase, not just funding, but choices and quality and security, to provide a prescription drug benefit, and to place Medicare on firm financial ground.


Here is my plan: We will keep the guarantee of health security. Every senior, without exception, will be entitled to the current set of Medicare benefits.


We will also give seniors a number of additional options -- additional options, so you can choose a better policy that meets your individual needs, including benefits like preventive care, or vision care and dental care. Some new benefit packages will be traditional fee-for-service, others may be networks run by doctors. All must offer the minimum Medicare benefits and can add additional services to compete for customers.

You can choose to keep your current Medicare benefit exactly the way it is or, if you decide, you can add to it or you can improve it. It's your choice.

Every health care plan that participates in Medicare must offer a policy that includes prescription drugs. And every senior will get assistance to make that coverage affordable.

Seniors with incomes of less than $11,300, couples making less than $15,200, will pay no premium for their medical insurance and will get prescription drug coverage at no cost.


Those just above that income level will get a substantial subsidy to help them afford prescription coverage. Twelve million low-to- moderate income seniors will have a strong insurance plan, including prescription drug benefits. And all seniors at every income level will get help with at least 25 percent of the premiums for their coverage of prescription drugs.

All the policies available through Medicare will be approved by the federal government to ensure the proper benefits are offered and to provide seniors with clear information to compare the plans available, and these reforms will be made without increasing the eligibility age of Medicare or increasing the payroll taxes.

My position is clear. There will be no age increase, no tax increase and this is my commitment to the American people.


What will be the real world results for our seniors? First, they will have a system with a proven track record. Nine million federal employees already have a similar plan and they report one of the highest levels of satisfaction of any health care system in the country. Like federal employees, including members of the United States Senate and the United States House of Representatives, seniors will get a book each year, just like this one right here, exactly the kind of book a senior will get.

It will list all the health care plans and compare the benefits of each plan.

Seniors can stay in the current Medicare system with no changes at all. Or they can choose another plan for no cost at all. Or they can choose to pay a little more for a plan with additional benefits. And every low-income senior will get a high-option plan for free.

Second, if seniors aren't happy with the service they receive, they can do what federal workers do, they can do what members of Congress do, they can simply change their policy. It's the best way to make a health bureaucracy responsive, giving customers the freedom to choose.

Third, government regulators will no longer be making decisions about health coverage, which slows the adoption of new medical technologies, so seniors will see medical advances covered by their insurance more quickly.

Fourth, this plan will mean that every low- to moderate-income senior in America will be able to afford prescription drug benefits -- every single one.

And finally, the modernization will make Medicare economically stable in the future, strengthening the program for current seniors and preserving it for the next generation.

This is the path to bipartisan, long-term reform. Yet, there's a short-term crisis demanding an immediate response. For many seniors as we speak, prescription drugs are a daily need, affording them a daily struggle.

Medigap coverage is costly. Medicare HMOs, important to so many seniors here in Pennsylvania, have been crippled by this administration. And some seniors are left with constant worries and few options, except to skip pills or break them in half or to go without.

Consider the case of an 80-year-old widow from Johnstown, Pennsylvania. With an income of less than $11,000, she needs prescription drugs that cost $2,500 a year. With bills like that, she was facing the prospect of selling her home to buy medicine.

These are the cruel choices some seniors face: Heat or medicine. Food or pills.

In a wealthy nation, this is a scandal. In a compassionate nation, it is a call to action.

Because there are no prescription drug benefits in Medicare, 23 states have now established state drug assistance programs, programs that pay drug costs for low-income seniors.

Here in Pennsylvania, that widow from Johnstown was helped by just this kind of program. Without it, she says, she would have lost her dignity and her life. Her story had a happy ending, and we can multiply it by millions.

We'll modernize Medicare, but we will not wait to help seniors afford prescription drugs. We'll give them direct aid now by expanding and funding state assistance programs.

Today, I'm announcing an initiative called "An Immediate Helping Hand." For four years, during the transition to better Medicare coverage, we will provide $12 billion a year in direct aid to low- income seniors in all 50 states.


Every senior with an income less of $11,300, $15,200 for a couple, will have the entire cost of their prescription drugs covered. For seniors with incomes less than $14,600, or $19,700 for a couple, there'll be a partial subsidy. With these large buying pools, states will be able to negotiate significant discounts on drugs.

In addition, we will set a cap, a maximum limit on out-of-pocket drug costs of $6,000 for every senior in America, the same limit we will set for all Medicare costs in broader Medicare modernization.


This plan sets aside $158 billion additional dollars for Medicare over the next 10 years.


This plan sets aside $158 billion additional dollars for Medicare over the next 10 years, four years to provide "An Immediate Helping Hand," an additional $110 billion for Medicare modernization.

In the past, I've said that education reform will be my first priority as president, the first bill I will propose to Congress. The measure I'm proposing today, immediate prescription drug help for all seniors -- for seniors -- will be my second bill. And this plan will help seniors much sooner -- much sooner -- than anything proposed by my opponent.


Eight years ago, Bill Clinton and Al Gore promised Medicare reform. Four years ago, they did the same. This is a patient country, but our patience is wearing thin. This is not a time for third chances. It's a time for new beginnings and new leadership.


On health care, my opponent offers the same old tired partisan ideas that have led our country nowhere. His is the path of politics, the path of posturing, the path of least resistance, but it is not the path to true leadership.

Modernizing Medicare will be bipartisan or it won't happen at all. Only by working together will we strengthen Medicare and get prescription drugs to seniors who need them.

This administration has shown what it thinks of bipartisanship by frustrating it. I will take a different road. I will join a rising generation of reformers, Democrats and Republicans, who want to move beyond the same old politics to get results, leaders like Senators Bob Kerrey and John Breaux and Bill Frist.

I agree with the Progressive Policy Institute, the think tank of Joe Lieberman's Democrat Leadership Counsel, when it calls on leaders, and I quote, "To seize this opportunity to push for bipartisan agreement that uses the Breaux approach is the basic blueprint for Medicare reform."

As president, my message to Congress will be clear: Instead of seeking advantage, let us set common goals. Instead of polarizing this country, let us honor our commitment to elderly Americans. Instead of pointing the figure of blame for failure, let us share the credit for success.

This is the way to fulfill the promise of Medicare, and this is the way to serve the seniors of our country.

Thank you very much.

HEMMER: Texas Governor George Bush, a much anticipated speech today outlining his plans for health care, if elected to the White House come November 7th. Governor Bush talking about a number of things, including emphasizing that Medicare must be modernized for our times, in his words; one time comparing it to a 1965 Mustang, still sitting, he says, in the lot, still nor running. Medicare needs overhaul, according to the Texas governor.

He said, it's a rigid program, but a vital program. And then pointed the finger squarely at the Clinton administration, saying they have claimed to do help for eight years, but have failed to act. Bill Schneider back in Washington, quick analysis, Bill. And clearly, Governor Bush is talking about choice, a heavy emphasis of what he feels his plan would provide.

WILLIAM SCHNEIDER, CNN SR. POLITICAL ANALYST: He wants more flexibility, more choices, more options in the Medicare program. He argues that Medicare is a gigantic government bureaucracy, which served well 35 years ago, when it was first invented. And in fact, it was invented by Lyndon Johnson, and the Great Society, whom he, rather uncharacteristically for a Republican, praised; a lot of Republicans were critical of the program when it started. But he expressed his commitment to Medicare, called it one of the great successes of the Lyndon Johnson Great Society. And said that it has gotten out of date, it is too top heavy, too bureaucratic, and he wants to reform it. And that is interesting because that is a John McCain word. He wants to become a reformed by adding new options to the Medicare program, allowing seniors a greater variety of choice.

HEMMER: And clearly, the Bush camp would like to shift some attention in their direction, especially what we have seen over the past two weeks where Al Gore really has made some in roads. This speech today, this proposal, is it enough to jump start some things in his favor?

SCHNEIDER: Well, it might be. I mean, it is certainly competitive with the Gore proposal. We will have to look in detail at the cost of it, the benefits that are going to be provided. He didn't elaborate that too much in his speech. But it certainly is a proposal one can put side by side with the Gore proposal to see exactly which one would benefit seniors more, which one would reform Medicare to a greater degree, and which one would cost more.

HEMMER: Somebody much smarter than I will be able to answer this one, his direct comments toward the Clinton-Gore administration, will they take root?

SCHNEIDER: Well, that is difficult to say, because, you know, I think to argue that the Clinton and Gore administration haven't really done very much. Well, look, you have had a Republican Congress, Democratic president, the president tried to do something very substantial in his health care reform program, it was far too much, even a Democratic Congress wouldn't give that to him. So you have had a lot of politics, a lot of wrangling between the president and the Congress.

I think where Bush scores his best point is when he says that he intends to be bipartisan. He wants to have a bipartisan approach. And in fact, several times, three or four times in his speech, he mentioned a Democrat from Louisiana, John Breaux, who is co-chairman of a Medicare Reform Commission, as an example of the kind of moderate Democrats that he feels he can work with. He also mentioned Senator Bob Kerrey, who is retiring from the United States Senate.

I think his point is: Clinton and Gore have had too much politics and not enough substance in their administration. He intends to operate from substance and to reach across the aisle to Democrats to work with them.

HEMMER: Bill Schneider, live in Washington. Thanks, Bill, for the analysis there. $158 billion proposal spread out over 10 years now on the table for voters to look at and decide.



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