Remarks on Medicare Prescription Drug Coverage

Weekly Compilation of Presidential Documents, June 19, 2000

June 13, 2000

Well, Ruth, this is the most laughs we've had in this room in a long time. [Laughter] You can come back tomorrow and the next day and the next day. [Laughter]

She made the trip all the way from Idaho here. She had bad weather in Chicago last night. This is hard. She went to a lot of trouble to come here. Let's give her another hand. Let's thank her very much. [Applause]

I want to thank Secretary Shalala for her work on this. And Congressman Strickland, thank you, sir. And I especially want to thank Senator Max Baucus who has been on this issue of the particular impact of the prescription drug problem on rural seniors for a very long time now.

I'd also like to introduce the other Members of Congress who are here from rural America: Behind me, Congressman John Baldacci from Maine; Congressman Marion Berry from Arkansas; Congressman Leonard Boswell from Iowa; Congressman Chris John from Louisiana; Representative Paul Kanjorski from Pennsylvania; Representative David Minge from Minnesota; Representative Ciro Rodriguez from Texas; Representative John Tanner from Tennessee; Representative Jim Turner from Texas; and Representative Bud Cramer from Alabama. I think that's everybody. Let's give them a hand. They're all on our side. [Applause]

Patients' Bill of Rights

We're involved in two or three great health care issues here in this millennial year, and I want to talk about, obviously, the one that we came to talk about, but there was a very important decision yesterday by the Supreme Court on HMO's that I would like to just mention briefly.

We--those of us that have been pushing a strong Patients' Bill of Rights--believe Americans should have the right, even if they're in HMO's, to see a specialist, to go to the nearest emergency room, to maintain continuity of care if they change jobs--if they're in a cancer treatment, for example, or in the process of having a baby--and they have a right to hold their health plans accountable.

But yesterday the Supreme Court--I've got this headline here that's in all the papers-"HMO Ruling Passes Debate Back to Congress." The Supreme Court ruled yesterday, I believe unanimously, what we all knew, which is that only Congress can provide to the American people in HMO's a comprehensive Patients' Bill of Rights.

Now, we've been fighting this battle a long time. And there's, obviously, I think--there's a clear majority in the House for a good bill, and we failed by only one vote in the Senate this week. We think there's a majority there, if we can ever get a clean shot. So we're going to keep working. But I just want to emphasize, the Supreme Court now has removed any doubt that this can be handled anywhere but Congress.

Medicare Prescription Drug Coverage

Now, the same is true about dealing with this prescription drug issue. They have become an indispensable part of modern medicine. But more than three in five seniors in America on Medicare now lack dependable insurance coverage for the drugs that could lengthen and enrich their lives. And as the report we're releasing today shows, the situation of rural seniors is even worse.

Now, you heard Ruth talk about her situation. We know that rural seniors have a harder time getting to a doctor or a pharmacy. They're just further away. We know they're much less likely to have HMO's or other insurers willing to offer reasonably priced coverage; they don't have economies of scale. Yet, more often they are in poor health and in need of prescription drugs than their urban and suburban counterparts.

As a result, rural seniors and rural people with disabilities spend 25 percent more out-of-pocket for the prescriptions they need. They are 60 percent more likely not to get those drugs at all. You remember what Ruth said, that she knew people who could not afford to fifl the prescriptions their doctors had ordered them to take. And it is important to emphasize that, depending upon the size of the monthly bill, this could be true not only for low income seniors but also for middle income seniors.

This report could not be more timely, because we--you can't go vote yet; I'm nearly done. [Laughter] This is amazing to me that we're even having this debate. We've got a strong economy. We've got a big projected surplus. We know that the surplus will be revised upward by some amount in the so-called midsession review that's coming just a few days from now. Now, there is no excuse not to do this right, not to provide prescription drug coverage under Medicare.

If we were starting Medicare all over again, everybody knows we'd do it. It's just that it was created in 1965 as basically a problem for serious medical emergencies and for doctors, for hospitals. In the last 35 years there's been a sea change in what pharmaceuticals can do to keep people healthy, to keep people living, to keep people out of the hospital. So the real question is, are we going to do now what we would have done in 1965 if we'd have the tools then that we have now, and are we going to do it in the right way and provide it as an optional benefit to all the people on Medicare? That's what we think we ought to do.