President Bush hailed passage of the Medicare reform bill during two Western appearances on Tuesday, describing it as a "major victory to improve the health care system in America."
He had lobbied hard for the legislation, which is expected to be the centerpiece of his domestic program as he heads into next year's reelection campaign.
"The Medicare system is a central commitment of the federal government," the president said. "Our federal government has made a commitment to our seniors that we will provide them an up-to-date, decent health care system. It's a basic trust that has been upheld throughout the generations. We're keeping that trust."
First in Las Vegas and then in Phoenix, Bush argued that the federally sponsored insurance program has not kept pace with recent medical advances, especially the development of sophisticated drug therapies.
"When Medicare was passed in 1965, health care meant house calls, surgery and long hospital stays. And that's how the Medicare system was designed, to deal with that type of medicine," Bush told seniors and local supporters at the Los Olivos Senior Center in Phoenix.
"Think about how much medicine changed since 1965," he added. "Medicare didn't change with it."
Passage of the bill, which Bush is expected to sign as early as next week, helps the president fulfill a campaign promise to expand Medicare to include a prescription drug benefit.
"Medicare will pay $28,000 for a needed hospital stay for ulcer surgery. Yet it will not pay for the $500 for the anti-ulcer drugs that would keep the senior out of the hospital in the first place," Bush said. "Now, that doesn't make any sense to me.... Medicare ought to cover medications that will keep our seniors from getting sick in the first place."
In his remarks, Bush argued that provisions to encourage seniors to move into HMOs and other managed care programs will offer seniors more choice and infuse the health care system with more competition from private providers. Critics say those provisions will alter the program's essential protections.
"When seniors, or any citizen makes a demand, the system responds," Bush said in Las Vegas. "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 needs."
Public views of the new bill are mixed. In Las Vegas, the audience of doctors and other hospital workers gave Bush a subdued response, applauding loudest when the president pledged to reform the medical liability system to reduce malpractice suits and insurance premiums for physicians.
"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 need medical liability reform now," Bush said. "And the members of the Senate must understand: This is a compelling national issue, and I will keep it on the front burner until we get the problem solved."
The president's reception was more enthusiastic in Phoenix, in part because, in an apparent warm-up for the campaign, Bush spoke in a more informal manner, leaning on the podium and apparently ad-libbing from notes.
"You know, our job in Washington is to tackle problems when we see them, not to pass them on to future Congresses or future presidents or future generations," Bush said, emphasizing a theme he has used repeatedly in campaign-related appearances.
"Medicare has worked for many people. It got a little old, it got a little tired, it needed to be changed. We changed it, and the system is better for it."
Bush's campaign chairman, Kenneth Mehlman, tried to downplay the political aspect of Bush's message.
"Good policy is good politics, and this is good policy," Mehlman told reporters on the airport tarmac in Phoenix. "It's an example of the president and members of Congress working together to achieve a result that is good for the American people."
In both cities, Bush followed his speeches with fund-raising events, adding $3 million to his campaign coffers. The luncheon in Las Vegas raised $1.2 million and a cocktail reception in Phoenix raised $1.8 million.
The president then headed to Crawford, Texas, where he plans to celebrate the Thanksgiving holiday at his ranch.