Editorial Don’t Let Politics Destroy Opportunity For Drug Benefit

By the time this issue of The Healthcare News hits the newsstands, there’s a chance that this month’s health law feature on page 22 could be obsolete.
That’s because the issue — a proposed bill to bring the nation’s senior citizens a Medicare prescription drug benefit — gained considerable momentum in Washington at press time when the American Association of Retired Persons (AARP) gave the plan a thumbs-up.

It wasn’t the most ringing endorsement, but Bill Novelli, the association’s president, approved of enough features of the plan to say lawmakers should take the opportunity to pass the historic legislation — which would be the largest expansion of Medicare since 1965.

What took many political observers aback was that the plan is primarily a creation of Republican congressmen — not typically a group that gains AARP support on anything. And that has some Democrats, including both of the Commonwealth’s U.S. senators, Edward M. Kennedy and John F. Kerry, fuming.

Kerry blasted the proposal at a forum of Democratic presidential candidates in New Hampshire the evening Novelli made his statement, while Kennedy insisted the plan must be changed before it passes.

The Healthcare News doesn’t doubt that both men have reservations about the details of this particular plan, which involves HMOs to, in effect, compete with Medicare. And even though it protects against catastrophic prescription costs over a given year, the proposal does include a coverage gap — and none of it takes effect until 2006, meaning the plan simply isn’t exhaustive enough and wouldn’t be instituted quickly enough for some lawmakers.

But we also must point out that there is plenty at stake for Democrats politically as well, and that fact tends to color their statements. Elder medical issues have been a staple of Kennedy’s core platform for decades, and he is suddenly faced with being on the outside of a major piece of legislation that has traditionally been ‘his’ issue.

For Kerry, the stakes are even higher, as passage of the drug benefit with the support of senior groups and medical organizations (such as the American Medical Association, which gave a ringing endorsement) essentially hands Republicans — and, by association, President Bush — a significant policy victory just a year before the 2004 election.

It must be said that many congressional Republicans have their own reservations about the plan. Fiscal conservatives in particular cringe at the prospect of creating such an expensive entitlement, even if it does mean providing drug coverage for 40 million seniors and disabled people who need it.

Other Republicans say the plan does not provide enough incentives for private insurers to compete with Medicare, and that a provision legalizing the importation of Canadian drugs shouldn’t be included. By no means are Republicans walking in step on every aspect of the bill.

“Those of us who would like to scrap this bill and start over are feeling more encouraged as we talk to our colleagues,” U.S. Rep. Mike Pence, R-Ind., said.
The Healthcare News suggests they decide against that course. To us, the mixed approval and criticism coming from both parties — and from organizations that typically lean toward one party — is a sign of bipartisanship, not faulty legislation.

And bipartisanship is typically not a happy, huggy affair, but an often messy business of give and take. The fact that Republicans and Democrats are even this close gives hope that a compromise can be worked out and that seniors can eventually have the drug coverage they seek.

Novelli said that, after his announcement, the group received a barrage of phone calls, mostly in opposition to his position. How many of these comments are knee-jerk reactions to a Republican-led plan harshly criticized by some Democratic leaders, and how many result from measured analysis of the actual proposal, is impossible to tell right now.

For its part, the AARP is launching a $7 million campaign to convince its members the plan is a good one. And even Senate Minority Leader Tom Daschle, D-S.D., has acknowledged that recent changes to the bill, including extra assistance to low-income people, make Democratic support more likely.

Let’s hope that’s the case. Lawmakers, particularly in an election mode, tend to think in terms of winners and losers, but perhaps this time, they won’t allow politics to crush a solid opportunity to hand a victory to senior citizens.