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2004-01-06 -- Despite New Law, the Fight Over Medicare Continues


So why did the Democrats support the Senate version of the Medicare
privatization act?


New York Times, January 6, 2004

By ROBERT PEAR

WASHINGTON, Jan. 5 - The fight over Medicare is picking up exactly
where it left off four weeks ago, when President Bush signed a bill
offering prescription drug benefits to the elderly.

Democrats, denouncing the arm-twisting tactics used to pass the bill
in the House, vowed Monday to rewrite the law to reduce the role of
private health plans, to increase drug benefits and to authorize the
government to negotiate drug prices.

President Bush and other Republicans plan to trumpet the law as a boon
to the elderly and will oppose changes, saying the law should be given
a chance to work. Administration officials and Congressional
Republicans predicted that the Democrats would not gain traction with
their arguments.

Within hours after Mr. Bush signed the Medicare law on Dec. 8,
Democrats and labor unions held a rally on Capitol Hill.

"We have only just begun to fight," Senator Edward M. Kennedy of
Massachusetts said then. Jean Friday of Pittsburgh, a spokeswoman for
a group of retired steelworkers, described the bill as "an
abomination." Representative Nancy Pelosi of California, the House
Democratic leader, advised the elderly, "Beware of Republicans bearing
gifts."

Mr. Kennedy said Monday that Democrats and their allies would resume
the effort when Congress convened on Jan. 20. "If Republicans think
this fight is over, they are wrong," he said.

At the moment, Democrats appear to have no chance of modifying any
significant provisions of the law. Republicans said they saw no need
for even technical corrections. With their majority in the House, they
can usually block consideration of Democratic amendments.

But Democrats plan to make a political ruckus and said they hoped to
put Republicans on the defensive.

"We want the debate to start now," said Representative Benjamin L.
Cardin, a Maryland Democrat who is drafting a bill to revise the new
law. "This issue is far from resolved. We don't want people to go
through the election and the year without knowing what's in the law."

Democrats said they planned to raise their concerns day after day on
the Senate floor.

Representative Rahm Emanuel, Democrat of Illinois, said: "The Medicare
issue will be dormant this year only if we allow it to be dormant.
We'd be fools if we did."

On Jan. 16, the administration is scheduled to announce higher
Medicare payment rates for private health plans, including health
maintenance organizations. Democrats said they would attack the rates
as a giveaway to the insurance industry. In March and April, Congress
is likely to debate a budget for the coming year. Democrats will offer
amendments to increase the drug benefit. In May, insurers will start
issuing government-approved drug discount cards to Medicare
beneficiaries. Democrats will cite studies saying such cards produce
small savings.

The White House, AARP and Congressional Republicans say they know they
need to educate the elderly about the new law.

Critics are eager to help. Ronald F. Pollack, executive director of
Families U.S.A., a consumer group, said he was planning a "road show,"
which will visit about 25 states in March and April. He will explain
the law, including what he sees as its strengths and weaknesses.

Republicans are prepared to defend the law they wrote. The House
Republican Conference has given its members "suggested responses" to
Democratic arguments.

The materials assert that "seniors will initially save 25 percent or
more through the prescription drug card" - somewhat more than the
typical savings of 10 percent to 15 percent envisioned by the
Department of Health and Human Services.

Mr. Kennedy and Senator Tom Daschle of South Dakota, the Democratic
leader, have introduced bills to alter the new law. Democrats in the
Senate and House are developing comprehensive bills.

The proposals would allow people to import prescription drugs from
Canada; eliminate tax breaks for health savings accounts; fill in gaps
in Medicare drug coverage (the "doughnut hole"); reduce payments to
private plans; and abolish a demonstration project that will require
traditional Medicare to compete directly with private plans.

Republicans say the Democrats are sore losers, angry at losing control
of the Medicare program.

For the first time in years, the "liberal intelligentsia" was excluded
from the process of writing a Medicare law, a House Republican said.
The law was written mainly by conservatives and centrists.