- The Washington Times - Friday, June 13, 2003

Republicans have come a long way from the mid-1990s, when then-House Speaker Newt Gingrich predicted Medicare’s bureaucracy would “wither on the vine” and Senate Majority Leader Bob Dole said he was proud to have voted against creating the program.

Now most Republicans in both the House and Senate are backing a new entitlement to prescription drugs as part of a $400 billion, 10-year overhaul of Medicare.

“It’s just a huge, huge, huge new entitlement program in my view, and that’s not what we as Republicans should be doing,” said Arizona Rep. Jeff Flake, who voted against the 2002 House Republican version and said he doesn’t think he will support this year’s plan either.

The Senate Finance Committee passed its version of the overhaul last night, 16-5, with two conservative Republicans joining three Democrats in opposing it. Meanwhile, House Republicans announced their own proposal yesterday that they said combines reform with a new drug benefit.

The bills vary in their details, but both would cover a portion of seniors’ prescription drug costs whether they choose to stay in traditional Medicare or move to a managed care option.

Republican leaders say their embrace of prescription drugs is not so much a change in philosophy as it is a marriage of the possible and the necessary.

“The seniors have demanded that any health care coverage they choose provide for some sort of prescription drugs benefit package,” said House Majority Leader Tom DeLay, Texas Republican.

“What I view it as is we are headed for a train wreck, and we are trying to anticipate that train wreck and still provide the kind of health care our senior citizens deserve and are calling for,” he said, adding that Republicans’ proposal will encourage competition, which should bring down drug costs.

Rep. Billy Tauzin, Louisiana Republican and chairman of the Energy and Commerce Committee, which is writing part of the House bill, said Republicans had deep concerns over the fiscal condition of Medicare, but have always agreed that a drug program had to be done. He said now is the time.

“The term paper is due tomorrow,” he said. “We’ve got to get whatever reforms we can get because seniors can’t wait any longer for this benefit.”

Polls show overwhelming support for a prescription drug program, with 77 percent of voters saying it is appropriate to spend taxpayer money on such a program, according to a February survey by Andres McKenna Polling and Research, a Republican strategy firm in Washington.

But there’s no need to even look at the polls, said one conservative Republican committee chairman, speaking on the condition of anonymity: “Nobody needs a poll. All you have to do is show up in your district.”

He said Republicans simply have to put a policy forward.

“There are two things we do here: We do policy, and we do politics,” the chairman said. “When it comes to prescription drugs, it’s the politics of prescription drugs.”

Republican leaders said the nature of medicine has changed since Medicare’s first year, in 1966. Since then, they said, prescription drugs have become a much more prominent part of health care. That means it must be addressed in federal health insurance programs.

“I think part of it is the realization that it is impossible to have a modern medical delivery system for seniors without inclusion of the most important tools to help seniors,” said Sen. Rick Santorum, Pennsylvania Republican, who voted for the bill in the Finance Committee yesterday.

He and several other conservative senators say they would like to have seen a smaller bill than the $400 billion, 10-year figure the House and Senate are using.

Some Republicans say whatever Congress passes will inevitably grow beyond expectation.

In Medicare’s first year, 1966, it had a budget of $1 billion for hospital insurance, which was expected to grow to $9 billion in 1990. In reality, by 1990 the cost of hospital insurance under Medicare was $66 billion. The administration says that 2004 Medicare will spend more than $250 billion in 2004 to cover care for about 41 million seniors and disabled persons.

Some conservatives also said that Congress has left the reform out as they have rushed to a prescription drug package.

“Frankly, some Republicans run scared and used bumper-sticker rhetoric rather than talking common sense on this issue,” said Rep. Ernest Istook, Oklahoma Republican, who said Medicare and its 160,000 pages of regulations are tying doctors up in red tape and bankrupting the American medical system.

Mr. Istook and Mr. Flake were two of only eight Republicans to vote against the prescription drug bill in 2002.

Mr. Flake said in past years it was clear the Senate and House weren’t going to be able to agree on a drug program, so there was no danger in voting for it. But by voting for it without linking it to broad Medicare reform, Republicans have tied themselves to getting something done this year, even if it violates their principles.

“I think that’s what we really have done over the last four or five years — we’ve talked about it, and we’ve let Democrats define what ought to happen,” Mr. Flake said.

He and others praised President Bush for demanding reform at the same time, but they worried that the president will end up signing a bill that violates the principles of reform he laid out — just as he did with campaign finance reform or the education bill, which in the end did not include school choice provisions.

Mr. Istook said it is Republicans in Congress who haven’t followed through.

“I believe Republicans could have if they would have. Frankly there’s too much pandering on the issue, and not enough honesty and common sense,” Mr. Istook said.

Amy Fagan contributed to this report.

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