- The Washington Times - Tuesday, June 24, 2003

Some conservatives are still worried that passing a prescription-drug law is a bad idea. Perhaps they should listen more closely to Democrats, who are screaming that the sky is falling because House and Senate working drafts take Medicare in a market-oriented direction. “It is a pathetic bill, it is a dangerous bill. It’s cruel, fallacious, misleading, cynical, calculating, political in its formulations,” fumed West Virginia Sen. Jay Rockefeller. AFL-CIO President John Sweeney worried that current legislation “gives the administration a significant precedent for their plan to privatize Medicare.” That is true, and, if a prescription-drug law like the current versions is enacted, that would be progress.

That liberals are so alarmed about the policy implications is a good indication the legislation has significant value. As Robert Goldberg of the free-market Manhattan Institute explains on our editorial page, “Rather than see this bill as the beginning of the end of Medicare, conservatives should realize that this is the end of the beginning of changing the health-care system.” The House version introduces competitive bidding for medical equipment and drugs, guarantees choice (and thus competition) of at least two plans within Medicare, allows for a senior’s choice of pharmacy and cuts numerous regulations and paperwork from every corner. The Senate draft carries similar provisions for competitive bidding and, according to the Republican Conference, there is still hope for a differential amendment, which would limit benefits to alternative plans. Both versions include incentives for private employers to maintain programs that cover retirees.

Votes are planned in both houses by late Thursday or early Friday. Senate strategists are confident they will have more than 60 votes lined up by then, but it promises to be a nailbiter in the lower chamber. Those on the fence might want to reconsider election prospects next year. While Republican numbers are high now, there are many unpredictable factors to come in the next 16 months, such as the economy and the reality that the world is on a hairtrigger on a number of fronts. If some members have closer races than expected, it might be difficult to explain away a vote against something as popular as the bills now under consideration. The 75 percent of Americans who favor a prescription subsidy for seniors includes a sizable chunk of the conservative Republican base.

It is not always a straight path to reforming massive government programs. With the goal of bringing about a more market-oriented health-care system, it would be nice if conservatives could chip away at government spending little by little, and, one day — presto — the private sector would take over. The real world doesn’t work that way, however. Stable transitions must be guaranteed, and that can necessitate increased spending in the short-term in order to have a secure enough environment to handle systemic change. Health and Human Services Secretary Tommy Thompson understood that when he led the way on welfare reform as governor of Wisconsin. Yesterday, Mr. Thompson visited the House and Senate to try to convince reluctant conservatives that passing a prescription-drug law is a step in the right direction toward reforming Medicare. We hope they were listening.

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