- The Washington Times - Wednesday, March 26, 2003

Health and Human Services Secretary Tommy G. Thompson said yesterday that a true overhaul of the health care system should include not only Medicare changes, but also changes to Medicaid, help for the uninsured, medical liability reform and improved patient safety in hospitals.

"They're all inextricably linked together," he said in a discussion hosted by the Republican Main Street Partnership, a group of centrist Republicans. "And you have to sell it, I believe, as a package."

Mr. Thompson was optimistic there would be progress this year.

"I believe this is the year we can transform health care," he said.

Other observers are skeptical, noting financial challenges, the war in Iraq and continuing disagreements in Congress about the details of the administration's proposals.

Mr. Thompson said that while the war is the focus right now, it will end and people will want health care reform to be the top domestic priority.

He also cited political pressure to enact health care changes.

"They've been fighting for 15 years," he said of lawmakers. "Would you want to go back in front of another campaign with nothing done?

"The president is pushing hard, I'm pushing hard," he said. "I think we have a good chance of getting something done."

When it comes to Medicare, President Bush and other Republicans want to give people choices of private health plans outside of government-run Medicare. Under Mr. Bush's plan, seniors could remain in traditional fee-for-service Medicare, or they could choose to enter private plans, which would offer enhanced benefits, including prescription-drug and preventative-care coverage.

Seniors also could choose a third option involving managed-care plans.

"To us, what a tremendous way to allow for a competitive private model," Mr. Thompson said.

But the proposal has been criticized on Capitol Hill. Democrats say the president is trying to privatize Medicare by forcing seniors to leave it to get decent coverage.

"He's trying to discourage people from being in traditional Medicare and he's doing everything he can to force people into private sector insurance plans that undermine Medicare," said Sen. Debbie Stabenow, Michigan Democrat.

And some Republicans such as Iowa Sen. Charles E. Grassley, chairman of the Senate Finance Committee have said they want to be sure that the drug coverage for those who stay in traditional Medicare is adequate.

Division exists within Republican ranks over whether to target most of the $400 billion set aside for Medicare reform to low-income elderly or to spread it among all Medicare recipients.

Some, including Mississippi Sen. Trent Lott, say the money should be targeted to low-income seniors, while others want the benefit to be available to all Medicare recipients.

Sen. John B. Breaux, Louisiana Democrat and supporter of Mr. Bush's plan, said the Finance Committee he sits on will be able to approve something along the lines of the president's proposal or a similar plan championed in previous years, but he said he didn't know whether opponents would try to block such a proposal on the Senate floor.

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