- The Washington Times - Wednesday, March 5, 2003

President Bush offered a broad framework yesterday for overhauling Medicare that includes rewarding recipients who shift to private health care providers, a plan Senate Democrats immediately dismissed and vowed to defeat.

The president's $400 billion plan would give the nation's 40 million elderly and disabled Americans enrolled in Medicare three choices: Remain in the traditional program and receive small discounts on prescription drugs; enter Enhanced Medicare and choose among multiple insurers, with the federal government paying most of the cost; or select Medicare Advantage, which would allow low-cost medical coverage through health networks with fewer requirements for the providers.

"A modern Medicare system must offer more choices and better benefits to every senior, all seniors," Mr. Bush said in a speech to American Medical Association members gathered at the Washington Hilton.

"The element of choice is essential. When a bureaucracy is in charge of granting benefits, new benefits usually come slowly and grudgingly, if at all. When insurance providers compete for a patient's business, they offer new treatments and services quickly," he said.

Senior Democrats, including Sen. Edward M. Kennedy of Massachusetts, immediately panned the plan.

"The president's proposal is a radical prescription for dismantling Medicare that will be rejected by senior citizens and should be rejected by the Congress. It denies senior citizens the comprehensive Medicare prescription-drug benefits they need unless they join an HMO or other private insurance plan," Mr. Kennedy said.

Mr. Kennedy accused the Bush administration of structuring the program to "provide billions in new profits for the insurance industry at the expense of elderly patients."

But Mr. Bush said Medicare recipients should be given the same choice of benefits as members of Congress, who enjoy affordable care through the Federal Employee Health Benefits Program.

"If you have to go to a hospital, Medicare charges you an $840 deductible. After two months, you are charged $210 a day. After three months, Medicare charges $420 a day. And after five months, Medicare leaves you with the whole bill," the president said.

"By comparison, a standard plan for members of the United States Congress and other federal employees charges a co-payment of $100 when you enter the hospital and not a dollar more, no matter how long you have to stay. Medicare is supposed to protect the savings of our seniors. In many cases, it doesn't," Mr. Bush said.

Some Republicans were cautiously optimistic about the president's plan.

Sen. Charles E. Grassley, Iowa Republican and chairman of the Finance Committee, said Mr. Bush has "come a long way" in addressing Mr. Grassley's initial concerns that the plan provide adequate prescription-drug coverage for seniors who choose to stay in the Medicare system. Mr. Grassley said he has to study the president's plan to see whether it goes "far enough."

Revamping Medicare is likely to be a key issue in the 2004 presidential election. The president's 10-year plan addresses Medicare enrollment, expected to rise from 41 million today to 77 million by 2031.

Senate Minority Leader Tom Daschle, South Dakota Democrat, said Monday that he would seek to revive a 10-year, $600 billion Medicare overhaul that did not pass the Senate last year. That plan would offer prescription-drug coverage to any Medicare participant in return for a $25 a month premium.

Yesterday, House Democrats introduced their own prescription-drug plan, which replicates the 10-year, $900 billion plan they proposed last year. They said the plan would add the drug benefit to the existing Medicare framework, which would mean the federal government would pay 80 percent of drug costs and patients would cover the other 20 percent the same formula for regular physician care under Medicare.

Stephen Dinan and Amy Fagan contributed to this report

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