- The Washington Times - Thursday, March 6, 2003

Providing prescription drugs for seniors is the "dessert" being offered by the White House to get Congress to force down a bitter plate of fundamental Medicare reform, Health and Human Services Secretary Tommy G. Thompson said yesterday.
Medicare will start running deficits in 2016 and go bankrupt in 2030, so fundamental reform must begin now, Mr. Thompson said. He accused Congress of not having the political will to ensure the system's long-term solvency.
"Congress has no great desire to work on Medicare. They just want to pass a prescription-drug benefit without making any changes," said Mr. Thompson. "That's the dessert, that's the driving force. And unless we make some of the changes [now], we'll probably never get back to making the fundamental changes that we're trying to do with this program."
President Bush announced a $400 billion plan Tuesday to introduce market forces into Medicare and provide limited prescription-drug coverage for seniors.
Democrats have characterized the drug coverage as too meager, and panned the plan to encourage seniors to enroll in private health plans.
"Senior citizens and people with disabilities deserve better than what the Bush proposal offers," said Sen. Byron L. Dorgan, North Dakota Democrat. "Medicare has worked well. It does not need to be privatized. It needs a comprehensive prescription-drug benefit."
Mr. Bush's Medicare-reform plan would break the program down into three parts.
Seniors would have the option to stay in the current fee-for-service plan, and would be offered a prescription-drug discount card good for 10 percent to 25 percent savings beginning next year, and coverage for catastrophic drug costs above an undetermined threshold. Those with lower incomes would get $600 annually to help pay for drug costs in addition to the discount card.
A second option, called "Medicare Advantage," would break the country down into 10 "Medicare regions," in which seniors could enroll in low-cost and high-coverage managed care plans that also include drug subsidies.
The president wants as many seniors as possible to join "Enhanced Medicare," which offers more benefits and is modeled after the insurance plan that covers federal employees. The program, which would begin in 2006, provides prescription drugs and preventative care benefits through private managed care companies.
Mr. Thompson conceded that the president's reform ideas would not drive down the costs of Medicare or resolve its long-term fiscal health. Those issues will be addressed "in the future," Mr. Thompson said, "but this is a giant step forward."
Democrats have pledged to oppose the president's plan, and might stage a filibuster in the Senate. House Democrats have offered a $900 billion prescription-drug plan that doesn't make any changes to Medicare.
A plan by Senate Democrats would cost $600 billion over 10 years.
To counter that opposition, Mr. Thompson said the White House "is looking at" tacking Medicare reform to this year's budget-reconciliation bill, which would only require a simple majority to pass.
However, even some Republicans especially in rural areas have expressed skepticism toward Mr. Bush's plan. The White House left many details out of its proposal to give Republican lawmakers the maximum flexibility.
Mr. Thompson said he doesn't expect the final product to be exactly what the president has proposed, but put the odds at "80-20" that something similar to Mr. Bush's proposal will be passed this year.

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