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Sen. Bill Frist and Medicare

Comment on Sen. Bill Frist and Medicare:

In the recent election, Sen. Frist counseled the Republican candidates to support prescription coverage for senior citizens but without providing any of the specifics of their proposal. The Republicans will now have to deliver on that promise even if their proposal will be inadequately funded, and will primarily benefit pharmacy benefit managers, private insurers and pharmaceutical firms, while providing little benefit for patients.

Most agree that give-back legislation will be important to prevent the exodus of providers from the Medicare program. But the Republican insistence on budget-neutral adjustments does not bode well for maintaining the fiscal integrity of the Medicare program. This is more bad news for Medicare patients.

Sen. Frist strongly supports Medicare privatization through the Breaux-Thomas-Frist premium support proposal. Regardless of their "marketplace competition" rhetoric, the real purpose of shifting from the public program to private plans is to reduce public costs by allowing "more affordable" private plans that shift more costs to patients, while simultaneously supporting the private, middleman health plan industry.

Republicans will continue to block prescription coverage through the traditional Medicare program, authorizing only a separate benefit by private insurers. By doing so, Medicare beneficiaries will be incentivized to exit the public program and enroll in private plans.

If these issues are addressed individually, the Democrats can muster enough support by exposing the nefarious policies behind each issue. It is much more likely that Sen. Frist will orchestrate a plan to present an omnibus bill that "provides prescription coverage, controls Medicare costs by modernizing the program, and assures the viability of providers by reducing some of the scheduled cuts in funding." Superficially, the package may have broad appeal and gain the support of conservative Democrats that barely survived the last election. These Senators would have little to lose and some to gain by supporting a package that may look good to voters and that really doesn't cost much at a time when more tax cuts are on the agenda.

Sen. Frist, by "saving Medicare," will further his personal ambition to assume the number two spot on the 2004 ticket as a step toward the number one spot in 2008.

Although enacting comprehensive reform will be impossible in the next two
years, it will be imperative that we make every effort to:

(1) Protect Medicare as a program of social insurance by opposing privatization efforts,
(2) Fight for a prescription benefit that is incorporated into Medicare's program of social insurance, and
(3) Assure that adequate give-back provisions are passed that do not parasitize some sectors of Medicare providers for the benefit of others.

Please accept my apologies for this blatantly partisan commentary. But only the Republicans have it in their power to save Medicare through a bipartisan effort that supports the Democratic positions on these issues.

Don McCanne