JUST KEEP ROLLING THE DICE

NEXT STOP: MEDICARE? (Michael Barone, June 9, 2003, US News)

Now comes Medicare, a much harder issue. The administration has produced no draft legislation, just a "framework." The idea is to use the leverage of the demand for a prescription drug benefit to make Medicare more like the Federal Employees Health Benefits Program (FEHBP). Seniors would be offered a choice: 1965 Medicare with a drug benefit or an array of health maintenance organizations (HMOs) and preferred provider organizations (PPOs), with varying drug benefits. There would be more options than under the 1997 law encouraging HMOs, which has had disappointing results: HMOs closed up shop in many states and are unavailable in most rural areas; only about 15 percent of seniors are enrolled in them. [Bill] Thomas, who pushed a stand-alone prescription drug benefit through the House in June 2002, is aiming for a mid-June markup in committee. There's little doubt that Speaker Dennis Hastert and Majority Leader Tom DeLay can round up majorities on the floor. [...]

One problem: The tax cut required only 51 votes for passage, but Medicare may require 60. Some Democrats are opposed to having private insurers in the program on the grounds that it would amount to a retreat from 1965 Medicare's one-tier structure, which they hope will someday be a model for a national health insurance system. But other Democrats seem more interested in getting a generous prescription drug benefit and may be willing to accept more private options in exchange. Sen. Edward Kennedy could play a major role here in either passing or stopping a bill.

There is a political calculation for Democrats, as well. In the 2002 elections, they didn't get the mileage they had hoped from the prescription-drug issue because the Republican House passed a bill and the Democratic Senate failed to do so. Now, if the Republican House passes a bill, and if a Senate majority is frustrated by a filibuster, Republicans will be able to say that obstructionist Democrats denied seniors a prescription drug benefit.

So, are the Democrats still "progressives" or are they now completely reactionary? Posted by Orrin Judd at June 1, 2003 4:57 PM