Negotiations Begin for Breaux-Frist Medicare Plan
Sens. John Breaux (D-La.) and Bill Frist (R-Tenn.) will introduce legislation on Wednesday that would "overhaul" Medicare and add a prescription drug benefit to the program, Reuters/Los Angeles Times reports. Under the proposal, a national Medicare Board would approve benefits and premiums for a variety of "competitive" plans, which would all be required to offer current Medicare benefits as well as cover prescription drugs. While seniors would pay a premium, low-income beneficiaries would not be responsible for the expense. In addition, a "special trust fund" would be created "[t]o safeguard Medicare's finances." Similar legislation was introduced in 1999 and 2000, but stalled without support from the Clinton administration. By introducing the reform package, the lawmakers say they hope to "jump start" negotiations with President Bush, who has introduced his own plan to offer Medicare beneficiaries prescription drug coverage. The Bush proposal is a "short term" initiative that would spend $48 billion over four years for block grants to help states to develop prescription programs while the federal government worked on "overhaul[ing] the whole system." Bush aides have said the Breaux-Frist proposal is a "starting point" in negotiations on Medicare reform. Last week, Breaux met with Bush to discuss the different plans. White House spokesperson Ari Fleischer said Bush "did not endorse each and every part" of the Breaux-Frist plan, but added that the plan is a "very strong consensus recommendation." Breaux said, "The issues are not that difficult. It's a question of having enough courage to make some difficult decisions. Any time you try to make changes in something as sensitive as health care, it's very difficult" (Entous, Reuters/Los Angeles Times, 2/2).
While President Bush's "Immediate Helping Hand" plan illustrates "smart politics" by meeting a campaign promise and "showing concern for seniors," the Los Angeles Times writes in an editorial that the plan has "impossible management burdens" and is based on "historically disastrous private-sector efforts to provide Medicare benefits." Arguing that states are "notoriously slow" to establish new benefit programs, the Times writes that many states may not apply for the funding for "fear" of creating a new entitlement that would go unfunded when the federal grants would expire in four years. The "biggest flaw," however, is the plan's "assumption" that private insurers will want to handle any new benefits established by the state. In addition, the plan has little congressional support, as leaders from both parties, including Sens. Charles Grassley (R-Iowa) and Edward Kennedy (D-Mass.) have criticized the program as "too limited." Instead, the Times writes that the "most cost-effective" method of providing drug coverage to seniors would be to expand Medicare and not to "depend on private insurers." The editorial concludes, "[W]ith prescription drugs clearly the fastest-growing health cost in the United States, and with Americans increasingly seeing them as a basic health care right, Congress should at least craft a more practical plan and challenge Bush to accept it" (Los Angeles Times, 2/5).