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Analysis:
Medicare to Be Election Issue By
David Espo, the Democrats want the cards shuffled and dealt again, quickly, for fear of
losing a topic that has worked to their advantage for a generation. Either way, the landmark legislation will be an issue next year. While Bush said it means Medicare "will be modern and it will be
strong," his Democratic rivals all opposed it. Some sought additional
political mileage by joining a futile, last-minute filibuster aimed at
killing the bill in the Senate. Like all complex legislation, this one was the result of dozens of
compromises, large and small, as well as shifting tactics. As president, Bush decreed that any drug benefit should apply broadly.
"All seniors should have the choice of a health care plan that
provides prescription drugs," he said in last winter's State of the
Union address. That effectively eclipsed the view of many Republicans that only
low-income older Americans and those with extraordinarily high drug costs
should be covered. Not all Republicans reconciled to that. "Once you made it
universal, I think it was the beginning of the end," Sen. Trent Lott,
R-Miss., said Sunday on ABC's "This Week," referring to the
additional costs involved. Additionally, 25 House conservatives opposed the measure rather than
support creation of a huge new government benefit program. At the same time, under pressure from Senate Democrats, Speaker Dennis
Hastert, R-Ill., and other key Republicans, the White House quickly
abandoned efforts to limit the new drug benefit to those people willing to
give up traditional Medicare. Hastert, who has spent much of his career working on health care
issues, let it be known he viewed that proposal as inhumane, and the White
House let it slip from its list of priorities. Among Democrats, Massachusetts Sen. Edward M. Kennedy made a key
decision in June that helped trigger strong bipartisan support for an
earlier version of the bill. "A major breakthrough," he called
it at the time. Provoking anger among fellow Democrats, he agreed to a fundamental
Republican goal: creation of a vast new role for private health plans
under the government-run program. He also accepted the $400 billion
overall ceiling on spending that Republicans imposed. But months later, Republicans deliberately kept Kennedy at arms' length
when they negotiated a final House-Senate compromise. Instead, they turned
to the AARP - long viewed as a Democratic ally in Medicare wars - and
Democratic Sens. John Breaux of That kept the final Senate vote relatively close, at 54-44, and the
rhetoric heated. But from the GOP perspective, Kennedy's last-minute, futile bid to
block the bill and the harsh attacks that he, Senate Democratic leader Tom
Daschle and others leveled at the AARP were powerful signs of political
success. The final Senate roll call also underscored the extent to which
Democratic unity had fractured on an issue that the party has long used
successfully against Republicans. In the end, 11 of the Senate's 48
Democrats voted in favor of the bill. In the House, the GOP leadership worried all year about preventing mass
defections among their own conservatives and little or nothing about
enlisting bipartisan support. That made it easier for Democratic leader
Nancy Pelosi's attempt to make the legislation a clear-cut issue for 2004.
In the end, only 16 of 205 House Democrats defected. "This bill is wrong and when the public sees what's in this bill,
I think it's going to be a negative to have voted for it," she said
in an interview a few days before the final House vote. In the Senate, Daschle said much the same thing, then went a step
further. Shortly after the legislation was passed, he introduced a bill to
repeal portions of it and to legalize the importation of prescription
drugs from "This debate is not over, it's just beginning," he said, and
the Democratic presidential hopefuls agreed. Among the five lawmakers running for the party nomination, Sen. John
Edwards of For his part, though, Bush is already celebrating, with a formal
signing ceremony yet to come. "They used to call Medicare 'Mediscare' for people in the
political process," he said, virtually taunting Democrats over an
issue they once called their own. "Some said Medicare reform can never be done. For the sake of our seniors, we got something done," he said. Copyright
© 2002 Global Action on Aging |
