In December 8, President George W. Bush signed into law a bill that will provide drug benefits under Medicare. Supporters have hailed the measure as a groundbreaking step. Opponents have criticized it on two grounds-for being too modest in the help it will provide seniors and for capitulating to lobbyists representing insurance companies and private health plans.
Both Republicans and Democrats agree about the desirability of including drugs in Medicare coverage, but their different approaches to effecting that change reflect deeper divisions about the role of government in health-care policy. Senator Ted Kennedy (D-Mass.) believes that providing the benefit through private insurers is the opening wedge in an effort to privatize Medicare. He fears that such a fundamental change will lure younger and healthier seniors into private plans, thereby shrinking the pool and leaving sicker, more vulnerable seniors to pay higher premiums for the traditional program. Senate Majority Leader Bill Frist (R-Tenn.) wants to introduce greater competition in the Medicare market. He favors “premium support,” in effect tax-based vouchers for seniors to shop around among qualified plans and choose the one that best meets their individual needs. In doing so, he hopes to provide greater innovation and flexibility in the health-care choices of seniors and to reduce the costs of Medicare over time.