Republican House leaders were in a hurry, as salesmen with an inferior product to sell so often are.

Many of their congressional colleagues wanted more time to study the $395-billion Medicare bill, arguing that the initiative before them was so expensive -- and, at 678 pages, so complex -- that they needed more than the 24 hours allotted to read it.

But the coalition of pharmaceutical industry apparatchiks and political illusionists who had crafted the bill in secret knew nothing good could come from closer scrutiny of their work.

The more conservatives read, the more obvious it would be that the Medicare bill's authors had abandoned any serious effort to restrain drug prices.

The more liberals read, the more incensed they'd become at how many tax dollars and how much control over Medicare's future had been yielded to for-profit health care providers.

And the more seniors read, the more they'd realize that the bill's prescription-drug benefit might leave many of them with less money in their pockets.

The secret ingredients

My suspicion is that neither the eight House Republicans from Michigan who voted for the Medicare bill nor the six Michigan Democrats and lone GOP holdout who voted against it have actually read the thing from start to finish. They simply haven't had time.

The final text of the House-Senate compromise hatched between 10 Republican lawmakers and two Democratic senators -- House Democrats, including Michigan's most venerable health policy maven John Dingell, were excluded -- wasn't available until late Thursday.

On Sunday -- more than 24 hours after it passed the House, 220-215, in a vote that concluded just before sunrise Saturday, details of the bill were still dribbling out.

The bill provides a government prescription-drug benefit for 40 million Medicare recipients. But that doesn't mean all those people will spend less of their own money on prescription drugs.

Some retirees who receive relatively generous prescription coverage from their former employers will likely lose it when the Medicare drug benefit kicks in. Debbie Stabenow, the junior Democratic senator from Michigan, predicts that 143,000 Michigan retirees will be dropped from private plans.

The real beneficiaries

But the Medicare bill's most damning shortcoming is its failure to address soaring drug prices. Language that would have allowed the government to negotiate prices directly with manufacturers and permitted the importation of lower-cost drugs from Canada was omitted from the final bill at drug manufacturers' insistence.

As a result, the Consumers Union says, rising drug prices will likely offset the new Medicare coverage, leaving most seniors with higher drug costs by 2007.

Another provision deleted from the final legislation is even more telling.

The Senate's version of the Medicare bill included language that would have limited Congress' own prescription-drug coverage to the benefits provided for Medicare recipients. In the compromise bill made public Thursday, that what's-good-for-the-goose provision had disappeared.

In the end, lawmakers must have realized that the only seniors certain to profit from the new prescription benefit are those who were prescient enough to invest their retirement savings in drug company stocks.

Contact BRIAN DICKERSON at 248-351-3697 or via e-mail at: dicker@freepress.com.

Topplebush.com
Posted: November 28, 2003