WASHINGTON — Having failed to deliver a Medicare prescription drug benefit, lawmakers are searching for other ways to help the nation's elderly voters shortly before the November congressional elections.
But very little of the sum--up to $50 billion--that the Senate is on course to approve early next month would reach the program's 40 million beneficiaries. Instead, the so-called givebacks--Medicare fee increases--would go to doctors, hospitals, nursing homes, HMOs and other health-care providers.
Among the potential recipients are overworked physicians in Iowa, air ambulance firms in Montana, HMOs in New York and the collection of state and local medical associations, specialty groups and other health-care professionals that consistently rank among the nation's top five political contributors.
"No one's given up on the issue of prescription drugs," said Michael Siegel, Democratic spokesman for the Senate Finance Committee. "But it would be unfortunate if we sacrificed an opportunity to do Medicare givebacks."
AARP, the advocacy group for seniors, hasn't formally surrendered on its No. 1 priority, prescription drug coverage. It has threatened to use the muscle of its 35 million members at the voting booth if Congress does not produce.
But its leaders are realistic.
The givebacks are "so much about home-state politics," said policy director John Rother. "That often overwhelms bigger issues."
But as congressional elections approach, lawmakers don't dare leave seniors empty-handed.
To sweeten the pot, some senators are pushing for a broader "Medicare improvement bill" that would include not only the higher fees but also some new Medicare benefits, such as coverage of oral anti-cancer drugs, nutrition therapy for heart patients and some preventive care.
And Sen. Bob Graham (D-Fla.), looking to save both seniors and taxpayers money, wants to require competitive bidding among companies that rent and sell wheelchairs, oxygen tanks and other medical equipment to Medicare beneficiaries for home use.
"It is critical that any proposal passed out of the Finance Committee strike an appropriate balance between addressing provider payment needs and making needed improvements to the Medicare benefit package," several senators said Friday in a letter to committee Chairman Max Baucus (D-Mont.) and its top-ranking Republican, Sen. Charles E. Grassley of Iowa.
