WASHINGTON — Jewett Pattee of Long Beach, who at 80 still enters cross-country bike races and works part time as a pharmacist, has every reason to be loyal to his Medicare HMO.
For Medicare's standard monthly premium of $58.70, he is charged just $10 or $15 for each doctor's visit and for his annual physical and eye exam. Another co-payment gets him unlimited generic drugs and some brand-name prescriptions -- a benefit not covered by basic Medicare.
Pattee was in Washington for the first time last week to hear President Bush promote legislation adding prescription drug coverage to Medicare.
"This bill we're trying to get passed has to be done," Pattee said. "A lot of seniors can't afford the medication, and they just stop taking it."
But there is a lot more to the bill than prescription drug coverage. And many seniors strongly oppose key elements that could emerge next week from a House-Senate conference committee.
With the deadline for action fast approaching, both Democrats and Republicans ratcheted up the political rhetoric this week.
Sen. John B. Breaux (D-La.) warned that unless both sides were willing to compromise, Congress would end up with nothing more than "a basket full of excuses to give to seniors.... And they can't take excuses to the drug store to get their prescriptions."
Here, based on the tentative agreements negotiators have reached and the details of unresolved matters that remain on their agenda, is what a "modernized" Medicare might look like.
* How much will prescription drugs cost me?
For the first time since the program was created in 1965, Medicare beneficiaries would not have to buy a private supplemental policy or hock the family silver to pay for their medications. But they would still have to pay more than many working people who have employer-sponsored insurance.
Within six months after Congress passed a bill, seniors could get a Medicare-endorsed drug discount card. For an annual fee of about $30, the card would give seniors discounts of 15% to 25% for each prescription. Beneficiaries with incomes of less than $12,123 for an individual or $16,362 for a couple (35% more than the federal poverty level) would qualify for a federal subsidy of $600 a year.
The discount card would be phased out in 2006, when the full drug benefit would take effect. In most areas of the country, the benefit would be administered by a private insurance company. Some beneficiaries might have direct access to a Medicare-administered drug plan.
