What is most remarkable about the debate over a drug benefit for Medicare is that after five years of talking about this issue and widespread agreement that Medicare has not kept pace with changes in medical treatment, the various proposals remain so far apart. Not only are the cost estimates for the two leading Senate bills hundreds of billions of dollars different, the questions of who should qualify and what entity – government or business – should run such a benefit have yet to be answered.

These are large differences but a single bill that can achieve a needed 60 Senate votes still is possible because the alternative of passing nothing is worse. After spending so much time with an issue that so many agree must be solved to make prescription drugs affordable to the elderly, to end the session without a bill would make the majority Democrats look “silly,” Senate Finance Chairman Max Baucus, D-Mont., said in a news report. Repub-licans, justifiably, would use it as a campaign cudgel in the fall.

Members of the Finance Committee, including Sen. Olympia Snowe, wrote the bill with the best chance for passage. With Republican Charles Grassley of Iowa, Democrat John Breaux of Louisiana and independent Jim Jeffords of Vermont, it has attracted support by the Senate pragmatists who recognize the need for generous benefits but also know that any affordable bill must include some co-pays and deductibles.

It would cover half of a recipient’s drug costs between $250 to $3,450 a year, then pick up 90 percent above $3,700. The coverage is voluntary and would extend additional assistance to low-income seniors, depending on a combination of federal oversight and private insurers to deliver services.

About 38 percent of all seniors have no insurance coverage for drugs, according to a Kaiser Family Foundation study. But with drugs among the most rapidly rising medical costs, not coincidentally at a time of the nation’s greatest reliance on them for treatment, this lack of coverage means that millions of people 65 and older are paying too much out of pocket for care. The buying power of a group with coverage would allow for lower negotiated prices and important savings for those most in need.

The Finance Committee bill is not only closer to the version passed by the House but stands the greater chance of being sustained well into the future as more pressure is put on the Medicare system by baby boom retirees. It is expected to cost $350 billion over 10 years vs. the leading Democratic proposal, at $500 billion over six years.

It is the best answer Congress has to meet the rising cost of prescription drugs for seniors and could include, for instance, some of the payment levels of the Democratic bill to attract enough votes for passage.

The choice is to do that or look silly in the fall.