One More Senate Shot

What made the recent Senate failure to pass a prescription drug plan for seniors so frustrating was not merely that the two parties could not agree on a bill, but that a large majority of senators agreed on much of the legislation but could solve the final issue of who would offer the coverage.

Some areas where there are the needed 60 votes to pass a bill: through one plan or another, 97 senators have supported a universal Medicare prescription drug benefit, one that would reach all beneficiaries and include a broad formulary; a sufficient number of senators support establishing benefit levels based on ability to pay; the total, 10-year package will arrive with a price of approximately $400 billion. The major disagreement is over whether the public or private sectors would deliver this coverage, an important point because this massive new health-care program could well serve as a model for future health plans.

But even on this question, there are discussions of compromise, with a leading suggestion having private companies handle the coverage except in regions where there is so little competition that one company has a monopoly or near monopoly. Another proposal would have the government begin by offering this benefit, then phase out its presence, letting private insurers take over. Neither solution is perfect – does the government ever really phase out anywhere? – but each holds the possibility of compromise and, with it, an increasingly important benefit for seniors in a medical system that more and more often relies on prescription drugs for treatment.

Sen. Olympia Snowe has been at the center of the debates on the issue, helping to write the tripartisan plan that sought to combine the best elements that had been considered over the last several years. In a commentary last week, she said, “By building on the principles of universal, affordable, permanent coverage embodied in our tripartisan plan, I believe we can – and must – find consensus and pass a package of benefits this year.” This is not an easy assignment because the Senate is in session for a mere month more before recessing for the year and has plenty of work to do on budget bills. But passing a drug bill may be possible if Senate leaders can agree on a plan this month to present to the full Senate in September. Sen. Majority Leader Tom Daschele has handled the drug debate poorly throughout the summer; he could redeem himself by urging Democrats to join with Republicans in finding a compromise bill.

Senators are home for the month of August and would no doubt appreciate hearing from as many constituents as possible about the need to find a way out of the drug deadlock.