Fw: Subject Reference: Medicare drug plan likely to move..pharma. co's

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Sent: Saturday, November 16, 2002 9:16 PM

Subject: Subject Reference: Medicare drug plan likely to move..pharma. co's

Medicare drug plan likely to moveNov. 16 — Republican control of both the White House and Congress may unexpectedly offer the best chance in decades for a major expansion of Medicare to include prescription drug coverage for millions of senior citizens, according to lawmakers, pollsters and strategists in both parties. CAMPAIGN PROMISES BY President Bush and Republican candidates on the issue paid dividends for the GOP in the midterm elections and raised expectations that the party will indeed act, they said. “They made a prime commitment to do something before 2004,†said Blendon, a pollster at Harvard’s Kennedy School of Government. In addition to drug coverage for some retirees, Blendon predicted Republicans would tackle malpractice tort reform, tax credits for the uninsured and a small-scale patients’ bill of rights. “They’re going to address these things, but they’re going to address them in their way.†Senate negotiations over a Medicare prescription plan broke down last summer over two concerns: cost and delivery. Several prominent Republicans, emboldened by the election results, said they intended to pursue legislation that would subsidize private insurers that sell drug coverage to seniors. Many Democrats and health care advocates say that for-profit insurers will sell drug plans to only the healthiest people. The blueprint Republican leaders are discussing would cost about $300 billion over 10 years — much more generous than Bush’s original $190 billion package, but not enough to provide prescription drugs for even half the 40 million seniors and disabled citizens now on Medicare. Novelli, executive director and chief executive officer of AARP, the nation’s largest retiree group, said the task would become even more difficult in the next session as drug expenditures continue to climb and federal dollars disappear. “Every year this is delayed, it gets more expensive,†he said. “We can see how you start with low-income people and catastrophic coverage, but this is not just a low-income problem. People in the middle class are really hurt by this.†DEMOCRAT TERRITORY Since Lyndon ’s Great Society legislation created Medicare, Democrats have traditionally laid claim to the health care agenda and its core constituency, senior citizens. In the weeks before the Nov. 5 elections, many Democrats predicted that despite their failure to enact a Medicare drug plan, elderly voters would give them the benefit of the doubt on the issue. But Republicans — with major financial support from the pharmaceutical industry — rewrote the political equation largely by embracing a subject that “typically accrues to the benefit of the Democrats,†said Republican pollster DiVall. “I advised all of our candidates to go on television early and put down a marker on where you stand before someone else does it to you,†said Sen. Bill Frist (R-Tenn.), chairman of the Republican Senatorial Campaign Committee. “It’s the one issue besides Social Security that people say they are traditionally most comfortable having Democrats deal with. We neutralized that.†Frist, a physician and a leading architect of the GOP’s electoral gains, said he was determined from the outset not to cede the prescription drug issue, as the party had in the past. That meant persuading incumbent lawmakers to support Medicare drug legislation on the Senate floor and helping challengers establish their own proposals. “We had the ammunition to not just respond, but to lead on the issue,†he said. It wasn’t that Republicans won on health care, said Sen. Judd Gregg (R-N.H.), but that they ensured they would not lose because of it. He cited Republicans Talent and E. Sununu, who won Senate seats in Missouri and New Hampshire, respectively, in part by touting votes they cast in the House for a prescription drug bill. Chip Kahn, president of the Federation of American Hospitals, agreed that Republicans benefited by simply entering the Medicare debate. “Health is not their central issue, but it’s an issue that, if they engage on it, can clearly help them against the Democrats,†he said. “Republicans, after two election cycles, have learned to talk about health.†ELDERLY VOTE Republicans defeated Democrats by 12 percentage points among elderly voters, and the two parties split evenly among voters who listed prescription drugs as their top issue, said GOP pollster Bill McInturff. The strategy got a major boost from the drug industry, which is eager to reap the revenue from a Medicare package. Pharmaceutical companies comprised the eighth-largest political contributor this cycle, giving $18 million as of late September. The industry also acknowledged that it subsidized two advocacy groups, United Seniors Association and 60 Plus, that poured more than $16 million into advertising and direct mail. The lion’s share of pharmaceutical money went to Republicans. Some Democrats, while acknowledging that Republicans effectively neutralized the drug issue during the campaign, predicted that it would be much more difficult for the GOP to live up to its promises. “They’re going to be held accountable,†said Democratic pollster Celinda Lake. “Voters can’t be bought off easily here; they will know if their prescription drugs are more affordable or not.†Sen. M. Kennedy (D-Mass.) struck a conciliatory note, saying he was willing to negotiate. “I’m all for taking the gradual approach,†he said, “but we have to make it worthwhile to seniors.†He said, for instance, that few retirees would purchase drug coverage with high premiums and deductibles. “If seniors are not going to buy into it, it doesn’t matter what we pass,†he said. One congressional Democrat suggested that the Republican effort would break down between conservatives who have no desire to spend large sums on a social program and moderates who will discover that the cost of providing tangible benefits is much higher than party leaders estimate. But Blendon and other analysts said Bush and his chief political adviser may force the party to resolve those differences — before he faces the voters in 2004. “I think [White House political aide] Karl Rove’s strategy is that to maintain the majority, you have to do things,†said Blendon. “Two years from now, they’ll have a list of health care items and something to check in each box.â€

ELDERLY VOTE Republicans defeated Democrats by 12 percentage points among elderly voters, and the two parties split evenly among voters who listed prescription drugs as their top issue, said GOP pollster Bill McInturff. The strategy got a major boost from the drug industry, which is eager to reap the revenue from a Medicare package. Pharmaceutical companies comprised the eighth-largest political contributor this cycle, giving $18 million as of late September. The industry also acknowledged that it subsidized two advocacy groups, United Seniors Association and 60 Plus, that poured more than $16 million into advertising and direct mail. The lion’s share of pharmaceutical money went to Republicans. Some Democrats, while acknowledging that Republicans effectively neutralized the drug issue during the campaign, predicted that it would be much more difficult for the GOP to live up to its promises. “They’re going to be held accountable,†said Democratic pollster Celinda Lake. “Voters can’t be bought off easily here; they will know if their prescription drugs are more affordable or not.†Sen. M. Kennedy (D-Mass.) struck a conciliatory note, saying he was willing to negotiate. “I’m all for taking the gradual approach,†he said, “but we have to make it worthwhile to seniors.†He said, for instance, that few retirees would purchase drug coverage with high premiums and deductibles. “If seniors are not going to buy into it, it doesn’t matter what we pass,†he said. One congressional Democrat suggested that the Republican effort would break down between conservatives who have no desire to spend large sums on a social program and moderates who will discover that the cost of providing tangible benefits is much higher than party leaders estimate. But Blendon and other analysts said Bush and his chief political adviser may force the party to resolve those differences — before he faces the voters in 2004. “I think [White House political aide] Karl Rove’s strategy is that to maintain the majority, you have to do things,†said Blendon. “Two years from now, they’ll have a list of health care items and something to check in each box.†gigi* http://www.msnbc.com/news/835865.asp?0si=-

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