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Medicare: Champagne for some, stale beer for others

American farmers, with an average age now a hair's breadth from 55, and thousands of them already on Medicare, will probably have as much reason as any group to rue Congress' last-minute, desperation passage of legislation to reform the health care system for the elderly.

The legislation, which had its genesis six years ago in a joint presidential/congressional study commission, and had been the subject of contentious wrangling in ensuing congressional sessions, was about ready for last rites as this year's Congress got ready to close up shop and head home for the holidays.

In the end, though, the Republican majority, with a lot of back-scratching, arm-twisting, and massive subsidies to the health care sector, insurance companies, and pharmaceutical industry, finally managed a 220-215 vote to secure House passage. The Senate approved it 54-44, and President Bush is expected to eagerly sign it (look for it to be a key crowing point for his 2004 re-election campaign).

The changes, the most far-reaching since Medicare begin in 1965, are centered on providing, for the first time ever, a provision to help seniors with the skyrocketing costs of prescription drugs. It won't become effective until 2006, is projected to cost $400 billion over 10 years (although everyone expects it will be much more), and given the various holes in coverage, will leave a lot of seniors still scrambling to cope with purchasing needed medicines.

But champagne corks were doubtless popping in the Washington offices of the high-powered lobbyists for the health care industry and related businesses. The almost 700-page bill contains some $125 billion in benefits for their clients — doctors, hospitals, drug companies, and managed health care organizations, not to mention a virtual blank check to insurance companies.

However much the Republican majority, the White House, and health care lobbyists wanted the legislation's passage, it likely would not have happened without the surprise last-minute support of the politically powerful 35 million-member American Association for Retired Persons (AARP). The organization's CEO and board of directors, in a closed-door Washington meeting, agreed to support the measure.

That news had scarcely hit the wires when the AARP's phone/fax lines and Web site got a tidal wave of protests from members. “Sell-out” and “traitors” were the key words in the communiqués. The organization that should've been the lobby for seniors instead chose to put its own lucrative health insurance business ahead of its members' best interests, the messages charged. A great many included a vow to cancel membership.

Most of the mostly Republican Mid-South congressional delegation supported the package. One who did not was Rep. Marion Berry, D-Ark. “We either serve drug companies or we serve our seniors. I will not be a part of the drug manufacturer's efforts to rob the senior citizens of America.”

Farmers and other rural area residents are already among those most under-served by a health care system centered on “managed care” and HMOs. The fear is that this bill is another step toward the Republican goal of privatization of the health care system, and that it will further narrow the options of those in areas where choices for medical care are already limited.


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