2002 Priorities

Congress will return in 2002 to a triple challenge: the war against terrorism, an economy in recession, and the pending November elections. By focusing on health care, they can address all three.

The war: While the U.S. military was extremely well prepared to mount the air and ground war in Afghanistan, the U.S. health care system is woefully unprepared to defend the nation against a biological attack.

Aware of the danger, Congress worked to pass bioterrorism defense legislation in December but didn’t finish before adjourning. When members return, there will not be a moment to waste to send a completed package to President Bush to sign.

But Congress needs to be careful to do more than throw money at the problem.

Bioterrorism legislation must establish guidelines to create a strong and coordinated network of state and local public health facilities, private and public hospitals, and medical professionals who are following action plans that are based upon good science. Americans must have confidence in public leadership or they will ignore it, with potentially deadly results.

The recession: Whether or not the economy is pulling out of recession, it will take time for companies to regain confidence and begin hiring new workers. Consequently, the debate over assistance to displaced workers will continue.

The stumbling point in the December negotiations over an economic stimulus plan was how best to provide health insurance to displaced workers.

Democratic leaders wanted to provide more funds to employers to keep displaced workers on their insurance rolls and to let middle-income Americans enroll in government entitlement programs like Medicaid.

Republican leaders wanted instead to give all displaced workers a subsidy that they could use to buy the private health insurance of their choosing.

This issue reveals deep differences between the two parties, and neither was willing to compromise. Passage of assistance to displaced workers will hinge on which side does a better job of convincing voters their approach is right.

The elections: On November 5, a third of the Senate and all 435 members of the House of Representatives will go before the voters.

None of them wants to face the voters without having made a serious effort to fulfill their 2000 campaign promises. A pledge to provide a prescription drug benefit for Medicare beneficiaries tops many lists.

But Congress has two big obstacles before it can act: Money and ideology. The costs of fighting the war against terrorism and the recession mean there is less money for a drug benefit.

In the giddy days of early 2001 when huge budget surpluses were anticipated, members were exploring options to provide a drug benefit to ALL Medicare beneficiaries, even though two-thirds of them already have other drug coverage.

While most Republicans and many Democratic centrists believe that the best solution is to incorporate a drug benefit into overall Medicare reform, few believe this is likely in 2002.

In a more realistic scenario, members will focus on a targeted drug benefit so lower-income seniors can buy maintenance drugs as well as have protection from catastrophic drug expenses.

But liberals fear breaking Medicare’s social contract and want to make the drug benefit universal.

Whatever the outcome, health care issues will dominate the 2002 congressional debate and give voters a clearer sense of which candidates to support when they go to the polls in November.

Grace-Marie Turner is president of the Galen Institute, a not-for-profit research organization focusing on ideas to promote free-market health reform. She can be reached at P.O. Box 19080, Alexandria, VA, 22320.

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