A Times Editorial

A middle way

Sen. William Roth's proposal for Medicare drug coverage stakes out ground between those of Democrats and other Republicans. It is a worthy compromise.

© St. Petersburg Times, published July 24, 2000

The Medicare drug plan offered by Sen. William Roth, R-Del., could break the logjam in Congress over a benefit Americans deserve. Roth's plan strikes a good middle ground to modernize Medicare with a price tag that's affordable over the near term. Congress and the president should put their posturing aside and compromise before the November elections.

Roth's proposal is less ambitious than what the president and many Democrats want. Seniors with high drug costs would be forced to pay a portion of their bills, whereas some Democratic plans would have the government pay all expenses above a certain level. Roth also would force beneficiaries to pay 20 percent of their home health care costs in exchange for receiving drug benefits. Tying the benefits together could create a "two-tier" system whereby those most needing financial help could not afford the co-payments for drug benefits.

Still, Roth's plan is far better than any the Republicans have proposed. It would establish drug coverage as a fixed benefit, an important distinction from most GOP plans, which would have the government merely subsidize coverage offered by the private sector. The troubles millions of seniors face with health maintenance organizations leaving Medicare offers a lesson in why the government, and not private industry, should administer any drug benefit.

Roth's plan also would insulate seniors against the meteoric rise in drug costs, extend new subsidies to low-income seniors and offer more protection than most Republican plans to seniors with higher-than-average bills. While those benefits mirror most Democratic plans, Roth's five-year, $40-billion spending proposal is far more modest than the leading Democratic alternative.

The real beauty of Roth's plan is that its few details give both parties plenty of room to negotiate. That bodes well not only for adding a drug benefit, but for reforming health care delivery and spending under Medicare.

Sen. Bob Graham of Florida, sponsor of the leading Democratic drug plan, has said he intends to work in a bipartisan approach through the Finance Committee that Roth chairs. These two senators have the skills to narrow the gap. Roth and Graham should agree on the principles of coverage: A drug benefit should be voluntary, affordable and government-run; the private sector could compete and public subsidies should be targeted to low-income patients and those faced with catastrophic bills.

Roth's proposal is a timely nod to moderates in both major parties. He should open the debate within the Finance Committee so voters know before November who is helping and who is posturing.

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