Negotiations in Congress to develop a prescription drug benefit for Medicare are stalled, and the prognosis is poor for a bill that can satisfy Republicans, Democrats and a skeptical public.

There are many problems with the legislation and the differences between the House and Senate versions make middle ground tough to find. It’s likely, in fact, that the drug bill that passed in the House by a single vote would fail today.

Meanwhile, the Maine Council of Senior Citizens is recruiting people without prescription drug insurance for a bus trip to Canada, where they can buy drugs at a heavily discounted price. According to the council, 21 people on a similar trip in May saved $19,000 by buying six months’ worth of the prescriptions they needed.

The disparity between what is happening in Maine and what is happening in Washington couldn’t be greater.

Significant problems exist in the prescription drug legislation. It is expensive during a time of exploding deficits, with a price tag of $400 billion over 10 years. It offers some protection for seniors with catastrophic drug costs and for seniors with the fewest financial resources. There’s a large gap in the plan that many seniors would fall in to.

In addition, the existence of a government program for drugs might prompt employers who maintain drug insurance for their retirees to stop. Such a change would likely reduce benefits for those seniors.

And, finally, the House version of the bill would force Medicare to compete with private insurance companies by 2010. Such an overhaul could threaten the benefit program by making it attractive to only the sickest and poorest Americans, while creating large government payouts to private insurers to cover younger seniors, who are in better health.

While the Senate plan seems to be a flawed compromise, the House plan is a smoke screen. Its real intent is not to provide a drug benefit, but to drastically change the Medicare entitlement.

Politics in Washington may eventually doom the latest efforts to expand Medicare. Early in the process, it seemed there was a bipartisan realization that something had to be done. Support for either of the two plans has withered with seniors, and the momentum is on the verge of being lost.

Back in Maine, it’s a good thing we’re not waiting on Washington to address this problem. The bus trips to Canada continue, and Maine Rx Plus is poised, baring further legal challenges from drug makers, to begin in January.

By leveraging the state’s purchasing power, the state hopes to reduce drug costs and provide discounts ranging from 15 to 60 percent for about 275,000 low-income seniors.

When it comes to providing affordable and effective health care to America’s seniors, including prescription drugs, we need a national approach. Otherwise, we risk creating a tiered health care system in which the country’s sickest are drawn to states with the best plans.

But until the time when Congress can craft a better solution than what’s currently on the table, we will have to fend for ourselves on state, local and individual levels.


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