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Medicare Reform is Good, Not Perfect

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The Medicare reform bill has been called a "grand bargain" by Senate and House negotiators.

The bill is supposed to cost nearly $400 billion over the next 10 years. Even that number is suspect. But some congressional conservatives have little faith that the Medicare prescription drug bill can be held to its projected cost over 10 years.

Sen. Don Nickles, R-Okla., who helped negotiate the proposal and who remains undecided, predicts that figure will double.

So what to think about the bill, as written?

It does add a prescription drug benefit for some 40 million Americans as well as new subsidies for the poor. The bargain side includes an experiment where billions of dollars will be paid directly to insurance companies as incentives for them to offer seniors an alternative to Medicare.

But that private sector competition isn't scheduled to begin until 2010 -- and even then many suspect the law will be amended and the experiments will never occur. That fact alone gives hope to those -- including this newspaper -- who see Medicare as an important step toward some sort of a basic universal health care guarantee.

One of the best elements in the bill -- that might mean something to seniors now -- is supposed to start next May. That's a discount card for seniors, reducing current prescription spending by 15 percent. On top of that, low-income seniors could receive an annual subsidy of $600.

We have said before that helping people cope with the extraordinary costs of prescription drugs is critical -- and for all its problems, this looks like a shaky first step.

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