BOYNTON BEACH, Fla. - In the Leisureville retirement community, with its tracts of square, whitewashed houses, Alice Russell is a cheerful resident with a blond bob and bright pink lipstick to match her upbeat demeanor, but her anxiety is clear these days.
"Now that my husband is sick, our drug bills are terrible," Russell, a Republican from Philadelphia who spent $2,000 last year on prescriptions, said on a recent morning as she sipped coffee and chatted with friends at the recreation center.
"And I know women who have to sacrifice medicine to pay for their food."
As Congress and President Bush grapple with how to provide prescription drug coverage for some 40 million Medicare recipients, senior citizens in this enclave of working-class retirees are struggling with the day-to-day reality of paying for high-priced medication.
It is their struggle - and their anger - that is motivating Republicans and Democrats finally to make good on years of promises. Indeed, with GOP control of the House, Senate and White House, Republicans are feeling pressured like never before to move forward on the $400 billion prescription drug benefit - if only to avoid blame from frustrated voters.
Charles Bubriak, who was busy crushing his Styrofoam coffee cup a few seats away from Russell, had a warning for politicians in Washington if they fail: "The voters are going to vote for who they think is going to accomplish something on Medicare and prescription medicine."
This year, Congress and the president may finally be listening. The House and Senate are debating legislation to provide prescription drug benefits to the elderly. Both chambers are expected to approve bills by week's end, with a final compromise and the president's signature shortly thereafter.
This reflects what pollsters are telling members of Congress - that the displeasure and anger expressed by residents of Leisureville are part of a national phenomenon.
"Politicians know that seniors want this done," said Bill McInturff, a Republican pollster who has studied public opinion on prescription drugs. "But however much they think they know it, they underestimate the power of this issue."
AARP, a major advocacy group for senior citizens, has tried to remind lawmakers of its members' keen interest in adding a prescription drug benefit to Medicare, the government's medical insurance program for the elderly.
Using a toll-free number, AARP has patched more than 10,000 seniors through to senators and House members in recent weeks. Mike Naylor, the director of advocacy for AARP, said the group's members are saying they want a bill enacted this year, and they want legislation that will clearly reduce their out-of-pocket drug costs.
"The party that drags its feet and makes it look like they're keeping it from happening pays the penalty," warned Susan MacManus, a political science professor at the University of South Florida in Tampa. "You just look at 50-and-over, and that spells the majority of the electorate."
Nowhere are seniors more potent than in Florida - the ultimate swing state, where the 2000 presidential election came down to the wire. Younger people in Florida are typically less inclined to vote, a trait seen nationwide.
Among registered voters in the state, 26 percent are 65 or older. Another 14 percent are 55 to 64, meaning they will qualify for Medicare within a decade.
"It's not just old people who are interested in this prescription drug issue, it's (Baby) Boomers as well," MacManus said. "The demographics of this issue is really what's driving both sides of the aisle to rush to this."
A new survey by the Kaiser Family Foundation and the Harvard School of Public Health reflects the frustration many senior citizens feel. In December of 1999, for example, 16 percent said neither party was doing a good job addressing seniors' prescription drug needs. By last month, the survey found, 32 percent said they felt that way.
"The public is saying, `Hey, we've told you over and over again we think this is important,' " said Mollyann Brodie, vice president and director of public opinion and media research for Kaiser, a health policy think tank.
Medicare was created in 1965 to provide a medical safety net for the nation's elderly. At that time, prescription drugs played a far smaller role in medicine than they do now, and no drug benefit was included in the program.
By the late 1990s, President Bill Clinton and others began calling for a new prescription drug benefit for the elderly, and both Bush and Democrat Al Gore promised in the 2000 campaign to fight for such a benefit.
Frustration among the elderly that it still has not materialized appears to be growing. On Capitol Hill, lawmakers say they have gotten the message.
"There's a lot of pressure in terms of people just expecting it," said Rep. Deborah Pryce (R-Ohio), a Republican House leader. "They know it's got to be fixed, and we know as a party it's got to be fixed."
In the Senate, Sen. Olympia Snowe (R-Maine) said Congress cannot allow the legislation to collapse as it has in the past.
"We cannot possibly go home and tell our seniors again that we just couldn't do it," Snowe said on the Senate floor recently. "Action is long overdue."
Political analysts said Republicans especially are feeling the pressure. Since they control Congress and the White House - the elected segments of the federal government - they are likely to receive considerable blame if a prescription drug benefit fails. But now that Bush and GOP leaders are pushing hard, Democrats are wary of being seen as obstructionist.
Republicans and Democrats have taken different approaches, with Republicans supporting a bigger role for the private sector. But with Sen. Edward Kennedy (D-Mass.) lending his support to a Senate compromise bill, and with Bush and House Republicans making concessions in the interest of pushing legislation through, momentum has been building.
Still, in Florida, retirees are jaded from years of promises. At the Boys Farmers Market in Del Ray Beach, a gathering spot where retirees slowly push their grocery carts through huge displays of fruits and vegetables, senior citizens said they doubted Congress will do anything. And if Congress does act, they doubt it will do any good.
"If they do it, it won't matter because it won't be big enough to matter," said Ruth Davis, who spends $300 a month on two cholesterol-fighting prescriptions for herself and her husband, Milton. "If it's a tiny little bit, it won't do any good at all."
The seniors picking through the fragrant cantaloupe and pineapple at the market knew to the dollar just how much they spend for prescription drugs each year. They could recite key differences between the House and Senate bills. And they remained deeply skeptical that help is on the way.
"I don't think either plan from either house is satisfactory," said Irving Resnick. "All in all, it's typical. They're not doing what they should be doing."
Arthur Primack, a native Chicagoan who spent $6,500 last year on medication for himself and his wife, Barbara, was beyond anger. "I'm one of the people it's supposed to help, but I'm not sure what will come out of it," he said with a touch of resignation.
And Albert Langweiler, a former country club manager, said he doesn't believe either party is sincere about addressing the issue. "The insurance companies have the politicians in their pockets," Langweiler said. "They're using all sorts of excuses."
(c) 2003, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.