Arizona’s U.S. Sen. Jon Kyl is in demand.
As one of 20 conferees charged with reaching consensus on a prescription drug bill, the junior Republican senator’s ear has become a hot commodity among a host of special interest groups.
At stake is the future of the 40-yearold health care system that serves millions of elderly Americans, as well as the political fortunes of elected officials who promised to help seniors pay for their drugs.
Protestors from a union-backed group have picketed Kyl’s office — a Mesa retiree and six others were arrested — demanding that he meet with constituents. Letters and phone calls have rained down from insurance companies, retirement groups, chiropractors, the pharmaceutical industry, doctors, cancer patients and hospitals, among others.
"If you’re elected by the people you should occasionally talk to the people," said retired Mesa High School teacher Bob Bloom, 67, one of the protesters. "We have a lot of unanswered questions. We would like him to try to answer some of them."
But the lobbying frenzy will do little to bridge the broad ideological chasm between the House and Senate Medicare proposals, which health and political experts say could doom the whole thing.
While Kyl spent most of the August recess in the White Mountains, his aides stayed in Washington to iron out smaller differences with other congressional staffers so the real dickering could begin when Congress returns to work this week.
There are dozens of differences between the two 700-plus-page proposals, from deductibles to the so-called "doughnut hole" — gaps in coverage that would require seniors to pay for drugs out of pocket while still paying their premiums.
But the fundamental issue is whether or not to push seniors away from Medicare into private plans, as the House proposal would do. Democrats and some Senate Republicans fear the House plan would doom Medicare, while the Bush administration and conservative Republicans say taxpayers can’t afford to add a drug benefit without some form of privatization.
"The administration wants Medicare reform, but it wants a bill passed," said Brad Kirkman-Liff, an Arizona State University professor of health administration and policy. "They may not be able to have it both ways."
Kyl is pushing a third Medicare alternative — styled after coverage federal employees enjoy — that would offer a broader array of plans and ensure services are available in rural areas. The House and Senate proposals both limit to three the number of companies that can provide coverage, but Kyl said anyone who can meet the conditions of the contract should be able to offer health coverage.
"There isn’t enough money in the world to pay for everything," Kyl said in an interview.
No one would be forced to leave Medicare, Kyl said, but some kind of cuts will be necessary to pay for the $400 billion drug benefit.
"This is going to come out of general revenues," he said. "That means that a struggling family of four, trying to provide for their kids, will be paying for this benefit for seniors, many of whom are much better off. So we’ve got to be careful we don’t burden taxpayers too much here."
But many East Valley seniors aren’t buying it.
"He doesn’t give a fig for the needs of the people," said Dr. Gerald Weiner of Paradise Valley, a retired orthopedic surgeon. "What are they trying to do? Why are they trying to destroy Medicare?"
Weiner said he’s visited Kyl’s office several times but has never been able to talk with him. Like other East Valley seniors, including protesters from the local chapter of the Alliance for Retired Americans, he has become convinced of the influence of money in politics.
Kyl received more than $234,000 in health care related contributions during his 2000 campaign, including $40,000 from the pharmaceutical industry. Drug companies handed out nearly $20.7 million to federal candidates during the last election cycle, according to the Center for Responsive Politics.
Kyl acknowledged that some employers would likely drop their coverage for retirees under the assumption that the federal government would pick up the drug benefit. The Congressional Budget Office estimates that more than one-third of retirees would lose private coverage under the Senate bill.
But Kyl said conferees could agree on a financial incentive for employers to keep retiree benefits, as the House bill proposes.
Although both the House and Senate voted to allow reimportation of drugs from Canada, Kyl said the vote was pure politics and there will be no such provision in any compromise bill. Thousands of area seniors get prescription drugs from Canada, aided by local companies, but Kyl said the U.S. Food and Drug Administration and the Bush administration won’t allow it.
Kyl was one of 53 senators who signed a drug industry-backed letter in July opposing reimportation, and he supports the industry’s efforts to overturn drug price controls in other countries.
Besides, he predicted, once a prescription drug benefit is approved, the government’s bulk buying will drive down drug prices. "We have to let them make an adequate profit based on the risks they take to produce the drugs," he said.
Kyl has agreed to meet with members of the union retiree group in Washington this week, and tentatively plans to hold town halls in Arizona in a few weeks. "Everybody wants to get a better idea of what this is going to look like, and then take it back home."
Observers, however, are skeptical that anything will get through this year, saying the House would have to cave in on its reform plans to get the Senate to agree. Yet some House conservatives have said they only voted for their version — which passed by one vote, 216-215 — to get it to conference committee and win structural reform.
Bush may decide that anything, even without reform, is better than nothing. Though it’s possible that the drug bill could simply die under its own weight.
"There are all sorts of things being hung on this bill for all sorts of special interest groups . . . that have nothing to do with Medicare reform or prescription drug benefits," Kirkman-Liff said. "It’s all horse trading at this point."
That doesn’t surprise seniors like Weiner, who remembers the days when everyone got treatment, no questions asked.
"What I’d like to see Senator Kyl do is not protect corporate interests," he said, "but to protect the patient."