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Senators disagree on Medicare vote

Sen. Frist, left, and Sen. Harkin with their visual aids: a prescription drug bottle and the text of the Medicare bill.
Sen. Frist, left, and Sen. Harkin with their visual aids: a prescription drug bottle and the text of the Medicare bill.

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Bill Frist
Tom Harkin

(CNN) -- Senators were preparing Monday for a showdown over a sweeping Medicare bill, which for the first time would offer retirees prescription drug coverage.

CNN anchor Soledad O'Brien spoke Monday with two senators with differing views on the proposed bill -- Senate Majority Leader Bill Frist, a Tennessee Republican, who is pushing for a vote on Monday, and Sen. Tom Harkin, an Iowa Democrat, who says a vote at this stage would be premature.

O'BRIEN: Opponents say that this is the first step toward dismantling Medicare. They also say that ultimately it will hurt seniors. In addition, some of your own colleagues say it is just too darn expensive. What's your response to all of that?

FRIST: Soledad, it's going to be a remarkable vote today. The vote today and this attempt to filibuster is the only thing that stands between 40 million seniors and prescription drugs. If we're successful today -- which I expect we will be -- these 40 million seniors for the first time in the history of Medicare are going to have access to prescription drugs.

No longer will any of them have to choose between food on the table and prescription drugs. Is it expensive? Yes, it is because seniors don't have access today to the most important part of medicine, prescription drugs.

... Four hundred billion dollars is a lot of money, but our seniors and individuals with disability deserve that sort of treatment.

O'BRIEN: You continue to talk about seniors and access to prescription drugs. But if you're trying to help seniors get access, why not just expand the drug benefits? Why is $86 billion in this $400 billion going to employers? Why are there so many billions of dollars also going to HMOs and drug companies? Why not just help out the seniors?

FRIST: Well, a lot of people ask that. [There's] a fairly simple answer to that. Because the problem that we face, because of the baby boomers, the demographics, the fertility curve after the last world war, has resulted into something that cannot be sustained. We have to modernize Medicare. It's an antiquated system that does not involve preventive care, does not have chronic disease management, other types of disease management. We have to update that system.

Our seniors deserve the sort of healthcare that we in the United States Congress get, that federal employees get. They deserve the same choices. So at the same time we're giving them access to prescription drugs, we're going to modernize the system to strengthen and improve Medicare to include preventive medicine and disease management.

O'BRIEN: But they're saying it cannot be sustained or potentially can't be sustained -- and I think the number is just going to run out at 2026 or somewhere around there. But it can't be sustained as it is now when you talk about what is clearly the biggest entitlement since the 1960s, doesn't that argue the point that that also cannot be sustained?

FRIST: No, absolutely not. The whole point of modernizing the system is to make it more efficient so that every taxpayer dollar invested -- and your taxpayer dollar and all of ours -- has greater value at higher quality and better access. It's a better way of doing things.

But again, all of this is voluntary. So if you're a senior listening to me right now, remember you don't have to participate in any of the choices that we're going to be giving you if you don't want to. You can keep exactly what you want to have.

O'BRIEN: Earlier today, we heard [U.S. Department of Health and Human Services] Secretary [Tommy] Thompson talk about this being a major expansion. Isn't that inconsistent really with the principles of limited government principles of Republicans? Aren't you being inconsistent with your own party?

FRIST: No. Listen. Our role in government through the obligation that we really put forth in 1965 with Medicare is healthcare security for our seniors, to give them the sort of security in healthcare that they deserve. Right now, it makes absolutely no sense to deny our seniors if this could give them healthcare security from prescription drugs, the most important part of healthcare delivery today. It makes no sense. It's not fair and our seniors simply deserve better. And we're going to fulfill that promise today.

O'BRIEN: Among the senators who say they will not support the bill is Iowa Democrat Tom Harkin. Sen. Harkin is also with us. What don't you like about this bill? What's your biggest objection?

HARKIN: Well, the biggest objection is it's rushed. Here it is. This is the bill we got here. Oh, it's about 1,100 or 1,200 pages -- right here -- and we got it dated November 20th. No one's read this bill. No one really knows what's in it.

And the drug benefits, the benefits that the distinguished majority leader talked about, don't go into effect until 2006. So what's the rush?

What we ought to do is get this out to the countryside. Let's go home for Thanksgiving and the Christmas holidays. Let's come back in February, after the people of this country have had a chance to digest this, and then debate it and pass it. What's the rush? ...

It's the HMOs and the doctors and the pharmaceutical industries here pushing to get this done as soon as possible.

O'BRIEN: So are you saying you're against the bill because you feel like you haven't had an opportunity to read the whole thing or because you feel like there's been heavy lobbying from the doctors and the HMOs and the pharmaceutical companies?

HARKIN: Well, my biggest reason for trying to hold it up is to give people time to digest it, and let's hear from the countryside.

I do have other objections to the bill which center around the fact that most of the benefits go to enrich drug companies. Look at the thing in the paper this morning, "Medicare Bill Would Enrich Companies." There's so much money in here to buy off HMOs, to give to the pharmaceutical companies, and you wonder what happened to the poor senior out there that we're suppose to try to help?

O'BRIEN: AARP supports this bill. How do you go back and explain to your senior constituency [that] you don't support something that their lobbying group does support?

HARKIN: AARP had three hearings in Iowa a few months ago in three major cities in Iowa. Several hundred people showed up. They asked seniors there how many would sign up for this program as in the House or Senate bill. Not one hand was raised.

A poll was taken: Only 18 percent of AARP members liked what they've heard about this bill. They don't know the whole thing. That's why I say we need some time to get this out there. Let people take a look at it. And then, let's come back in a deliberate manner, rather than being rushed pell-mell to pass a fundamental change in Medicare.

That's what it is. This is not just a prescription drug bill. It's a fundamental change in Medicare.

O'BRIEN: Do Democrats have enough votes for a filibuster?

HARKIN: Well, I sure hope so. Because, again, I think we ought to get the bill out there. Let's take some time to look at this. There's no rush. The only rush is the pharmaceutical companies and the HMOs, they want their money, big bucks, billions of dollars of taxpayer money going in to bribe them to come in and to provide drugs and benefits to seniors. I think we ought to take some time and think about this.

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