Seniors happy with the current Medicare system should be able to keep their coverage just the way it is. And just like you -- the members of Congress, and your staffs, and other federal employees -- all seniors should have the choice of a health care plan that provides prescription drugs.

My budget will commit an additional $400 billion over the next decade to reform and strengthen Medicare. Leaders of both political parties have talked for years about strengthening Medicare. I urge the members of this new Congress to act this year. "

While on the surface this sounds great, I have to wonder about the substance and feasibility of a plan for Medicare that will depend on the private sector for success.

Medicare currently has three parts, Medicare Part A, Part B and Part C (also know as Medicare +Choice). Medicare Parts A and B mirror traditional health coverage. They cover hospital care, nursing home and home health care and doctors fees. Traditional Medicare provides no benefits for preventive care (yearly check ups) or for prescription drugs. Medicare +Choice is a plan by which HMO's provide Medicare benefits using their networks of doctors and other healthcare providers. Medicare (through the Healthcare financing agency. Less than 10% of Medicare beneficiaries are enrolled in Medicare +Choice plans. Many seniors have never had the opportunity to enroll as these plans were usually not available in smaller markets and sparsely populated rural areas. Many HMO's have also pulled out of markets over the last few years because of rising health care expenditures and decreasing profits with increasing losses.

HMO's have not been able to keep a handle on health care costs over the last few years have for the most part had to increase premiums and increase the cost share for their beneficiaries.

Healthcarereform, but I doubt that with the distractions of war and a lagging economy we will see much if any progress on this issue. I predict that this will once again be an issue in the 2004 presidential election.

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