With the spotlight on Medicare, especially as it relates to the cost of prescription drugs, now may be a good time to redirect the discussion toward real solutions to the health care crisis.

The current crisis is the fruit of right-wing, conservative forces who have pushed “marketplace competition” between profit-making insurance carriers and HMOs as the way to contain costs. This has been the prevailing policy since 1994, when Clinton’s health plan was defeated.

Reed Abelson, writing in the July 5 issue of The New York Times, cites the failure of managed care under privatized Medicare HMOs in the 1990s. He then describes the current Medicare “reform” bill proposed by Bush, which will do exactly the same thing. The only difference is that this time around the federal government will give even more millions to the private-sector profiteers.

Unhappily, Sen. Charles Schumer (D-N.Y.) and Sen. Edward Kennedy (D-Mass.) were among the few Democrats who voted in favor of this bill, which is nothing less than a boondoggle to the insurance and pharmaceutical companies.

With two different versions of the bill coming from the House and Senate, it appears that the bills will not be reconciled until the fall, at the earliest. The House bill is the most pro-corporate. The differences over the bill reflect the greed of the competing forces over who gets the most profits.

The prescription drug portion of the bill is a high-profile issue. A recent Wall Street Journal article reveals how the pharmaceutical companies are quite openly demanding outrageously high, guaranteed profit levels before they will consider participating in the program. In addition to working people, employers, who have to pay part of the bill, are also balking at this blatant greed. It is a classic case of intra-corporate-monopoly feuding.

The Alliance for Retired Americans, closely linked to the AFL-CIO, is taking a strong, militant lead in opposing the bill. But all of labor should be in this fight. A true people’s front to defend Medicare is needed and is possible.

To galvanize even larger numbers of activists, however, we need to think big. It simply makes no sense to repeat the failures of the 1990s. A little more or less profit in the system will not solve the problem.

While we must work to defeat the Bush Medicare bill, this is also a perfect time to open a third front. A true reform direction would demand the re-federalization of the whole Medicare and Medicaid systems. Such a vision will bring more people into the fight. It would add an anti-corporate element into the picture, something that every public poll indicates would be very popular among the electorate.

The amount of money saved by going in this direction would be in the billions of dollars. A recent publication by the Senior Action Network, written by Dr. Tom Bodenheimer, a national health care expert, says, “In 2003, Medicare privatization means that Preferred Provider Organizations (PPOs) rather than HMOs would offer care to Medicare beneficiaries. All the problems discussed in this report about Medicare HMOs are also true of Medicare PPOs. Often owned by the same private insurance companies that run HMOs, PPOs will reduce choice, increase costs to patients and government, and put insurance company business decisions above medical decisions between patient and physician.”

The financial crisis facing retirees is very dramatic and not highlighted enough. “In 2001,” Bodenheimer writes, “the average Medicare HMO enrollee in good health spent $1,786 out-of-pocket; for those in poor health, the out-of-pocket cost was a staggering $4,783.”

The Bush prescription for Medicare is a recipe for disaster. Bodenheimer shows how Bush intends to use this Medicare bill as stepping-stone to his first real election. How convenient for Bush that the bill’s harmful effects won’t show up until well after Election Day.

But Bush’s plan can be stopped. In 1989, when Congress tried to pass a disastrous catastrophic health care bill directed at seniors, former Ways and Means Committee Chairman Dan Rostenkowski was chased down the street by angry seniors. The incident made the evening news. The bill was withdrawn.

Every member of Congress must be contacted and told, “Re-federalize Medicare and Medicaid – Put billions toward health, not profits.” Bush should not be allowed any public venue to promote his anti-senior, pro-corporate Medicare proposal. This is the way to recapture Congress and the White House for the people’s needs.

The author can be reached at pww@pww.org