Shift in Congress Puts Health Care Back on the Table

A poll by the Harvard School of Public Health and the Kaiser Family Foundation found that majorities of Democrats, Republicans and independents want government to help lower health-care costs.

The question is whether and how such public sentiments will translate into political action. Here is a look at some of what will be on the agenda in the new Congress:

· Medicare prescription drug price negotiations. Proponents, mainly Democrats, argue that repealing a provision in the 2003 Medicare drug benefit law and forcing the Bush administration to haggle with drug companies over prices could save billions of dollars a year. But Democrats no longer say the savings would be enough to fill the "doughnut hole," the gap in coverage during which beneficiaries are responsible for all drug costs.

Opponents favor the current system, in which private insurers negotiate prices with drug companies. They say government negotiations would amount to price controls and be logistically difficult and might reduce seniors' choice of drugs. Prospects for passage are better in the House than the Senate, where incoming Senate Finance Committee Chairman Max Baucus (D-Mont.) has committed only to holding hearings on the idea. Bush opposes government negotiations, and some Democrats expect him to veto any bill to create them.

· Stem cell research. In July, Bush used the only veto of his presidency so far to quash a bill that would have lifted federal funding restrictions on embryonic stem cell research. Scientists say embryonic cells are more versatile than adult stem cells and are promising in the treatment of paralysis and many diseases because they have the potential to develop into any tissue or organ. Bush said that the bill "would support the taking of innocent human life in the hope of finding medical benefits for others" and that it "crosses a moral boundary that our decent society needs to respect." Advocates in both parties say the bill will pass again -- but many expect another veto.

· State Children's Health Insurance Program. There is bipartisan support for reauthorizing this 10-year-old program that provides health coverage to more than 4 million children whose families do not qualify for Medicaid but cannot afford insurance on their own. The fight will be over how much money to add to the $5 billion annually that the federal government now spends on the effort. Experts say at least $12.7 billion more is needed over the next five years just to keep covering the same number of children. Some Democrats have discussed using the program to expand coverage to some uninsured adults -- a move that would add billions more in costs and bring stiff opposition from Republicans, who say the program should focus on attracting more eligible kids.

· Health information technology. Both the House and Senate approved bills in the last Congress to promote the use of electronic health records and other information technology, in part by setting in motion efforts to develop standards for data storage and ensure that different systems can communicate with one another. But disputes over privacy concerns and potential financial conflicts of interest if hospitals were to sell such technology to their doctors scuttled attempts to reconcile the two bills. Lawmakers say they are confident they can overcome those hurdles and win bipartisan final approval in the 110th Congress.

· Drug safety. Lawmakers of both parties have complained that the FDA has fallen short in monitoring drug safety. They cite the 2004 withdrawal of the painkiller Vioxx because it raised the risk of heart attacks as one example. Leaders of the Senate health committee have signaled that they will push for changes on that front when the panel considers reauthorizing a law that allows the FDA to collect fees from drug companies to speed the new drug-approval process.