President Clinton took his Medicare reform proposals on the road today, telling 350 cheering senior citizens that "no American should have to choose between fighting infection and fighting hunger."
In a pitch aimed at Congress as much as to the outwardly grateful seniors gathered in an ornate hall in Chicago's downtown Cultural Center, Clinton said, "This is not a political issue anywhere in America, and it should not be a political issue in Washington."
He said his aim is to start giving older Americans federal help in buying prescription drugs and change the way private health plans compete for elderly patients in a way that seniors can afford and "constructed in a way that America can afford."
Clinton made his remarks during his first stop in a daylong Midwest swing that combined policy initiatives with political fund-raising. Clinton also watched four innings of a Chicago Cubs game at Wrigley Field, where he met with Sammy Sosa after the slugger hit his 30th home run of the year.
The most enthusiastic response to the Medicare speech came when Clinton outlined his plan for providing beneficiaries with prescription drug coverage. Under the plan, recipients would pay a $24 monthly premium in 2002, increasing to $44 by 2008. In exchange, the government would pay half the cost of drugs up to a limit beginning at $1,000 and eventually rising to $2,500.
Clinton said the the most depressing aspect of the Medicare system is aged beneficiaries having to choose between medicines that prolong their lives and the essentials that sustain their quality of life.
He said he was moved by the narrative of Hanna Bratman, a 79-year-old Chicago widow and asthma sufferer who told him that the inhalers upon which she depends for easy breathing are not covered by Medicare. Bratman said she spends $2,800 a year -- 10 percent of her annual income -- on asthma medication.
"The Medicare program we came to rely on is not there for us," Bratman said. "Most seniors would be happy to pay a modest premium for drug coverage."
The prescription drug plan also drew praise from those sitting in the audience, including Epperson Bond, 76, a retired Veterans Administration research chemist. Before Clinton's speech, she said: "I'm for it 100 percent because it will provide prescription drugs for those who have to choose between buying food and buying medicine."
Linda Esposito, a pharmacist from Cicero, Ill., who specializes in geriatric medicine, described how some patients are forced to hoard their drugs and stretch out the doses longer than their prescriptions call for in order to make ends meet.
"These people literally fall between the cracks," Esposito said. "Having to watch people make those kinds of decisions is extremely hard."
Clinton said that because of an expected $99 billion budget surplus this fiscal year and a booming economy, there is an "unprecedented opportunity" to strengthen Medicare, which he said would be bankrupt by 2015 without reforms. All told, Clinton wants to tap $794 billion in projected surpluses over the next 15 years to strengthen the program.
"The sooner you deal with these issues the easier it is," the president said. He said his plan would extend Medicare's solvency to 2027, long enough to take in almost the entire baby boom generation.
"If we were creating Medicare today, no one would ever consider not having a prescription drug benefit," Clinton said. "We have the money. This is simply a matter of choice."
Back in Washington, the basic idea of helping make medicine more affordable has widespread support, but health policy experts are giving mixed reviews to the specific approach the White House has in mind.
While the administration believes that much of the drug coverage could be paid for through savings elsewhere in the program, Gail Wilensky, who chairs a council that advises Congress on Medicare policy, said it is risky for Clinton to rely partly on anticipated budget surpluses. "No matter how you slice and dice it, this is a new entitlement . . . that has some questionable financing in the future," said Wilensky, a former administrator of the agency that runs Medicare.
On the other hand, economist Robert D. Reischauer, a senior fellow at the Brookings Institution, praised the plan as "bringing the Medicare benefit package into the 20th century as we enter the 21st century." In fact, Reischauer said, Clinton's proposal does not go as far as most private insurance policies for younger Americans because it includes no limit on how much patients with particularly large pharmaceutical bills would have to pay out of pocket.
Tonight, Clinton attended a $5,000-a-head fund-raising dinner for 100 Democratic supporters at the Lincoln Park home of telecommunications executive Lewis Manilow and his wife, Susan.
Staff writer Amy Goldstein in Washington contributed to this report.
CAPTION: President Clinton said the prescription drug plan for Medicare "is not a political issue anywhere in America, and it should not be a political issue in Washington."