A key Senate committee yesterday approved a compensation package for individuals who suffer serious complications from the smallpox vaccine, but a series of testy exchanges illustrated the bitter partisan divide over the issue as it heads to the Senate floor.
Democrats accused the Bush administration and Republican lawmakers of attempting to lure health care workers into a risky immunization program "on the cheap," as Sen. Edward M. Kennedy (D-Mass.) put it.
Republicans countered that their bill was "reasonable," timely and the only game in town. "It's the only approach on the table that's moving forward," said Sen. Judd Gregg (R-N.H.), chairman of the Health, Education, Labor and Pensions Committee.
Back and forth the pair went, seated elbow to elbow in the packed hearing room, Kennedy's voice booming, Gregg's barely heard.
"It's a tin cup response to a major kind of health threat, and it insults the first responders of this country," Kennedy said of the proposal to pay $262,000 in death and disability benefits.
"It's not an insult," Gregg replied. "It's a genuine attempt to solve a problem."
"This bill is already dead in the House of Representatives," Kennedy countered.
"We don't have to mark up this bill," said Gregg, a hint of a threat in his voice.
It took the senior woman in the Senate to quell the squabbling. "This is America," said Sen. Barbara A. Mikulski (D-Md.) "We should be able to debate."
In the end, the panel voted along party lines to send the GOP version to the floor.
When President Bush announced his decision to offer smallpox vaccine to medical workers and emergency responders, administration officials said they intended to inoculate 450,000 health care workers by Feb. 1. But the program has recruited just 25,000 so far, and at least 10 states have suspended vaccinations while experts investigate two dozen cardiac-related problems that have arisen in people recently inoculated.
Republicans argue that settling on a compensation program would dramatically increase participation among the many doctors and nurses who have expressed fears about side effects and accidentally spreading the vaccine's live virus to patients.
"We've got to get this program in place to immediately lower the barriers," said Majority Leader Bill Frist (Tenn.). "This is a global security issue."
Frist said $35 million set aside in a supplemental appropriations bill for smallpox compensation should go a long way toward reassuring health care workers.
But Democrats are pushing for more generous benefits and a guaranteed pot of money so that victims would not be dependent on the annual appropriations process for compensation.
The Republican bill is "totally, completely inadequate," Kennedy said. Noting that scientists predict only one or two people out of every 1 million immunized will die, and that as many as 52 may suffer life-threatening complications, he said he was "baffled" why the legislation has encountered so many roadblocks.
"This thing ought to fly through," said Kennedy. "It's not a big drain on the Treasury."
Sen. Hillary Rodham Clinton (D-N.Y.), noting that her home state has suspended inoculations, said the 180-day limit for filing claims "is a coercive deadline." Gregg said it was possible the two sides could reach a compromise on the time limit.
On party line votes, the committee rejected Kennedy's two amendments that would have extended the $262,000 maximum benefit to people who were permanently disfigured by the vaccine and would have eliminated the $50,000 cap on lost wages.
With the United States at war, Gregg said, smallpox inoculation is a "national security issue" that cannot wait.
"Today, anybody who gets vaccinated for smallpox has no compensation at all, and that's the way it's going to be until we pass this bill," he said. "The people who are harmed significantly are going to receive more benefits than the soldier who died on the battlefield today."