Frist Plans Radical Surgery for Medicare

WASHINGTON, Nov. 29, 2002 -- An organ transplant is the ultimate high-risk, big-stakes procedure in surgery. Its corollary in politics is performing radical surgery on Medicare. Sen. Bill Frist (R-Tenn.), has done the first and is about to tackle the second.

Frist, shown holding a human heart

As a transplant surgeon, Frist performed more than 200 heart-lung transplants and directed the transplant center at Vanderbilt University. Now Frist, a close ally of President Bush and one of the most influential Republicans on health care issues, has set a goal of "modernizing" the 37-year-old Medicare program during the 108th Congress.

Adding a prescription drug benefit, while important, is not enough, Frist says. Instead of the current single-payer system, Frist and the White House are talking about a more competitive model that would allow seniors to stay with traditional Medicare or choose from a variety of private plans -- much as federal employees now choose from a variety of insurance plans covering life, health and long-term care.

Besides opening what is now a closed system to competition, Frist wants to improve information gathering and analysis. He talks about a "health care infrastructure" that would measure outcomes, improve information flow among patients, doctors and other components of the health-care sysetm and, perhaps, make it possible to detect, analyze and prevent mistakes that now go undetected.

With an appointment to the Senate Finance Committee, Frist will be in position to influence the debate. His medical background helps, as does his recent term as chairman of the GOP campaign committee. He is credited with helping Republicans regain control of the Senate.

During the campaign, Frist cautioned candidates that prescription drug coverage was "the first issue" they had to handle successfully, the second being Social Security. Both must be approached with compassion, not just with an eye towards fiscal prudence, Frist counseled.

Democrats are lining up against any effort to reduce the federal government's role in Medicare, warning that the issue of "vouchers" is a nonstarter certain to encounter stiff resistance in both houses of Congress. First counters that it is crucial to get the program on sounder fiscal and public health footing before the first baby boomers hit age 65 in 2011.