Frist’s elevation elevates the stakes

WASHINGTON - The departure of Trent Lott and arrival of Bill Frist as the next Senate Majority Leader will, by all accounts, sharpen the focus on health care in the next Congress. Frist (R-Tenn.), a Harvard-trained heart surgeon, has identified health care as his top priority. In 2000, he proposed a piece of legislation (Breaux-Frist) that would radically alter the complexion of the Medicare program by de-emphasizing HCFA (now CMS) in favor of the Medicare HMO program. One of the likely discussions to take place in the next Congress, given Frist's ascension, involves the privatization of the Medicare program: Should Congress provide incentive for seniors to move to Medicare HMOs by attaching the prescription drug plan to it, or go even further with privatization? “There's a lot of talk about getting into it [privatization] deeply,” said AAHomecare CEO Tom Connaughton. “I would suspect Bill Frist would be an activist who'd want to get into that debate. I don't know that for sure, but I would suspect it.” The risk of really significant Medicare reform resurrects the specter of Hillary Clinton's single-payer healthcare efforts in the 1990s, a debacle that no one in the White House wants to revisit. For that reason, observers expect the White House to temper any grand plans Frist might have for moderate reform that produce a prescription drug benefit. However aggressive Frist's proposed reforms in the next Congress, his healthcare background is likely to evoke discussion that may have lain dormant under Lott's leadership. “Prior to this changeover, there'd been talk that [Frist] would also go on to the Finance Committee, which is a Medicare committee,” said Connaughton. “So if all that comes to pass - a majority leader, on the Finance Committee, who knows more about health policy than anybody else - I would indeed think he's going to have an impact here.” HME