FRIST VICTORIOUS ON MEDICARE; NINE REPUBLICANS VOTE NO.

At the end of his first session as Senate Majority Leader, Sen. Bill Frist (R-TN) emerged victorious Nov. 25 by a vote of 54 to 44 after a bruising battle over a Medicare prescription drug bill that pitted him against conservative members of his party as well as most Democrats.

The conservatives, concerned about the high cost of a Medicare prescription-drug entitlement program, almost succeeded in blocking the measure from coming up for a vote on budget-related objections.

Frist needed 61 votes to defeat the motion, and he succeeded in getting the 61st only when Sen. Trent Lott (R-MS) agreed to vote with his party on the procedural issue although not on the final measure.

Meanwhile, Senate Democrats, led by Sen. Edward Kennedy (D-MA), put up a strong fight against what they see as watering down of the Medicare program. But they could not stop defectors from rural states because of the $25 billion the bill will provide to doctors and hospitals in rural areas. Senate conferees Charles E. Grassley (R-IA), Max Baucus (D-MT) and John Breaux (D-LA) had insisted on that provision despite opposition from the conference chairman, Rep. Bill Thomas (R-CA), and it proved crucial to final passage.

After passage, Frist portrayed the bill as a bipartisan victory even though only 11 Democrats voted for it, but President Bush is expected to capitalize on it in the upcoming presidential campaign as a Republican victory.

During the last presidential campaign, Bush promised to "make prescription drugs available and affordable for every senior who needs them."

He now is poised to claim he delivered on his promise, letting him take credit for an issue which traditionally has given the Democratic candidate the advantage.

Democrats, however, intend to fight the battle in Congress before the election and with the voters in the next election as a boondoggle for the pharmaceutical and insurance industry.

They are counting on a backlash from seniors after they learn how the new program will work, much like the backlash which occurred in the late 1980s after Congress passed catastrophic health care coverage for seniors.

Republicans also will be attacked from the conservative wing of their party. Subsequent news accounts confirm intense pressure from House Speaker Dennis Hastert (R-IL), Majority Whip Tom DeLay (R-TX) and the White House used to persuade recalcitrant House conservatives to vote for the bill.

When it became clear they hadn't succeeded during the roll call vote started at 3 a.m. Nov. 22, they held the vote open for an unprecedented three hours until they finally succeeded in getting the two votes they needed (Liability & Insurance Week, Nov. 24).

Those two Republicans, Reps. C.L. "Butch" Otter (ID) and Trent Franks (AZ), said they decided to vote with the President only after they received a call from him in the early morning hours and were persuaded House Democrats intended to force a vote on the Senate-passed bill if the conference measure was defeated.

Now they have learned it would have been impossible for the House Democrats to have forced such a vote.

In his syndicated column last week, columnist Robert Novak wrote the conservatives almost defeated their president and their congressional leadership because "there were only 210 yes votes after an hour (long past the usual time for House roll calls), against 224 no's."

He described how the 30 Republicans who said they would vote against the bill were threatened that their no votes were "endangering their political futures" and, in the case of Rep. Nick Smith (R-MI), endangering the political future of his son, who is seeking to replace him in the next election.

Only one conservative in the Senate, Sen. Wayne Allard (R-CO), was persuaded to change his vote. He reluctantly agreed to vote for the proposal, which he considered far too costly because it contained the health savings account provision House conservatives had insisted be in the final measure.

The nine Senate Republicans voting against the measure were: Sens. Lincoln Chafee (RI), John Ensign (NV), Lindsey Graham (SC), Judd Gregg (NH), Chuck Hagel (NE), Lott, John McCain (AZ), Don Nickles (OK) and John Sununu (NH).

The 11 Democrats who voted for the measure were: Sens. Baucus, Breaux, Thomas Carper (DE), Kent Conrad (ND), Byron Dorgan (ND), Dianne Feinstein (CA), Mary Landrieu (LA), Blanche Lincoln (AR), Zell Miller (GA), Ben Nelson (NE) and Ron Wyden (OR).