Congressional Outlook

With the prospect of war on the horizon, it is hard to be excited about watching what will unfold domestically in 2003. Nonetheless, a major part of our population will be focusing intently on Washington as President Bush attempts to address both domestic issues and international crises while initiating his own re-election campaign.

The President's Jan. 28 State of the Union address was one of the more interesting that I have witnessed. It was full of surprises — initiatives for developing a hydrogen-powered car, assisting those suffering from addiction and providing medicines to AIDS victims in Africa — balanced with strong and determined words about the situation in Iraq. The President seemed to say that the United States would provide compassionate assistance to those in need around the world, but would also provide security by serving as an international “policeman” that will come down very hard on “outlaws.” I believe the contrasts and the delivery of the last two-thirds of the speech — where the President's compassion and determination came through so clearly — made this a memorable address.

The major domestic issues that will be the subject of great debate this year were mentioned only briefly and were overpowered by the rest of the speech. The President was very vague about Medicare, and subsequent attempts by the press to clarify what the President has in mind regarding reform have not met with much success.

Prior to the State of the Union, there were rumors that the President would propose a major overhaul of Medicare, with the intent of moving beneficiaries from the existing fee-for-service plan into health maintenance organizations and preferred provider organizations administered by the managed care industry. The carrot for seniors to move into managed care would be the availability of a prescription drug benefit in those plans — and only in those plans. In his speech, the President clearly implied that the prescription drug benefit would not be available to those who stayed in the traditional Medicare plan. Yet, the White House dodged questions about this after the speech and said it would be a few weeks before it would send details to Congress.