The President and Congress repeatedly promised to provide Medicare beneficiaries with the same drug coverage available to them and other federal employees under Federal Employee Health Benefit Program (FEHBP). They have not kept their promises. In fact, they have proposed plans that would hurt, rather than help, the disabled and elderly who rely on Medicare for their health and well-being.

The Congressional Research Service has said that the actuarial value of the prescription drug benefit under FEHBP is higher than the Medicare prescription drug benefit proposed under either of the current Medicare reform bills. So inferior are the proposed Medicare drug benefits that Congress actually introduced legislation designed to prevent FEHBP from reducing its drug benefit to match Medicare should a reform bill pass.

While the overall FEHBP model would not serve Medicare beneficiaries well, the drug benefit under the most popular FEHBP plan is considerably better than what Congress proposes for Medicare. There is no deductible and no gap in coverage, and there is no additional premium for drug benefits. In contrast, the Senate and House versions of the Medicare bill have $275 and $250 annual deductibles respectively. Beneficiaries would be completely responsible for drug costs between $4,501 to $5,813 per year under the Senate proposal and between $2,001 and $4,900 annually in the House version. The estimated premium under both the Senate and House bills is $35 per month, but the actual premium would be set by each private plan. Clearly these plans include ominous beneficiary costs and coverage gaps -- far more than under FEHBP.

What is good enough for Congress and the President ought to be good enough for the elderly and disabled people who rely upon Medicare. Instead, neither the House bill nor the Senate bill creates an affordable, uniform, stable drug benefit that reflects the needs and legitimate expectations of Medicare beneficiaries.

Among a host of drawbacks, both bills would require older people and people with disabilities to pay hefty premiums -- not guaranteed by statute -- even when the plan no longer covered their expenses, to change plans whenever the private insurance companies choose to enter and leave a market and perhaps most troubling, to watch the uniform fairness of Medicare be undermined, since desirable benefits would vary from plan to plan and the prescription drug benefit would be tied to income. This is a significant departure from the original spirit of Medicare, which was created to provide benefits to all Americans who were over a particular age or who were disabled, regardless of socioeconomic status.

All of this is not to say that Medicare beneficiary advocates embrace FEHBP as a Medicare model. We do not. FEHBP does not offer a defined and stable set of benefits as is currently available to Medicare beneficiaries. Costs of premiums, particularly for drug coverage, vary from plan to plan and from year to year, and they have increased significantly these last several years. Furthermore, FEHBP beneficiaries must evaluate and make plan selections annually, weighing and making complicated decisions about health care options. Many Medicare recipients would find this burdensome.

A Medicare beneficiary recently told the Center for Medicare Advocacy of her relief at turning 65 because for the first time in her life, when her health is at its poorest, she feels in control of her healthcare bills. She and other Medicare beneficiaries rightly feel that their peace of mind is being threatened by legislators who are bargaining for political advantage with the health of their constituents.

Congress and the President should stop playing politics and start playing fair. They should keep their promises and create a secure, reliable, and affordable Medicare prescription drug benefit -- without exacting a multitude of encroachments to the existing Medicare program. Peace of mind is far too valuable for people who rely upon Medicare to lose in return for untested schemes based on privatization.