Anchorage Daily News

Help may be on the way for Alaska senior citizens who can't find primary care doctors who'll treat them.

Most Alaska primary care doctors are not accepting patients on Medicare, the government funded health insurance for those 65 and over. They say Medicare imposes doctor fees that are so low, they can't afford to treat the elderly.

But our congressional delegation got a 35 percent permanent increase for Alaska doctors written into a Medicare bill that passed the House Tuesday.

They deserve credit for their efforts.

The increase should end the disgraceful situation in which older Alaskans can't even find a regular doctor.

U.S. Rep. Don Young voted for the bill, even though President Bush has threatened to veto it.

Unlike past measures that have temporarily raised Medicare payments in Alaska, "This is a permanent fix, not one will expire in a few months," Young said in a statement. "This is a great day for Alaska's seniors."

Now the measure goes to the Senate.

Congress must complete work on Medicare bills in the next few days to avoid a programmed 10.6 percent cut in doctor payments nationwide beginning July 1.

With Congress working to stave off that cut, our delegation saw the chance to bring Medicare's doctor fees in Alaska closer to reasonable levels. Sen. Ted Stevens first introduced the 35 percent increase for Alaska on the Senate side, and it was picked up in the House bill, said a spokesman for Rep. Young.

The Senate has yet to pass any of different versions of the Medicare repair bill though. It is still fighting over how to pay for increases.

The pending bills, if passed, will encourage Alaska doctors to open up their practices to Medicare patients, said Jim Jordan, executive director of the Alaska State Medical Association.

That's what happened before when payment rates increased in Alaska.

But this latest fix doesn't cure the basic problem with Medicare. It leaves in place the system of regularly scheduled payment decreases that take an act of Congress to stave off.

It's going to take a new president and new Congress to do the major overhaul that Medicare needs.

BOTTOM LINE: A helpful Medicare bill has passed the House. Hang on for imminent action in the Senate.

AIDS relief

It's simply the right thing to do

Treat AIDS patients. Care for AIDS orphans. Battle malaria. Overcome drug-resistant strains of tuberculosis. Train tens of thousands of health care workers.

By any decent definition, this is good work, the stuff of the beatitudes.

It's expensive -- $50 billion over the next five years.

It's worth it.

President Bush and a strong bipartisan majority in Congress want to reauthorize the President's Emergency Plan for AIDS Relief with $50 billion over five years. The current program, begun in 2003, expires in September.

Operating mostly in sub-Saharan Africa, the program has provided treatment for at least 1.5 million AIDS patients, prevented millions of new infections and cared for several million AIDS orphans.

The numbers are staggering; the progress is real.

What would another $50 billion over five years do?

• Provide $31 billion to treat an estimated 3 million AIDS victims, prevent 12 million new HIV infections and care for another 12 million AIDS victims -- including 5 million orphans.

• Provide $10 billion to the Global Fund, a worldwide effort to treat and prevent AIDS, malaria and tuberculosis. The fund reaches many more countries than the U.S. initiative, where it's well-established and effective.

• Provide $4 billion for effective TB treatment. Tuberculosis is a primary killer of HIV-infected people. Ineffective and insufficiently funded treatment has created a man-made, drug-resistant strain of TB that requires special attention.

• Provide $5 million to continue the fight against malaria. U.S. aid has provided millions of mosquito nets.

Seven conservative senators, led by budget hawk Tom Coburn of Oklahoma, held up the bill until Wednesday. They reached a compromise with Senate leaders and the White House that would require at least half the money be spent on direct treatment of AIDS, prohibit funds from wealthier developing nations like Russia and China and require only-FDA approved drugs be used.

The conservatives still aren't happy about the price tag, and still want the chance to debate the bill and offer amendments on the floor.

President Bush and bill sponsors had hoped for final passage of the bill before the G-8 summit next week. With the $50 billion commitment, the president could encourage other wealthy nations to give more to the fight. Now it may not happen until after the Fourth of July recess.

To her credit and Alaska's, Sen. Lisa Murkowski supported the measure in the Senate Foreign Relations Committee. Sen. Ted Stevens has supported massive AIDS relief before. Alaska's senators should do so again, and urge their hard-right colleagues to remember that doing the right thing best serves America's interests.

BOTTOM LINE: The U.S. should continue its leadership in the worldwide fight against AIDS, malaria and tuberculosis.

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