SUSAN DENTZER: A recent fall festival and parade in rural Leslie, Michigan, drew local marching bands, fire-fighting brigades and political candidates hoping to curry favor with voters in advance of the November elections.
MIKE ROGERS: Mike Rogers, nice to see you, how are you?
SUSAN DENTZER: In fact, all across Michigan, a key battleground state, there is a political parade afoot. It's the string of candidates talking about perhaps the hottest issue in scores of this year's races: Paying for prescription drugs for the nation's senior citizens.
DIANNE BYRUM: I believe we need to have a plan under Medicare -- that's voluntary -- so people like you who have that benefit aren't forced into a plan they don't need but is still available to all seniors.
SUSAN DENTZER: Democratic state senator Dianne Byrum has made prescription drug coverage a main element of her campaign. She's in a dead heat in the race for Michigan's 8th Congressional District, where she's battling another state senator, Republican Mike Rogers.
MIKE ROGERS: I don't think the federal government ought to run prescription coverage in a one-size-fits-all, kind of big government program. I think that is dangerous.
SUSAN DENTZER: The Byrum-Rogers contest is one of the congressional races that could determine which party controls the House of Representatives. Then there's the state's closely watched Senate race, where Republican Senator Spencer Abraham is in the lead.
SPENCER ABRAHAM: What we want to make sure is that seniors who right now can't afford insurance have in effect the protections that they could get if they were able to afford it.
SUSAN DENTZER: Abraham hopes to fend off a challenge from the Democrat who currently occupies the 8th district seat, Debbie Stabenow.
DEBBIE STABENOW: Next year if I am in the Senate, I will be replacing someone who has voted five times against Medicare coverage for prescription drugs, five times.
SUSAN DENTZER: Al Gore and George W. Bush are dueling over prescription drug coverage as they wrestle for Michigan's 18 crucial electoral votes. They clashed over the subject in this week's debate.
GOV. BUSH: I want all seniors to have prescription drugs in Medicare. We want to reform Medicare.
VICE PRESIDENT GORE: I believe that all seniors should be able to choose their own doctors and get prescription drugs from their own pharmacists with Medicare paying half the bill.
JIM LEHRER: As a practical matter, both of you want to bring prescription drugs to seniors. Correct?
GOV. BUSH: Correct.
VICE PRESIDENT GORE: Correct. But the difference is I want to bring it to 100 percent and he brings it only to 5 percent.
JIM LEHRER: All right. All right
GOV. BUSH: That's just totally false. That's just totally false.
SUSAN DENTZER: Medicare doesn't pay for most prescription drugs for patients who aren't in hospitals. As a result, fewer than six out of 10 beneficiaries have drug coverage for an entire year. That leaves many seniors struggling to afford their drugs. Sometimes they skip pills or avoid filling their prescriptions altogether. The problem has been growing for years, as drugs become an increasingly important weapon in battling disease. The issue has taken the campaign trail by storm.
ED SARPOLUS: I can't think of anybody that's not talking about this issue, from the barber shop, to the bowling lanes, to a VFW hall.
SUSAN DENTZER: Ed Sarpolus, a Michigan pollster, calls prescription drugs a "flag" issue that signals that a politician cares about issues dear to voters' hearts -- like health care.
ED SARPOLUS: The number one issue in Michigan or in the swing states is health care by over 30 percent. And all the swing voters, be it, be a woman, a union worker, a Catholic, they also list that as their number one issue. And also we got -- we can't forget that, that the plurality of voters are going to be retired or almost-retired people there, so this issue of prescription drugs is very important to them.
SUSAN DENTZER: A case in point is 60-year-old Wanda Tyler, a retired medical billing clerk whom we spoke to at John's Coney Island Restaurant in Flint. She told candidate Dianne Byrum that she has prescription drug coverage now. But she worries that she will lose it next year, when she can no longer buy it through her former employer's policy.
WANDA TYLER: My concern was that for the people -- not just myself, but for the people -- that are going to be in my situation when we reach 62 or 65, whatever. Then at least prescription drug coverage would be available in some form, whether we pay for it ourselves, or whether it's done through the government or however they can do with it.
SUSAN DENTZER: But at the Marsh Pointe senior citizen residence in Haslett, 86-year-old Donna McCrum was skeptical about the candidates' pledges.
DONNA McCRUM: They tell a good story but it's just for votes as far as I'm concerned. Anytime anybody wants to get the government's foot on something it costs us money. It isn't free like it sounds.
SUSAN DENTZER: Politicians are floating three basic approaches for providing drug coverage to seniors. One, pushed by Vice President Gore and many other Democrats, is to add a prescription drug benefit to the existing Medicare program.
DEBBIE STABENOW: We're saying just update Medicare. Add an optional - let me make that clear -- voluntary, your choice, Part C under Medicare. If you don't have insurance, for about $25 a month in a premium you would be able to get coverage from your first prescription.
SUSAN DENTZER: Another approach, adopted by House Republicans earlier this year, would pay government subsidies to private insurance companies to provide new drug coverage policies to seniors.
And a third approach, endorsed by George W. Bush, would restructure Medicare completely. Beneficiaries would then choose from an array of private health plans, as well as a new version of the Medicare program offering drug benefits. But revamping Medicare this way would take time. So Bush would start by giving money to states so they could help the neediest low-income seniors buy prescription drugs.
MIKE ROGERS: The beauty of that plan is if we can get an agreement from the federal government to send that money to the states, we can implement that today, right now.
SUSAN DENTZER: A new national poll by the NewsHour, the Kaiser Family Foundation and the Harvard School of Public Health asked whether respondents favored expanding Medicare or obtaining drug benefits through private insurers.
Those surveyed preferred expanding Medicare -- the approach favored by many Democrats -- by almost a two-to-one margin. The poll also asked whether respondents favored a plan that would help all seniors pay drug costs or another approach that would target just low-income seniors for assistance, as Bush would do initially. Almost half favored helping all seniors, while 38 percent favored the targeted approach.
Pollster Sarpolus says that's bad news for Republicans.
ED SARPOLUS: Republicans know they can't win on the issue, so they have to pose a question of doubt in the solution the Democrats are posing.
SUSAN DENTZER: And that's why in Michigan in particular Republican candidates and their backers are bombarding the airwaves with commercials attacking the Democratic approach. This commercial for Abraham zeroes in on the premiums beneficiaries would have to pay, which are projected to rise to $600 a year, but not until 2009.
ABRAHAM AD SPOKESMAN: Compare the prescription drug plans. Debbie Stabenow charges seniors a big new government fee, $600 a year. Spencer Abraham's plan has no big fee. Debbie Stabenow -- a $600 fee, thousands a year in drug costs -- a prescription for disaster.
SUSAN DENTZER: In response, commercials for Stabenow have taken aim at the financial support Abraham's campaign has drawn.
STABENOW AD SPOKESMAN: Spencer Abraham has received over $300,000 from the insurance and pharmaceutical industries. No wonder Abraham's prescription plan subsidizes private insurance companies with taxpayer's dollars.
SUSAN DENTZER: The candidates aren't alone in airing commercials on the issue. So are state parties, and outside interest groups, such as the AFL-CIO and Citizens for Better Medicare, a group backed by pharmaceutical companies. Sarpolus says Senator Abraham has outspent his opponent three to one in political advertising. His polls show that's worked to siphon support from Stabenow and left 24 percent of voters undecided.
ED SARPOLUS: Abraham can be said to have used the drug issue effectively because he's confused it in Michigan. If you look at the lead he has over Debbie Stabenow, you would say that he's effectively neutralized the issue.
SUSAN DENTZER: And indeed, many Michigan voters we spoke to confessed to being thoroughly confused about the candidates' plans. Among them were these members of the local Lions Club who were watching the parade in Leslie.
PAT FOGG: When you see a commercial for Spencer Abraham, what he says about Debbie Stabenow, you don't know if it's true.
SHARON FAUSER: One guy will tell you this and then like Abraham will tell you this, and Stabenow tells you the opposite. It's like, wait a minute, and where do you go now?
SUSAN DENTZER: Back at the Marsh Pointe seniors' residence, the issue prompted a lively discussion. John Bolhouse, 83, said he didn't think either Bush or Gore would follow through on proposals for prescription drug coverage.
JOHN BOLHOUSE: I don't like either one of them. I don't trust them either. I really don't trust them.
SUSAN DENTZER: Esme Beals, who's 76, spends at least $250 a month out of pocket for prescription drugs. That's for 10 medications to treat conditions ranging from diabetes to heart disease to arthritis.
ESME BEALS: I'm a registered Republican and I still think the Democrats are better off this time than the Republicans' platform.
SUSAN DENTZER: Genevieve Brozo, who's 83, has an income below $8,000 a year. She told us even her Medicaid coverage won't pay for some of the drugs she needs, and she wants action.
GENEVIEVE BROZO: Why don't they have a good health system where everybody can get their health? You know, especially people that have worked all their lives and have very little retirement money. Why can't they be entitled to prescriptions, you know, with a very small pay or health insurance where everybody is taken care of?
SUSAN DENTZER: Sarpolus' latest pre-debate poll shows Al Gore ahead of George Bush in the state, 45 percent to 39 percent. In the 8th Congressional District, meanwhile, Democrat Byrum's support among voters is at 40 percent while Republican Rogers is at 42 percent. In races this tight, how votes like Brozo feel about the candidates' stances on prescription drugs could prove decisive.
GENEVIEVE BROZO: I think we ought to get a group of honest people that would be sincere, you know, and work this thing out and maybe we could have something.
SUSAN DENTZER: And that something -- prescription drug benefit for seniors -- now seems destined to be a major item on the next president's agenda.