S.C. senators today can help make our state one of the first to do something about the plight facing seniors who need prescriptions to preserve their quality of life. Senators can pass, unamended, a bill that would allow the state to buy prescription drugs in bulk and sell them to older South Carolinians at cost.

That would send the bill, H. 3856, directly to the desk of Gov. Mark Sanford. If he signs it, our state's elected leaders could take credit for relieving the angst that hundreds of thousands of South Carolinians - even those who have retired at the middle-class level - routinely feel in paying for their medications.

The cause of the angst is the shifting focus of seniors' health care. When Congress created Medicare in 1966, seniors most needed help meeting hospital and doctor costs. That need has diminished with the advent of "miracle" medications that stave off debilitating medical conditions and manage their symptoms on an outpatient basis.

But Medicare doesn't pay prescription costs. And many seniors can't find - or can't afford - Part B Medicare supplemental health policies that cover prescription costs. As a result, they face huge, monthly, out-of-pocket prescription costs that bleed away their retirement savings.

Some may extend their medications by taking partial doses. Others skimp on food and utilities to pay for their prescriptions.

H. 3856, which Rep. Alan Clemmons, R-Myrtle Beach, sponsored and guided through the S.C. House, would create the S.C. Retirees and Individuals Pooling Together for Savings program. SCRIPTS would be open to all S.C. residents 65 or older without regard for income.

The S.C. Department of Health and Human Services would oversee the program, charging members a fee large enough to cover administrative costs. As the bill's supporters in the S.C. Silver Haired Legislature and other senior lobbying groups envision SCRIPTS, the department would market the drugs to members through participating pharmacies.

But H. 3856 has to become law before HHS can use S.C. seniors' pooled market leverage to ratchet down drug costs. The hope must be that S.C. senators take that next-to-last step today, and that Sanford will sign it soon after.

Medicare blues

Medicare is a fee-for-service health plan, created in 1966, that Americans can join six months before they turn 65. It pays set reimbursements for specified hospital and doctor procedures. The source of the payments is a trust fund fueled with workers' payroll taxes. Because workers are supporting a burgeoning senior Medicare population, the trust fund faces shortfalls. Congress has dealt with this problem by holding down reimbursements relative to medical and monetary inflation.

Seniors can close the gap between doctor and hospital costs and Medicare reimbursements with so-called Part B private insurance plans, some of which offer prescription coverage in return for co-pays. But the premiums for many such Part B plans are prohibitive. And other "Medigap" health plans don't offer prescription coverage.

President Bush has proposed a Medicare prescription plan that would require participants to leave the traditional fee-for-service program and submit to managed-care cost containment. It is pending before Congress.