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WASHINGTON-The time to overhaul the federal Medicare program to avoid insolvency is now, says the former Senate Majority Leader and the 1996 Republican candidate for the presidency.

"I want to fix Medicare. We want it to be there 10 and 15 years from now," said former Sen. Robert Dole, R-Kan.

Speaking earlier this month before the annual Washington meeting of the Assn. of Private Pension & Welfare Plans, a benefits lobbying group, Sen. Dole said

Medicare provisions in a tentative budget outline hammered out by congressional Republicans and Democrats do little to fundamentally reform Medicare, which is projected to go insolvent by 2001.

Referring to the budget agreement, Sen. Dole said, "I don't see much reform when it comes to Medicare."

Broad provisions in the budget pact that would slow the growth of payments to hospitals and physicians do not constitute fundamental reform of the federal program that provides health benefits to about 37 million people, Sen. Dole said.

Sen. Dole, though, did suggest several changes he thinks could help to shore up Medicare. One change, he suggested, would be to require well-to-do retirees to pay a greater share of Part B Medicare, which covers physician services.

Currently, Part B premiums paid by retirees-regardless of their incomes-cover only 25% of the program's costs.

Another Medicare reform Sen. Dole suggests would be to expand the number of health care options available to beneficiaries. About 15% of Medicare beneficiaries are enrolled in health maintenance organizations, with the remainder covered in Medicare's traditional indemnity plan.

Despite the growing crisis facing Medicare, Sen. Dole worries that the public and legislators don't seem inclined to act.

"It is shocking that no one is shocked. People don't have a sense of urgency," he said.

But Sen. Dole said congressional interest in a true Medicare fix may increase once a real budget and tax agreement is reached. Such an agreement could "clear the deck" for consideration of Medicare reform legislation.

Noting the political sensitivity of Medicare changes, Sen. Dole said one way to defuse that sensitivity would be the establishment of a bipartisan commission that would recommend changes.

The commission approach worked successfully in the early 1980s when then-President Reagan set up a blue-ribbon panel to suggest ways to shore up Social Security, which then faced a short-term financial crisis. Congress later adopted many of the panel's recommended reforms. Sen. Dole was a member of that commission.

Sen. Dole warned his employer audience that business has a vital stake in keeping Medicare solvent. Reform proposals, Sen. Dole said, "could pick the pockets of business."