For Senate majority leader Tom Daschle the man with the toughest job on Capitol Hill this week's defeat of a plan to help seniors pay for prescription drugs was a bitter pill.
If the vote stands, it will mean Democrats have failed to deliver on their signature issue in an election year, again. House Republicans passed a prescription-drug plan last month; after the final Senate vote Wednesday, they were blasting Mr. Daschle for "yet another un-accomplishment."
It's also a personal hit on a leader whose defining quality is an ability to get members of a very diverse Democratic caucus to agree or even to agree to disagree, but to not air their differences in public. Daschle succeeded in rapidly moving important legislation through the Senate after 9/11, including appropriations for homeland defense and the USA Patriot Act. He also got through a farm bill, a tough law on corporate accountability, and new trade authority for the president.
But partisan divisions still run deep in the Senate. The gridlock on prescription drugs is emblematic of the difficulties Daschle faces there difficulties sharpened, some say, by his own strategic errors in pushing bills out of committee and onto the Senate floor.
"From the very beginning it's been hard to reach a consensus [on prescription drugs]," Daschle said Wednesday. "My hope was that if we pressed this issue on the floor, ultimately people would say, 'Look, it might not be not exactly what we wanted but it's better than nothing.' "
But on issues as fraught as healthcare, it takes more than holding Democrats in line to pass legislation: Overcoming a filibuster takes 60 votes. For Daschle, that means finding support across the aisle without losing hard-core Democrats.
In an election year, when failure to legislate can be grist for fundraisers and damning 10-second campaign spots, that calculus is even more complex. But if voters come to resent both parties for failure to act, the blame could fall on incumbents.
"Our seniors back home don't understand all this haggling back and forth that we've been doing now for two weeks," Sen. Zell Miller (D) of Georgia said after the final vote on prescription drugs. "If that's all we have to show for ourselves come November, I guarantee you both parties will pay a steep price at the polls."
US healthcare costs have risen steeply since Medicare was established in 1965. From 1960 to 2000, personal health care spending increased from $23.4 billion to $1.1 trillion; it is expected to pass $2.4 trillion by 2011, according to the US Health Care Financing Administration. Outside hospitals, Medicare does not cover the cost of prescription drugs, which have become a much more significant part of medical treatment than in the 1960s.
In early debates in the 1960s, Republicans strongly opposed making health care a public entitlement. Democrats recall Ronald Reagan warning that if Medicare passed, Americans would "spend their sunset years telling our children and children's children what it was like in American when men were free."
That ideological divide still defines the debate over prescription drugs. Republicans want to rely on private insurers to design and administer a Medicare drug benefit, while Democrats want to make payment for prescription drugs a part of the current Medicare system.
The decisive moment in the current fight came when Daschle pulled the bill out of the Finance Committee, where a compromise plan was taking shape, and threw it on to the floor of the Senate. It's a tactic he has used before on big issues, when it looked as if the plan emerging from committee would not be acceptable to the whole Democratic caucus.
Once, in the final hours of Republican control of the Senate, Daschle watched a $2.3 trillion tax cut he bitterly opposed pass with 12 Democratic votes the result of a compromise worked out in the Finance Committee between then-Chairman Charles Grassley (R) of Iowa and ranking Democrat Max Baucus (D) of Montana.
As minority leader, there was little Daschle could do but rail from the floor. But as majority leader, he can determine what bills come to the floor and when. It's a power he has used to full effect.
Now chairman of the Senate Finance Committee, Senator Baucus has seen several key bills pulled out before a compromise could be reached. A fourth-term senator, Baucus faces a tight race this year. Since only 1 in 3 Montana voters backed a Democrat in the last presidential election, some Democrats worry Baucus may bend under pressure to lean toward the GOP.
But Republicans insist they were close to a compromise that could have passed the House. "The Senate majority leader has made himself chairman of every committee. If Senator Baucus had had the freedom to work out a compromise, we would have had a bill today," Mr. Grassley says.
Larry Sabato, a political scientist at the University of Virginia, is similarly critical. "Daschle had reason to believe that whatever came from the Finance Committee would be closer to a Republican than to a Democratic position, and he wanted to start from a position of strength," he says, "But it was possible to come up with a compromise on prescription drugs.
"What we don't know is whether it was a strategic error or intention that the Senate did not," he adds.