Republicans continue

Even Medicaid, the federal health program for the poor, appears to employ better negotiators than the private Medicare plans. On Jan. 1, 6 million elderly and disabled people were switched from Medicaid pharmacy plans to the new Medicare program.

Overnight, many drugmakers began selling the same drugs at higher prices. Pfizer, for example, reported saving $325 million in Medicaid discounts during the first six months of this year "due primarily to the impact of" the Medicare drug benefit, according to a company report to the Securities and Exchange Commission.

"At some point, someone has to stand up to these industries that are doing so well in this program," said Robert M. Hayes, president of the Medicare Rights Center, a New York advocacy group. "It only makes sense that if the industries do less well, the taxpayers and the consumers will do better."

John C. Rother, policy director for AARP, the powerful lobby for elderly Americans, said he has no doubt that the next Congress (with the Democrats) will give government some role in negotiating Medicare drug prices. "This is an idea that's favored by 90 percent of the American public," Rother said. "It's not like you have to convince the American public that this is a good idea."

Already, the Republicans are gearing up to fight the idea of negotiating medicare drug prices.