The debate in Congress over various proposals for a Medicare prescription drug benefit is heating up. But between election-year time pressures, competing Congressional business (including homeland security), and ever-mounting fiscal problems mainly attributable to last year's big tax cut, it's unclear whether a bill will reach the President's desk this year.

Even before this Congressional session began, North Carolina's New Democrat Governor Mike Easley decided his state would move on its own to begin addressing the problem. "We have waited on Washington long enough. North Carolina is ready to move forward to assist seniors with the rising cost of prescription drugs."

Obviously, North Carolina does not have the resources to provide universal prescription drug benefits for all of its seniors. That's why federal action remains critical.

But Easley designed a plan for his state that intelligently uses limited dollars to deal with the most acute problem: low-income seniors who need prescription drugs to treat serious, chronic diseases.

Tapping the state's Health and Wellness Trust Fund, whose commission (chaired by Lt. Gov. Beverly Eaves Perdue) has approved $35 million for this purpose, North Carolina will, beginning this summer, cover medications used to treat three diseases -- cardiovascular disease, diabetes mellitus, and chronic obstructive pulmonary disease -- for all seniors with an income of up to 200 percent of the Federal Poverty Level. The benefit will cover 60 percent of drug costs up to a "cap" of $1,000 per year.

North Carolina estimates that 71 percent of its seniors have one of these three diseases. Roughly 100,000 residents of the state will benefit from the plan's coverage.

But just as importantly, the plan also includes an aggressive program of patient, physician/nurse and pharmacist education to integrate the new drug benefits into a broader system of disease management -- a rapidly-spreading movement in the health care field that encourages health care professionals to enable patients to follow treatment plans and care for themselves, improving their overall health while also lowering emergency room visits, hospitalizations, and nursing home enrollments.

Easley's prescription drug plan is interesting not only because it represents a state-level initiative to extend drug coverage to seniors, but also because it provides a very timely reminder that prescription drugs are simply a means to an end -- better health and better management of chronic diseases.

As President Clinton often said in promoting a Medicare prescription drug benefit, no one would today design a comprehensive health insurance program for seniors without drug coverage, because drugs have become radically more important in medical treatment over the nearly four decades since Medicare's enactment. Sometimes the debate over prescription drugs sounds like little more than an effort to help seniors pay for an especially important and ever-more-costly living expense. The more important point is to move Medicare -- and indeed, our overall health care system -- towards a focus on quality services and actual health outcomes, for seniors and for all Americans.

Gov. Easley's plan is a valuable step in the right direction towards affordable and quality health care, and better health outcomes, for North Carolinians.