Threatening to veto any changes to the Medicare prescription drug benefit law, President George W. Bush implies that the law can't be improved.

That's an odd notion, given that:

Congress narrowly passed the bill in the early morning hours of Nov. 22, 2003 and only after serious arm twisting and favor trading.

Soon after passage, critics noted the highly confusing rules and regulations contained in the bill's 681 pages.

The latest 10-year cost estimates for the drug benefit program are $712 billion, while the cost estimate little more than a year ago was $400 billion. Less than two months after Congress passed the bill, the White House upped the cost estimate to $534 billion from $400 billion, but many observers believe the true 10-year cost might be closer to $1.1 trillion.

The bill specifically prohibits price negotiation by Medicare, the very technique that allows other countries (notably Canada) to offer prescription drugs at prices well below those charged to Americans.

While threatening to veto any changes to the law, Bush is suggesting that he is looking out for the best interests of senior citizens. But some of the provisions in the law make it appear that he looking out, instead, for the best interests of big pharmaceutical companies. Why else would he defend a law that does not allow Medicare to negotiate bulk buying discounts for drugs as Canada and even the U.S. Veterans Administration do?

In recent weeks, lawmakers from both parties have begun talking about modifying the law, officially known as the Prescription Drug Improvement and Modernization Act of 2003, before it takes full effect next January. Some fiscally conservative Republican lawmakers want to revisit the law because of the $750 billion 10-year price tag revealed in Bush's latest budget plan, a price nearly double the $400 billion proposed a year earlier. Other lawmakers want to press for reforms that would permit Medicare to negotiate lower prices, and to permit importation of cheaper drugs from Canada - both changes that the Bush administration opposes.

In his threat last week to veto any changes, Bush described the law as "a landmark achievement in American health care." That's clearly overstating the law's significance.

There might be value in encouraging market competition by involving private health insurance companies. And other features of the law might be worth retaining - or even expanding, but surely it can be improved for seniors.

Letting Medicare negotiate lower drug prices through its massive buying power would be a good place to start.

The U.S. pharmaceutical industry is represented by an army of lobbyists in Washington, D.C., and because of that, any efforts to produce lower drug prices will be fought. As they come down on one side of this debate or the other, elected officials will reveal their true allegiances.