Lawmakers are considering the most significant changes to Medicare -- the federal health-insurance program for the elderly and disabled -- since it was established in 1965. If they reach an agreement, Medicare's 41 million beneficiaries will be able to obtain prescription-drug coverage through private health-insurance plans. Private insurers also will likely play an expanded role delivering health services to seniors. But Republicans and Democrats remain far apart. Republicans want to inject market competition into the Medicare system, convinced it is the only way to control rising program costs. Democrats want to protect Medicare's core fee-for-service program and its principle of equal benefits for all. The negotiations are shaping up to be the most significant health-policy debate in years.

Adriel Bettelheim is a reporter for Congressional Quarterly's CQ Weekly magazine, covering telecommunications, science, and technology. He has been a reporter for the Denver Post and the Syracuse Herald-Journal. He graduated from Case Western Reserve University with a bachelor's degree in chemistry.