In recent years, lifesaving drugs have become an indispensable part of modern medicine. Yet, 13 million senior citizens in this country -- three out of five of our elderly population -- lack dependable drug coverage. Furthermore, millions of older Americans, the ones who need prescription drugs the most, pay the highest prices for them.

Pat Brown, a senior citizen from Johnson City, Tenn., knows firsthand just how hard life can be without insurance to help pay for prescription drugs. Pat, who suffers from five chronic illnesses, used to have drug coverage under her Medigap policy. But her premiums increased to the point that she had to buy a less expensive policy, one that did not cover her medicine. Today, Pat pays approximately $4,200 a year for her prescriptions drugs, and not surprisingly, she is worried about spending her life's savings and depleting the money she has put aside for her retirement.

Unfortunately, Pat is not alone.

The price of prescription drugs is rising 12 percent each year, more than any other segment of the health care industry. Coupled with the fact that seniors lack the collective power to negotiate discounts, our elderly citizens pay twice as much for their medicines as those in large groups that command steep discounts.

The high cost of today's prescriptions forces too many seniors to choose between paying for food and utilities, or paying for medicine. Some opt for the medically risky route of taking smaller doses of their medications than their doctors recommend -- sacrificing their health and well-being in order to make their drugs last longer. And everyday, groups of senior citizens climb aboard buses to Canada, where they can purchase their medicines at a fraction of the cost they would pay in this country.

Medicare, created 35 years ago to protect the health of Americans as they grow older, is a success story. Before Medicare, nearly half of our seniors had no health coverage at all, and families were left to bear the financial burden of caring for their loved ones.

Medicare changed all that.

In the past 35 years, though, the medical landscape has changed. Today, new medicines play an increasingly important role in providing quality health care to all our citizens, but especially to our senior citizens. Prescription drugs can accomplish what once could be done only through surgery, at less pain and lower cost. And the number of new drugs is rising every day. In 1998, pharmacists filled 2.8 billion prescriptions -- a number that is expected to grow to 4 billion in the next five years.

Despite all this, and although Medicare covers doctor and hospital benefits, we let our seniors go without the very prescription drugs that could keep them healthy. It doesn't make sense.

If we were crafting the Medicare program today, we would never consider proposing a program without a prescription drug benefit. It's time to do what we know is right.

This week, the President submitted his budget to Congress. In addition to making Medicare more efficient, competitive and fiscally sound -- extending its solvency until at least the year 2025 -- his plan creates a long-overdue, voluntary prescription drug benefit that offers high-quality medicines to senior citizens at affordable prices. Furthermore, the President's budget includes a reserve fund to protect those who are confronted with catastrophic drug costs.

Beneficiaries who opt for the prescription drug coverage would pay $26 a month in the first year, an amount that would rise to $51 a month in later years. Premiums would drop -- in some cases to zero -- for low-income recipients. There would be no deductible, and the plan would cover half of each beneficiary's drug cost, from the first prescription filled each year up to an annual limit of $5,000. Let me reiterate: Despite what some television ads would have you believe, the President's plan is entirely voluntary. No senior would be required to participate.

Medicare is truly at a crossroads. When the baby boom generation retires, it will be called on to care for twice as many Americans as it does today. Yet, this important program, which, for 35 years, has played such a vital role in preserving and improving the health of our senior citizens, will not be up to the task, unless we act now.

If we are to protect our children from shouldering the burden of caring for us as we age, we must strengthen and reform Medicare. We must make it fiscally sound, and we must offer a prescription drug benefit to those who feel they need it.

In his State of the Union speech last month, the President had this to say: "In good conscience, we cannot let another year pass without extending to all our seniors this lifeline of affordable drugs." He has taken the first step. Now, it is up to members of Congress to do their part. Pat Brown and 13 million of her fellow citizens -- this country's parents and grandparents -- are counting on it.

To find out more about Hillary Rodham Clinton and read her past columns, visit the Creators Syndicate web page at www.creators.com.

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