Senate Approves Health Care Bills

      WASHINGTON - In a flurry of last-minute health care legislating, the Senate passed a $919.5 million package intended to better prepare the nation for a possible bioterrorist attack and pave the way for placing heart defibrillators in all federal buildings.

      But the action was overshadowed by President Clinton''s vow to veto a separate Medicare bill. The $30 billion Medicare measure would boost payments to health care providers who say 1997 budget cuts went too far.

      ``You insist on an unjustifiable spending increase for HMOs,'' Clinton said Thursday in a letter to Congress.

      The House went ahead and passed the measure, 237-174. The Senate began debating the measure, part of an overall tax bill. Democrats have said they have enough votes to sustain a veto.

      Clinton complains the measure gives managed care companies too much without enough accountability. The president, hoping to deter HMOs from dropping out of Medicare, wants provisions forcing managed care companies to stay in the program - which benefits elderly and the disabled - at least three years.

      Meanwhile, a compilation of several health bills introduced this session passed the Senate without dissent Thursday. The House was scheduled to vote on the package Friday.

      ``This comprehensive legislation contains a variety of public health bills that will help to improve the health and safety of all Americans,'' said Sen. Bill Frist, R-Tenn., a physician.

      A major portion of the bill authorizes $540 million to strengthen the nation''s ability to deal with serious public health threats such as anti-microbial resistance and bioterrorist attacks.

      It provides grants to study how well public health agencies respond to disease outbreaks, coordinates efforts between federal agencies and authorizes the National Institutes of Health and Centers for Disease Control and Prevention to develop new vaccines for biological weapons.

      The heart defibrillator provision allows the Health and Human Services Department to make recommendations on placing these devices in federal buildings. It also protects from liability someone who comes to the aid of a heart attack victim.

      Among the legislation''s other provisions are measures that would:

      -Authorize $180 million to modernize laboratories at the Centers for Disease Control and Prevention and instruct the CDC to implement a prostate screening program.

      -Expand lupus and Alzheimer''s research.

      -Develop treatment for sexually transmitted diseases through research at the National Institutes of Health.

      Another House-passed bill, renewing the Older Americans Act, was sent to the president after the Senate passed it, 94-0.

      That measure renewed for another five years several programs for the elderly including training, pension counseling and the popular Meals on Wheels home-delivery service. It also creates a new program to help those who care for frail older family members.

      The Senate also sent to the president a measure to reduce needle-related injuries by requiring the use of new devices that automatically cover needle tips after an injection. The House passed it this month.

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