WASHINGTON - The murky status of a deal cut last week to exempt biotechnology products from a Medicare rebate mirrors the overall status of health care reform.

While the Washington rumor mill is grinding over time, predicting dozens of scenarios from the death of health care reform in the current legislative session to a renaissance of the single payer plan, a thousand small battles over details in various bills are being waged.

One skirmish involves the biotech exemption. The obstacles its backers are facing, problems caused by hastily written legislative language drafted by inexperienced staffers, road blocks from powerful, recalcitrant lawmakers, and delays in scoring by the Congressional Budget Office, are a microcosm of the overall struggle as Congress seeks to compress the revision of nearly a year's work into a couple of weeks.

Declared victory

A group of House Democrats, including Lynn Schenk and Anna Eshoo of California and Joe Kennedy of Massachusetts, emerged from a meeting with Majority Leader Richard Gephardt last week declaring a major victory for the biotech industry (see BioCentury Extra, Thursday Aug. 11). They announced that the Missouri Democrat had agreed to exempt biotech products, present and future, from a 15 percent rebate that would be imposed on Medicare drugs administered "incident to" a physician's services under the original Gephardt health