If Congress and the Centers for Medicare and Medicaid Services agreed today on a plan to cure glaring problems with Medicare HMOs, it could take several years to implement all of the remedies, according to U.S. Rep. Phil English and Tom Scully, head of the federal agency.

"Medicare has a lot of structural problems," Scully said at a public forum Friday at UPMC WomanCare Center in Hermitage. "It is a multi-hundred billion dollar problem."

The cost of health care will increase about 11 percent this year, while reimbursements for Medicare+Choice programs will go up only 2 percent, Scully said.

"We are not going to be able to solve all of our problems today or immediately. But relief is on the way," said English, who organized the event.

The health programs run by the Centers of Medicare and Medicaid Services, within the U.S. Department of Health and Human Services, benefit about 75 million Americans. The agency provides reimbursements to insurers offering Medicare HMOs in the Medicare+Choice program.

For more than two years, insurers doing Medicare business in Mercer and Crawford counties have received lower reimbursement rates because the federal agency said the counties are rural.

As a result, seniors in Mercer County pay up to eight times more in monthly premiums than those in neighboring Lawrence County and other "metropolitian" counties in the Pittsburgh area.

English asked those attending the public forum -- about 200 people, most of them seniors -- to share their personal stories with Scully so he could take them back to Washington to strengthen an argument for more federal support. President Bush has proposed $190 billion for Medicare reform, mostly for expanded prescription drug coverage, Scully said.

"I have to stretch my medicine. I'm not taking what I should," one woman said. "Seniors should not have to pay property taxes. They've already put children through school. Then they could afford their medicine."

Clyde Anderson, 46, of Greenville said his medications cost about $800 a month, but his plan covers only $125 every three months.

"If these problems are not rectified, I will begin a one-man crusade," a man said.

"Join the crusade," English said.