WASHINGTON – There was a little something for everyone – patients, pharmacists, even providers of wheelchairs and oxygen machines – in Congress' legislation to overturn a Medicare cut for doctors. And with those sweeteners, the ranks of Republicans willing to break with the president began to grow.

Both houses overrode President Bush's veto of the bill this week with strong bipartisan majorities – bigger even than when the legislation was first passed.

Health and Human Services Secretary Mike Leavitt described it this way: “Congress has once again given in to special interests.”

The bill's architect, Sen. Max Baucus, D-Mont., said the sweeteners weren't designed to attract support. Rather, he said, they addressed complaints that providers and patients had been talking to him about for months. Complaints by pharmacists that they weren't getting paid by private insurance plans on time and from seniors facing large co-payment demands for their mental health treatments.

So what did he do?

He put in the bill a requirement that pharmacists be paid within 14 days of submitting an electronic billing and a provision that lowered mental health copays to 20 percent instead of 50 percent.

“I didn't go out and say, 'What do you want? What do you want?' I didn't do that all,” Baucus said. “I just said, 'OK, here's the Medicare bill. What can we put into it that includes good policy that this country needs.'”

In the end, he said, good policy turned out to be good politics.

In addressing the pharmacists' wants, Baucus put into play a network touching every congressional district in the country. Members of the National Community Pharmacists Association wrote nearly 1,000 letters to the editors of their local newspapers during the July Fourth recess and met, called or wrote members of Congress some 25,000 times.

The legislation will reverse a cut in reimbursement rates for doctors. It will pay for that largely by spending less on private Medicare Advantage plans, which are run by health insurers and serve about 9.5 million people.

The insurance companies opposed the bill. But there was a long list of organizations lining up against them, including AARP, the National Council on Aging, the American Heart Association and the American Hospital Association.

“I understand when we have 50 groups supporting our bill and you only have one ... it gets a little annoying,” said Rep. Pete Stark, D-Calif., during the House debate. “But we will see if we can find one other group to support your bill. I doubt it, but we will try.”

Stark was being typically sarcastic. But he had a point when it came to the strategy supporters used to generate momentum for the Medicare legislation. Not only did lawmakers hear from doctors when they went back home, they heard from just about every type of health care provider in their communities as well as patient groups.

“I think it was central to passing a bill at veto-proof levels,” said Sen. Gordon Smith, R-Ore. “If the bill were just about providers and left behind beneficiaries, then you only have half a package.”

Rep. Frank Pallone, D-N.J., helped fashion the bill on the House side.

“Many organizations pointed out problems they were having with their Medicare reimbursements,” Pallone said. “We were certainly trying to accommodate a lot of concerns in addition to the doctors, and it was a big factor in its passing.”

No Democrats voted against the bill. And over the past few weeks, the bill attracted more Republican support.

Sen. Kit Bond, R-Mo., was one four senators who voted against proceeding to the bill last week but ended up supporting the veto override on Tuesday.

His spokeswoman, Shana Marchio, said the senator always had opposed the cuts in Medicare payments to doctors and he supported protections put into the bill for low-income patients, pharmacists and others. He had voted against proceeding to the bill because Democrats blocked all attempts to amend and improve it, she said.

“Most importantly, Senator Bond wanted a bipartisan compromise which would have avoided a presidential veto, which ultimately delayed protections for providers and patients,” Marchio said.

Others Republican senators who voted against limiting debate but in favor of the override were Richard Lugar of Indiana and Thad Cochran and Roger Wicker of Mississippi.

In the House, about two dozen Republicans voted against the bill in June but ended up voting for the override. Rep. John Shaddegg. R-Ariz., said he voted against the bill because he wanted a solution before July 1 and he wanted to give Republican colleagues in the Senate some negotiating leverage.

“It seemed to me not to make any sense to vote against it again. There are lots of things I don't like, but there are lots of things in lots of bills you don't like,” Shaddegg said. “If you can improve them, you do. And if you can't, you have to make a call. In this case, I made the call that it was better to give the docs a fix than to stand in the way.”