My vote on the Medicare prescription drug bill was one of the toughest votes I have cast since becoming a Senator in 2001.

Since entering the Senate, I have sponsored and co-sponsored bills that would provide a comprehensive prescription drug benefit in Medicare and lower prices for all Americans. These are the goals that I have fought for and have spoken out for on the Senate floor time and time again.

The bill that the Senate passed only accomplishes some of my goals and the goals of my Democratic colleagues. It has its strengths and weaknesses. It is a step in the right direction, but only a beginning step.

On a positive note, this bill establishes an outpatient prescription drug benefit for all seniors for the first time since the entire program was created in 1965.

Unfortunately, the benefit is confusing and will vary depending upon decisions made by insurance companies, but at least this bill establishes for the first time that there should be a benefit.

Some other positive features of the Senate bill:

• It provides a benefit for low-income seniors who make less than 160 percent of poverty.

• It provides a catastrophic benefit for seniors who have extraordinary prescription drug bills each year.

• It improves payments for Medicare providers, specifically increased payments for rural providers such as hospitals, ambulance services and home health agencies.

The bill also makes great strides in helping to lower prescription drug prices for all Americans. For the first time, we have closed loopholes in our drug laws that have allowed brand-name drug makers to keep lower-cost generic drugs off the market. This bill will mean that there will be more competition among similar drugs and thus lower prices for families.

It also includes a provision that I have long championed that will allow pharmacies and families to purchase lower-priced prescription drugs from Canada.

Unfortunately, this bill has serious drawbacks as well. The Republican Congress, along with the president, was unwilling to allocate enough funding to provide a comprehensive benefit to most of our middle-class seniors.

They arbitrarily picked a figure of $400 billion in total spending for 10 years, even though we know that it would take twice that amount to provide American seniors with the same kind of prescription drug coverage that we in Congress enjoy. Why was that decision made? I have always said this is a question of values and priorities.

Which is more important — more effective — in putting money in people’s pockets and improving the quality of life for all Americans: Another trillion-dollar tax cut for the privileged few, or a meaningful prescription drug benefit that will help our seniors afford life-saving medicine?

The answer to that question, I believe, is clear. Unfortunately, misplaced priorities have resulted in a prescription drug plan that is much less than older Americans need and deserve.

There are many shortcomings in this plan that I will continue to do everything in my power to correct.

Among the flaws:

• The drug benefit stops when a senior’s drug expenditures are from $4,500 to $5,800.

• The co-payments, deductibles and premiums are too high and too unpredictable. The $35 premium often quoted is not even guaranteed in the bill.

• And there are not enough incentives in the plan to make sure that employers do not drop existing prescription drug coverage for their retirees.

Beyond these problems, one of the most negative parts of this bill is the fact that it does not allow seniors to get their prescription drugs through the traditional Medicare system as their first choice. Under the bill passed by the Senate, seniors must pick a private prescription drug plan or enroll in a private PPO or HMO if one is available to them.

I believe that seniors should have many choices, including the choice to stay in the Medicare program they know and trust.

We know that when given a choice between a Medicare HMO and traditional Medicare, 89 percent of our seniors and persons with disabilities have chosen traditional Medicare. This choice is not available to them under this bill, and I believe this major flaw must be corrected.

During the debate, my Democratic colleagues and I sponsored amendments that would have corrected all of these problems. Regrettably, none of them received the necessary support from our Republican colleagues to pass.

When deciding how I would cast my vote on this bill, I looked at all of these things — the positive and the negative.

I evaluated whether this was a step forward for Michigan families, for Michigan workers, for Michigan businesses and, most importantly, for our seniors, who have waited too long for help to pay for their medicine.

After many hours of review and discussions with those affected, I voted in favor of this bill, not because it was the best we can do, but because it is a first step in the right direction.

And as we know, this legislation is not finished. It must now go to a conference committee where differences between the Senate and the House bills will be addressed. There are critical differences between the two bills. The House passed — by one vote — a bill that I believe truly begins to unravel Medicare and set it on the road to privatization.

If I had been in the House, I would have voted no. If the House bill comes before the Senate as it is currently written, I will vote no.

Our seniors deserve a final bill that offers choices while strengthening traditional Medicare for the future. I will continue to work with my colleagues to try to achieve that goal now and in the future.

Sen. Debbie Stabenow (D-Mich.) is a member of the Special Aging Committee.