Wednesday, July 16, 2008

Making Sausage

In a rare show of spine, the 110th Congress managed more than enough votes to override a presidential veto of a Medicare payment bill. The over-ride, which came as a result of dueling lobbyists actually benefited the country. From today's Washington Post:

President Bush sought to block a bill yesterday aimed at forestalling an 11 percent cut in payments to doctors taking care of Medicare patients, but Congress quickly overrode his veto.

With organized medicine and other lobbies promoting the popular measure in an election year, Republicans broke heavily from the White House. A total of 153 House Republicans voted to defy the White House, 24 more than in a June 24 vote that started the momentum toward passage of the Medicare doctors' bill yesterday. Twenty-one Senate Republicans voted for the bill this time, including four senators who had voted "nay" in the two previous Medicare votes.

The Medicare bill is the third, along with the recent farm bill and a water resources bill, to become law despite Bush's veto. Overall, Bush has vetoed 12 pieces of legislation during his presidency, including a "pocket veto" of last year's defense authorization bill.

...a 10.6 percent cut in fees for doctors was supposed to go into effect July 1, Congress overwhelmingly voted instead to reduce the reimbursement to insurance companies that serve Medicare beneficiaries under its managed-care program. Those reductions would allow the postponement of the pay cut to doctors for 18 months, but would cost the insurers $14 billion over five years.

As the article makes clear, organizations such as the AMA and AARP lobbied congress critters relentlessly to avoid the pay cut to physicians, and with good reason. For those doctors who take Medicare patients (and not all do, sadly), the cut in payments would frequently mean treating patients at a loss because of the necessary paper work and protocols connected with the program. The last thing Medicare and its beneficiaries needed was fewer doctors.

A more important aspect of the bill in my opinion was the cutting of payments to those privileged insurance companies in the "Medicare Advantage" program. As I've pointed out in the past (here and here) this program, which involves payment to private insurers in a 'managed health' system, costs Medicare more than it would cost to keep the beneficiaries in traditional Medicare, about 13 percent more.

The White House knew this and still pushed hard against the bill, essentially lying about the cost effectiveness of Medicare Advantage. What a surprise, eh?

Regardless of the pressures from lobbyists and election year politics, this time Congress managed to do the right thing, and for that I am grateful.

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Blogger Ruth said...

Hiya, Ralphie, missing the crack den aren't we? Just watched the CSpan hostess tell a caller that what he said wasn't true, Obama not a Muslim. Yay!

5:05 AM  

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