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Health Last Updated: Jul 18th, 2008 - 00:55:07

Bush Medicare veto gets a final trouncing by Congress!
By Jerry Mazza
Online Journal Associate Editor

Jul 18, 2008, 00:28

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Tuesday Congress showed some bipartisan backbone, once more overriding George Bush�s veto of a bill to prevent cutting doctors� Medicare fees by 10 percent, which would seriously impact on the health care of millions of beneficiaries. Phyician fee cuts would also inspire Medicare insurance HMOs to follow suit and reduce co-pay coverage.

The final vote was far more than the two-thirds majority needed to override Bush�s veto of HR 6331. It was 383 yeas, 41 nays, NV (Not voting) 11, a rousing trouncing of executive domination. It was a welcome flexing of Congress�s power to come to the aid of health for seniors, the poor, and veterans. In fact, it provided for a 1.1 percent increase in doctor fees.

Moreover Congress� bill will remove many of the subsidies for Medicare Advantage, a privatized form of Medicare enacted in 1997, purportedly to reduce costs and improve care through better management. Where have I heard that song before? Long before, when I still had private insurance through my employers that began to get sliced and diced by HMOs.

Specifically, Medicare Advantage popped up with the 1997 Balanced Budget Act, which invited more loosely managed private plans to join the pork party. It increased payments to draw in more private plans. Greedy companies rushed to profit but found they couldn�t gouge under tight restrictions on cost increase. So many plans dropped out, which caused major disruptions for more than 2 million beneficiaries.

That led the way for the so-called Medicare Modernization Act, which took another stab (deeply) at Medicare with private Advantage plans to coax beneficiaries to come back in. Today, Medicare now shells out on average 13 percent more for Advantage plans than for the identical services via traditional Medicare. The handouts to insurance companies have sparked explosive growth ironically in the least-efficient plans, fee-for-service plans, which do little or nothing to incur their 17 percent overpayment.

Medicare Advantage plans not only are not cutting costs or improving services, instead we are paying more for them than traditional Medicare, which is delivering less-expensive, more effective and efficient care. The only explanation as a July 14 New York Times� editorial noted is the �Republicans� ideological compulsion to provide a private option.�

The Democrats in Congress, and the Republicans with guts enough to join them for once deserve a pat on the back for cutting part of the subsidy to private insurers and preventing the cuts to doctors� fees.

It�s a first step towards fixing Medicare�s over-stated fiscal problems, which could be rectified easily with raising income caps on Social Security taxes that go towards paying for future Medicare and Medicaid recipients. This would easily bring in the funds to meet the costs of future generations. The superrich just have to get over their phobia about paying taxes according to their means. After all, it this very economic system, including progressive not regressive taxation, that has provided the matrix of their wealth.

Jerry Mazza is a freelance writer living in New York. Reach him at

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