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 gvmaz@verizon.net.