|
|
--------------------------------------------------------------------------------------------------------
Medicare fees to doctors to fall
starting Tuesday
6/30/2008
One unpleasant task lawmakers will have over the July 4 recess is
explaining to seniors why they didn't stop a 10 percent fee cut, going
into effect Tuesday, for doctors who treat Medicare patients.
Physicians have been running ads hinting that patients may find doctors
less willing to treat them.
In a particularly vitriolic exchange, Democrats and Republicans blamed
each other for what Dr. Nancy H. Nielsen, president of the American
Medical Association, said has put the country "at the brink of a
Medicare meltdown."
"Seniors need continued access to the doctors they trust. It's urgent
that Congress make that happen," the AMA said in ads taken out in
Capitol Hill newspapers read by members of Congress and their aides.
One near-certainty was that lawmakers, not willing to face millions of
angry seniors at the polls in November, will act quickly when they
return to Washington the week of July 7 to reverse the fee cut and
provide retroactive payments to doctors for losses they incur after July
1.
Just two years ago, after a cut had taken effect, Congress froze
payments retroactively at the previous year's levels. In 2002 doctors
had to live with a 5.4 percent cut.
The likelihood of retroactive relief didn't deter dire predictions last
Thursday after the Senate fell just one vote short of the 60 needed to
proceed to legislation that would have stopped the fee cut.
Doctors have complained for years that Medicare payments have failed to
cover rising costs. "Many more physicians will reluctantly retire early
or reduce clinical practice time. This hurts access to fragile senior
populations," said Dr. Jack Lewin, chief executive officer of the
American College of Cardiology.
Beginning Tuesday, payments will be cut for some 600,000 doctors who
treat Medicare patients because of a formula that requires fee cuts when
spending exceeds established goals. Almost every year, Congress finds a
way to block the cuts.
This year majority Democrats homed in on cutting the Medicare Advantage
program, which is an ideological issue for both parties. The Bush
administration and Republicans like Medicare Advantage because it lets
the elderly and disabled choose to get their health benefits through
private insurers rather than through traditional Medicare. Democrats
argued that government payments to the insurers are too generous.
The White House warned that President Bush would be urged to veto a bill
that contained cuts to Medicare Advantage. "The bill would fundamentally
change the private fee-for-service program and consequently reduce
access, benefits and choices for many of the approximately 2.25 million
beneficiaries" in such plans, the White House said in a statement.
That didn't stop the House last Tuesday from approving the legislation
355-59, well above the margin needed to override a veto. Every Democrat
supported it, and Republicans, bucking their president, voted 129-59 for
it.
In the Senate, however, most Republicans are not facing re-election this
fall. They were more united in opposition Thursday in a 58-40 vote, two
short of the 60 needed, that would have led to passing the bill.
Actually, 59 senators present supported the bill — Senate Majority
Leader Harry Reid, D-Nev., changed his vote to "no" in a procedural move
allowing him to bring up the issue again.
Reid said Friday he will hold another vote after lawmakers return next
week to give Republicans "another opportunity to reconsider their
unfortunate decision to hurt patients and doctors."
Nine Republicans joined Democrats in supporting the legislation. The
only nonvoting senators were the ailing Edward Kennedy, D-Mass., and GOP
presidential hopeful John McCain, R-Ariz.
After the vote, there was hyperbole on both sides. An angry Reid said
Senate Republicans "have done what they thought is appropriate, and that
is to wipe out Medicare as we know it today." He chided Republicans for
sticking with a lame-duck president with a 29 percent approval rating:
"How in the world could anybody be afraid of him vetoing a bill?"
Republican leader Mitch McConnell of Kentucky shot back that Democrats
were acting irresponsibly by not granting his request for a 30-day
extension of current physician payment rates in order to give the two
sides time to work out a compromise. How that would have occurred was
unclear; the House already had adjourned until July 8 and couldn't vote
on it.
The doctors' cut will take place "because of this recalcitrant view,
this excessively partisan approach that refuses to accept any input from
this side of the aisle," McConnell said.
Sen. Arlen Specter, a moderate Republican from Pennsylvania, said he
objected to the take-it-or-leave-it approach of the Democrats and gave
assurances that Congress would take steps in early July to eliminate the
doctor cuts and take care of hospitals and providers.
Sen. Jim DeMint, a conservative Republican from South Carolina, said he
backed alternative legislation to protect physician fees but couldn't
support what he said was "a deliberate attempt to move Americans away
from private insurers and into socialized medicine."
Health and Human Services Department Secretary Mike Leavitt said his
agency "will take all steps available to the department under the law to
minimize the impact on providers and beneficiaries." If and when the
higher fee schedules are restored, his department will "move promptly to
reprocess claims and take other steps necessary," he said.
|
