Medicare fiasco marks yet another low point

In the end, it was too big of an issue for anyone but the lame ducks to let party politics get in the way – especially in an election year.

Last month, a high-wire drama played out in Congress over Medicare payments to physicians, as President Bush and the American medical community – along with AARP – squared off over a 10.6 percent cut in reimbursements to doctors.

At the heart of the debate was political posturing over how best to fund the financially strapped and ever-more-complex Medicare program. In essence, the battle boiled down to a choice between providing funding to avoid the cut or reducing payments to insurance companies offering Medicare Advantage plans.

Bush, along with many Senate Republicans including Colorado’s Wayne Allard, sided with the insurance industry, while Senate Democrats mostly aligned themselves with the doctors who provide care to the vast majority of the nation’s 44 million Medicare recipients.

The 10.6 percent cut would likely have resulted in a huge number of family care physicians refusing to take on new Medicare patients and possibly dropping some of their existing patients, according to Thomas Allen, M.D., a family care physician practicing in Fort Collins.

“It was a big deal,´ said Allen, who noted that, factoring in overhead related to treating Medicare patients, the cut would have had more than double the impact on his practice. “Basically, it would have made it harder for docs to participate and harder for patients to find someone to serve them.”

That’s already a trend, as falling Medicare reimbursement schedules and increasing paperwork have begun to turn doctors away from accepting new patients.

Just before the Congress’s Fourth of July recess, the House passed – on a bipartisan vote of 355-59 – HR6331, which would have prevented the 10.6 percent reimbursement cut. But in the Senate Republicans blocked efforts to take up the bill before the recess. The cut took effect on July 1, but the Bush administration delayed processing new claims to give Congress time to come up with a possible compromise.

On July 8, the Senate – electrified by the appearance of Massachusetts Democratic Sen. Ted Kennedy who had been absent undergoing treatment for a recently diagnosed brain tumor – voted 69-30 to pass HR6331. That set the stage for a promised veto by Bush, which the Congress promptly overrode by a vote of 384-41 on July 15.

All but two members of Colorado’s Congressional delegation ultimately voted to support HR6331. Rep. Tom Tancredo, R-Littleton, and Sen. Wayne Allard, R-Fort Collins – both lame-duck legislators – voted against it.

Steve Wymer, communications director for Allard, said the senator continued to oppose the bill throughout the voting process because he felt a better bill could have been passed that did not harm the nation’s 10 million seniors with Medicare Advantage plans.

“Sen. Allard was committed to a better bill, particularly in rural areas,” Wymer said, adding that it was “shameful” how the medical community characterized Allard as being anti-Medicare. “I would say it’s incredibly short-sighted to judge someone’s political record on one vote.”

Medicare Advantage plans were first introduced in 1997 as Medicare Part C. The plans offer coverage not provided by Medicare and lower co-payments but plan enrollees may have less choice in the doctors they see or the hospitals they go to.

While the medical community was revved up to promote the passage of HR6331, a gigantic effort was mounted by the senior organization AARP to enlist Congressional support.

“This was huge,´ said Kelli Fritts, advocacy representative for AARP Colorado. “This was our No. 1 issue this year.”

Fritts said the 39-million-strong AARP sent more than 750,000 e-mails to Congress, made more than 117,000 telephone calls and gathered almost 226,000 signatures for an online petition to impress Congress with its support for HR6331.

Fritts said she believed the issue was more complicated than simply choosing to cut Medicare or choosing to cut the Medicare Advantage plans. In the end it was about access to doctors, she said.

“If you don’t have a doctor willing to see you, what good is (a Medicare Advantage) plan?” she said. “We already have a problem in Colorado with finding doctors willing to take people on Medicare and we certainly didn’t want to add to that.”

Fritts said AARP is trying to find better ways to provide access to senior health-care through its “Divided We Fail” campaign that emphasizes non-partisan solutions to the nation’s problems.

And she notes that, even though this year saw a victory in maintaining reimbursement rates to providers, next year – one that’s not an election year – will bring another battle unless something changes.

“That’s why we’re seeking an overall solution to this problem,” she said. “What we hope to see next year is not to have to do this again, because it’s always a hard, ugly fight.”

Steve Porter covers health care for the Northern Colorado Business Report. He can be reached at 970-221-5400, ext. 225, or at sporter@ncbr.com.

on Facebook on LinkedIn