Medicare Bill Passed and We Smell a Rat

As our readers already doubtless know, last week President Bush vetoed the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331), a veto which was promptly overturned.

President Bush’s move certainly did not make him popular with the AMA and AOA, which had been whipping their constituents into a frenzy to get the act passed. Of course, both organizations responded to the veto with an even greater vigor, calling for another volley of communication to representatives. As stated by ACOFP President Ronnie Martin in the July 15 newsletter, “The danger lies in not letting our voices be heard loudly and often as we face this final hurdle in our attempt to reform Medicare and the SGR.”

The AMA and AOA had their way and physicians have avoided their scheduled Medicare pay cuts again this year. They’ve done their annual civic duty. But what else did they do in getting HR 6331 passed?

The money to cover not cutting physician fees from the Medicare budget had to come from somewhere. The source of that funding probably passed unnoticed in the radar of many AMA and AOA constituents. That funding came from the Medicare Advantage program, which will now lose $14 billion in funding over the next five years.

Medicare Advantage, or Medicare C, is the branch of Medicare that allows its enrollees to use Medicare funding to select a private insurance plan instead of using Medicare A and B. The plan is sort of stepping stone towards privatizing Medicare, allowing enrollees to let insurance companies compete for their business, potentially driving down prices and improving quality.

Analysis of the aftermath of the bill by insurance rating and analyst company A.M. Best shows that less insurance companies may now participate in Medicare Advantage plans and that many enrollees may switch over to Medicare A and B. It stands to reason that with less funding available to purchase private plans, the quality of plans available decreases and that more seniors will be back on government-prescribed health care.

Free Market Physician won’t go so far as to call foul play on the act. The physician cuts for Medicare patients are ridiculous and needed to be dealt with. However, the means of fixing it in HR 6331 were only a temporary fix and played perfectly into the hands of those who advocate increased government control in the health field. For example, the AOA received a special letter of congratulations and thanks for their leadership and work in securing passage of the legislation by Senate Majority Leader Harry Reid of Nevada.

Free Market Physician won’t go so far as to out rightly condemn the AMA or AOA for using the Medicare pay cuts to motivate their constituents to fall in with a political agenda at this time, either. However, this act is just one of many examples of how the professional organizations have contributed to higher prices for health care, physician shortages, and increased government meddling in the industry.

Nancy Nielson, MD, President of the AMA thanked the physicians who had fallen in line for preventing a “Medicare meltdown.”

“I am so grateful to all of you, the patients and physicians of America. Without your effort this victory would not have been won,” she wrote on the AMA website.

She also stated that only the health insurance industry, for purely selfish motives, opposed the bill. She can put Free Market Physician on the list of those who are at least a little cynical about it. FMP will certainly have a more skeptical eye out in 18 months when Congress proposes its next “solution” to Medicare pay cuts.

Rusty Scalpel