Turning His Back On Elderly, Their Doctors

With 5½ months to go in his administration, President Bush attempted to pull the rug out from under the nation’s elderly and their doctors.

On Tuesday, Bush vetoed a bill intended to prevent significant Medicare reimbursement cuts. In doing so, he broke with moderates, and even some conservatives, in his own party who had backed the measure.

Seniors can be glad they have the Congress on their side. The House voted to override the veto Tuesday afternoon and the Senate was expected to quickly follow suit.

We applaud this action to shore up the flagging Medicare system. Although this is a temporary fix, it is an essential one.

If the 10.6 percent cuts were allowed to stand, many doctors would quit accepting new Medicare patients. The move would be one of economic necessity.

Worse, some doctors would quit treating Medicare patients at all. This lack of access to doctors would be most acute for the rural elderly, like our neighbors in Southwest Virginia – much of which is classified as a medically underserved region by the federal government.

Nor would the negative effects likely be confined to Medicare alone. Private insurers often base their reimbursements on the Medicare fee structure. This could quickly become a race to the bottom that limits access to doctors but does little to stem the overall rate of health care spending.

Doctors and patients have become unwitting pawns in a philosophical struggle over health care. On one side, the president and his supporters would like to privatize Medicare. On the other side are those who respect the promises made to the nation’s seniors.

Make no mistake, the president vetoed this bill to protect insurance industry fat cats, who objected to new limits on government subsidies to the private Medicare Advantage program.

About one in five of Medicare’s 44 million enrollees is part of a Medicare Advantage plan. Bush praises the plans as offering “choice” to seniors, but experts have yet to uncover any evidence that the plans do a better job at keeping their participants healthy and out of the hospital. The federal government pays 17 percent more in administrative costs to the private plans.

This tiff over federal largesse for private insurance companies must not jeopardize the system that provides health care for most of the nation’s elderly residents. Until there is credible evidence that the plans improve the health of their participants, they should be approached with caution.

A word of praise is due to the region’s congressional delegation for its support of Medicare. Both Reps. Rick Boucher, D-Va., and David Davis, R-Tenn., voted in favor of the bill. Sens. Lamar Alexander and Bob Corker, both R-Tenn., initially opposed the measure but changed their tune in exchange for a promise to shore up Medicaid payments to some Tennessee hospitals. Sen. John Warner, R-Va., also initially opposed the bill, but later voted for it. Sen. Jim Webb, D-Va., also supported the bill.

We hope they remain committed to Medicare. The needs of their frail, elderly constituents and the doctors who serve them should come before duty to party or ideology.

This isn’t a permanent solution. Doctors will face even larger reimbursement cuts – around 20 percent – in the not-so-distant future if nothing else done. The problem will be waiting for the next president and Congress.

Meanwhile, Medicare quit processing payments to doctors on July 1 to avoid the reimbursement cut. Congress must set the system, upon which so many Americans rely, back in motion.