New York Times: The Senate Stalls on Medicare


Before leaving town for the Fourth of July recess, Senate Republicans thwarted a vote on a sensible Medicare bill that would benefit doctors and patients at the expense of overpaid private health plans.

The House approved the legislation with a vote of 355 to 59. The bill is supported by most doctors, hospitals and pharmacists. But it is vehemently opposed by the insurance industry and its Republican coddlers.

The bill would protect doctors from a 10 percent cut in their reimbursement rates, and it would give them a tiny increase next year. It would also spend more money to enhance preventive services, improve low-income assistance programs and make other modest but worthwhile changes. The bill would largely and sensibly offset the additional costs by reducing payments to the private plans that participate in Medicare.

That has inflamed opposition from the White House and Senate Republicans who seem determined to protect inefficient private plans from the rigors of competing fairly against traditional Medicare coverage. Medicare pays these private plans, known as Medicare Advantage, an average of 13 percent more to provide the same services as the traditional Medicare program.

The new bill would start reducing the payment disparity through some modest adjustments. It would also require the fastest-growing category of private plans — private fee-for-service plans — to organize networks of doctors and hospitals and report measures of quality, just as other private plans do, so that beneficiaries would have guaranteed access to capable medical providers.

The likely result would be slower growth for the private fee-for-service plans, which are the most heavily subsidized and least efficient Medicare plans. That is an outcome to be welcomed, not deplored.

We would prefer eliminating a provision that would postpone a promising new competitive bidding program for durable medical equipment. But even with that weakness, this bill needs to pass so that Congress can start the politically difficult task of wringing unjustified subsidies from the most inefficient private Medicare plans.

In the Senate, every Democrat (except the ailing Edward Kennedy, who was not there) voted to take a final vote on the bill. Nine Republicans went along, leaving the bill only one vote short of forcing a vote and up to eight votes short of a veto-proof majority.

Every American represented by one of the recalcitrant Republican senators should press them to change their votes. Medicare is in deep financial trouble. Voters should demand that their leaders help control spending by reducing clearly unjustified subsidies to private Medicare plans. Let them compete on a level playing field with the government-run Medicare program.

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